Valerie Michaelson

Testing the theory of holism: A study of family systems and adolescent health.

Holism is an ancient theory that can be applied contemporarily to adolescent health and its determinants. This theory suggests that there is value in considering factors that influence health together as integrated wholes, in addition to consideration of individual components. Characteristics of families are fundamental determinants of health and provide opportunity for exploration of this theory. In a “proof-of-concept” analysis we therefore: (1) developed a multidimensional, composite (holistic) measure to be used to characterize family systems; and (2) related this measure and its individual components to adolescent health outcomes, in order to test the theory of holism. Cross-sectional analyses of survey reports from the 2014 Canadian Health Behaviour in School-aged Children study (weighted n = 19,333) were performed. Factor analysis was used to confirm the psychometric properties of the holistic measure to describe a family system (the “holistic measure”). Associations between this holistic measure, its individual components, and various indicators of health were examined descriptively and using binomial regression. The holistic measure (4 items, α = 0.62; RMSEA = .04; SRMR = 0.01; AGFI = 0.99) included components describing family: material wealth, meal practices, neighbourhood social capital, and social connections. It was consistently associated with various health behaviours, and social and emotional health outcomes. In 22/24 comparisons, this holistic measure related to positive health outcomes more strongly than did its individual components; for negative health outcomes this occurred in 20/24 comparisons. Study findings suggest that it is possible to assess family systems holistically. Such systems are strongly associated with adolescent health outcomes, and there is etiological and theoretical value in considering family systems as integrated wholes.

Inequalities in the spiritual health of young Canadians: a national, cross-sectional study

BackgroundSpiritual health, along with physical, emotional, and social aspects, is one of four domains of health. Assessment in this field of research is challenging methodologically. No contemporary population-based studies have profiled the spiritual health of adolescent Canadians with a focus on health inequalities. In a 2014 nationally representative sample of Canadians aged 11–15 years we therefore: (1) psychometrically evaluated a series of items used to assess the perceived importance of spiritual health and its four potential sub-domains (connections with: self, others, nature and the natural environment, and the transcendent) to adolescents; (2) described potential inequalities in spiritual health within adolescent populations, overall and by spiritual health sub-domain, by key socio-demographic factors.MethodsCross-sectional analysis of survey reports from the 2014 (Cycle 7) of the Canadian Health Behaviour in School-aged Children study (weighted n = 25,036). Principal components analysis followed by confirmatory factor analysis were used to explore the psychometric properties of the spiritual health items and the associated composite scale describing perceived importance of spiritual health. Associations among this composite scale, its individual sub-domains, and key socio-demographic factors were then explored.ResultsThe principal components analysis best supported a four-factor structure where the eight scale items loaded highly according to the original four domains. This was also supported in confirmatory factor analyses. We then combined the eight items into composite spiritual health score as supported by theory, principal components analysis findings, and acceptable tests of reliability. Further confirmatory factor analysis suggested the need for additional refinements to this scale. Based upon exploratory cross-sectional analyses, strong socio-demographic inequalities were observed in the spiritual health measures by age, gender, relative material wealth, immigration status, and province/territory.ConclusionsStudy findings highlight potential inequalities in the spiritual health of young Canadians, as well as opportunities for methodological advances in the assessment of adolescent spiritual health in our population.

Forming ideas about health: A qualitative study of Ontario adolescents

Adolescence is a crucial period of child development during which ones ideas about health are formed. However, little is known about the different contexts, experiences, and potential other factors that contribute to shaping the health ideas of adolescent populations, particularly when they are not seeking out the information for a particular purpose. In this Ontario-based qualitative study, grounded theory methods were used to explore ways that health knowledge is obtained in adolescents (age 10–16). A purposeful, criterion-based sampling strategy was used, and data were collected through seven focus groups (n=40). Findings indicate that while young people get their ideas about health through both didactic and organic learning contexts, the significant impact of organic learning is often overlooked. Categories of organic learning that emerged include self-reflective experience, the experience of close contacts, casually observing others, and common discourse. This study suggests that one central way that young people get their ideas about health is from living life: from the people they watch, the conversations that they have, and the experiences they live. Findings support the development of effective health promotion messages and also contribute to considering the place of some aspects of organic learning in the development of health-related resources that target adolescent populations.

Perceptions of the influence of computer-mediated communication on the health and well-being of early adolescents

ABSTRACT Recent technological advances have provided many youth with daily, almost continuous cell-phone and Internet connectivity through portable devices. Young people’s experiences with computer-mediated communication (CMC) and their views about how this form of communication affects their health have not been fully explored in the scientific literature. A purposeful maximum variation sample of young people (aged 11–15 years) across Ontario was identified, using key informants for recruitment. The young people participated in seven focus groups (involving a total of 40 adolescents), and discussed various aspects of health including the health impacts of CMC. Inductive content analysis of the focus group transcripts revealed two overarching concepts: first, that the relationship between health and the potential impacts of CMC is multidimensional; and secondly, that there exists a duality of both positive and negative potential influences of CMC on health. Within this framework, four themes were identified involving CMC and: (1) physical activity, (2) negative mental and emotional disturbance, (3) mindfulness, and (4) relationships. With this knowledge, targeted strategies for healthy technology use that draw on the perspectives of young people can be developed, and can then be implemented by parents, teachers, and youth themselves.

