Showing papers by "Rebecca Gokiert published in 2019"

Aboriginal Perspectives on Social-Emotional Competence in Early Childhood

Abstract: Gaining an understanding of how best to support the development of Aboriginal children is important in promoting positive social, emotional, educational, and health outcomes. The purpose of the current study was to identify the most important elements of healthy development for Aboriginal children, with a particular focus on social-emotional development. Focus groups were conducted with 37 Aboriginal Canadians, including parents, service providers, adolescents, and young adults. Five inter-connected themes emerged: cultural wellness, emotional wellness, mental wellness, social wellness, and strong identity, with strong identity described as central and foundational to the other themes. This study strengthens the assertion that Aboriginal children require an additional set of social-emotional skills to successfully navigate different cultural contexts during development. Implications for research and practice are discussed.

MyHEARTSMAP: development and evaluation of a psychosocial self-assessment tool, for and by youth.

Abstract: Background Paediatric mental health-related visits to the emergency department are rising. However, few tools exist to identify concerns early and connect youth with appropriate mental healthcare. Our objective was to develop a digital youth psychosocial assessment and management tool (MyHEARTSMAP) and evaluate its inter-rater reliability when self-administered by a community-based sample of youth and parents. Methods We conducted a multiphasic, multimethod study. In phase 1, focus group sessions were used to inform tool development, through an iterative modification process. In phase 2, a cross-sectional study was conducted in two rounds of evaluation, where participants used MyHEARTSMAP to assess 25 fictional cases. Results MyHEARTSMAP displays good face and content validity, as supported by feedback from phase 1 focus groups with youth and parents (n=38). Among phase 2 participants (n=30), the tool showed moderate to excellent agreement across all psychosocial sections (κ=0.76–0.98). Conclusions Our findings show that MyHEARTSMAP is an approachable and interpretable psychosocial assessment and management tool that can be reliably applied by a diverse community sample of youth and parents.

Impact evaluation of a school-based oral health program: Kuwait National Program.

Abstract: This study evaluated the relationship between enrolment in a school-based oral health prevention program (SOHP) and: 1) children’s dental health status and oral health-related quality of life (OHRQoL), and 2) mothers’ oral health (OH) knowledge, attitude, practice, and OHRQoL. This cross-sectional study, in the Kuwait Capital, included 440 primary school children aged 11 to 12 years and their mothers. Participants were classified into two groups: SOHP and non-SOHP. The SOHP group had been enrolled in the prevention program for at least 3 years: children had twice-a-year applications of fluoride varnish and fissure sealants if needed; mothers had, at least, one oral health education session. The non-SOHP group had negative consents and had not been exposed to the prevention program activities. Dental examinations were performed at schools using portable dental units. Caries experience was determined using the decayed (D/d), missing (M/m), and filled (F/f) teeth (T/t)/surface (S/s) indices. Children’s OHRQoL was assessed using a self-administered validated Child Perceptions Questionnaire 11–14 (CPQ11–14). Mothers’ OH knowledge, attitude, practice, and OHRQoL were also assessed. After Bonferroni correction, a p-value of less than 0.05 was considered statistically significant for caries experience measures while a p-value of less than 0.013 was considered statistically significant for OHRQoL subscales and mothers’ OH knowledge, attitude, practice, and OHRQoL. Mean (SD) DT/dt, DMFT/dmft and DMFS/dmfs were 1.41 (1.66), 2.35 (2.33), and 4.41 (5.86) for SOHP children, respectively. For non-SOHP children, the means were 2.61 (2.63), 3.56 (3.05), and 7.24 (7.78), respectively. The difference between the SOHP and non-SOHP was statistically significant (p 0.013). Enrolment in the SOHP prevention services was associated with a positive impact on children’s caries level with no significant impact on mothers’ knowledge, attitude, practice, or OHRQoL.

Continued attendance for paediatric weight management: A multicentre, qualitative study of parents' reasons and facilitators.

