Browsing by Author "McIntyre, Lynn"
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Item Open Access Correction to: Developing a framework to inform scale-up success for population health interventions: a critical interpretive synthesis of the literature(2020-06-05) Nguyen, Duyen T K; McLaren, Lindsay; Oelke, Nelly D; McIntyre, LynnAn amendment to this paper has been published and can be accessed via the original article.Item Open Access Determinants of childhood weight status in Canadian boys and girls(2011) Potestio, Melissa Lee; McIntyre, Lynn; McLaren, LindsayItem Open Access Developing a framework to inform scale-up success for population health interventions: a critical interpretive synthesis of the literature(2020-04-29) Nguyen, Duyen T K; McLaren, Lindsay; Oelke, Nelly D; McIntyre, LynnAbstract Background Population health interventions (PHIs) have the potential to improve the health of large populations by systematically addressing underlying conditions of poor health outcomes (i.e., social determinants of health) and reducing health inequities. Scaling-up may be one means of enhancing the impact of effective PHIs. However, not all scale-up attempts have been successful. In an attempt to help guide the process of successful scale-up of a PHI, we look to the organizational readiness for change theory for a new perspective on how we may better understand the scale-up pathway. Using the change theory, our goal was to develop the foundations of an evidence-based, theory-informed framework for a PHI, through a critical examination of various PHI scale-up experiences documented in the literature. Methods We conducted a multi-step, critical interpretive synthesis (CIS) to gather and examine insights from scale-up experiences detailed in peer-reviewed and grey literatures, with a focus on PHIs from a variety of global settings. The CIS included iterative cycles of systematic searching, sampling, data extraction, critiquing, interpreting, coding, reflecting, and synthesizing. Theories relevant to innovations, complexity, and organizational readiness guided our analysis and synthesis. Results We retained and examined twenty different PHI scale-up experiences, which were extracted from 77 documents (47 peer-reviewed, 30 grey literature) published between 1995 and 2013. Overall, we identified three phases (i.e., Groundwork, Implementing Scale-up, and Sustaining Scale-up), 11 actions, and four key components (i.e., PHI, context, capacity, stakeholders) pertinent to the scale-up process. Our guiding theories provided explanatory power to various aspects of the scale-up process and to scale-up success, and an alternative perspective to the assessment of scale-up readiness for a PHI. Conclusion Our synthesis provided the foundations of the Scale-up Readiness Assessment Framework. Our theoretically-informed and rigorous synthesis methodology permitted identification of disparate processes involved in the successful scale-up of a PHI. Our findings complement the guidance and resources currently available, and offer an added perspective to assessing scale-up readiness for a PHI.Item Open Access Does Integrated Management of Childhood Illness (IMCI) Training Improve the Skills of Health Workers? A Systematic Review and Meta-Analysis(PLoS, 2013-06-12) Nguyen, Duyen Thi Kim; Leung, Karen K.; McIntyre, Lynn; Ghali, William A.; Sauve, RegItem Open Access Exploring Changing Patterns of Weight Classification among Stunted Women in South Asia, 1996-2007(2012) Rostami, Mahnoush; McIntyre, LynnItem Embargo Exploring changing patterns of weight classificiation among stunted women in South Asia, 1996-2007(2012) Roastami, Mahnoush; McIntyre, LynnItem Open Access The household food insecurity gradient and potential reductions in adverse population mental health outcomes in Canadian adults(Elsevier, 2017-05-31) Jessiman-Perreault, Genevieve; McIntyre, LynnPurpose: Household food insecurity is related to poor mental health. This study examines whether the level of household food insecurity is associated with a gradient in the risk of reporting six adverse mental health outcomes. This study further quantifies the mental health impact if severe food insecurity, the extreme of the risk continuum, were eliminated in Canada. Methods: Using a pooled sample of the Canadian Community Health Survey (N = 302,683), we examined the relationship between level of food insecurity, in adults 18–64 years, and reporting six adverse mental health outcomes. We conducted a probit analysis adjusted for multi-variable models, to calculate the reduction in the odds of reporting mental health outcomes that might accrue from the elimination of severe food insecurity. Results: Controlling for various demographic and socioeconomic covariates, a food insecurity gradient was found in six mental health outcomes. We calculated that a decrease between 8.1% and 16.0% in the reporting of these mental health outcomes would accrue if those who are currently severely food insecure became food secure, after controlling for covariates. Conclusion: Household food insecurity has a pervasive graded negative effect on a variety of mental health outcomes, in which significantly higher levels of food insecurity are associated with a higher risk of adverse mental health outcomes. Reduction of food insecurity, particularly at the severe level, is a public health concern and a modifiable structural determinant of health worthy of macro-level policy intervention.Item Open Access Identification of neighbourhood-level built environment predictors of childhood injury risk through city-wide mapping and a divergent case approach in Calgary, Canada(2011) Kryzanowski, Julie; McIntyre, LynnItem Open Access Just Fun or