The goal of this study is to critically examine health information sources in order to determine whether Aboriginal women are represented in these resources, and if so, how they are being presented. This research is intended to illuminate the practices around the construction of information, and to demonstrate that the manners in which information is conveyed can be problematic. To accomplish these goals, critical discourse analysis was utilized to explore both consumer health publications available to pregnant women in Edmonton, Alberta, as well as academic publications available to students and healthcare providers through the University of Alberta Libraries. Through this critical analysis of these resources, it is clear that information is being constructed in a manner that supports neocolonial practices and reinforces negative stereotypes of Aboriginal women. The analysis of these sources also demonstrates ways in which information can be constructed more appropriately, to avoid racializing tendencies.

Mental illness is common, and usually starts early in life. However, the majority of those affected never seek mental health care. The overall aim of this thesis was to increase knowledge about help-seeking young adults with mental illness in order to improve diagnostic procedures in clinical psychiatry. A group of young adult psychiatric out-patients (n=217) were consecutively invited to participate in the study between October 2002 and September 2003. Altogether 200 (92%) agreed to participate. Among them, there were 161 (80%) women and 39 (20%) men. Participants’ mean age was 22.4±1.9 years. All participants were carefully and comprehensively assessed with respect to axes I, II, IV and V in the DSM-IV. Psychiatric disorders and personality disorders were assessed using the Structured Clinical Interview for DSM-IV for axis I disorders and the Structured Clinical Interview for DSM-IV for axis II disorders. Psychosocial and environmental problems (axis IV) were evaluated through structured interviewing by a social worker and by self-assessment with a questionnaire. Professional and patient ratings on the Global Assessment of Functioning scale were compared before and after treatment. Patients also reported on the Swedish universities Scales of Personality, the Child and Adolescent Psychiatric Screening Inventory-Retrospect and the Coddington’s life event scale. Taken together, the young adult, psychiatric outpatients were characterized by an early onset of their mental disorders, by co-morbidity, by being female and by having mood or anxiety disorders. There were no significant differences between self-referred and those referred by medical professionals according to either number of current or lifetime diagnoses. Childhood onset of depression was associated with more severe symptoms, more psychosocial risk factors, and more childhood developmental delays. Axis IV psychosocial stress categories were related to the presence of axis I disorders, personality disorders, co-morbidity, and impaired functioning. Agreement between patients’ and professionals’ ratings on the GAF scale was good before treatment and excellent after treatment. In summary, the findings suggest that direct self-referral to specialized psychiatric care does not seem to be associated with overutilization of such care. Childhood onset of depression is associated with a more complex illness. The revised axis IV according to DSM-IV seems to have concurrent validity, but is still hampered by limited reliability. And finally, the results support the usefulness of the self-report GAF instrument for measuring outcome in psychiatric care.

Reason for information seeking by consumers and community members has been the subject of previous research to ascertain any unique issues about the personal attributes of the information seeker, the search environment and context or particular issues associated with the goods or services being researched. Several researchers have identified ways to study how information on health related topics is communicated to the community. While research is limited on the sources, search approaches and conditions associated with obtaining reliable information on health issues and topics, there is extensive literature on the important aspects of communication processes that impact on the unique, and at times complex, environment within which health consumer research occurs. This research project has enabled a review of the interpersonal and noninterpersonal communication modes to understand a range of issues that impact on the community member as the receiver of messages on health issues and topics. A qualitative and quantitative research approach has been utilised in original research to examine a number of issues associated with where community members in Australia turn to find information on health related topics. The study involves the comparison of a number of communication and information gathering approaches and expectations with a picture of information source experiences. The study highlights a range of considerations for campaign, individual communication, environment and background communication planning for those involved in engaging with the community to impart health care orientated messages.

