Communities In Alberta Research Articles

Survey of northern informal and formal mental health practitioners

BackgroundThis survey is part of a multi-year research study on informal and formal mental health support in northern Canada involving the use of qualitative and quantitative data collection and analysis methods in an effort to better understand mental health in a northern context.ObjectiveThe main objective of the 3-year study was to document the situation of formal and informal helpers in providing mental health support in isolated northern communities in northern British Columbia, northern Alberta, Yukon, Northwest Territories and Nunavut. The intent of developing a survey was to include more participants in the research and access those working in small communities who would be concerned regarding confidentiality and anonymity due to their high profile within smaller populations.DesignBased on the in-depth interviews from the qualitative phase of the project, the research team developed a survey that reflected the main themes found in the initial qualitative analysis. The on-line survey consisted of 26 questions, looking at basic demographic information and presenting lists of possible challenges, supports and client mental health issues for participants to prioritise.ResultsThirty-two participants identified various challenges, supports and client issues relevant to their mental health support work. A vast majority of the respondents felt prepared for northern practice and had some level of formal education. Supports for longevity included team collaboration, knowledgeable supervisors, managers, leaders and more opportunities for formal education, specific training and continuity of care to support clients.ConclusionFor northern-based research in small communities, the development of a survey allowed more participants to join the larger study in a way that protected their identity and confidentiality. The results from the survey emphasise the need for team collaboration, interdisciplinary practice and working with community strengths as a way to sustain mental health support workers in the North.

Informal and formal mental health: preliminary qualitative findings

BackgroundNorthern-based research on mental health support, no matter the specific profession, helps to inform instruction of new practitioners and practitioners already working in rural or isolated conditions. Understanding the complexities of northern mental health support not only benefits clients and practitioners living in the North, but also helps prepare psychologists and counsellors preparing to work in other countries with large rural and isolated populations. The qualitative phase is part of a multi-year research study on informal and formal mental health support in northern Canada involving the use of qualitative and quantitative data collection and analysis methods.ObjectiveThe main objective of the qualitative phase interviews was to document in-depth the situation of formal and informal helpers in providing mental health support in isolated northern communities in northern British Columbia, northern Alberta, Yukon and Northwest Territories (NWT). The intent of in-depth interviews was to collect descriptive information on the unique working conditions of northern helping practitioners for the development of a survey and subsequent community action plans for helping practitioner support.DesignTwenty participants in northern BC, Yukon and NWT participated in narrative interviews. Consensual qualitative research (CQR) was used in the analysis completed by 7 researchers. The principal researcher and research associate then worked through all 7 analyses, defining common categories and themes, and using selections from each researcher in order to ensure that everyone's analysis was represented in the final consensual summary.ResultsThe preliminary results include 7 main categories consisting of various themes. Defining elements of northern practice included the need for generalist knowledge and cultural sensitivity. The task of working with and negotiating membership in community was identified as essential for northern mental health support. The need for revised codes of ethics relevant to the reality of northern work was a major category, as was insight on how to best sustain northern practice.ConclusionMany of the practitioners who participated in this study have found ways to overcome the biggest challenges of northern practice, yet the limitations of small populations and lack of resources in small communities to adequately address mental health support were identified as existing. Empowering communities by building community capacity to educate, supervise and support formal and informal mental health workers may be the best approach to overcoming the lack of external resources.

Exploring the Barriers and Facilitators to Children’s Active Transportation to and From School From the Perspectives of Practitioners

Despite the health benefits associated with physical activity participation, activity levels of North American children are declining. In response, practitioners are placing emphasis on active forms of transportation to and from school. The purpose of this study was to explore the barriers and facilitators to active transportation to school (ATS) from the perspectives of practitioners. The perspectives of 19 practitioners (eg, health promoters, traffic engineers, police, etc.) from 3 communities in Alberta, Canada were captured using focus group interviews followed by content analysis. Subthemes tied to barriers included logistics, lifestyle, safety, and lack of resources; while facilitators were comprised of collaboration, education, and leadership. The results were interpreted using an ecological model of health behavior. The most common ATS barriers: attitudes and safety concerns, lack of resources and time, and the nature of the natural and built environments were associated with the intrapersonal, organizational, and physical environmental factors, respectively. The most significant organizational facilitators concerned collaboration among parents, schools, businesses, community organizations, and government agencies. While the multifaceted nature of barriers and facilitators add complexity to the issue, it also challenges practitioners to think and act creatively in finding solutions.

