• Understanding End-of-Life in a Long-Term Care Home: Perceptions of Bereaved Family Members

      Thoms, Shannon; Applied Health Sciences Program
      Rather than a natural aspect of life, adherence to the medical model within long-term care (LTC) homes has framed death as something to be avoided and a failure of the system. The purpose of this phenomenological study was to contribute to the ongoing discussion in the literature regarding the experience of dying and death in a LTC home from the perspective of bereaved family members. Interviews were conducted with eight family members who had a relative die in a LTC home within the preceding 12 months. Interviews with participants focused on their experiences while their relative approached the end-of-life, at the time of death, and after their death. My findings resulted in the overall theme of Respecting the Life and Death. Within this theme, I found that taking a compassionate approach to care; staff, families, and residents coming together for care; and the continuation of care all supported residents on their end-of-life journey. The findings of this research call attention to the multifaceted nature of dying beyond physiological care and work to address ways to provide quality end-of life care.
    • Understanding Network Governance: A Case Study Exploration of Active Canada 20/20

      Wu, Brandon R.; Applied Health Sciences Program (Brock University, 2015-01-06)
      Consistent with the governance shift towards network forms of governance, a number of new social movements have formed in response to the declining levels of physical activity in the Western world. One such movement is Active Canada 20/20: A Physical Activity Strategy and Change Agenda for Canada. Network governance is employed as the theoretical framework for this case study exploration of Active Canada 20/20 and the political landscape surrounding its development and implementation. Semi-structured interviews were conducted in addition to document/policy analysis and direct observations. Analysis of the data resulted in three overarching themes – the defining characteristics of network governance, the political landscape, and intersectoral linkages – that interconnect multifariously based the nature of the Canadian federal government and its relationship with the voluntary sector for physical activity. Despite progress in driving Active Canada 20/20 forward, entrenched dynamics of power need to be navigated within the political landscape surrounding network governance.
    • Understanding the Integration of Living Skills Through the Context of Health and Physical Education: A Case Study of Educators’ Experiences

      Weir, Jillian; Applied Health Sciences Program (Brock University, 2013-09-19)
      The research presented is a qualitative case study of educators’ experiences in integrating living skills in the context of health and physical education (HPE). In using semi-structured interviews the study investigated HPE educators’ experiences and revealed their insights relative to three major themes; professional practice, challenges and support systems. Professional practice experiences detailed the use of progressive lesson planning, reflective and engaging activities, explicit student centered pedagogy as well as holistic teaching philosophies. Even further, the limited knowledge and awareness of living skills, conflicting teaching philosophies, competitive environments between subject areas and lack of time and accessibility were four major challenges that emerged throughout the data. Major supportive roles for HPE educators in the integration process included other educators, consultants, school administration, public health, parents, community programs and professional organizations. The study provides valuable discussion and suggestions for improvement of pedagogical practices in teaching living skills in the HPE setting.
    • "Unfreezing" Year-Round Programming: A Case Study of Organizational Change in Summer Camps

      Dabrowski, Hannah; Applied Health Sciences Program
      The term summer camp does not often bring to mind tobogganing and ice skating, yet more and more frequently, summer camps are transitioning into programs capable of running year-round. This study aimed to examine both the formation and process of creating year-round programming within summer camps in Ontario. A descriptive case study was employed to uncover answers to the study’s research questions: (1) in what ways have camps become year-round programs? and (2) what has been learned by individuals involved in creating year-round programming? Interviews were conducted with camp directors from six camps who had created year-round programming. Narratives and themes were identified from the interviews with eight major themes highlighted. These eight themes were “inherited or donated,” “planning,” “correctly the first time,” “marketing,” “relationships,” “staffing,” “benefits to other seasons” and “financial justification.” Using Kurt Lewin’s Three-Step model of planned change, themes were characterized into one of Lewin’s stages of “unfreezing,” “changing,” and “refreezing.” Two themes did not pertain to one of Lewin’s stages, but were still relevant. Although listed individually, the themes were all connected in order to prescribe what may be an ideal process of creating year-round programming.
    • University Physical Education Students’ Understanding and Interpretation of Social Interaction as Part of a Meaningful Physical Education Experience

