Canadian Rural Research Articles

Correction to: Barriers to Safety Planning for Female Victims of Domestic Violence in Canadian Rural, Remote, and Northern Communities

Correction to: Barriers to Safety Planning for Female Victims of Domestic Violence in Canadian Rural, Remote, and Northern Communities

Barriers to Safety Planning for Female Victims of Domestic Violence in Canadian Rural, Remote, and Northern Communities

Barriers to Safety Planning for Female Victims of Domestic Violence in Canadian Rural, Remote, and Northern Communities

Virtual Healthcare in Rural and Remote Settings: A Qualitative Study of Canadian Rural Family Physicians' Experiences during the COVID-19 Pandemic.

Objective: This paper aims to explore the experiences of rural family physicians using virtual healthcare in their clinical practice during the COVID-19 pandemic in Canada. Design: A community-based participatory approach. Setting: Rural and remote communities in Canada. Participants: Thirteen rural family physicians with at least one year of clinical experience. Results: The data illustrate significant issues associated with virtual healthcare in rural healthcare. The adoption of virtual healthcare has been expressed to pose a harsh polarity; the benefit conferred to rural family physicians with the opportunity to have flexible working hours and work at home while interacting with family members is starkly contrasted with the struggles of insufficient financial support to facilitate setting up virtual healthcare for rural physicians, unreliable technological infrastructure, and inadequate technological resources, which are all exacerbated by the lack of adequate health literacy in rural communities. Results were compiled into five major categories underpinning the lived experiences of rural family physicians: 1—potential trade-off between convenience and quality of care; 2—work–family boundaries; 3—patient-doctor communication; 4—technology as barrier or enabler; 5—increased call duration. Conclusion: The differing trends assessed in the findings illustrate the complications faced in providing virtual healthcare, which resonates with the experiences and views of rural physicians. The findings of this study may guide the development of tailored technologies that adjust for the complexity of administering virtual healthcare in rural communities.

Perspectives of Canadian Rural Consultant Pediatricians on Diagnosing Autism Spectrum Disorder: A Qualitative Study.

Consultant pediatricians represent a potential resource for increasing autism spectrum disorder (ASD) diagnostic capacity; however, little is known about how they perceive their roles in ASD diagnosis. The objective of this study was to examine the perspectives of rural consultant pediatricians regarding their perceived roles, facilitators, and barriers in ASD diagnosis. We performed a qualitative study using thematic analysis. Consultant pediatricians from 3 small-sized and medium-sized Ontario communities were recruited. Semistructured interviews were conducted, transcribed, coded, and analyzed. Fourteen pediatricians participated in this study. Participants all considered ASD diagnosis to be in their scope of practice. The major theme identified was the process of diagnosing ASD, which occurred in 3 stages: preassessment (gathering information before the first clinic visit), diagnosis, and service access. All these stages are influenced by ecological factors consisting of characteristics of the child, family, individual physician, pediatric group practice, and the broader system of ASD care. Consultant pediatricians practicing in nonurban Ontario communities see ASD diagnosis as part of their scope of practice and collaboratively work within groups to address the needs of their communities. Strategies aimed at increasing diagnostic capacity should target salaried group practices and improve the efficiency of assessments through preclinic information gathering.

Our Last Frontier: Imperialism and Northern Canadian Rural Women’s Organizations

Our Last Frontier: Imperialism and Northern Canadian Rural Women’s Organizations

Enhancing Professional Practice and Professionalism among Canadian Rural Paramedics

Introduction The scope of paramedic practice is being redefined and expanded. Professional development and clinical expertise are not only necessary for paramedics to perform their clinical functions and operational responsibilities, they are at the very core of their professionalisation. Professionalisation is a complex process, and the degree to which it can accomplished will impact society's perception of the profession – and its trust in it – for years to come. This study investigated ways to enhance professional practice, from the point of view of the main healthcare providers in a rural area of Ontario, Canada. Methods A qualitative analysis informed by action research methodology was used. The research design was staged and consisted of focus groups and a World Café. The data were coded and organised into themes, using thematic analysis, and were triangulated with the literature. Results Three key themes emerged from the World Café and focus group conversations including current enablers of professionalisation; system components that promote professionalism; and community of practice to support professional development and clinical expertise. Conclusion Paramedic practice is evolving. This should be reflected in clinical practice and education, and more paramedic-led research. Paramedic training may need to move from the college to the university environment to reflect equal standing with colleagues in the broader healthcare system. This study shows strong motivation among paramedics and management to enhance professional practice and professionalism. To achieve this, a culture of trust, developing engagement and communication strategies and establishing a community of practice are crucial.

