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Intersectoral collaborations are recommended as effective strategies to reduce health inequalities. People most affected by health inequalities, as are people living in poverty, remain generally absent from such intersectoral collaborations. Community-based participatory research (CBPR) projects can be leveraged to better understand how to involve people with lived experience to support both individual and community empowerment. In this paper, we offer a critical reflection on a CBPR project conducted in public housing in Québec, Canada, that aimed to develop intersectoral collaboration between tenants and senior executives from four sectors (housing, health, city and community organizations). This single qualitative case study design consisted of fieldwork documents, observations and semi-structured interviews. Using the Emancipatory Power Framework (EPF) and the Limiting Power Framework (LPF), we describe examples of types of power and resistance shown by the tenants, the intersectoral partners and the research team. The discussion presents lessons learned through the study, including the importance for research teams to reflect on their own power, especially when aiming to reduce health inequalities. The paper concludes by describing the limitations of the analyses conducted through the EPF-LPF frameworks and suggestions to increase the transformative power of future studies.
Subject(s)
Community-Based Participatory Research , Public Housing , Qualitative Research , Humans , Quebec , Intersectoral Collaboration , Health Status Disparities , Empowerment , Power, Psychological , Interviews as TopicABSTRACT
LGBT2Q+ (lesbian, gay, bisexual, transgender, Two-Spirit, queer, plus) Canadians face minority stressors that lead to higher mental health inequalities such as worse self-reported mental health and increased risk of mental health issues when compared to their heterosexual/straight and cisgender counterparts. However, there are within-group (intracategorical) differences within a community as large as LGBT2Q+ peoples. Guided by the Andersen Model of Healthcare Utilization, we sought to explore intracategorical differences in LGBT2Q+ Canadian predisposing, enabling, and need factors in mental health service utilization within the past year. Using data from the 2020 LGBT2Q+ Health Survey (N = 1542), modified Poisson logistic regression found that more polysexual respondents and trans/gender-diverse respondents were more likely to have utilized mental health services within the past year than their gay, lesbian, and cis male counterparts. As well, compared to White respondents, Indigenous respondents were more likely to have utilized mental health services, while other racialized respondents were associated with less utilization. Backwards elimination of Andersen model of healthcare utilization factors predicting mental health service utilization retained two predisposing factors (ethnoracial groups and gender modality) and two need factors (self-reporting living with a mood disorder and self-reporting living with an anxiety disorder). Results suggest that polysexual, trans and gender-diverse, and racialized LGBT2Q+ peoples have an increased need for mental health services due to increased specific minority stressors that cisgender, White, monosexual peoples do not face. Implications for healthcare providers are discussed on how to improve service provision to LGBT2Q+ peoples.
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Purpose: Mental health disparities in sexual orientation and/or gender identity and/or expression (SOGIE) minority groups are well-documented, with research consistently showing higher levels of suicidality, even in Canada, considered one of the world's most accepting countries of SOGIE minority groups. Adverse outcomes in these groups are often framed using minority stress theory, with social support frequently studied as an integral buffer to these outcomes. This analysis explores facets of minority stress and social support associated with past-year suicidal ideation and suicide attempts. Methods: A cross-sectional internet survey of SOGIE diverse people in Canada (n = 1542) was conducted. Binary logistic regression calculated bivariate and multivariate factors associated with past-year suicidal ideation and suicide attempts. Backward elimination (retaining sociodemographic factors and self-rated mental health) identified salient minority stress and social support (provisions) factors. Results: Over half (56.72%) of participants had ever thought of dying by suicide, with 24.84% having attempted suicide. During the past year, 26.80% had thought of dying by suicide, with 5.32% having attempted suicide. Victimization events, and guidance (e.g., someone to talk to about important decisions) and attachment (e.g., close relationships providing emotional security) social provision subscales remained salient after backward elimination procedures. Conclusion: Our findings emphasize that a fulsome, multilevel approach considering structural, community, and individual strategies to address overt discrimination, integrating social connections and guidance, is necessary to prevent dying by suicide.
