Raewyn Bassett

Grocery lists: Connecting family household and grocery store

Purpose – This paper aims to investigate grocery list use in the lives of participant families in a study on decision making about food choices and eating practices.Design/methodology/approach – A total of 46 families from three ethno‐cultural groups living in two regions in Canada participated in the study: in British Columbia, 12 Punjabi Canadian and 11 European Canadian families; in Nova Scotia, 13 African Canadian and ten European Canadian families. In each family, at least three individuals over the age of 13 years, one of whom was a woman between the ages of 25 and 55 years, were interviewed. Researchers participated in a meal and accompanied each family on a grocery trip.Findings – Most family members contributed to a grocery list. The shopper(s) in the family may take the written list with them, have the list in memory, use a combination of both memory and written list, or shop without a list. Finds the articulation of taken‐for‐granted, intersecting knowledge about family, household and grocery s...

Evidence on how to practice intersectoral collaboration for health equity: a scoping review

The persistence of health inequities is reflected in repeated calls for intersectoral collaboration on the social determinants of health, specifically through public policy action. Yet, how to do intersectoral collaboration specifically for policy action toward health equity is articulated rather scarcely in the scientific literature. With this scoping review, we intended to generate insight into current peer-reviewed literature to identify gaps about evidence-based approaches to practices of intersectoral collaboration for health equity-oriented policy action. Seven search engines were used: Proquest, Web of Science, CINAHL, Pubmed, Sociological Abstracts, Project Muse and ERIC. Social determinants of health, including public policy and intersectoral collaboration, are related concepts for the health equity agenda and were used as a conceptual framework to map selected literature. Out of 227 articles, our review identified 64 articles describing intersectoral collaboration specifically in relation to public policy. Of those articles with a policy topic, 10 had a focus on broad public policy areas, while 51 publications articulated specific policies relevant to the determinants of health and only three articles examined effective practices of intersectoral collaboration in public policy through phenomenology, literature review and case study research. The majority of policy-focused publications described that collaboration was used as a strategy to address intersectoral public policy issues, but failed to report how the process of collaboration unfolded. Perhaps it is time to re-direct the gaze onto collaborative teams to generate evidence of effective intersectoral collaboration practices in public policy.

A Conceptual Framework of Organizational Capacity for Public Health Equity Action (OC-PHEA).

The Canadian public health sector’s foundational values of social justice and equity, and its mandate to promote population health, make it ideally situated to take a strong lead in addressing persistent and unacceptable inequities in health between socially disadvantaged, marginalized or excluded groups and the general population. There is currently much attention paid to improving understanding of pathways to health equity and development of effective population health interventions to reduce health inequities. Strengthening the capacity of the public health sector to develop, implement and sustain equity-focused population health initiatives - including readiness to engage in a social justice-based equity framework for public health - is an equally essential area that has received less attention. Unfortunately, there is evidence that current capacity of the Canadian public health sector to address inequities is highly variable. The first step in developing a sustained approach to improving capacity for health equity action is the identification of what this type of capacity entails. This paper outlines a Conceptual Framework of Organizational Capacity for Public Health Equity Action (OC-PHEA), grounded in the experience of Canadian public health equity champions, that can guide research, dialogue, reflection and action on public health capacity development to achieve health equity goals.RésuméLe secteur canadien de la santé publique, avec ses valeurs fondamentales de justice sociale et d’équité et son mandat de promotion de la santé des populations, est idéalement situé pour jouer un rôle de premier plan face aux iniquités en santé persistantes et inacceptables entre les groupes socialement défavorisés, marginalisés ou exclus et la population générale. On essaie beaucoup, en ce moment, de mieux comprendre les voies de l’équité en santé et d’élaborer des interventions efficaces en santé des populations pour réduire les iniquités en santé. Une mesure tout aussi essentielle et pourtant moins reconnue est de renforcer les capacités du secteur de la santé publique à élaborer, à mettre en oeuvre et à soutenir des initiatives de santé des populations axées sur l’équité - y compris la volonté d’employer en santé publique une grille d’équité basée sur la justice sociale. Malheureusement, il semble que la capacité actuelle du secteur canadien de la santé publique d’aborder les iniquités varie considérablement. La première étape, si l’on veut mettre au point une approche soutenue en vue d’améliorer les capacités d’agir sur l’équité en santé, est de déterminer ce qu’une telle capacité implique. Notre article définit un « cadre conceptuel de la capacité organisationnelle pour une action de la santé publique en matière d’équité », ancré dans l’expérience des champions de la santé publique canadienne sur la question de l’équité, pour orienter la recherche, le dialogue, la réflexion et l’action sur le renforcement des capacités en santé publique et atteindre les objectifs d’équité en santé.