A Canadian Rural Living Lab Hospital: Implementing solutions for improving rural emergency care

More than 6 million Canadians live in rural areas (approximately 20% of the population) and emergency services are a critical safety net for them. We want to create, in Baie-Saint-Paul (rural emergency department, Québec, Canada), an experimental milieu where all stakeholders develop, implement and evaluate solutions to address the problems that beset their environment. The Living Lab will rely on the quadruple aim approach to improve health system performance and will use a multimethod approach based on the philosophy of open and user-driven innovation. Three pilot projects will be implemented (quality of work life programme, computed tomography implementation study and telemedicine in ambulances). Other possible solutions will be evaluated and prioritised (in situ simulation, care protocol, telemedicine, point-of-care ultrasound, helicopters and drones). We are confident that this Living Lab will contribute to saving lives, will improve the quality of work life for rural healthcare professionals, and will inspire similar innovation internationally.

Introduction: Place-Based Sustainability Research in the Provincial North

First published advance online January 27, 2020As one of the most sparsely populated countries in the world, Canada depends on widely dispersed rural and northern settlements to support the use and development of the country’s agricultural and natural resources that are at the heart of Canadian livelihoods and the economy (Hallstrom, Beckie, Hvenegaard, & Mundel, 2016; Markey, Breen, Gibson, Mealy, & Ryser, 2015; Hodge, Hall, & Robinson, 2017). The sustainability of these regional communities depends on a complex network of organizations dedicated to promoting the high standard of living for which Canada is recognized around the world (Hodge et al., 2017; Hall, Vodden, & Greenwood, 2016; Halseth & Ryser, 2016; Schiff, 2014). For example, a 2013 inventory of regional development organizations in Newfoundland and Labrador identified more than 1,000 organizations involved in development at the regional scale in that province (Vodden, Hall, & Freshwater, 2014). The future challenges of Canada’s regional centres are among the country’s key future challenges. To consider these issues, we hosted the workshop “Regional centres and the sustainability of Canada’s rural and northern landscapes” in May 2018 at Lakehead University (supported by funding from the Social Sciences and Humanities Research Council of Canada). Our aim was to explore the role of regional centres in Canada’s development as a nation and the role that they will play into the future. The workshop brought together researchers from regional centres across the country to focus on key challenges across the landscape of Canada’s Provincial Norths. Ken Coates, Canada Research Chair in Regional Innovation at the Johnson-Shoyama Graduate School of Public Policy at the University of Saskatchewan delivered a keynote presentation on regional policy in Canada. He discussed ways that regional centres can prepare for an uncertain future dominated by rapid technological change, mobile workforces, and the need for culturally appropriate social and health services. Over two days the participants met to share perspectives and establish connections. More specifically, by reflecting on the special role of regional centres and their place in addressing Canada’s future challenges, we hoped to lay the groundwork for research focused on supporting the emerging needs of regional centres, and the rural and remote communities that they support. By exchanging narratives, histories, and perspectives among cultures from across the country, we sought, from a national perspective, to anticipate the role that regional centres will play in Canada’s future. This special collection in the Northern Review is meant to provide a glimpse into some of the conversations and issues discussed over the course of the two-day workshop. While this collection could not include the full breadth of the issues faced in regional centres, it does provide a look at critical issues—developing and supporting resilient local and regional food systems (Connie Nelson and Mirella Stroink); supporting small-scale commercial fisheries that have played an important role in northern food security, food sovereignty, and regional economies (Kristen Lowitt, Charles Levkoe, and Connie Nelson); northern rural sustainability planning and policy (Rebecca Schiff); community-based participatory research approaches to addressing housing and homelessness issues (Marleny Bonnycastle and Maureen Simpkins); and new tools for post-secondary education, which can encourage a deepening of conversations about place-based sustainability (David Greenwood and Devon Lee). These articles provide insight into the many strengths of, and challenges facing, northern, regional centres, and highlight our collective work toward development of more sustainable northern communities and regions. ReferencesHall, H, Vodden K, & Greenwood R. (2016). From dysfunctional to destitute: The governance of regional economic development in Newfoundland and Labrador. International Planning Studies, 22(2), 49–67. https://doi.org/10.1080/13563475.2016.1167585Hallstrom L, Beckie M, Hvenegaard G, & Mundel K. (2016). Sustainability planning and collaboration in rural Canada: Taking the next steps. University of Alberta Press.Halseth, G., & L. Ryser. (2006). Trends in service delivery: Examples from rural and small town Canada, 1998–2005. Canadian Geographer, 43, 69–90. https://journals.brandonu.ca/jrcd/article/view/40Hodge G, Hall H, & Robinson I. (2017). Planning Canadian regions (2nd ed.). UBC Press.Markey S, Breen S, Gibson R, Mealy R, & Ryser L. (2015). The state of rural Canada 2015. Canadian Rural Revitalization Foundation/Fondation canadienne pour la revitalisation rurale.Schiff, R. (2014). Rethinking governance: Supporting healthy development through systems-level collaboration in Canada’s provincial north. The Northern Review, 38, 133–154. https://thenorthernreview.ca/index.php/nr/article/view/329Vodden K, Hall H, & Freshwater D. (2014). Understanding regional governance in Newfoundland and Labrador: A survey of regional development organizations. Memorial University.