While overall road deaths in Australia have fallen since the late 1980's and the impact of road-safety advertising appears to be positive, alcohol-related road fatalities remain the leading cause of death among young Australian adults. Fatality and injury rates continue within this cohort despite increases in alcohol-related knowledge, continuing education efforts in the Australian school system, increased funding for police enforcement and high media presence of road safety advertising (Peder et al 2004). Notwithstanding advances in communication technologies, highly graphic, emotional, shock style television advertising remains the primary medium for road safety message dissemination. Rather than targeting those highest at-risk for drink driving, road safety advertisements typically target an undifferentiated general audience. To date understanding the process by which road safety advertising influences attitudes and behaviour has been the centre of fear arousal research. Nonetheless, there has been little examination of how young adults who differ in drink-driving risk-propensity (high versus low) respond to and process anti-drink driving advertisements designed to modify an avoidable behaviour. Taking a receiver oriented approach, the focus of this study examines how young adult, novice drivers who differ in 'need-for-sensation' (NFS) risk propensity respond to, and process, anti-drink driving advertisements that differ in arousal capacity (i.e. high, low sensation-value). The investigation was conducted in two stages: Study 1 (qualitative) and Study II (quantitative). Study I, the qualitative phase, explored by focus group interviews attitudes, perceptions, beliefs and experiences of sixty young adults aged 18 to 25 years towards alcohol consumption, drink-driving, and anti-drink driving advertising. The major qualitative finding is that young adults characterise drink-driving as a rational, deliberate, planned and accepted behaviour. Young adults were aware of the choices available for not drinking and driving and were aware of the health, social and physical (self and property) risks associated with alcohol consumption and associated behaviours. Nonetheless, the short-term personal experiences of revelry and group cohesion were more pertinent to them on an everyday basis. Alcohol consumption and drink-driving behaviour did not appear to differ between university and nonuniversity students or gender, yet there were differences in attitudes and behaviour across the degree studied within the university cohort. Study II, the quantitative phase, was segmented into three sections. First, the study provides empirical support for NFS as a relevant a priori individual differences segmentation variable for differentiating between those more likely, versus less likely, to engage in responsible drink-driving behaviour. As expected low NFS individuals were more likely to not drink and drive. Second, findings support an interaction effect between an advertisement's sensation value and individual differences variable, NFS, on response outcomes. High NFS individuals engaged in higher levels of adaptive appraisal on the high sensation-value advertisement condition as compared to the low sensationvalue advertisement condition. Low NFS individuals did not discriminate across either advertisement condition. Adaptive appraisal was not counteracted by a corresponding increase in maladaptive appraisal. Both high and low NFS individuals viewed the high sensation-value advertisement condition with high levels of perceived threat and viewed the low sensation-value advertisement with higher levels of perceived efficacy. Yet, although high NFS individuals viewed the high sensation-value advertisement with high levels of threat they simultaneously viewed this advertisement with low levels of perceived efficacy. Third, NFS was not found to be a strong predictor moderating the relationship between message processing (cognitive, sensory, narrative) and response outcomes. The findings indicate strong support for a direct relationship between two modes of message processing: cognitive and narrative processing and response outcomes. Message recipients processed anti-drink driving advertisements via two routes to persuasion. There was stronger cognitive processing evident on advertisements possessing high arousal capacity, whereas stronger narrative processing was evident on low arousal capacity advertisements. This study suggests that those advertisements that possess high arousal capacity have the capability of facilitating attention to the central argument, the consequences of drinking and driving, as well as how drinking and driving may affect the message recipients' life. Alternatively, those messages that impart high levels of rational information have the capability of increasing attention to the peripheral cues in the message. It is also suggested that different styles of message processing, central versus peripheral, act in a synergistic way to influence response outcomes which indicates that there is no single route to persuasion. Individuals process messages in a complex manner attending to various signals in order to evaluate various components of the message. For road safety practitioners and social marketers the results of this study illustrates practical benefits for the design of anti-drink driving advertisements based on the segmentation variable NFS. The finding that high NFS individuals require advertisements that possess high levels of arousal capacity (i.e.: high in sensation-value) is an important development. Importantly, low NFS individuals do not discriminate in accepting the recommendations of advertisements that differ in arousal capacity clearly suggests that they accept messages regardless of their arousal capacity. This finding indicates that the goal of road traffic authorities, advertising agencies and social marketers should be directed towards targeting high NFS individuals who are more atrisk for a drink-drive fatality. That message recipients process anti-drink driving messages via two routes to persuasion indicates that message designers need to consider the mix between the sensation-value of the message and consideration of the way message recipients' process the message, i.e. via central/systematic versus peripheral/heuristic components of the advertisement. Further investigation into the dual processing of anti-drink driving advertisements once individuals are exposed to the message is warranted to further understand the psychological processes influencing message processing. The findings of this research have important implications for both practitioners and academics. This research has provided an insight into the complexity of young adult's response outcomes and message processing of fear-based anti-drink driving messages.

