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Okusanya IG, Meyer SB. Barriers to Accessing Mental Health Services That Impact Black Canadians: A Scoping Review and Thematic Analysis. J Racial Ethn Health Disparities 2025:10.1007/s40615-025-02306-y. [PMID: 39934498 DOI: 10.1007/s40615-025-02306-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2024] [Revised: 01/29/2025] [Accepted: 01/31/2025] [Indexed: 02/13/2025]
Abstract
Although experiencing lower levels of mental health compared to the general population of Canada, Black Canadians are less inclined to seek help from mental health services. Thus, the aim of this scoping review is to systematically document the current literature on the barriers in accessing mental health services among Black Canadians. Following PRISMA guidelines, a systematic search of the existing literature was conducted using PubMed, PsycINFO, Cumulative Index to Nursing and Allied Health, and Scopus on September 8, 2024. The final dataset consisted of 20 studies published between 1998 and 2023. Findings were synthesized using the sociobehavioural model of health service use to define the subtypes of barriers and the construct of Mental Health Literacy to guide the thematic analysis of the extracted data. Barriers impacting Black Canadians' access of mental health services included language barriers, difficulties in navigating the mental healthcare system, wait times, the quality of resources, and the lack of mental health services in their communities. Themes identified as barriers of use were Mental Health Literacy, Negative Perceptions of the Mental Healthcare System, and Discrimination. Challenges discussed in this review implicate the importance of a multitargeted approach to increasing the access and usage of mental health services among Black Canadians. This review also provides a foundation for research and practice that aims to investigate and develop strategies to promote the mental health of the Black population in Canada. Accordingly, we identify gaps in research-regarding the mental health perceptions, beliefs, and experiences of Black Canadians, required to properly develop interventions that increase mental health service access.
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Affiliation(s)
| | - Samantha B Meyer
- School of Public Health Sciences, University of Waterloo, Waterloo, ON, Canada
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2
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Hernandez BE, McDaniel HL, Bradshaw CP. Urban Black adolescents' victimization experiences: The moderating role of family factors on internalizing and academic outcomes. JOURNAL OF COMMUNITY PSYCHOLOGY 2025; 53:e23151. [PMID: 39319627 DOI: 10.1002/jcop.23151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Revised: 07/22/2024] [Accepted: 09/04/2024] [Indexed: 09/26/2024]
Abstract
This study investigated the moderating role of family factors on victimization experiences and internalizing and academic outcomes. Data (collected 2017-2019) on 471 Black urban ninth graders (51% male; Mage = 14 years) with elevated externalizing symptoms were analyzed and we explored how the interaction between (self-reported) racial socialization, parent relations, and (teacher-reported) family academic involvement and (self-reported) violence exposure, racial discrimination, and (teacher-reported) bullying potentially influenced (student- and teacher-reported) anxiety and depression, and (student-reported) academic engagement and negative school attitudes. High racial socialization and parent relations were associated with lower internalizing symptoms for youth with discrimination and heard violence, respectively. High academic involvement and parent relations were linked with higher internalizing symptoms for youth with discrimination and high parent relations were linked with higher anxiety for bullied youth. Racial socialization and parent relations may help offset the potential influence of discrimination and heard violence, respectively, for adolescents.
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Affiliation(s)
- Belinda E Hernandez
- Department of Human Services, University of Virginia, Charlottesville, Virginia, USA
| | - Heather L McDaniel
- Department of Human Services, University of Virginia, Charlottesville, Virginia, USA
| | - Catherine P Bradshaw
- Department of Human Services, University of Virginia, Charlottesville, Virginia, USA
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Bakermans‐Kranenburg MJ, van IJzendoorn MH. Anything goes for participant, patient and public involvement in youth mental health research. JCPP ADVANCES 2024; 4:e12258. [PMID: 39734925 PMCID: PMC11669783 DOI: 10.1002/jcv2.12258] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Accepted: 05/09/2024] [Indexed: 12/31/2024] Open
Abstract
Background Participant and Public Involvement in youth mental health research aims at making research more responsive to the needs of youth struggling with mental health issues, their parents, and mental health professionals and other stakeholders. Do characteristics of Patient and Public Involvement (PPI) in youth mental health research align with transparency and replication prerequisites as necessary conditions for translation? Relatedly, the question is addressed whether co-authorship should be assigned to youth involved in the study. Methods Here we address these questions re-visiting 50 PPI studies included in two recent systematic reviews of PPI on characteristics that are pertinent to questions about transparency, replicability, translatability, and co-authorship in PPI research. Results Almost two-third of the studies on youth mental health incorporating PPI translate their results to policy or practice, mostly as recommendations but sometimes also by dissemination of (online) interventions. At the same time the authors of a substantial majority of the studies (70%) also suggest the need for further work on their results, for example, in randomized controlled trials to validate the outcome of their exploratory inquiry. Only a quarter of the studies using PPI met the conditions for replicability, thus a majority of the PPI studies suggest premature translation of results. Authorship to involved participants was assigned in 24% of the studies. Conclusions "Anything goes" for PPI in an exploratory stage to generate fruitful hypotheses. Translation of the findings of PPI studies however require a firm evidence base of replicated results. Radical merging of research and action in participatory action research seems incompatible with replicable and therefore translatable inquiry. Assigning co-authorship to PPI representatives is often at odds with current guidelines for authorship. More evidence from randomized trials on the translational impact of PPI is needed before grant foundations should require PPI in grant proposals.
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Affiliation(s)
| | - Marinus H. van IJzendoorn
- Research Department of Clinical, Educational and Health PsychologyUCLLondonUK
- Facultad de Psicologia y HumanidadesUniversidad San SebastiánConcepciónChile
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Mohamud H, Toulany A, Grandi SM, Altaf A, Fu L, Strauss R, Saunders NR. Language ability and virtual mental healthcare utilisation among immigrant and refugee youth: a population-based cohort study. Arch Dis Child 2024; 109:997-1002. [PMID: 39304205 PMCID: PMC11672042 DOI: 10.1136/archdischild-2023-326507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Accepted: 08/09/2024] [Indexed: 09/22/2024]
Abstract
BACKGROUND AND OBJECTIVES The widespread adoption of virtual care during the pandemic may not have been uniform across populations, including among paediatric immigrants and refugees. We sought to examine the association between virtual mental healthcare utilisation and immigration factors. METHODS This population-based cohort study of immigrants and refugees (3-17 years) used linked health administrative databases in Ontario, Canada (March 2020 to December 2021). Exposures included self-reported Canadian language ability (CLA) at arrival and immigration category (economic class, family class and refugee). The primary outcome was the visit modality (inperson/virtual) measured as a rate of physician-based mental healthcare visits. Modified Poisson regression model estimated adjusted rate ratios (aRRs) with 95% CIs. RESULTS Among 22 420 immigrants, 12 135 (54%) did not have CLA (economic class: 6310, family class: 2207, refugees: 3618) and 10 285 did (economic class; 6293, family class: 1469, refugees: 2529). The cohort's mean age (SD) was 12.0 (4.0) years and half (50.3%) were female. Of 71 375 mental health visits, 47 989 (67.2%) were delivered virtually. Compared with economic class immigrants with CLA (referent), refugees with and without CLA had a lower risk of virtual care utilisation (CLA: aRR 0.89, 95% CI 0.86 to 0.93; non-CLA: aRR 0.80, 95% CI 0.77 to 0.83), as did family class immigrants with CLA (aRR 0.96, 95% CI 0.92 to 0.99). No differences in virtual care utilisation were observed among economic class immigrants with CLA and other immigrant groups. CONCLUSIONS Language ability at arrival and immigration category are associated with virtual mental healthcare utilisation. Whether findings reflect user preference or inequities in accessibility, particularly for refugees and those without CLA at arrival, warrants further study.
