1
|
Parry K, Picard C, Devkota R, Tate K. Emergency Department Navigator Interventions and Outcome Measures: A Scoping Review. Int J Older People Nurs 2025; 20:e70026. [PMID: 40165450 PMCID: PMC11959214 DOI: 10.1111/opn.70026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2024] [Revised: 02/04/2025] [Accepted: 03/09/2025] [Indexed: 04/02/2025]
Abstract
INTRODUCTION Emergency department (ED) patient navigators are increasingly used, but a lack of understanding of how ED navigator interventions are designed, described, and evaluated creates gaps in our ability to understand, monitor and improve care. The purpose of this scoping review is to identify how the literature describes and evaluates ED patient navigator interventions for older people transitioning to a primary care setting. METHODS A scoping review was conducted following the Johanna Briggs Institute updated methodological guidance for the conduct of scoping reviews. We searched three databases: MEDLINE, EMBASE and CINAHL. We included English language articles without any restrictions on study designs that two reviewers screened. All articles focused on distinct ED navigator roles to facilitate transitions for older people from the ED to primary care were included. Data extraction was completed by the primary reviewer and validated by two secondary reviewers. We report study characteristics in a table. Descriptive content analysis was used to analyse the main findings. RESULTS A total of 10 studies were included out of 2102 articles identified. All studies used quantitative designs except one, which used a qualitative research design. Four studies were conducted in the United States, two in Australia and the UK and one in Canada and Belgium. Twenty unique outcome measures were identified, with hospital admission rate, frequency of ED presentations and ED/hospital length of stay being the most common. We identified six intervention components: assessment, consultation, liaison, development of care plan, referral and follow-up. Interventions using 4 or more components more commonly reported positive outcomes. Outcome measures used to evaluate interventions were often not tracked across care settings, potentially obscuring the impact of ED navigator interventions across the care continuum. CONCLUSION Future research should examine which patients benefit from ED navigation and which outcome measures might help contextualise intervention effectiveness across care settings.
Collapse
Affiliation(s)
| | | | - Rashmi Devkota
- Nursing, College of Health SciencesUniversity of AlbertaEdmontonCanada
| | - Kaitlyn Tate
- Nursing, College of Health SciencesUniversity of AlbertaEdmontonCanada
| |
Collapse
|
2
|
San Martin-Feeney D, Samborn S, Allemang B, Patton M, Punjwani Z, Pfister K, Ryan L, Guilcher GM, Hamiwka L, Klarenbach S, Lang E, McBrien K, Nettel-Aguirre A, Pacaud D, Pinzon J, Scott SD, Zwaigenbaum L, Perrott C, Andersen J, Andrew G, Mackie AS, Samuel S, Dimitropoulos G. Transition experiences of adolescents and young adults working with a patient navigator. HEALTH CARE TRANSITIONS 2024; 3:100088. [PMID: 39712475 PMCID: PMC11658225 DOI: 10.1016/j.hctj.2024.100088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/21/2024] [Revised: 11/25/2024] [Accepted: 11/25/2024] [Indexed: 12/24/2024]
Abstract
Introduction The transition from pediatric to adult care poses challenges for adolescents and young adults (AYA) with chronic conditions and their caregivers. A patient navigator (PN) intervention may mitigate transition-related barriers. Methods A qualitative study was conducted within a pragmatic randomized controlled trial. A purposive sample was recruited of AYA with diverse diagnostic and demographic characteristics who worked with the PN and/or their caregivers. Seventeen participants completed semi-structured interviews at baseline and post-intervention and optional journal entries. Thematic analysis was used inductively. Results Analysis yielded two themes from baseline interviews: 1) uncertainty and hesitation with leaving a place of support, 2) navigator assistance with post-secondary education, and three themes from post-intervention interviews: 1) emotional support, 2) informational and task-focused support, 3) navigator guidance to become more independent. Discussion Our findings describe the needs of AYA and the experience of PN support; our findings may guide future implementation of PNs in transition care.