Canadian Rural Youth and Role Tension of the Police: ‘It’s Hard in a Small Town’

This article presents findings from a case study examining youth perceptions of the police in rural areas of Eastern Canada. A total of 20 semistructured focus group discussions were conducted with 60 youth from Canadian rural Atlantic areas, who were purposively recruited, with groups stratified by age and gender. Discussions centered on role tension regarding the police’s role, that is, along a continuum between law enforcement and public protection versus community policing and crime prevention. Our discussions highlight the arguably ironic view that it is harder to maintain trust when there are strong personal relations with the police. Discussions highlight the ‘pros and cons’ of informal familiarity with police officers, especially the presence of school resource officers and policing in the context of monitoring youth on modes of transportation germane to rural Atlantic Canada (i.e. skidoos). Implications from this study suggest that when dealing with youth, identifying and addressing youth perceptions of the police role can help improve police–youth interactions.

Perceptions of Early Childhood Educators: Factors Influencing the Promotion of Physical Activity Opportunities in Canadian Rural Care Centers

Physical activity is a key component of health living and it reduces the risk of developing chronic disease. Current research indicates that Canadian early years children are not active enough for healthy growth and development. Parents play a key role in establishing healthy behaviours; however caregivers also have a strong influence, as many early years children spend a large portion in their day in care centres. To date, very little is known about the physical activity practises in rural care centres. The purpose of this study is to use an ecological framework to identify specific factors (facilitators and barriers) that rural caregivers face when providing physical activity opportunities in care centres. Caregivers in rural settings participated in one on one semi-structured interviews. Reported facilitators and barriers perceived by caregivers were categorized using the ecological model as individual level (i.e., intrapersonal) or social environmental (interpersonal, institutional, community, and policy). Caregivers identified individual facilitators and barriers. (i.e., personal health and wellness) and several social environmental facilitators and barriers (i.e., lack of knowledge; parental support), that influence their ability to provide physical activity opportunities for children in their care.

Building against Structure: Designing a Cross-grade Curricular Inquiry Project in a Small Canadian Rural Secondary School

Building against Structure: Designing a Cross-grade Curricular Inquiry Project in a Small Canadian Rural Secondary School

CIES Bibliography 2010

CIES Bibliography 2010

Healthy Eating Perceptions of Older Adults Living in Canadian Rural and Northern Communities

Aging produces physiologic changes that can affect the nutritional health of the older adult. It is estimated that 80% of community-dwelling older adults have inadequate intakes of four or more nutrients. Socioeconomic factors, such as income and geographic location, can also play an important role in nutritional status; however, limited research is available that specifically explores this. The purpose of this qualitative study was to examine the healthy eating perceptions of older adults residing in rural and northern communities in one Canadian province. Five focus groups were conducted in three rural and two northern Manitoba communities. Thirty-nine older adults participated in audio-recorded focus groups. Five themes emerged from the discussions. All respondents stated that healthy eating was important, but knowledge deficits were observed regarding label reading, understanding and visualizing portion sizes, and vitamin D recommendations and sources. Food programs were not commonly attended by participants due to availably and resistance. Regularly delivered nutrition education programs would assist in providing current nutrition information to older adults and their families in rural settings.