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It is well-known that trans and non-binary individuals experience worse health outcomes due to experiences of violence and discrimination. For this reason, accessible healthcare for trans and non-binary people is crucial. There is a lack of Canadian literature on the experiences of non-binary people within the healthcare system. This study sought to understand barriers to healthcare among non-binary people living in a mid-sized urban/rural region of Canada. Interviews were conducted between November 2019 to March 2020 with 12 non-binary individuals assigned female at birth, living in Waterloo Region, Ontario, Canada, as a part of a larger qualitative study exploring experiences within the community, healthcare and employment. Three broad themes were developed: erasure, barriers to access to healthcare, and assessing whether (or not) to come out. Sub-themes included institutional erasure, informational erasure, general healthcare barriers, medical transition healthcare barriers, anticipated discrimination, and assessing safety. Policy and institutional changes are needed to increase the safety and accessibility of healthcare services to non-binary individuals.
Subject(s)
Transgender Persons , Transsexualism , Infant, Newborn , Humans , Female , Ontario , Employment , Violence , Health Services AccessibilityABSTRACT
Social media has become increasingly integrated into the lives of students for the past decade; however, the public health restrictions associated with the COVID-19 pandemic have led to a sharp increase in social media use in a short period of time. The purpose of this study was to investigate the effects of social media use on university students during the COVID-19 pandemic. Fifteen students from a mid-sized Canadian city were interviewed to share their experiences with social media during the COVID-19 pandemic. Purposive sampling was conducted to gather a diverse sample of participants, including individuals of various ages, gender and sexual identities, and ethnicities. Thematic analysis on the 15 interviews was completed using NVivo (version 12). Participants experienced both advantages and disadvantages associated with social media use. Ease of communication and stress relief were acknowledged as the strongest benefits. Social comparison, loneliness, development of bad habits, and lack of focus were cited as major disadvantages to social media use during the pandemic. Cost-benefit analysis of social media was common, and participants expressed the importance of using social media with moderation, balance, and awareness. Our study indicates that the focus on health with respect to the pandemic should not be solely based on physical health, rather the potential mental health risks associated with social media use during the pandemic should be recognized and addressed by healthcare providers.
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HIV testing and diagnosis are the gateway into treatment and eventual viral suppression. With gay, bisexual, and other men who have sex with men (GBMSM) persistently over-representing new HIV diagnoses in Canada, combined with the evolving nature of community social connection, an exploration of factors associated with recent HIV testing is warranted. As most studies of GBMSM rely on samples obtained from larger metropolitan regions, examining HIV testing from an under-researched region is necessary. With data collected from an online survey of LGBTQ+ persons 16 or older living, working, or residing in the Region of Waterloo, Ontario, Canada, we used multinomial logistic regression to explore socio-demographic, behavioural, and psychosocial factors associated with recent HIV testing for GBMSM. In the final multivariate multinomial logistic regression model: sense of belonging was associated with more recently testing, as was having an increasing proportion of LGBT friends, app use to find sex partners in the past 12 months, access to the local AIDS service organization, and general sense of belonging to local community, among other. This analysis highlights the continued importance of enabling and need factors when accessing testing, and suggests areas for further testing promotion in physical and virtual spaces frequented by GBMSM.
Subject(s)
HIV Infections , Sexual and Gender Minorities , Male , Humans , Homosexuality, Male/psychology , HIV Infections/diagnosis , HIV Infections/epidemiology , Ontario/epidemiology , HIV TestingABSTRACT
Public housing aims to reduce social inequalities by providing affordable dwellings as a social policy. Anchored in an ecological perspective, the paper reports on a multicase photovoice study documenting public housing tenants' perceptions of how their residential environment influences their well-being. This design can provide a deeper understanding of the public housing environment to inform change at a programmatic level. To this end, 303 captioned photos were collected by 59 tenant-researchers at six sites in Québec (Canada). An in-depth cross-case analysis of the material led to two key themes with five subthemes each. In the Residential environment perceived as mostly positive theme, the subthemes were access to nature, community resources and services, positive relations among tenants, opportunities for participation, and specific aspects of their home. In the Negative aspects focused on life in public housing theme, the subthemes were strict regulations, lack of respect for tenants' needs, lack of intimacy, lack of proper maintenance, and conflicts between tenants. Findings highlight the dynamic interplay between the residential environment and public housing tenants' well-being. Two recurring programmatic issues are highlighted: problematic maintenance and limited opportunities for tenants' empowerment. Changes to address these concerns at the programmatic level of public housing could potentially increase tenants' well-being.
