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Describing the situational contexts of sweetened product consumption in a Middle Eastern Canadian community: application of a mixed method design.

https://arctichealth.org/en/permalink/ahliterature120228
Source
PLoS One. 2012;7(9):e44738
Publication Type
Article
Date
2012
Author
Jean-Claude Moubarac
Margaret Cargo
Olivier Receveur
Mark Daniel
Author Affiliation
�cole de Santé Publique, Université de Montréal, Montréal, Canada. jcmoubarac@gmail.com
Source
PLoS One. 2012;7(9):e44738
Date
2012
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Beverages
Canada
Cross-Sectional Studies
Dietary Sucrose
Female
Humans
Male
Middle Aged
Snacks
Sweetening Agents
Young Adult
Abstract
Little is known about the situational contexts in which individuals consume processed sources of dietary sugars. This study aimed to describe the situational contexts associated with the consumption of sweetened food and drink products in a Catholic Middle Eastern Canadian community. A two-stage exploratory sequential mixed-method design was employed with a rationale of triangulation. In stage 1 (n?=?62), items and themes describing the situational contexts of sweetened food and drink product consumption were identified from semi-structured interviews and were used to develop the content for the Situational Context Instrument for Sweetened Product Consumption (SCISPC). Face validity, readability and cultural relevance of the instrument were assessed. In stage 2 (n?=?192), a cross-sectional study was conducted and exploratory factor analysis was used to examine the structure of themes that emerged from the qualitative analysis as a means of furthering construct validation. The SCISPC reliability and predictive validity on the daily consumption of sweetened products were also assessed. In stage 1, six themes and 40-items describing the situational contexts of sweetened product consumption emerged from the qualitative analysis and were used to construct the first draft of the SCISPC. In stage 2, factor analysis enabled the clarification and/or expansion of the instrument's initial thematic structure. The revised SCISPC has seven factors and 31 items describing the situational contexts of sweetened product consumption. Initial validation of the instrument indicated it has excellent internal consistency and adequate test-retest reliability. Two factors of the SCISPC had predictive validity for the daily consumption of total sugar from sweetened products (Snacking and Energy demands) while the other factors (Socialization, Indulgence, Constraints, Visual Stimuli and Emotional needs) were rather associated to occasional consumption of these products.
Notes
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PubMed ID
23028597 View in PubMed
Less detail

Environmental risk conditions and pathways to cardiometabolic diseases in indigenous populations.

https://arctichealth.org/en/permalink/ahliterature138012
Source
Annu Rev Public Health. 2011;32:327-47
Publication Type
Article
Date
2011
Author
Mark Daniel
Peter Lekkas
Margaret Cargo
Ivana Stankov
Alex Brown
Author Affiliation
Social Epidemiology and Evaluation Research Unit, Sansom Institute for Health Research, University of South Australia, Adelaide, SA, Australia. mark.daniel@unisa.edu.au
Source
Annu Rev Public Health. 2011;32:327-47
Date
2011
Language
English
Publication Type
Article
Keywords
Cardiovascular Diseases - ethnology
Environment
Humans
Metabolic Diseases - ethnology
Population Groups
Risk factors
Abstract
This review examines environments in relation to cardiometabolic diseases in Indigenous populations in developed countries. Environmental factors are framed in terms of context (features of places) and composition (features of populations). Indigenous peoples are seen to have endured sociopolitical marginalization and material disadvantage spanning generations. Past adverse collective experiences, modified by culture, are reflected by current heterogeneity in environmental context and composition. As risk conditions, unfavorable contextual and compositional exposures influence the expression of cardiometabolic risk for individuals. Minimal research has evaluated heterogeneity in risk conditions against heterogeneity in cardiometabolic diseases between or within Indigenous populations. Thus far, the features of populations, not of places themselves, have been implicated in relation to cardiometabolic diseases. Behavioral, psychosocial, and stress-axis pathways may explain the relationships between risk conditions and cardiometabolic diseases. Implications of environmental factors and their pathways as well as important research needs are discussed in relation to ecological prevention to reduce cardiometabolic diseases.
PubMed ID
21219157 View in PubMed
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Legitimizing diabetes as a community health issue: a case analysis of an Aboriginal community in Canada.

