Canadian Women Research Articles

Cervical Cancer Screening Uptake and Experiences of Black African Immigrant Women in Canada

Cervical cancer is one of the leading causes of cancer-related death among African women. Unfortunately, in most sub-Saharan African nations, women are vulnerable if they are unaware that cervical cancer is preventable with frequent screening and early treatment. The aim of this study was to examine Black African immigrant women’s perceptions and experiences of cervical screening in British Columbia, Canada. Twenty Black African immigrant women were interviewed using the qualitative research method Interpretive Description. Data collection approaches included indepth interviews and analytic memos. Data were analyzed using a constant comparative technique guided by a socioecologic framework to capture subjective experiences and perceptions. Four key themes were identified, including confusing conceptualizations about cancer and cancer screening, competing priorities, concerns for modesty, and commitment to culture. The study findings point to the need for more active approaches to promoting cervical screening for this population.

Theorizing a denial reaction to coming out: Revising Goffman's stigma through a sexual identity process model

AbstractErving Goffman's seminal theorization of stigma is at the heart of social scientific conceptualizations of identity management. Using data from qualitative interviews with queer South Asian women in Canada, this article proposes revisions of Goffman's Stigma theory. Intervening his supposition of acceptance and hostility as the two possible reactions to stigma revelation, I establish denial as an additional reaction to identity disclosure. A denial reaction has four key characteristics: (1) resistance to queer sexuality, (2) prescriptive enforcement of heterosexuality, (3) refusal to accept lesbian relationships, and (4) avoidance of conversation about queerness. I argue that disclosure to parents does not always translate to outness; rather, it can force the individual back into the closet. I refer to this non‐linear process as the culturally expansive closet. The article presents a sexual identity management process model that accounts for these culturally collectivist experiences. The results are significant for rethinking and affirming non‐Western ways of managing stigmatized identities.

Lady Sunrise: Reimagining a Modern Chinese Spoken Drama Classic in Contemporary Canada

This article examines Lady Sunrise, Canadian playwright Marjorie Chan’s localized and contemporary rewriting of Sunrise (1936), a modern Chinese spoken drama classic, which premiered in February–March 2020 at Toronto’s Factory Theatre under the direction of Nina Lee Aquino. Chan has condensed the massive dialogue play of fifteen male and female characters in a modern Chinese city to mostly monologues by six Asian Canadian women in present-day Vancouver and Richmond. The author focuses on the play’s transformation in both content—from clash of the haves and have-nots of the 1930s’ China to contemporary racial, gender, and class conflicts in contemporary Canada—and form—from realistic dialogue drama to one relying predominantly on the monologue format, together with the implications of its all-female Asian cast and predominantly female creative team.

Conversations in Breast Cancer Screening: An Exploration of Age, Density, and Emerging Technologies

Breast Cancer remains a significant burden in Canada, reflecting global patterns as one of the most common cancers affecting women. In 2023, it was estimated that 26% of all new cancer cases among Canadian women were attributed to breast cancer, contributing to 13% of all cancer deaths in this group. Recent advancements in both detection and treatment of breast cancer have significantly improved cure rates, particularly when breast cancer is detected early. Early-stage breast cancer detected through screening can have a 5-year survival rate of 99%. Thus, the quest for early detection through effective and economical screening initiatives is a critical component in minimizing the burden of disease and reducing breast cancer-related mortality. However, ongoing dialogue continues within the medical community regarding the optimal timing of screening initiation for women at average risk. Discussion about the appropriate age to discontinue screening is an evolving topic. This conversation is complex and multifaceted, involving careful consideration of the intricate balance between the benefits of early detection, economic implications of population screening, and potential harms such as overdiagnosis and the psychological impact of false positives. Current Canadian guidelines, last updated in 2018, recommended mammography screening every 2–3 years for women aged 50–74 years, reflecting an expert consensus that considers both scientific evidence and population health needs. These guidelines are under revision with an update expected in 2024, while other major organizations have recently published new recommendations, reflecting the value of early detection at a younger age in the effort to minimize cancer deaths. Additionally, the efficacy of mammography alone as a screening modality in women with dense breast tissue, who constitute up to 43% of the screening population, has come into question.7,8 This challenge has catalyzed discussion around recommended supplementary screening modalities to improve cancer detection rates in women with dense breast tissue.9 This article explores the ongoing discourse on breast cancer screening recommendations for average-risk women, including the age at which to initiate and stop screening, imaging modalities, and emerging technologies.