Subject(s)
Public Housing , Social Environment , Humans , Quebec , Canada , Sexual Behavior , HousingABSTRACT
Context In Quebec, adult mental health (AMH) first-line teams are mandated to provide psychosocial services to people living with mental health difficulties, including anxiety and mood disorders. Following the establishment of new clinical guidelines in 2017, the duration of interventions was not to exceed 15 sessions, with some exceptions. Objectives The overall aim of the longitudinal component of the Shared Knowledge study was to evaluate the care experience of individuals with an anxiety or depressive disorder receiving a short-term intervention (<15 sessions) by first-line AMH teams, and the evolution of recovery over time. Specifically, the objectives were to: 1) determine the appreciation of short-term interventions by service users; and 2) assess the evolution over time of the symptomatology, functioning and quality of life and recovery of individuals receiving short-term interventions. Method A mixed method longitudinal design was used. Telephone interviews were conducted with participants, in which the following variables were quantitatively and qualitatively assessed: appreciation of services received, quality of relationship with the provider (INSPIRE), depressive symptoms (PHQ-9), anxiety symptoms (GAD-7), global functioning (WHODAS), quality of life (ReQOL), and personal recovery (ERTAD). Linear mixed model analyses were performed to examine changes over time on quantitative measures. Content analysis was performed on the qualitative data. Results A total of 63 individuals participated in an interview before the start of their intervention and 22 of them participated after the end of this intervention. Statistical analyses showed a significant improvement in anxiety symptoms, quality of life, and personal recovery, but no difference was observed in depressive symptoms and level of functioning. Nearly half (47.4%) of participants reported that the intervention they received had "completely" met the need that had led them to seek help, and 33.3% felt "completely" equipped or empowered in their recovery. The quality of the relationship with the caregiver, the opportunity to take part in decision-making, and the personalization of the intervention according to their needs and preferences were some of the elements that were particularly appreciated. Conclusion Short-term interventions seem to be appreciated and produce positive effects in many people suffering from anxiety or depressive disorders. However, they remain insufficient for a number of them. A personal recovery measure should be used in conjunction with symptomatology and functioning scales to monitor the progress of people using first-line mental health services.
Subject(s)
Depressive Disorder , Quality of Life , Adult , Humans , Anxiety/therapy , Anxiety Disorders , Mental HealthABSTRACT
BACKGROUND: Relationships between primary care providers (PCP) and trans patients remain important, necessitating discussions about gender identity, health and their intersections. METHODS: Using an online survey, we explored socio-demographic and psycho-social factors associated with: (1) disclosing gender identity; (2) discussing gender identity-related health issues; and (3) comfort sharing gender identity with PCPs, among trans people (n =112) over 16years of age, sampled in Waterloo, Ontario, Canada. Bivariate and multivariate methods using modified Poisson regression generated effect estimates. RESULTS: Age, birth presumed gender, employment status, family support, and transphobia were significantly associated with disclosing gender identity, discussing gender identity-related health issues, and comfortability sharing gender identity with PCPs. CONCLUSION: Increasing PCPs' knowledge of trans-related health issues is stressed to improve access and quality for trans patients.
Subject(s)
Gender Identity , Primary Health Care , Humans , Female , Male , Surveys and Questionnaires , CanadaABSTRACT
Discrimination (i.e. racism, homo/bi/transphobia) at both the individual and systemic levels may negatively impact the well-being of racialised LGBTQ+ newcomers living in Waterloo Region, Ontario, Canada. Current research about the experiences of LGBTQ+ newcomers focuses predominantly on homogeneous samples of gay men living in large metropolitan city centres. The present study aims to extend the current literature by exploring the experiences of discrimination and its impacts on well-being among racialised LGBTQ+ newcomers living in a small urban area and representing a variety of intersecting identities (i.e. ethno-racial background, LGBTQ+ identity, newcomer status). Using a qualitative method, 10 individuals were invited to complete a semistructured interview between fall 2019 and summer 2020 about their experiences of discrimination in Waterloo Region, and how such experiences impact their well-being. Using an intersectional lens, a thematic analysis revealed that racialised LGBTQ+ newcomers experienced discrimination before and after settlement in Waterloo Region. Prior to settlement, participants spoke predominantly about experiences of homo/biphobia and the associated feelings of internalised oppression. Alternatively, upon settling in Waterloo Region, experiences of discrimination were predominantly racism, and, in particular, systemic racism, which manifested as an inability to access adequate services and a lack of representation in various spaces throughout Waterloo Region. These results extend previous research by identifying the service barriers experienced by racialised LGBTQ+ newcomers living in a small urban area and can be used to inform best practices for addressing these barriers in Waterloo Region and other small urban areas with similar demographics. Implications and limitations are discussed.
