There is a significant body of research that describes the psychosocial, rehabilitation and health needs of men diagnosed with prostate cancer. These needs cannot always be met by professional health care services, particularly in the case of health promotion programs intended to help men with prostate cancer maintain and optimize their health and well being. While more and more men are accessing community-based support services such as Prostate Cancer Support Groups, little is known about whom these groups serve, what services they offer, and how they are funded.
Dr. John Oliffe is exploring the role of Prostate Cancer Support Groups in health promotion, and determining how men’s health and illness behaviours are informed and influenced through attending these support groups. Through a better understanding of how these groups operate, he hopes to develop recommendations about how best to support this type of resource, and identify potential ways to integrate the groups with professional health care services. This work will help inform future content, design and implementation of prostate cancer health promotion programs.
The prevalence of childhood obesity is rapidly increasing in Canada, increasing fivefold for both boys and girls from 1981-99. As the genetic characteristics of the human population have not changed in the past 30 years, childhood obesity is thought to be caused by behavioural and environmental factors that predispose children to consume more calories than they expend. Obesity is also linked to a number of diseases, including cardiovascular disease, type 2 diabetes, and some cancers. Schools provide an ideal setting to intervene on childrenâs behaviours. Recently, policy strategies have been proposed to change the school environment to limit access to unhealthy food and to increase opportunities for children to be more physically active. However, these changes are taking place without the scientific evidence necessary to support these strategies. Louise Mâsse is examining the impact of school-based policies on changing nutrition and physical activity behaviours among children. In addition, she is identifying the factors that prevent from implementing healthy school policies and creating healthier environments. The results of her study will provide insightful information for policy-makers to improve the health of BC children
Two broadly-defined approaches to conceptualizing social class can be applied to the empirical study of health inequalities. In the first, social class is equated with the socioeconomic status of individuals, i.e., with individual-level measures of wealth, educational credentials and/or occupational prestige. Explanations for empirical relationships between health and this particular conception of social class generally address material, behavioural or psychosocial phenomena, such as housing conditions, lifestyle choices or perceptions of relative standing. In the second, social classes are social groups, defined by the nature of their relationships to the economic mode of production and forms of control wielded in the workplace (the perspective of the neo-Marxist theorist Erik Olin Wright), or defined relationally in social space by their possession and utilization of various economic, educational, social and cultural capitals (the perspective of the French social theorist Pierre Bourdieu). In this tradition, explanations for class-health associations attempt to simultaneously address individual-level and group-level factors in a complex mix of agency and structure. Dr. Gerry Veenstra is investigating relationships between social class and health and well-being in Canada, integrating individual-level models founded upon material, lifestyle and psychosocial explanatory factors with social-structural theoretical frameworks inspired by theorists like Bourdieu and Wright. Building upon his previous work in BC, Dr. Veenstra will engage in an ethnographic exploration of different class positions and then administer a questionnaire survey to randomly-selected Canadian adults, assessing possession of various manifestations of control and capital. He will apply linear-causal statistical techniques such as regression analysis and relational techniques such as multiple correspondence analysis to this survey data in an attempt to identify and explain factors underlying social class and health inequalities in Canada.
Osteoarthritis is a leading cause of disability in Canada. This type of arthritis causes deterioration in the joints, leading to swelling, pain and stiffness. It often results in lost work time and places limits on an individualâs normal function and recreational activity. Both the increasing prevalence of osteoarthritis in the provinceâs aging population, and the lengthy surgical wait times for replacing osteoarthritic joints are high profile health care issues in British Columbia. Physical activity can offer almost universal improvements in health, which includes decreasing the risk of heart disease, stroke, high blood pressure and cancer. Health Canada recommends all adults participate in at least 30 minutes of moderate-intensity exercise most days. But some types or too much physical activity, such as competitive sports or heavy physical work, can cause excessive wear and tear in the joints, increasing the risk of osteoarthritis. In addition, some people may be more vulnerable to the type or amount of physical activity because of the way their legs are aligned (e.g. bow-legged) and/or because of increased flexibility (hypermobility). Chuck Ratzlaff is comparing data on lifetime physical activity and these joint factors in people with knee and hip osteoarthritis to those who donât have the condition, as part of a national arthritis study. The results can be used to recommend appropriate amounts and types of physical activities that may decrease the risk of osteoarthritis of the hip and knee.