Canadian Rural Women’s Experiences with Rural Primary Health Care Nurse Practitioners

Background: In Canada, one in five women lives in a rural area. These rural women often experience different health challenges than urban women, including lower life expectancy, higher rates of disability and cancer, fewer available health care resources and greater distances to access health care services. Nurse practitioners [NPs] provide important primary health care [PHC] services to rural women. Research Objective: The purpose of this research study was to explore rural women’s experiences with primary health care nurse practitioners [PHCNPs]. Method and Sample: In-depth, face-to-face interviews using interpretive description methodology were conducted with nine rural women, aged 18-80, who used NP services in rural southwest Ontario, Canada. Results: The participants in the study particularly appreciated the nursing knowledge of the NP, the time the NPs spent with them, and the thoroughness of the care provided by NPs. These foundational elements of the participants’ experiences with rural NPs created a sense of trust and respect, which lead to a collaborative partnership between the NP and the rural women. Conclusions: Results of this study suggest that these rural women were overwhelmingly satisfied with the care provided by NPs. In particular, they valued the collaborative partnership with the NP. These findings have important implications for rural health care practice, policy, and education.

Using Telehealth for Assessment of Fetal Alcohol Spectrum Disorder: The Experience of Two Canadian Rural and Remote Communities

Telehealth has been used for fetal alcohol spectrum disorder (FASD) diagnostic assessment in select Manitoban communities since 2000. The purpose of this study was to evaluate the FASD telehealth program within two rural and remote Northern Manitoban communities by comparing community practices from the perspective of professionals working with the FASD diagnostic clinics in these communities. Recommendations for the further development of FASD assessment by telehealth were made to further improve current implementation and guide expansion of the FASD telehealth program within the province. Semistructured interviews were conducted from October 19 to December 11, 2009. Participants (N = 26) were comprised of professionals, including those in the education, social services, and health sectors. Two themes emerged from the data and covered the perceived strengths and drawbacks with the program, and meaningful suggestions to improve the service. Participants regarded the FASD telehealth program as successful and useful, especially given the remote location of the communities and the lack of on-site services. Recommendations addressing the barriers pertaining to the process were made from the study's findings and available scientific literature. This study will provide a solid basis for the successful further development of the FASD telehealth programs.

Educational Leadership to Create Authentic Inclusive Schools: The Experiences of Principals in a Canadian Rural School District

Inclusive education—based on the premise of social justice—advocates equal ac-cess to educational opportunities for all students. This research provides insight into the inclusive experiences of school principals in a Canadian rural school dis-trict through quantitative and qualitative inquiries. A survey was administered to 16 school administrators, and following initial data analysis, individual inter-views with four school principals were carried out as part of a multi-perspective case study of students with special needs. Overall, inclusion was viewed in a posi-tive light and extended beyond classroom placement to meeting the needs of diverse groups of students within the regular classroom. The responsibilities and strategies of the principals that support inclusion are outlined and other factors that contribute to effective inclusion identified. Key factors include collaboration among key players in the students’ education and opportunities for professional development. The results have implications for school leadership preparation and professional development of school administrators.

Community Cohesion and Canadian Rural E-Mail Behavior

This is an empirical examination of the association between community cohesion and the pattern of e-mail among rural Canadians. Residents of 27 diverse Canadian rural communities were invited to complete an Internet survey that included questions about the frequency of e-mail and the Buckner Scale subdimension of psychological sense of community (PSOC). Controlling for demographic variables including age, residence, income, education, language, and gender, as well as computer skill, and as based on ordinary least squares regressions, PSOC predicted local, regional, and provincial e-mail use but not national or international communication. The effects of PSOC declined with distance. Results suggest that e-mail use could be increased by developing greater computer skills; it could also be increased by changing the attitudes that people have as measured in PSOC.