https://arctichealth.org/en/permalink/ahliterature178873
Source
Health Promot Int. 2004 Sep;19(3):317-26
Publication Type
Article
Date
Sep-2004
Author
Sherri Bisset
Margaret Cargo
Treena Delormier
Ann C Macaulay
Louise Potvin
Author Affiliation
Groupe de Recherche Interdisciplinarie en Santé, Université de Montréal, C.P. 6128, Succ. Centre-ville, Montréal, Québec, Canada H3C 3J7. sherri.l.bisset@umontreal.ca
Source
Health Promot Int. 2004 Sep;19(3):317-26
Date
Sep-2004
Language
English
Publication Type
Article
Keywords
Canada - epidemiology
Community Health Planning - organization & administration
Diabetes Mellitus, Type 2 - ethnology - prevention & control
Female
Health Education - organization & administration
Health Services, Indigenous - organization & administration
Humans
Indians, North American
Male
Primary Prevention - organization & administration
Program Evaluation
Risk factors
Abstract
The Kahnawake Schools Diabetes Prevention Project (KSDPP) is an ongoing participatory research and intervention project aimed at the primary prevention of type 2 diabetes. Formally initiated in 1994 with strong community support, KSDPP provides a fertile opportunity to learn about how a community came to identify the need for preventive action on a health problem such as diabetes. The purpose of our study was to describe the various conditions in the community of Kahnawake, which gave rise to its mobilization for the prevention of type 2 diabetes. Qualitative data consisted of 12 individual interviews and one focus group with key community members and health professionals living and/or working in the community of Kahnawake, along with historically relevant documents. The data collection and analysis procedures of the grounded theory method were applied. Results describe a preceding phase to formal KSDPP implementation, triggered by returning research results on the community prevalence of type 2 diabetes. This phase of 'legitimizing diabetes as a community health issue' is characterized by a shift in the perceived preventability of diabetes among community members; from a problem that was to be lived with to a problem that was to be prevented. The shift in perceptions was facilitated by the context in the community, described by structural developments, cognitive and relational elements. In addition to reaffirming the critical importance of utilizing lay knowledge during the planning of a health promotion intervention, our study has uncovered some of the key conditions through which individuals in the community came to participate in the identification and planning of a diabetes prevention project.
PubMed ID
15306616 View in PubMed
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Aboriginal health workers experience multilevel barriers to quitting smoking: a qualitative study.

https://arctichealth.org/en/permalink/ahliterature124122
Source
Int J Equity Health. 2012;11:27
Publication Type
Article
Date
2012
Author
Anna P Dawson
Margaret Cargo
Harold Stewart
Alwin Chong
Mark Daniel
Author Affiliation
University of South Australia, Sansom Institute for Health Research, Social Epidemiology and Evaluation Research Group, GPO Box 2471, IPC: CEA-01, Adelaide, South Australia, 5001, Australia.
Source
Int J Equity Health. 2012;11:27
Date
2012
Language
English
Publication Type
Article
Keywords
Cultural Competency
Delivery of Health Care - ethnology - methods
Female
Focus Groups
Health Manpower - statistics & numerical data
Health Policy
Health Status Disparities
Healthcare Disparities - ethnology - statistics & numerical data
Humans
Interviews as Topic
Male
Oceanic Ancestry Group - psychology - statistics & numerical data
Smoking Cessation - ethnology - methods - psychology - statistics & numerical data
Abstract
Long-term measures to reduce tobacco consumption in Australia have had differential effects in the population. The prevalence of smoking in Aboriginal peoples is currently more than double that of the non-Aboriginal population. Aboriginal Health Workers are responsible for providing primary health care to Aboriginal clients including smoking cessation programs. However, Aboriginal Health Workers are frequently smokers themselves, and their smoking undermines the smoking cessation services they deliver to Aboriginal clients. An understanding of the barriers to quitting smoking experienced by Aboriginal Health Workers is needed to design culturally relevant smoking cessation programs. Once smoking is reduced in Aboriginal Health Workers, they may then be able to support Aboriginal clients to quit smoking.
We undertook a fundamental qualitative description study underpinned by social ecological theory. The research was participatory, and academic researchers worked in partnership with personnel from the local Aboriginal health council. The barriers Aboriginal Health Workers experience in relation to quitting smoking were explored in 34 semi-structured interviews (with 23 Aboriginal Health Workers and 11 other health staff) and 3 focus groups (n = 17 participants) with key informants. Content analysis was performed on transcribed text and interview notes.
Aboriginal Health Workers spoke of burdensome stress and grief which made them unable to prioritise quitting smoking. They lacked knowledge about quitting and access to culturally relevant quitting resources. Interpersonal obstacles included a social pressure to smoke, social exclusion when quitting, and few role models. In many workplaces, smoking was part of organisational culture and there were challenges to implementation of Smokefree policy. Respondents identified inadequate funding of tobacco programs and a lack of Smokefree public spaces as policy level barriers. The normalisation of smoking in Aboriginal society was an overarching challenge to quitting.
Aboriginal Health Workers experience multilevel barriers to quitting smoking that include personal, social, cultural and environmental factors. Multidimensional smoking cessation programs are needed that reduce the stress and burden for Aboriginal Health Workers; provide access to culturally relevant quitting resources; and address the prevailing normalisation of smoking in the family, workplace and community.
Notes
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PubMed ID
22621767 View in PubMed
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Implementing participatory intervention and research in communities: lessons from the Kahnawake Schools Diabetes Prevention Project in Canada.

