Low Socioeconomic Communities Research Articles

‘Girls do this, guys do that’: how first-in-family students negotiate working-class gendered subjectivities during a time of social change

AbstractDespite efforts to foster a more equitable gender representation, Australia's higher education sector and workforce continue to be highly segregated. This article focusses on the gendered experiences of first-in-family (FIF) students—many who are from low-socioeconomic communities—transitioning to Australian universities. In terms of the gendered nature of widening participation, we know students who are FIF will often study disciplines which align with traditional gender norms. Drawing on the First-in-Family Project (n = 48), we present the analysis of our findings in two parts. First, we provide an overview of the cohort where we analyse the gendering of degree choice of FIF students. Second, underpinned by theoretical work focussed on student gendered and classed subjectivities, we address how FIF young people negotiated classed and gendered norms during the transition to university. Our data suggest that young people engage in ‘gender work’ and ‘class work’ which informs their identities and how they make choices about their futures. Based on our research, we argue that to achieve social justice there is a need for a renewed attention to gender within the widening participation agenda.

Screening for dementia and associated factors in older adults from low socioeconomic communities in iLembe, KwaZulu-Natal.

Dementia is one of the leading non-communicable causes of disability and mortality in older adults, with recent research showing that it is increasing in low-middle-income countries compared to high-income countries. As such, multidisciplinary efforts are needed to effectively reduce the prevalence and risk of dementia through quick screening, diagnosis, and management of those with dementia and those at risk. The study's objectives were to estimate the prevalence of dementia and measure the sociodemographic and clinical risks in older adults in low socioeconomic communities. The study was conducted among older adults aged ≥ 60 years from the iLembe district in South Africa. This cross-sectional, one-phased, household study was conducted to screen for dementia over 8 months between October 2018 and October 2019. Demographic and clinical data were collected using a semi-structured questionnaire. In addition, the Mini-Mental Status Exam, Ascertain Dementia Eight-item questionnaire and Instrumental Activities of Daily Living Scale were administered to a multi-stage cluster sample of 320 participants to ascertain dementia prevalence. Frequencies and multivariate logistic regression were conducted to determine risk factors correlated with dementia. The prevalence of dementia was 13.4%. Participants aged 80 years and above were 2.73 times more likely to develop dementia than participants younger than 80 years. Those with an education level of Grade 1-7 had a 69% less chance of developing dementia than those without formal education. Single participants showed an almost seven-fold increase in dementia. Lastly, depression increased the risk of dementia by two-fold. Dementia was probable in over one-sixth of the sample. Dementia risk factors were both modifiable and non-modifiable. Dementia prevalence in South Africa is increasing and therefore it is crucial to develop a dementia plan that is specific to the South African context which will include strategies for early identification of the disease, reducing modifiable risks and strategic management of dementia associated medical conditions such as depression and vascular diseases.

Achievement of Goal Orientation and Academic Engagement among Adolescents in Southwestern Uganda

Enhancing academic engagement is essential for improving the educational experiences of adolescents. Guided by Social Cognitive Theory, this study explored the relationship between achievement goal orientation and academic engagement among 510 secondary school students in Southwestern Uganda. The study focused on two forms of goal orientation—mastery-approach and performance-approach goals—and examined the mediating and moderating role of academic self-efficacy. The results, derived from self-reported data, indicate that approach achievement goals (mastery and performance) positively predict academic engagement, independently. Moreover, academic self-efficacy plays a dual role: while it mediates the relationship between approach achievement goals (mastery and performance) and academic engagement, self-efficacy also moderates the relationship between performance-approach achievement goals and academic engagement. These findings underscore the importance of academic self-efficacy and achievement goal orientation in enhancing academic engagement among adolescent students, especially in low socioeconomic status communities. This research contributes to the understanding of factors like teacher-student relationship, external support offered by Compassion International program, goal setting skills training and predetermined external rewards can enrich the educational experiences of students in low resource education contexts

Experiences of families living with Nyaope users in Tshwane, Gauteng province.