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Affiliation(s)
| | - Alene Toulany
- University of Toronto, Toronto, Ontario, Canada
- Division of Adolescent Medicine, The Hospital for Sick Children, Toronto, Ontario, Canada
- Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Ontario, Canada
- ICES, Toronto, Ontario, Canada
| | - Sonia M Grandi
- University of Toronto, Toronto, Ontario, Canada
- Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Ontario, Canada
| | | | | | | | - Natasha Ruth Saunders
- University of Toronto, Toronto, Ontario, Canada
- Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Ontario, Canada
- ICES, Toronto, Ontario, Canada
- Division of Paediatric Medicine, The Hospital For Sick Children, Toronto, Ontario, Canada
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Hempeler C, Schneider-Reuter L, Windel AS, Carlet J, Philipsen L, Juckel G, Gather J, Yeboah A, Faissner M. Intersectional Discrimination in Mental Health Care: A Systematic Review With Qualitative Evidence Synthesis. Psychiatr Serv 2024; 75:1125-1143. [PMID: 38938095 DOI: 10.1176/appi.ps.20230252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/29/2024]
Abstract
OBJECTIVE Discriminatory practices in mental health care undermine the right to health of marginalized service users. Intersectional approaches enable consideration of multiple forms of discrimination that occur simultaneously and remain invisible in single-axis analyses. The authors reviewed intersectionality-informed qualitative literature on discriminatory practices in mental health care to better understand the experiences of marginalized service users and their evaluation and navigation of mental health care. METHODS The authors searched EBSCO, PubMed, MEDLINE, and JSTOR for studies published January 1, 1989-December 14, 2022. Qualitative and mixed-methods studies were eligible if they used an intersectional approach to examine discrimination (experiences, mechanisms, and coping strategies) in mental health care settings from the perspective of service users and providers. A qualitative evidence synthesis with thematic analysis was performed. RESULTS Fifteen studies were included in the qualitative evidence synthesis. These studies represented the experiences of 383 service users and 114 providers. Most studies considered the intersections of mental illness with race, sexual and gender diversity, or both and were performed in the United States or Canada. Four themes were identified: the relevance of social identity in mental health care settings, knowledge-related concerns in mental health care, microaggressions in clinical practice, and service users' responses to discriminatory practices. CONCLUSIONS Discriminatory practices in mental health care lead to specific barriers to care for multiply marginalized service users. Universities and hospitals may improve care by building competencies in recognizing and preventing discrimination through institutionalized training.
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Affiliation(s)
- Christin Hempeler
- Institute for Medical Ethics and History of Medicine (Hempeler, Schneider-Reuter, Carlet, Philipsen, Gather) and Department of Psychiatry, Psychotherapy and Preventive Medicine (Juckel, Gather, Faissner), Ruhr University Bochum, Bochum, Germany; private practice for general medicine, Cologne, Germany (Windel); Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital Zurich, University of Zurich, Zurich (Carlet); private practice for psychiatry and psychotherapy, and psychodynamic supervision, Cologne, Germany (Yeboah); Institute of the History of Medicine and Ethics in Medicine, Charité-Universitätsmedizin Berlin, Berlin (Faissner)
| | - Lydia Schneider-Reuter
- Institute for Medical Ethics and History of Medicine (Hempeler, Schneider-Reuter, Carlet, Philipsen, Gather) and Department of Psychiatry, Psychotherapy and Preventive Medicine (Juckel, Gather, Faissner), Ruhr University Bochum, Bochum, Germany; private practice for general medicine, Cologne, Germany (Windel); Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital Zurich, University of Zurich, Zurich (Carlet); private practice for psychiatry and psychotherapy, and psychodynamic supervision, Cologne, Germany (Yeboah); Institute of the History of Medicine and Ethics in Medicine, Charité-Universitätsmedizin Berlin, Berlin (Faissner)
| | - Anne-Sophie Windel
- Institute for Medical Ethics and History of Medicine (Hempeler, Schneider-Reuter, Carlet, Philipsen, Gather) and Department of Psychiatry, Psychotherapy and Preventive Medicine (Juckel, Gather, Faissner), Ruhr University Bochum, Bochum, Germany; private practice for general medicine, Cologne, Germany (Windel); Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital Zurich, University of Zurich, Zurich (Carlet); private practice for psychiatry and psychotherapy, and psychodynamic supervision, Cologne, Germany (Yeboah); Institute of the History of Medicine and Ethics in Medicine, Charité-Universitätsmedizin Berlin, Berlin (Faissner)
| | - Jona Carlet
- Institute for Medical Ethics and History of Medicine (Hempeler, Schneider-Reuter, Carlet, Philipsen, Gather) and Department of Psychiatry, Psychotherapy and Preventive Medicine (Juckel, Gather, Faissner), Ruhr University Bochum, Bochum, Germany; private practice for general medicine, Cologne, Germany (Windel); Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital Zurich, University of Zurich, Zurich (Carlet); private practice for psychiatry and psychotherapy, and psychodynamic supervision, Cologne, Germany (Yeboah); Institute of the History of Medicine and Ethics in Medicine, Charité-Universitätsmedizin Berlin, Berlin (Faissner)
| | - Lea Philipsen
- Institute for Medical Ethics and History of Medicine (Hempeler, Schneider-Reuter, Carlet, Philipsen, Gather) and Department of Psychiatry, Psychotherapy and Preventive Medicine (Juckel, Gather, Faissner), Ruhr University Bochum, Bochum, Germany; private practice for general medicine, Cologne, Germany (Windel); Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital Zurich, University of Zurich, Zurich (Carlet); private practice for psychiatry and psychotherapy, and psychodynamic supervision, Cologne, Germany (Yeboah); Institute of the History of Medicine and Ethics in Medicine, Charité-Universitätsmedizin Berlin, Berlin (Faissner)
| | - Georg Juckel
- Institute for Medical Ethics and History of Medicine (Hempeler, Schneider-Reuter, Carlet, Philipsen, Gather) and Department of Psychiatry, Psychotherapy and Preventive Medicine (Juckel, Gather, Faissner), Ruhr University Bochum, Bochum, Germany; private practice for general medicine, Cologne, Germany (Windel); Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital Zurich, University of Zurich, Zurich (Carlet); private practice for psychiatry and psychotherapy, and psychodynamic supervision, Cologne, Germany (Yeboah); Institute of the History of Medicine and Ethics in Medicine, Charité-Universitätsmedizin Berlin, Berlin (Faissner)
| | - Jakov Gather
- Institute for Medical Ethics and History of Medicine (Hempeler, Schneider-Reuter, Carlet, Philipsen, Gather) and Department of Psychiatry, Psychotherapy and Preventive Medicine (Juckel, Gather, Faissner), Ruhr University Bochum, Bochum, Germany; private practice for general medicine, Cologne, Germany (Windel); Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital Zurich, University of Zurich, Zurich (Carlet); private practice for psychiatry and psychotherapy, and psychodynamic supervision, Cologne, Germany (Yeboah); Institute of the History of Medicine and Ethics in Medicine, Charité-Universitätsmedizin Berlin, Berlin (Faissner)
| | - Amma Yeboah
- Institute for Medical Ethics and History of Medicine (Hempeler, Schneider-Reuter, Carlet, Philipsen, Gather) and Department of Psychiatry, Psychotherapy and Preventive Medicine (Juckel, Gather, Faissner), Ruhr University Bochum, Bochum, Germany; private practice for general medicine, Cologne, Germany (Windel); Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital Zurich, University of Zurich, Zurich (Carlet); private practice for psychiatry and psychotherapy, and psychodynamic supervision, Cologne, Germany (Yeboah); Institute of the History of Medicine and Ethics in Medicine, Charité-Universitätsmedizin Berlin, Berlin (Faissner)
| | - Mirjam Faissner
- Institute for Medical Ethics and History of Medicine (Hempeler, Schneider-Reuter, Carlet, Philipsen, Gather) and Department of Psychiatry, Psychotherapy and Preventive Medicine (Juckel, Gather, Faissner), Ruhr University Bochum, Bochum, Germany; private practice for general medicine, Cologne, Germany (Windel); Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital Zurich, University of Zurich, Zurich (Carlet); private practice for psychiatry and psychotherapy, and psychodynamic supervision, Cologne, Germany (Yeboah); Institute of the History of Medicine and Ethics in Medicine, Charité-Universitätsmedizin Berlin, Berlin (Faissner)
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Alaazi DA, Yohani S, Salami B. Culturally Responsive Approaches to Health Research with Black Canadians: Challenges and Strategies. J Racial Ethn Health Disparities 2024:10.1007/s40615-024-02175-x. [PMID: 39302565 DOI: 10.1007/s40615-024-02175-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2024] [Revised: 08/29/2024] [Accepted: 09/02/2024] [Indexed: 09/22/2024]
Abstract
INTRODUCTION Canada's Black population has more than doubled over the last two decades, with the fastest growth occurring in the Prairie provinces of Manitoba, Saskatchewan, and Alberta. Despite a growing interest in Black health research in Canada, there is still limited knowledge on culturally responsive approaches to collecting, analyzing, and reporting health data on Black Canadians. This review presents a synthesis of challenges and strategies for conducting culturally responsive health research in Black communities. METHODS Guided by Arksey and O'Malley's framework [1], this scoping review addresses the questions: What cultural considerations inform health data collection methods with Black Canadians on the Prairies? What gaps exist in current use of culturally appropriate approaches to health research with this population? We systematically searched selected electronic databases-Sociological Abstracts, PsychINFO, Embase, Social Science Citation Index, Social Services Abstract, Social Work Abstracts, CINAHL, Scopus, Medline, Cochrane Library, Proquest, and Web of Science-for studies on Black health in Manitoba, Saskatchewan, and Alberta. We completed a citation chaining of selected studies, searched thesis repositories, and consulted Black health researchers on the Prairies. Using our inclusion criteria, we screened 453 records and selected 27 articles for the review. RESULTS Most of the included articles described research conducted in Alberta (77.7%) and between 2015 and 2022 (74.1%). We identified four themes relevant to culturally responsive approaches to Black health research: use of theory in research design; research leadership; research participation, uptake, and community engagement; and data collection procedures. CONCLUSIONS Black leadership, critical representation on project teams, and partnerships with community gatekeepers can improve trust, acceptability, and research uptake. Cultural considerations in Black health research include attending to gender, age, and religion in data collection. There is also a need to reform research practices and guidelines to attend to the social, cultural, and religious needs of Black Canadians.
