At the international level, evidence supports the position that regardless of whether a country is industrialized or less developed, vulnerable populations living in poor social conditions are at disproportionate risk of injury. The Aboriginal population of Canada is one such vulnerable population. In addition to poor social conditions and marginalization related to historical injustices, this population is faced with the challenge of working with little or no descriptive injury data relevant to the community level. It has been and continues to be a significant barrier to the adoption and implementation of injury prevention strategies and programs. Recognizing that surveillance is an intrinsic component of public health practice, this study was undertaken to address a critical data gap facing Aboriginal communities. The objective of the study was to develop the conceptual design of an injury surveillance framework that would be culturally relevant, that is 'acceptable and owned by the target population', and would meet the specific requirements for injury data and data collection methods for the study population. The methodology was undertaken with focus groups at national and community levels, and relied on the use of strategic activities such as benchmarking, guided discussions, nominal group technique exercises and critical document reviews. The process of benchmarking served to identify that injury surveillance systems described in the literature, linking data to action, are not a predominant reality. The locus of control is often removed from the population of interest and resides primarily with experts under the jurisdiction and control of designated authorities. In order for the surveillance system to have cultural relevance, the focus group identified that the locus of control must be defined by the population of interest at the community level, and that the system must be germane and flexible to consider the local environment. The Aboriginal framework proposed places the locus of control with the community, in partnership with its data sources. Surveillance activities remain largely distinct from communities of interest, leading us to consider whether structural changes can serve to promote a link between data and action. Traditional or standard surveillance systems, by virtue of their structure, promote a disassociation between information and community action. Data management under the complete jurisdiction of sources external to a community appears to obstruct potential linkages between information and action.
How Canadian dietitians define and use non-dieting and size acceptance approaches (SAAs) in the context of weight management was explored.
Fifteen focus groups with 104 dietitians were conducted in seven Canadian cities. Questions were designed to explore participants' understanding and use of non-dieting and SAAs, including counselling goals, techniques, and outcome measures. Sessions were tape-recorded, transcribed verbatim, coded, and analyzed using qualitative methods.
Participants generally agreed that non-dieting involves promoting healthy lifestyles and avoiding restrictive diets. Participants also agreed that size acceptance means accepting all body shapes and sizes and promoting comfort with one's body. Many dietitians said they use size acceptance only with appropriate clients, most often with those who are lighter or without other health risks. Others said that size acceptance, by definition, is appropriate for everyone. Opinions varied about the appropriateness of teaching portion sizes or using meal plans, and whether weight loss could be a goal of non-dieting and SAAs.
Views on the usefulness of non-dieting and size acceptance strategies in weight management counselling were related, at least partially, to the different understanding that dietitians had of these approaches. Terminology needs to be clarified when we speak about non-dieting and SAAs. The varied understanding about these concepts should help dietitians reflect on their own perspectives and practice.
This study examined students' perceptions of and suggestions for the Northern Fruit and Vegetable Program, a free, school-based fruit and vegetable snack program implemented in elementary schools in 2 regions of northern Ontario, Canada.
This was a qualitative study involving 18 focus groups with students in 11 elementary schools in the Porcupine region and 7 schools in the Algoma region. One hundred thirty-nine students from grades 5-8 participated in this study. Inductive content analysis was used to identify key themes.
Children perceived the Northern Fruit and Vegetable Program to be a valuable program that allowed them to try new fruits and vegetables (FVs). Participants stated they now eat more FVs at home and at school. Participants would like the program offered more frequently and with more variety.
Although children identified several areas for program improvement, they generally perceived the program to be positive and valuable in promoting FV consumption.
The aim of the present study was to examine the meaning and experiences of client supervision from the perspective of Norwegian public health nurses. The World Health Organization (WHO) states that new intervention strategies to improve public health are necessary. Supervision represents such a strategy. Three focus groups were interviewed twice. The data were analyzed by qualitative content analysis. The findings revealed three themes: (i) the meaning of the umbrella term client supervision; informing, teaching, giving advice and ensuring the quality of supervision; (ii) factors influencing supervision; the public health nurses' available time and competence and the clients' ability to be supervised; and (iii) events and content representing the complexity of conducting supervision. In conclusion, the width of the concept, the influencing factors and the complexity claim that public health nurses have competence to supervise.
Participation in physical activity is important for the positive development and well-being of youth. A community- academic partnership was formed to improve access to physical activity for youth in one disadvantaged community in Ottawa, Canada. After consulting this community, a new hip-hop dance intervention was implemented. Adolescents aged 11 to 16 years participated in one of two 3-month sessions. A girls-only and a boys-and-girls format were offered both sessions. This article investigates the implementation of the intervention from the perspective of the youth participants, parents, staff, and researchers. Multiple methods were used, including document review, observation, questionnaire, focus groups, and interviews. Overall, the consistency and quality of program implementation were moderately satisfactory; however, important concerns were noted and this program appeared to be only partially delivered as planned. These findings will be discussed in terms of suggestions for improving the implementation of this intervention and similar recreation programs prioritizing disadvantaged communities.
