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Addressing the non-medical determinants of health: a survey of Canada's health regions.

https://arctichealth.org/en/permalink/ahliterature165318
Source
Can J Public Health. 2007 Jan-Feb;98(1):41-7
Publication Type
Article
Author
C James Frankish
Glen E Moulton
Darryl Quantz
Arlene J Carson
Ann L Casebeer
John D Eyles
Ronald Labonte
Brian E Evoy
Author Affiliation
Institute of Health Promotion Research, University of British Columbia, Vancouver. Frankish@interchange.ubc.ca
Source
Can J Public Health. 2007 Jan-Feb;98(1):41-7
Language
English
Publication Type
Article
Keywords
Canada
Cooperative Behavior
Health Care Reform - organization & administration
Health Priorities - organization & administration
Health Status Indicators
Humans
Interinstitutional Relations
Public Health Administration
Regional Health Planning - organization & administration
Rural Health
Socioeconomic Factors
Sociology, Medical
Urban health
Abstract
The Canadian health system is undergoing reform. Over the past decade a prominent trend has been creation of health regions. This structural shift is concurrent with a greater emphasis on population health and the broad determinants of health. In parallel, there is a movement toward more intersectoral collaboration (i.e., collaboration between diverse segments of the health system, and between the health system and other sectors of society). The purpose of this exploratory study is to determine the self-reported level of internal action (within regional health authorities) and intersectoral collaboration around 10 determinants of health by regional health authorities across Canada.
From September 2003 to February 2004, we undertook a survey of regional health authorities in Canadian provinces (N = 69). Using SPSS 12.0, we generated frequencies for the self-reported level of internal and intersectoral action for each determinant. Other analyses were done to compare rural/suburban and urban regions, and to compare Western, Central and Eastern Canada.
Of the 10 determinants of health surveyed, child development and personal health practices were self-reported by the majority of health regions to receive greatest attention, both internally and through intersectoral activities. Culture, gender and employment/working conditions received least attention in most regions.
The exploratory survey results give us the first Canadian snapshot of health regions' activities in relation to the broad range of non-medical determinants of health. They provide a starting data set for baselining future progress, and for beginning deeper analyses of specific areas of action and intersectoral collaboration.
PubMed ID
17278677 View in PubMed
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Assessment of communication barriers in community pharmacies.

https://arctichealth.org/en/permalink/ahliterature182710
Source
Eval Health Prof. 2003 Dec;26(4):380-403
Publication Type
Article
Date
Dec-2003
Author
Elan C Paluck
Lawrence W Green
C James Frankish
David W Fielding
Beth Haverkamp
Author Affiliation
Regina Qu'Appelle Health Region, Saskatchewan, Canada.
Source
Eval Health Prof. 2003 Dec;26(4):380-403
Date
Dec-2003
Language
English
Publication Type
Article
Keywords
Adult
Aged
Attitude of Health Personnel
British Columbia
Communication Barriers
Community Pharmacy Services - standards - statistics & numerical data - utilization
Drug Prescriptions
Female
Humans
Male
Middle Aged
Pharmacists - standards - statistics & numerical data
Pharmacy Administration
Professional-Patient Relations
Prospective Studies
Questionnaires
Regression Analysis
Reproducibility of Results
Verbal Behavior
Abstract
This study identified previously reported facilitators and barriers to pharmacist-client communication and then evaluated their impact on the observed communication behaviors of pharmacists. Pharmacists (n = 100) completed a seven-page questionnaire collecting information on 11 variables that had been organized according to the Policy, Regulatory and Organizational Constructs in Educational and Ecological Development (PROCEDE) model as predisposing, enabling, or reinforcing of pharmacist communication with their clients. Demographic variables also were included. "Communication quality" served as the study's dependent variable, whereas pharmacist responses served as the independent variables. Communication quality scores for each pharmacist were obtained from the analysis of 765 audiorecordings of verbal exchanges occurring between the study pharmacists and their consenting clients during 4-hour, on-site observation periods. Four of the variables examined in the study were found to share a unique relationship with communication quality (pharmacists' attitude, year of graduation, adherence expectations, and outcome expectations). Hierarchical multiple regression analysis revealed that the variables measured in the questionnaire accounted for 23% of the variance in communication quality scores. Plausible explanations for why the study was unable to capture more of the variance in its proposed relationships and future areas for research are provided.
PubMed ID
14631610 View in PubMed
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Challenges of citizen participation in regional health authorities.

