Examining second-stage shelters: insights into housing instability and tailored support for IPV survivors.

BACKGROUND: Intimate Partner Violence (IPV) exposes women and children to a wide range of challenges across housing, employment, social connections, and child well-being and is a public health issue. IPV survivors are at heightened risk of housing insecurity and homelessness. Emergency shelters have historically offered respite and support, but the emergence of second-stage shelters provides longer-term solutions. Despite their significance, there has been a lack of comprehensive research on second-stage shelters. This study focuses on understanding the needs of IPV survivors accessing second-stage shelters, aiming to illuminate unexplored aspects of support. To examine the current published peer-reviewed literature and gray literature on second-stage shelters, a scoping review was conducted. METHODS: This scoping review used the method suggested by Arksey & O'Malley (2005) and considered all studies that focused on women who had experienced IPV and were accessing transitional housing/second-stage shelters. RESULTS: Sixteen articles, mainly from the USA and published between 1985 and 2022, were included in the analysis. The findings highlighted themes of (1) a safe(r) place, with the subtheme of 'gated' communities, and (2) programming and services, with the subtheme of does one size fit all? and (3) insider support, with subthemes of paid insider support and peer insider support. CONCLUSIONS: Housing instability was evident, and the need for multiple and individualized tailored options of programming and support along with housing security was identified. Second-stage housing policy and practice implications are addressed which illuminate unexplored aspects of support.

A WISH to be Housed: Exploring the Winter Interim Solution to Homelessness (WISH) Temporary Accommodation Model in London, Canada.

Temporary housing programs (THPs) aim to serve the homeless population. This article explores the impacts of a THP, the Winter Interim Solution to Homelessness (WISH) in London, Canada, which applied a barrier-free, harm reduction model. Adopting an intersectional lens and interpretive description methodology, we analyzed data collected from WISH residents, utilizing a thematic analytic approach. Identified themes included: (1) "(It's) kinda like a real home" (WISH is unlike other shelters); (2) "It's like a buddy system" (A sense of community was fostered); (3) "It's the same size as a jail cell" (Problems with infrastructure); (4) "To keep us on focus" (Un/supportive staff/volunteers); (5) "I'm not sure what I'm going to do after" (The dearth of permanent housing creates trauma); and (6) "Too much bloody money in too little hands" (Distrust of housing providers). Although WISH was helpful to some residents, the temporary nature of the program limited its long-term impact.

Personal digital technology use among practicing Registered Nurses and Registered Practical Nurses.

Many clinicians are using their personal digital devices (such as smartphones) while at work for personal and professional purposes. The purpose of this research was to understand how Ontario nurses used their own digital devices within the workplace. Reported here are the findings from the on-line questionnaire of a mixed methods design. Participants (N = 169) had a mean age of 41 years, were mostly female, and with an average of 15.2 years of nursing experience. Most (73%) used their own device within the workplace for pragmatic reasons (telling time), patient care (accessing information, drug management, and administration), and communication among the healthcare team. This research offers emerging insight into how personally owned devices are being integrated into healthcare practices and highlighted tensions among workplace efficiency and enhanced team communication. This research supports the development of guidelines for personal device use within healthcare settings.

Community engagement with African American clergy: faith-based model for culturally competent practice.

OBJECTIVE: The intent of this exploratory qualitative study was to examine African American Baptist clergy's pastoral care to older congregants with mental disorders. Critical Race Theory was the guiding framework in this study. METHOD: A purposive sample of 18 African American clergy participated in one-on-one interviews. RESULTS: Collectively, all participants were active in the provision of mental health to older congregants with mental disorders. The primary emergent theme 'shepherding the flock' the central phenomenon uncovered in the data, was used to organize a model of pastoral care, which is presented in this paper. Findings from this study supported results from previous studies on the integral role of the Church and clergy in the African American community. CONCLUSION: Moreover, this study highlights the importance of internal ministries in the Church and the need for further study and potential partnership opportunity.

Laboring to mother in the context of past trauma: the transition to motherhood.

