Biomedical subjects

Susan J Elliott

Publications and source records attributed to Susan J Elliott.

12 recordsLinked to original sources

PubMed2006

Understanding facilitators of and barriers to health promotion practice.

The health promotion best practices literature is imbued with hope for knowledge mobilization, enhanced practice, and improved population health. Given constrained medical care systems, health promotion is key to reducing the significant burden of chronic disease. However, we have seen little evidence of change. This article investigates facilitators of, and barriers to, three stages of health promotion practice in public health organizations, interagency coalitions, and volunteer committees. The article focuses not on what works but why it does or does not, drawing on five case studies within the Canadian Heart Health Initiative. Results indicate that the presence or absence of appropriately committed and/or skilled people, funds and/or resources, and priority and/or interest are the most common factors affecting all stages of health promotion practice. The article extends the literature on internal and external factors affecting health promotion and highlights strategic influences to consider in support of effective health promotion practice.

Canada↗

PubMed2006

Taking environmental action: the role of local composition, context, and collective.

This article explores individual and community action taken in response to perceived environmental risks by investigating the determinants of environmental action across a range of action types. A conceptual framework is first presented, which provides a foundation for investigating the role of local compositional (i.e., individual characteristics), contextual (i.e., neighborhood environment), and collective (i.e., social networks) factors in environmental action. To test the utility of the conceptual framework, a quantitative survey was administered to a random sample of households (n = 512) in Hamilton, Canada. The results suggest that the predictors of environmental action vary by action type (i.e., personal change, individual civic action, and cooperative civic action), and that factors related to perceived environmental exposure and social capital generally play a stronger, more consistent role in civic environmental action than sociodemographic or neighborhood factors. The results underscore the role of social connection in responses to perceived environmental risks.

Attitude↗

PubMed2006

Developing and implementing a triangulation protocol for qualitative health research.

In this article, the authors present an empirical example of triangulation in qualitative health research. The Canadian Heart Health Dissemination Project (CHHDP) involves a national examination of capacity building and dissemination undertaken within a series of provincial dissemination projects. The Project's focus is on the context, processes, and impacts of health promotion capacity building and dissemination. The authors collected qualitative data within a parallel-case study design using key informant interviews as well as document analysis. Given the range of qualitative data sets used, it is essential to triangulate the data to address completeness, convergence, and dissonance of key themes. Although one finds no shortage of admonitions in the literature that it must be done, there is little guidance with respect to operationalizing a triangulation process. Consequently, the authors are feeling their way through the process, using this opportunity to develop, implement, and reflect on a triangulation protocol.

Canada↗

PubMed2005

Evaluating a food bank recipe-tasting program.

Food banks mitigate immediate food insecurity, but their ability to promote healthy nutrition is constrained by how often recipients may visit and the range of foods available. In a descriptive study, a formative evaluation was completed of a combined heart-healthy recipe-tasting and education program that aims to promote healthy eating knowledge and skills in a group of food bank recipients in Hamilton, Ontario. Fifty-five adults were surveyed about food bank attendance, program awareness, perceived enhancement of knowledge and skills, and suggestions for program improvement. Most participants (73%) were positive about the program, and 91% wanted the program to continue. In addition, 78% would prepare the recipes sampled. In contrast, program awareness and planning food bank visits to coincide with the program were generally low. Food banks are potential sites for effective nutrition promotion programs. To reach more recipients, more frequent implementation and seeking the use of a designated room are suggested for the current program. The findings also suggest that the sampling approach to promoting healthy eating to food bank recipients deserves further study. For example, monitoring the selection of featured recipe ingredients would be a useful indicator of behaviour.

Adult↗

PubMed2005

Protective behavior and West Nile virus risk.

We conducted a cross-sectional, household survey in Oakville, Ontario, where an outbreak of West Nile virus (WNV) in 2002 led to an unprecedented number of cases of meningitis and encephalitis. Practicing > or =2 personal protective behavior traits reduced the risk for WNV infection by half.

