S. Michelle Driedger

Finding Common Ground in Team-Based Qualitative Research Using the Convergent Interviewing Method

Research councils, agencies, and researchers recognize the benefits of team-based health research. However, researchers involved in large-scale team-based research projects face multiple challenges as they seek to identify epistemological and ontological common ground. Typically, these challenges occur between quantitative and qualitative researchers but can occur between qualitative researchers, particularly when the project involves multiple disciplinary perspectives. The authors use the convergent interviewing technique in their multidisciplinary research project to overcome these challenges. This technique assists them in developing common epistemological and ontological ground while enabling swift and detailed data collection and analysis. Although convergent interviewing is a relatively new method described primarily in marketing research, it compares and contrasts well with grounded theory and other techniques. The authors argue that this process provides a rigorous method to structure and refine research projects and requires researchers to identify and be accountable for developing a common epistemological and ontological position.

Communication Accommodation and Managing Musculoskeletal Disorders: Doctors' and Patients' Perspectives

This study examined the ways in which health care providers (general practitioners and specialists) and patients communicate with each other about managing musculoskeletal (MSK) disorders, a major cause of long-term pain and physical disability. In managing their illness, patients must interact closely with health care providers, who play a large role in transferring knowledge to them. In-depth interviews with patients, general practitioners, and specialist rheumatologists in Australia and Canada were analyzed using Leximancer (a text-mining tool). Results indicated that, in their communication, doctors subtly emphasized accepting and adjusting to the illness (“new normal”), whereas patients emphasized pain relief and getting “back to normal.” These results suggest that doctors and patients should accommodate in their communication across subtle and often unexpressed differences in the priorities of provider and patient, or they are likely to be at cross purposes and thus less effective.

Creating shared realities through communication: exploring the agenda‐building role of the media and its sources in the E. coli contamination of a Canadian public drinking water supply

The medias role as an agenda‐setter has been documented in the literature, however less attention has been given to the role of the media as an agenda‐builder. The role of news agencies in constructing and shaping news stories serve to mediate risk messages to the public by virtue of what elements of a story they report, the types of sources they use in reporting the different ‘sides’, and how they package a story. The media are not the only ones who seek to set and build agendas. The sources, upon which the news media rely, can and do similarly engage in agenda‐building activities. They do so by appropriating the very ‘media‐ted’ process to use the mass media as a delivery vehicle for their own communication claims through their own packaged ‘take’ on the story. Drawing on a national print and televised media analysis of the Walkerton, Ontario, Canada drinking water contamination event, this study explores the agenda‐building role of the media and of Walkerton residents and citizen group members (Concerned Walkerton Citizens) quoted in media stories. The implications of this for risk communication will be discussed.

Do the first 10 days equal a year? Comparing two Canadian public health risk events using the national media

It has been suggested that the way in which a risk event is presented within the first 10 days of media coverage provides the major frames that will dominate news media presentations of any new information about the event over time. A media content analysis for two prominent Canadian health risk events (the E. coli water contamination event in Walkerton, Ontario, in 2000 and the discovery of Bovine Spongiform Encephalopathy or Mad Cow Disease in a cow in Alberta in 2003) in a major national newspaper was used to examine this hypothesis. For both case studies, the story frames in the first 10 days of coverage were not significantly different than during a full 1-year period following the event, indicating that a 10 day analysis should be sufficient to determine media presentations of the risk events. The increased accessibility of information during this period (as indicated by the greater number of articles on the front page of the newspaper) reinforces the usefulness of looking at the first 10 days to establish dominant frames. However, the 10 day analysis is only reliable for a risk event that remains relatively constant over time provided that media coverage remains high for an extended period and that no new salient issues emerge.