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Affiliation(s)
- Dominic A Alaazi
- School of Health Studies, Faculty of Health Sciences, Western University, London, ON, Canada.
| | - Sophie Yohani
- Department of Educational Psychology, University of Alberta, Edmonton, AB, Canada
| | - Bukola Salami
- Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
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Martínez-Vega R, Maduforo AN, Renzaho A, Alaazi DA, Dordunoo D, Tunde-Byass M, Unachukwu O, Atilola V, Boatswain-Kyte A, Maina G, Hamilton-Hinch BA, Massaquoi N, Salami A, Salami O. Scoping review on mental health standards for Black youth: identifying gaps and promoting equity in community, primary care, and educational settings. Child Adolesc Psychiatry Ment Health 2024; 18:113. [PMID: 39252127 PMCID: PMC11385802 DOI: 10.1186/s13034-024-00800-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Accepted: 08/20/2024] [Indexed: 09/11/2024] Open
Abstract
BACKGROUND Youth mental health is a growing concern in research, practice, and policy. Practice standards, guidelines, or strategies provide an invisible infrastructure that fosters equity, quality, and safety, potentially addressing inconsistencies and more effectively attending to the mental wellness of Black youth as a particular population of concern. This scoping review aimed to address the following question: What standards exist for the delivery of mental health services to Black youth in community, primary care, and educational settings? Due to a limited initial search yield on publications about standards for the delivery of mental health services for Black youth population, our goal was then to identify and map mental health standards, recommendations, or guidelines for the delivery of mental health services using the same settings to all youth. METHODS Searches were conducted in various databases, including PubMed/MEDLINE, PsycINFO, Embase, SocINDEX, CINAHL, Gender Studies Database, Social Services Abstracts, Sociological Abstracts, Scopus, Web of Science, and Google Scholar. Screening was independently conducted by two reviewers, with disagreements resolved by a third. Information extraction was performed by two independent reviewers. RESULTS Out of the 2,701 screened publications, 54 were included in this scoping review. Among them, 38.9% were published between 2020 and 2023, with 40.7% originating from the United States of America, 20.4% from the United Kingdom, and 13% from Canada. Concerning the settings, 25.9% of the publications focused on primary care, 24.1% on health care services, 20.4% on educational settings, and 3.7% on the community. Additionally, 25.9% were classified as general because recommendations were applicable to various settings. Attention-deficit/hyperactivity disorder (11.1%) was the most frequently considered specific condition, followed by autism spectrum disorder (9.3%) and depression (9.3%). However, 31.5% of the included references addressed mental health in general. Only three references provided specific recommendations for the Black population. CONCLUSIONS Recommendations, guidelines, or standards for Black youth mental health services in community, primary care, or educational settings are scarce and limited to North American countries. This scoping review emphasizes the need to consider ethnicity when developing guidelines or standards to improve racial equity and reduce disparities in access to mental health services.
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Affiliation(s)
- Ruth Martínez-Vega
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, 3280 Hospital Drive, Calgary, Canada
| | - Aloysius Nwabugo Maduforo
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, 3280 Hospital Drive, Calgary, Canada
| | - Andre Renzaho
- School of Medicine, Western Sydney University, David Pilgrim AvenueNSW2560, Campbelltown , Australia
| | - Dominic A Alaazi
- School of Health Studies, University of Western Ontario, 1151 Richmond Street, London, ON, Canada
| | - Dzifa Dordunoo
- School of Nursing, University of Victoria, HSD Building A402A, Victoria, VIC, Canada
| | - Modupe Tunde-Byass
- Temerty Faculty of Medicine, University of Toronto, 123 Edward Street, Suite 1200, Toronto, Canada
| | - Olutoyosi Unachukwu
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, 3280 Hospital Drive, Calgary, Canada
| | - Victoria Atilola
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, 3280 Hospital Drive, Calgary, Canada
| | | | - Geoffrey Maina
- College of Nursing, University of Saskatchewan, 173-1061 Central Avenue, PrinceAlbert, Canada
| | - Barbara-Ann Hamilton-Hinch
- Dalhousie University, Nova Scotia. School of Health and Human Performance, 5981 University Avenue, Room 4210F, Halifax, Canada
| | - Notisha Massaquoi
- Department of Health and Society, University of Toronto, Scarborough, 246 Bloor Street W, Toronto, Canada
| | - Azeez Salami
- Alberta Health Services, 604 Main Street S, T4B 3K7, Airdrie, Alberta, Canada
| | - Oluwabukola Salami
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, 3280 Hospital Drive, Calgary, Canada.
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Bailey K, Allemang B, Vandermorris A, Munce S, Cleverley K, Chisholm C, Cohen E, Davidson C, El Galad A, Leibovich D, Lowthian T, Pillainayagam J, Ramesh H, Samson A, Senthilnathan V, Siska P, Snider M, Toulany A. Benefits, barriers and recommendations for youth engagement in health research: combining evidence-based and youth perspectives. RESEARCH INVOLVEMENT AND ENGAGEMENT 2024; 10:92. [PMID: 39223602 PMCID: PMC11370084 DOI: 10.1186/s40900-024-00607-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Accepted: 07/05/2024] [Indexed: 09/04/2024]
Abstract
BACKGROUND Youth engagement refers to the collaboration between researchers and youth to produce research. Youth engagement in health research has been shown to inform effective interventions aimed at improving health outcomes. However, limited evidence has identified promising practices to meaningfully engage youth. This synthesis aims to describe youth engagement approaches, frameworks, and barriers, as well as provide both evidence-based and youth-generated recommendations for meaningful engagement. MAIN BODY This review occurred in two stages: 1) a narrative review of existing literature on youth engagement and 2) a Youth Advisory Council (YAC) to review and supplement findings with their perspectives, experiences, and recommendations. The terms 'youth engagement' and 'health research' were searched in Google Scholar, PubMed, Web of Science, Scopus, and PsycINFO. Articles and non-peer reviewed research works related to youth engagement in health research were included, reviewed, and summarized. The YAC met with research team members and in separate youth-only forums to complement the narrative review with their perspectives. Types of youth engagement include participation as research participants, advisors, partners, and co-investigators. Barriers to youth engagement were organized into youth- (e.g., time commitments), researcher- (e.g., attitudes towards youth engagement), organizational- (e.g., inadequate infrastructure to support youth engagement), and system-level (e.g., systemic discrimination and exclusion from research). To enhance youth engagement, recommendations focus on preparing and supporting youth by offering flexible communication approaches, mentorship opportunities, diverse and inclusive recruitment, and ensuring youth understand the commitment and benefits involved. CONCLUSIONS To harness the potential of youth engagement, researchers need to establish an inclusive and enabling environment that fosters collaboration, trust, and valuable contributions from youth. Future research endeavors should prioritize investigating the dynamics of power-sharing between researchers and youth, assessing the impact of youth engagement on young participants, and youth-specific evaluation frameworks.
