Historically, research on Aboriginal education issues has ignored the needs of Aboriginal people and disempowered the Aboriginal community. This thesis seeks to offer a corrective to that trend. The intent of the thesis research was to establish a process for conducting educational research with one Aboriginal community - the Dakota People of Wahpeton which would enable this community to have a legitimate voice and control over future research that will be conducted on their behalf. A methodology called community-Based Participatory Research (CBPR) was utilized because it provided the means for community input and direction. Through the use of CBPR, collaborative relationships were established with 20 Dakota People of Wahpeton, who were identified as the research participants. The interview was used as the primary research method. The thesis discusses how the conflict between two cultural world views - the Aboriginal view of the Dakota, Nakota, and Lakota People, generally referred to as "Sioux", and the contemporary Western view - was resolved within the process of implementing the Community-Based Participatory Research methodology. This resolution of differences was accomplished by bridging, then mirroring, the methodologies and ways of gaining knowledge unique to these two respective cultural world views. Additionally, theoretical and practical suggestions are offered so that the thesis might serve as a model for Dakota-Nakota-Lakota Community-Based Participatory Research in the future. In keeping with Community-Based Participatory Research, the voice of the people will be emphasized in this thesis, through extensive use of quotes. Furthermore, the voice of the researcher will be clearly identified so that he may be held accountable for his input.

There is a dearth of literature to guide the development of community-based HIV and Sexually Transmitted Infection (STI) prevention and sexual health promotion programs within Inuit communities. The aim of this research project was to create a dialogue with Inuit women to inform future development of such programs. This study employed Indigenous methodologies and methods by drawing from Inuit Qaujimajatuqangit and postcolonial research theory in a framework of Two-Eyed Seeing, and utilizing storytelling sessions to gather data. Community-Based Participatory Research Principles informed the design of the study, ensuring participants were involved in all stages of the project. Nine story-sharing sessions took place with 21 Inuit women ages 18-60. Participants identified several key determinants of sexual health and shared ideas for innovative approaches that they believe will work as prevention efforts within their community. These research results build upon the limited knowledge currently available about perceptions of HIV and STI among Inuit women living in the remote north. / Graduate / 0573 / jenny.r.rand@gmail.com

Philosophiae Doctor - PhD / Type 2 diabetes mellitus (T2DM) and pre-diabetes contribute increasingly to the global burden of disease. Along with other behavioural risk factors, diet plays a key role in the onset and management of the disease, in turn largely determined by what foods are immediately accessible in local food environments. With this in mind, this thesis aims to answer the research question: What role do local food environments play in promoting or inhibiting access to healthy foods as part of the self - management of T2DM in urban and rural communities in South Africa, and what can be learned from an international perspective? Specific research objectives include, to: 1. Understand the current national-level policy context with regard to the observed rise in NCDs, their proximal determinants (specifically an observed change in diet patterns), and contributing environmental factors; 2. Identify the current food-related environmental factors associated with the onset and/or management of T2DM in an urban and a rural setting (as well as in four additional international settings in order to provide an international perspective); 3. Explore community perspectives of the role the local food environment plays in the self-management of T2DM in an urban and a rural setting; and, consequently 4. Recommend intervention- and/or policy-related actions that can be implemented based on study findings. A review of the literature and relevant policies was conducted towards achieving the first research objective. Quantitative data were systematically collected at an urban and rural site in South Africa through the creation of an ‘environmental profile’ in an attempt to achieve the second objective – comparable urban and rural data was also collected as part of a larger study at two other international sites (Kampala, Uganda and Stockholm, Sweden) to provide an international perspective. Included in the third objective is the collection of qualitative data through a community based participatory research method at the same urban and rural sites in South Africa. Finally, intervention and/or policy-related recommendations are developed based on study findings and in consultation with relevant stakeholders through interviews. / 2018-12-14

The concept of interprofessional practice and education is not new but has recently gained attention as the result of a paradigm shift in the future of healthcare and how it is delivered and financed. Universities are now addressing ways to incorporate interprofessional education and learning experiences into the curriculum to ensure graduating healthcare professionals are competent to collaborate as a team and deliver quality effective healthcare. A regional research university in East Tennessee with health programs across five Health Science colleges (Clinical and Rehabilitative Health Sciences, Medicine, Nursing, Pharmacy, and Public Health), Psychology, and Social Work has offered an interprofessional rural course for more than six years. The two-semester course is focused on vulnerable or underserved populations and rural communities in the south central Appalachian region. Each course section comprised of 8 to 10 students is led by a team of two or more faculty who represent a cross section of healthcare disciplines and focuses on a specific population or community. The student groups develop interprofessional working relationships among each other and faculty while partnering with rural communities. Using a community-based participatory research approach they prioritize health needs, and develop and implement evidence-based strategies to address the identified needs. Interprofessional education, cross cultural learning, and a university/community partnership within the context of the Hispanic migrant farmworker population are addressed in this paper. The course process, target population, cultural learning, and student outcomes are specifically discussed.