https://arctichealth.org/en/permalink/ahliterature186552
Source
Soc Sci Med. 2003 Mar;56(6):1295-305
Publication Type
Article
Date
Mar-2003
Author
Louise Potvin
Margaret Cargo
Alex M McComber
Treena Delormier
Ann C Macaulay
Author Affiliation
Kahnawake Schools Diabetes Prevention Project, P.O. Box 1000, Kahnawake Territory, Mohawk Nation, Québec, Canada J0L 1B0. louise.potvin@umontreal.ca
Source
Soc Sci Med. 2003 Mar;56(6):1295-305
Date
Mar-2003
Language
English
Publication Type
Article
Keywords
Child
Community Health Planning - organization & administration - standards
Consumer Participation
Diabetes Mellitus, Type 2 - ethnology - prevention & control
Guidelines as Topic
Health Promotion - organization & administration
Humans
Indians, North American
Organizational Case Studies
Patient Participation
Primary Prevention - organization & administration
Program Development
Program Evaluation
Quebec
School Health Services - organization & administration
Social Justice
Abstract
Community public health interventions based on citizen and community participation are increasingly discussed as promising avenues for the reduction of health inequalities and the promotion of social justice. However, very few authors have provided explicit principles and guidelines for planning and implementing such interventions, especially when they are linked with research. Traditional approaches to public health programming emphasise expert knowledge, advanced detailed planning, and the separation of research from intervention. Despite the usefulness of these approaches for evaluating targeted narrow-focused interventions, they may not be appropriate in community health promotion, especially in Aboriginal communities. Using the experience of the Kahnawake Schools Diabetes Prevention Project, in Canada, this paper elaborates four principles as basic components for an implementation model of community programmes. The principles are: (1) the integration of community people and researchers as equal partners in every phase of the project, (2) the structural and functional integration of the intervention and evaluation research components, (3) having a flexible agenda responsive to demands from the broader environment, and (4) the creation of a project that represents learning opportunities for all those involved. The emerging implementation model for community interventions, as exemplified by this project, is one that conceives a programme as a dynamic social space, the contours and vision of which are defined through an ongoing negotiation process.
PubMed ID
12600366 View in PubMed
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A psychological autopsy study of suicide among Inuit in Nunavut: methodological and ethical considerations, feasibility and acceptability.

https://arctichealth.org/en/permalink/ahliterature115144
Source
Int J Circumpolar Health. 2013;72:20078
Publication Type
Article
Date
2013
Author
Eduardo Chachamovich
Jack Haggarty
Margaret Cargo
Jack Hicks
Laurence J Kirmayer
Gustavo Turecki
Author Affiliation
Department of Psychiatry, McGill Group for Suicide Studies, McGill University, Montreal, Quebec, Canada. eduardo.chachamovich@mcgill.ca
Source
Int J Circumpolar Health. 2013;72:20078
Date
2013
Language
English
Publication Type
Article
Keywords
Arctic Regions - epidemiology
Ethics, Research
Family Relations
Humans
Interpersonal Relations
Mental health
Models, Psychological
Motivation
Nunavut - epidemiology
Research Design
Retrospective Studies
Social Support
Socioeconomic Factors
Suicide - ethnology - psychology
Abstract
The increasing global prevalence of suicide has made it a major public health concern. Research designed to retrospectively study suicide cases is now being conducted in populations around the world. This field of research is especially crucial in Aboriginal populations, as they often have higher suicide rates than the rest of the country.
This article presents the methodological aspects of the first psychological autopsy study on suicide among Inuit in Nunavut. Qaujivallianiq Inuusirijauvalauqtunik (Learning from lives that have been lived) is a large case-control study, including all 120 cases of suicide by Inuit that occurred in Nunavut between 1 January 2003 and 31 December 2006. The article describes the research design, ethical considerations and strategies used to adapt the psychological autopsy method to Nunavut Inuit. Specifically, we present local social and cultural issues; data collection procedures; and the acceptability, reliability and validity of the method.
A retrospective case-control study using the psychological autopsy approach was carried out in 22 communities in Nunavut. A total of 498 individuals were directly interviewed, and medical and correctional charts were also reviewed.
The psychological autopsy method was well received by participants as they appreciated the opportunity to discuss the loss of a family member or friend by suicide. During interviews, informants readily identified symptoms of psychiatric disorders, although culture-specific rather than clinical explanations were sometimes provided. Results suggest that the psychological autopsy method can be effectively used in Inuit populations.
Notes
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PubMed ID
23539438 View in PubMed
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Suicide Among Inuit: Results From a Large, Epidemiologically Representative Follow-Back Study in Nunavut.

