Missing pathways to self-governance: Aboriginal health policy in British Columbia. Lavoie et al., (2015).

Lavoie, J., Browne, A.J., Varcoe, C., Wong, S., Fridkin, A., Littlejohn, D., & Tu, D. (2015). Missing pathways to self-governance: Aboriginal health policy in British Columbia. International Indigenous Policy Journal, 6(1). Retrieved from http://ir.lib.uwo.ca/iipj/vol6/iss1/2

Abstract from authors:

This article explores how current policy shifts in British Columbia, Canada highlight an important gap in Canadian self-government discussions to date. The analysis presented draws on insights gained from a larger study that explored the policy contexts influencing the evolving roles of two long-standing urban Aboriginal health centres in British Columbia. We apply a policy framework to analyze current discussions occurring in British Columbia and contrast these with Ontario, Canada and the New Zealand Māori health policy context. Our findings show that New Zealand and Ontario have mechanisms to engage both nation- or tribal-based and urban Indigenous communities in self-government discussions. These mechanisms contrast with the policies influencing discussions in the British Columbian context. We discuss policy implications relevant to other Indigenous policy contexts, jurisdictions, and groups.

Article can be found here.

A critical second look at integrated knowledge translation. Kothari, A., & Wathen, C. N. (2013).

Kothari, A., & Wathen, C. N. (2013). A critical second look at integrated knowledge translation. Health Policy, 109(2), 187-191. http://dx.doi.org/10.1016/j.healthpol.2012.11.004

Abstract from Authors:

Integrated knowledge translation (IKT) requires active collaboration between researchers and the ultimate users of knowledge throughout a research process, and is being aggressively positioned as an essential strategy to address the problem of underutilization of research-derived knowledge. The purpose of this commentary is to assist potential “knowledge users”, particularly those working in policy or service settings, by highlighting some of the more nuanced benefits of the IKT model, as well as some of its potential costs. Actionable outcomes may not be immediately (or ever) forthcoming, but the process of collaboration can result in group-level identity transformation that permits access to different professional perspectives as well as, we suggest, added organizational and social value. As well, the IKT approach provides space for the re-balancing of what is considered “expertise”. We offer this paper to help practitioners, administrators and policymakers more realistically assess the potential benefits and costs of engaging in IKT-oriented research.

 Article can be found here

A theory-based primary health care intervention for women who have left abusive partners. – Ford-Gilboe, M., Merritt-Gray, M., Varcoe, C. M., & Wuest, J. (2011).

Ford-Gilboe, M., Merritt-Gray, M., Varcoe, C. M., & Wuest, J. (2011). A theory-based primary health care intervention for women who have left abusive partners. Advances in Nursing Science, 34(3), 1-17.

Abstract from Authors:

Although intimate partner violence is a significant global health problem, few tested interventions have been designed to improve women’s health and quality of life, particularly beyond the crisis of leaving. The Intervention for Health Enhancement After Leaving is a comprehensive, trauma informed, primary health care intervention, which builds on the grounded theory Strengthening Capacity to Limit Intrusion and other research findings. Delivered by a nurse and a domestic violence advocate working collaboratively with women through 6 components (safeguarding, managing basics, managing symptoms, cautious connecting, renewing self, and regenerating family), this promising intervention is in the early phases of testing.

Article can be found here

Access to primary care from the perspective of Aboriginal patients at an urban emergency department. – Browne, Annette J., Smye, Victoria L., Rodney, Patricia, Tang, Sannie Y., Mussell, Bill, & O’Neil, John D. (2011).

Browne, Annette J., Smye, Victoria L., Rodney, Patricia, Tang, Sannie Y., Mussell, Bill, & O’Neil, John D. (2011). Access to primary care from the perspective of Aboriginal patients at an urban emergency department. Qualitative Health Research, 21(3), 333-348. doi: 10.1177/1049732310385824

Abstract from Authors:

In this article, we discuss findings from an ethnographic study in which we explored experiences of access to primary care services from the perspective of Aboriginal people seeking care at an emergency department (ED) located in a large Canadian city. Data were collected over 20 months of immersion in the ED, and included participant observation and in-depth interviews with 44 patients triaged as stable and nonurgent, most of whom were living in poverty and residing in the inner city. Three themes in the findings are discussed: (a) anticipating providers’ assumptions; (b) seeking help for chronic pain; and (c) use of the ED as a reflection of social suffering. Implications of these findings are discussed in relation to the role of the ED as well as the broader primary care sector in responding to the needs of patients affected by poverty, racialization, and other forms of disadvantage.