No description available.

Background: People who use illegal drugs are disproportionately affected by HIV and hepatitis C, stigmatization and social exclusion. Health inequities are worsened by drug policy of criminalization, which thwarts health promotion efforts and hinders access to services. To address these inequities, people who use drugs are increasingly included in decisions that affect them by sitting on policy, service delivery and research committees. This study addressed a gap in understanding how power inequities are transformed in committees where people who use drugs are at the table. Methods: In partnership with the Drug Users Advocacy League and the Society of Living Illicit Drugs Users, this participatory critical emancipatory inquiry explored power relations in four committees in Ontario and BC. Data were collected in 2013 through meeting observations, interviews, demographics surveys and document reviews. Data analysis was guided by theoretical frameworks grounded in critical theory and transformative learning theory. Results: Findings confirmed striking socioeconomic inequities between people who use drugs and others at the table. Inconsistent measures were taken by committees to alleviate barriers to inclusion. Despite openness to inclusion, committee members tended to underestimate people who use drugs. The presence of local organizations of people who use drugs ensured a more democratic selection of their representatives to sit on committees. Once at the table, creating a safe space entailed building trust, authentic relationships, relational and reflective dialogue, and skilled facilitation. Democratic practices of negotiated relationships and consensus-based decision-making enhanced meaningful inclusion. A structural environment in which drug policy criminalizes people who use illegal drugs hindered capacity to transform power inequities by feeding stigma, which worsens health and social inequities. Committees were committed to inclusion of people who use drugs though capacity to do so varied due to budgetary and human resources constraints. Study limitations, practice implications and future research directions are offered. / Graduate / 0700 / 0680 / lynnebel@uvic.ca

Metabolic syndrome (MetS), a global public health problem, is the primary cause of type 2 diabetes and cardiovascular disorders. Lifestyle modification interventions (dietary and physical activity modifications) are effective in preventing and ameliorating MetS and associated comorbidities. However, the impact of lifestyle changes on MetS among Mexican Americans has yet to be investigated, particularly due to high attrition rates in this population. The overall goal of the explanatory mixed-methods study presented in this dissertation was to identify efficacious lifestyle modification efforts directed towards Mexican Americans to promote their retention in lifestyle modification programs, ameliorate the severity of MetS, and understand underlying behavior modification process. In particular, we examined secondary data from an extensive study Beyond Sabor to 1) examine predictors of program completion, 2) compare variation in MetS severity scores (z-scores) between intervention (Beyond Sabor) and attention control (Healthy Living) groups, over time and, 3) investigate processual development of self-efficacy in a sample of 1153 disadvantaged Mexican Americans participants. Findings suggest that program completers were more likely to be older, had more years of education, lower fasting blood glucose levels, and participated in sites with high group cohesiveness. Results also revealed that when compared with the standard nutrition program, Healthy Living, the lifestyle modification intervention, Beyond Sabor, was more effective in ameliorating MetS severity, systolic blood pressure, triglyceride, and fasting plasma glucose levels among study participants. Qualitative results demonstrate the high acceptability of Beyond Sabor intervention. Four sub-themes emerged illustrating important underlying conditions contributing to participants’ improved self-efficacy: desire to gain knowledge about ways to improve health, development of social support, adoption of program teachings in family lifestyle, and improvement in health outcomes. Findings of the current study may allow researchers to identify Mexican Americans at risk of non-completion and to develop strategies to improve lifestyle modification program attendance, and thus health outcomes. Qualitative findings underscore the importance of sociocultural context on individuals’ attempts to make lifestyle changes to manage their chronic illnesses. Successful adaptation of lifestyle interventions such as Beyond Sabor for at-risk populations in community-based settings will be critical in stemming the tide of MetS.