Nyaope is one of the commonly used drugs in many low socio-economic communities in South Africa. Because of its highly addictive properties, the vast majority of users are not able to quit, which results in long-term difficulties for their families. The aim of this study was to explore and describe the experiences of families living with nyaope users in a township in Tshwane Metropolitan Municipality. Data were collected at the Social Development Centre, which serves a variety of social needs of families, including the various needs of families whose problems emanate from nyaope use. The family members were recruited from the registry of the centre. A qualitative design and in-depth interviews were used to collect data from a sample of family members who were purposively sampled. NVIvo 12 was used for thematic analysis of the data. Three major themes emerged from the data, these being, consequences of nyaope use on the family, family interventions, and coping strategies. Although the families have devised interventions and developed coping strategies, nyaope use remains a serious mental health challenge in affected families. The study highlighted the negative impact of nyaope on the social and mental health of the families. The assistance offered at Social Development is broad and general for substance abuse, but does little to mitigate the complex difficulties brought about by nyaope use.

Comparing population-level humoral and cellular immunity to SARS-Cov-2 in Bangalore, India

Two types of immunity, humoral and cellular, offer protection against COVID. Humoral protection, contributed by circulating neutralizing antibodies, can provide immediate protection but decays more quickly than cellular immunity and can lose effectiveness in the face of mutation and drift in the SARS-CoV-2 spike protein. Therefore, population-level seroprevalence surveys used to estimate population-level immunity may underestimate the degree to which a population is protected against COVID. In early 2021, before India began its vaccination campaign, we tested for humoral and cellular immunity to SARS-Cov-2 in representative samples of slum and non-slum populations in Bangalore, India. We found that 29.7% of samples (unweighted) had IgG antibodies to the spike protein and 15.5% had neutralizing antibodies, but at up to 46% showed evidence of cellular immunity. We also find that prevalence of cellular immunity is significantly higher in slums than in non-slums. These findings suggest (1) that a significantly larger proportion of the population in Bangalore, India, had cellular immunity to SARS-CoV-2 than had humoral immunity, as measured by serological surveys, and (2) that low socio-economic status communities display higher frequency of cellular immunity, likely because of greater exposure to infection due to population density.

Piloting a T-Shaped Approach to Develop Primary Students’ Close Reading and Writing of Literary Texts

AbstractThe study was a pilot intervention to develop Year 5–8 students’ close reading and writing of literary texts using the T-Shape Literacy Model (Wilson and Jesson in Set Res Inf Teach 1:15–22, 2019). Students analysed text sets to explore how different authors use language to engender mood and atmosphere. The study used a single-subject design logic for repeated researcher-designed and a quasi-experimental, matched control group design for repeated standardised measures of reading and writing. Nine teachers and their classes participated. The schools were part of a large school improvement programme using digital tools and pedagogy to accelerate students’ learning participated that the authors were research-practice partners in. The schools all served low socio-economic status communities and the majority of students were Māori (51%) and Pacific (28%). There was a large effect size on the overall score for the researcher-designed measure (effect size = 1.00) and for the close reading of single texts sub-score (effect size = 0.90). There was a moderate-to-high effect for students’ identification of language features (effect size = 0.75) but no significant effect on their synthesis scores. Students in the intervention significantly outperformed matched control group students in the standardised writing post-test (effect size = 0.65) but differences for the standardized reading comprehension test were not significant (effect size = 0.15). Results overall suggest the approach has promise for improving the metalinguistic knowledge, literary analysis and creative writing of younger and historically underserved groups of students.

Environmental Detection of Parasites in the Marginalized Paiute Reservations Compared to a Nearby Area.

The amounts of parasite DNA in soil samples from different playgrounds and other public areas can help identify areas of possible microbe transmission and give indications of the possible occurrence of parasite infection in nearby communities. We collected 207 soil samples from parks in Paiute indigenous tribal areas in southwestern Utah and from the higher income city of St. George, Utah, and tested them for 11 parasites that can cause human disease. Molecular tests revealed an elevated odds ratio (OR) of 3.072 (range, 1.114-8.065) for detecting the helminth Trichuris trichiura and an elevated OR of 3.036 (range, 1.101-7.966) for any protozoa (not including Acanthamoeba) in the tribal land playgrounds compared with St. George parks. These findings support previous studies showing that areas in lower socioeconomic communities, especially marginalized communities, tend to have more parasites in the soil, which may lead to higher disease prevalence rates.