Collapse
Affiliation(s)
| | - Sophie Samborn
- Department of Pediatrics, University of Calgary, Calgary, Canada
| | - Brooke Allemang
- Office of Patient, Family, and Community Engagement, Hospital for Sick Children, Calgary, Canada
- Child Health Evaluative Sciences, SickKids Research Institute, Calgary, Canada
- Factor-Inwentash Faculty of Social Work, University of Toronto, Canada
| | - Megan Patton
- Department of Pediatrics, University of Calgary, Calgary, Canada
| | - Zoya Punjwani
- Department of Pediatrics, University of Calgary, Calgary, Canada
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Ken Pfister
- Department of Pediatrics, University of Calgary, Calgary, Canada
| | - Laurel Ryan
- Department of Pediatrics, University of Calgary, Calgary, Canada
| | - Gregory M.T. Guilcher
- Section of Pediatric Oncology and Blood and Marrow Transplant, Cumming School of Medicine, University of Calgary, Canada
| | - Lorraine Hamiwka
- Department of Pediatrics, University of Calgary, Calgary, Canada
| | | | - Eddy Lang
- Department of Emergency Medicine, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Kerry McBrien
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Canada
- Department of Family Medicine, University of Calgary, Calgary, Canada
| | - Alberto Nettel-Aguirre
- Department of Pediatrics, University of Calgary, Calgary, Canada
- Faculty of Engineering and Information Services, University of Wollongong, Australia
| | - Danièle Pacaud
- Department of Pediatrics, University of Calgary, Calgary, Canada
- Alberta Children’s Hospital Research Institute, Calgary, Canada
| | - Jorge Pinzon
- Department of Pediatrics, University of Calgary, Calgary, Canada
| | | | | | | | - John Andersen
- Department of Pediatrics, University of Alberta, Edmonton, Canada
- Glenrose Rehabilitation Hospital, Edmonton, Canada
| | - Gail Andrew
- Department of Pediatrics, University of Alberta, Edmonton, Canada
| | - Andrew S. Mackie
- Department of Pediatrics, University of Alberta, Edmonton, Canada
- Stollery Children’s Hospital, Edmonton, Canada
| | - Susan Samuel
- Department of Pediatrics, University of Calgary, Calgary, Canada
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Canada
- Alberta Children’s Hospital Research Institute, Calgary, Canada
| | - Gina Dimitropoulos
- Alberta Children’s Hospital Research Institute, Calgary, Canada
- Faculty of Social Work, University of Calgary, Calgary, Canada
- Mathison Centre for Mental Health Research and Education, Calgary, Canada
| |
Collapse
|
3
|
Varanasi AP, Burhansstipanov L, Dorn C, Gentry S, Capossela MA, Fox K, Wilson D, Tanjasiri S, Odumosu O, Saavedra Ferrer EL. Patient navigation job roles by levels of experience: Workforce Development Task Group, National Navigation Roundtable. Cancer 2024; 130:1549-1567. [PMID: 38306297 DOI: 10.1002/cncr.35147] [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] [Indexed: 02/04/2024]
Abstract
PLAIN LANGUAGE SUMMARY Cancer patient navigators work in diverse settings ranging from community-based programs to comprehensive cancer centers to improve outcomes in underserved populations by eliminating barriers to timely cancer prevention, early detection, diagnosis, treatment, and survivorship in a culturally appropriate and competent manner. This article clarifies the roles and responsibilities of Entry, Intermediate, and Advanced level cancer patient navigators. The competencies described in this article apply to patient navigators, nurse navigators, and social work navigators. This article provides a resource for administrators to create job descriptions for navigators with specific levels of expertise and for patient navigators to advance their oncology careers and attain a higher level of expertise.