      Chee, Caleb Siang Heng; Applied Health Sciences Program
      The promotion of meaningful experiences is a primary way teachers can enact a transformative physical education (PE) curriculum for students (Kretchmar, 2006). Recent advances have led to a framework that outlines the following features of a meaningful experience: social interaction, challenge, fun, motor competence, delight, and personally relevant learning (Beni, Fletcher, & Ní Chróinín, 2017). This study examined how university physical education students understand, learn to articulate, and plan to enact positive social interaction as one feature of meaningful experiences in PE. The study took place in one undergraduate class where the instructor emphasized and articulated the components of positive social interaction. Participants (n = 10) took part in one or two individual interviews at the beginning and/or end of one academic term. Non-participant observations (5) of the class were conducted and exit slips (42) collected from students. Students had a basic understanding of positive social interaction at the first data collection point, whereby finding and making friends or encouraging one another were emphasized, which revealed a lack of sophistication in understanding. At the end of the course, students developed a deeper understanding of social interaction and its components, which they contributed to their teacher educator intentionally reflecting on positive social interaction and articulating the complexity of it with them, organizing inclusive class activities, and making an effort to develop meaningful relationships. This study is significant because it highlights the need for PE teacher education (PETE) instructors to be explicit in articulating and demonstrating ways in which social interaction can be understood, interpreted, and enacted.
    • Unpacking Pieces of a Puzzle: Understanding Obesity-Related Health Risk through Lifestyle Behaviours and Well-Being

      Brooks, Kimberly M.; Applied Health Sciences Program (Brock University, 2014-08-26)
      The primary objective of this non-experimental study was to examine the differences based on obesity-related health risk in terms of physical activity, sedentary behaviour and well-being in adults. Participants (N = 50; Mage = 38.50, SDage = 14.21) were asked to wear a SenseWear Armband (SWA) across a seven day monitoring period followed by a questionnaire package. Using the National Institute of Health’s (1998) criteria, participants were classified as either least, increased, or high risk based on waist circumference and Body Mass Index scores. Differences between these classifications were found in the amount of time spent in active energy expenditure for bouts of ten minutes or more (p = .002); specifically between least and high risk (p < .05). No other differences (p > .05) emerged. Participants’ also perceived the SWA as a practical and worthwhile device. Overall, these findings provide practical applications and future directions for health promotional research.

      Cracknell, Janel; Applied Health Sciences Program (Brock University, 2014-03-24)
      Cognitive interviews were used to evaluate two draft versions of a financial survey in Jamaica. The qualitative version used a few open-ended questions, and the quantitative version used numerous close-ended questions. A secondary analysis based on the cognitive interview literature was used to guide a content analysis of the aggregate data of both surveys. The cognitive interview analysis found that the long survey had fewer respondent errors than the open-ended questions on the short survey. A grounded theory analysis then examined the aggregate cognitive data, showing that the respondents attached complex meanings to their financial information. The main limitation of this study was that the standard assessments of quantitative and qualitative reliability and validity were not utilized. Further research should utilize statistical methods to compare and contrast aggregated cognitive interview probe responses on open and close ended surveys.
    • Using Network Analysis to Understand and Advance Falls Prevention Services and Programs

      Dang, Phuc; Applied Health Sciences Program (Brock University, 2013-08-22)
      The purpose of this study was to understand referral linkages that exist among falls prevention agencies in a southern Ontario region using network analysis theory. This was a single case study which included fifteen individual interviews. The data was analyzed through the constant comparative approach. Ten themes emerged and are classified into internal and external factors. Themes associated with internal factors are: 1) health professionals initiating services; 2) communication strategies; 3) formal partnerships; 4) trust; 5) program awareness; and 6) referral policies. Themes associated with external factors are: 1) client characteristics; 2) primary and community care collaboration; 3) networking; and 4) funding. Recommendations to improve the referral pathway are: 1) electronic database; 2) electronic referral forms; 3) educating office staff; and 4) education days. This study outlined the benefit of using network analysis to understand referral pathways and the importance of implementing strategies that will improve falls prevention referral pathways.
    • The Values of Community Curling: A Case Study

