Browsing by Author "Macpherson, Alison"
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- ItemOpen AccessExamining Measures of Weight as Risk Factors for Sport-Related Injury in Adolescents(2016-07-20) Richmond, Sarah A.; Nettel-Aguirre, Alberto; Doyle-Baker, Patricia K.; Macpherson, Alison; Emery, Carolyn A.Objectives. To examine body mass index (BMI) and waist circumference (WC) as risk factors for sport injury in adolescents. Design. A secondary analysis of prospectively collected data from a pilot cluster randomized controlled trial. Methods. Adolescents () at the ages of 11–15 years from two Calgary junior high schools were included. BMI (kg/m2) and WC (cm) were measured from direct measures at baseline assessment. Categories (overweight/obese) were created using validated international (BMI) and national (WC) cut-off points. A Poisson regression analysis controlling for relevant covariates (sex, previous injury, sport participation, intervention group, and aerobic fitness level) estimated the risk of sport injury [incidence rate ratios (IRR) with 95% confidence intervals (CI)]. Results. There was an increased risk of time loss injury (IRR = 2.82, 95% CI: 1.01–8.04) and knee injury (IRR = 2.07, 95% CI: 1.00–6.94) in adolescents that were overweight/obese; however, increases in injury risk for all injury and lower extremity injury were not statistically significant. Estimates suggested a greater risk of time loss injury [IRR = 1.63 (95% CI: 0.93–2.47)] in adolescents with high measures of WC. Conclusions. There is an increased risk of time loss injury and knee injury in overweight/obese adolescents. Sport injury prevention training programs should include strategies that target all known risk factors for injury.
- ItemOpen AccessRoad safety, health equity, and the built environment: perspectives of transport and injury prevention professionals in five Canadian municipalities(2023-06-22) McCullogh, Emily; Macpherson, Alison; Hagel, Brent; Giles, Audrey; Fuselli, Pamela; Pike, Ian; Torres, Juan; Richmond, Sarah A.Abstract Background Concerns regarding health equity (HE) and the built environment (BE) are well established in the Canadian urban context. Transport and injury prevention professionals across sectors, such as transportation and public health, are involved in designing and implementing BE interventions that enhance the safety of vulnerable road users (VRUs). Results from a larger study examining barriers and facilitators to BE change are used to illustrate how transport and injury prevention professionals perceive HE concerns in their work in five Canadian municipalities. Broadening our understanding of how HE influences the professional BE change context is crucial when advocating for modifications that enhance the safety of equity-deserving VRUs and groups who experience marginalization. Methods Interview and focus group data were gathered from transport and injury prevention professionals working in policy/decision-making, transport, police services, public health, non-profit organizations, schools/school boards, community associations, and private sectors across five Canadian urban municipalities: Vancouver, Calgary, Peel Region, Toronto, and Montréal. Data were analyzed using thematic analysis (TA) to illustrate how equity considerations were perceived and applied in participants’ BE change work. Results The results of this study illustrate transport and injury prevention professionals’ awareness of the varying needs of VRUs, as well as the inadequacies of current BEs in the Canadian urban context and consultation processes utilized to guide change. Participants emphasized the importance of equitable community consultation strategies, as well as specific BE changes that would support the health and safety of VRUs. Overall, the results highlight how HE concerns inform transport and injury prevention professionals’ BE change work in the Canadian urban context. Conclusion For professionals working in urban Canadian transport and injury prevention sectors HE concerns influenced their perspectives of the BE and BE change. These results illustrate a growing need for HE to guide BE change work and consultation processes. Further, these results contribute to ongoing efforts in the Canadian urban context to ensure that HE is at the forefront of BE policy change and decision-making, while promoting existing strategies to ensure that the BE, and related decision-making processes, are accessible and informed by a HE lens.