Collapse
Affiliation(s)
| | | | - Carrie Dorn
- National Association of Social Workers, Washington, DC, USA
| | - Sharon Gentry
- Academy of Oncology Nurse and Patient Navigators (AONN+), Lewisville, North Carolina, USA
| | | | - Kyandra Fox
- Patient Navigation, Education and Training, Susan G. Komen Foundation, Allen, Texas, USA
| | - Donna Wilson
- HCA Henrico Doctors' Hospital/Virginia Cancer Patient Navigator Network (VaCPNN), Midlothian, Virginia, USA
| | - Sora Tanjasiri
- Department of Health, Society and Behavior, University of Irvine, Irvine, California, USA
| | | | - Elba L Saavedra Ferrer
- College of Education and Human Sciences, University of New Mexico, Albuquerque, New Mexico, USA
| |
Collapse
|
4
|
Charlton P, Nagel DA, Azar R, Kean T, Campbell A, Lamontagne ME, Déry J, Kelly KJ, Fahim C. 'Snapshot in time': a cross-sectional study exploring stakeholder experiences with environmental scans in health services delivery research. BMJ Open 2024; 14:e075374. [PMID: 38309766 PMCID: PMC10840033 DOI: 10.1136/bmjopen-2023-075374] [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: 05/05/2023] [Accepted: 11/21/2023] [Indexed: 02/05/2024] Open
Abstract
OBJECTIVE To describe stakeholder characteristics and perspectives about experiences, challenges and information needs related to the use of environmental scans (ESs). DESIGN Cross-sectional study. SETTING AND PARTICIPANTS A web-based survey platform was used to disseminate an online survey to stakeholders who had experience with conducting ESs in a health services delivery context (eg, researchers, policy makers, practitioners). Participants were recruited through purposive and snowball sampling. The survey was disseminated internationally, was available in English and French, and remained open for 6 weeks (15 October to 30 November 2022). ANALYSIS Descriptive statistics were used to describe the characteristics and experiences of stakeholders. Thematic analysis was used to analyse the open-text questions. RESULTS Of 47 participants who responded to the survey, 94% were from Canada, 4% from the USA and 2% from Australia. Respondents represented academic institutions (57%), health agency/government (32%) and non-government organisations or agencies (11%). Three themes were identified: (a) having a sense of value and utility; (b) experiencing uncertainty and confusion; and (c) seeking guidance. The data suggest stakeholders found value and utility in ESs and conducted them for varied purposes including to: (a) enhance knowledge, understanding and learning about the current landscape or state of various features of health services delivery (eg, programmes, practices, policies, services, best practices); (b) expose needs, service barriers, challenges, gaps, threats, opportunities; (c) help guide action for planning, policy and programme development; and (d) inform recommendations and decision-making. Stakeholders also experienced conceptual, methodological and practical barriers when conducting ESs, and expressed a need for methodological guidance delivered through published guidelines, checklists and other means. CONCLUSION ESs have value and utility for addressing health services delivery concerns, but conceptual and methodological challenges exist. Further research is needed to help advance the ES as a distinct design that provides a systematic approach to planning and conducting ESs.