Subject(s)
Racism , Sexual and Gender Minorities , Health Services , Humans , Male , OntarioABSTRACT
BACKGROUND: The integration of a personal recovery-oriented practice in mental health services is an emerging principle in policy planning. Self-management support (SMS) is an intervention promoting recovery that aims at educating patients on the nature of their mental disorder, improving their strategies to manage their day-to-day symptoms, fostering self-efficacy and empowerment, preventing relapse, and promoting well-being. While SMS is well established for chronic physical conditions, there is a lack of evidence to support the implementation of structured SMS programs for common mental disorders, and particularly for anxiety disorders. This study aims to examine the effectiveness of a group-based self-management support program for anxiety disorders as an add-on to treatment-as-usual in community-based care settings. METHODS/DESIGN: We will conduct a multicentre pragmatic randomized controlled trial with a pre-treatment, post-treatment (4-month post-randomization), and follow-ups at 8, 12 and 24-months. TREATMENT AND CONTROL GROUPS: a) group self-management support (10 weekly 2.5-h group web-based sessions with 10-15 patients with two trained facilitators); b) treatment-as-usual. Participants will include adults meeting DSM-5 criteria for Panic Disorder, Agoraphobia, Social Anxiety Disorder, and/or Generalized Anxiety Disorder. The primary outcome measure will be the Beck Anxiety Inventory; secondary outcome measures will comprise self-reported instruments for anxiety and depressive symptoms, recovery, self-management, quality of life, and service utilisation. STATISTICAL ANALYSIS: Data will be analysed based on intention-to-treat with a mixed effects regression model accounting for between and within-subject variations in the effects of the intervention. DISCUSSION: This study will contribute to the limited knowledge base regarding the effectiveness of structured group self-management support for anxiety disorders. It is expected that changes in patients' self-management behaviour will lead to better anxiety management and, consequently, to improved patient outcomes. TRIAL REGISTRATION: ClinicalTrials.gov: NCT05124639 . Prospectively registered 18 November 2021.
Subject(s)
Panic Disorder , Self-Management , Adult , Agoraphobia/therapy , Anxiety Disorders/psychology , Anxiety Disorders/therapy , Chronic Disease , Humans , Multicenter Studies as Topic , Quality of Life , Randomized Controlled Trials as Topic , Treatment OutcomeABSTRACT
The negative emotional and health effects of work-life conflict (WLC) have been demonstrated in numerous studies regarding organizational psychology and occupational health. However, little is known about WLC's relationship with positive wellbeing outcomes, including emotional, psychological, and social aspects of workers' thriving. Furthermore, the mediating processes underlying the effects of WLC remain mostly unknown. The current study investigated the associations of perceived time- and strain-based WLC with positive mental health and thriving at work, as well as the mediating role of mindfulness in these associations. It is argued that WLC causes reduced mindfulness capacities among workers, which is in turn associated with lower positive wellbeing given the importance of mindfulness in emotion regulation. A sample of 330 workers based in Québec, Canada, completed an online survey including a measure of strain- and time-based interference with personal projects (i.e., the goals and activities that define the daily life of an individual) and validated scales of wellbeing outcomes and mindfulness. Results of structural equation modeling revealed negative associations between time- and strain-based WLC with positive mental health and thriving at work. Work-life conflict was related to lower mindfulness, which played a mediating role in the associations between time-based WLC with positive mental health and thriving at work, as well as strain-based WLC with positive mental health. The mediation was complete for the time-based WLC and positive mental health association, but partial for the other mediated pathways, highlighting the need for more research to identify additional mediators. These results highlight that beyond resulting in negative emotional/health outcomes often studied in previous research, WLC may be associated with workers' reduced potential to live a fulfilling life, in general and in the workplace. Recommendations (e.g., mindfulness intervention to promote emotional regulation, personal project intervention) for workplace policymakers and practitioners are identified.
