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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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'About time!' Insights from Research with Pride: a community-student collaboration.

https://arctichealth.org/en/permalink/ahliterature131754
Source
Health Promot Int. 2012 Sep;27(3):372-81
Publication Type
Article
Date
Sep-2012
Author
Kira A Abelsohn
Jessica M Ferne
Kyle A Scanlon
Broden L Giambrone
Sivan B Bomze
Author Affiliation
The 519 Church Street Community Centre, Toronto, Canada. kira.abelsohn@gmail.com
Source
Health Promot Int. 2012 Sep;27(3):372-81
Date
Sep-2012
Language
English
Publication Type
Article
Keywords
Community Health Services
Community-Based Participatory Research
Cooperative Behavior
Female
Health Promotion - organization & administration
Healthcare Disparities
Homosexuality
Homosexuality, Female
Homosexuality, Male
Humans
Male
Ontario
Students
Universities
Abstract
Research with Pride (RwP) was a community-student collaborative initiative to promote and build capacity for community-based research exploring health and wellness in lesbian, bisexual, trans and queer (LGBTQ) communities. The event took place at University of Toronto's Dalla Lana School of Public Health (DLSPH) in September 2009, and engaged over 100 students, community members and academic researchers in a full day of discussion, learning and networking. RwP was initiated by a group of graduate students in Health Promotion who identified a gap in resources addressing LGBTQ health, facilitating their further learning and work in this area. By engaging in a partnership with a community service organization serving LGBTQ communities in downtown Toronto, RwP emerges as a key example of the role of community-student partnerships in the pursuit of LGBTQ health promotion. This paper will describe the nature of this partnership, outline its strengths and challenges and emphasize the integral role of community-student partnerships in health promotion initiatives.
PubMed ID
21880613 View in PubMed
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Access to emergency operative care: a comparative study between the Canadian and American health care systems.

https://arctichealth.org/en/permalink/ahliterature149522
Source
Surgery. 2009 Aug;146(2):300-7
Publication Type
Article
Date
Aug-2009
Author
Susan A Krajewski
S Morad Hameed
Douglas S Smink
Selwyn O Rogers
Author Affiliation
Department of Surgery, University of British Columbia, Vancouver, British Columbia, Canada. susankrajewski@post.harvard.edu
Source
Surgery. 2009 Aug;146(2):300-7
Date
Aug-2009
Language
English
Publication Type
Article
Keywords
Adult
Appendicitis - pathology - surgery
Canada
Emergency medical services
Ethnic Groups
Female
Health Services Accessibility
Healthcare Disparities
Humans
Income
Insurance, Health
Male
Medicaid
Medicare
Middle Aged
National Health Programs
Socioeconomic Factors
United States
Universal Coverage
Young Adult
Abstract
Canada provides universal health insurance to all citizens, whereas 47 million Americans are uninsured. There has not been a study comparing access to emergency operative care between the 2 countries. As both countries contemplate changes in health care delivery, such comparisons are needed to guide health policy decisions. The purpose of this study is to determine whether or not there is a difference in access to emergency operative care between Canada and the United States.
All patients diagnosed with acute appendicitis from 2001 to 2005 were identified in the Canadian Institute for Health Information database and the US Nationwide Inpatient Sample. Severity of appendicitis was determined by ICD-9 codes. Patients were further characterized by age, gender, insurance status, race, and socioeconomic status (SES; income). Univariate and multivariate analyses were performed to determine the odds of appendiceal perforation at different levels of SES in each country.
There were 102,692 Canadian patients and 276,890 American patients with acute appendicitis. In Canada, there was no difference in the odds of perforation between income levels. In the United States, there was a significant, inverse relationship between income level and the odds of perforation. The odds of perforation in the lowest income quartile were significantly higher than the odds of perforation in the highest income bracket (odds ratio, 1.20; 95% confidence interval, 1.16-1.24).
The results suggest that access to emergency operative care is related to SES in the United States, but not in Canada. This difference could result from the concern over the ability to pay medical bills or the lack of a stable relationship with a primary care provider that can occur outside of a universal health care system.
PubMed ID
19628089 View in PubMed
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Access to fertility services for lesbian women in Canada.