Adolescent↗

PubMed2004

Using linking systems to build capacity and enhance dissemination in heart health promotion: a Canadian multiple-case study.

The purpose of this paper is to examine the utility of linking systems between public health resource and user organizations for health promotion dissemination and capacity building, and to identify factors related to the success of linking systems. The design is a parallel-case study using key informant interviews and content analysis of project reports (synthesized qualitative and quantitative data) of three provincial dissemination projects of the Canadian Heart Health Initiative-Dissemination Phase. Each provincial project used linking activities with public health user groups including meetings, skill building, resources, collaboration, networking and research feedback to facilitate capacity building for and implementation of heart health promotion activities. This paper presents empirical examples of linking system designs, activities, and qualitative and quantitative changes in the public health user groups' health promotion capacity, program delivery and sustainability. The findings indicate enhanced health promotion skills, partnerships, resources, infrastructure, and increased programming and sustainability in the targeted public health organizations of all three provincial projects. Identified barriers to the success of linking systems included lack of appropriately skilled personnel, funds, buy-in and leadership. We conclude that linking systems can be flexibly used to build capacity and disseminate health promotion innovations, and suggest conditions for success.

Canada↗

PubMed2003

Impacts of an environmental disaster on psychosocial health and well-being in Karakalpakstan.

The people of Karakalpakstan, along with those of the entire Aral Sea region, are facing a multitude of health problems corresponding to the drying of the Aral Sea and accompanying ecological consequences. In case studies of other environmental disasters, research has shown that environmental exposures may impact not only the physiological but also the psychosocial health of individuals. This research aims to determine the contribution of the environmental disaster to the psychosocial health of people living in Karakalpakstan, a semi-autonomous Republic in Uzbekistan. An interview survey was carried out by Médecins Sans Frontières, with the assistance of the McMaster Institute of Environment and Health, local Universities and local health care workers, on a random sample of 1118 individuals aged 18 years and older in three communities in Karakalpakstan in May/June 1999. The communities were chosen according to distance from the former seashore, urban/rural characteristics and ethnic composition. The survey included questions about perceived general health, the General Health Questionnaire, the somatic symptom checklist of the Symptom Check List-90, questions about perceptions of the environmental disaster, social support as well as socio-demographic and socio-economic characteristics. Findings show that 41% of all respondents reported environmental concern while 48% reported levels of somatic symptoms (SCL-90) associated with emotional distress, above the normalized cut-point. Significant differences in levels of emotional distress were reported between men and women as well as between ethnic groups. Environmental problems are commonly perceived to be the cause of somatic symptoms and are significantly related to self-rated health status.

Adolescent↗

PubMed2003

The Aral Sea disaster and self-rated health.

This study examined the effect of psychosocial factors and environmental perceptions on self-rated health in the environmentally devastated Aral Sea area of Karakalpakstan. Self-rated health was assessed using a questionnaire on 881 randomly selected individuals from three communities. Communities were chosen based on relative differences with regards to economic and ethnic characteristics, and distance from the sea coast. Consistent with mortality rates in the area, the prevalence of 'poor' self-rated health was high. Factors negatively associated with self-rated health include psychosocial impacts and reported environmental concern, as well as community of residence and age. These results demonstrate that the population has a poor perception of their own health, a significant finding given that self-rated health is a strong predictor of morbidity and mortality. It is also clear that psychosocial health is strongly associated with health perceptions. Thus, to improve the overall health of this population, health remediation measures must address physical as well as psychosocial health problems.

Adult↗

PubMed2003

Organizational capacity and implementation change: a comparative case study of heart health promotion in Ontario public health agencies.