The Impact of Environmental Factors on Adolescents’ Involvement in School Bullying

This article analyzes the environmental factors contributing to adolescents’ school bullying involvement. Compared with internal factors such as psychosocial factors, environmental factors are more likely to be manipulated, so the study of environmental factors of school bullying is of profound practical significance for the prevention and control of school bullying. Through systematic analysis and conclusion of relevant literature on environmental factors that cause school bullying in Google Scholar, these environmental factors are frequently influencing aspects of bullying, such as social context: (immigration issues, poor academic achievements, low socioeconomic status, community, and inferiority), school: (physical, emotional, and social environment), peer influence: (normative social influence and group think), family: (family economic conditions, parental conflict and the quality of the family environment and family-of-origin parenting styles). Those environmental factors that have potential negative effects on the physical and mental health of adolescents are revealed so as to offer insight into finding feasible ways to reduce campus violence.

Pancreatic tuberculosis: a case report

Tuberculosis is a bacterial infection secondary to Mycobacterium tuberculosis with highest burden within low socioeconomic communities. Most individuals with tuberculosis infection are immunocompromised due to underlying medical conditions such as human immunodeficiency virus. However, tuberculosis can manifest in immunocompetent individuals although the incidence is significantly less. Pancreatic tuberculosis is exceedingly rare with autopsy series revealing pancreatic tuberculosis <5% of tuberculosis infected individuals. This case report will discuss a 16-year-old female presenting with pancreatic tuberculosis masquerading as possible pancreatic malignancy. Emphasis is placed on the challenging diagnostic nature of pancreatic tuberculosis as it presents with non-specific clinical symptoms which are in keeping with a wide range of differential diagnoses. Once correctly diagnosed pancreatic tuberculosis presents the potential of cure. It is for this reason whilst a rare diagnosis clinicians should be mindful of pancreatic tuberculosis to ensure timely correct treatment is pursued and unnecessary surgical procedures avoided.

Risky Choices – Autonomy and Surveillance in Secondary English Classrooms

Achievement data from New Zealand secondary schools suggest that students from lower socio-economic communities have fewer opportunities to engage with complex content in subject English. This article examines this phenomenon by drawing on Foucault’s notion of governmentality and considers how a context of simultaneously increased autonomy and surveillance may shape curriculum and assessment choices. To explore these ideas, I use interview data from ten secondary English teachers in the wider Auckland region. I complement Foucault’s (1982) explanation of governmentality with Ball, Maguire, and Braun’s (2012) notion of policy enactment to explore spaces of both compliance and resistance.

Abstract A054: Leveraging the power of Hope Leaders for enhancing diversity in clinical trials via a bi-directional cancer health information model

Abstract Introduction: Despite increasing recognition of the need for diversity in clinical trials, participation from racial and ethnic minorities, particularly from low socioeconomic communities, remains dismally low. This underrepresentation hinders the generalizability of trial results and perpetuates health disparities. Low socioeconomic environments, characterized by economic instability, restricted healthcare access, food scarcity, and deficient educational resources, exacerbate these challenges. Residents of such communities often lean on "Hope Leaders" - trusted community figures - as a strategy to navigate through these adversities. Recognizing the pivotal role of these Hope Leaders, we advocate for a community-centered bi-directional cancer health information flow model, which positions these Leaders at the core of community engagement endeavors. This model fosters a bi-directional health information exchange that synergizes Hope Leaders with the scientific community, thereby promoting improved health equity within clinical intervention research. The implementation of this model commences with a pre-engagement phase, a respectful approach where we familiarize ourselves with the community and its dynamics, without imposing any specific demands or expectations. Approach: The University of Illinois Cancer Center has had 6 community engagement specialists that have engaged with community members through numerous pre-engagement events that encompass activities ranging from mental health, cancer prevention, survivorship events, education, health fairs and community meetings. Based on these insights, we established a dedicated working group to identify hope leaders and to create targeted engagement strategies for specific areas of our catchment region through the bi-directional cancer health information flow model. These strategies are tailored to address the unique challenges and barriers these communities face regarding enrollment in cancer clinical trials. Additionally, the community-driven health communication model was implemented to identify Hope Leaders and engage them with cancer researchers as a part of our phase I activities for this model. Conclusion: This innovative approach aims to leverage the unique position of Hope Leaders in underserved communities to amplify community voices, improve engagement, and ultimately, increase minority representation in cancer clinical trials. The model provides a promising strategy to address the persistent disparity in clinical trial participation, facilitating more equitable and inclusive research outcomes. Citation Format: Joseph Dufraine, Yamile Molina, Jeanette Gonzalez, Maria Olivero, Theresa Mobley, Saria Lofton, Dedra Reis. Leveraging the power of Hope Leaders for enhancing diversity in clinical trials via a bi-directional cancer health information model [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr A054.