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Affiliation(s)
- Katherine Bailey
- Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
| | - Brooke Allemang
- Child Health Evaluative Sciences, SickKids Research Institute, Toronto, ON, Canada
| | - Ashley Vandermorris
- Department of Pediatrics, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Division of Adolescent Medicine, The Hospital for Sick Children, 555 University Ave, Toronto, ON, M5G 1X8, Canada
| | - Sarah Munce
- KITE, Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
- Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada
- Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, ON, Canada
| | - Kristin Cleverley
- Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Lawrence S. Bloomberg School of Nursing, University of Toronto, Toronto, ON, Canada
- Margaret and Wallace McCain Centre for Child, Youth & Family Mental Health, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Cassandra Chisholm
- Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Eva Cohen
- Department of Psychology and Neuroscience, Dalhousie University, Halifax, NS, Canada
| | - Cedar Davidson
- Neurosciences and Mental Health, SickKids Research Institute, Toronto, ON, Canada
| | - Asil El Galad
- Michael De Groote School of Medicine, McMaster University, Hamilton, ON, Canada
| | | | - Trinity Lowthian
- Department of Health Sciences, University of Ottawa, Ottawa, ON, Canada
| | | | | | - Anna Samson
- Patient Partner, Canadian Arthritis Patient Alliance, Toronto, ON, Canada
| | - Vjura Senthilnathan
- KITE, Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
- Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada
| | | | | | - Alene Toulany
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada.
- Department of Pediatrics, Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
- Division of Adolescent Medicine, The Hospital for Sick Children, 555 University Ave, Toronto, ON, M5G 1X8, Canada.
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Wang J, Pasyk SP, Slavin-Stewart C, Olagunju AT. Barriers to Mental Health care in Canada Identified by Healthcare Providers: A Scoping Review. ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2024; 51:826-838. [PMID: 38512557 DOI: 10.1007/s10488-024-01366-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/04/2024] [Indexed: 03/23/2024]
Abstract
The mental health treatment gap remains wide across the world despite mental illness being a significant cause of disability globally. Both end-user and healthcare provider perspectives are critical to understanding barriers to mental healthcare and developing interventions. However, the views of providers are relatively understudied. In this review, we synthesized findings from current literature regarding providers' perspectives on barriers to mental healthcare in Canada. We searched Medline, PsycINFO, Embase, and CINAHL for eligible Canadian studies published since 2000. Analysis and quality assessment were conducted on the included studies. Of 4,773 reports screened, 29 moderate-high quality studies were reviewed. Five themes of barriers emerged: health systems availability and complexity (reported in 72% of the studies), work conditions (55%), training/education (52%), patient accessibility (41%), and identity-based sensitivity (17%). Common barriers included lack of resources, fragmented services, and gaps in continuing education. Interestingly, clinicians often cited confusion in determining the ideal service for patients due to an overwhelming number of potential services without clear descriptions. These five domains of barriers present a synthesized review of areas of improvement for mental healthcare spanning both patients and clinicians. Canadian mental health systems face a need to improve capacity, clinician training, and in particular service navigability and collaboration.
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Affiliation(s)
- Jeffrey Wang
- Department of Psychiatry and Behavioral Neurosciences, McMaster University/St Joseph's Healthcare Hamilton, 100 West 5th Street, Hamilton, ON, L8N 3K7, Canada
| | - Stanislav P Pasyk
- Department of Psychiatry and Behavioral Neurosciences, McMaster University/St Joseph's Healthcare Hamilton, 100 West 5th Street, Hamilton, ON, L8N 3K7, Canada
| | - Claire Slavin-Stewart
- Department of Psychiatry and Behavioral Neurosciences, McMaster University/St Joseph's Healthcare Hamilton, 100 West 5th Street, Hamilton, ON, L8N 3K7, Canada
| | - Andrew T Olagunju
- Department of Psychiatry and Behavioral Neurosciences, McMaster University/St Joseph's Healthcare Hamilton, 100 West 5th Street, Hamilton, ON, L8N 3K7, Canada.
- Discipline of Psychiatry, The University of Adelaide, North Terrace, Adelaide, SA, 5000, Australia.
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10
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Chawla S, Kaida A, Brouillette MJ, Kleiner B, Dubuc D, Skerritt L, Burchell AN, Rouleau D, Loutfy M, de Pokomandy A. Mental health service use and shortages among a cohort of women living with HIV in Canada. BMC Health Serv Res 2024; 24:923. [PMID: 39135046 PMCID: PMC11321070 DOI: 10.1186/s12913-024-11396-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2024] [Accepted: 08/02/2024] [Indexed: 08/15/2024] Open
Abstract
BACKGROUND The prevalence of mental health conditions among women with HIV in Canada ranges between 29.5% and 57.4%, highlighting the need for accessible mental health care. We aimed to (1) describe the availability and use of mental health services among women with HIV and (2) identify characteristics associated with reporting that shortages of these services presented a problem in their care. METHODS Baseline data from the Canadian HIV Women's Sexual and Reproductive Health Cohort Study were analysed. Self-reported availability and use of mental health services were examined using descriptive statistics. Participants indicated whether a lack of mental health support was a problem in their care. Logistic regression models were constructed to determine associations between sociodemographic, clinical, and psychosocial characteristics and reported problematic shortages. RESULTS Of 1422 women, 26.7% (n = 380) used mental health services in the last year, which most accessed through their HIV clinic. Thirty-eight percent (n = 541) reported that a shortage of mental health support was a problem in their care. Among this subset, 22.1% (n = 119) used services at their HIV clinic, 26.5% (n = 143) reported available services but did not use them, and 51.4% (n = 277) either indicated that these services were unavailable, did not know if such services were available, or were unengaged in HIV care. Factors associated with reporting problematic shortages included rural residence [adjusted odds ratio (aOR): 1.69, 95% confidence interval (CI): 1.03-2.77], higher education level (aOR: 1.43, 95% CI: 1.02-2.02), and higher HIV stigma score (aOR: 1.03, 95% CI: 1.02-1.03). Conversely, African/Caribbean/Black identity (aOR: 0.37, 95% CI: 0.26-0.54), history of recreational drug use (aOR: 0.56, 95% CI: 0.39-0.81), and Quebec residence (aOR: 0.69, 95% CI: 0.50-0.96) were associated with lower odds of reporting service shortages. CONCLUSION Our findings highlight the HIV clinic as the primary location of mental health service use. However, existing services may not be sufficient to reach all patients or meet specific needs. Furthermore, the low uptake among those reporting a shortage suggests a lack of connection to services or patient knowledge about their availability. Characteristics associated with reporting shortages reflect geographic and socioeconomic disparities that must be accounted for in future service design.
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Affiliation(s)
- Seerat Chawla
- Department of Family Medicine, McGill University, Montreal, QC, Canada
- Harvard Medical School, Boston, MA, USA
| | - Angela Kaida
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada
| | - Marie-Josée Brouillette
- Infectious Diseases and Immunity in Global Health Program, Research Institute of the McGill University Health Centre, Montreal, QC, Canada
- Department of Psychiatry, McGill University, Montreal, QC, Canada
| | - Bluma Kleiner
- Department of Family Medicine, McGill University, Montreal, QC, Canada
| | - Danièle Dubuc
- Chronic Viral Illness Service, McGill University Health Centre, Montreal, QC, Canada
| | - Lashanda Skerritt
- Department of Family Medicine, McGill University, Montreal, QC, Canada
| | - Ann N Burchell
- MAP-Centre for Urban Health Solutions, Unity Health Toronto, St. Michael's Hospital, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
- Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada
| | - Danielle Rouleau
- Department of Microbiology, Infection and Immunology, University of Montreal, Montreal, QC, Canada
| | - Mona Loutfy
- Department of Medicine, University of Toronto, Toronto, ON, Canada
- Women's College Research Institute, Women's College Hospital, Toronto, ON, Canada
| | - Alexandra de Pokomandy
- Department of Family Medicine, McGill University, Montreal, QC, Canada.
- Infectious Diseases and Immunity in Global Health Program, Research Institute of the McGill University Health Centre, Montreal, QC, Canada.
- Chronic Viral Illness Service, McGill University Health Centre, Montreal, QC, Canada.