"It Was one of the Most Revealing Experiences of My Life:" Women's Views on Group Counseling for Survivors of Intimate Partner Violence.

Groups are a common clinical intervention for women survivors of intimate partner violence (IPV). This secondary mixed-methods analysis from a study of 567 Canadian women from the prairie provinces compared the mental health and well-being of 131 women who had attended a IPV group to 436 women who had not attended any group. Qualitatively, perspectives from 131 women (113 comments; 18 interviews) who attended some form of group treatment were analyzed. Of the 199 coded comments about the IPV groups, most were positive (157 or 78.9%), while the remaining 21.1% (42) reflected concerns or suggested changes. Clinical implications are provided.

What I say, or how I say it? Ethnic accents and hiring evaluations in the Greater Toronto Area

Abstract: This study investigated accent bias against job applicants with extralocal (non-Canadian) English accents in the Greater Toronto Area. Verbal guises recorded by British, Chinese, German, Indian, Jamaican, and Nigerian women and by Canadian women with at least one parent from these countries were evaluated by forty-eight human resources students, who rated the content of job interview responses and the candidates’ ‘expression’ and ‘employability’, determined what job they should be interviewed for, and provided commentary. Canadian voices were especially privileged in comments on speech. Quantitative analysis of responses reflected bias against extralocal voices. Consequently, we provide recommendations for relevant stakeholders.

Evaluation of recurrence rate in Canadian patients with stage II/III HR+/HER2- early breast cancer in the real-world setting.

e23303 Background: Breast cancer is the most prevalent cancer and second leading cause of cancer-related mortality among Canadian women. Most of cases belong to the HR+/HER2- subtype, representing approximately two-thirds of all instances. Treatment for this subtype encompasses a multifaceted approach with a curative intent. This real-world evidence study aims to comprehensively analyze the clinical outcomes of Canadian patients diagnosed with early-stage HR+/HER2- breast cancer, focusing on recurrence rates after initiation of adjuvant endocrine therapy to identify opportunities for enhancing patient care. Methods: This is a retrospective, longitudinal cohort study involving 541 patients enrolled in the pan-Canadian cancer patient registry PMT (Personalize My Treatment), with newly diagnosed or recurrent stage II or III HR+/HER2- breast cancer between January 1st, 1996, and May 31st, 2022. We evaluated disease recurrence rates, time to recurrence, and overall survival (OS). Furthermore, the study explored duration of endocrine therapy (ET) in the adjuvant setting. Results: 409 patients received adjuvant ET representing 75.6% of the total cohort, emphasizing the role of ET as standard of care for adjuvant treatment in this patient population. The median duration of adjuvant ET was 4.5 years. In the overall adjuvant patient population, recurrence rates progressively increased over time from 13.2% after 2 years, 21.4% after 3 years, 30.3% after 5 years, and peaking at 58.4% after 10 years. Median time to recurrence for the overall patient population on ET was 7.76 years. OS rate for patients on ET was 94.6% at 5 years and 78.3% at 10 years. Conclusions: This study marks a pioneering real-world analysis utilizing pan-Canadian EHR data, demonstrating increasing recurrence rates over time in HR+/HER2- early breast cancer. It highlights the high unmet need in stage II and stage III breast cancer, with 1 patient out of 3 recurring after 5 years, and more than half recurring after 10 years despites adjuvant treatment with ET alone. This indicates the need for more efficacious and tolerable treatment options to reduce short- and long-term recurrence and to prolong survival, not only in the higher risk patient population, but in the overall HR+/HER2- breast cancer patients at increased risk of recurrence.

