Small nonprofit organizations are faced with limited resources and budgets for setting and reaching their goals. Some are nevertheless able to mitigate these challenges and achieve success. This thesis examines how this can be done. Organizations with excellent public relations programs have been found to be successful in achieving their goals (Grunig et al., 2002). Through the lens of the excellence model, this thesis analyzes, using in depth, semi-structured interview data, how senior managers of seven successful small nonprofits account for their success and address challenges as well as how their practices reflect the excellence model. This thesis does not test the excellence model in the context of small nonprofits, but rather attempts to establish recommendations for communication and PR success for small nonprofits based on what is learned from a small group of successful organizations.

Background: Infertility rates in the Middle East and North Africa are among the highest worldwide. Despite its elevated prevalence among men and women, infertility is mainly blamed on women’s reproductive health failures. Consequently, infertility threatens women’s social and marital security, social power, and status in society. In Canada, the Arab population constitutes the second largest group of newcomers, but very little research has explored Arab immigrant women’s experiences with and access to comprehensive reproductive health services. Objectives: This project aimed to fill a gap in the literature on reproductive health in Ontario. This study explored: 1) Arab women’s experiences with infertility and infertility-related services in Ontario; 2) the barriers these women face when seeking these services; and 3) possible ways infertility-related information and services could be improved. Methods: This qualitative study consisted of in-depth interviews with Arab immigrant women and interviews with key informants. We used a multi-modal recruitment strategy including social media ads, flyers, advertisements through community organizations, and an Arabic-language radiobroadcast. We analyzed both components for content and themes using deductive and inductive techniques. Results: Participants struggled with primary infertility, mainly due to polycystic ovarian syndrome or endometriosis. Women identified cost, socio-cultural dynamics, stigma, and embarrassment as barriers to seeking treatment. Women described existing services as lacking comprehensive information, cultural sensitivity, and emotional support. Conclusions: Our findings suggest that Arab immigrants face barriers in accessing infertility care in Ontario. These services can be improved through engaging in education and awareness raising efforts, providing psychosocial support services, and building bridges between organizations and the community.

Introduction The Northwest Territories as a rural and remote region of Canada has higher colorectal cancer rates and lower uptake of colorectal cancer screening compared to the rest of the country. Understanding the complex health system processes involved in screening is necessary to develop informed solutions to improve screening access amongst marginalized populations. A systems approach to describe and understand the health care processes and system-level factors influencing colorectal cancer screening access was undertaken. Methods Semi-structured interviews with health care providers (N=29) involved in colorectal cancer screening in all health authorities within the Northwest Territories (N=8) were performed from September to December 2015. Interview transcripts were analyzed using qualitative content analysis methods within a Collaborative Information Behaviour (CIB) and Continuity of Care framework. Exploratory models of colorectal cancer screening processes were developed and translated into quantitative parameters for simulation modelling. Results Colorectal cancer screening access was defined by patient health care interactions supported by foundational information processes. Eighteen models of colorectal cancer screening access within the territory were identified, with varying complexity in care access seen across communities. Screening access problems included screening initiation, colonoscopy scheduling, screening recall and information silos, and were influenced by multiple contextual factors including a transient health work force, social health determinants, and patient travel. Qualitative models were translated into a system dynamics (SD) design framework for development of further quantitative modeling. Conclusions Colorectal cancer screening access in the Northwest Territories is a complex process comprising patient interactions and information processes linking primary care and hospital care processes, which are influenced by challenging contextual factors in the rural and remote health care environment. In developing screening access solutions the foundational role of information support and the need for system trade-offs in restructuring health system processes are necessary considerations. Optimizing information processes through the utilization of health informatics tools such as standardized referral forms and EMRs may also support health system transformation to improve screening access across the Northwest Territories. Understanding and evaluating system trade-offs may be best achieved using a combination of qualitative and quantitative modeling through future application of SD modeling research.