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11
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Faissner M, Braun E. The ethics of coercion in mental healthcare: the role of structural racism. JOURNAL OF MEDICAL ETHICS 2024; 50:476-481. [PMID: 37845011 PMCID: PMC11228209 DOI: 10.1136/jme-2023-108984] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 09/28/2023] [Indexed: 10/18/2023]
Abstract
In mental health ethics, it is generally assumed that coercive measures are sometimes justified when persons with mental illness endanger themselves or others. Coercive measures are regarded as ethically justified only when certain criteria are fulfilled: for example, the intervention must be proportional in relation to the potential harm. In this paper, we demonstrate shortcomings of this established ethical framework in cases where people with mental illness experience structural racism. By drawing on a case example from mental healthcare, we first demonstrate that biases in assessing whether the coercive intervention is proportional are likely, for example, due to an overestimation of dangerousness. We then show that even if proportionality is assessed correctly, and the specific coercive intervention would thus be regarded as ethically justified according to the standard framework, coercion may still be ethically problematic. This is because the standard framework does not consider how situations in which coercive measures are applied arise. If structural racism causally contributes to such situations, the use of coercion can compound the prior injustice of racist discrimination. We conclude that the ethical analysis of coercion in mental healthcare should consider the possibility of discriminatory biases and practices and systematically take the influence of structural discrimination into account.
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Affiliation(s)
- Mirjam Faissner
- Department of Psychiatry, Psychotherapy and Preventive Medicine, Ruhr University Bochum, Bochum, Germany
- Institute for Medical Ethics and History of Medicine, Ruhr University Bochum, Bochum, Germany
| | - Esther Braun
- Institute for Medical Ethics and History of Medicine, Ruhr University Bochum, Bochum, Germany
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Salami B, Maduforo AN, Aiello O, Osman S, Omobhude OF, Price K, Henderson J, Hamilton HA, Kemei J, Mullings DV. Factors That Contribute to the Mental Health of Black Youth during COVID-19 Pandemic. Healthcare (Basel) 2024; 12:1174. [PMID: 38921289 PMCID: PMC11203374 DOI: 10.3390/healthcare12121174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2024] [Revised: 05/23/2024] [Accepted: 06/06/2024] [Indexed: 06/27/2024] Open
Abstract
BACKGROUND The mental health of Black youth during the COVID-19 pandemic is potentially influenced by various systemic factors, including racism, socioeconomic disparities, and access to culturally sensitive mental health support. Understanding these influences is essential for developing effective interventions to mitigate mental health disparities. METHODS Our project used a community-based participatory (CBP) research design with an intersectional theoretical perspective. An advisory committee consisting of fourteen Black youth supported all aspects of our project. The research team consisted of experienced Black researchers who also trained six Black youths as research assistants and co-researchers. The co-researchers conducted individual interviews, contributed to data analysis, and mobilized knowledge. Participants were recruited through the advisory committee members and networks of Black youth co-researchers and sent an email invitation to Black community organizations. Forty-eight Black identified were interviewed between the ages of 16 and 30 in Canada. The data was analyzed thematically. We kept a reflexive note throughout all aspects of the project. RESULTS Participants reported significant challenges with online schooling, including a lack of support and access to resources. Lockdowns exacerbated stress, particularly for those living in toxic living/home environments. Financial burdens, such as food insecurity and precarious employment, were prevalent and exacerbated mental health challenges. Additionally, experiences of anti-Black racism and police brutality during the pandemic heightened stress and anxiety among participants. CONCLUSIONS The findings underscore the complex interplay of systemic factors in shaping the mental health of Black youth during the COVID-19 pandemic. Addressing these disparities requires targeted interventions that address structural inequities and provide culturally competent support to mitigate the impact on mental well-being.
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Affiliation(s)
- Bukola Salami
- Cumming School of Medicine, University of Calgary, Calgary, AB T2N 1N4, Canada
| | | | - Olivia Aiello
- Faculty of Nursing, University of Alberta, Edmonton, AB T6G 1C9, Canada; (O.A.); (S.O.); (O.F.O.); (K.P.)
| | - Samah Osman
- Faculty of Nursing, University of Alberta, Edmonton, AB T6G 1C9, Canada; (O.A.); (S.O.); (O.F.O.); (K.P.)
| | | | - Kimberly Price
- Faculty of Nursing, University of Alberta, Edmonton, AB T6G 1C9, Canada; (O.A.); (S.O.); (O.F.O.); (K.P.)
| | - Jo Henderson
- Margaret and Wallace McCain Centre for Child, Youth and Family Mental Health, Centre for Addiction and Mental Health, Toronto, ON M6J 1H4, Canada;
| | - Hayley A. Hamilton
- Institute for Mental Health Policy Research, Centre for Addictions and Mental Health, Toronto, ON M6J 1H4, Canada;
| | - Janet Kemei
- Faculty of Nursing, Grant McEwan University, Edmonton, AB T5J 4S2, Canada;
| | - Delores V. Mullings
- Equity, Diversity, Inclusion and Anti-Racism, Memorial University of Newfoundland, St. John’s, NL A1C 5S7, Canada;
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13
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Sherman AD, Febres-Cordero S, Bonds Johnson K, Clark KD, Klepper M, Duroseau B, Lin Y, Zhang W, Coleman M, Prakash D, Daniel GA, Chand AT, Kalu U, Tarter R, Allgood S, Cohen S, Kelly U, Balthazar M. Intersectionality in nursing research: A scoping review. INTERNATIONAL JOURNAL OF NURSING STUDIES ADVANCES 2023; 5:100155. [PMID: 37982092 PMCID: PMC10655863 DOI: 10.1016/j.ijnsa.2023.100155] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 09/21/2023] [Accepted: 09/25/2023] [Indexed: 11/21/2023] Open
Abstract
Background An intersectional approach to health research provides an analytical foundation to explain the multidimensionality of health status, resource accessibility, privilege, oppression, and current and historical context. The use of intersectionality in health research has known limitations. Its use in health-related fields too often focuses on outcomes, such as health disparities, rather than processes, such as power structures and social determinants. Objective This scoping review serves to examine how intersectionality has been implemented by nurses in the peer-reviewed literature. We offer insight into how it may be incorporated to inform future nursing research and healthcare provision. Design & Methods Systematic searches of PubMed (n = 257), SCOPUS (n = 807), EMBASE (n = 396), CINAHL (n = 224), and Health Source: Nursing and Academics (n = 491), published since the seminal publication on intersectionality (1989 - 2023), identified 131 research articles that met inclusion and exclusion criteria. Data extraction and synthesis were used to describe the breadth and depth of the literature specific to the application of intersectionality in nursing research. Results The included studies used intersectionality to examine the intersections of numerous identities, such as race, gender, and immigration status. However, most studies were descriptive/observational in nature, underreported their methods, and conducted deficit-based research instead of strength-based inquiries. Of note, the vast majority of included articles were published within the last five years. Conclusions Future researchers using intersectionality as a framework can improve their approach by reporting clear definitions and operationalization of intersectionality. Observational science dominated the included studies; future research should focus on intervention development and evaluation using an intersectional lens. Lastly, caution should be placed on research that focuses solely on deficits among marginalized communities, which places scientists at risk of perpetuating stereotypes or enhancing already-existing stigmas.
