Debbie Martin

Does moving from a high-poverty to lower-poverty neighborhood improve mental health? A realist review of 'Moving to Opportunity'

Ray Pawsons realist review method was used to analyse 22 evaluations/reviews of the Moving to Opportunity (MTO) housing intervention. MTO was a randomized controlled trial that moved families from high-poverty to low-poverty neighborhoods in five US cities between 1994 and 2006. This realist review focussed on mental health outcomes of families who moved, as well as the mechanisms through which moving influenced mental health. It identified and assessed the effectiveness of the underlying theory driving MTO, and suggests revising the existing theory. This realist review suggests that, even when moves are voluntary, there are potentially negative mental health outcomes from these types of social interventions. Directing resources towards the improvement of existing communities is one way of improving health outcomes for all community residents.

“Now we got lots to eat and they’re telling us not to eat it”: understanding changes to south-east Labrador Inuit relationships to food

Objectives. Culture, history and social circumstances shape how people understand their relationships to food, what foods are eaten, when, how much and how often. This ultimately shapes overall health. This study aims to connect research about food, culture and health by positioning south-eastern Labrador Inuit understandings of food at the forefront of how we begin to address chronic disease within southeastern Labrador Inuit communities. Study design. This study collected stories about food from 3 generations of men and women who live in the south-east Labrador Inuit community of St. Lewis, Newfoundland and Labrador. Methods. Qualitative interviews (n=24) and 1 focus group (n=8) were conducted with 3 generations of men and women who were asked to share stories about how they experience and understand their relationships to food. Results. Local plants and animals have historically been used for shelter, clothing and medicines, and their procurement provided opportunities for physical activity, sharing with others and passing along generational knowledge. The historical absence of government services has meant that stable food supplies were unavailable; local sources of food have, until the recent past, been essential for survival. The significant change over a short period, from having to ensure that one has enough to eat and avoiding nutritional deficiencies, to having both healthy and unhealthy food choices constantly available, has required a different “way” of understanding food. Conclusions. It is imperative that nutrition programs and resources directed towards improving the health of south-east Labrador Inuit take into account how cultural, historical and social circumstances have shaped south-east Labrador Inuit understandings of food.

Enhancing Indigenous Health Promotion Research Through Two-Eyed Seeing: A Hermeneutic Relational Process:

The intention of this article is to demonstrate how Indigenous and allied health promotion researchers learned to work together through a process of Two-Eyed Seeing. This process was first introduced as a philosophical hermeneutic research project on diabetes prevention within an Indigenous community in Quebec Canada. We, as a research team, became aware that hermeneutics and the principles of Haudenosaunee decision making were characteristic of Two-Eyed Seeing. This article describes our experiences while working with each other. Our learning from these interactions emphasized the relational aspects needed to ensure that we became a highly functional research team while working together and becoming Two-Eyed Seeing partners.

Reconciliation and Relationality in Water Research and Management in Canada: Implementing Indigenous Ontologies, Epistemologies, and Methodologies

Water-related issues disproportionately affect Indigenous communities in Canada. Despite millions in investment, Western-trained scientists, engineers, and other researchers as well as the government agencies that have constitutionally-mandated fiduciary responsibilities to address such issues have been rather unsuccessful in solving them. This has been due, in large part, to an overreliance on methods of Western science and management, ignoring the vast place-based wisdom of Indigenous knowledge systems and relational practices regarding water found across the country. The underlying reasons for this partiality are not innocuous; entrenched colonial and racist policies, programs, and practices have persisted across time and space. In recent years, there is increasing recognition of the importance of applying Indigenous approaches to water challenges in Canada. But strategies for successful implementation are only beginning to emerge. In an attempt to respond to this knowledge gap, our research has sought to systematically identify and assess how both Indigenous and Western ontologies, epistemologies, and methodologies have been implemented in water research and management. In doing so, this chapter identifies some of the most promising practices in Canada. We share these with the goal of contributing to processes of reconciliation and responsibility towards each other as well as our roles as water stewards across the country.

Youth Views on Environmental Changes, the Future of the Environment, and Stewardship: The Case of a Canadian Coastal Community

This article discusses and provides insights concerning rural youths perceptions of their natural environment and the future role of rural youths in environmental stewardship. Insights are based on two focus groups with youths 17–24 years of age living in an isolated coastal Canadian community. The youths expressed a strong attachment to place, as well as a concern for local, natural resources. However, because of the economic instability of their local community, many youths are planning a future in places far away with more lucrative employment and education opportunities. We suggest that strategies need to be developed that allow youths to engage in environmental stewardship activities “from away.” Some suggestions for “virtual stewardship” are discussed.