Analysing responses to climate change through the lens of reflexivity

Sociologists are increasingly directing attention toward social responses to climate change. As is true of any new field of inquiry, theoretical frameworks guiding the research to date have room for improvement. One advance could be achieved through closer engagement with Reflexivity Theory, particularly the work of Margaret Archer, who asks just how individuals come to give attention to certain problems, and formulate responses to them. Individuals vary significantly in regard to their understanding of and concern for anthropogenic climate change, and these standpoints in turn influence commitment to mitigation and adaptation. The emergent social interactions among all such agents in turn influence the morphogenetic trajectories through which social structures will evolve, but the role of 'meta-reflexives' is particularly crucial. Identifying pathways of individual climate change reflexivity can make a valuable contribution to our understanding of the potential for and nature of collective responses. In this paper, I explore climate change reflexivity, with particular attention to climate change meta-reflexives, through a qualitative analysis of personal interviews with residents of two small communities in Alberta, Canada. Applying Reflexivity Theory to this context articulates dimensions of reflexive processing not elaborated in current theoretical treatments, including future outlook and comfort with uncertainty, among others.

Creating neighbourhood groupings based on built environment features to facilitate health promotion activities.

Detailed assessments of the built environment often resist data reduction and summarization. This project sought to develop a method of reducing built environment data to an extent that they can be effectively communicated to researchers and community stakeholders. We aim to help in an understanding of how these data can be used to create neighbourhood groupings based on built environment characteristics and how the process of discussing these neighbourhoods with community stakeholders can result in the development of community-informed health promotion interventions. We used the Irvine Minnesota Inventory (IMI) to assess 296 segments of a semi-rural community in Alberta. Expert raters "created" neighbourhoods by examining the data. Then, a consensus grouping was developed using cluster analysis, and the number of IMI variables to characterize the neighbourhoods was reduced by multiple discriminant function analysis. The 296 segments were reduced to a consensus set of 10 neighbourhoods, which could be separated from each other by 9 functions constructed from 24 IMI variables. Biplots of these functions were an effective means of summarizing and presenting the results of the community assessment, and stimulated community action. It is possible to use principled quantitative methods to reduce large amounts of information about the built environment into meaningful summaries. These summaries, or built environment neighbourhoods, were useful in catalyzing action with community stakeholders and led to the development of health-promoting built environment interventions.

Creating Neighbourhood Groupings Based on Built Environment Features to Facilitate Health Promotion Activities

Detailed assessments of the built environment often resist data reduction and summarization. This project sought to develop a method of reducing built environment data to an extent that they can be effectively communicated to researchers and community stakeholders. We aim to help in an understanding of how these data can be used to create neighbourhood groupings based on built environment characteristics and how the process of discussing these neighbourhoods with community stakeholders can result in the development of community-informed health promotion interventions.We used the Irvine Minnesota Inventory (IMI) to assess 296 segments of a semi-rural community in Alberta. Expert raters "created" neighbourhoods by examining the data. Then, a consensus grouping was developed using cluster analysis, and the number of IMI variables to characterize the neighbourhoods was reduced by multiple discriminant function analysis.The 296 segments were reduced to a consensus set of 10 neighbourhoods, which could be separated from each other by 9 functions constructed from 24 IMI variables. Biplots of these functions were an effective means of summarizing and presenting the results of the community assessment, and stimulated community action.It is possible to use principled quantitative methods to reduce large amounts of information about the built environment into meaningful summaries. These summaries, or built environment neighbourhoods, were useful in catalyzing action with community stakeholders and led to the development of health-promoting built environment interventions.