Article can be found here.

Abuse-related injury and symptoms of posttraumatic stress disorder as mechanisms of chronic pain in survivors of intimate partner violence. – Wuest, J., Ford-Gilboe, M., Merritt-Gray, M., Varcoe, C. M., Lent, B., Wilk, P., et al. (2009).

Wuest, J., Ford-Gilboe, M., Merritt-Gray, M., Varcoe, C. M., Lent, B., Wilk, P., et al. (2009). Abuse-related injury and symptoms of posttraumatic stress disorder as mechanisms of chronic pain in survivors of intimate partner violence. Pain Medicine, 10(4), 739-747.

Abstract from Authors:

Objective.  To examine the role of abuse-related injury and posttraumatic stress disorder (PTSD) symptom severity in mediating the effects of assaultive intimate partner violence (IPV) severity, psychological IPV severity, and child abuse severity on chronic pain severity in women survivors of IPV.

Methods.  Using data collected from a community sample of 309 women survivors of IPV, structural equation modeling was used to test a theoretical model of the relationships among the key variables.

Results.  The theoretical model accounted for almost 38% of the variance in chronic pain severity. PTSD symptom severity was a significant mediator of the relationships of both child abuse severity (beta = 0.13) and assaultive IPV severity (beta = 0.06) with chronic pain severity. Lifetime abuse-related injury was also a significant mediator of the relationships between both child abuse severity (beta = 0.05) and assaultive IPV severity (beta = 0.06) and chronic pain severity. Child abuse severity made the largest significant contribution to the model (beta = 0.35). Assaultive IPV severity had a significant indirect effect (beta = 0.12) on chronic pain severity while psychological IPV severity had a significant direct effect (beta = 0.20).

Conclusions.  Management of chronic pain in IPV survivors requires attention to symptoms of PTSD, abuse-related injury, and lifetime experiences of violence. Ensuring that acute pain from injury is adequately treated and followed over time may reduce the extent of chronic pain in abused women. The results also support the importance of routine assessment for IPV and child abuse.

Article can be found here

Addressing trauma, violence and pain: Research on health services for women at the intersections of history and economics. – Browne, Annette J., Varcoe, Colleen M., & Fridkin, Alycia. (2011).

Browne, Annette J., Varcoe, Colleen M., & Fridkin, Alycia. (2011). Addressing trauma, violence and pain: Research on health services for women at the intersections of history and economics. In O. Hankivsky (Ed.), Health Inequities in Canada: Intersectional Frameworks and Practices (pp. 295-311). Vancouver: UBC Press.

Using an intersectional perspective in health services research, this book chapter is aimed at analyzing and improving health care by drawing attention to the following: how health problems are framed; why particular problems are prioritized, and thus legitimized, over others; how multiple health and social issues such as violence and trauma, chronic pain, addictions, and poverty intersect; and the importance of structuring health services in ways that address the intersecting realities of people’s lives. These areas of analysis are critical to developing strategies for mitigating the ongoing marginalizing and racializing inequities that shape the lives and health of many women in Canada.

Attributing selected costs to intimate partner violence in a sample of women who have left abusive partners: A social determinants of health approach. – Varcoe, C. M., Hankivsky, O., Ford-Gilboe, M., Wuest, J., Wilk, P., Hammerton, J., et al. (2011).

Varcoe, C. M., Hankivsky, O., Ford-Gilboe, M., Wuest, J., Wilk, P., Hammerton, J., et al. (2011). Attributing selected costs to intimate partner violence in a sample of women who have left abusive partners: A social determinants of health approach. Canadian Public Policy, 37(3), 359-380.

Abstract from Authors:

Selected costs associated with intimate partner violence were estimated for a community sample of 309 Canadian women who left abusive male partners on average 20 months previously. Total annual estimated costs of selected public- and private-sector expenditures attributable to violence were $13,162.39 per woman. This translates to a national annual cost of $6.9 billion for women aged 19–65 who have left abusive partners; $3.1 billion for those experiencing violence within the past three years. Results indicate that costs continue long after leaving, and call for recognition in policy that leaving does not coincide with ending violence.

Article can be found here