How to carry out participatory research that takes account of sex and gender issues: a scoping review of guidelines targeting health inequities.

OBJECTIVE: Conducting participatory research (PR) aimed at improving health implies considering inequitable power relations, including those related to sex/gender (S/G). This necessitates specific skills and methods and may be challenging especially since guidelines are scarce. Our objective was to perform a scoping review to provide a typology of existing guidelines for researchers on how to take account of S/G in the context of PR in public health, with a focus on occupational and environmental health. METHODS: All steps of the research were conducted with the collaboration of an advisory committee, following PR principles. Nineteen documents were retained from 513 references identified in nine scientific databases and grey literature between 2000 and 2020. Data on recommendations were extracted and coded qualitatively. Cluster analysis based on similarities in recommendations proposed in the documents identified four types: (1) empowerment-centered; (2) concrete action-centered; (3) macrosystem-centered; and (4) stakeholder-centered. SYNTHESIS: Many sources gave pointers on how to include S/G during data collection and analysis or during the dissemination of findings, but there was a dearth of suggestions for building partnerships with stakeholders and producing sustainable S/G sociopolitical transformations. Occupational health PR showed less similarities with other public health subfields including environmental health PR. Power relationships with workplace stakeholders generated specific obstacles related to S/G integration that require further attention. Intersectionality and reflexive practices emerged as overarching themes. CONCLUSION: This review provides helpful guidelines to researchers at different stages of planning PR, ranging from familiarizing themselves with S/G approaches to anticipating difficulties in their ongoing S/G-transformative PR.

RéSUMé: OBJECTIF: Les recherches participatives (RP) visant l'amélioration de la santé doivent tenir compte de rapports de pouvoir inéquitables, incluant ceux liés au sexe/genre (S/G). Cela peut s'avérer difficile vu les compétences requises et la rareté de recommandations. Notre objectif consistait à réaliser une revue de portée menant à une typologie des recommandations existantes pour les chercheurs.euses sur l'intégration du S/G en contexte de RP en santé publique, particulièrement en santé environnementale ou au travail. MéTHODOLOGIE: Un comité d'encadrement a participé à chaque étape de l'étude. Nous avons retenu 19 documents parmi 513 références identifiées dans neuf bases de données scientifiques et la littérature grise (2000­2020). L'extraction et le codage qualitatif des recommandations a mené à une analyse de clusters basée sur les similitudes identifiant quatre types centrés sur : 1) pouvoir d'agir; 2) actions concrètes; 3) macro-système; et 4) parties prenantes. SYNTHèSE: Plusieurs sources indiquaient comment intégrer le S/G pendant la collecte/analyse des données ou la diffusion des résultats. Peu de recommandations touchaient l'aspect S/G au niveau des partenariats avec des parties prenantes ou des transformations sociopolitiques durables. Les recommandations en santé au travail étaient moins similaires aux autres sous-domaines de santé publique. Les relations de pouvoir en milieu de travail engendrent des obstacles spécifiques liés à l'intégration du S/G et nécessitent une attention particulière. L'intersectionnalité et les pratiques réflexives sont apparues comme des thèmes primordiaux. CONCLUSION: Les recommandations repérées aideront des chercheurs.euses à différents stades de leur parcours d'intégration du S/G dans une RP en cours, allant de la familiarisation à l'anticipation de difficultés.

Socio-semantic networks as mutualistic networks.

Several studies have shown that discourse and social relationships are intertwined and co-evolve. However, we lack theoretical models to explain the phenomenon. Inspired by recent work in ecology, we propose to model socio-semantic networks as an interaction between two intermingled data generating processes: a social community process and a document-based process. We consider the link between semantic and social ties as analogous to the interactions found in pollination networks whereby agents visit hidden topics in a similar way that insects visit specific plants for pollination. We use the ENRON socio-semantic email network to investigate if it exhibits properties that characterize mutualistic networks, namely moderate connectance, heterogeneous degree distribution, moderate modularity and high nestedness. To do so, we build a plant-pollinator matrix where "insect species" are communities detected via block modelling, "plant species" are latent topics detected with topic modelling, and the interaction between the two is the total number of visits a community makes to specific topics. Our results show that the ENRON socio-semantic interaction matrix respects the aforementioned criteria of mutualism paving the way for the development of a relevant framework to better understand the dynamic of human socio-semantic interactions.