To determine how residents of the Inuit community of Nain, Nunatsiavut, Canada would like research results disseminated to their community.
Qualitative study using focus groups and key informant interviews.
As part of a larger study on food safety, one focus group was conducted with hunters (n=7) and a second with members of the general community (n=7) to determine research dissemination strategies previously used in the community, and to obtain recommendations for effective and appropriate strategies for future use. One-on-one key informant interviews were also conducted with Nain community members (n=5) selected for their insights on the study themes. Informants included a teacher, a nurse, a community elder, and one official from each of the Nain and Nunatsiavut governments. Data from focus groups and key informant interviews were combined and analysed using thematic analysis.
Open houses were identified as the preferred method to present research results to the community. Presentation methods should be interactive, visual and presented in both English and Inuktitut. Research dissemination efforts should be timely and involve both the researcher and a local official or community member to give the results additional validity and relevance. If possible, involving youth in the presentations will increase the impact of the message.
Preferred information dissemination techniques in this Inuit community echo successful techniques from research conducted in Aboriginal communities. Future knowledge translation efforts in Inuit communities should consider involving youth in presentations due to their influential nature within the community.
Systematic preventive health checks in primary care have been introduced in several countries. The Danish Health Service does not provide this service, but health checks are nevertheless being conducted unsystematically. Very little is known about the GPs' experience with this service.The purpose of our study is to describe GPs' attitudes towards and concerns about providing preventive health checks and to describe their experiences with the health checks that they provide in daily practice.
A qualitative descriptive study was conducted based on three semi-structured focus group interviews with 16 GPs from Central Region, Denmark. The focus group interviews took place at the Department of Public Health, Section for General Practice, Aarhus University in November 2010.
We found that the participating GPs all conducted some kind of preventive health checks, but also that there was great diversity in the content. The GPs were somewhat ambivalent towards health checks. Many GPs found the service beneficial for the patients. Concurrently, they had reservations about promoting ill-health, they questioned whether the health checks were a core mission of primary care, and they were concerned whether the health checks would benefit the "right" patients. The GPs felt a need for further documentation of the benefits for the patients before a possible future implementation of systematic health checks. Some GPs found that health checks could be performed in other settings than general practice.
Our study revealed that health checks are performed differently. Their quality differs, and the GPs perform the health check based on their personal attitude towards this service and prevention in general. Our analysis suggests that the doctors are basically uncertain about the best approach. Our study also uncovers the GPs' reservations about inducing negative psychological reactions and decreased well-being among the health check participants. Further studies are needed to disclose where these concerns emerge.
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Eat Smart! Ontario's Healthy Restaurant Program is a standard provincial health promotion program. Public health units give an award of excellence to restaurants that meet nutrition, food safety, and non-smoking seating standards. The purpose of this study was to determine why some restaurant operators have not applied to participate in the program, and how to get them to apply. Four focus group interviews were conducted with 35 operators who didn't apply to participate. The analysis of responses yielded various themes. The participants' perceived barriers to participation were misunderstandings about how to qualify for the program, lack of time, concern about different non-smoking bylaw requirements, and potential loss of revenue. Their perceived facilitators to participation were convenience of applying to participate, franchise executives' approval to participate, a 100% non-smoking bylaw, flexibility in the assessment of restaurants, the opportunity for positive advertising, alternative payment for food handler training, and customer demand. Program staff can use the findings to develop and use strategies to encourage participation.
The aim of this study was to investigate whether organic school meals can be an effective strategy to provide healthy food to children and promote their healthy eating habits. Furthermore, the study aimed to examine pupils' attitudes predicting intention and behaviours in relation to organic food and health. An observational cross-sectional study was designed, and the participants were 6th grade Danish pupils from two schools with organic food provision and two schools with non-organic food provision. The pupils were asked to complete an online adapted food frequency questionnaire, after which selected pupils were invited to focus group interviews. More positive school lunch habits were observed in pupils in the organic schools than in the non-organic schools. Generally all the pupils had positive attitudes towards organic food and health and this had a significant impact on their intention to consume organic food but not on their behaviour. In addition, all participants were willing to adopt healthier eating habits in the future both at school and in the home. These findings suggest that children attending schools where meals include organic ingredients might be more aware of healthy foods, organic foods and healthy eating habits.
The "Drugged Driving Kills project: Why Drive High?" social marketing campaign was developed and implemented by youth leaders and adult facilitators from public and community health to increase youth awareness of the adverse effects of marijuana on driving. The youth-led adult-guided project was founded on the Holden's youth empowerment conceptual model. This article reports on the results of the focus group evaluation, conducted to determine to what extent the tailored youth-led adult-guided framework for the "Why Drive High?" social marketing campaign provided an environment for youth leadership development.