The occurrence of interpersonal trauma is a reality for many women, with effects that often persist long after the traumatic events end. The purpose of this feminist grounded theory study was to examine how past trauma shaped the lives of women as they became new mothers. We recruited a purposive sample of 32 women from two Canadian communities and conducted semistructured, dialogic interviews during the second trimester of pregnancy. We analyzed data using thematic content analytic methods, including open coding whereby we read transcripts line by line and applied codes to portions of text that illustrated concepts or themes. The substantive grounded theory, "laboring to mother in the context of past trauma," describes the exceedingly difficult emotional and cognitive work undertaken by pregnant women with histories of trauma as they anticipate becoming mothers. In this article, we present key components of the theory and offer recommendations for health and social service providers.

Historical analysis of professionalism in western societies: implications for interprofessional education and collaborative practice.

Health care systems around the world are under tremendous pressure to change their models of health care delivery - from the current multiprofessional health care delivery into interprofessional collaborative care models with the ultimate goal of improving patient/client outcomes. The growing diversity of the population, the increasing number of vulnerable persons (elderly, homeless, those living with chronic health conditions), the complexity of health problems, and the shortage of health care providers have forced health policymakers to call for sweeping revisions to how health care is provided, impacting how health care program students are educated. However, in professional training emphasis is placed on uniprofessional education. Learners are socialized in isolation from those in other related professions to ensure the development of a shared professional identity. Consequently, by program completion each student will not only master the knowledge, skills and norms of his/her own profession, but will also develop a silo identity, called "uniprofessional identity". This isolationist identity creates a lack of understanding of others. In limiting their exposure to learning about the roles and value of other health care professionals, persistent negative stereotypical attitudes towards other professionals are reinforced. In this paper, we present the historical evolution(s) of the discourse of professionalism to assist us to develop a deeper understanding of socio-historical context within which interprofessional education (IPE) is embedded within, and collaborative person-centered practice (CPCP). With greater insight, we can (re)conceptualize the possibilities, and advance research on, interprofessional education and practice in the present.

Short- and Long-Term Predicted and Witnessed Consequences of Digital Surveillance During the COVID-19 Pandemic: Scoping Review.

BACKGROUND: The COVID-19 pandemic has prompted the deployment of digital technologies for public health surveillance globally. The rapid development and use of these technologies have curtailed opportunities to fully consider their potential impacts (eg, for human rights, civil liberties, privacy, and marginalization of vulnerable groups). OBJECTIVE: We conducted a scoping review of peer-reviewed and gray literature to identify the types and applications of digital technologies used for surveillance during the COVID-19 pandemic and the predicted and witnessed consequences of digital surveillance. METHODS: Our methodology was informed by the 5-stage methodological framework to guide scoping reviews: identifying the research question; identifying relevant studies; study selection; charting the data; and collating, summarizing, and reporting the findings. We conducted a search of peer-reviewed and gray literature published between December 1, 2019, and December 31, 2020. We focused on the first year of the pandemic to provide a snapshot of the questions, concerns, findings, and discussions emerging from peer-reviewed and gray literature during this pivotal first year of the pandemic. Our review followed the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) reporting guidelines. RESULTS: We reviewed a total of 147 peer-reviewed and 79 gray literature publications. Based on our analysis of these publications, we identified a total of 90 countries and regions where digital technologies were used for public health surveillance during the COVID-19 pandemic. Some of the most frequently used technologies included mobile phone apps, location-tracking technologies, drones, temperature-scanning technologies, and wearable devices. We also found that the literature raised concerns regarding the implications of digital surveillance in relation to data security and privacy, function creep and mission creep, private sector involvement in surveillance, human rights, civil liberties, and impacts on marginalized groups. Finally, we identified recommendations for ethical digital technology design and use, including proportionality, transparency, purpose limitation, protecting privacy and security, and accountability. CONCLUSIONS: A wide range of digital technologies was used worldwide to support public health surveillance during the COVID-19 pandemic. The findings of our analysis highlight the importance of considering short- and long-term consequences of digital surveillance not only during the COVID-19 pandemic but also for future public health crises. These findings also demonstrate the ways in which digital surveillance has rendered visible the shifting and blurred boundaries between public health surveillance and other forms of surveillance, particularly given the ubiquitous nature of digital surveillance. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-https://doi.org/10.1136/bmjopen-2021-053962.

Conducting research with criminalized women in an incarcerated setting: the researcher's perspective.