      Brooks, Donald; Applied Health Sciences Program (Brock University, 2014-07-22)
      This qualitative case study research shows that within the realm of curling, the professionalization of the sport, at the national level, has limited to no effect on the core values of respect, belonging, and giving back that the grassroots level of curling identify as important. Through an interview process with twelve community level curlers, from four separate clubs within the Niagara region, data were collected and analyzed using traditional coding techniques. Utilizing institutional theory, the research shows a growing gap between the national level of curling and the grassroots level. Data also shows that value alterations, at the community level, are based on the changing Canadian environment in regards to legislation (smoking and drinking laws) and social behaviours (the busier Canadian lifestyle) rather than changes at the national level. These findings have a profound effect on how sports are administered in the Canadian sport system
    • Volunteering and Social Capital: A Case Study of Older Hospital Volunteers in Southern Ontario

      Subramaniam, Saranjah; Applied Health Sciences Program
      Volunteering as a form of social activity can facilitate older adults’ active aging through community engagement. The purpose of this qualitative case study was to understand the views on older adults’ volunteerism in a community hospital network in Southern Ontario. Utilizing in-depth interviews with 10 older volunteers (over the age of 65), document analysis, and a key informant interview, I explored their experiences of volunteering and social capital development at six hospitals in the network. Data analyses included open and axial coding, and conceptualization of the themes. Four major themes emerged from the data: reasons to volunteer, management’s influence, negative experiences of volunteering, and connections with others. The findings of this research emphasized older volunteers’ strong commitment and enthusiasm to support the hospital in their own communities, the power of volunteering to enhance the development of bonding, bridging, and linking social capital, and the influence of two major contextual factors (i.e. the Auxiliary Factor and the Change Factor) to facilitate or hinder older volunteers’ social capital development in the hospitals. Future research directions should focus on further unpacking the different degrees to which each type of social capital is developed, placing emphasis on the benefits of social capital development for volunteers in healthcare settings. The implications for practice include the targeted recruitment of older adults as healthcare volunteers while creating volunteer positions and environments in which they can develop social capital with their peer volunteers, hospital staff, patients, and people in surrounding communities. To sustain their existing dedicated long-term volunteers, in particular their Auxiliary groups, the community hospital network can enhance facilitating factors such as the Auxiliary Factor while mitigating the negative effects of the Change Factor. By developing social capital through volunteering in their own communities, older adults can engage in active aging, while participating in the development of an age-friendly community.
    • "Weathering a hidden storm" : an application of Andersen's behavioral model of health, and health services use for those with diagnosable anxiety disorder

      Kovacs, Sandy Lee; Applied Health Sciences Program (2012-07-05)
      "Weathering a Hidden Storm": An App~ication of Andersen's Behaviora~ Mode~ of Hea~th, and Hea~th Services Use for Those With Diagnosab~e Anxiety Disorder Research has primarily focused on depression and mood disorders, but little research has been devoted to an examination of mental health services use amongst those with diagnosable anxiety disorder (Wittchen et al., 2002; Bergeron et al., 2005). This study examined the possible predicting factors for mental health services utilization amongst those with identifiable anxiety disorder in the Canadian population. The methods used for this study was the application of Andersen's Behavioral Model of Health Services Use, where predisposing, need and enabling 111 characteristics were regressed on the dependent variable of mental health services use. This study used the Canadian Community Health Survey (cycle 1.2: Mental Health and Well- Being) in a secondary data analysis. Several multiple logistics models predicted the likelihood to seek and use mental health services. Predisposing characteristics of gender and age, Enabling characteristics of education and geographical location, and those with co-occurring mood disorders were at the greatest increased likelihood to seek and use mental health services.
    • “Weathering a Hidden Storm”: An Application of Andersen’s Behavioral Model of Health, and Health Services Use for Those with Diagnosable Anxiety Disorder

      Kovacs, Sandy Lee; Applied Health Sciences Program (Brock University, 2011-06-27)
      Abstract: Research has primarily focused on depression and mood disorders, but little research has been devoted to an examination of mental health services use amongst those with diagnosable anxiety disorder (Wittchen et al., 2002; Bergeron et al., 2005). This study examined the possible predicting factors for mental health services utilization amongst those with identifiable anxiety disorder in the Canadian population. The methods used for this study was the application of Andersen’s Behavioral Model of Health Services Use, where predisposing, need and enabling characteristics were regressed on the dependent variable of mental health services use. This study used the Canadian Community Health Survey (cycle 1.2: Mental Health and Well-Being) in a secondary data analysis. Several multiple logistics models predicted the likelihood to seek and use mental health services. Predisposing characteristics of gender and age, Enabling characteristics of education and geographical location, and those with co-occurring mood disorders were at the greatest increased likelihood to seek and use mental health services.
    • A Week in the Life of Community Programs: Describing Barriers Experienced by Three Transition Age Youth with Autism Spectrum Disorder and their Caregivers