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Affiliation(s)
- Athena D. F. Sherman
- Nell Hodgson Woodruff School of Nursing, Emory University, 1520 Clifton Road Office: 310, Atlanta, GA 30322, USA
| | - Sarah Febres-Cordero
- Nell Hodgson Woodruff School of Nursing, Emory University, 1520 Clifton Road Office: 310, Atlanta, GA 30322, USA
| | - Kalisha Bonds Johnson
- Nell Hodgson Woodruff School of Nursing, Emory University, 1520 Clifton Road Office: 310, Atlanta, GA 30322, USA
| | - Kristen D. Clark
- Department of Nursing, University of New Hampshire, Durham, NH, USA
| | | | | | - Yufen Lin
- Nell Hodgson Woodruff School of Nursing, Emory University, 1520 Clifton Road Office: 310, Atlanta, GA 30322, USA
| | - Wenhui Zhang
- Nell Hodgson Woodruff School of Nursing, Emory University, 1520 Clifton Road Office: 310, Atlanta, GA 30322, USA
| | - Mercy Coleman
- Ross and Carol Nese College of Nursing, Pennsylvania State University, University Park, PA, USA
| | - Diane Prakash
- Nell Hodgson Woodruff School of Nursing, Emory University, 1520 Clifton Road Office: 310, Atlanta, GA 30322, USA
| | - Gaea A. Daniel
- Nell Hodgson Woodruff School of Nursing, Emory University, 1520 Clifton Road Office: 310, Atlanta, GA 30322, USA
| | - Arzina Tabassum Chand
- Ross and Carol Nese College of Nursing, Pennsylvania State University, University Park, PA, USA
| | - Ugo Kalu
- Ross and Carol Nese College of Nursing, Pennsylvania State University, University Park, PA, USA
| | - Robin Tarter
- Oregon Health and Science University, Portland, OR, USA
| | | | - Sydney Cohen
- Nell Hodgson Woodruff School of Nursing, Emory University, 1520 Clifton Road Office: 310, Atlanta, GA 30322, USA
| | - Ursula Kelly
- Nell Hodgson Woodruff School of Nursing, Emory University, 1520 Clifton Road Office: 310, Atlanta, GA 30322, USA
- Atlanta VA Health Care System, Atlanta, Georgia, USA
| | - Monique Balthazar
- Nell Hodgson Woodruff School of Nursing, Emory University, 1520 Clifton Road Office: 310, Atlanta, GA 30322, USA
- Ross and Carol Nese College of Nursing, Pennsylvania State University, University Park, PA, USA
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Nweze N, Davids J, Fang X, Holding A, Koestner R. The Impact of Language on the Mental Health of Black Quebecers. J Racial Ethn Health Disparities 2023; 10:2327-2337. [PMID: 36745264 DOI: 10.1007/s40615-022-01412-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Revised: 09/01/2022] [Accepted: 09/04/2022] [Indexed: 02/07/2023]
Abstract
Quebec's English-speaking Black community finds itself at the intersection of racial and linguistic discrimination, which presents challenges to mental wellness. The present study aims to add necessary detail to the conversations surrounding racism and mental health in Canada while including language as a determinant of health and intersecting element affecting the wellbeing of English-speaking Black Quebecers. We recruited 531 Black adults who are currently living in Quebec to complete a survey on various community-relevant items, including their mental and physical health, their experiences of discrimination, and barriers to accessing mental healthcare. Our analyses revealed that English-speaking participants experience more discrimination across all types and report more barriers to mental healthcare and lower mental health than their French-speaking counterparts. Furthermore, we found that language also had a mediated effect on mental health through discrimination and barriers to mental healthcare. Our study adds to the sparse race-based and intersectional literature about Black people in Canada and substantiates a mechanism by which language affects mental health by exposing Black Quebecers to more discrimination and thus higher barriers to care.
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Affiliation(s)
| | - John Davids
- Black Community Resource Center, Montreal, QC, Canada
| | - Xiaoyan Fang
- McGill University, Montreal, QC, Canada
- Black Community Resource Center, Montreal, QC, Canada
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15
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Hampton-Anderson JN, Novacek DM, Zhen-Duan J, Latimer S, Perry T, Renard D. Redefining the Role of Public Health Professionals Serving Black Youths Seeking Mental Health Care: Implications for Training and Mentoring. Am J Public Health 2023; 113:S140-S148. [PMID: 37339410 PMCID: PMC10282850 DOI: 10.2105/ajph.2022.307194] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/03/2022] [Indexed: 06/22/2023]
Abstract
Attrition rates for Black youths in mental health treatment settings are high, and the extant literature suggests this may be because treatment is not meeting their unique needs. Public health professionals, defined here as all individuals who work to increase the well-being of youths, can play a major role in changing these outcomes. The purpose of this article is to suggest a broader scope of practice, or a redefined role, for public health professionals who work with Black youths seeking outpatient mental health care and to explicate ways in which training and mentoring can help accomplish this goal. Bolstered by a socioecological conceptual model, we suggest 3 standards of practice that we believe must be satisfied to meet the requirement for this redefined public health professional role: using a sociocultural framework, exercising flexibility in one's assigned role, and understanding and incorporating culturally specific strengths and protective factors into care. (Am J Public Health. 2023;113(S2):S140-S148. https://doi.org/10.2105/AJPH.2022.307194).
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Affiliation(s)
- Joya N Hampton-Anderson
- Joya N. Hampton-Anderson is with the Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA. Derek M. Novacek is with the Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, and the Desert Pacific Mental Illness Research, Education, and Clinical Center, VA Greater Los Angeles Healthcare System. Jenny Zhen-Duan is with the Department of Medicine, Massachusetts General Hospital, and Harvard Medical School, Boston, MA. Saundra Latimer is with the Emory University School of Public Health, Atlanta. Tyler Perry is with the Emory University School of Medicine, Atlanta. Destini Renard is with the College of Arts and Sciences, Emory University, Atlanta
| | - Derek M Novacek
- Joya N. Hampton-Anderson is with the Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA. Derek M. Novacek is with the Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, and the Desert Pacific Mental Illness Research, Education, and Clinical Center, VA Greater Los Angeles Healthcare System. Jenny Zhen-Duan is with the Department of Medicine, Massachusetts General Hospital, and Harvard Medical School, Boston, MA. Saundra Latimer is with the Emory University School of Public Health, Atlanta. Tyler Perry is with the Emory University School of Medicine, Atlanta. Destini Renard is with the College of Arts and Sciences, Emory University, Atlanta
| | - Jenny Zhen-Duan
- Joya N. Hampton-Anderson is with the Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA. Derek M. Novacek is with the Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, and the Desert Pacific Mental Illness Research, Education, and Clinical Center, VA Greater Los Angeles Healthcare System. Jenny Zhen-Duan is with the Department of Medicine, Massachusetts General Hospital, and Harvard Medical School, Boston, MA. Saundra Latimer is with the Emory University School of Public Health, Atlanta. Tyler Perry is with the Emory University School of Medicine, Atlanta. Destini Renard is with the College of Arts and Sciences, Emory University, Atlanta
| | - Saundra Latimer
- Joya N. Hampton-Anderson is with the Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA. Derek M. Novacek is with the Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, and the Desert Pacific Mental Illness Research, Education, and Clinical Center, VA Greater Los Angeles Healthcare System. Jenny Zhen-Duan is with the Department of Medicine, Massachusetts General Hospital, and Harvard Medical School, Boston, MA. Saundra Latimer is with the Emory University School of Public Health, Atlanta. Tyler Perry is with the Emory University School of Medicine, Atlanta. Destini Renard is with the College of Arts and Sciences, Emory University, Atlanta
| | - Tyler Perry
- Joya N. Hampton-Anderson is with the Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA. Derek M. Novacek is with the Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, and the Desert Pacific Mental Illness Research, Education, and Clinical Center, VA Greater Los Angeles Healthcare System. Jenny Zhen-Duan is with the Department of Medicine, Massachusetts General Hospital, and Harvard Medical School, Boston, MA. Saundra Latimer is with the Emory University School of Public Health, Atlanta. Tyler Perry is with the Emory University School of Medicine, Atlanta. Destini Renard is with the College of Arts and Sciences, Emory University, Atlanta
| | - Destini Renard
- Joya N. Hampton-Anderson is with the Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA. Derek M. Novacek is with the Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, and the Desert Pacific Mental Illness Research, Education, and Clinical Center, VA Greater Los Angeles Healthcare System. Jenny Zhen-Duan is with the Department of Medicine, Massachusetts General Hospital, and Harvard Medical School, Boston, MA. Saundra Latimer is with the Emory University School of Public Health, Atlanta. Tyler Perry is with the Emory University School of Medicine, Atlanta. Destini Renard is with the College of Arts and Sciences, Emory University, Atlanta
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Kemei J, Alaazi DA, Olanlesi-Aliu A, Tunde-Byass M, Sekyi-Otu A, Mohamud H, Salami B. What contributes to COVID-19 online disinformation among Black Canadians: a qualitative study. CMAJ Open 2023; 11:E389-E396. [PMID: 37130607 PMCID: PMC10158753 DOI: 10.9778/cmajo.20220197] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/04/2023] Open
Abstract
BACKGROUND Black Canadians are disproportionately affected by the COVID-19 pandemic, and the literature suggests that online disinformation and misinformation contribute to higher rates of SARS-CoV-2 infection and vaccine hesitancy in Black communities in Canada. Through stakeholder interviews, we sought to describe the nature of COVID-19 online disinformation among Black Canadians and identify the factors contributing to this phenomenon. METHODS We conducted purposive sampling followed by snowball sampling and completed in-depth qualitative interviews with Black stakeholders with insights into the nature and impact of COVID-19 online disinformation and misinformation in Black communities. We analyzed data using content analysis, drawing on analytical resources from intersectionality theory. RESULTS The stakeholders (n = 30, 20 purposively sampled and 10 recruited by way of snowball sampling) reported sharing of COVID-19 online disinformation and misinformation in Black Canadian communities, involving social media interaction among family, friends and community members and information shared by prominent Black figures on social media platforms such as WhatsApp and Facebook. Our data analysis shows that poor communication, cultural and religious factors, distrust of health care systems and distrust of governments contributed to COVID-19 disinformation and misinformation in Black communities. INTERPRETATION Our findings suggest racism and underlying systemic discrimination against Black Canadians immensely catalyzed the spread of disinformation and misinformation in Black communities across Canada, which exacerbated the health inequities Black people experienced. As such, using collaborative interventions to understand challenges within the community to relay information about COVID-19 and vaccines could address vaccine hesitancy.