Low birthweight and maternal smoking as predictors of infant lung function from a South African birth cohort within low socioeconomic communities


 
 
 
 Background. Early assessment of infant lung function (ILF) is necessary to improve our understanding of factors that determine long- term respiratory health.
 Objective. To identify predictors of lung function among infants aged 6 weeks, 6, 12 and 24 months, from low socioeconomic settings, enrolled within the Mother and Child in the Environment (MACE) study.
 Methods. ILF tests were performed assessing multiple breath washout and tidal breathing during spontaneous sleep. Several risk factors, relating to infant growth, maternal and environmental exposures, were assessed cross-sectionally against the lung function parameters in multivariable models for each age group.
 Results. Maternal smoking during pregnancy affected the ratio of time to peak expiratory flow, showing a decline across the age groups, while being statistically significant (β (95% confidence interval (CI)) at 6 weeks (–24.6% (–43.92 - –4.59)) and 12 months (−12.68 (−25.25 - −0.11)). Low birthweight was associated with a lower tidal volume at 6 weeks (−5.99 mL (–9.59 - –2.39)), 6 months (−15.02 mL (−22.48 - −7.57)) and 12 months (−23.7 mL (−35.55 - −11.85)), compared with those with normal birthweight. This was further observed for minute ventilation at 6 weeks (−157.78 mL/min (−338.95 - 23.38)), 6 months (−325.57 mL/min (–619.06 - −32.08)) and 12 months (−527.58 mL/min (−947.85 - −107.32)), though less evident at 24 months.
 Conclusion. Low birthweight was the main predictor for low tidal volumes and minute ventilation at 6 weeks, with smaller differences observed at 12 and 24 months. Lung function development early in life is primarily driven by infant size and postnatal growth factors, consistent with other studies.
 
 
 

Underrepresentation of blind and deaf participants in the All of Us Research Program.

Blind and deaf individuals comprise large populations that often experience health disparities, with those from marginalized gender, racial, ethnic and low-socioeconomic communities commonly experiencing compounded health inequities. Including these populations in precision medicine research is critical for scientific benefits to accrue to them. We assessed representation of blind and deaf people in the All of Us Research Program (AoURP) 2018-2023 cohort of participants who provided electronic health records and compared it with the Centers for Disease Control and Prevention 2018 national estimates by key demographic characteristics and intersections thereof. Blind and deaf AoURP participants are considerably underrepresented in the cohort, especially among working-age adults (younger than age 65 years), as well as Asian and multi-racial participants. Analyses show compounded underrepresentation at the intersection of multiple marginalization (that is, racial or ethnic minoritized group, female sex, low education and low income), most substantively for working-age blind participants identifying as Black or African American female with education levels lower than high school (representing one-fifth of their national prevalence). Underrepresentation raises concerns about the generalizability of findings in studies that use these data and limited benefits for the already underserved blind and deaf populations.

FRI060 Real World Experience Of Weight Management In Low Socioeconomic Community Clinic