I think it, but don't often write it: the barriers to charting in private practice

PURPOSE To describe barriers to charting identified by physiotherapists working in private practice in New Brunswick. METHOD Physiotherapists were invited to focus-group interviews to discuss the results of a comprehensive chart audit. Sixty-nine physiotherapists who responded were assigned to nine focus groups. Seven of nine audiotaped interviews (49 participants) were of sufficient quality to be transcribed and imported into qualitative data analysis software for thematic analysis. RESULTS Participants described the challenges of including charting in their routine client care. Barriers included the disjuncture between charting and thinking, the translation of impairment goals to functional goals, the time it takes to chart, fear of failure, and the difficulty of predicting length of treatment. Strategies to facilitate charting were suggested by participants. CONCLUSION Understanding barriers to charting in private practice is necessary to improve the quality of documentation. Barriers described are related to the fast-moving nonverbal, kinaesthetic, and cognitive process that is clinical reasoning in physiotherapy. This tacit, implicit process is mismatched with the charting task, which requires that the implicit become explicit in written form. Strategies to facilitate charting noted by participants address some of these issues; however, a broader, profession-wide discussion is necessary.

Resilience and art in chronic pain

Background: Previous work has identified the importance of art in health and healing but little has been published on specific responses from artistic populations. Aims: The aim of this study was to explore the experience of a group of people living with chronic pain who were able to continue to create art in the face of pain. Our hypothesis was that each of these participants had made a positive adaptation to the experience of pain and that we could learn more about the process of coming to terms with pain from them. Methods: A qualitative approach using thematic analysis was undertaken using a self-report questionnaire containing 16 questions. The data were analyzed using a general inductive approach, dominant themes were summarized and interpretive analysis was done. Results: Key themes that emerged addressed the impact of pain (e.g. limitation, loss, social isolation, stigmatization) along with the process needed to come to terms with it (acceptance, adaptation) and the transformative aspects of creating art. Conclusions: This study confirms the depth of suffering associated with the experience of chronic pain and the incredible resilience required of the creative mind in overcoming serious adversity in a way that fosters growth and finds new meaning.

Client Education: Communicative Interaction between Physiotherapists and Clients with Subacute Low Back Pain in Private Practice

PURPOSE To explore, through focus-group interviews, client education provided by physiotherapists in private practice who treat injured workers with subacute low back pain (SA-LBP). METHODS Six focus-group interviews were held in the fall of 2006 to explore treatment practices of physiotherapists for this population. Each of the 44 physiotherapists who volunteered attended one of six regional sessions. RESULTS Three overarching themes emerged: the critical importance of education; education: a multidimensional concept; and the physiotherapist-client relationship. In this study, we found that education provides continuity by tying together the separate tasks occurring during one treatment session. Our participants said that time is of the essence in private practice and described how they provide education seamlessly, making this type of delivery efficient. CONCLUSIONS Education is a highly valued aspect of practice for physiotherapists. Verbal, tactile, and visual information obtained from the client as assessment and treatment progress is explored, expanded, and contextualized in conversation with the client. In a communicative, interactive process, client fears, other contextual information, and physiotherapist information about procedures and techniques, exercises, and anatomy are collaboratively interrelated.