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Affiliation(s)
- Janet Kemei
- Faculty of Nursing (Kemei, Olanlesi-Aliu, Salami) and Health and Immigration Policies and Practices (HIPP) Research Program (Alaazi, Bukola Salami), University of Alberta, Edmonton, Alta.; Obstetrics and Gynaecology (Tunde-Byass), University of Toronto and North York General Hospital; Black Opportunity Fund (Sekyi-Otu), Toronto, Ont.; IMPACT Institute of Canada (Mohamud); Intersections of Gender Signature Area (Bukola Salami), University of Alberta, Edmonton, Alta
| | - Dominic A Alaazi
- Faculty of Nursing (Kemei, Olanlesi-Aliu, Salami) and Health and Immigration Policies and Practices (HIPP) Research Program (Alaazi, Bukola Salami), University of Alberta, Edmonton, Alta.; Obstetrics and Gynaecology (Tunde-Byass), University of Toronto and North York General Hospital; Black Opportunity Fund (Sekyi-Otu), Toronto, Ont.; IMPACT Institute of Canada (Mohamud); Intersections of Gender Signature Area (Bukola Salami), University of Alberta, Edmonton, Alta
| | - Adedoyin Olanlesi-Aliu
- Faculty of Nursing (Kemei, Olanlesi-Aliu, Salami) and Health and Immigration Policies and Practices (HIPP) Research Program (Alaazi, Bukola Salami), University of Alberta, Edmonton, Alta.; Obstetrics and Gynaecology (Tunde-Byass), University of Toronto and North York General Hospital; Black Opportunity Fund (Sekyi-Otu), Toronto, Ont.; IMPACT Institute of Canada (Mohamud); Intersections of Gender Signature Area (Bukola Salami), University of Alberta, Edmonton, Alta
| | - Modupe Tunde-Byass
- Faculty of Nursing (Kemei, Olanlesi-Aliu, Salami) and Health and Immigration Policies and Practices (HIPP) Research Program (Alaazi, Bukola Salami), University of Alberta, Edmonton, Alta.; Obstetrics and Gynaecology (Tunde-Byass), University of Toronto and North York General Hospital; Black Opportunity Fund (Sekyi-Otu), Toronto, Ont.; IMPACT Institute of Canada (Mohamud); Intersections of Gender Signature Area (Bukola Salami), University of Alberta, Edmonton, Alta
| | - Ato Sekyi-Otu
- Faculty of Nursing (Kemei, Olanlesi-Aliu, Salami) and Health and Immigration Policies and Practices (HIPP) Research Program (Alaazi, Bukola Salami), University of Alberta, Edmonton, Alta.; Obstetrics and Gynaecology (Tunde-Byass), University of Toronto and North York General Hospital; Black Opportunity Fund (Sekyi-Otu), Toronto, Ont.; IMPACT Institute of Canada (Mohamud); Intersections of Gender Signature Area (Bukola Salami), University of Alberta, Edmonton, Alta
| | - Habiba Mohamud
- Faculty of Nursing (Kemei, Olanlesi-Aliu, Salami) and Health and Immigration Policies and Practices (HIPP) Research Program (Alaazi, Bukola Salami), University of Alberta, Edmonton, Alta.; Obstetrics and Gynaecology (Tunde-Byass), University of Toronto and North York General Hospital; Black Opportunity Fund (Sekyi-Otu), Toronto, Ont.; IMPACT Institute of Canada (Mohamud); Intersections of Gender Signature Area (Bukola Salami), University of Alberta, Edmonton, Alta
| | - Bukola Salami
- Faculty of Nursing (Kemei, Olanlesi-Aliu, Salami) and Health and Immigration Policies and Practices (HIPP) Research Program (Alaazi, Bukola Salami), University of Alberta, Edmonton, Alta.; Obstetrics and Gynaecology (Tunde-Byass), University of Toronto and North York General Hospital; Black Opportunity Fund (Sekyi-Otu), Toronto, Ont.; IMPACT Institute of Canada (Mohamud); Intersections of Gender Signature Area (Bukola Salami), University of Alberta, Edmonton, Alta.
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Salami B. Decolonizing research with Black youths. Nurs Philos 2023; 24:e12435. [PMID: 36919268 DOI: 10.1111/nup.12435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 03/03/2023] [Accepted: 03/06/2023] [Indexed: 03/16/2023]
Abstract
Black youths experience poor mental health especially due to anti-Black racism. Research related to Black youths have been conducted on Black youths with little or no participation or engagement rather than with Black youths. This paper presents information from a dialogue on decolonizing nursing research. I draw on interviews and conversation cafes with around 120 Black youths in Canada to identify strategies for decolonizing research with Black youths. First, I reflect on my relations with the Indigenous land in which the study was conducted as well as my positionality as a Black woman. In this paper, I discuss how community based participatory action research can integrate capacity building component, amplify youth's voices and capitalize on the agency of youths as fruitful actors. I also reflect on the opportunities and benefits of decolonizing nursing research.
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Affiliation(s)
- Bukola Salami
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
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18
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McCabe E, Amarbayan M(M, Rabi S, Mendoza J, Naqvi SF, Thapa Bajgain K, Zwicker JD, Santana M. Youth engagement in mental health research: A systematic review. Health Expect 2023; 26:30-50. [PMID: 36385452 PMCID: PMC9854331 DOI: 10.1111/hex.13650] [Citation(s) in RCA: 34] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 10/21/2022] [Accepted: 10/22/2022] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION Patient engagement in youth mental health research has the potential to inform research on the interventions, services and policies that will benefit youth. At present, there is little evidence to guide mental health researchers on youth engagement. This systematic review aims to describe the impacts of youth engagement on mental health research and to summarize youth engagement in mental health research. METHODS We searched the following databases: MEDLINE, EMBASE and PsycINFO, using a combination of subject headings, keywords and synonyms for the concepts 'patient engagement', 'youth' and 'mental health'. Articles that described engaging youth in mental health research were included. Two reviewers performed the study selection. Study characteristics, research activities performed by youth, impacts of youth engagement, challenges, and facilitators to engagement and recommendations for youth engagement described by authors were extracted. Quality appraisal involved determining the level of engagement of youth and the stage(s) of research where youth were involved. RESULTS The database search returned 2836 citations, 151 full-text articles were screened and 16 articles, representing 14 studies, were selected for inclusion. Youth were involved at nearly all stages of the research cycle, in either advisory or co-production roles. Youth engagement impacts included enhancing relevant research findings, data collection and analysis and dissemination to academic and stakeholder audiences. Both youth and academic researchers reported personal development across many domains. One negative impact reported was the increase in funding and resources needed for engagement. We produced a list of 35 recommendations under the headings of training, youth researcher composition, strategy, expectations, relationships, meeting approaches and engagement conditions. CONCLUSIONS This study provides an understanding of the impacts and recommendations of youth engagement in mental health research. The findings from this study may encourage researchers to engage youth in their mental health research and support youth engagement in funding applications. PATIENT AND PUBLIC CONTRIBUTION We consulted three youths with experience being engaged in mental health research about the review findings and the discussion. One youth designed a visual representation of the results and provided feedback on the manuscript. All youth's input informed the way the findings were presented and the focus of the discussion.