Collapse
Affiliation(s)
- Patricia Charlton
- Adjunct Faculty, Faculty of Nursing, University of Prince Edward Island, Charlottetown, Prince Edward Island, Canada
| | - Daniel A Nagel
- College of Nursing, University of Manitoba Rady Faculty of Health Sciences, Winnipeg, Manitoba, Canada
| | - Rima Azar
- Psychology Department, Mount Allison University, Sackville, New Brunswick, Canada
| | - Terri Kean
- Faculty of Nursing (Retired), University of Prince Edward Island, Charlottetown, Prince Edward Island, Canada
| | - Alyson Campbell
- Faculty of Nursing, University of Prince Edward Island, Charlottetown, Prince Edward Island, Canada
| | | | - Julien Déry
- Interdisciplinary Center for Research in Rehabilitation and Social Integration, Laval University, Quebec city, Quebec, Canada
| | - Katherine Jennifer Kelly
- Department of Applied Human Sciences, University of Prince Edward Island, Charlottetown, Prince Edward Island, Canada
| | | |
Collapse
|
5
|
Yeh SCJ, Wang WC, Yu HC, Wu TY, Lo YY, Shi HY, Chou HC. Relationship between using cancer resource center services and patient outcomes. Support Care Cancer 2023; 31:706. [PMID: 37975908 DOI: 10.1007/s00520-023-08169-5] [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: 04/28/2023] [Accepted: 11/07/2023] [Indexed: 11/19/2023]
Abstract
PURPOSE Psychological and social support are crucial in treating cancer. Cancer resource centers provide patients with cancer and their families with services that can help them through cancer treatment, ensure that patients receive adequate treatment, and reduce cancer-related stress. These centers offer various services, including medical guidance, health education, emotional assistance (e.g., consultations for cancer care), and access to resources such as financial aid and post recovery programs. In this study, we comprehensively analyzed how cancer resource centers assist patients with cancer and improve their clinical outcomes. METHODS The study participants comprised patients initially diagnosed with head and neck cancer or esophageal cancer. A total of 2442 patients from a medical center in Taiwan were included in the study. Data were analyzed through logistic regression and Cox proportional hazards regression. RESULTS The results indicate that unemployment, blue-collar work, and a lower education level were associated with higher utilization of cancer resource center services. The patients who were unemployed or engaged in blue-collar work had higher risks of mortality than did their white-collar counterparts. Patient education programs can significantly improve the survival probability of patients with cancer. On the basis of our evaluation of the utilization and benefits of services provided by cancer resource centers, we offer recommendations for improving the functioning of support systems for patients with cancer and provide suggestions for relevant future research. CONCLUSIONS We conclude that cancer resource centers provide substantial support for patients of low socioeconomic status and improve patients' survival.
Collapse
Affiliation(s)
- Shu-Chuan Jennifer Yeh
- Institute of Health Care Management & Department of Business Management, National Sun Yat-Sen University, 70 Lian Hai Road, Kaohsiung, 80424, Taiwan.
| | - Wen Chun Wang
- Department of Business Management, National Sun Yat-Sen University, Kaohsiung, Taiwan
| | - Hsien-Chung Yu
- Division of Gastroenterology, Department of Internal Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Tzu-Yu Wu
- National Taiwan University Hospital Research Ethics Committee Office, Taipei, Taiwan
| | - Ying-Ying Lo
- Department of Healthcare Administration, I-Shou University, Kaohsiung, Taiwan
| | - Hon-Yi Shi
- Department of Healthcare Administration and Medical Informatics, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Hsueh-Chih Chou
- Department of Business Management, National Sun Yat-Sen University, Kaohsiung, Taiwan
- Department of Nursing, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| |
Collapse
|
6
|
Chan RJ, Milch VE, Crawford-Williams F, Agbejule OA, Joseph R, Johal J, Dick N, Wallen MP, Ratcliffe J, Agarwal A, Nekhlyudov L, Tieu M, Al-Momani M, Turnbull S, Sathiaraj R, Keefe D, Hart NH. Patient navigation across the cancer care continuum: An overview of systematic reviews and emerging literature. CA Cancer J Clin 2023; 73:565-589. [PMID: 37358040 DOI: 10.3322/caac.21788] [Citation(s) in RCA: 116] [Impact Index Per Article: 58.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2022] [Revised: 03/30/2023] [Accepted: 03/31/2023] [Indexed: 06/27/2023] Open
Abstract