Public versus expert knowledge and perception of climate change-induced heat wave risk: a modified mental model approach

Effects of climate change and its induced extreme environmental events have been the object of intense public debate in recent years. Extreme environmental events, such as heat waves, and their impact upon the elderly and the poor are of special concern to policy- and decision-makers. However, how the public views these issues is critical for dealing with the associated risks. Recognizing the importance of risk assessments and implementation of mitigation measures, we adopted a comparative approach to assess and extend a generic methodology to examine diverse sets of beliefs about climate change-induced heat wave hazards. Using a modified mental model approach, this study mapped existing knowledge structures about the risk associated with climate change-induced heat waves in an urban setting of Canada (Winnipeg, Manitoba). ‘Public models’ were developed from open-ended interviews with diverse community groups; ‘influence diagrams’ were formulated based on open-ended discussions with experts in the pertinent fields. An assessment of the juxtaposition of the public and experts’ knowledge and perception of heat wave risk has revealed significant gaps in the perception of: (a) the effects of climate change-induced heat wave and (b) of responsible authority for policy intervention to affect the cause or impacts. It further identifies misconceptions in public perception regarding: (a) thinning of ozone layer to cause a rise in earth’s temperature; and (b) whether precautionary measures can be taken to reduce heat wave mortality; (c) of future heat wave ‘risk estimation’ in the city of Winnipeg. Based on our results, we argue that by developing interactive risk communication tools and practicing public engagement in knowledge enhancement, heat wave risk assessment and mitigation capacity of both public and experts can be improved.

Canadian Media Representations of Mad Cow Disease

A Canadian case of bovine spongiform encephalopathy (BSE) or “mad cow disease” was confirmed in May, 2003. An in-depth content analysis of newspaper articles was conducted to understand the portrayal of BSE and variant Creutzfeldt–Jakob disease (vCJD) in the Canadian media. Articles in the “first 10 days” following the initial discovery of a cow with BSE in Canada on May 20, 2003, were examined based on the premise that these initial stories provide the major frames that dominate news media reporting of the same issue over time and multiple occurrences. Subsequent confirmed Canadian cases were similarly analyzed to determine if coverage changed in these later media articles. The results include a prominence of economic articles, de-emphasis of health aspects, and anchoring the Canadian outbreak to that of Britains crisis. The variation in media representations between those in Canada and those documented in Britain are explored in this study.

Understanding Vaccine Hesitancy in Canada: Results of a Consultation Study by the Canadian Immunization Research Network

“Vaccine hesitancy” is a concept now frequently used in vaccination discourse. The increased popularity of this concept in both academic and public health circles is challenging previously held perspectives that individual vaccination attitudes and behaviours are a simple dichotomy of accept or reject. A consultation study was designed to assess the opinions of experts and health professionals concerning the definition, scope, and causes of vaccine hesitancy in Canada. We sent online surveys to two panels (1- vaccination experts and 2- front-line vaccine providers). Two questionnaires were completed by each panel, with data from the first questionnaire informing the development of questions for the second. Our participants defined vaccine hesitancy as an attitude (doubts, concerns) as well as a behaviour (refusing some / many vaccines, delaying vaccination). Our findings also indicate that both vaccine experts and front-line vaccine providers have the perception that vaccine rates have been declining and consider vaccine hesitancy an important issue to address in Canada. Diffusion of negative information online and lack of knowledge about vaccines were identified as the key causes of vaccine hesitancy by the participants. A common understanding of vaccine hesitancy among researchers, public health experts, policymakers and health care providers will better guide interventions that can more effectively address vaccine hesitancy within Canada.

Mapping as a knowledge translation tool for Ontario Early Years Centres: views from data analysts and managers

BackgroundLocal Ontario Early Years Centres (OEYCs) collect timely and relevant local data, but knowledge translation is needed for the data to be useful. Maps represent an ideal tool to interpret local data. While geographic information system (GIS) technology is available, it is less clear what users require from this technology for evidence-informed program planning. We highlight initial challenges and opportunities encountered in implementing a mapping innovation (software and managerial decision-support) as a knowledge translation strategy.MethodsUsing focus groups, individual interviews and interactive software development events, we taped and transcribed verbatim our interactions with nine OEYCs in Ontario, Canada. Research participants were composed of data analysts and their managers. Deductive analysis of the data was based on the Ottawa Model of Research Use, focusing on the innovation (the mapping tool and maps), the potential adopters, and the environment.ResultsChallenges associated with the innovation included preconceived perceptions of a steep learning curve with GIS software. Challenges related to the potential adopters included conflicting ideas about tool integration into the organization and difficulty with map interpretation. Lack of funds, lack of availability of accurate data, and unrealistic reporting requirements represent environmental challenges.ConclusionDespite the clear need for mapping software and maps, there remain several challenges to their effective implementation. Some can be modified, while other challenges might require attention at the systemic level. Future research is needed to identify barriers and facilitators related to using mapping software and maps for decision-making by other users, and to subsequently develop mapping best practices guidelines to assist community-based agencies in circumventing some challenges, and support information equity across a region.