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Affiliation(s)
- Erin McCabe
- Department of Pediatrics, School of Public PolicyUniversity of CalgaryCalgaryAlbertaCanada
| | | | - Sarah Rabi
- Department of Community Health SciencesUniversity of CalgaryCalgaryAlbertaCanada
| | - Justino Mendoza
- Department of Biology, Faculty of Science and TechnologyMount Royal UniversityCalgaryAlbertaCanada
| | - Syeda Farwa Naqvi
- Department of Community Health SciencesUniversity of CalgaryCalgaryAlbertaCanada
| | | | - Jennifer D. Zwicker
- Department of Social Policy and Health, School of Public PolicyUniversity of CalgaryCalgaryAlbertaCanada
| | - Maria Santana
- Department of Pediatrics, Community Health SciencesUniversity of CalgaryCalgaryAlbertaCanada
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Otiono K, Nkonge B, Olaiya OR, Pierre S. Dépistage du cancer de la prostate chez les hommes noirs au Canada : Argument en faveur des soins stratifiés en fonction du risque. CMAJ 2023; 195:E101-E105. [PMID: 36649960 PMCID: PMC9851637 DOI: 10.1503/cmaj.220452-f] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Affiliation(s)
- Kikachukwu Otiono
- Faculté de médecine Michael G. DeGroote (Otiono), Exploration et commercialisation biomédicales (Nkonge) et Division de chirurgie plastique (Olaiya), Faculté des sciences de la santé, Université McMaster, Hamilton, Ont.; Division d'urologie (Pierre), Hôpital Queensway Carleton, Ottawa, Ont.
| | - Brenda Nkonge
- Faculté de médecine Michael G. DeGroote (Otiono), Exploration et commercialisation biomédicales (Nkonge) et Division de chirurgie plastique (Olaiya), Faculté des sciences de la santé, Université McMaster, Hamilton, Ont.; Division d'urologie (Pierre), Hôpital Queensway Carleton, Ottawa, Ont
| | - Oluwatobi R Olaiya
- Faculté de médecine Michael G. DeGroote (Otiono), Exploration et commercialisation biomédicales (Nkonge) et Division de chirurgie plastique (Olaiya), Faculté des sciences de la santé, Université McMaster, Hamilton, Ont.; Division d'urologie (Pierre), Hôpital Queensway Carleton, Ottawa, Ont
| | - Sean Pierre
- Faculté de médecine Michael G. DeGroote (Otiono), Exploration et commercialisation biomédicales (Nkonge) et Division de chirurgie plastique (Olaiya), Faculté des sciences de la santé, Université McMaster, Hamilton, Ont.; Division d'urologie (Pierre), Hôpital Queensway Carleton, Ottawa, Ont
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20
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Fortin G, Vandermorris A, Sall M, McKinnon B. Evaluation of a youth-led participatory action research to address adolescent sexual and reproductive health and rights issues in Senegal. Glob Public Health 2022; 17:2977-2990. [PMID: 35156552 DOI: 10.1080/17441692.2022.2038653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Participatory approaches are increasingly popular in public health, but remain little used to address adolescent health issues. However, adolescent participation in research has enormous potential for identifying solutions to health issues that concern them. In Senegal, a youth-led participatory action research (YPAR) project was implemented in four communities where teams of adolescents were trained to conduct a research project and identify solutions to address adolescent sexual and reproductive health and rights (ASRHR) issues. This article presents the results of the project evaluation, which aimed to explore the potential of YPAR to address ASRHR issues and inform future YPAR projects. Observations and interviews were carried out during results dissemination meetings in each of the communities. The evaluation of the project demonstrated the potential of YPAR to identify relevant solutions, while promoting positive and meaningful adolescent participation. Despite some difficulties, such as community resistance, the youth researchers were able to successfully complete their research project, while developing their confidence and self-esteem. The adolescents were convinced that they could act as agents of positive social change. This project has shown that it is possible and relevant to involve adolescents in research projects, and that this approach has significant potential in global health.
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Affiliation(s)
- Geneviève Fortin
- School of Public Health of the University of Montreal (ESPUM), Montreal, Canada.,Centre de recherche en santé publique (CReSP), Univeristy of Montreal, Montreal, Canada
| | - Ashley Vandermorris
- SickKids Centre for Global Child Health, University of Toronto, Toronto, Canada.,Division of Adolescent Medicine, Hospital for Sick Children, Toronto, Canada
| | - Mohamadou Sall
- Institut de population, développement et santé de la reproduction (IPDSR), University Cheikh Anta Diop, Dakar, Senegal
| | - Britt McKinnon
- SickKids Centre for Global Child Health, University of Toronto, Toronto, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
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21
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Otiono K, Nkonge B, Olaiya OR, Pierre S. Prostate cancer screening in Black men in Canada: a case for risk-stratified care. CMAJ 2022; 194:E1411-E1415. [PMID: 36280242 PMCID: PMC9616133 DOI: 10.1503/cmaj.220452] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Affiliation(s)
- Kikachukwu Otiono
- Michael G. DeGroote School of Medicine (Otiono), Biomedical Discovery and Commercialization (Nkonge) and Division of Plastic Surgery (Olaiya), Faculty of Health Sciences, McMaster University, Hamilton, Ont.; Division of Urology (Pierre), Queensway Carleton Hospital, Ottawa, Ont.
| | - Brenda Nkonge
- Michael G. DeGroote School of Medicine (Otiono), Biomedical Discovery and Commercialization (Nkonge) and Division of Plastic Surgery (Olaiya), Faculty of Health Sciences, McMaster University, Hamilton, Ont.; Division of Urology (Pierre), Queensway Carleton Hospital, Ottawa, Ont
| | - Oluwatobi R Olaiya
- Michael G. DeGroote School of Medicine (Otiono), Biomedical Discovery and Commercialization (Nkonge) and Division of Plastic Surgery (Olaiya), Faculty of Health Sciences, McMaster University, Hamilton, Ont.; Division of Urology (Pierre), Queensway Carleton Hospital, Ottawa, Ont
| | - Sean Pierre
- Michael G. DeGroote School of Medicine (Otiono), Biomedical Discovery and Commercialization (Nkonge) and Division of Plastic Surgery (Olaiya), Faculty of Health Sciences, McMaster University, Hamilton, Ont.; Division of Urology (Pierre), Queensway Carleton Hospital, Ottawa, Ont
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22
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Greene C, Urbanik MM, Samuels-Wortley K. "It Stays with You for Life": The Everyday Nature and Impact of Police Violence in Toronto's Inner-City. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10503. [PMID: 36078218 PMCID: PMC9518342 DOI: 10.3390/ijerph191710503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 08/02/2022] [Accepted: 08/11/2022] [Indexed: 06/15/2023]
Abstract
In recent years, police violence has amassed notable international attention from the public, practitioners, and academics alike. This paper explores experiences and perceptions of police violence in Canada, documenting the impacts of direct and vicarious experiences of police violence on inner-city residents. The study employed semi-structured interviews with 45 community members across three Toronto inner-city neighbourhoods. Using a general interview prompt guide, participants were asked a range of questions about their experiences with and perceptions of police, and particularly, of police violence in their community. The interviews were audio recorded, transcribed, thematically coded, and analyzed. All participants reported direct and/or vicarious experiences of police violence, and most described experiencing long-standing, and continual fear that police contact would result in harm to them. Further, participants described a variety of serious and negative outcomes associated with experiencing and/or witnessing police violence. Police violence in Canada is a public health issue that requires an integrated public health policy approach to address the negative outcomes associated with direct and vicarious police violence exposure.
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Affiliation(s)
- Carolyn Greene
- Faculty of Humanities and Social Sciences, Athabasca University, Athabasca, AB T9S 3A3, Canada
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De Sousa I, Varcoe C. Centering Black feminist thought in nursing praxis. Nurs Inq 2022; 29:e12473. [PMID: 34820943 PMCID: PMC9286449 DOI: 10.1111/nin.12473] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 10/22/2021] [Accepted: 10/23/2021] [Indexed: 12/24/2022]
Abstract
Femininity and whiteness dominate Western nursing, silencing ontologies and epistemologies that do not align with these dominant norms while perpetuating systemic racism and discrimination in nursing practice, education, research, nursing activism, and sociopolitical structures. We propose Black feminist thought as a praxis to decenter, deconstruct, and unseat these ideologies and systems of power. Drawing from the work of past and present Black feminist scholars, we examine the ontological and epistemological perspectives of Black feminist thought. These include (i) the uniqueness and particular experiences of people, (ii) the acceptance of ontological and epistemological pluralism of truths and ways of knowing, and (iii) the mandate for equity in the health, social, political, and environmental structures of society. By focusing our attention on lived experiences and voices of those systematically excluded in nursing practice, education, research, and society, Black feminist thought offers an anticolonial, antiracist, and antidiscriminatory foundation for more effectively upholding nursing's disciplinary mandate for social justice and equity.
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Affiliation(s)
- Ismalia De Sousa
- School of NursingUniversity of British ColumbiaVancouverBritish ColumbiaCanada
| | - Colleen Varcoe
- School of NursingUniversity of British ColumbiaVancouverBritish ColumbiaCanada
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