This paper reports the results of a comparative case study that examines factors influencing changes in implementation of heart health promotion activities in Ontario public health units. The study compared two cases that experienced large changes in implementation from 1994 to 1996, but in opposite directions. Multiple data sources were used, with an emphasis on secondary analyses of quantitative surveys of health units and other community agencies, and in-depth interviews of public health staff, collected as part of the Canadian Heart Health Initiative Ontario Project. Guided by social ecological and organizational theories, changes in implementation were explained by examining changes in (1) organizational predisposition to undertake heart health promotion activities, (2) organizational practices to undertake these activities, (3) other internal organizational factors and (4) external system factors. Findings show that in communities with diverse characteristics, implementation change was most strongly influenced by an interplay of changes in internal features of public health agencies; notably, leadership, structure and staff skills. Findings support a social ecological approach to health promotion by demonstrating the importance of the institutional context in the implementation change process, the interaction of individual (skills) and organizational (structure) levels in explaining implementation change, and community context in shaping the change process. Findings also reinforce the value of strengthening capacity within public health agencies and suggest further research on the implementation change process, especially in different systems and over longer periods of time.

Cardiovascular Diseases↗

PubMed2002

Community reappraisal of the perceived health effects of a petroleum refinery.

This paper presents results from a study of the community health impacts of a petroleum refinery in Oakville, Ontario in Canada. The research is informed by the environmental stress and coping literatures and the focus is on community reappraisal of the refinery's impacts before and after the implementation of a substantive odour reduction initiative on the part of the refinery operators. Community health surveys were conducted in 1992 (n = 391) and 1997 (n = 427) to examine changes in odour perception and annoyance and self-reported health status attributable to the odour reduction plan. The findings reported here suggest an on-going process of cognitive reappraisal, whereby negative perceptions and concerns decreased between 1992 and 1997. Irrespective of this positive reappraisal of the refinery efforts, those living close to the refinery continue to report negative health impacts. A strong mediating effect of odours on the refinery exposure-symptom reporting relationship was confirmed by our results. While the relationship between odour perception and symptom reporting indicates the importance of odour perception and annoyance as the principal mechanism mediating ill-health reporting, the plausibility of other causal pathways is recognized. Residents' sensitivity to the negative effects of the refinery on their health and the health of their children suggests a psychosocial reaction to the environmental stress associated with perceived and actual refinery emissions.

Adolescent↗

PubMed2002

Community responses and coping strategies in the vicinity of a petroleum refinery in Oakville, Ontario.

This paper investigates community perceptions of and coping responses to a petrochemical refinery in Oakville, Ontario. The analysis of in-depth interviews (n=29) revealed the effects of social and community factors on residents' everyday life experiences of refinery emissions, and the factors that shape residents' perceptions and responses after the refinery's implementation of extensive measures to reduce emissions and odours. Overall, residents reported a reduction in odours from the refinery. While the refinery now poses a minimal or tolerable level of risk to some people in the community, it is still intolerable to others. The results show residents' shifting concerns, with their fears now focused on invisible emissions. Residents continue to employ both action-focused and emotion-focused coping strategies. These findings suggest that refinery intervention may have to move beyond the focus on technological measures to reduce odours to address the psychological and social concerns of residents.

Adaptation, Psychological↗

PubMedDate not supplied

Research as intervention in heart health promotion.

BACKGROUND: Capacity building in health promotion has traditionally involved training interventions to support knowledge, skill and resource building for effective practice. However, there is a need to understand how research can be used to support capacity building and practice. METHODS: Findings are based on a parallel case study comprising qualitative analysis of 66 key informant interviews from five provincial heart health projects (Manitoba, Prince Edward Island, Ontario, Saskatchewan, and Newfoundland and Labrador) as part of the Canadian Heart Health Dissemination Project. FINDINGS: Results indicate research was used primarily to monitor and report results about health promotion capacity and dissemination to stakeholders, and contribute to participatory processes. Respondents noted that research as intervention had an influence on five areas of health promotion capacity and practice: increased heart health promotion knowledge/skills; improved programming, planning and prioritizing; increased motivation for (heart) health promotion initiatives; and cultivation of relationships as well as buy-in. INTERPRETATION: Research was a complementary capacity-building activity, although it did not directly increase program implementation. These findings contribute to linking researchers, practitioners and community decision-makers in the process of enhancing health promotion practice.

Canada↗