306 THE EFFECT OF BoviPURE GRADIENT ON BISON SPERM CRYOPRESERVATION

Endemic tuberculosis and brucellosis threaten Canada’s wood bison population. For the purposes of developing a procedure to harvest pathogen-free sperm from bison, a sperm separation and purification product, BoviPure, was tested to determine its effect on bison sperm viability before and after cryopreservation. BoviPure (NidaCon International AB, Mölndal, Sweden) is a density centrifugation gradient system that contains trypsin and is designed to separate motile from non-motile sperm and remove infectious pathogens. Spermatozoa were expelled from the caudal epididymis of bison testicles collected at slaughter and diluted in 3 to 5 mL of TCM-199 medium (Gibco, Burlington, Ontario, Canada). After 1 h of incubation at 37°C, 1 to 1.5 mL of diluted sample (approximately 300 × 106 sperm) was placed in (1) a BoviPure gradient containing trypsin (n = 18 samples), (2) a BoviPure gradient without trypsin (n = 10 samples), or 3) left untreated (control; n = 20). Gradients were centrifuged at 300g for 20 min. The sperm pellet was resuspended in 5 mL of TCM-199 medium and recentrifuged at 500 g for 10 min. Total and progressive motility were estimated using computer-assisted sperm analysis (CASA). Gradient-treated and untreated sperm samples were diluted in an egg yolk extender (Triladyl; Minitube Canada, Ingersoll, Ontario, Canada), placed in 0.5-mL straws (50-200 × 106 spermatozoa per straw), frozen, and stored in liquid nitrogen for a minimum of 24 h. Semen straws were thawed by plunging in a 37°C water bath for 30 s, and motility measurements were taken immediately by CASA. Total and progressive motility were compared among groups by analysis of variance. Before cryopreservation, total motility and progressive motility were not affected by gradient processing. Total motility was 85±5.1%, 80±4.8%, and 77 ± 3.7% for untreated, BoviPure with trypsin, and BoviPure without trypsin, respectively (mean ± SEM), and progressive motility was 74 ± 2.7%, 77 ± 3.8%, and 68 ± 4.7%, respectively. After freezing and thawing, total motility decreased compared to unfrozen samples (P < 0.0001) but was not different among groups (37 ± 3.6%, 33 ± 3.7%, and 29 ± 4.8% for untreated, BoviPure with trypsin, and BoviPure without trypsin, respectively). Similarly, progressive motility decreased compared to unfrozen samples (P < 0.0001) but was not different among groups (26 ± 3.6%, 21 ± 3.7%, and 14.5 ± 4.9% for untreated, BoviPure with trypsin, and BoviPure without trypsin, respectively). We conclude that the BoviPure gradient with or without trypsin does not influence total motility or progressive motility of bison sperm either before or after cryopreservation and has potential as a method of harvesting pathogen-free sperm from wild animals of unknown disease status. This study was supported by Canadian Adaptation and Rural Development in Saskatchewan.

Distance Education Potential For A Canadian Rural Island Community

The purpose of the study was to investigate the potential impact of distance education on a small, rural, Canadian island community. Presently, the population of small, rural island communities on the west coast of Canada are facing numerous challenges to retain and to attract permanent residents and families and to provide support and direction for those residents who wish to pursue K-12 accreditation, post-secondary education, vocational/trades training and up-grading or life-long learning. A unique set of considerations confront many of these isolated communities if they wish to engage in distance education and training. This set ranges from internet access to excessive travel by secondary students to the lack of centralized facility. For this study, a group of 48 participants were interviewed to determine their perceptions of the potential for distance education to impact on the community's educational, both academic and vocational, life-long learning and economic needs. The results indicated that there were four general areas of purported benefit: academic advancement, an improved quality of life, support for young families and a stabilizing affect on the local economy. Suggestions for the implementation of a suitable distance education resource are noted.

Exploring the Placelessness of Reading among Older Teens in a Canadian Rural Municipality

Situated in a review of rural, cultural, and youth geographies, this article reports on a qualitative study of the role of reading and libraries in the lives of older rural teenagers. The primary method of data collection was the use of in‐depth, flexibly structured interviews with twenty‐seven youth between the ages of fifteen and nineteen years, supplemented with data from unobtrusive observation and environmental scanning in a specific geographic locale. Four themes are discussed: the habitual, quotidian reading of teenagers; the shifting visibility of the public library; the Internet and the World Wide Web as a default reading site; and the temporal constraints on reading for pleasure. With the use of ideas informed by cultural geography, the space of nonactive teen readers and the placelessness of reading are explored.