Participação e transdisciplinaridade em Ecosaúde: a perspectiva da análise de redes sociais / Participation and transdisciplinarity in Ecohealth: a social network analysis perspective

Resumo A Ecosaúde usa abordagens participativas e transdisciplinares com o intuito de compreender as inter-relações entre os componentes dos sistemas socioecológicos e como estas interações influenciam a saúde das populações humanas. O objetivo do artigo é usar a Análise de Redes Sociais (ARS) para entender o papel das relações de colaboração entre os diversos atores envolvidos nos processos participativos e transdisciplinares em projetos de Ecosaúde. Apresentamos um conjunto de indicadores de ARS para caracterizar a evolução e a equidade de participação e diferenciar a inter e a transdisciplinaridade. A análise foi feita com base na rede de colaboração entre os atores da Iniciativa de Liderança em Ecosaúde para as Enfermidades Transmitidas por Vetores (ETV) na América Latina e Caribe. O processo participativo ficou mais intenso ao longo do projeto, com mais sujeitos envolvidos e um número crescente de colaborações. A cooperação entre os atores das ciências sociais, ambientais e da saúde é pouco equitativa; assim, predominam as ciências da saúde. Os poucos cientistas ambientais presentes estão, porém, ativamente envolvidos em colaborações interdisciplinares. A abordagem tem aplicação ampla para estudar a participação e a transdisciplinaridade em projetos sobre saúde e meio ambiente.

Abstract Ecohealth uses participatory and transdisciplinary approaches to understand the relationships between the components of socio-ecological systems and how these interactions influence the health of human populations. This article aims to use Social Network Analysis (SNA) to understand the role of collaborative relationships between the various actors involved in participatory and transdisciplinary processes in Ecohealth projects. We present a set of SNA indicators to characterize the evolution and equity of participation and to differentiate inter- and transdisciplinarity. The analysis was based on the collaboration network among the members of the Iniciativa Para el Liderazgo y Desarrollo del Campo de Ecosalud y Enfermedades Transmitidas por Vectores (ETV) en América Latina y el Caribe. The participatory process intensified throughout the project, with more individuals involved and increasing collaborations. Cooperation between members from social, environmental, and health sciences is unbalanced and health scientists predominate. The few environmental scientists are, however, actively involved in interdisciplinary collaborations. The proposed approach has wide application to study participation and transdisciplinarity in projects about health and environment.

Personal Social Networks and Adiposity in Adolescents: A Feasibility Study.

Background and Objective: Weight-related behaviors are determined by multiple individual and contextual factors, with recent evidence implicating personal social networks (PSNs). Greater understanding of these relationships could help inform healthy weight promoting interventions. We conducted a feasibility study among youth at risk of obesity to document process outcomes, to discern relationships between PSN features and weight-related behaviors, and to generate hypotheses with respect to perceived social support (SS) and sex. Methods: Participants (egos) nominated up to 10 people (alters) with whom they discussed important matters. Egos reported their own and each alter's age, sex, body shape, lifestyle behaviors, relation, frequency of exercising with each alter, and of being encouraged by each alter to exercise. We examined relationships between PSN features and weight-related outcomes and explored the role of SS, using both correlational and linear regression analyses. Results: There were 45 participants (mean age 16.4 years) and body mass index z-score (zBMI) ranged from -1.2 to 3.9. There were few missing responses to PSN items; broad variation across most items, including SS scores, was reported. Correlations pointed to plausible relationships implicating PSN features and lifestyle behaviors. In exploratory analyses, network-based SS was positively associated with adiposity in girls and negatively associated in boys, while lifestyle role modelling was not associated with adiposity. Conclusions: Our findings support the feasibility of measuring the PSN in youth and the potential for using social network analysis to investigate social and behavioral mechanisms associated with obesity.

Impacts of considering sex and gender during intervention studies in occupational health: Researchers' perspectives.

The aim of this article is to examine the impacts of incorporating sex and gender (s/g) analysis in integrated knowledge translation (iKT) initiatives in the field of ergonomics and occupational health. The article presents findings based on a retrospective analysis of twelve intervention-research (IR) studies, including a thematic content analysis of in-depth interviews conducted with 15 researchers involved in these IRs. The findings offer an overview of various categories of impacts, such as changes in partners' views, in workplace settings and conditions, in practices and policies, and in economic outcomes. In these types of IR, health effects measurement is not the main objective, and direct health outcomes are difficult to assess. Explicitly talking about sex/gender led more often to system-level changes but less often to workplace-level changes, compared to interventions where sex/gender was not identified as a specific object of the intervention.

Understanding the Connections Between Dogs, Health and Inuit Through a Mixed-Methods Study.