Physical Activity Intensity and Cardiometabolic Risk in Youth

To determine the association between physical activity (PA) intensities and cardiometabolic risk factors in youth. Cross-sectional study using data from the 2008 Healthy Hearts Prospective Cohort Study of Physical Activity and Cardiometabolic Health in Youth. Rural and urban communities in Alberta, Canada. A convenience sample of 605 youth aged 9 to 17 years. Youth were on average aged 12.1 years, 248 were boys (41%), and 157 were overweight or obese (26%). Actical accelerometer-measured PA intensity. The primary outcome was body mass index (calculated as weight in kilograms divided by height in meters squared) z score. Secondary outcome measures included waist circumference, systolic blood pressure, and cardiorespiratory fitness (maximal oxygen consumption [[Vdot]O2max]). Body mass index z score, waist circumference, and systolic blood pressure decreased and [Vdot]O2max increased in a dose-response manner across tertiles of vigorous PA (adjusted P < .001). No significant differences in cardiometabolic risk factors were seen across tertiles of moderate or light PA in multivariable analyses. Achieving more than 7 minutes of vigorous PA daily was associated with a reduced adjusted odds ratio of overweight status (0.56; 95% CI, 0.33-0.95) and elevated systolic blood pressure (0.36; 95% CI, 0.16-0.79). The odds of overweight status and elevated blood pressure decreased with increasing time and intensity of PA. Only vigorous PA was consistently associated with lower levels of waist circumference, body mass index z score, systolic blood pressure, and increased cardiorespiratory fitness in youth. These findings underscore the importance of vigorous PA in guidelines for children and adolescents.

Rural physicians' skills enrichment program: A cohort control study of retention in Alberta

The Rural Physician Action Plan of Alberta introduced an enrichment program in 2001 to improve physician access to skills training. The objective of this study was to evaluate this program and measure retention compared with matched controls over 5 years. Longitudinal, matched, case control study and program evaluation. Rural communities in Alberta, Canada. Rural physicians. Thirty-one rural physicians self-selected their personal skills training program and listed three goals they wished to attain. They were matched by age, specialty, years in practice and size of community with rural physicians who did not participate in a skills training or upgrading program. Goal attainment for subject physicians, use of skills at 5 years and comparison of rural retention of physicians at 5 years. Thirty-two of thirty-five physicians classified their goal attainment to be as expected or greater, and all were using their new skills at 5 years. Of the matched physicians, 29 training participants remained in rural practice at 5 years compared with only 22 of 29 matched control: relative risk 1.31, confidence interval 1.06-1.62 P < 0.05. The enrichment program provides focused, valued skills training for rural physicians and long-term benefits to rural communities.

Spatial analysis to locate new clinics for diabetic kidney patients in the underserved communities in Alberta

Canadians with chronic diseases often live far away from healthcare facilities, which may compromise their level of care. We used a new method for selecting optimal locations for new healthcare facilities in remote regions. We used a provincial laboratory database linked to data from the provincial health ministry. From all patients with serum creatinine measured at least once between 2002 and 2008 in Alberta, Canada, we selected those with diabetes and an estimated glomerular filtration rate (eGFR) of 15-60 mL/min/1.73 m(2). We then used two methods to select potential locations for new clinics that would serve the greatest number of remote-dwelling patients: plots showing the unadjusted density of such patients per 100 km(2) and SatScan analysis presenting the prevalent clusters of patients on the basis of chronic kidney disease (CKD) rates (adjusted for population size). We studied 32,278 patients with concomitant diabetes and CKD. A substantial number of patients (8%) resided >200 km from existing nephrologists' clinics. Density plots mapped with ArcGIS were useful for localizing a large cluster of underserved patients. However, objective assessment with SatScan technique and ArcGIS permitted us to detect additional clusters of patients in the northwest and southeast regions of Alberta--and suggested potential locations for new clinics in these areas. Objective techniques such as SatScan can identify clusters of underserved patients with CKD and identify potential new facility locations for consideration by decision-makers. Our findings may also be applicable to patients with other chronic diseases.