Challenges in assessing food environments in northern and remote communities in Canada

Effective tools for retail food environments in northern and remote communities are lacking. This paper examines the challenges of conducting food environment assessments in northern and remote communities in Canada encountered during our experience with a food costing project. One of the goals of the Paying for Nutrition in the North project is to develop guidelines to improve current food costing tools for northern Canada. Paying for Nutrition illustrates the complex context of measuring food environments in northern and remote communities. Through the development of a food costing methodology guide to assess northern food environments, several contextual issues emerged, including retail store oligopolies in communities; the importance of assessing food quality; informal social food economies; and the challenge of costing the acquisition and consumption of land- and water-based foods. Food environment measures designed for northern and remote communities need to reflect the geographic context in which they are being employed and must include input from local residents.

First Nations, Inuit and Métis health: Considerations for Canadian health leaders in the wake of the Truth and Reconciliation Commission of Canada report

First Nations, Inuit and Métis peoples living in Canada face profound health disparities relative to non-Indigenous Canadians on almost every measure of health and well-being. Advancing health opportunities for Indigenous peoples require responses at all levels of healthcare delivery and policy. Therefore, it is critical for health leaders and providers within Canada’s healthcare institutions, systems, and settings to understand and address the determinants of health unique to Indigenous peoples, including the legacy of colonialism and both long-standing and present-day racism. The Truth and Reconciliation Commission of Canada provides a starting point from which positive responses to injustices can be advanced.

Can we Build on Social Movement Theories to Develop and Improve Community-Based Participatory Research? A Framework Synthesis Review

Abstract A long‐standing challenge in community‐based participatory research (CBPR) has been to anchor practice and evaluation in a relevant and comprehensive theoretical framework of community change. This study describes the development of a multidimensional conceptual framework that builds on social movement theories to identify key components of CBPR processes. Framework synthesis was used as a general literature search and analysis strategy. An initial conceptual framework was developed from the theoretical literature on social movement. A literature search performed to identify illustrative CBPR projects yielded 635 potentially relevant documents, from which eight projects (corresponding to 58 publications) were retained after record and full‐text screening. Framework synthesis was used to code and organize data from these projects, ultimately providing a refined framework. The final conceptual framework maps key concepts of CBPR mobilization processes, such as the pivotal role of the partnership; resources and opportunities as necessary components feeding the partnerships development; the importance of framing processes; and a tight alignment between the cause (partnerships goal), the collective action strategy, and the system changes targeted. The revised framework provides a context‐specific model to generate a new, innovative understanding of CBPR mobilization processes, drawing on existing theoretical foundations.

Understanding community-based participatory research through a social movement framework: a case study of the Kahnawake Schools Diabetes Prevention Project

BackgroundA longstanding challenge of community-based participatory research (CBPR) has been to anchor evaluation and practice in a relevant theoretical framework of community change, which articulates specific and concrete evaluative benchmarks. Social movement theories provide a broad range of theoretical tools to understand and facilitate social change processes, such as those involved in CBPR. Social movement theories have the potential to provide a coherent representation of how mobilization and collective action is gradually developed and leads to systemic change in the context of CBPR. The current study builds on a social movement perspective to assess the processes and intermediate outcomes of a longstanding health promotion CBPR project with an Indigenous community, the Kahnawake Schools Diabetes Prevention Project (KDSPP).MethodsThis research uses a case study design layered on a movement-building evaluation framework, which allows progress to be tracked over time. Data collection strategies included document (scientific and organizational) review (n = 51) and talking circles with four important community stakeholder groups (n = 24).ResultsFindings provide an innovative and chronological perspective of the evolution of KSDPP as seen through a social movement lens, and identify intermediate outcomes associated with different dimensions of movement building achieved by the project over time (mobilization, leadership, vision and frames, alliance and partnerships, as well as advocacy and action strategies). It also points to areas of improvement for KSDPP in building its potential for action.ConclusionWhile this study’s results are directly relevant and applicable to the local context of KSDPP, they also highlight useful lessons and conclusions for the planning and evaluation of other long-standing and sustainable CBPR initiatives. The conceptual framework provides meaningful benchmarks to track evidence of progress in the context of CBPR. Findings from the study offer new ways of thinking about the evaluation of CBPR projects and their progress by drawing on frameworks that guide other forms of collective action.

La santé des Premières nations, des Inuits et des Métis: les facteurs que doivent envisager les leaders en santé canadiens dans la foulée du rapport de la Commission de vérité et réconciliation du Canada

Les peuples des Premières nations, inuits et métis qui habitent au Canada sont aux prises avec de profondes disparités en matière de santé par rapport aux Canadiens non autochtones, et ce, dans presque toutes les mesures liées à la santé et au bien-être. Pour faire progresser les services de santé auprès des peuples autochtones, il faut passer à l’action dans tous les ordres de prestation des soins et des politiques en santé. Il est donc essentiel que les leaders et les prestataires des établissements, des systèmes et des installations de santé du Canada comprennent et prennent en main les déterminants de la santé propres aux peuples autochtones, y compris l’héritage du colonialisme et le racisme ancien et actuel. La Commission de vérité et réconciliation du Canada est le point de départ pour réagir de manière positive aux injustices.