Time filter

Source Type

Tremblay M.-C.,University of Montreal | Richard L.,University of Montreal | Brousselle A.,Universite de Sherbrooke | Brousselle A.,Charles yne Hospital Research Center | Beaudet N.,Montreal Health and Social Services Agency
Health Promotion International

In recent decades, reflexivity has received much attention in the professional education and training literature, especially in the public health and health promotion fields. Despite general agreement on the importance of reflexivity, there appears to be no consensus on how to assess reflexivity or to conceptualize the different forms developed among professionals and participants of training programs. This paper presents an analysis of the reflexivity outcomes of the Health Promotion Laboratory, an innovative professional development program aimed at supporting practice changes among health professionals by fostering competency development and reflexivity. More specifically, this paper explores the difference between two levels of reflexivity (formative and critical) and highlights some implications of each for practice. Data were collected through qualitative interviews with participants from two intervention sites. Results showed that involvement in the Health Promotion Laboratory prompted many participants to modify their vision of their practice and professional role, indicating an impact on reflexivity. In many cases, new understandings seem to have played a formative function in enabling participants to improve their practice and their role as health promoters. The reflective process also served a critical function culminating in a social and moral understanding of the impacts on society of the professionals' practices and roles. This type of outcome is greatly desired in health promotion, given the social justice and equity concerns of this field of practice. By redefining the theoretical concept of reflexivity on two levels and discussing their impacts on practice, this study supports the usefulness of both levels of reflexivity. ©The Author (2013). Source

MacDonald J.-A.M.,University of Prince Edward Island | Gagnon A.J.,McGill University | Mitchell C.,McGill University | Di Meglio G.,McGill University | And 2 more authors.
Qualitative Health Research

Encouraging youth voice, visibility, and active participation in adolescent-related research is strongly advocated in the literature. In this article, we describe how participatory approaches informed by arts-based methods (e.g., reflective writing, dramatization) were used with adolescents to enhance the research process in an exploratory study designed to develop and evaluate prevention resources for sexual risk-taking behaviors.Youth aged 15 to 17 years participated in iterative focus groups conducted over a 1-year period in school settings in Prince Edward Island, Canada. Descriptions of our experiences, strategies, and insights provide evidence for guiding practice to optimize adolescent participation in research. © 2011 The Author(s). Source

Tousignant P.,Agency Systems | Tousignant P.,McGill University | Diop M.,Agency Systems | Fournier M.,Montreal Health and Social Services Agency | And 4 more authors.
Annals of Family Medicine

PURPOSE In a primary care context favoring group practices, we assessed the validity of 2 new continuity measures (both versions of known provider continuity, KPC) that capture the concentration of care over time from multiple physicians (multiple provider continuity, KPC-MP) or from the physician seen most often (personal provider continuity, KPC-PP).METHODS Patients with diabetes or cardiovascular disease (N = 765) were approached in the waiting rooms of 28 primary care clinics in 3 regions of the province of Quebec, Canada; answered a survey questionnaire measuring relational continuity, interpersonal communication, coordination within the clinic, coordination with specialists, and overall coordination; and gave permission for their medical records to be reviewed and their medical services utilization data for the previous 2 years to be accessed to measure KPC. Using generalized linear mixed models, we assessed the association between KPC and the patients’ responses.RESULTS Among the 5 different patient-reported measures or their combination, KPC-MP was significantly related with overall coordination of care: for high continuity, the odds ratio (OR) = 2.02 (95% CI, 1.33-3.07), and for moderate continuity, OR = 1.61 (95% CI, 1.06-2.46). KPC-MP was also related with the combined continuity score: for high continuity, OR = 1.52 (95% CI, 1.11-2.09), and for moderate continuity, OR = 1.48 (95% CI, 1.10-2.00). KPC-PP was not significantly associated with any of the survey measures.CONCLUSIONS The KPC-MP measure, based on readily available administrative data, is associated with patient-perceived overall coordination of care among multiple physicians. KPC measures are potentially a valuable and low-cost way to follow the effects of changes favoring group practice on continuity of care for entire populations. They are easy to replicate over time and across jurisdictions. Source

Miranda-Moreno L.F.,McGill University | Strauss J.,McGill University | Morency P.,Montreal Health and Social Services Agency
Transportation Research Record

This paper proposes a new approach to represent cyclist risk exposure. This approach considers disaggregate motor vehicle and cyclist flows and develops cyclist injury frequency models. Three definitions of risk exposure were used in this research, including aggregated flows, motor vehicle flows aggregated by movement type, and potential conflicts between motor vehicles and cyclists. As an application environment, a large sample of signalized intersections on the island of Montreal, QCbec, Canada, was used, along with data that comprised disaggregate motor vehicle and cyclist flows. Several negative binomial models were fitted to the data. This study showed that cyclist collisions were sensitive to changes in both cyclist and motor vehicle flows. A 10% increase in bicycle flow was associated with a 4.4% increase in the frequency of cyclist injuries. A 10% increase in the total number of motor vehicles that passed through the intersection would result in a 3.4% increase in cyclist injury occurrence. When motor vehicle flows were considered on the basis of movement type, right-turn movements had a great effect on injury occurrence. Similar results, which identified right turns as having the greatest effect on cyclist injuries, were produced when the impact of potential conflicts was determined. The number of bus stops in the proximity of the intersection increased cyclist injury occurrence. Some geometric design factors, such as the presence of a median, parking entrance, and the number of intersection legs, were tested. The effect, however, was found to be statistically nonsignificant. Source

Haggerty J.L.,McGill University | Roberge D.,Universite de Sherbrooke | Levesque J.-F.,Montreal Health and Social Services Agency | Levesque J.-F.,Institute National Of Sante Publique Du Quebec Inspq | And 3 more authors.
Health and Place

Comparing accessibility between urban and rural areas requires measurement instruments that are equally discriminating in each context. Through focus groups we explored and compared care-seeking trajectories to understand context-specific accessibility barriers and facilitators. Rural care-seekers rely more on telephone access and experience more organizational accommodation but have fewer care options. Urban care-seekers invoke the barrier of distance more frequently. Four consequences of accessibility problems emerged across settings which could be used for valid comparisons of access: having to restart the care-seeking process, abandoning it, using emergency services for primary care, and health deterioration due to delay. © 2014 Elsevier Ltd. Source

Discover hidden collaborations