Abstract Disclosure: B.A. West: None. S. Mon: None. Pilot Study: Real-world experience of weight management in low socioeconomic community clinic Introduction: Management of obesity and unhealthy behaviors is an essential step in patients with Prediabetes and T2DM, particularly those with socioeconomic status (SES) in whom obesity is more prevalent. While several behavior interventions targeting obesity exist, a successful adaptation of interventions in routine care is challenging especially in those with low SES. We examined the real word experience of weight loss management in our community clinic. Method: Retrospective chart review of consecutive patients seen in an endocrinology clinic at a hospital-based community clinic. Result: A total of 23 female patients, average age 48.4 ± 10.8 years, with average BMI 37.4 ± 6.9 kg/m2, were provided comprehensive lifestyle counseling focusing on nutrition, exercise, sleep health at each visits along with semaglutide at the highest tolerable dose of 2.4 mg/dl weekly. Within 6 months from the initiation of semaglutide and the weight loss intervention, 11/23 (48%) patients lost weight by >5% from their baseline visit, and 17/20 (85%) patients at the end of 1 year. 12/20 (60%) and 6/20 (30%) lost weight at least by 10% and 15% respectively at the end of 1 year. Compared to the baseline data, weight ( 101.2±18.4) kg, SBP 127.6 ± 13.4 mmHg, HbA1C 6.0 ± 1.1 mg/dL, Total Cholesterol 182.1 ± 40.4 mg/dL, LDL 102.4 ± 35.8 mg/dL, most parameters were improved at the end of 6 and 12 months respectively: weight 91.0± 18.6 vs 88.4± 16.2 kg, SBP 125.2± 16.8 vs. 126.9± 15.6 mmHg, HbA1C 5.8 ± 1.2 vs 6.3 ± 1.4 mg/dl, Total cholesterol 178.9± 33.1 vs 175.0 ± 50.7mg/dl, LDL 100.4± 27.7 vs 101.8± 47.7 mg/dL. Conclusion: This real-world implementation study reported the benefits of weight loss and other clinical parameters after the intervention consisting of a combined health behavior counseling and use of semaglutide at the low-SES community clinic. Presentation: Friday, June 16, 2023

Extracurricular activity participation, school belonging, and depressed mood: a test of the compensation hypothesis during adolescence

Feelings of acceptance within school communities can promote positive psychological outcomes. Despite occurring outside of the classroom, youth who engage in extracurricular activities typically report greater school belonging. Accordingly, we examined the longitudinal effect of extracurricular activities on school belonging and depressed mood in a nationally representative, Australian sample of adolescents (N = 3,850, Mage = 12.41) followed for four years. A random-intercept cross-lagged panel model revealed extracurricular activity participation at Time 1 predicted higher school belonging two years later. In turn, higher school belonging reinforced positive mental health outcomes, by predicting within-person decreases in depressed mood. Further, the direct and indirect effect of extracurricular activities were moderated by community-level socioeconomic status. Participants residing in low socioeconomic status communities garnered the greatest benefit from participating in activities, despite having the lowest levels of participation. Our data highlight how structured leisure time pursuits can promote wellbeing, especially within more disadvantaged communities.

Indoor particulate matter heavy metals and their potential health risks in low socio-economic communities

Indoor particulate matter heavy metals and their potential health risks in low socio-economic communities

Cloth sharing with a scabies case considerably explains human scabies among children in a low socioeconomic rural community of Ethiopia

BackgroundIn 2020, scabies were integrated into the WHO roadmap for neglected tropical diseases, aimed at ending the negligence to realize the SDGs. Ethiopia has also introduced scabies as a notifiable disease in drought-prone localities since 2015. Many of the previous studies employed study designs that might be subject to bias. Moreover, there is no scientific evidence about scabies in this area. Hence, this study aimed to determine the prevalence and associated factors of scabies among children aged below 15 years in rural Ethiopia.MethodsA community-based cross-sectional study was carried out among 942 children in rural kebeles of Lay Gayent District from March through May 15, 2021. A two-stage sampling technique was applied. Data on sociodemographics, housing, water supply and sanitation, children’s personal hygiene, and caregivers’ knowledge about scabies were collected by a structured questionnaire. Data quality was maintained through pretesting, training of data collectors and supervisors, and supervision. An adjusted binary logistic regression was modelled to identify factors associated with scabies. The Hosmer–Lemeshow goodness-of-fit test was run to check the model fitness.ResultsThe prevalence of scabies was 21.5% (95% CI 19.0–24.3). Maternal illiteracy (adjusted odds ratio (AOR) = 1.61; 95% CI 1.07–2.43); low household wealth (AOR = 2.04; 95% CI 1.25–3.33); unimproved water source (AOR = 1.58; 95% CI 1.05–2.40); not cleaning a house daily (AOR = 2.43; 95% CI 1.63–3.62); not trimming nails (AOR = 2.21; 95% CI 1.50–3.25); cloth sharing with a scabies case (AOR = 11.77; 95% CI 6.94–19.97); and low caregiver knowledge about scabies (AOR = 2.44; 95% CI 1.64–3.63) were factors associated with scabies.ConclusionsScabies remains a significant public health issue among children aged below 15 years in the district. Maternal illiteracy, low household wealth, unimproved water source, not cleaning a house daily, not trimming nails, cloth sharing with a scabies case, and low caregiver knowledge about scabies were factors associated with scabies. Community-wide interventions with prime emphasis on improving maternal education and caregivers’ knowledge about scabies, upgrading household wealth, ensuring a safe water supply, providing healthy housing, and ensuring adequate personal hygiene are warranted.