Patient navigation is a strategy for overcoming barriers to reduce disparities and to improve access and outcomes. The aim of this umbrella review was to identify, critically appraise, synthesize, and present the best available evidence to inform policy and planning regarding patient navigation across the cancer continuum. Systematic reviews examining navigation in cancer care were identified in the Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, Embase, Cumulative Index of Nursing and Allied Health (CINAHL), Epistemonikos, and Prospective Register of Systematic Reviews (PROSPERO) databases and in the gray literature from January 1, 2012, to April 19, 2022. Data were screened, extracted, and appraised independently by two authors. The JBI Critical Appraisal Checklist for Systematic Review and Research Syntheses was used for quality appraisal. Emerging literature up to May 25, 2022, was also explored to capture primary research published beyond the coverage of included systematic reviews. Of the 2062 unique records identified, 61 systematic reviews were included. Fifty-four reviews were quantitative or mixed-methods reviews, reporting on the effectiveness of cancer patient navigation, including 12 reviews reporting costs or cost-effectiveness outcomes. Seven qualitative reviews explored navigation needs, barriers, and experiences. In addition, 53 primary studies published since 2021 were included. Patient navigation is effective in improving participation in cancer screening and reducing the time from screening to diagnosis and from diagnosis to treatment initiation. Emerging evidence suggests that patient navigation improves quality of life and patient satisfaction with care in the survivorship phase and reduces hospital readmission in the active treatment and survivorship care phases. Palliative care data were extremely limited. Economic evaluations from the United States suggest the potential cost-effectiveness of navigation in screening programs.
Collapse
Affiliation(s)
- Raymond J Chan
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
- Cancer and Palliative Care Outcomes Centre, School of Nursing, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Vivienne E Milch
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
- Cancer Australia, Sydney, New South Wales, Australia
- School of Medicine, The University of Notre Dame Australia, Sydney, New South Wales, Australia
| | - Fiona Crawford-Williams
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
| | - Oluwaseyifunmi Andi Agbejule
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
| | - Ria Joseph
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
| | - Jolyn Johal
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
| | - Narayanee Dick
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
| | - Matthew P Wallen
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
- Institute of Health and Wellbeing, Federation University Australia, Ballarat, Victoria, Australia
| | - Julie Ratcliffe
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
| | - Anupriya Agarwal
- Cancer Australia, Sydney, New South Wales, Australia
- National Health and Medical Research Council Clinical Trials Centre, The University of Sydney, Sydney, New South Wales, Australia
- Faculty of Medicine and Health, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia
| | - Larissa Nekhlyudov
- Internal Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Matthew Tieu
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
| | | | | | | | - Dorothy Keefe
- Cancer Australia, Sydney, New South Wales, Australia
- School of Medicine, University of Adelaide, Adelaide, South Australia, Australia
| | - Nicolas H Hart
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
- Cancer and Palliative Care Outcomes Centre, School of Nursing, Queensland University of Technology, Brisbane, Queensland, Australia
- Institute for Health Research, The University of Notre Dame Australia, Perth, Western Australia, Australia
- Exercise Medicine Research Institute, Edith Cowan University, Perth, Western Australia, Australia
- Human Performance Research Centre, Innovative Solutions for Well-being and Health (INSIGHT) Research Institute, Faculty of Health, University of Technology Sydney (UTS), Sydney, New South Wales, Australia
| |
Collapse
|
7
|
Spithoff S, Mogic L. Enterprise Healthcare Physician Services in Canada: An Environmental Scan. Healthc Policy 2023; 19:71-80. [PMID: 37695709 PMCID: PMC10519332 DOI: 10.12927/hcpol.2023.27155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/13/2023] Open
Abstract
Employers in Canada are increasingly offering physician services to their employees through third-party "enterprise" virtual care platforms. In our environmental scan, we identified nine enterprise healthcare companies offering physician services to millions of Canadian employees via enterprise platforms. All platforms offered rapid access to virtual physician services. Some offered in-person visits, access to specialists, health system navigation and sharing of information with an employee's regular care provider. Almost half shared aggregate or de-identified health data with employers. These platforms provide rapid and convenient access to physician services but also disrupt the continuity of care, pose risks to employee privacy and expand two-tiered healthcare.