This study introduces empirical data essential to our understanding of the relationship between suicidal individuals and the internet. Strong support was found for hypotheses that suicidal individuals purposely use the internet to resolve suicidal problems, whether for life or for death, and actively engage in an internal suicidal debate. A computer-administered survey (N = 64), and a multinational online survey (N = 1016), provided data on suicide-risk factors, online help-seeking, and internet use. Results from the computer-administered survey showed negative problem-solving approach, using phone helplines, and reluctance to seek professional mental health services, predicted online help-seeking for suicidal ideation. Results from the online survey demonstrated suicide-risk individuals form a unique online population. Suicide-risk participants were more likely, than nonsuicidal, to use online forums, while suicide-risk females, compared to nonsuicidal females, were more likely to create original online content (e.g., blogs, social networking), and spend time surfing/browsing. Suicide-risk participants, particularly females, were more likely to go online in search of new interpersonal relationships (as evidenced by the author-developed Online Relationship Building scale), and demonstrated some acceptance of online help sources. Suicide surfers (suicide-risk individuals who reported going online for suicide-related purposes) were compared with suicide-risk online users (who did not report such experience). Suicide surfers were found to be a higher risk group, reporting more severe suicidal and depressive symptoms, and less social support. Surfers reported higher satisfaction with unmoderated online forums, compared with helpsites and online mental health professionals. Online, they also found more support, felt less alienated, and had more satisfying communications. Results showed strong support for the internal suicidal debate hypotheses. In addition, reasons for living and dying significantly differed between highly suicidal and not suicidal participants, and most highly suicidal participants reported using the internet to look for and/or confirm their reasons for living and dying. Implications include a need for helpsites to be more user and communication oriented. Research implications include new directions for exploring the spectrum of suicidal ideation, and further examining online suicide-related behaviors.