- ItemOpen AccessSocial determinants of health and disparities in pediatric trauma care: protocol for a systematic review and meta-analysis(2024-03-22) Gnanvi, Janyce E.; Yanchar, Natalie; Freire, Gabrielle; Beaulieu, Emilie; Tardif, Pier-Alexandre; Bérubé, Mélanie; Macpherson, Alison; Pike, Ian; Zemek, Roger; Gagnon, Isabelle J.; Carsen, Sasha; Gabbe, Belinda; Gnanou, Soualio; Duval, Cécile; Moore, LynneAbstract Background Social determinants of health (SDH), including “the conditions in which individuals are born, grow, work, live and age” affect child health and well-being. Several studies have synthesized evidence about the influence of SDH on childhood injury risks and outcomes. However, there is no systematic evidence about the impact of SDH on accessing care and quality of care once a child has suffered an injury. We aim to evaluate the extent to which access to care and quality of care after injury are affected by children and adolescents’ SDH. Methods Using Cochrane methodology, we will conduct a systematic review including observational and experimental studies evaluating the association between social/material elements contributing to health disparities, using the PROGRESS-Plus framework: place of residence, race/ethnicity/culture/language, occupation, gender/sex, religion, education, socioeconomic status, and social capital and care received by children and adolescents (≤ 19 years of age) after injury. We will consult published literature using PubMed, EMBASE, CINAHL, PsycINFO, Web of Science, and Academic Search Premier and grey literature using Google Scholar from their inception to a maximum of 6 months prior to submission for publication. Two reviewers will independently perform study selection, data extraction, and risk of bias assessment for included studies. The risk of bias will be assessed using the ROBINS-E and ROB-2 tools respectively for observational and experimental study designs. We will analyze data to perform narrative syntheses, and if enough studies are identified, we will conduct a meta-analysis using random effects models. Discussion This systematic review will provide a synthesis of evidence on the association between SDH and pediatric trauma care (access to care and quality of care) that clinicians and policymakers can use to better tailor care systems and promote equitable access and quality of care for all children. We will share our findings through clinical rounds, conferences, and publication in a peer-reviewed journal. Systematic review registration PROSPERO CRD42023408467
- ItemOpen AccessThe built environment and active transportation safety in children and youth: a study protocol(2019-06-11) Hagel, Brent E; Macpherson, Alison; Howard, Andrew; Fuselli, Pamela; Cloutier, Marie-Soleil; Winters, Meghan; Richmond, Sarah A; Rothman, Linda; Belton, Kathy; Buliung, Ron; Emery, Carolyn A; Faulkner, Guy; Kennedy, Jacqueline; Ma, Tracey; Macarthur, Colin; McCormack, Gavin R.; Morrow, Greg; Nettel-Aguirre, Alberto; Owens, Liz; Pike, Ian; Russell, Kelly; Torres, Juan; Voaklander, Donald; Embree, Tania; Hubka, TateAbstract Background Active transportation, such as walking and biking, is a healthy way for children to explore their environment and develop independence. However, children can be injured while walking and biking. Many cities make changes to the built environment (e.g., traffic calming features, separated bike lanes) to keep people safe. There is some research on how effective these changes are in preventing adult pedestrians and bicyclists from getting hurt, but very little research has been done to show how safe various environments are for children and youth. Our research program will study how features of the built environment affect whether children travel (e.g., to school) using active modes, and whether certain features increase or decrease their likelihood of injury. Methods First, we will use a cross-sectional study design to estimate associations between objectively measured built environment and objectively measured active transportation to school among child elementary students. We will examine the associations between objectively measured built environment and child and youth pedestrian-motor vehicle collisions (MVCs) and bicyclist-MVCs. We will also use these data to determine the space-time distribution of pedestrian-MVCs and bicyclist-MVCs. Second, we will use a case-crossover design to compare the built environment characteristics of the site where child and youth bicyclists sustain emergency department reported injuries and two randomly selected sites (control sites) along the bicyclist’s route before the injury occurred. Third, to identify implementation strategies for built environment change at the municipal level to encourage active transportation we will conduct: 1) an environmental scan, 2) key informant interviews, 3) focus groups, and 4) a national survey to identify facilitators and barriers for implementing built environment change in municipalities. Finally, we will develop a built environment implementation toolkit to promote active transportation and prevent child pedestrian and bicyclist injuries. Discussion This program of research will identify the built environment associated with active transportation safety and form an evidence base from which municipalities can draw information to support change. Our team’s national scope will be invaluable in providing information regarding the variability in built environment characteristics and is vital to producing evidence-based recommendations that will increase safe active transportation.