Fundamental? Fathers’ Narratives of Leisure with Their Children with Autism Spectrum Disorder(2017) Mitchell, Jennifer; Lashewicz, Bonnie; Hughson, Anne; McIntyre, Lynn; Dewey, Deborah; McConnell, David; Badry, DorothyAnchored in the generative fathering framework and critical disability studies (CDS), I used a narrative approach to study 11 fathers’ stories of leisure with their children with autism spectrum disorder (ASD) to highlight how leisure activities are given meaning and constructed as part of active fathering. I produced four narratives - narratives of action, narratives of adjustment, narratives of tension and narratives of relationships that captured fathers’ experiences of leisure with their children with ASD. Narratives of action are the stories of what fathers are doing in their day- to- day interactions with their children. Narratives of adjustment depict how fathers have shifted and re-defined expectations of their children and themselves following their children’s diagnosis of ASD. Narratives of tension capture fathers’ strain in concurrently having to acquiesce and advocate against financial, environmental and societal constraints. Lastly, in narratives of relationships, fathers illustrate the relational outcomes of their involvement with their children, including an appreciation of their children’s individuality and the father-child connection. The findings augment a deeper understanding of fathering children with ASD and the father-child relationship. By understanding fathers’ perceived successes and challenges in leisure activities in the home and community settings, service providers can better engage and support fathers in home- and community-based leisure.Item Open Access Perceptions of the social determinants of health by two groups more and less affiliated with public health in Canada(BioMed Central, 2013-07-01) McIntyre, Lynn; Shyleyko, Robert; Nicholson, Cherie; Beanlands, Hope; McLaren, LindsayItem Open Access Scaling Up [to] a Population Health Intervention: A Readiness Assessment Framework(2016) Nguyen, Duyen Thi Kim; McIntyre, Lynn; McLaren, Lindsay; Emery, Herb; Oelke, NellyBackground: Attempts to scale up a population health intervention (PHI) have achieved variable success, which, in part, is attributable to limited knowledge of scale up and lack of systematic guidance to support successful scale up. The concept of readiness is underrepresented in scale up and its consideration may improve the likelihood of success. Objective: To develop and assess a conceptual framework focused on the successful scale up of a PHI, which may be employed to gauge a PHI’s readiness for scale up success. Theoretical framework: This study integrated diffusion of innovations, organizational readiness for change, and complex adaptive systems theories. Methods and Results: The Scale Up Readiness Assessment Framework was developed and refined through a primarily qualitative methods design with three complementary studies, which were informed by the theoretical and empirical literature. Study one used a critical interpretive synthesis of the literature to develop the Framework. The synthesis identified 11 important actions in the successful scale up of a PHI, which were organized into three phases: Groundwork, Implementation, and Sustainment. Key components and hallmarks of a successful scale up approach were also determined. Study two used a modified Delphi method to assess content and face validity of the Framework’s actions and phases. A panel of PHI and scale up experts agreed all phases and actions were important; the Groundwork phase and six actions were representative of a successful scale up; and all were logically presented. Experts’ assessments guided the Framework’s second version. Study three involved pilot tests with potential users of the Framework (version 2.0), who commented how the Framework’s utility, value, and face validity might apply to their PHI. Participants concluded the Framework was informative, offered valuable guidance, and may serve multiple purposes beyond readiness assessment. Pilot feedback led to a final Framework revision (version 3.0). Conclusion: This research provides important conceptual advancements and insights regarding the practice of successful scale up. The research produced a usable product, the Framework, which may be used by academic and government PHI stakeholders for scale up readiness assessment and planning. Learnings from this framework have potentially diverse applications beyond its initial intended purpose.Item Open Access The Intersection of Gender/Sex and Food Insecurity on Mental Health Outcomes(2016) Jessiman-Perreault, Geneviève; McIntyre, Lynn; Letourneau, Nicole; Johnston, J. Cyne; McLaren, LindsayGender and food insecurity are important social determinants of health and are related to a wide spectrum of mental health conditions. Food insecurity typically contains four dimensions: qualitative, quantitative, social and psychological; each of which has its own unique stressors. Food insecurity is a chronically stressful experience, and chronic stress has been consistently associated with the development of mental health problems. This thesis examines, using a pooled sample from a national data set, how the sex gap in seven mental health outcomes is affected by consideration of food insecurity status. For the full sample, the sex gap in five of seven mental health outcomes was pronounced. When only the food insecure sub-sample was examined, there were no statistically significant sex differences in six of seven mental health outcomes. Therefore, food insecurity has a sex neutralizing effect on the sex gap in mental health outcomes, an indication of its powerful effect as a stressor.