Although women incarcerated by the criminal justice system encounter significant challenges to their health, there has been little research focusing on their health practices. To contribute to the research literature on the health experiences of criminalized women, the authors conducted a multi-method study as part of a program of research exploring the health promotion and health-literacy skills of women in conflict with the law. Conducting research in an incarcerated setting posed unique challenges and ethical dilemmas that problematized each phase of data collection. The authors share their experiences as health researchers conducting research in an incarcerated setting and with criminalized women. They document some of the challenges, successes, and valuable lessons learned during the research process in the hope that by sharing their knowledge with other health researchers they will support future studies with criminalized women.

An investigation of mHealth and digital health literacy among new parents during COVID-19.

Introduction: Especially during the COVID-19 pandemic, parents were expected to understand increasingly sophisticated information about health issues and healthcare systems and access online resources as a part of their caregiving role. Yet little is known about parents' online digital technology use and digital health literacy skill. This study aimed to investigate parents' digital technology use, their self-reported digital health literacy skill, and demographic information as potential factors influencing their use of digital technologies. Methods: An online survey utilizing convenience sampling was administered to new parents during the COVID-19 pandemic that inquired about their demographic information, digital technology use, and digital health literacy skills within Ontario, Canada. Results: A total of 151 individuals responded to the survey; these were primarily mothers (80%) who self-reported as white (72%), well-educated 86%), heterosexual (86%) females (85%) with incomes over $100,00 per year (48%). Participants reported consistent and persistent online activity related to their parenting role and mostly via mobile smartphone devices (92%). Participants had moderate to high digital health literacy skills, greater than the Canadian national average. Almost half of participants reported negative health and well-being consequences from their digital online behaviours. There were no significant relationships between technology use, digital health literacy skill, and demographic variables. Discussion: The COVID-19 pandemic has reinforced the need for and importance of effective and equitable digital health services. Important opportunities exist within clinical practice and among parenting groups to proactively address the physical and mental health implications of digital parenting practices. Equally important are opportunities to insert into clinical workflow the inquiry into parents' online information-seeking behaviours, and to include digital health literacy as part of prenatal/postnatal health education initiatives.

'Putting all my eggs into the app': Self, relational and systemic surveillance of mothers' use of digital technologies during the transition to parenting.

This paper builds on thematic findings from a larger study that explored how digital technologies (e.g. smartphones, apps, search engines) shape expectant and new mothers' early parenting practices. An overarching theme that arose across these mothers' experiences which deserved deeper exploration was relational digital surveillance. In the context of this paper, relational digital surveillance describes how mothers evaluate their sense of preparedness, goodness or suitability for motherhood as they transition into parenting in relation to: their own use of digital technologies when caring for their pregnant bodies (self-surveillance), partners' and family members' commentary and/or judgement regarding their use of digital technologies to support their parenting and decision-making (familial surveillance) in addition to service/health care providers' commentary and/or judgement concerning their technology use (systemic surveillance). Mothers' use of digital technologies in this study not only provided others (partners, family members, health care providers) with means to watch over their actions and bodies as they transitioned into motherhood but offered a new evaluative dimension for others to scrutinize their behaviour as a new mother. Such understandings of relational digital surveillance within the transition to parenting context raise critical questions concerning the promotion and commercialization of digital self-surveillance technologies among expectant/new parents given the ways these technologies can further push the boundaries of hegemonic mothering practices and contribute to feelings of inadequacy and self-doubt. Alternatively, these insights offer avenues where health care providers can intervene to facilitate activities that enhance digital health literacy skills and mitigate parents' exposure to platforms that amplify anxieties.

Understanding the Tensions of "Good Motherhood" Through Women's Digital Technology Use: Descriptive Qualitative Study.