If you build it, they still may not come: outcomes and process of implementing a community-based integrated knowledge translation mapping innovation

BackgroundMaps and mapping tools through geographic information systems (GIS) are highly valuable for turning data into useful information that can help inform decision-making and knowledge translation (KT) activities. However, there are several challenges involved in incorporating GIS applications into the decision-making process. We highlight the challenges and opportunities encountered in implementing a mapping innovation as a KT strategy within the non-profit (public) health sector, reflecting on the processes and outcomes related to our KT innovations.MethodsA case study design, whereby the case is defined as the data analyst and manager dyad (a two-person team) in selected Ontario Early Year Centres (OEYCs), was used. Working with these paired individuals, we provided a series of interventions followed by one-on-one visits to ensure that our interventions were individually tailored to personal and local decision-making needs. Data analysis was conducted through a variety of qualitative assessments, including field notes, interview data, and maps created by participants. Data collection and data analysis have been guided by the Ottawa Model of Research Use (OMRU) conceptual framework.ResultsDespite our efforts to remove all barriers associated with our KT innovation (maps), our results demonstrate that both individual level and systemic barriers pose significant challenges for participants. While we cannot claim a causal association between our project and increased mapping by participants, participants did report a moderate increase in the use of maps in their organization. Specifically, maps were being used in decision-making forums as a way to allocate resources, confirm tacit knowledge about community needs, make financially-sensitive decisions more transparent, evaluate programs, and work with community partners.ConclusionsThis project highlights the role that maps can play and the importance of communicating the importance of maps as a decision support tool. Further, it represents an integrated knowledge project in the community setting, calling to question the applicability of traditional KT approaches when community values, minimal resources, and partners play a large role in decision making. The study also takes a unique perspective--where research producers and users work as dyad-pairs in the same organization--that has been under-explored to date in KT studies.

The More the Better? A Comparison of the Information Sources Used by the Public during Two Infectious Disease Outbreaks

Recent infectious disease outbreaks have resulted in renewed recognition of the importance of risk communication planning and execution to public health control strategies. Key to these efforts is public access to information that is understandable, reliable and meets their needs for informed decision-making on protective health behaviours. Learning from the trends in sources used in previous outbreaks will enable improvements in information access in future outbreaks. Two separate random-digit dialled telephone surveys were conducted in Alberta, Canada, to explore information sources used by the public, together with their perceived usefulness and credibility, during the 2003 Severe Acute Respiratory Syndrome (SARS) epidemic (n = 1209) and 2009–2010 H1N1 pandemic (n = 1206). Traditional mass media were the most used information sources in both surveys. Although use of the Internet increased from 25% during SARS to 56% during H1N1, overall use of social media was not as high as anticipated. Friends and relatives were commonly used as an information source, but were not deemed very useful or credible. Conversely, doctors and health professionals were considered credible, but not consulted as frequently. The use of five or more information sources increased by almost 60% between the SARS and H1N1 surveys. There was a shift to older, more educated and more affluent respondents between the surveys, most likely caused by a decrease in the use of landlines amongst younger Canadians. It was concluded that people are increasingly using multiple sources of health risk information, presumably in a complementary manner. Subsequently, although using online media is important, this should be used to augment rather than replace more traditional information channels. Efforts should be made to improve knowledge transfer to health care professionals and doctors and provide them with opportunities to be more accessible as information sources. Finally, the future use of telephone surveys needs to account for the changing demographics of the respondents accessed through such surveys.