Harried by Harding and Haraway: student–mentor collaboration in disability studies

Exploring the friendships of disabled youth in forthcoming doctoral research raised many unsettling questions. Members of academic and disability communities thoughtfully asked how the researcher could legitimately understand, interpret and represent the experiences of disabled youth. The initial impulse was to rely on nearly two decades of clinical practice with children and youth with disabilities; however, the futility of this strategy quickly surfaced. Uncertainty about how to proceed arose. A colleague and mentor suggested that a careful reading of Sandra Harding, Donna Haraway and Mats Alvesson and Kaj Sköldberg might provide the conceptual tools required to address these concerns. This paper presents a student’s stumbling, hesitant and sometimes ‘harried’ attempts to grapple with their unfamiliar arguments while simultaneously exploring tentative connections with disability studies. The evolutionary cycle of queries, responses and reflections from a series of e‐mails demonstrate a transition in thinking about research and representation.

Pensive Poetics Reflections on Interprofessional Team Collaboration

As a researcher the author began to reflect on her role on a team project as she and her colleagues developed a research design and Letter of Intent (LOI) for submission to a funding agency. The area of research interest was interprofessional collaboration. The author and her colleagues intended to observe a team of health professionals collaborating in health care decisions. The research team had not worked together previously, which provided an ideal forum for observing their own collaborative development. The team’s observations and reflections might prepare them for observing the collaborative practices of other teams. However, they found collaboration difficult to put into practice. The reflection presented here is author’s alone. As the author pondered her role in the team, she found the economy of words in poetry forced her to explicitly think about and face, emotionally, the part she played in the team’s stilted collaborative efforts. As a team, the author and her colleagues continue to work at collaboration.

Ways of knowing about healthy eating in three ethnocultural groups in Canada

Decisions about ‘healthy eating’ are the result of complex processes which involve diverse ways of drawing on, perceiving and understanding discourses about food, diet and health. Although we are increasingly aware of diverse views of the role of food in health and well being, there is paucity of knowledge about how people pull together discourses of healthy eating. How do people obtain and conceptualize various pieces of information about food and well-being? What influences the acceptance or rejection of a particular healthy eating discourse? We have begun to address these questions in research exploring peoples ‘ways of knowing’ about healthy eating. Participants discuss experiences, interpretations and reasoning used in learning and deciding what to believe and/or reject about healthy eating. Participants came from families of three different ethnocultural groups in Canada: African Nova Scotians, Punjabi British Columbians and European Canadians. Through in-depth, individual interviews with teenagers and adults from these groups, we were able to consider both between and within group differences in how people come to understand what healthy eating means to them. Understanding the various ways people conceptualize, trust or reject healthy eating discourses will provide direction for developing more relevant and sensitive responses regarding diet and health related decision-making of individuals and families.

Food-related health concerns of Punjabi British Columbians: postcolonial perspectives on nutrition and health education

Food consumption and food-related practices serve many purposes in human life. From a cultural perspective, food practices are involved in creating a sense of community, belonging, and common experiences and needs. Food practices, in terms of cooking and eating, are an aspect of culture that can be carried over during migration from the country of origin to the host country. This is, however, usually countered with some degree of acculturation. A current public health concern in North America is that immigrants’ dietary acculturation may lead to a decrease in the healthfulness of their food choices and therefore increase their risk for certain diet-related diseases. The decreased healthfulness is suggested to be a result of adopting unhealthy North American food patterns, and/or preserving or amplifying unhealthy aspects of traditional food patterns. One group experiencing this phenomenon is the South Asian immigrant population, which is believed to have a higher risk for developing cardiovascular disease and type 2 diabetes than does the general population in North American or the general population in India. In this study, we explored the food-related health concerns of Punjabi British Columbians, a sizeable population living in British Columbia, Canada. Through semi-structured interviews with teenagers and adults, we examined the multiple discourses evident in their comments about food and health concerns, finding complex intermingling of traditional South Asian and contemporary medicalized North American discourses. These findings are interpreted through a postcolonial theoretical lens to raise questions regarding health promotion and nutrition education practices.