BACKGROUND: Research suggests that expectant and new mothers consult and value information gathered from digital technologies, such as pregnancy-specific mobile apps and social media platforms, to support their transition to parenting. Notably, this transitional context can be rich with profound physiological, psychological, and emotional fluctuation for women as they cope with the demands of new parenting and navigate the cultural expectations of "good motherhood." Given the ways in which digital technologies can both support and hinder women's perceptions of their parenting abilities, understanding expectant and new mothers' experiences using digital technologies and the tensions that may arise from such use during the transition to parenting period warrants nuanced exploration. OBJECTIVE: This study aims to understand mothers' use of digital technologies during the transition to parenting period. METHODS: A descriptive qualitative study was conducted in a predominantly urban region of Southwestern Ontario, Canada. Purposive and snowball sampling strategies were implemented to recruit participants who had become a parent within the previous 24 months. Researchers conducted focus groups using a semistructured interview guide with 26 women. The interviews were audio recorded, transcribed, and thematically analyzed. RESULTS: Participants' experiences of using digital technologies in the transition to parenting period were captured within the overarching theme "balancing the tensions of digital technology use in the transition to parenting" and 4 subthemes: self-comparison on social media, second-guessing parenting practices, communities of support, and trusting intuition over technology. Although digital technologies purportedly offered "in-the-moment" access to community support and health information, this came at a cost to mothers, as they described feelings of guilt, shame, and self-doubt that provoked them to question and hold in contention whether they were a good mother and using technology in a morally upright manner. CONCLUSIONS: These findings raise critical questions concerning the promotion and commercialization of digital technologies and the ways in which they can further push the boundaries of hegemonic parenting practices, provoke feelings of inadequacy, and compromise well-being among expectant and new mothers.

An investigation of media reports of digital surveillance within the first year of the COVID-19 pandemic.

Introduction: The COVID-19 pandemic prompted a surge in digital public health surveillance worldwide, with limited opportunities to consider the effectiveness or impact of digital surveillance. The news media shape public understanding of topics of importance, contributing to our perception of priority issues. This study investigated news media reports published during the first year of the pandemic to understand how the use and consequences of digital surveillance technologies were reported on. Methods: A media content analysis of 34 high- to low-income countries was completed. The terms "COVID-19," "surveillance," "technologies," and "public health" were used to retrieve and inductively code media reports. Results: Of the 1,001 reports, most were web-based or newspaper sources on the development and deployment of technologies directed at contact tracing, enforcing quarantine, predicting disease spread, and allocating resources. Technology types included mobile apps, wearable devices, "smart" thermometers, GPS/Bluetooth, facial recognition, and security cameras. Repurposed data from social media, travel cards/passports, and consumer purchases also provided surveillance insight. Media reports focused on factors impacting surveillance success (public participation and data validity) and the emerging consequences of digital surveillance on human rights, function creep, data security, and trust. Discussion: Diverse digital technologies were developed and used for public health surveillance during the first year of the COVID-19 pandemic. The use of these technologies and witnessed or anticipated consequences were reported by a variety of media sources worldwide. The news media are an important public health information resource, as media outlets contribute to directing public understanding and shaping priority public health surveillance issues. Our findings raise important questions around how journalists decide which aspects of public health crises to report on and how these issues are discussed.

Use of digital technologies for public health surveillance during the COVID-19 pandemic: A scoping review.

Throughout the COVID-19 pandemic, a variety of digital technologies have been leveraged for public health surveillance worldwide. However, concerns remain around the rapid development and deployment of digital technologies, how these technologies have been used, and their efficacy in supporting public health goals. Following the five-stage scoping review framework, we conducted a scoping review of the peer-reviewed and grey literature to identify the types and nature of digital technologies used for surveillance during the COVID-19 pandemic and the success of these measures. We conducted a search of the peer-reviewed and grey literature published between 1 December 2019 and 31 December 2020 to provide a snapshot of questions, concerns, discussions, and findings emerging at this pivotal time. A total of 147 peer-reviewed and 79 grey literature publications reporting on digital technology use for surveillance across 90 countries and regions were retained for analysis. The most frequently used technologies included mobile phone devices and applications, location tracking technologies, drones, temperature scanning technologies, and wearable devices. The utility of digital technologies for public health surveillance was impacted by factors including uptake of digital technologies across targeted populations, technological capacity and errors, scope, validity and accuracy of data, guiding legal frameworks, and infrastructure to support technology use. Our findings raise important questions around the value of digital surveillance for public health and how to ensure successful use of technologies while mitigating potential harms not only in the context of the COVID-19 pandemic, but also during other infectious disease outbreaks, epidemics, and pandemics.

"It brought my family more together": Mixed-methods study of low-income U.S. mothers during the pandemic.