Attention-Deficit Hyperactivity Disorder (ADHD) is one of the most frequently diagnosed psychiatric disorders of childhood. Children with ADHD have a high rate of disciplinary problems in school, experience social and academic difficulties, and encompass 30 to 40 per cent of referrals to child guidance clinics. Given the frequent occurrence of ADHD and the issues associated with it, effective and appropriate treatment has become a critical issue. With the desire to provide a healthy and effective solution in treating the symptoms of ADHD, Nicole Smithâs study is exploring the effects that repeated physical activity may have on the symptoms of ADHD in a practical setting. Using a standardized ADHD questionnaire, parents and teachers will indicate the degree of influence a long-term, province-wide, school-based physical activity initiative has on the behavioural symptoms of children with ADHD while in their classroom and home environments. The primary goal of Nicoleâs research is to evaluate the effect of school-based physical activity intervention on ADHD symptoms and classroom disruption among children ages 9 to 12 with ADHD. Since little research exists on the impact of exercise on the behavioural symptoms of ADHD in children, there is potential for this research to make a significant contribution in the areas of child mental health, ADHD health promotion and intervention.
Headache disorders are a prevalent health issue affecting between 10 to 35 per cent of the Canadian population. Headache disordersâwhich range from migraines to tension headachesâare associated with significant emotional, social and economic costs, including lost work days, decreased productivity and increased health care costs. There is increasing interest in understanding the role of psychosocial influences, such as personality traits, interpersonal interactions, coping and stress, in the onset, frequency and severity of headaches among sufferers. Perfectionism is a personality trait that has been identified as a potential risk factor for headache disorders. Perfectionists tend to experience greater stress due to their high expectations, self-critical tendencies and interpersonal conflict. Dayna Lee-Baggley is examining how perfectionism may generate and magnify risk factors (e.g., stress) for headache episodes. Her study is the first to monitor perfectionistsâ experience of headaches on a daily basis. By identifying the risk factors associated with headache disorders, Daynaâs research will allow researchers to identify targets for intervention that could prevent or minimize the occurrence and impact of headaches for a substantial group of people.
The estimated 1,000 female sex workers in Vancouverâs Downtown Eastside (DTES) live in Canadaâs poorest neighbourhood, characterized by deplorable housing conditions and high rates of hepatitis C and HIV infections. HIV prevalence is an alarming 26 per cent, according to a recent study of 198 female sex workers in the DTES. Although violence, poverty and social marginalization have been identified as putting these women at risk, we know very little about two of the defining issues that characterize sex work and make these women vulnerable to HIV: types of sex workers, and the intimate relationships women form with boyfriends and regular clients. Treena Orchard is exploring whether there is a link between a particular type of sex worker and relationship structure that places certain groups of women at greater risk for HIV infection. Her hypothesis is that women with an established sex work status are more likely to form lasting relationships and avoid high-risk sexual practices. Treenaâs research is examining how different types of sex workers are identified and organized, and how these women construct and attach meaning to their intimate relationships, especially in relation to the issues of sexuality, health and trust. This study will use individual interviews, focus groups and social mapping to determine the broader social processes and health determinants that structure the HIV risk of these female sex workers. Examining the social organization of sex work and relationships in this context is critical to improving the womenâs health status and developing HIV prevention programs that are population and gender-specific. As one of the few qualitative studies to address these issues among Canadian sex workers, this research will be relevant to other researchers, health authorities and â through their participation â the women themselves.