PRENATAL SCREENING IN CANADIAN AND UNITED STATES MIDWIFERY PRACTICES: AN EXPLORATORY STUDY

Midwifery practice in Canada and the United States (U.S.) developed along similar philosophical principles, but different practice models have evolved. Within these two frameworks of midwifery practice, this retrospective, exploratory study investigated the prenatal screening tests that often pose decision-making dilemmas for both clients and midwives. Women in the U.S. (n=60) were more likely to have four of the five prenatal screening tests than Canadian women (n=56). U.S. midwifery clients (n=60) more frequently received the genetic screen (p=0.029), HIV (p=0.0005), ultrasound (p=0.0005) and serum glucose screen (p=0.0005). Canadian midwifery clients (n=56) were more likely to receivehte Group BStreptococcus screen (p=0.004) than their US.. counterparts. In addition, hte mean number of ultrasounds performed during pregnancy was significantly higher for U.S. women than Canadian women (p=0.001). Women with any post-secondary education were more likely to choose to have the glucose screen (p=0.017) and primiparous women were more likely to have an ultrasound (p=0.020) and the glucose screen (p=0.038). Factors that may influence which tests women receive are discussed ni relation to the philosophic framework of midwifery practice in Canada and the U.S.

"It's a Valuable Service but a Hard Place to Be:" Women's Views About Violence Against Women Shelters.

This mixed-methods secondary analysis examined VAW shelter use by 662 Canadian women abused by partners (50.5% Indigenous, 43.4% White, and 6.1% visible minority). Women who had never resided in shelters (n = 242) had less Severe Combined and Total IPV on the Composite Abuse Scale and fewer PTSD symptoms. More nonresidents worked full time and had higher incomes and no children. The 420 women residents mentioned strengths (70.4%) such as supportive staff and safety, and concerns (29.6%) about unsupportive staff and the shelter rules or facility. Some Indigenous women reported racist attitudes by shelter staff and child apprehensions. Practice implications are presented.

A Culture of Knowledge Sharing: Information Resources and Dissemination Practices for All

Volume 8, Issue 1 of The International Journal of Information, Diversity & Inclusion (IJIDI). This introductory article presents the theme, “A Culture of Knowledge Sharing,” which we have identified as a common thread that weaves the papers featured in this regular issue. These papers cover knowledge sharing in research, literature reviews, and reports from the field discussing topics such as ways Hebrew children’s literature can bridge cultures in Israel, research from Nigeria examining prison libraries as information resources for rehabilitation, and community-based information projects empowering immigrant women in Canada. The papers in this issue highlight how knowledge sharing impacts citizens' information behaviors worldwide. Two book reviews are featured.

Chronic pain experiences of immigrant Indian women in Canada: A photovoice exploration

ABSTRACT Background Over the past two decades, the prevalence of chronic pain has significantly increased globally, with approximately 20% of the world’s population living with pain. Although quantitative measures are useful in identifying pain prevalence and severity, qualitative methods, and especially arts-based ones, are now receiving attention as a valuable means to understand lived experiences of pain. Photovoice is one such method that utilizes individuals’ own photography to document their lived experiences. Aims The current study utilized an arts-based method to explore immigrant Indian women’s chronic pain experiences in Canada and aimed to enhance the understanding of those experiences by creating a visual opportunity for them to share their stories. Methods Twelve immigrant Indian women captured photographs and participated in one-on-one interviews exploring daily experiences of chronic pain. Results Women’s photographs, and description of these photographs, provided a visual entry into their lives and pain experiences. Three themes emerged from our analysis: (1) bodies in pain, (2) traversing spaces including immigration, and (3) pain management methods. Findings revealed that women’s representations of pain were shaped by a clash between culturally shaped gender role expectations and changing gender norms due to immigration processes. The use of photovoice visually contextualized and represented pain experiences, proving to be a valuable tool for self-reflection. Conclusions This research uncovers the multifaceted nature of chronic pain and identifies the influence of immigration, gender, and social relations on the exacerbation of pain in immigrant Indian women.