Objective: We sought to understand challenges and positive experiences of low-income families during the pandemic. Background: Strength-based perspectives of economically disadvantaged mothers are missing from literature on the impact of the COVID-19 pandemic. Although it is imperative to recognize disparities that were highlighted by the pandemic, strengths-based approaches and a resilience framework can help professionals build upon and learn from ways families manage during those times. Method: We used a mixed-method approach to gain understanding of the unique experiences of 15 low-income mothers at the height of the pandemic. We administered a brief COVID-19 stress screener, the Five-Minute Speech Sample measure, and an open-ended question about potential positive experiences during the pandemic. Results: We learned that strength and resilience supersede the liabilities brought on by COVID-19 that are so often focused on. We found highly divergent experiences across mothers in terms of stress; even mothers with high levels of stress readily identified positive aspects of life during the pandemic. Mothers' responses were indicative of greater feelings of warmth and tenderness than negativity about their children. Conclusion and Implications: We discuss findings in terms of strengths-based practices and policies for mothers receiving public assistance and provide suggestions for continued research on resilience of mothers during the pandemic.

"Let me know when I'm needed": Exploring the gendered nature of digital technology use for health information seeking during the transition to parenting.

This paper presents results of a qualitative descriptive study conducted to understand parents' experiences with digital technologies during their transition to parenting (i.e. the period from pre-conception through postpartum). Individuals in southwest Ontario who had become a new parent within the previous 24 months were recruited to participate in a focus group or individual interview. Participants were asked to describe the type of technologies they/their partner used during their transition to parenthood, and how such technologies were used to support their own and their family's health. Focus group and interview transcripts were then subjected to thematic analysis using inductive coding. Ten focus groups and three individual interviews were conducted with 26 heterosexual female participants. Participants primarily used digital technologies to: (1) seek health information for a variety of reproductive health issues, and (2) establish social and emotional connections. The nature of such health information work was markedly gendered and was categorized by 2 dominant themes. First, "'Let me know when I'm needed'", characterizes fathers' apparent avoidance of health information seeking and resultant creation of mothers as lay information mediaries. Second, "Information Curation", captures participants' belief that gender biases built-in to popular parenting apps and resources reified the gendered nature of health and health information work during the transition to parenting. Overall, findings indicate that digital technology tailored to new and expecting parents actively reinforced gender norms regarding health information seeking, which creates undue burden on new mothers to become the sole health information seeker and interpreter for their family.

Investigation of Digital Technology Use in the Transition to Parenting: Qualitative Study.

BACKGROUND: The transition to parenting-that is, the journey from preconception through pregnancy and postpartum periods-is one of the most emotionally charged and information-intense times for individuals and families. While there is a developing body of literature on the use and impact of digital technology on the information behaviors of children, adolescents, and young adults, personal use of digital technology during the transition to parenting and in support of infants to 2 years of age is relatively understudied. OBJECTIVE: The purpose of this study was to enhance our understanding of the ways digital technologies contribute to the experience of the transition to parenting, particularly the role these technologies play in organizing and structuring emerging pregnancy and early parenting practices. METHODS: A qualitative descriptive study was conducted to understand new parents' experiences with and uses of digital technology during 4 stages-prenatal, pregnancy, labor, and postpartum-of their transition to becoming a new parent. A purposive sampling strategy was implemented using snowball sampling techniques to recruit participants who had become a parent within the previous 24 months. Focus groups and follow-up interviews were conducted using semistructured interview guides that inquired about parents' type and use of technologies for self and family health. Transcribed audio recordings were thematically analyzed. RESULTS: A total of 10 focus groups and 3 individual interviews were completed with 26 participants. While recruitment efforts targeted parents of all genders and sexual orientations, all participants identified as heterosexual women. Participants reported prolific use of digital technologies to direct fertility (eg, ovulation timing), for information seeking regarding development of their fetus, to prepare for labor and delivery, and in searching for a sense of community during postpartum. Participants expressed their need for these technologies to assist them in the day-to-day demands of preparing for and undertaking parenting, yet expressed concerns about their personal patterns of use and the potential negative impacts of their use. The 3 themes generated from the data included: "Is this normal; is this happening to you?!", "Am I having a heart attack; what is this?", and "Anyone can put anything on Wikipedia": Managing the Negative Impacts of Digital Information. CONCLUSIONS: Digital technologies were used by mothers to track menstrual cycles during preconception; monitor, document, and announce a pregnancy during the prenatal stage; prepare for delivery during labor/birth stage; and to help babies sleep, document/announce their birth, and connect to parenting resources during the postpartum stage. Mothers used digital technologies to reassure themselves that their experiences were normal or to seek help when they were abnormal. Digital technologies provided mothers with convenient means to access health information from a range of sources, yet mothers were apprehensive about the credibility and trustworthiness of the information they retrieved. Further research should seek to understand how men and fathers use digital technologies during their transition to parenting. Additionally, further research should critically examine how constant access to information affects mothers' perceived need to self-monitor and further understand the unintended health consequences of constant surveillance on new parents.