About 16 per cent of Canadian women over age 50 have osteoporosis â a condition with low bone density that increases their risk of fracture. Osteoporosis costs the health system $1.3 billion annually, and both prevalence and costs are expected to rise in the next two decades as the population ages. Optimizing peak bone mass during womenâs younger years is key to preventing osteoporosis. In western culture where thinness is idealized, many women experience body dissatisfaction. In response, women attempt to control their body size and weight, typically through diet and/or exercise. The eating attitudes of many women are characterized by high levels of cognitive dietary restraint (CDR) – the perception that one is constantly monitoring and attempting to limit food intake in an effort to control weight. While the adverse consequences of clinical eating disorders (e.g. anorexia nervosa) are well-recognized, the potential health effects of subtle disturbances of eating attitudes, such as high levels of CDR, are only beginning to receive researchersâ attention. Jennifer Bedford is studying whether these eating attitudes affect young womenâs bone density. Previous research in the area suggests that women with high CDR have higher levels of the stress hormone, cortisol, which may negatively affect bone density directly by disrupting bone and calcium metabolism. It also affects bone indirectly by disturbing the menstrual cycle hormones, resulting in disturbances in ovarian function. Jennifer is conducting the first prospective study to examine the relationships between eating attitudes, cortisol levels, ovarian function and bone density in young women. The findings should lead to health and nutrition education strategies to inform young women of the potential health effects of their attitudes about food, eating and their bodies.
Women engaged in survival sex work in Vancouverâs Downtown Eastside (DTES) face multiple vulnerabilities that directly enhance their risk of HIV transmission, including entrenched poverty, homelessness, repeated episodes of violence and assault, substance abuse, and social marginalization. In addition, the illegal, clandestine and largely unregulated nature of sex trade work in Canadian cities increasingly pushes street-entrenched women to the outskirts of society, limiting their means to protect themselves and access to supportive health services. Despite increasing evidence of gender differentials in new HIV infections facing women â particularly youth and women of Aboriginal ancestry â and extensive harm reduction and public health efforts focusing on illicit drug use in this community, little information exists about the complex social, environmental and structural factors that facilitate prevention, harm reduction practices, and access to care. Kate Shannonâs research will use participatory-action research methodologies to explore the social and environmental barriers and facilitators to HIV prevention among survival sex workers. While several individual factors have been shown to elevate HIV and STI (sexually transmitted infection) risk among female substance users in this setting, far less attention has been paid to the role of social and structural violence and power relations in facilitating HIV risk through both sexual and drug use pathways. Using social mapping, focus group discussions and interview-questionnaires, Kateâs research will aim to demonstrate the social and environmental factors that mitigate the HIV risk environment of survival sex workers, and in particular, the role of violence and power relations in the negotiation of HIV prevention behaviours among drug-addicted women and their intimate and working partners This research will provide valuable information about a population that has remained largely on the periphery of public health and harm reduction strategies and services. It is anticipated that the research will also foster capacity building among survival sex workers and help inform evidence-based policy and practice tailored to this population.
There is a strong relationship between education and health. People with lower levels of education demonstrate poorer health, higher rates of health risk behaviours, lower rates of preventive health care use, and higher rates of early mortality. Thus, one important approach for reducing disparities in health is to enhance childrenâs opportunities for academic success. School readiness is the term used to describe a childâs preparedness at age five or six to take advantage of the learning opportunities offered in school. Encompassing physical well-being, motor development, emotional health, social competence, language skills, general knowledge, and cognitive skills, readiness to learn at school entry has shown a strong association with later academic performance. Dr. Susan Dahinten is determining the extent to which childrenâs academic success in Grade Four can be predicted by their school readiness in kindergarten, before and after accounting for other individual, family, neighbourhood, and school characteristics that may influence their development. The sample for this study includes BC children for whom school readiness was measured at kindergarten between 2000 and 2002. By anonymously linking this data with data from BCâs education database, and with census data describing the childrenâs neighbourhoods, she is investigating whether, and why, some schools may be more or less successful at reducing inequalities among students of different backgrounds.