Education, employment, and care work over adulthood: gendered life course trajectories in Canada and Germany

ABSTRACT This article compares the education, employment, and care work biographical sequences of Canadian and German women and men from late adolescence into mid-adulthood. Through the lenses of comparative gendered life course theory and welfare regime theory, sequence and cluster analyses are used to determine the adult life course sequences of women and men in each country and to assess the extent to which they differ across contexts. The analyses reveal clear gender differences in work–family balance in labour market participation and unpaid care work. Groups also differ strongly on educational attainment, income, and family composition. Comparatively, gender differences are less marked in the Canadian context. These results suggest that differing gendered trajectories result in diverse outcomes depending on the national context, shaping different outcomes for women cross-nationally. Our findings highlight how historical and contemporary country-specific welfare state policies support or hinder women as active and productive members of society.

Introduction: IJCAR – 2023 Issue

Dear readers, I am pleased to introduce the 2023 Issue of the International Journal of Child and Adolescent Resilience (IJCAR). This issue includes: two regular articles on trauma and maltreatment and associated impacts; three brief reports on varying aspects of hardships and resilience in different populations; and one theoretical paper about a narrative shelter model to give youth who experienced violence a voice and choice. In particular, the regular articles shed light on hardships and resilience experienced by differing populations. Bégin and colleagues examined the effects of using the internet survey method compared to a population-based telephone survey method on the profile of women with a history of child sexual abuse, in terms of socio-demographic data, victimization experiences, and mental health symptoms in adulthood. Jamison and colleagues aimed to gain insights on youth of color in the United States who have experienced violence regarding the associations between resilience and psychological health, social support, and school engagement. Furthermore, the 2023 issue of IJCAR also includes three brief reports on different topics associated to experiences of trauma, maltreatment, and resilience in various populations. Firstly, Brend et al. compared a sample of Finnish social workers serving children and families or social workers in other domains, in terms of the associations between moral distress and burnout amongst these groups. Secondly, Frederickson et al. investigated whether child maltreatment predicted the severity of posttraumatic stress disorder symptoms and symptom clusters for Canadian women during pregnancy, as well as changes in symptoms from pregnancy to three months postpartum. Finally, Souza et al. aimed to determine if social media in Brazil is a viable outlet for the dissemination of empirically supported information surrounding the topics of child abuse, adverse childhood events, and resilience. Finally, the issue ends with a theoretical paper by Nyirinkwaya and Jenney, regarding a shelter narrative model for research and practice on childhood experiences of intimate partner violence in young people, in order to integrate storytelling and storylistening to help youth exercise their voice and choice. Thus, we encourage you to read these various articles to obtain rich information about ongoing research in the field of resilience. I wish to also take this opportunity to sincerely thank all the members of the IJCAR team for their continuous and dedicated work in the editing and publishing process. Particularly, I wish to thank our associate editors, Dr. Tara Black, Dr. Delphine Collin-Vézina, Dr. Isabelle Daigneault, Dr. Rachel Langevin, and Dr. Nicole Racine; layout editor, Manon Robichaud; and managing editor and senior copyeditor, Teresa Pirro, all of which have done a fantastic job in their varying roles. I also want to take this opportunity to welcome Dr. Roxanne Guyon as a new associate editor. We hope you enjoy reading the current issue! This is also a friendly reminder to prepare your manuscripts for the next issue. Please submit your manuscripts in English, or in French, and feel free to forward this information to colleagues and students who may be interested. We look forward to your manuscripts and to the next issue of IJCAR. Happy reading! Martine Hébert, Editor-in-Chief

The Struggle for Justice for Battered Women: Still a Colossal Work in Progress, as Exemplified by Helen Naslund’s Case

This article recounts the campaign for justice for Helen Naslund, a Canadian woman who lived in rural Alberta when she killed her abusive husband Miles in 2011 as he slept. Rather than go to trial on self-defence, on the advice of counsel Helen pled guilty to manslaughter and then, consequent to a joint submission on sentencing made with the Crown, she was sentenced to 18 years in prison in 2020, the longest sentence on record for such a woman in Canada. The contributors to Helen’s journey, including Helen herself, a Senator, an academic, an activist, a lawyer and a journalist, all describe the roles they played in supporting Helen’s successful appeal against sentence in 2022 and her release from prison in 2023.