https://arctichealth.org/en/permalink/ahliterature112457
Source
Fertil Steril. 2013 Oct;100(4):1077-80
Publication Type
Article
Date
Oct-2013
Author
Shannon L Corbett
Helena M Frecker
Heather M Shapiro
Mark H Yudin
Author Affiliation
Ottawa Fertility Centre, University of Ottawa, Ottawa, Ontario, Canada. Electronic address: scorbett@conceive.ca.
Source
Fertil Steril. 2013 Oct;100(4):1077-80
Date
Oct-2013
Language
English
Publication Type
Article
Keywords
Ambulatory Care Facilities - organization & administration
Canada
Female
Fertility
Health Care Surveys
Health Policy
Health Services Accessibility
Healthcare Disparities
Homosexuality, Female
Humans
Questionnaires
Reproductive Techniques, Assisted
Sex Factors
Women's Health Services - organization & administration
Abstract
To determine reproductive services offered to lesbian patients by Canadian fertility clinics, policies of practice, ease of access to these services, and sensitivity of clinics to this population of patients.
Survey sent to assisted reproductive technology (ART) clinic directors.
Academic medical center, university-based ethics institute.
None.
The percentage of Canadian fertility clinics that will provide reproductive services to lesbian patients; services offered; the presence of clinic policies on lesbian care; and the presence on web sites of heteronormative material.
Completed surveys were received from 71% (24/34) of clinics. All clinics surveyed provided reproductive services to lesbian patients, with the exception of one clinic. Five of 24 (21%) clinics have a written policy on care for lesbian patients; 29% (7/24) will provide services to lesbian patients without prior investigations. All clinics will offer IUI and cycle monitoring to lesbian patients. Twenty-three of 24 clinics (96%) will offer IVF services when required. Fourteen of 32 clinic web sites (44%) make mention of lesbian patients and 27% (8/30) have heteronormative information only.
Lesbians encounter several barriers to accessing reproductive services in Canada. Addressing these issues could improve experiences of lesbian women and couples seeking care at fertility clinics.
PubMed ID
23830154 View in PubMed
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Access to health care among status Aboriginal people with chronic kidney disease.

https://arctichealth.org/en/permalink/ahliterature154422
Source
CMAJ. 2008 Nov 4;179(10):1007-12
Publication Type
Article
Date
Nov-4-2008
Author
Song Gao
Braden J Manns
Bruce F Culleton
Marcello Tonelli
Hude Quan
Lynden Crowshoe
William A Ghali
Lawrence W Svenson
Sofia Ahmed
Brenda R Hemmelgarn
Author Affiliation
Department of Medicine, Division of Nephrology, University of Calgary, Calgary, AB.
Source
CMAJ. 2008 Nov 4;179(10):1007-12
Date
Nov-4-2008
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Alberta - epidemiology
Chronic Disease
Creatinine - blood
Delphi Technique
Female
Glomerular Filtration Rate
Health Services Accessibility
Healthcare Disparities
Humans
Indians, North American - statistics & numerical data
Kidney Diseases - epidemiology
Male
Middle Aged
Nephrology
Office visits - statistics & numerical data
Patient Admission - statistics & numerical data
Registries
Severity of Illness Index
Abstract
Ethnic disparities in access to health care and health outcomes are well documented. It is unclear whether similar differences exist between Aboriginal and non-Aboriginal people with chronic kidney disease in Canada. We determined whether access to care differed between status Aboriginal people (Aboriginal people registered under the federal Indian Act) and non-Aboriginal people with chronic kidney disease.
We identified 106 511 non-Aboriginal and 1182 Aboriginal patients with chronic kidney disease (estimated glomerular filtration rate less than 60 mL/min/1.73 m(2)). We compared outcomes, including hospital admissions, that may have been preventable with appropriate outpatient care (ambulatory-care-sensitive conditions) as well as use of specialist services, including visits to nephrologists and general internists.
Aboriginal people were almost twice as likely as non-Aboriginal people to be admitted to hospital for an ambulatory-care-sensitive condition (rate ratio 1.77, 95% confidence interval [CI] 1.46-2.13). Aboriginal people with severe chronic kidney disease (estimated glomerular filtration rate
Notes
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Comment In: CMAJ. 2008 Nov 4;179(10):985-618981431
PubMed ID
18981441 View in PubMed
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Access to health care for undocumented migrant children and pregnant women: the paradox between values and attitudes of health care professionals.