https://arctichealth.org/en/permalink/ahliterature189795
Source
Soc Sci Med. 2002 May;54(10):1471-80
Publication Type
Article
Date
May-2002
Author
C James Frankish
Brenda Kwan
Pamela A Ratner
Joan Wharf Higgins
Craig Larsen
Author Affiliation
Institute of Health Promotion Research, University of British Columbia, Vancouver, Canada. frankish@interchange.ubc.ca
Source
Soc Sci Med. 2002 May;54(10):1471-80
Date
May-2002
Language
English
Publication Type
Article
Keywords
Canada
Consumer Participation
Governing Board
Health Care Reform
Health Planning Councils - organization & administration
Humans
Politics
Public Opinion
Regional Health Planning - organization & administration
Social Responsibility
Abstract
Citizen participation has been included as part of health reform, often in the form of lay health authorities. In Canada, these authorities are variously known as regional health boards or councils. A set of challenges is associated with citizen participation in regional health authorities. These challenges relate to: differences in opinion about whether there should be citizen participation at all; differences in perception of the levels and processes of participation; differences in opinion with respect to the roles and responsibilities of health authority members; differences in opinion about the appropriate composition of the authorities; differences in opinion about the requisite skills and attributes of health authority members; having a good support base (staff, good information, board development); understanding and operationalizing various roles of the board (governance and policy setting) versus the board staff (management and administration); difficulties in ensuring the accountability of the health authorities; and measuring the results of the work and decisions of the health authorities. Despite these challenges, regional health authorities are gaining support as both theoretically sound and pragmatically based approaches to health-system reform. This review of the above challenges suggests that each of the concerns remains a significant threat to meaningful public participation.
PubMed ID
12061482 View in PubMed
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Homelessness and health in Canada: research lessons and priorities.

https://arctichealth.org/en/permalink/ahliterature173498
Source
Can J Public Health. 2005 Mar-Apr;96 Suppl 2:S23-9
Publication Type
Article
Author
C James Frankish
Stephen W Hwang
Darryl Quantz
Author Affiliation
Institute of Health Promotion Research, University of British Columbia, Library Processing Center, Vancouver. frankish@interchg.ubc.ca
Source
Can J Public Health. 2005 Mar-Apr;96 Suppl 2:S23-9
Language
English
Publication Type
Article
Keywords
Adult
Alcoholism - epidemiology
Canada - epidemiology
Female
Health Behavior
Health Policy
Health status
Homeless Persons
Humans
Male
Mood Disorders - epidemiology
Poverty
Prevalence
Quality of Life
Substance-Related Disorders - epidemiology
Abstract
This article was for prepared for an international think-tank on reducing health disparities and promoting equity for vulnerable populations. Its purposes are to provide an overview of homelessness research and to stimulate discussion on strategic directions for research. We identified studies on homelessness, with an emphasis on Canadian research. Studies were grouped by focus and design under the following topics: the scope of homelessness, the health status of homeless persons, interventions to reduce homelessness and improve health, and strategic directions for future research. Key issues include the definition of homelessness, the scope of homelessness, its heterogeneity, and competing explanations of homelessness. Homeless people suffer from higher levels of disease and the causal pathways linking homelessness and poor health are complex. Efforts to reduce homelessness and improve health have included biomedical, educational, environmental, and policy strategies. Significant research gaps and opportunities exist in these areas. Strategic research will require stakeholder and community engagement, and more rigorous methods. Priorities include achievement of consensus on measuring homelessness, health status of the homeless, development of research infrastructure, and ensuring that future initiatives can be evaluated for effectiveness.
PubMed ID
16078553 View in PubMed
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Housing first improves residential stability in homeless adults with concurrent substance dependence and mental disorders.

https://arctichealth.org/en/permalink/ahliterature106555
Source
Am J Public Health. 2013 Dec;103 Suppl 2:e30-6
Publication Type
Article
Date
Dec-2013
Author
Anita Palepu
Michelle L Patterson
Akm Moniruzzaman
C James Frankish
Julian Somers
Author Affiliation
Anita Palepu is with the Department of Medicine, University of British Columbia, Vancouver, British Columbia. Michelle L. Patterson, Akm Moniruzzaman, and Julian Somers are with the Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia. C. James Frankish is with the School of Public and Population Health, University of British Columbia, Vancouver.
Source
Am J Public Health. 2013 Dec;103 Suppl 2:e30-6
Date
Dec-2013
Language
English
Publication Type
Article
Keywords
Adult
Canada - epidemiology
Chronic Disease - epidemiology
Female
Homeless Persons - psychology - statistics & numerical data
Housing - statistics & numerical data
Humans
Male
Mental Disorders - epidemiology
Middle Aged
Severity of Illness Index
Socioeconomic Factors
Substance-Related Disorders - epidemiology
Abstract
We examined the relationship between substance dependence and residential stability in homeless adults with current mental disorders 12 months after randomization to Housing First programs or treatment as usual (no housing or support through the study).
The Vancouver At Home study in Canada included 2 randomized controlled trials of Housing First interventions. Eligible participants met the criteria for homelessness or precarious housing, as well as a current mental disorder. Residential stability was defined as the number of days in stable residences 12 months after randomization. We used negative binomial regression modeling to examine the independent association between residential stability and substance dependence.
We recruited 497 participants, and 58% (n = 288) met the criteria for substance dependence. We found no significant association between substance dependence and residential stability (adjusted incidence rate ratio = 0.97; 95% confidence interval = 0.69, 1.35) after adjusting for housing intervention, employment, sociodemographics, chronic health conditions, mental disorder severity, psychiatric symptoms, and lifetime duration of homelessness.
People with mental disorders might achieve similar levels of housing stability from Housing First regardless of whether they experience concurrent substance dependence.
PubMed ID
24148035 View in PubMed
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Predictors and outcomes of household food insecurity among inner city families with preschool children in Vancouver.