A robot-based surveillance system for recognising distress hand signal

Abstract Unfortunately, there are still cases of domestic violence or situations where it is necessary to call for help without arousing the suspicion of the aggressor. In these situations, the help signal devised by the Canadian Women’s Foundation has proven to be effective in reporting a risky situation. By displaying a sequence of hand signals, it is possible to report that help is needed. This work presents a vision-based system that detects this sequence and implements it in a social robot, so that it can automatically identify unwanted situations and alert the authorities. The gesture recognition pipeline presented in this work is integrated into a cognitive architecture used to generate behaviours in robots. In this way, the robot interacts with humans and is able to detect if a person is calling for help. In that case, the robot will act accordingly without alerting the aggressor. The proposed vision system uses the MediaPipe library to detect people in an image and locate the hands, from which it extracts a set of hand landmarks that identify which gesture is being made. By analysing the sequence of detected gestures, it can identify whether a person is performing the distress hand signal with an accuracy of 96.43%.

Women’s Homelessness and the Justice System: A Study of Desistance and Social (Re)integration Among Canadian Women Who Used or Did Not Use Criminal Activities to Survive

Women experiencing homelessness (WEH) are a marginalized group who often lack support services, leading them to adopt alternative survival strategies that leave them at risk of being victimized and becoming involved with the justice-system. To better understand this problem, we analyzed the adaptive strategies Canadian WEH use to survive. Comparing the life histories of WEH who turned to criminal activities ( n = 4) with WEH who demonstrated prosocial resilience ( n = 4) makes it possible to identify protective and risk factors for criminal behavior and to propose adaptive strategies that can be used to support these women to adopt a prosocial lifestyle. The results provide a framework for understanding the needs of WEH, filling a gap that results from the focus on men needs in most scientific literature and by many resources, and suggesting that meeting those needs may reduce the likelihood that WEH will become involved with the justice-system.

Effectiveness of a web-enabled psychoeducational resource for postpartum depression and anxiety among women in British Columbia.

Postpartum depression (PPD) and anxiety (PPA) affect nearly one-quarter (23%) of women in Canada. eHealth is a promising solution for increasing access to postpartum mental healthcare. However, a user-centered approach is not routinely taken in the development of web-enabled resources, leaving postpartum women out of critical decision-making processes. This study aimed to evaluate the effectiveness, usability, and user satisfaction of PostpartumCare.ca, a web-enabled psychoeducational resource for PPD and PPA, created in partnership with postpartum women in British Columbia. Participants were randomized to either an intervention group (n = 52) receiving access to PostpartumCare.ca for four weeks, or to a waitlist control group (n = 51). Measures evaluating PPD (Edinburgh Postnatal Depression Scale) and PPA symptoms (Perinatal Anxiety Screening Scale) were completed at baseline, after four weeks, and after a two-week follow-up. User ratings of website usability and satisfaction and website metrics were also collected. PPD and PPA symptoms were significantly reduced for the intervention group only after four weeks, with improvements maintained after a two-week follow-up, corresponding with small-to-medium effect sizes (PPD: partial η2 = 0.03; PPA: partial η2 = 0.04). Intervention participants were also more likely than waitlist controls to recover from clinical levels of PPD symptoms (χ 2 (1, n = 63) = 4.58, p = .032) and PostpartumCare.ca's usability and satisfaction were rated favourably overall. Findings suggest that a web-enabled psychoeducational resource, created in collaboration with patient partners, can effectively reduce PPD and PPA symptoms, supporting its potential use as a low-barrier option for postpartum women. Protocol for this trial was preregistered on NIH U.S. National Library of Medicine, ClinicalTrials.gov as of May 2022 (ID No. NCT05382884).