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Purpose: Even in cases of medical emergency, mistreatment and negative experiences in life or in medical settings can deter trans patients from seeking necessary care. The purpose of this study was to identify factors associated with trans persons' emergency department (ED) avoidance in the mixed urban-rural Region of Waterloo, Ontario, Canada. Methods: The OutLook Study was a community-based partnership that created an online, cross-sectional questionnaire for lesbian, gay, bisexual, transgender, and other sexual and gender minority community members. Participants in this analysis were 16 years of age or older, lived, worked, or attended school in Waterloo Region, and identified as trans (n=112). Binary logistic regression was used to test associations between sociodemographic, resilience, and risk variables, and ED avoidance. Sociodemographic variables statistically significant at p<0.05 at the bivariate level were included as controls to explore different combinations of resilience and risk factor in multivariable models. Results: Participants reporting complete or partially complete medical transitions were more likely to report ED avoidance, compared to those who had not initiated medical transition. Elevated transphobia was associated with greater likelihood of avoidance. However, increasing levels of social support decreased the likelihood of avoidance. In multivariable models, social support, support from a special person, and transphobia were always significant, regardless of controlled variables. Conclusion: Transphobia-enacted in the contexts of everyday life and health care-can deter patients from seeking care. Patient-centered care requires careful attention to trans identity and health needs, especially in emergency settings. In the absence of structural changes, providers can take steps to mitigate the erasure and discrimination trans patients experience and anticipate when accessing EDs.
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Research highlights several risk and resilience factors at multiple ecological levels that influence individuals' mental health and wellbeing in their everyday lives and, more specifically, in disaster or outbreak situations. However, there is limited research on the role of these factors in the early days of the COVID-19 crisis. The present study examined if and how potential risk factors (i.e., reduction in income, job insecurity, feelings of vulnerability to contracting the virus, lack of confidence in avoiding COVID-19, compliance with preventative policies) and resilience factors (i.e., trait resilience, family functioning, social support, social participation, and trust in healthcare institutions) are associated with mental health and well-being outcomes, and whether these resilience factors buffer (i.e., moderate) the associations between risk factors and said outcomes. One to two weeks after the government recommended preventative measures, 1,122 Canadian workers completed an online questionnaire, including multiple wellbeing outcome scales in addition to measures of potential risk and resilience factors. Structural equation models were tested, highlighting that overall, the considered risk factors were associated with poorer wellbeing outcomes, except social distancing which was associated with lower levels of stress. Each of the potential resilience factors was found to have a main effect on one or more of the wellbeing outcomes. Moderation analysis indicated that in general these resilience factors did not, however, buffer the risk factors. The findings confirm that the COVID-19 crisis encompasses several stressors related to the virus as well as to its impact on one's social, occupational, and financial situation, which put people at risk for lower wellbeing as early as one to two weeks after the crisis began. While several resilience factors emerged as positively related to wellbeing, such factors may not be enough, or sufficiently activated at that time, to buffer the effects of the numerous life changes required by COVID-19. From an ecological perspective, while mental health professionals and public health decision-makers should offer/design services directly focused on mental health and wellbeing, it is important they go beyond celebrating individuals' inner potential for resilience, and also support individuals in activating their environmental resources during a pandemic.
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BACKGROUND: The aim of this study was to identify self-management strategies that can be used in a workplace setting by workers living with depression and anxiety. METHODS: A two-round Delphi study was conducted among three panels of experts: (1) employees living with anxiety or depression (nâ¯=â¯31); (2) managers of employees living with anxiety or depression (nâ¯=â¯12); and (3) researchers with expertise in workplace mental health (nâ¯=â¯15). Participants had to indicate whether each of 60 self-management strategies was applicable at work, and how useful each was for managing their symptoms while working. They could also reformulate or add strategies that were then evaluated in the second round. RESULTS: A total of 60 existing and new self-management strategies were retained following the two rounds. Most useful strategies refer to the ability to set boundaries, maintain work-life balance, identify sources of stress and create positive relationships with supervisor and colleagues. Panels differed in their assessment of the usefulness of strategies focusing on employees' empowerment. LIMITATIONS: Most participants were from Canada, limiting the generalizability of the results. CONCLUSION: The self-management strategies identified in this study should be included in programs focusing on mental health at work and disseminated to employees living with depression and anxiety. Managers should take employee's perspective into account when searching for solutions to help them. Future research should use an inductive approach to identify strategies that are specifically related to the workplace setting. Quantitative studies are also needed to evaluate the effect of such strategies on work functioning.