PhD / Department of Public Health / See the attached abstract

The obesity epidemic is a global health concern. In the United States alone, 68.5% of adults are categorized as overweight or obese; of these, 35.1% are considered obese. Obesity is a leading cause of morbidity and mortality from diabetes and cardiovascular disease, two diseases adversely affecting minority groups such as Mexican Americans. Yet, a modest 5% decrease in weight, through changes in diet and physical activity, can help control type 2 diabetes. The current study extracted the dietary data and selected outcome variables from Beyond Sabor, a 12 week intervention conducted in the Lower Rio Grande Valley, Texas, a predominantly Mexican American disadvantaged community. Social Cognitive Theory, guided the design of this culturally tailored intervention. Community resources and natural helpers emerged through the utilization of community based participatory research methods. Study participants (n= 1,273) were recruited from local food bank sites and randomized into treatment and control groups. The treatment group received 12 weekly sessions focusing on healthier eating habits, cooking methods, and physical activity. The control group received 6 nutrition education sessions on similar topics. The study measured changes in several food groups including consumption of soda, fruit juice, and fruit and vegetables. A repeated measures Analysis of Variance was employed to determine changes in treatment and control groups from baseline, post intervention and 40 week follow up. The results showed a significant decrease in soda (F= 8.48, p< .001) and fruit juice (F= 3.12, p= .045) consumption for both groups, with a particular decrease in soda for the treatment group. In addition, there was a significant increase in fruit (F=15.32, p< .001) and vegetable (F=3.16, p= .04) consumption in both groups. The outcome variables selected were weight, body mass index (BMI), and fasting plasma glucose (FPG). There were significant changes for all three variables over time. The intervention resulted in changes in dietary behaviors that ultimately led to changes in weight, BMI, and FPG. It is evident from the current study, that the use of community based helpers facilitated changes in food habits. This study serves as a prognosticator for future interventions.

The values of the disability rights movement and community psychology promote research that focuses on improving the lives of individuals with disabilities (Dowrick & Keys, 2001). Using the Internet for social interactions has been shown to contribute to an individual's identity development, sense of community, and well-being (Obst, Zinkiewicz, & Smith, 2002a; Turkle, 1995). While challenges in typical social interactions have traditionally been considered a defining feature of autism spectrum disorder, autistic individuals have taken advantage of the Internet to develop social interactions (Blume, 1997a). The present study focused on the online Autistic community and how the importance and value of involvement in it is related to Autistic identity, sense of community, and psychological well-being. The Academic Autistic Spectrum Partnership in Research and Education (AASPIRE) partnered with the Gernsbacher Lab to form the Gateway Project. Using the Gateway Project, AASPIRE conducted the Internet Use, Community, and Well-Being Study and collected data from 72 autistic adults online. It was hypothesized that the importance and value of involvement in the online Autistic community would be positively related to Autistic identity and sense of community, Autistic identity and sense of community would be positively related, and Autistic identity and sense of community would be positively related to psychological well-being. It was also hypothesized that the positive relationship between the importance and value of involvement in the online Autistic community and psychological well-being would be mediated by Autistic identity and sense of community. Correlations were examined among the hypothesized relationships, and a mediated regression model (Baron & Kenny, 1986) was used to explore the relationship between the importance and value of involvement in the online Autistic community and psychological well-being with Autistic identity and sense of community as mediators. Significant relationships were found between the importance and value of involvement in the online Autistic community and Autistic identity, between the importance and value of involvement in the online Autistic community and sense of community, and between autistic identity and sense of community. As a first step to test the mediated regression models, psychological well-being was regressed on the importance and value of involvement in the online Autistic community. The regression was not significant; therefore the hypothesized model was not significant. Despite non-significant mediated regression model results, significant relationships among the importance and value of involvement in the online Autistic community and Autistic identity and sense of community offer important results. These finding illuminate the potential positive impact of the importance and value of involvement in the online Autistic community, including evidence counter to the myth that autistic individuals lack skills necessary for social relationships. These findings support the positive utility of involvement in the online Autistic community for autistic adults. Further research with a larger sample size is recommended, due to low power coefficients in the analyses. Additional research may also further illuminate the findings of the current study. Possible topics may include sense of community and Autistic identity in individuals that do not use the Internet, differences in the way the Internet is used in autistic individuals, and different measures of involvement in the online Autistic community and well-being.