Dogs have been an integral part of the Inuit social and cultural environment for generations, but their presence also generates public health risks such as bites and exposure to zoonotic diseases such as rabies. In Nunavik, Canada, some prevention and control interventions targeting dogs have been implemented but have not demonstrated their effectiveness in a long-term sustainable perspective. This study was conducted in one Inuit community of Nunavik and used mixed methods to get a better understanding of factors that affect human and dog health, dog-related risks for humans and perceptions of dogs in Inuit communities using an interdisciplinary perspective in line with the Ecohealth approach. Results unveiled different perceptions and practices between Inuit and non-Inuit members of the community with regard to dogs and highlighted the positive role of dogs and their importance for Inuit health and well-being. This study provides new knowledge that is crucial for the development of integrated, sustainable and culturally adapted solutions to both the mitigation of dog-related health risks and the reinforcement of health and wellness benefits of dogs for Inuit.

Work/Family Balancing and 24/7 Work Schedules: Network Analysis of Strategies in a Transport Company Cleaning Service: Concilier travail-famille et horaires 24/7: analyse réseau des stratégies au sein du service de nettoyage d'une compagnie de transport.

Whether or not official work/family balance measures exist within an organization, scheduling accommodations often go through informal channels involving colleagues and superiors and are negotiated within interpersonal relationships. This study examines the relationship dimensions of the scheduling strategies of cleaners working atypical hours in the transport sector through the lenses of ergonomic activity, network, and gender analyses. Using semi-directed interviews, observation, and network analysis, we revealed the effect of gender on relationship dynamics and the influence of these dynamics on work/family balance strategies deployed by cleaners. One of the main contributions of this study is to demonstrate the decisive effect of relationships by revealing inequalities in access to organizational social networks. Creating spaces to discuss work/family balancing and a more equitable circulation of information could contribute to reducing inequalities associated with gender, social status, and family responsibilities and support the work/family strategies developed by workers dealing with restrictive work schedules. Résumé Les accommodements du temps de travail pour la conciliation travail-famille (CTF) passent souvent par des ententes informelles qui s'inscrivent dans les relations entre collègues ou avec des gestionnaires. Notre étude, intégrant l'ergonomie et la communication dans une perspective de genre, porte sur les dimensions relationnelles des stratégies de choix d'horaire d'agentes et agents de nettoyage devant composer avec des horaires atypiques dans le secteur des transports. À partir d'entretiens semi-dirigés, d'observations et d'analyse de réseaux, nous avons pu observer l'influence des dynamiques relationnelles, notamment de genre, sur les stratégies de CTF. Un apport central de cette étude est de montrer l'effet structurant des relations en révélant notamment des inégalités dans l'accès aux ressources facilitant le choix d'horaire, mais aussi dans l'inclusion au sein du réseau de relations. L'article conclut en proposant des pistes de solutions concrètes pour la réduction de ces inégalités.

Women's Occupational Health: Resisting When We Can: Santé des femmes au travail: mobiliser quand c'est encore possible.

The continuing worldwide struggle for decent working conditions is under intense economic, social, and political pressures. Women are particularly affected by these pressures because of their still-tenuous position in the service sector, in lowprestige, low-paid occupations. In addition, their occupational health issues are often overlooked or minimized. Nevertheless, women continue to struggle, as individuals and collectively. This issue describes a number of instances where women in the Québec labor movement have attempted to reconcile equality concerns with protecting their own health. There are successes, failures, and puzzles. Résumé La lutte mondiale pour des conditions de travail décentes subit d'intenses pressions économiques, sociales et politiques. Les femmes sont particulièrement touchées par ces pressions à cause de leur situation encore fragile dans le secteur des services, dans des professions de faible prestige et salaire. De plus, leurs besoins en santé au travail sont souvent minimisés ou ignorés. Toutefois, les femmes continuent à résister, individuellement et collectivement. Ce numéro décrit un certain nombre d'exemples où des travailleuses militantes ont tenté de concilier leurs revendications d'égalité et d'accès au travail avec leur besoin de protéger leur santé.

Ecohealth as a field: looking forward.

This forum paper proposes a reflection on the "field of ecohealth" and on how best to sustain a supportive environment that enables the evolution of diverse partnerships and forms of collaboration in the field. It is based on the results of a preconference workshop held in October 2012, in Kunming, China at the fourth biennial conference of the International Association for Ecology and Health. Attended by 105 persons from 38 countries, this workshop aimed to have a large-group and encompassing discussion about ecohealth as an emerging field, touching on subjects such as actors, processes, structures, standards, and resources. Notes taken were used to conduct a qualitative thematic analysis combined with a semantic network analysis. Commonalities highlighted by these discussions draw a portrait of a field in which human health, complex systems thinking, action, and ecosystem health are considered central issues. The need to reach outside of academia to government and the general public was identified as a shared goal. A disconnect between participants' main concerns and what they perceived as the main concerns of funding agencies emerged as a primary roadblock for the future.