https://arctichealth.org/en/permalink/ahliterature264524
Source
Can J Psychiatry. 2015 Jun;60(6):268-75
Publication Type
Article
Date
Jun-2015
Author
Eduardo Chachamovich
Laurence J Kirmayer
John M Haggarty
Margaret Cargo
Rod Mccormick
Gustavo Turecki
Source
Can J Psychiatry. 2015 Jun;60(6):268-75
Date
Jun-2015
Language
English
Publication Type
Article
Abstract
The Inuit population in Canada's North has suffered from high rates of death by suicide. We report on the first large-scale, controlled, epidemiologically representative study of deaths by suicide in an Indigenous population, which investigates risk factors for suicide among all Inuit across Nunavut who died by suicide during a 4-year period.
We identified all suicides by Inuit (n = 120) that occurred between January 1, 2003, and December 31, 2006, in Nunavut. For each subject, we selected a community-matched control subject. We used proxy-based procedures and conducted structured interviews with informants to obtain life histories, Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Axis I and II diagnoses, and measures of impulsive and (or) aggressive traits.
Compared with control subjects, subjects who died by suicide were more likely to have experienced childhood abuse (OR 2.38; 95% CI 1.39 to 4.08), have family histories of major depressive disorder (P = 0.002) and suicide completion (P = 0.02), and have been affected by major depressive disorder (OR 13.00; 95% CI 6.20 to 27.25), alcohol dependence (OR 2.90; 95% CI 1.59 to 5.24), or cannabis dependence (OR 3.96; 95% CI 2.29 to 6.8) in the last 6 months. In addition, subjects who died by suicide were more likely to have been affected with cluster B personality disorders (OR 10.18; 95% CI 3.34 to 30.80) and had higher scores of impulsive and aggressive traits (P
PubMed ID
26175324 View in PubMed
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Can the democratic ideal of participatory research be achieved? An inside look at an academic-indigenous community partnership.

https://arctichealth.org/en/permalink/ahliterature159393
Source
Health Educ Res. 2008 Oct;23(5):904-14
Publication Type
Article
Date
Oct-2008
Author
Margaret Cargo
Treena Delormier
Lucie Lévesque
Kahente Horn-Miller
Alex McComber
Ann C Macaulay
Author Affiliation
Psychosocial Research Division, Douglas Hospital Research Centre-McGill University, Verdun, Québec, Canada H4H 1R3. margaret.cargo@unisa.edu.au
Source
Health Educ Res. 2008 Oct;23(5):904-14
Date
Oct-2008
Language
English
Publication Type
Article
Keywords
Adult
Canada
Community-Institutional Relations
Consumer Participation
Diabetes Mellitus, Type 2 - ethnology - prevention & control
Female
Health Services, Indigenous - organization & administration
Humans
Indians, North American
Male
Middle Aged
Abstract
Democratic or equal participation in decision making is an ideal that community and academic stakeholders engaged in participatory research strive to achieve. This ideal, however, may compete with indigenous peoples' right to self-determination. Study objectives were to assess the perceived influence of multiple community (indigenous) and academic stakeholders engaged in the Kahnawake Schools Diabetes Prevention Project (KSDPP) across six domains of project decision making and to test the hypothesis that KSDPP would be directed by community stakeholders. Self-report surveys were completed by 51 stakeholders comprising the KSDPP Community Advisory Board (CAB), KSDPP staff, academic researchers and supervisory board members. KSDPP staff were perceived to share similar levels of influence with (i) CAB on maintaining partnership ethics and CAB activities and (ii) academic researchers on research and dissemination activities. KSDPP staff were perceived to carry significantly more influence than other stakeholders on decisions related to annual activities, program operations and intervention activities. CAB and staff were the perceived owners of KSDPP. The strong community leadership aligns KSDPP with a model of community-directed research and suggests that equitable participation-distinct from democratic or equal participation-is reflected by indigenous community partners exerting greater influence than academic partners in decision making.
PubMed ID
18187491 View in PubMed
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Community governance of the Kahnawake Schools Diabetes Prevention Project, Kahnawake Territory, Mohawk Nation, Canada.