Factors Related to Self-perceived Health in Rural Men and Women.

ABSTRACT This study examined self-perceived health status among men and women who live on farms, as well as variations in factors related to negative health status observed by gender. Data were collected in the province of Saskatchewan, Canada, in 2013 through the use of a cross-sectional survey. A multistage sample was developed consisting of farms nested within rural municipalities and then agricultural soil zones. The response rate was 48.8% at the farm level, with a final sample of 2,353 (1,416 men, 937 women) from 1,119 farms. Variables under study included self-reports of health status, as well as demographic, behavioral, and farm operational factors that could influence perceived health status. The analysis was initially descriptive followed by multilevel logistic regression analyses. Self-reports of diagnosed comorbidities were strongly associated with negative health status among both men and women. Daytime sleepiness was more modestly associated with negative health status in both genders. Among men, additional risk factors tended to be functional, and included older age, part-time work status, and binge drinking. Among women, additional risk factors included cigarette smoking, overweight or obesity, and lower levels of education. The study demonstrated that there were both similarities and differences between men and women on farms in the factors related to negative self-perceived health status. These findings should inform the content and targeting of health promotion programs aimed at rural populations.

It still takes a village: an epidemiological study of the role of social supports in understanding unexpected health states in young people

BackgroundThis study of adolescent Canadians examines two groups who are anomalous in their health experiences: (1) those with perceived low affluence yet who perceive themselves to have excellent general health status; (2) those of perceived high affluence but who are reporting poor health status. Our hope was to explore the role of social supports in explaining such anomalies. We hypothesized that cumulative levels of social support available to these young people would have an influence on their perceived health status, with more support being associated with better self reported health.MethodsYoung people (n = 26,078 from 436 schools) aged 11–15 years were administered a general health survey in classroom settings during the 2009–10 academic school year. Descriptive and regression-based cross-sectional analyses (with an affluence-social support interaction term) were used to relate both individual and cumulative levels of social support in homes, neighborhoods, schools, and peer groups to self-reported health status.ResultsSocial supports and their cumulative availability indeed were strongly related to perceived health, with more supports being associated with better self-perceived health. Less affluent children were much more likely to report excellent health in the presence of numerous social supports. More affluent children were much more likely to report poor health in the absence of such supports. The strength and dose-dependent nature of the findings were consistent and striking.ConclusionsStudy findings from this large, contemporary and national analysis affirm the importance of social supports as potential determinants of health for young people from both high and low affluent groups. Conceptually, findings affirm the wisdom of the ancient principle: “it takes a village to raise a child”.

Canadian Children and Spiritual Health: Foundations for Spiritual Care

The spiritual health of adolescents is recognized as being a topic of profound importance, yet little is known about the relationship between spiritual health and its broader impacts on the health of adolescents. This knowledge is necessary if we are to provide adequate spiritual health care to this population. In this article, we present the results of analyses involving a multi-dimensional scale for spiritual health that was adapted for use within adolescent populations.

A mixed methods study of Canadian adolescents’ perceptions of health

Health perceptions adopted during childhood lay foundations for adult health trajectories and experiences. This study used a sequential mixed methods design to generate new evidence about child perceptions of health in two samples of Canadian children. A core qualitative study was followed by a complementary quantitative analysis to aid interpretation. Generational theory was used as a lens through which to interpret all data. Findings suggested that good health is perceived as customized and subjective. The strengths and liabilities of these perceptions are discussed, as well as implications for health promotion and prevention strategies. Through intentional consideration of the perspectives of this population group, this study makes both empirical and theoretical contributions to appreciating how cultural environments shape health perceptions.Health perceptions adopted during childhood lay foundations for adult health trajectories and experiences. This study used a sequential mixed methods design to generate new evidence about child perceptions of health in two samples of Canadian children. A core qualitative study was followed by a complementary quantitative analysis to aid interpretation. Generational theory was used as a lens through which to interpret all data. Findings suggested that good health is perceived as customized and subjective. The strengths and liabilities of these perceptions are discussed, as well as implications for health promotion and prevention strategies. Through intentional consideration of the perspectives of this population group, this study makes both empirical and theoretical contributions to appreciating how cultural environments shape health perceptions.

Eucharistic Eating, Family Meals and the Health of Adolescent Girls

Abstract This national study of adolescent Canadian girls focuses on church or religious group involvement as a potential determinant of health, as well as participation in family meals as a spiritual practice with potential health benefits. Current church involvement did not relate to improved emotional health, suggesting the need for more integrative messages and practices. Findings confirmed the strong protective relationship between regular participation in the family meal and health benefits among girls. Drawing on health research and theological reflection, we argue that regular participation in the family meal is a potentially powerful practice that could benefit adolescent girls. By helping families to understand the importance of the family meal as a spiritual practice, and by providing practical, theologically rich tools for practicing the family meal in our busy culture, these findings have the potential to contribute to the overall holistic health of young people, both in and outside the church.

Introduction to Holism

In this first chapter of this small book, we introduce the theory of holism in simple terms. We revisit its historic roots, including insights from Indigenous approaches to health and wellness, and then we discuss the more recent re-emergence of holism in ideas and debates in the field of health promotion, including those that involve children. This theoretical framework lays the foundation for the main purpose of this book, which is very simple and practical: to apply basic principles of holism to many aspects of the health of children.