Research shows that there is an increasing number of international students studying in universities and colleges in Canada, with China a top source country of international students. However, Chinese students’ experience studying in Canada has been rarely researched. Taking University of Ottawa as a case, this study explores the experience of Chinese students in terms of their relationships with instructors through a relational communication lens. Semi-structured in-depth interviews were conducted with Chinese first year students studying at the University of Ottawa to explore their experience of student-instructor relationships, to understand their overall experience of the student-instructor relationship, to identify the contributors and hindrances to the development of positive student-instructor relationships, and to explore the impact of such relationship on the students. Findings indicate that Chinese students experience different education and acculturation which influences their overall experience of student-instructor relationships. Teacher immediacy, rapport and classroom justice are factors that affect the development of such relationships, whose impact include both academic and social outcomes.

Traumatic brain injury is a substantial cause of disability worldwide; recovery is a long-term, intensive process. Patients with traumatic brain injury are admitted to inpatient rehabilitation with the goal of preventing disability and the need for long-term care as well as promoting patient independence. Acknowledging that traumatic brain injury also affects the family, much of the literature focuses on the well-being of families and their needs, bringing attention to family functioning, resilience, and psychosocial well-being. Recognizing the important role of families in health care, Canadian healthcare institutions espouse family-centred philosophy. Not to mention, the resulting impairments from traumatic brain injury and the complex nature of inpatient rehabilitation can also lead to the involvement of families in this process. However, we do not yet fully understand how families are involved in adult inpatient traumatic brain injury rehabilitation. Given the adoption of a family-centred philosophy as well as the potential benefits of family-centred care for patient and family outcomes, it is important to understand this involvement to guide the provision of family-centred health and rehabilitation services. This study is the first step in a program of research that is devoted to understanding family involvement in adult inpatient traumatic brain injury rehabilitation. I used an interpretive qualitative approach with a two-phased sequential design to elucidate how families were involved in the inpatient rehabilitation process. I conducted one-on-one semi-structured interviews with six patients with TBI, four family members, and 10 healthcare professionals followed by observations on the inpatient Acquired Brain Injury ward at a Canadian adult rehabilitation centre. In Phase 1 interviews, both the patients and family members described family involvement as family members being with and supporting the patients, informing other family members as well as the healthcare professionals and keeping themselves informed, helping the patients to make decisions, and participating in care and therapy. The healthcare professionals similarly described family members being with and supporting the patients; however, they conversely illustrated family members’ involvement as providing information to and receiving information from the healthcare professionals as well as making decisions when required or deemed necessary by them, and learning care and therapy. While the observation findings supported the patients’, family members’, and healthcare professionals’ perceptions that family members support the patients by being present and spending time with them, they highlighted the healthcare professional-led nature of the rehabilitation process in the inpatient setting in relation to information sharing, decision making, and care and therapy. They also illuminated the potential impact of the ward environment on family involvement. This study was the first to explore family involvement with this adult patient population in the inpatient rehabilitation setting from the perspectives of patients, family members, and healthcare professionals as well as through direct observation. It revealed that patients and family members had different understandings than healthcare professionals of the ways in which families were involved. Given the adoption of a family-centred philosophy, we need to understand how to operationalize it in this type of adult setting and close the gap between theory and practice.

Surgeons regularly make changes in their practice to ensure they are providing high quality patient care. This includes the process of learning and safely integrating new skills, techniques and technologies into practice. When faced with the challenge of integrating a new surgical procedure into practice, surgeons must determine when they are ready to overcome the associated risks. This study sought to understand how surgeons experience risk when learning and integrating a new procedure into practice. A modified constructivist, grounded theory approach was utilized. Eighteen surgeons were purposively sampled from two Canadian academic medical institutions. Semi-structured interviews were conducted and interpreted through constant comparative analysis. Emergent themes were identified and a conceptual framework was developed for understanding the surgeon experience associated with adopting and integrating a new procedure into practice. Regardless of personal risk tolerance, surgeons described a similar approach to learning and implementing new skills. The experience of risk was one of several factors that affected their adoption of new techniques. They also described being influenced by individual, personality-driven factors, logistical considerations and the culture inherent to their departmental, institutional, professional and societal contexts. A framework for understanding the surgeon experience when adopting and integrating new skills was constructed. The complex, nuanced multifactorial interplay between a surgeon’s individual willingness to engage risk, his/her motivations and the systemic and cultural factors that serve to facilitate or hinder the implementation of a new surgical skill is at the core of this experience. An increased awareness of these factors highlights the challenges that surgeon face in adopting new procedures and may lead to the development of policies which support surgeons learning and implementing new skills, techniques and technologies while maximizing patient safety.