Safe and healthy integration into semiskilled jobs: does gender matter?

Women report fewer injuries than men when they are young, but report a higher proportion of professional diseases later in life (35 years +). Understanding early work conditions that lead to postponed health outcomes is necessary if we are to prevent women's injury as well as men's. Introduction to work and safe integration programs are often put forward to prevent injuries among youth. This paper aims to illustrate some differences in the job introduction / integration process for men and women and to discuss some gender-based Occupational Health and Safety (OHS) implications. Data come from two waves of interviews with 31 students enrolled in vocational training for a semiskilled trade. Results demonstrated differences between men and women: trades chosen, OHS complaints, supervising patterns, integration to work, etc. Women often choose customer service jobs, have less formal supervision and are often left to themselves when learning to do their job. Men declared more accidents while women reported more musculoskeletal symptoms. Findings from this research suggest young women's OHS issues should not be trivialized and that specific youth prevention programs for sectors where women are more present, such as customer service, should be developed.

Social communication network analysis of the role of participatory research in the adoption of new fish consumption behaviors.

The formulation and communication of fish advisories are highly complex because of the potential conflict between the nutritional and toxicological issues associated with fish consumption. Government and organization-sponsored fish advisories have had limited success in changing behaviors. Participatory approaches may enhance the understanding of complex issues and the adoption of new behaviors. Here we used social network analysis to investigate the adoption of dietary changes within the context of a community participatory research project. In the Brazilian Amazon, many communities are highly exposed to methylmercury from fish consumption. A participatory intervention based on dietary changes aimed at reducing methylmercury exposure while maintaining fish consumption was initiated in 1995. In 2001, we collected data on individual participation in the research, on the discussion network regarding mercury issues and on changes in fish consumption from 96 of the 110 village households. More than half of men and women had adopted new fish consumption behavior to reduce mercury exposure. Adoption was associated with participation in the research project for both women and men, and with a higher number of discussion partners about mercury issues for women. Adoption was likewise associated with the presence of a female communication partner in the personal networks of both men and women. At the household level, men and women who considered their spouse as a discussion partner were more likely to adopt than those who did not. Opinion le]adership was associated with change in fish consumption only for women. We discuss the contribution of community participation and communication networks to overcome the difficulties in generating complex messages that take into account both health benefits and risks of fish consumption. We also discuss the relevance of building preventive health programs based on participatory research approaches and the roles and relations specific to men and women.

Tools for thoughtful action: the role of ecosystem approaches to health in enhancing public health.

The intimate interdependence of human health and the ecosystems in which we are embedded is now a commonplace observation. For much of the history of public health, this was not so obvious. After over a century of focus on diseases, their biologic causes and the correction of exposures (clean water and air) and facilitation of responses (immunizations and nutrition), public health discourse shifted to embrace the concept of determinants of health as extending to social, economic and environmental realms. This moved the discourse and science of public health into an unprecedented level of complexity just as public concern about the environment heightened. To address multifactorial, dynamic impacts on health, a new paradigm was needed which would overcome the separation of humans and ecosystems. Ecosystem approaches to health arose in the 1990s from a rich background of intellectual ferment as Canada wrestled with diverse problems ranging from Great Lakes contamination to zoonotic diseases. Canada's International Development Research Centre (IDRC) played a lead role in supporting an international community of scientists and scholars who advanced ecosystem approaches to health. These collective efforts have enabled a shift to a research paradigm that embraces transdisciplinarity, social justice, gender equity, multi-stakeholder participation and sustainability.

Emergence and robustness of a community discussion network on mercury contamination and health in the Brazilian Amazon.

Information exchanges, debates, and negotiations through community social networks are essential to ensure the sustainability of the development process initiated in participatory research. The authors analyze the structural properties and robustness of a discussion network about mercury issues in a community in the Brazilian Amazon involved in a participatory research aimed at reducing exposure to the pollutant. Most of the villagers are connected in a large network and are separated from other individuals by few intermediaries. The structure of the discussion network displays resilience to the random elimination of villagers but shows vulnerability to the removal of one villager who has been a long-term collaborator of the project. Although the network exhibits a structure likely to favor an efficient flow of information, results show that specific actions should be taken to stimulate the emergence of a pool of opinion leaders and increase the redundancy of discussion channels.