Browsing by Author "Munene, Abraham"

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    Factors influencing perceptions of private water quality in North America: a systematic review
    (2019-05-10) Munene, Abraham; Hall, David C
    Abstract Background An estimated four million and 43 million people in Canada and the USA use private water supplies. Private water supplies are vulnerable to waterborne disease outbreaks. Private water supplies in Canada and the USA are often unregulated and private water management is often a choice left to the owner. Perceptions of water quality become important in influencing the adoption of private water stewardship practices, therefore safeguarding public health. Methods We conducted a systematic literature review to understand factors that shape perceptions of water quality among private water users. We searched six computer databases (Web of science, Medline, Scopus, EBSCO, PubMed and Agricola). The search was limited to primary peer-reviewed publications, grey literature and excluded conference proceedings, review articles, and non-peer review articles. We restricted the search to papers published in English and to articles which published data on surveys of private water users within Canada and the USA. The search was also restricted to publications from 1986 to 2017. The literature search generated 36,478 records. Two hundred and four full text were reviewed. Results Fifty-two articles were included in the final review. Several factors were found to influence perceptions of water quality including organoleptic preferences, chemical and microbiological contaminants, perceived risks, water well infrastructure, past experience with water quality, external information, demographics, in addition to the values, attitudes, and beliefs held by well owners. Conclusions Understanding the factors that shape perceptions of water quality among private water users is an important step in developing private water management policies to increase compliance towards water testing and treatment in Canada and the USA. As many jurisdictions in Canada and the USA do not have mandatory private water testing or treatment guidelines, delineating these factors is an important step in informing future research and guiding policy on the public health of private water systems.
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    Improving care for residents in long term care facilities experiencing an acute change in health status
    (2020-11-25) Munene, Abraham; Lang, Eddy; Ewa, Vivian; Hair, Heather; Cummings, Greta; McLane, Patrick; Spackman, Eldon; Faris, Peter; Zuzic, Nancy; Quail, Patrick B; George, Marian; Heinemeyer, Anne; Grigat, Daniel; McMillen, Mark; Reid, Shawna; Holroyd-Leduc, Jayna
    Abstract Background Long term care (LTC) facilities provide health services and assist residents with daily care. At times residents may require transfer to emergency departments (ED), depending on the severity of their change in health status, their goals of care, and the ability of the facility to care for medically unstable residents. However, many transfers from LTC to ED are unnecessary, and expose residents to discontinuity in care and iatrogenic harms. This knowledge translation project aims to implement a standardized LTC-ED care and referral pathway for LTC facilities seeking transfer to ED, which optimizes the use of resources both within the LTC facility and surrounding community. Methods/design We will use a quasi-experimental randomized stepped-wedge design in the implementation and evaluation of the pathway within the Calgary zone of Alberta Health Services (AHS), Canada. Specifically, the intervention will be implemented in 38 LTC facilities. The intervention will involve a standardized LTC-ED care and referral pathway, along with targeted INTERACT® tools. The implementation strategies will be adapted to the local context of each facility and to address potential implementation barriers identified through a staff completed barriers assessment tool. The evaluation will use a mixed-methods approach. The primary outcome will be any change in the rate of transfers to ED from LTC facilities adjusted by resident-days. Secondary outcomes will include a post-implementation qualitative assessment of the pathway. Comparative cost-analysis will be undertaken from the perspective of publicly funded health care. Discussion This study will integrate current resources in the LTC-ED pathway in a manner that will better coordinate and optimize the care for LTC residents experiencing an acute change in health status.
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    Investigating Perceptions of Well Water Quality in Rural Alberta
    (2019-07-17) Munene, Abraham; Hall, David C.; Checkley, Sylvia L.; Lockyer, Jocelyn M.; Massolo, Alessandro
    Adequate access to safe drinking water is important in maintaining public health. Over 400,000 rural Albertans use well water for domestic purposes. The current policy on the management of private water wells requires well owners be responsible for their own water well management and well water quality. Therefore, the decision of when to test well water, what to test for, and what treatments to use to safeguard or improve water quality, lies with well owners. The purpose of this thesis was to 1. Describe the perceptions, knowledge, and beliefs rural Albertan residents have of well water quality and whether they associate livestock farming with water well contamination. 2. Identify the barriers faced by water well owners with respect to implementing well water stewardship practices. 3. Identify factors associated with water well stewardship practices (i.e., testing and treatment). A mixed methods study was completed which included a systematic review, interviews with well owners, a questionnaire survey of well owners, and collection of well water samples to assess for microbiological indicators of drinking water contamination. Thematic analyses were used to understand factors shaping perceptions of well water quality and identify factors influencing water testing behaviour as viewed through the lens of the Health Belief Model. Descriptive statistics and logistic regression analyses were used to understand the characteristics of well owners, well use, well stewardship practices, as well as investigate associations between independent variables and well stewardship practices. Barriers to treatment included a lack of awareness of what treatments to use. Increased education and awareness may be important to increase the adoption of well stewardship practices. Several factors were found to influence perceptions of well water quality. Furthermore, well owners described issues such as low perceived susceptibility to water well contamination and logistical barriers when submitting water samples for testing.