Role of Policy in Best-Practice Dissemination: Informal Professional Advice Networks in Canadian Long-Term Care.

This article examines provincial policy influence on long-term care (LTC) professionals' advice-seeking networks in Canada's Maritime provinces. The effects of facility ownership, geography, and region-specific political landscapes on LTC best-practice dissemination are examined. We used sociometric statistics and network sociograms, calculated from surveys with 169 senior leaders in LTC facilities, to identify advice-seeking network structures and to select 11 follow-up interview participants. Network structures were distinguished by density, sub-group number, opinion leader, and boundary spanner distribution. Network structure was affected by ownership model in Nova Scotia and Prince Edward Island, and by regional geography in New Brunswick. Political instability within each province's LTC system negatively affected network actors' capabilities to enact innovation. Moreover, provincial policy variations influence advice-seeking network structures, facilitating and constraining relationship development and networking. Consequently, local policy context is essential to informing dissemination strategy design or implementation.

Digital technology and disease surveillance in the COVID-19 pandemic: a scoping review protocol.

INTRODUCTION: Infectious diseases pose a risk to public health, requiring efficient strategies for disease prevention. Digital health surveillance technologies provide new opportunities to enhance disease prevention, detection, tracking, reporting and analysis. However, in addition to concerns regarding the effectiveness of these technologies in meeting public health goals, there are also concerns regarding the ethics, legality, safety and sustainability of digital surveillance technologies. This scoping review examines the literature on digital surveillance for public health purposes during the COVID-19 pandemic to identify health-related applications of digital surveillance technologies, and to highlight discussions of the implications of these technologies. METHODS AND ANALYSIS: The scoping review will be guided by the framework proposed by Arksey and O'Malley and the guidelines outlined by Colquhoun et al and Levac et al. We will search Medline (Ovid), PsycInfo, PubMed, Scopus, CINAHL (EBSCOhost), ACM Digital Library, Google Scholar and IEEE Explore for relevant studies published between December 2019 and December 2020. The review will also include grey literature. Data will be managed and analysed through an extraction table and thematic analysis. ETHICS AND DISSEMINATION: Findings will be disseminated through traditional academic channels, as well as social media channels and research briefs and infographics. We will target our dissemination to provincial and federal public health organisations, as well as technology companies and community-based organisations managing the public response to the COVID-19 pandemic.

"It Is Important for Everyone as Humans to Feel Important, Right?" Findings from a Community-Based Participatory Needs Assessment with Street-level Sex Workers.

A community-based participatory research design informed the development and conduct of a needs assessment with street-level sex workers within a mid-sized city in Ontario, Canada. The research question was: What would help street-level sex workers to live with enhanced safety and dignity within their community? Twenty-four women who accessed a peer-driven drop-in center (SafeSpace) participated in in-depth interviews. Observational data of items requested by women who accessed SafeSpace were also documented over a 6-month time period. The overarching theme of relationships was identified as vital to participants' ability to live and work with enhanced safety and dignity in their community. Subthemes included: Informal/formal surveillance: Relationships to public space(s); Nowhere to go for us: Relationships with/in community services; and You're given the time you need: Relationships in a peer-driven drop-in center for/with/by sex workers. Our findings demonstrate how central relationships are, particularly peer, to enhancing or diminishing sex workers' sense of dignity, self-worth, safety, and enhanced their access to services.