Abstract: Although prolonged engagement in paediatric weight management (PWM) is associated with positive treatment outcomes, little is currently known about enablers of long-term programme attendance. The purpose of our study was to explore families' reasons for and facilitators of their continued attendance at health services for PWM. Semi-structured, individual interviews were conducted with parents of children (10-17 year old; body mass index ≥85th percentile) who completed the active phase of treatment in one of four Canadian multidisciplinary clinics for PWM. Interview data were recorded digitally, transcribed verbatim and analysed thematically. Parents' (n = 40) reasons for continued clinic attendance included ongoing concerns (eg, parental concern about their child's health), actual and expected benefits from treatment (eg, lifestyle improvements) and perceived quality of care (eg, structured, comprehensive, tailored health services). Several logistical and motivational factors contributed to continued attendance, including flexible work schedules, flexible appointment times, financial resources and children's motivation for treatment. Helping families address treatment barriers and ensuring that weight management services meet families' treatment expectations are promising strategies to enhance retention in PWM to optimize health outcomes.

Cultural Brokering with Syrian Refugee Families with Young Children: An Exploration of Challenges and Best Practices in Psychosocial Adaptation

Abstract: This study examined the challenges and critical psychosocial needs of Syrian refugee families with young children in Western Canada, and the role of cultural brokering in facilitating their psychosocial adaptation. Using a community-based participatory research approach and an adapted critical incident method, the study involved nine Arabic-speaking cultural brokers who were working with Syrian refugee families using holistic supports during early resettlement. Data collected through focus groups and semi-structured interviews are presented in five illustrative case studies, and reveal that Syrian families struggled with feeling safe and secure in Canada, adjusting to the changing roles in the family, and trying to find meaning in their lives. These struggles were attributed to families’ overall challenges navigating various domains of integration (i.e., health, social services, and education), resulting in a heavy reliance on cultural brokers for social linking and bonding activities (Ager & Strang, Journal of Refugee Studies, 21, 166–191, 2008), including connecting families to needed supports and helping family members build relationships with one another. Challenges faced by families mapped onto the five psychosocial needs of Silove’s (Intervention, 11, 237–248, 2013) Adaptation after Persecution and Trauma (ADAPT) conceptual framework as well as most of the core domains of Ager and Strang’s (Journal of Refugee Studies, 21, 166–191, 2008) Social Integration framework. This study provides evidence for the use of both of these frameworks in further studies involving Syrian refugee populations; they proved useful for understanding how families, over time, can develop necessary skills to engage on their own in linking activities with various Canadian institutions and bridging activities with communities at large.

Community Setting as a Determinant of Health for Indigenous Peoples Living in the Prairie Provinces of Canada: High Rates and Advanced Presentations of Tuberculosis

Abstract: Indigenous Peoples in Canada experience disproportionately high tuberculosis (TB) rates, and those living in the Prairie Provinces have the most advanced TB presentations (Health Canada, 2009). The community settings (i.e., urban centres, non-remote reserves, remote reserves, and isolated reserves) where Indigenous Peoples live can help explain high TB rates. Through qualitative description, we identify how community setting influenced Indigenous people’s experiences by (a) delaying accurate diagnoses; (b) perpetuating shame and stigma; and (c) limiting understanding of the disease. Participants living in urban centres experienced significant difficulties obtaining an accurate diagnosis. Reserve community participants feared being shamed and stigmatized. TB information had little impact on participants’ TB knowledge, regardless of where they lived. Multiple misdiagnoses (primarily among urban centre participants), being shamed for having the disease (primarily reserve community participants), and a lack of understanding of TB can all contribute to advanced presentations and high rates of the disease among Indigenous Peoples of the Prairie Provinces.

Evaluating child-friendly spaces: insights from a participatory mixed methods study of a municipality’s free-play preschool and space

Abstract: Free play, play controlled by the player(s), is an essential and positive determinant of children’s social, physical, and emotional health. Ensuring opportunities for dynamic free play in rich phys...