S12-4 Feasibility evaluation of the Move Well, Feel Good movement behaviours intervention

Abstract Purpose Improving children’s motor competence through school-based physical activity interventions may be a mechanism for promoting positive mental health through psychosocial factors. Move Well, Feel Good (MWFG) is a such an intervention that was co-designed with children, class teachers, physical education (PE) teachers, and school leaders. This presentation describes the feasibility evaluation of MWFG. Methods Five primary schools were recruited from a low socioeconomic status community in northwest England. A 10-week intervention was co-designed which aimed to enhance children’s mental health through motor competence and psychosocial development. The core delivery of the programme involved one PE lesson per week devoted to development of locomotor, object control, and stability skills. This was supplemented by optional recess and home activities, and by non-PE curricular activities. Teachers were asked to record details of each MWFG session taught, and feasibility was evaluated against pre-defined criteria using surveys, interviews (teachers), and participatory focus groups (children). Pre- and post-intervention assessments of motor competence, mental health, wellbeing, psychosocial factors, and 24-hour movement behaviours were also completed. Results The 5 schools represented 83% of the target number of schools and 108 children consented (43% of target). PE and class teachers were recruited in all schools (100% of target). Intervention dose was reflected by 76% of scheduled PE lessons being delivered. Adherence was strong with >85% of children attending ≥75% of lessons. Positive indicators of acceptability were provided by 86% of children, 83% of PE teachers, and 90% of class teachers. Teachers commented on the children’s positive engagement irrespective of ability, the quality of resources provided, and the challenges of competing demands for curriculum time and spaces to deliver MWFG. The data collection methods were deemed acceptable by 91% of children and 80% of class teachers, and children spoke positively about participating in the data collection. Secondary outcome data collection was completed by 87%-100% of children, with a 0%-6% attrition rate at post-intervention. Descriptive analysis revealed favourable changes in motor competence and mental health. Conclusions MWFG was deemed to be feasible to develop further into a pilot trial, with improved school and child recruitment strategies warranted.

Enabling educator oral health literacy: An impetus for oral health promotion in early childhood development.

This study reports on the process evaluation of an oral health promotion intervention for educators (principals and teachers) at early childhood development (ECD) centres within a low-socioeconomic community in South Africa. This approach was based on the premise that oral health literacy plays a significant role in shaping personal health and serves as an impetus to influence change in others. Using a cross-sectional, descriptive study design, 91 educators participated in the oral health intervention as part of their 1-year ECD training programme. The pre-test questionnaire measured perceived dental status, oral health-related knowledge, attitudes and practices and impact of oral health problems on oral health-related quality of life (OHRQoL). The post-test questionnaire evaluated the usefulness of the oral health workshop to participants, intentions for personal change as well as for the inclusion of oral health in their ECD centre programme. Participants reported: having their natural teeth (80%), being happy with their mouth (56.2%), having oral problems (34%), inadequate oral hygiene practices (43%), dental visits when symptomatic (74%), a compromised OHRQoL and inadequate knowledge of oral problems experienced. Oral health promotion activities at ECD centres were limited, with only 34% reporting on toothbrushing programmes. Following the intervention, participants reported positively on aspects such as, the value of the workshop for themselves and their ECD centres, intentions for personal change to hygiene practices (56%), dietary practices (76%) and dental visits (63%). The incorporation of oral health education in their ECD centres was mentioned by most educators. Daily toothbrushing was noted by up to 40% while some highlighted their engagement with parents. Building oral health literacy among educators has the potential for personal change and serves as an impetus to introduce oral health promotion programmes at ECD centres. The findings may be used to advocate for oral health partnerships with established community-based structures to increase access to oral care in ECD centres in underserved communities.

Exploring sense of purpose and conscientiousness as correlates to health and well-being with indigenous and low socioeconomic communities on Coast Salish Territories, Vancouver, Canada.

Exploring sense of purpose and conscientiousness as correlates to health and well-being with indigenous and low socioeconomic communities on Coast Salish Territories, Vancouver, Canada.