Members of the workplace are at the heart of the organizational learning process. They play a major role by communicating their shared perceptions, distributing knowledge, and acting as human components of the broader organizational memory. Today, three generations cohabitate in the work environment, each of whom have their own distinct traits that influence how they perceive and enact learning. This thesis explores how Millennials experience organizational learning and its significance. By applying Crossan et al.’s (1999) 4I Framework, the process of intuiting, interpreting, integrating, and institutionalizing are considered from the standpoint of the Millennial generation. The methodology for this study includes semi-structured interviews and qualitative thematic analysis to better understand this relationship. This is based on 13 conversations with members all drawn from a single organization. The findings describe how Millennials see learning as fundamental as well as how they overcome the challenges they face and apply their knowledge.

Background: Elderly patients have shown to have difficulties to adhere to a continuous independent exercising after a rehabilitation period. Therefore, there is a need for increased understanding among physiotherapists about how to prepare these patients to be independent. Aim: The aim of the study was to describe which factors elderly Arabic immigrants who has completed a clinical physiotherapy intervention, been advised to exercise on their own and then returned to physiotherapy again perceive as important factors for them to continue physical exercising on their own. Method: Ten semi-structured interviews were conducted with patients aged 65 years and more with Arabic background. The interviews were analysed with qualitative content analysis and were presented in themes and categories with illustrating quotes. Results: The result showed one theme "Factors influencing continued physical exercising "with four categories and sixteen subcategories that emerged from the analysis. The four categories were: Individual-related factors, Psychosocial-related factors, Physiotherapeutic factors, and Authority-supporting factors. All these factors varied in adherence to exercise among the participants, but were all common among all participants. Conclusion: Adherence to exercising in elderly Arabic immigrants individuals appeared to be multifactorial. The result of the study showed that the informants are aware of and acknowledge the influence of the individual-related factors that appeared to be the major motivators/inhibitors for them, such as: pain, mood, limited income, coldness and lack of discipline. Nevertheless the result of the study showed that the informants' views on the training are positive. The training gave them every day routines, to being a part of social life. Moreover getting support from physiotherapists was contributing factor to adherence to exercising. A large number of informants also indicated that they couldn’t continue their training because of the shortage in availability and affordability of training facilities which should be the responsibility of the authorities. Language barrier was expressed as an important factor that could contribute to misunderstanding and therefore non-adherence to exercising. / Bakgrund: Äldre patienter har visat sig ha svårigheter att följa en kontinuerlig självständig träning efter en rehabiliteringsperiod. Därför finns det ökat behov av förståelse bland fysioterapeuter om hur man förbereder dessa patienter för att vara självständiga. Syftet med studien var att beskriva vilka viktiga faktorer som äldre arabiska immigranter som har genomgått en färdig klinisk fysioterapeutisk behandling och har blivit rekommenderat att träna på egen hand uppfattar som viktiga faktorer för att de ska vara självständiga vid träning. Metod: Tio halvstrukturerade intervjuer genomfördes med patienter i åldern 65 år och mer med arabisk bakgrund. Intervjuerna analyserades med kvalitativ innehållsanalys och presenterades i teman och kategorier med illustrerande citat. Resultatet visade ett tema "Faktorer som påverkar fortsatt fysisk träning" med fyra kategorier och sexton subkategorier som framkom av analysen. kategorierna var: Individrelaterade faktorer, psykosociala faktorer, fysioterapeutiska faktorer och myndighetsstödande faktorer. Alla dessa faktorer varierade bland deltagarna, men var alla vanliga bland alla deltagare. Slutsats: Att hålla sig till fysiska övningar hos äldre arabiska immigranter tycktes vara multifaktoriella. Resultatet av studien visade att informanterna är medvetna om och bekräftar påverkan av de enskildrelaterade faktorer som verkade vara de främsta motivatorerna och hämmarna för dem, såsom: smärta, humör, begränsad inkomst, kyla och brist på disciplin. Resultatet av studien visade likväl att informatörernas syn på träning är positiva. Träningen gav dem dagliga rutiner och känsla av att vara en del av det sociala livet. Stödet från fysioterapeuterna var även motiverande faktor för försätta träning. Majoriteten av informanterna betonade också att de inte kunde fortsätta sin utbildning på grund av bristen på tillgänglighet och överkomliga kostnader för träningsanläggningar som borde vara myndigheternas ansvar. Språkbarriären uttrycktes som en viktig faktor som skulle kunna bidra till missförstånd och därmed inte överensstämma med träning.