      Toms, Demi; Applied Health Sciences Program
      Various barriers for participating in physical activity for people with Autism Spectrum Disorder (ASD) have been identified; specifically, the insufficient availability of programs and knowledgeable personnel to run them (Taub & Greer, 2000; WHO, 2015). Ironically, there are a magnitude of proven benefits specific to ASD that accrue from being physically active, including a decrease in stereotypic behaviours (hand flapping, object spinning) and sleep deprivation (Taud & Greer, 2002; Todd & Reid, 2006; Gaskin, Anderson & Morris, 2009; Connolly, 2008). Previous research has focused on investigating barriers for individuals experiencing disability in relation to environment, economic and political components (McDermott & Turk, 2011). However, minimal research involves the perspective of the individuals experiencing ASD who do not use verbal communication and require greater supports. The purpose of this phenomenological study was twofold. Firstly, to unearth barriers experienced by three transition aged youth with Autism who require 1:1 support or greater and their caregivers in a ‘typical week’. Secondly, to examine whether Priestley’s (1997) 6 principles of emancipatory research could be applied to this research process. In the process of engaging with the three youth participants and their caregivers in this study, I completed multiple observations of the youth participants in community programs and activities, then conducted semi-structured interviews with their caregivers, and non-traditional, alternative communication interviews with the youth participants. Analysis revealed that implementing Priestley’s 6 principles of emancipatory research could not be applied to this research process because of controversies with the ethics board. As well, barriers to participation in community programs included lack of staff training and inability to adapt to individual needs. The findings of this study imply a greater need for rapport based and embedded research with individuals experiencing complex ASD. Similarly, Research Ethics Boards need a greater understanding of individuals who do not use words to communicate to enable researchers to pursue authentic emancipatory research with complex and typically, under-represented participants.
    • What Constitutes an Expert Registered Nurse in Labour & Delivery?: A Phenomenological Inquiry

      Bowen, Kimberley; Applied Health Sciences Program
      The purpose of this study was to explore what constitutes an expert registered nurse in a labour and delivery unit. A qualitative, phenomenological approach was used to guide and analyze the interviews of twelve participants recruited through purposeful sampling. Patricia Benner’s From Novice to Expert theory was used as both a theoretical definition of expert as well as a baseline for participants to self-identify with one of the levels of skill acquisition (novice, advanced beginner, competent, proficient or expert). Three themes emerged from data analysis including: 1) characteristics of expert nurses, 2) significance and impact of loss and 3) difficulty with the word “expert”. The study results showed that expert is a fluid concept that is both difficult to define and maintain throughout a nurse’s career. Factors such as education, technology, culture, environment and most notably autonomy, impact a nurse’s ability to achieve expert status as well as the ability to remain an expert of the same capacity throughout their careers. In addition, environmental and practice related changes resulted in feelings of loss that also significantly impacted the nurse’s perception of expert nursing. Ultimately, it was identified that Benner’s definition of expert is not complete and would require additional research with a focus on relational and psychosocial elements of nursing specifically in the area of labour and delivery setting in order to achieve a more comprehensive definition.
    • What gets plans off the shelf? : a multi-site case study of the factors influencing municipal recreation plan implementation

      Leone, Michelle; Applied Health Sciences Program (Brock University, 2009-01-28)
      Municipalities that engage in recreation planning have the potential to use their resources more effectively. However, successful planning means getting the plan off the shelf and implemented. This study investigated the factors that influenced municipal recreation plan implementation in three municipalities. Interviews were conducted with eleven key informants (recreation directors, planning consultants, a city councillor, and members of plan steering committees). The findings of this study suggested that because the implementation of recreation plans occurs in a highly political environment, recreation professionals will need effective strategies to get their plans implemented and that implementation can be facilitated by developing or expanding strategies that: (l) build the power of the recreation department within the municipal government structure; (2) build support for recreation within the local community; and (3) build the political and organizational capacity in the recreation department.
    • What's for Supper? The Experience of Eating for Women at Midlife