Subject(s)
Anxiety/psychology , Depression/psychology , Self-Management/methods , Self-Management/psychology , Workplace/psychology , Adult , Anxiety Disorders , Canada , Female , Humans , Male , Mental Health , Middle AgedABSTRACT
BACKGROUND: Self-management is an important factor in maintaining and promoting mental health and recovery from mental health challenges. Thus, it is important to assess and support mental health self-management. In this study, we aimed to develop the Japanese version of the Mental Health Self-management Questionnaire (MHSQ-J), a scale to assess mental health self-management strategy, and clarify its psychometric properties among people with mental illness living in Japan. METHODS: An anonymous self-administered survey including MHSQ-J was conducted for psychiatric outpatient users (N = 295), and 104 of the participants completed MHSQ-J again about two weeks later. Internal consistency was assessed with Cronbach's α, and test-retest reliability was confirmed by the intraclass correlation coefficient (ICC). Construct validity was assessed based on structural validity with confirmatory factor analysis (CFA) and exploratory factor analysis (EFA), and hypotheses testing. The Self-management Skill Scale, the University of Tokyo Health Sociology version of the Sense of Coherence Scale ver1.2, the Japanese version of Self-identified Stage of Recovery Part-B, the Japanese version of the Flourishing Scale, and the Japanese version of the WHO Disability Assessment Scale 2.0 were used for hypotheses testing. RESULTS: Data from 243 respondents were analyzed. The result of CFA, the goodness-of-fit indices showed marginal fit (AGFI = .830, CFI = .852, RMSEA = .072). EFA identified three factors (Clinical, Empowerment, and Vitality), and the results suggested that the factor structure of the Japanese version of MHSQ was similar to the original 3-factor structure. Significant correlations were found with the hypotheses testing variables related to self-management and recovery, especially on the total score, the Empowerment subscale, and the Vitality subscale. Cronbach's α (Clinical: .65, Empowerment: .81, Vitality: .75, Total: .83) and ICC (Clinical: .75, 95% confidence interval (CI) [.62, .84], Empowerment: .81, 95% CI [.70, .88], Vitality: .62, 95% CI [.44, .75], Total: .84, 95% CI [.75, .90]) indicated good reliability. CONCLUSION: The results show that MHSQ-J has acceptable reliability and validity to measure the use of self-management strategies for mental health among community living people with mental illness in Japan.
Subject(s)
Mental Disorders/therapy , Mental Health , Psychological Tests , Self-Management , Surveys and Questionnaires , Adult , Aged , Aged, 80 and over , Factor Analysis, Statistical , Female , Humans , Japan , Male , Mental Disorders/psychology , Middle Aged , Power, Psychological , Reproducibility of Results , Young AdultABSTRACT
AIMS: The study aims to better understand the relationship between sense of community (SOC) and wellbeing from multiple analytical perspectives, considering different aspects of wellbeing and individual contextual factors. METHODS: Four hundred and ninety-one adults from Québec, Canada, completed an online survey, and 296 also completed it a month later. We explored 1) cross-sectional associations between SOC and wellbeing, 2) latent profiles of people, underlying the association between SOC and wellbeing, and 3) cross-lagged relationships between SOC and wellbeing. RESULTS: Correlation and regression showed that SOC and wellbeing were related cross-sectionally, although the association with negative wellbeing was weaker. Latent profile analysis identified four profiles showing differing SOC-wellbeing associations. Cross-lagged analyses showed that over time, SOC only marginally predicted emotional wellbeing but that wellbeing systematically predicted SOC. CONCLUSION: Researchers and psychologists should acknowledge the complexity of relationships between SOC and wellbeing using person-centered perspectives. Social justice and wellbeing promotion implications are discussed.