Tron på den egna förmågan att förbli återhållsam (”abstinence self-efficacy”) har visat sig vara en bidragande faktor till att personer med substansberoende lyckas förbli återhållsamma. Syftet med studien var att undersöka om det fanns gemensamma teman inom tron på den egna förmågan hos människor med substansberoende, med särskilt fokus på faktorer som bidrar till förmågan att förbli återhållsam. Detta har undersökts genom åtta intervjuer med människor som inte längre är aktiva i sitt substansberoende. Deltagarna var 19-65 år gamla, varav en var kvinna. Alla deltagare har haft någon form av substansberoende, varav sex deltagare hade alkohol som sin huvudsubstans. De teman som hittades inom förstärkande faktorer var yttre - relationer och aktiviteter, samt inre - inneboende motivation och tankar. Det tema som hittades inom faktorer som försvagar var motgångar. Studien kan användas för att bättre förstå vilka faktorer som är bidragande när det kommer till substansberoendes tro på den egna förmågan att förbli återhållsam.

Stroke is the primary cause of adult disability in the UK. Those who have experienced stroke have a higher risk of a subsequent stroke. Stroke recovery has physical, emotional and social dimensions and impacts on family caregivers as well as stroke survivors. Getting the right information at the right time is put forward as instrumental in supporting recovery and preventing further stroke. The research literature demonstrates persistent uncertainty about the best way to provide information to stroke survivors and carers in practice. The aim of this study was to explore the processes, motivations and perceptions of the impact of information exchange between stroke survivors, carers and health professionals. A qualitative case study strategy was utilised for the study as this provided a flexible framework to incorporate multiple perspectives upon information exchange in the practice context. A single setting in, Salford, Greater Manchester, was used to study the phenomenon of information exchange from the perspectives of stroke survivors, carers and health professionals. Data collection included interviews with participants, observations of communication and documentary analysis. Data was analysed using the Framework analysis approach in order to compare and contrast perspectives across the different respondent groups and so develop study propositions to explain the data. There was much common ground amongst respondents in the thematic categories identified from the data, but subtle differences in emphasis on different topics. The key findings from this research are in two areas. Firstly, the challenges of incorporating a self-management philosophy into information exchange post stroke are substantial. This is because patients experience a variable recovery trajectory and have insufficient contact time with the professionals who they perceive as valid information providers. Second, the research raises questions of what is meant by tailored information in practice: the timing of information was a critical issue for survivors and carers along with the desire for appropriate support to utilise information effectively. These findings suggest a need to shift the focus of research from information provision to information exchange post stroke; to examine not the best way of providing information, but rather the best way of assessing individual need, and pacing provision tailored to these specific needs. This would require debate and consensus among the stroke community about the core underlying principles of information exchange, a reassessment of key time-points for sharing information and a re-examination of professionals ongoing development needs in communication skills to underpin this.