      Petty, Lisa; Applied Health Sciences Program
      The midlife time period is not well defined and is not well understood for women, particularly in reference to eating. The purpose of this hermeneutic phenomenological study is to explore the experience of midlife for women and the meaning they give to eating. Low structured research conversations with seven Canadian, Caucasian women were analysed using van Manen's approach. The main themes that were identified were Not Me, You Lose, It's a Negotiation, and It's a Good Place. Findings of this study suggest that midlife women undergo intense and ongoing physical, emotional, and social transformations during a period in which demands on their time and energy are still high. In order to manage everyday demands, these women prioritize and make conscious choices and compromises in reference to eating that influence how their bodies feel on a daily basis.
    • When the Beautiful Game Turns Ugly: A Study of Fan Experiences of Perceived Match Fixing in Soccer

      Lamberti, Adriano; Applied Health Sciences Program (Brock University, 2014-10-24)
      Limited academic attention has been given to the nexus between corruption in soccer and its impact on fandom. Consequently, the purpose of this qualitative study was to better understand the lived experiences of highly identified soccer fanatics living through this era of match fixing in the sport. Social networking site Twitter was utilized to recruit participants from three continents – Africa, Europe, and North America – based on submissions to the site in response to a perceived fix from a high-profile March, 2013 match. A total of 12 semi-structured interviews were conducted with highly identified soccer fans in accordance with Funk and James’ (2001) Psychological Continuum Model (PCM). Despite the majority of participants feeling skepticism about the purity of soccer today, half of the participants’ fandom remained unchanged in the face of perceived match fixing. Directions for future research and recommendations are considered and discussed.
    • Who is on the Team? Exploring a Person-Centred Care Approach on an Interdisciplinary Healthcare Team, from the Healthcare Provider's Perspective

      Fucile, Bianca; Applied Health Sciences Program
      The purpose of this study was to gain an understanding from the perspective of healthcare providers how person-centre care ideologies are translated into day-to-day practice at an oncology center. This was a single case study, conducted at a local Oncology Center. The study included 15 interviews with healthcare providers, the analysis of 15 documents, and the keeping of a reflexive research journal. Four themes and ten sub-themes were found to represent the experiences of healthcare providers: (1) Educating with Empathy (2) Informed Personal Advocate, (3) Being the “Rock”, and (4) Progressing as a Team. This study demonstrates the roles of healthcare providers, patients and caregivers on a healthcare team committed to delivering person-centred care. It also introduces a new kind of team, a person-centred care team along with complimentary guiding principles to inform the practices of healthcare providers. This study contributes to the shift in the culture of care in oncology, where patients and caregivers are welcomed onto their healthcare team.
    • Wild Civility: Cultivating the Foundations of Social Justice through Participation in a Wilderness Program

      Hamel, Erica; Applied Health Sciences Program (Brock University, 2012-08-09)
      This heuristic inquiry examined if the foundations of social justice knowledge and beliefs were developed as a result of participation in a wilderness program and what knowledge and beliefs were developed. There were six participants in this study. Data collection involved participants completing pre- and post- program interviews and daily journals during the program. Through inductive analysis six themes emerged. Three of these were related to the development of certain foundations of social justice: (a) experienced conflict development and resolution; (b) experienced relationship change and development; and (c) shift from “me” to “we” mentality. The remaining three themes were included as additional findings: (a) experienced personal change and development; (b) identification of specific factors of the program responsible for changes; and (c) bringing learning back to everyday life. Results highlight wilderness program impacts on participants’ social justice knowledges and beliefs and inform wilderness program providers and social justice educators.
    • Writing Lives, Writing Loss: An autoethnography on the death of a teammate

      Faust, Katie; Applied Health Sciences Program
      This project began as a memorial to an athlete who died of cancer, and ended as a journey through grief. The focus of my research is to explore through an autoethnography of loss, how the death of a young athlete is experienced and how as an athlete, I make sense of loss outside of sport. Visiting and revisiting spaces of loss and grief in sport allowed me to explore more deeply my personal histories as fragmented stories of grief. Through autoethnography and meta-autoethnography, this research seeks to uncover the meanings that reside in grieving in sport, examining the language we use to talk about death and loss in a culture of grief shrouded with stories of heroics and feel-good narratives. As I continue on my grief journey, I negotiate and re-negotiate the meanings I have constructed in my experiences. I will continue to do that as I venture through life and navigate the texts, searching to find balance between writing lives and writing loss.