GP Surgeons’ Experiences of Training in British Columbia and Alberta: A Case Study of Enhanced Skills for Rural Primary Care Providers

There has been a steady erosion of family physicians with enhanced surgical skills providing care for rural residents. This has been largely due to the lack of formal training avenues and continuing medical education (CME) opportunities afforded to those interested, and attrition of those currently practicing. A qualitative study was undertaken using an exploratory policy framework to guide the collection of in-depth interview data on GP surgeons' training experiences. A purposive sample of GP surgeons currently practicing in rural BC and Alberta communities yielded interviews with 62 participants in person and an additional 8 by telephone. Interviews were audio recorded and transcribed then subjected to a process analysis. Participants thematically identified motivations for acquiring advanced skills training, resources required (primarily in the area of solid mentorship), the most efficacious context for a training program (structured), and differences in mentorship between obstetricians and general surgeons. Mentors and role models were the most salient influencing factor in the trajectory of training for the participants in this study. Mentorship between specialists and generalists was constrained at times by inter-professional tensions and was accomplished more successfully within a curriculum-based, structured environment as opposed to a learner-responsive training environment.

Assessing the Impact of the Introduction of Casinos in Two Northern Alberta First Nation Communities

This article argues that socio-economic analyses of reserve casino projects, specifically those studies structured to offer an overall assessment of success or failure, need to embrace mixed methods approaches. In particular, eliciting community-based perspectives through qualitative data gathering techniques is essential to provide a level of context required to better understand the casinos' overall influence. To date researchers tend to rely on First Nations leaders projections and assessments as the baseline data for their analysis. This article compares the impacts of two casinos in northern Alberta communities, and shows how focus groups provided a grassroots perspective of the casinos' positive and negative impacts that were not captured by the quantitative data.

Telepharmacy in a rural Alberta Community Cancer Network

Telepharmacy services were developed and adopted to compensate for the absence of a pharmacist in rural Cancer Centers. Preparation included the formation of an advisory committee, development of a training and certification process, establishing new policies and operating procedures, collecting utilization data and a survey of patient and user satisfaction. Pharmacy technicians at two remote community cancer centers were connected by telehealth with pharmacists at one of the two coordinating centers to oversee the compounding of intravenous (I.V.) chemotherapy and provide clinical review of physician orders. In 8 months of telepharmacy use, 247 intravenous preparations were compounded for 47 cancer patients during 109 treatment visits. Approximately 45,000 km (27,000 miles) of patient travel were averted. Pharmacy staff estimates requires an average of 10 additional minutes to process and compound each chemotherapy preparation. Nurses estimate an average of 27.5 additional minutes required to coordinate information for each patient order.

Ethical professional practice: exploring the issues for health services to rural Aboriginal communities

This article provides a first person account of the experience of professional ethics for a psychologist who has worked in several Aboriginal communities in Alberta, Canada. These small rural communities tend to have few services and health services are typically provided by multidisciplinary health teams. Team members are predominantly community members, creating an embedded service environment that highlights the need for integrity in relationships. As the psychologist travelling to these communities I require sensitivity to cultural considerations, multiple party responsibilities, and community pressure on service delivery. In these settings, in consideration of the principle of respect for the dignity of persons, there is enhanced need for non-discrimination, particularly as most community members are vulnerable persons. Also, the context of small community clinics highlights issues of privacy and confidentiality. Responsible caring in these kinds of general practice also raise ongoing questions about competence and the need for daily risk-benefit analysis. Finally, responsibility to society is also an overarching consideration given the conditions of Canadian Aboriginal communities.

Edge effects of three anthropogenic disturbances on spider communities in Alberta’s boreal forest

Increasing fragmentation of forests worldwide by timber and industrial development makes it important to understand the edge effects of common anthropogenic disturbances on forest fauna. We collected ground-active spiders along transects across the edge of logging clearcuts, gravel roads and gas pipelines in the boreal forest of Alberta, sampling on the disturbance (10 m from forest edge), and 10, 45, and 200 m into the forest. We asked whether the three disturbances were associated with edge effects on spider communities, and whether the extent of their associated edge effects were equivalent. The spider community at the edges of clearcuts was distinct from interior and on-disturbance communities 10 m into the forest from the clearcut edge, showing an edge effect of between 10 and 45 m from clearcut edges, while no edge effects were apparent at road and pipeline edges. Edge effects therefore differ at linear and non-linear openings in the boreal forest, which suggests that small linear openings may be associated with minimal edge effects compared to large polygonal forest openings. This result has important consequences for forest management, where clearcuts and other non-linear openings are likely to cause edge effects on spider communities that are between 10 and 45 m in their extent. The small size of clearcuts as practiced in the public forests of Canada, and their dense and broad application across the landscape, makes this edge effect of broad spatial significance in protecting biodiversity in managed landscapes.