Collapse
Affiliation(s)
- Sheryl Spithoff
- Assistant Professor Department of Family and Community Medicine University of Toronto Scientist Women's College Hospital Research Institute Women's College Hospital, Toronto, ON
| | - Lana Mogic
- Research Assistant Department of Family and Community Medicine Women's College Hospital Toronto, ON
| |
Collapse
|
8
|
Finlay B, Wittevrongel K, Materula D, Hébert ML, O'Grady K, Lach LM, Nicholas D, Zwicker JD. Pan-Canadian caregiver experiences in accessing government disability programs: A mixed methods study. RESEARCH IN DEVELOPMENTAL DISABILITIES 2023; 134:104420. [PMID: 36621140 DOI: 10.1016/j.ridd.2022.104420] [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: 07/15/2022] [Revised: 12/14/2022] [Accepted: 12/30/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND At present, little is known about the factors that contribute to the relatively low uptake of government-funded disability programs in Canada. AIM Understand how parents/caregivers of Canadian youth with neurodevelopmental disability (NDD) experience the process of applying for and accessing disability programs. METHODS AND PROCEDURES This mixed methods sequential explanatory study utilized two phases: an online survey (quantitative), followed by semi-structured interviews (qualitative). The quantitative phase gathered sociodemographic information and preliminary information about participant experiences applying for and accessing programs. The qualitative phase provided greater depth by asking participants to describe barriers and facilitators to program access. OUTCOMES AND RESULTS 499 participants completed the online survey and 81 participants completed an interview. Analysis of survey data revealed that many participants are not accessing disability programs and experience difficulty when applying. Regression analyses revealed that factors relating to the process of applying and applicant/family attributes are significantly associated with program access. Inductive thematic analysis of interview data revealed four barriers and three facilitators to access. Integration of findings provided an overview of the multi-faceted journey to program access. CONCLUSIONS AND IMPLICATIONS The results of this study highlight policy changes that are needed to ensure disability programs adequately support Canadian families.
Collapse
Affiliation(s)
- Brittany Finlay
- School of Public Policy, University of Calgary, Downtown Campus (5th floor), 906 8th Ave SW, Calgary, AB T2P 1H, Canada.
| | - Krystle Wittevrongel
- School of Public Policy, University of Calgary, Downtown Campus (5th floor), 906 8th Ave SW, Calgary, AB T2P 1H, Canada.
| | - Dercia Materula
- School of Public Policy, University of Calgary, Downtown Campus (5th floor), 906 8th Ave SW, Calgary, AB T2P 1H, Canada.
| | - Michèle L Hébert
- School of Public Policy, University of Calgary, Downtown Campus (5th floor), 906 8th Ave SW, Calgary, AB T2P 1H, Canada; Faculty of Social Work, University of Calgary, Canada Central and Northern Alberta Region, 3-250, 10230 Jasper Avenue, Edmonton T5J 4P6, AB, Canada.
| | - Kathleen O'Grady
- Simone de Beauvoir Institute, Concordia University, ER building, 2155 Guy St., 6th floor, Montréal H3H 2R9, QC, Canada.
| | - Lucyna M Lach
- School of Social Work, McGill University, 550 Sherbrooke Ouest, Suite 100, Tour Est, Montréal H3A 1B9, QC, Canada.
| | - David Nicholas
- Faculty of Social Work, University of Calgary, Canada Central and Northern Alberta Region, 3-250, 10230 Jasper Avenue, Edmonton T5J 4P6, AB, Canada.
| | - Jennifer D Zwicker
- School of Public Policy, University of Calgary, Downtown Campus (5th floor), 906 8th Ave SW, Calgary, AB T2P 1H, Canada; Faculty of Kinesiology, University of Calgary, 2500 University Drive NW, Calgary T2N 1N4, AB, Canada.
| |
Collapse
|