Abstract PO4-09-03: Environmental Metal Exposures and Breast Cancer Risk: A Prospective Study of Nationally Representative Canadian Data

Abstract Introduction: The impact of metal exposure on breast cancer risk remains unclear. Studies have explored metals independently with limited investigation into chronic exposures and mixture analyses. This project describes exposure to eight heavy and essential metals and evaluates the association between metals and breast cancer risk, independently and in a mixture, among Canadian women. Methods: Demographic information and concentrations of urinary or blood metal biomarkers from 2007-2017 of the Canadian Health Measures Survey (CHMS) were analyzed. Incident breast cancers were ascertained through linkage to the Canadian Cancer Registry. Metal exposure was described using weighted percentiles and categorized by tertiles. Cox proportional hazards regression was used to estimate hazard ratios (HR) and 95% confidence intervals (CI) for metal exposure and breast cancer risk. Quantile g-computation was used to estimate the joint association between metal exposure and breast cancer risk. Results: This analysis included 5,100 women (mean age 44.6 years) with an average follow-up of 6.6 years. Higher urinary arsenic (> 13.0 µg/L) and cadmium (> 10.0 µg/L) had a significant increased risk of breast cancer (HR Arsenic T3 vs. T1 = 2.05; 95%CI 1.05-3.94; HR Cadmium T3 vs. T1 = 1.71; 95%CI 1.01 – 5.87). Analyses into the joint association between the metal exposure mixture and breast cancer risk are ongoing, and matrix results will be presented. Conclusion: This represents the first evaluation of metal exposure and breast cancer risk in a nationally representative cohort. Our findings suggest that arsenic and cadmium, even at low levels, may be associated with an increased risk of breast cancer. These findings can inform population-level interventions to reduce the burden of cancer in Canada. Citation Format: Katherine Pullella, Jan Lubinski, Anthony Hanley, Shelley Harris, Steven Narod, Joanne Kotsopoulos. Environmental Metal Exposures and Breast Cancer Risk: A Prospective Study of Nationally Representative Canadian Data [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO4-09-03.

What I say, or how I say it? Ethnic accents and hiring evaluations in the Greater Toronto Area

This study investigated accent bias against job applicants with extralocal (non-Canadian) English accents in the Greater Toronto Area. Verbal guises recorded by British, Chinese, German, Indian, Jamaican, and Nigerian women and by Canadian women with at least one parent from these countries were evaluated by forty-eight human resources students, who rated the content of job interview responses and the candidates’ ‘expression’ and ‘employability’, determined what job they should be interviewed for, and provided commentary. Canadian voices were especially privileged in comments on speech. Quantitative analysis of responses reflected bias against extralocal voices. Consequently, we provide recommendations for relevant stakeholders.

Actions speak: personality, nonverbal behaviors, and self-perceptions of vulnerability in college-aged women

PurposeDespite representing a relatively small portion of the population, those who experience repeat victimization make up a significant share of all sexual and violent crimes, implying that perpetrators target them repeatedly. Indeed, research reveals specific traits (e.g. submissiveness) and behaviors (e.g. gait) related to past victimization or vulnerability. The purpose of this study is to explore the link between personality traits, self-assessed vulnerability and nonverbal cues.Design/methodology/approachIn all, 40 undergraduate Canadian women were videotaped while recording a dating profile. Self-report measures of assertiveness, personality traits and vulnerability ratings for future sexual or violent victimization were obtained following the video-recording. The videotape was coded for nonverbal behaviors that have been related to assertiveness or submissiveness.FindingsSelf-perceived sexual vulnerability correlated with reduced assertiveness and dominance and increased emotionality (e.g. fear and anxiety). Additionally, nonverbal behaviors differed based on personality traits: self-touch was linked to lower assertiveness, dominance and extraversion and higher submissiveness, emotionality and warm-agreeableness.Originality/valueTo the best of the authors’ knowledge, this is the first study of its kind to consider the relationships between personality, self-perceived vulnerability and nonverbal behaviors among college-aged women. Potential implications, including enhancing autonomy and self-efficacy, are discussed.