Independent evolution of leaf and root traits within and among temperate grassland plant communities.

In this study, we used data from temperate grassland plant communities in Alberta, Canada to test two longstanding hypotheses in ecology: 1) that there has been correlated evolution of the leaves and roots of plants due to selection for an integrated whole-plant resource uptake strategy, and 2) that trait diversity in ecological communities is generated by adaptations to the conditions in different habitats. We tested the first hypothesis using phylogenetic comparative methods to test for evidence of correlated evolution of suites of leaf and root functional traits in these grasslands. There were consistent evolutionary correlations among traits related to plant resource uptake strategies within leaf tissues, and within root tissues. In contrast, there were inconsistent correlations between the traits of leaves and the traits of roots, suggesting different evolutionary pressures on the above and belowground components of plant morphology. To test the second hypothesis, we evaluated the relative importance of two components of trait diversity: within-community variation (species trait values relative to co-occurring species; α traits) and among-community variation (the average trait value in communities where species occur; β traits). Trait diversity was mostly explained by variation among co-occurring species, not among-communities. Additionally, there was a phylogenetic signal in the within-community trait values of species relative to co-occurring taxa, but not in their habitat associations or among-community trait variation. These results suggest that sorting of pre-existing trait variation into local communities can explain the leaf and root trait diversity in these grasslands.

Attracting, preparing, and retaining under-represented populations in rural and remote Alberta-North communities

&lt;p&gt;For several years, the government of the western Canadian province of Alberta has drafted policies and conducted research on the problem of populations under-represented in adult education. This Alberta-North and Athabasca University study, funded by the Alberta government’s Innovation Fund, uses the advice and educational experiences of northern former and present students, and of other community members, to identify ways of better attracting, preparing, and retaining under-represented populations in northern Alberta communities through provision and training in the use of distance delivery methods.&lt;/p&gt;&lt;p&gt;The research reported here commences with a review of the literature to investigate the following: 1) the contribution distance education makes globally to learning access in remote areas (and resulting economic growth for under-served populations); 2) how support is provided to retain isolated students; and 3) the help needed to assist remote students to complete distance programs. Community consultations with social service and education agencies in three communities were conducted in order to obtain their perspectives about what helps to attract and support students to educational programs and the barriers students typically encounter, which might be mitigated by distance methods. Finally, a survey was designed and distributed in 87 Alberta-North communities in northern Alberta and across Canada’s Northwest Territories to add perspective to the consultation results.&lt;/p&gt;

Emerging longitudinal trends in health indicators for rural residents participating in a diabetes and cardiovascular screening program in northern Alberta, Canada.

Background. Geographic isolation, poverty, and loss of culture/tradition contribute to “epidemic” rates of diabetes amongst indigenous Canadians. The Mobile Diabetes Screening Initiative travels to rural indigenous and other remote communities in Alberta to screen for diabetes and cardiovascular risk. We sought to examine risk factors longitudinally. Methods. Clinical and anthropometric measurements were undertaken for 809 adults (aged 20–91) between November 2003 and December 2009. For those who had more than one MDSi visit, trend estimates (actual changes) were calculated for body mass index (BMI), weight, waist circumference, hemoglobin A1c (A1c), total cholesterol, and blood pressure. Results. Among those without diabetes (N = 629), BMI and weight increased (P < .01) and blood pressure decreased (P < .05). For those with diabetes (N = 180), significant improvements (P < .05) were observed for all indicators except waist circumference. Conclusion. Improvements observed suggest that MDSi's model may effectively mediate some barriers and support subjects in managing their health.

Bicycle helmet use after the introduction of all ages helmet legislation in an urban community in Alberta, Canada.