This ethnographic study in medical anthropology is a critically interpretative analysis of fieldwork documentation I recorded during field research conducted in the mining city of Mount Isa in the far northwest of Queensland during the 1980s. Eighteen months of participant observation research was undertaken over four fieldtrips (1981-82, 1983, 1985 and 1988) at inter-connected locations: two urban reserves for Aborigines and the people I refer to as the Reserve Dwellers, as well as the local hospital and a group of hospital resident medical officers who I refer to as the Residents. During the field research I found that both Reserve Dwellers and the Residents experienced a difficult relationship during their interactions in medical consultations in the hospital clinics. Now in this dissertation I ask an overarching question of my time-lag field data. It is How can we understand the problematic relationship between indigenous reserve-dwelling help-seekers and biomedical practitioners at their local hospital clinics in the 1980s. To describe this problematic relationship I analyse time-lag data from my diaried participant observation at both the reserves and the hospital; semi-structured interviews with the hospital Residents; case studies and case histories of consenting help-seekers from the Reserves; and illustrative transcriptions of consultations between Residents and Reserve Dwellers that were tape recorded by the Residents during hospital clinics. The contemporary ethnomedical system of the Reserve Dwellers was inclusive of biomedicalized clinics and the Residents as clinicians at this remote hospital in the 1980s. I provide an ethnographic account of a changing contemporary indigenous ethnomedical system and describe the lifeways of the Reserve Dwellers in the 1980s; their pattern of help-seeking at their local hospital including grievous happenings; and their experiences in outpatients clinics and the emergency section of the local non-indigenous hospital. Their lifeways and help-seeking were in many ways defined by the collective sociality of Kalkadunga and other regional indigenous cultures as impoverished, very sick survivors of a genocidal contact history less than 100 years before. This local history is also reconstructed. The Residents view of local indigenous illness, help-seeking, and experiences of biomedicalised hospital clinics further describe the socio-cultural reality of the time. I found that the Residents had an insightful, even predictive assessment of local illness burden. At the same time, they held strong views about a pattern of help-seeking in the outpatients and emergency clinics that was considered disruptive of hospital routines. I also describe how they expressed their difficulties interacting with Aboriginal help-seekers including the taking of biomedical histories. My thesis is that a localized socio-clinical reality was shaped by a synchronic, coeval relationship between Reserve Dwellers enculturated within a changing, contemporary ethnomedical belief system that incorporated biomedicalized hospital clinics, and the Residents as clinicians enculturated within a culture of biomedical science at a remote hospital. I argue that the lifeways and pattern of help-seeking of the Reserve Dwellers, as well as the Residents’ views about sick indigenous help-seekers, formed this particular socio-clinical reality. It was then consistently replicated by problematic socio-clinical interaction and biomedicalized praxis that inhibited investigation and curative outcomes for the Reserve Dwellers and other indigenous help-seekers.

This ethnographic study in medical anthropology is a critically interpretative analysis of fieldwork documentation I recorded during field research conducted in the mining city of Mount Isa in the far northwest of Queensland during the 1980s. Eighteen months of participant observation research was undertaken over four fieldtrips (1981-82, 1983, 1985 and 1988) at inter-connected locations: two urban reserves for Aborigines and the people I refer to as the Reserve Dwellers, as well as the local hospital and a group of hospital resident medical officers who I refer to as the Residents. During the field research I found that both Reserve Dwellers and the Residents experienced a difficult relationship during their interactions in medical consultations in the hospital clinics. Now in this dissertation I ask an overarching question of my time-lag field data. It is How can we understand the problematic relationship between indigenous reserve-dwelling help-seekers and biomedical practitioners at their local hospital clinics in the 1980s. To describe this problematic relationship I analyse time-lag data from my diaried participant observation at both the reserves and the hospital; semi-structured interviews with the hospital Residents; case studies and case histories of consenting help-seekers from the Reserves; and illustrative transcriptions of consultations between Residents and Reserve Dwellers that were tape recorded by the Residents during hospital clinics. The contemporary ethnomedical system of the Reserve Dwellers was inclusive of biomedicalized clinics and the Residents as clinicians at this remote hospital in the 1980s. I provide an ethnographic account of a changing contemporary indigenous ethnomedical system and describe the lifeways of the Reserve Dwellers in the 1980s; their pattern of help-seeking at their local hospital including grievous happenings; and their experiences in outpatients clinics and the emergency section of the local non-indigenous hospital. Their lifeways and help-seeking were in many ways defined by the collective sociality of Kalkadunga and other regional indigenous cultures as impoverished, very sick survivors of a genocidal contact history less than 100 years before. This local history is also reconstructed. The Residents view of local indigenous illness, help-seeking, and experiences of biomedicalised hospital clinics further describe the socio-cultural reality of the time. I found that the Residents had an insightful, even predictive assessment of local illness burden. At the same time, they held strong views about a pattern of help-seeking in the outpatients and emergency clinics that was considered disruptive of hospital routines. I also describe how they expressed their difficulties interacting with Aboriginal help-seekers including the taking of biomedical histories. My thesis is that a localized socio-clinical reality was shaped by a synchronic, coeval relationship between Reserve Dwellers enculturated within a changing, contemporary ethnomedical belief system that incorporated biomedicalized hospital clinics, and the Residents as clinicians enculturated within a culture of biomedical science at a remote hospital. I argue that the lifeways and pattern of help-seeking of the Reserve Dwellers, as well as the Residents’ views about sick indigenous help-seekers, formed this particular socio-clinical reality. It was then consistently replicated by problematic socio-clinical interaction and biomedicalized praxis that inhibited investigation and curative outcomes for the Reserve Dwellers and other indigenous help-seekers.