https://arctichealth.org/en/permalink/ahliterature168395
Source
Can J Public Health. 2006 May-Jun;97(3):214-6
Publication Type
Article
Author
Margaret A Broughton
Patricia S Janssen
Clyde Hertzman
Sheila M Innis
C James Frankish
Author Affiliation
Health Care and Epidemiology, University of British Columbia, Vancouver. margaret_broughton@telus.net
Source
Can J Public Health. 2006 May-Jun;97(3):214-6
Language
English
Publication Type
Article
Keywords
British Columbia - epidemiology
Child Nutritional Physiological Phenomena
Child, Preschool
Cooking - instrumentation
Cross-Sectional Studies
Family Characteristics
Female
Food Supply - standards - statistics & numerical data
Humans
Hunger
Income
Male
Malnutrition - epidemiology - etiology
Nutritive Value
Risk assessment
Risk factors
Urban Health - statistics & numerical data
Abstract
The purposes of this study were to measure household food security and to determine its association with potential predictor variables related to household and community environments, as well as the relationship between household food insecurity and preschool children's nutritional status.
In this cross-sectional study, household food security was measured in a convenience sample of households (n=142) with children aged 2-5 years in Vancouver in March 2004. We assessed the association between environmental predictors and household food security status, adjusted for household income. Indicators of children's nutrition were compared between categories of household food security.
Household food insecurity was associated with indicators of suboptimal health status in preschoolers. After controlling for household income, parents with less access to food of reasonable quality, fewer kitchen appliances and a lower rating of their cooking skills had greater odds of experiencing household food insecurity.
Our study results support the need to test interventions involving collaborative efforts among government, social planners and public health practitioners to remove barriers to food security for families. Multiple measures, including opportunities to gain practical food skills and household resources that enable convenient preparation of nutrient-dense foods, could be examined. Our findings suggest the need for improved selection and quality at existing small stores and an increase in the number of food outlets in low-income neighbourhoods.
PubMed ID
16827410 View in PubMed
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Using patient-driven computers to provide cost-effective prevention in primary care: a conceptual framework.

https://arctichealth.org/en/permalink/ahliterature186780
Source
Health Promot Int. 2003 Mar;18(1):67-77
Publication Type
Article
Date
Mar-2003
Author
Anthony P Shakeshaft
C James Frankish
Author Affiliation
National Health and Medical Research Council of Australia. a.shakeshaft@unsw.edu.au
Source
Health Promot Int. 2003 Mar;18(1):67-77
Date
Mar-2003
Language
English
Publication Type
Article
Keywords
British Columbia
Computers
Cost-Benefit Analysis
Decision Support Systems, Clinical
Humans
New South Wales
Preventive Health Services - economics - methods
Primary Health Care - economics - methods
Systems Integration
Abstract
This paper initially presents a rationale for the cost-effectiveness of using patient-driven computers in primary care services. It specifically defines the concepts of prevention and primary care, prior to outlining the advantages of promoting the implementation of prevention practices in primary care. It argues that greater use of computer technology represents one means of cost-effectively optimizing the integration of prevention into routine primary care, and identifies an apparent disjuncture between the potential of computers and the limited success with which attempts to integrate them into routine primary care services have been met, as evidenced in the published international literature. Among several possible explanations for this disjuncture, such as a possible lack of precision with which computers identify at-risk patients, perceived high costs associated with computers and physicians' concerns about the inflexibility and the more impersonal nature of computer interactions, is the apparent failure of researchers to utilize well designed and empirically tested models in the planning, implementation and evaluation of computerized care. An outline for such an approach, utilizing the Precede-Proceed model of health promotion planning and the Diffusion of Innovations theory, is presented.
PubMed ID
12571094 View in PubMed
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7 records – page 1 of 1.