Bicycle trauma is a common cause of recreational death and disability and helmets have been shown to reduce fatal and non-fatal head and face injuries. This study evaluated the effect of mandatory bicycle helmet legislation for all ages in St. Albert, Alberta. We observed bicyclists from June to September of 2006 in St. Albert, a community subject to both provincial (< 18 years old) and municipal (all ages) helmet legislation, and compared our results with observations taken in 2000 when no legislation existed. Helmet wearing and rider characteristics were recorded by trained observers. Poisson regression analysis was used to obtain helmet prevalence (HP) and prevalence ratio (PR) estimates. HP increased from 45% to 92% (PR = 2.03; 95% CI: 1.72-2.39) post-legislation. Controlling for other covariates, children were 53% (PR = 1.53; 95% CI: 1.34-1.74) and adolescents greater than 6 times (PR =6.57; 95% CI: 1.39-31.0) more likely to wear helmets; however, adults (PR = 1.26; 95% CI: 0.96-1.66) did not show a statistically significant change post-legislation. Restricting the analysis to high socio-economic status areas, adult helmet prevalence increased in St. Albert from 58% to 73% post-legislation compared with a 52% to 57% change across the province; this effect was not statistically significant. Helmet legislation in St. Albert was associated with a significant increase in helmet use among child and adolescent cyclists. A larger increase in HP was observed for adults in St. Albert than in other areas of the province; however, this difference was not statistically significant, which may reflect the small sample size or insufficient time passage after bylaw enactment.

Bicycle Helmet Use After the Introduction of All Ages Helmet Legislation in an Urban Community in Alberta, Canada

Background: Bicycle trauma is a common cause of recreational death and disability and helmets have been shown to reduce fatal and non-fatal head and face injuries. This study evaluated the effect of mandatory bicycle helmet legislation for all ages in St. Albert, Alberta. Methods: We observed bicyclists from June to September of 2006 in St. Albert, a community subject to both provincial (<18 years old) and municipal (all ages) helmet legislation, and compared our results with observations taken in 2000 when no legislation existed. Helmet wearing and rider characteristics were recorded by trained observers. Poisson regression analysis was used to obtain helmet prevalence (HP) and prevalence ratio (PR) estimates. Results: HP increased from 45% to 92% (PR=2.03; 95% CI: 1.72-2.39) post-legislation. Controlling for other covariates, children were 53% (PR=1.53; 95% CI: 1.34-1.74) and adolescents greater than 6 times (PR=6.57; 95% CI: 1.39-31.0) more likely to wear helmets; however, adults (PR=1.26; 95% CI: 0.96-1.66) did not show a statistically significant change post-legislation. Restricting the analysis to high socio-economic status areas, adult helmet prevalence increased in St. Albert from 58% to 73% post-legislation compared with a 52% to 57% change across the province; this effect was not statistically significant. Conclusions: Helmet legislation in St. Albert was associated with a significant increase in helmet use among child and adolescent cyclists. A larger increase in HP was observed for adults in St. Albert than in other areas of the province; however, this difference was not statistically significant, which may reflect the small sample size or insufficient time passage after bylaw enactment. Key words: Bicycling; head protective device; legislation; prevalence

Linking social structure, fragmentation, and substance abuse in a resource-based community

Drawing on case-study research from a rural, resource-based community in Alberta, Canada, this paper explores the social and economic context of substance abuse. Specifically, the linkages between social structure, community fragmentation, and family dysfunction offer a way of understanding differential resistance and susceptibility to substance abuse. Five thematic areas were linked to susceptibility in this study: (1) an economy based on multiple divergent sectors, which gives rise to income disparity and social inequality; (2) a highly transient population, which results in social distancing and lack of social support; (3) shift work, which prevents opportunities for consistent and productive family and community relationships; (4) high incomes, which lead to material competition and financial stress; and (5) a culture of entitlement, which produces certain expectations and perceived privileges among some workers and their families. Our findings are consistent with previous research on the link between substance abuse and shift work, work environments, and the social conditions in boomtowns. But this paper also identifies novel themes, such as high incomes and a culture of entitlement, and introduces the notion of slow disasters and cumulative risk histories to help explain susceptibility to substance abuse within this rural community.