Subject(s)
Group Processes , Personal Satisfaction , Psychological Distance , Social Identification , Adolescent , Adult , Aged , Cross-Sectional Studies , Female , Humans , Longitudinal Studies , Male , Middle Aged , Quebec , Young AdultABSTRACT
OBJECTIVE: Self-management support is recognized as an important component of the management of mood and anxiety disorders. The goal of this feasibility study was to evaluate the acceptability, implementation and perceived usefulness of a new comprehensive self-management tool (Getting better my way) in four care settings in Quebec, Canada. METHOD: Care providers offered the tool to people with difficulties related to mood or anxiety disorders during a 7-month period. A sample of 71 participants filled out an online survey and 27 accepted to participate in a follow-up interview. Focus groups were conducted with 82 care providers. RESULTS: Satisfaction ratings were high for the tool overall, the likelihood of recommending it to friends, its attractiveness and interest, and its completion time. Perceived usefulness was high overall and was not related to most demographic and clinical variables. No adverse effects were reported. CONCLUSION AND IMPLICATIONS FOR PRACTICE: The study highlights that Getting better my way is a comprehensive recovery-oriented tool, considered useful, acceptable and feasible to use in a variety of settings offering services for mood and anxiety disorders. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
Subject(s)
Anxiety Disorders/therapy , Mental Health Services , Mood Disorders/therapy , Pamphlets , Patient Acceptance of Health Care , Self-Management/methods , Adolescent , Adult , Aged , Feasibility Studies , Female , Humans , Male , Middle Aged , Qualitative Research , Quebec , Young AdultABSTRACT
Most research exploring the psychological benefits of the natural environment has focused on direct exposure to the outdoors. However, people spend most of their time indoors, particularly in office buildings. Poor employee mental health has become one the most prevalent and costly occupational health issues. The integration of high quality environmental features (e.g., access to sunlight) in green-certified office buildings offers a superior work environment. These nature-based experiences are anticipated to provide beneficial outcomes to wellbeing. This study is the first to empirically investigate these benefits. Participants in a green (LEED gold certified) office building (N = 213) in Canada completed an assessment of environmental features, measures of hedonic, eudaimonic and negative wellbeing (NWB) and assessments of psycho-environmental potential, environmental behaviors and social belonging. Linear regression analyses confirmed the benefits of indoor environmental features for all aspects of wellbeing. Multiple regression analyses were conducted to assess the effect of specific indoor environmental features on wellbeing. We explored physical features (e.g., air quality, light), and social features (e.g., privacy), as well as windows to the outside. Results suggest that physical features are important in promoting hedonic wellbeing, while social features prevent NWB. Both features equally predicted eudaimonic wellbeing (EWB). A view to the outside was positively correlated to wellbeing, although it did not uniquely predict it after accounting for other environmental features. Path analyses revealed the importance of person-environment fit, pro-environmental behavior and social belonging in mediating the association of indoor environmental features with hedonic and EWB. The results suggests that, by fostering person-environment fit, pro-environmental behaviors and feeling of community in a high quality setting, green buildings may lead to benefits on an array of wellbeing dimensions. The theoretical and practical implications of these findings are discussed.
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Despite the importance of healthy settings for health promotion, little is known about how neighborhood characteristics affect men's health. The present study aims to explore the associations between perceptions of home and workplace neighborhoods with diverse health outcomes, and to examine mediating mechanisms. A sample of 669 men members of labor unions in Quebec, Canada, completed a questionnaire assessing social and physical aspects of their work and home neighborhoods (the Health-Promoting Neighborhood Questionnaire) as well as subjective and objective health outcomes (perceived health, positive mental health, body mass index) and potential mediators (health behaviors, self-efficacy). Structural equation modeling (path analysis) revealed that the Health-Promoting Neighborhood Questionnaire was associated with all three health outcomes, either directly or indirectly through health behaviors and self-efficacy. Both home and workplace neighborhoods were associated with men's health, home neighborhood being more strongly associated. The findings suggest that physical and social aspects of neighborhood might contribute to men's health. The study highlights positive environmental levers for urban planners, policy makers, and health professionals to promote men's health.