This ethnographic study in medical anthropology is a critically interpretative analysis of fieldwork documentation I recorded during field research conducted in the mining city of Mount Isa in the far northwest of Queensland during the 1980s. Eighteen months of participant observation research was undertaken over four fieldtrips (1981-82, 1983, 1985 and 1988) at inter-connected locations: two urban reserves for Aborigines and the people I refer to as the Reserve Dwellers, as well as the local hospital and a group of hospital resident medical officers who I refer to as the Residents. During the field research I found that both Reserve Dwellers and the Residents experienced a difficult relationship during their interactions in medical consultations in the hospital clinics. Now in this dissertation I ask an overarching question of my time-lag field data. It is How can we understand the problematic relationship between indigenous reserve-dwelling help-seekers and biomedical practitioners at their local hospital clinics in the 1980s. To describe this problematic relationship I analyse time-lag data from my diaried participant observation at both the reserves and the hospital; semi-structured interviews with the hospital Residents; case studies and case histories of consenting help-seekers from the Reserves; and illustrative transcriptions of consultations between Residents and Reserve Dwellers that were tape recorded by the Residents during hospital clinics. The contemporary ethnomedical system of the Reserve Dwellers was inclusive of biomedicalized clinics and the Residents as clinicians at this remote hospital in the 1980s. I provide an ethnographic account of a changing contemporary indigenous ethnomedical system and describe the lifeways of the Reserve Dwellers in the 1980s; their pattern of help-seeking at their local hospital including grievous happenings; and their experiences in outpatients clinics and the emergency section of the local non-indigenous hospital. Their lifeways and help-seeking were in many ways defined by the collective sociality of Kalkadunga and other regional indigenous cultures as impoverished, very sick survivors of a genocidal contact history less than 100 years before. This local history is also reconstructed. The Residents view of local indigenous illness, help-seeking, and experiences of biomedicalised hospital clinics further describe the socio-cultural reality of the time. I found that the Residents had an insightful, even predictive assessment of local illness burden. At the same time, they held strong views about a pattern of help-seeking in the outpatients and emergency clinics that was considered disruptive of hospital routines. I also describe how they expressed their difficulties interacting with Aboriginal help-seekers including the taking of biomedical histories. My thesis is that a localized socio-clinical reality was shaped by a synchronic, coeval relationship between Reserve Dwellers enculturated within a changing, contemporary ethnomedical belief system that incorporated biomedicalized hospital clinics, and the Residents as clinicians enculturated within a culture of biomedical science at a remote hospital. I argue that the lifeways and pattern of help-seeking of the Reserve Dwellers, as well as the Residents’ views about sick indigenous help-seekers, formed this particular socio-clinical reality. It was then consistently replicated by problematic socio-clinical interaction and biomedicalized praxis that inhibited investigation and curative outcomes for the Reserve Dwellers and other indigenous help-seekers.