https://arctichealth.org/en/permalink/ahliterature184076
Source
Health Promot Int. 2003 Sep;18(3):177-87
Publication Type
Article
Date
Sep-2003
Author
Margaret Cargo
Lucie Lévesque
Ann C Macaulay
Alex McComber
Serge Desrosiers
Treena Delormier
Louise Potvin
Author Affiliation
KSDPP, Kahnawake Territory, Kanien'keh (Mohawk Nation), Québec, Canada. mcargo@total.net
Source
Health Promot Int. 2003 Sep;18(3):177-87
Date
Sep-2003
Language
English
Publication Type
Article
Keywords
Adult
Advisory Committees
Canada
Community Health Planning - organization & administration
Community Health Services - organization & administration
Consumer Participation
Cooperative Behavior
Decision Making
Diabetes Mellitus, Type 2 - ethnology - prevention & control
Diet
Exercise
Female
Health Promotion - organization & administration
Health Services, Indigenous - organization & administration
Humans
Indians, North American
Male
Middle Aged
Questionnaires
School Health Services - organization & administration
Abstract
Health promotion emphasizes the importance of community ownership in the governance of community-based programmes, yet little research has been conducted in this area. This study examined perceptions of community ownership among project partners taking responsibility for decision-making related to the Kahnawake Schools Diabetes Prevention Project (KSDPP). Project partners were surveyed cross-sectionally at 18 months (T1) and 60 months (T2) into the project. The perceived influence of each project partner was assessed at T1 and T2 for three domains: (i) KSDPP activities; (ii) KSDPP operations; and (iii) Community Advisory Board (CAB) activities. Project staff were perceived to have the greatest influence on KSDPP activities, KSDPP operations and CAB activities at both T1 and T2. High mean scores of perceived influence for CAB members and community researchers, however, suggests that project decision-making was a shared responsibility among multiple community partners. Although academic researcher influence was consistently low, they were satisfied with their level of influence. This was unlike community affiliates, who were less satisfied with their lower level of influence. In keeping with Kanien'kehaka (Mohawk) culture, the findings suggest a participatory democracy or shared decision-making as the primary mode of governance of KSDPP.
PubMed ID
12920138 View in PubMed
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Prevalence of psychological distress and mental disorders, and use of mental health services in the epidemiological catchment area of Montreal South-West.

https://arctichealth.org/en/permalink/ahliterature119350
Source
BMC Psychiatry. 2012;12:183
Publication Type
Article
Date
2012
Author
Jean Caron
Marie-Josée Fleury
Michel Perreault
Anne Crocker
Jacques Tremblay
Michel Tousignant
Yan Kestens
Margaret Cargo
Mark Daniel
Author Affiliation
Department of Psychiatry, McGill University, Douglas Mental Health University Institute Research Center, Montreal, Québec, Canada. jean.caron@mcgill.ca
Source
BMC Psychiatry. 2012;12:183
Date
2012
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Catchment Area (Health) - statistics & numerical data
Female
Health Services Needs and Demand - statistics & numerical data
Humans
Incidence
Longitudinal Studies
Male
Mental Disorders - epidemiology
Mental Health Services - utilization
Middle Aged
Prevalence
Quality of Life
Quebec - epidemiology
Residence Characteristics - statistics & numerical data
Risk factors
Risk-Taking
Self-Injurious Behavior - epidemiology
Stress, Psychological - epidemiology
Abstract
This report presents the initial results of the first Epidemiological Catchment Area Study in mental health in Canada. Five neighbourhoods in the South-West sector of Montreal, with a population of 258,000, were under study. The objectives of the research program were: 1) to assess the prevalence and incidence of psychological distress, mental disorders, substance abuse, parasuicide, risky behaviour and quality of life; 2) to examine the links and interactions between individual determinants, neighbourhood ecology and mental health in each neighbourhood; 3) to identify the conditions facilitating the integration of individuals with mental health problems; 4) to analyse the impact of the social, economic and physical aspects of the neighbourhoods using a geographic information system. 5) to verify the adequacy of mental health services.
A longitudinal study in the form of a community survey was used, complemented by focused qualitative sub-studies. The longitudinal study included a randomly selected sample of 2,433 individuals between the ages of 15 and 65 in the first wave of data collection, and three other waves are projected. An overview of the methods is presented.
The prevalence of psychological distress, mental disorders and use of mental health services and their correlates are described for the first wave of data collection.
Several vulnerable groups and risk factors related to socio-demographic variables have been identified such as: gender, age, marital status, income, immigration and language. These results can be used to improve treatment services, prevention of mental disorders, and mental health promotion.
Notes
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PubMed ID
23110632 View in PubMed
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