https://arctichealth.org/en/permalink/ahliterature126329
Source
Matern Child Health J. 2013 Feb;17(2):292-8
Publication Type
Article
Date
Feb-2013
Author
Mónica Ruiz-Casares
Cécile Rousseau
Audrey Laurin-Lamothe
Joanna Anneke Rummens
Phyllis Zelkowitz
François Crépeau
Nicolas Steinmetz
Author Affiliation
Department of Psychiatry, McGill University, Montreal, Canada. monica.ruizcasares@mcgill.ca
Source
Matern Child Health J. 2013 Feb;17(2):292-8
Date
Feb-2013
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Attitude of Health Personnel
Canada
Child
Female
Health Care Surveys
Health Policy
Health Services - utilization
Health Services Accessibility - statistics & numerical data
Healthcare Disparities
Human Rights
Humans
Middle Aged
Pregnancy
Pregnant Women
Questionnaires
Socioeconomic Factors
Transients and Migrants - statistics & numerical data
Young Adult
Abstract
Access to health care for undocumented migrant children and pregnant women confronts human rights and professional values with political and institutional regulations that limit services. In order to understand how health care professionals deal with these diverging mandates, we assessed their attitudes toward providing care to this population. Clinicians, administrators, and support staff (n = 1,048) in hospitals and primary care centers of a large multiethnic city responded to an online survey about attitudes toward access to health care services. Analysis examined the role of personal and institutional correlates of these attitudes. Foreign-born respondents and those in primary care centers were more likely to assess the present access to care as a serious problem, and to endorse broad or full access to services, primarily based on human rights reasons. Clinicians were more likely than support staff to endorse full or broad access to health care services. Respondents who approved of restricted or no access also endorsed health as a basic human right (61.1%) and child development as a priority (68.6%). A wide gap separates attitudes toward entitlement to health care and the endorsement of principles stemming from human rights and the best interest of the child. Case-based discussions with professionals facing value dilemmas and training on children's rights are needed to promote equitable practices and advocacy against regulations limiting services.
PubMed ID
22399247 View in PubMed
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Access to palliative care varies widely across Canada.

https://arctichealth.org/en/permalink/ahliterature137996
Source
CMAJ. 2011 Feb 8;183(2):E87-8
Publication Type
Article
Date
Feb-8-2011
Author
Roger Collier
Source
CMAJ. 2011 Feb 8;183(2):E87-8
Date
Feb-8-2011
Language
English
Publication Type
Article
Keywords
Benchmarking
Canada
Health Services Accessibility
Healthcare Disparities
Humans
Palliative Care
PubMed ID
21220440 View in PubMed
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Access to treatment and educational inequalities in cancer survival.

https://arctichealth.org/en/permalink/ahliterature266954
Source
J Health Econ. 2014 Jul;36:98-111
Publication Type
Article
Date
Jul-2014
Author
Jon H Fiva
Torbjørn Hægeland
Marte Rønning
Astri Syse
Source
J Health Econ. 2014 Jul;36:98-111
Date
Jul-2014
Language
English
Publication Type
Article
Keywords
Adult
Aged
Cancer Care Facilities - utilization
Educational Status
Female
Geography
Health Behavior
Health Services Accessibility
Health Status Disparities
Healthcare Disparities
Humans
Male
Middle Aged
Neoplasms - mortality
Norway - epidemiology
Physician-Patient Relations
Quality of Health Care
Referral and Consultation - standards - statistics & numerical data
Registries - statistics & numerical data
Socioeconomic Factors
Specialization - standards - statistics & numerical data
Survival Analysis
Travel
Abstract
The public health care systems in the Nordic countries provide high quality care almost free of charge to all citizens. However, social inequalities in health persist. Previous research has, for example, documented substantial educational inequalities in cancer survival. We investigate to what extent this may be driven by differential access to and utilization of high quality treatment options. Quasi-experimental evidence based on the establishment of regional cancer wards indicates that (i) highly educated individuals utilized centralized specialized treatment to a greater extent than less educated patients and (ii) the use of such treatment improved these patients' survival.
PubMed ID
24780404 View in PubMed
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The accumulated challenges of long-term care.

https://arctichealth.org/en/permalink/ahliterature146298
Source
Health Aff (Millwood). 2010 Jan-Feb;29(1):29-34
Publication Type
Article
Author
David Barton Smith
Zhanlian Feng
Author Affiliation
Center for Health Equality, School of Public Health, at Drexel University, in Philadelphia, Pennsylvania, USA. david.b.smith@drexel.edu
Source
Health Aff (Millwood). 2010 Jan-Feb;29(1):29-34
Language
English
Publication Type
Article
Keywords
Chronic Disease
Cost Control - methods
Health Policy - trends
Health Services Accessibility - statistics & numerical data - trends
Health Services for the Aged
Health Services, Indigenous - economics - supply & distribution
Healthcare Disparities
Humans
Long-Term Care - methods - organization & administration - standards - trends
Medicaid
Organizational Objectives
Quality of Health Care - standards
United States
Abstract
During the past century, long-term care in the United States has evolved through five cycles of development, each lasting approximately twenty years. Each, focusing on distinct concerns, produced unintended consequences. Each also added a layer to an accumulation of contradictory approaches--a patchwork system now pushed to the breaking point by increasing needs and financial pressures. Future policies must achieve a better synthesis of approaches inherited from the past, while addressing their unintended consequences. Foremost must be assuring access to essential care, delivery of high-quality services in an increasingly deinstitutionalized system, and a reduction in social and economic disparities.
PubMed ID
20048357 View in PubMed
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515 records – page 1 of 52.