This ethnographic study in medical anthropology is a critically interpretative analysis of fieldwork documentation I recorded during field research conducted in the mining city of Mount Isa in the far northwest of Queensland during the 1980s. Eighteen months of participant observation research was undertaken over four fieldtrips (1981-82, 1983, 1985 and 1988) at inter-connected locations: two urban reserves for Aborigines and the people I refer to as the Reserve Dwellers, as well as the local hospital and a group of hospital resident medical officers who I refer to as the Residents. During the field research I found that both Reserve Dwellers and the Residents experienced a difficult relationship during their interactions in medical consultations in the hospital clinics. Now in this dissertation I ask an overarching question of my time-lag field data. It is How can we understand the problematic relationship between indigenous reserve-dwelling help-seekers and biomedical practitioners at their local hospital clinics in the 1980s. To describe this problematic relationship I analyse time-lag data from my diaried participant observation at both the reserves and the hospital; semi-structured interviews with the hospital Residents; case studies and case histories of consenting help-seekers from the Reserves; and illustrative transcriptions of consultations between Residents and Reserve Dwellers that were tape recorded by the Residents during hospital clinics. The contemporary ethnomedical system of the Reserve Dwellers was inclusive of biomedicalized clinics and the Residents as clinicians at this remote hospital in the 1980s. I provide an ethnographic account of a changing contemporary indigenous ethnomedical system and describe the lifeways of the Reserve Dwellers in the 1980s; their pattern of help-seeking at their local hospital including grievous happenings; and their experiences in outpatients clinics and the emergency section of the local non-indigenous hospital. Their lifeways and help-seeking were in many ways defined by the collective sociality of Kalkadunga and other regional indigenous cultures as impoverished, very sick survivors of a genocidal contact history less than 100 years before. This local history is also reconstructed. The Residents view of local indigenous illness, help-seeking, and experiences of biomedicalised hospital clinics further describe the socio-cultural reality of the time. I found that the Residents had an insightful, even predictive assessment of local illness burden. At the same time, they held strong views about a pattern of help-seeking in the outpatients and emergency clinics that was considered disruptive of hospital routines. I also describe how they expressed their difficulties interacting with Aboriginal help-seekers including the taking of biomedical histories. My thesis is that a localized socio-clinical reality was shaped by a synchronic, coeval relationship between Reserve Dwellers enculturated within a changing, contemporary ethnomedical belief system that incorporated biomedicalized hospital clinics, and the Residents as clinicians enculturated within a culture of biomedical science at a remote hospital. I argue that the lifeways and pattern of help-seeking of the Reserve Dwellers, as well as the Residents’ views about sick indigenous help-seekers, formed this particular socio-clinical reality. It was then consistently replicated by problematic socio-clinical interaction and biomedicalized praxis that inhibited investigation and curative outcomes for the Reserve Dwellers and other indigenous help-seekers.

The purpose of this study is to determine social factors that influence help seeking behaviors by mothers who are concurrently involved in two social service systems: Child Protective Services (CPS) and family violence advocacy programs. Through the application of the behavioral model (of service use) for vulnerable populations, this study seeks to determine predisposing, enabling and need characteristics that impact help seeking behaviors at a family violence agency after participation in an ADVANCE (Acknowledging Domestic Violence and Navigating Child Protection Effectively) course, a group intervention class developed specifically for women involved with CPS. The research design is a mixed-method approach with an ADVANCE course evaluation embedded within the overall analysis of help seeking behaviors. The analytic strategies include pre-test/post-test means comparisons through paired t-tests, qualitative thematic analysis through arts-based methodology, and ordinary least squares and logistic regression analysis. This study considers six outcome variables related to protective help seeking behaviors: seeking services, seeking protective actions related to children, seeking a safety plan, seeking a protective order, seeking safe housing, and seeking financial independence. Several social factors identified influenced help seeking behaviors amongst child welfare involved women experiencing violence, namely, number of children, age of children, level of interest in services, previous participation in services, level of social support, perceived victim status, perceived need for a safety plan, and perceived need for change in family. This study should serve to enhance intervention practices utilized by both family violence advocates and child welfare professionals.