Homophobic beliefs and attitudes among mid-adolescent boys: exploring the ideas of hybrid masculinities.

Introduction: Homophobia is well-documented as key to social regulation of masculine behavior and practices in Western settings. Yet, empirical data from a number of Western settings has shown a decline in overt homophobic attitudes in the past decade, leading some to suggest that the nature of masculinities is also changing. However, theorizing on the changing nature of masculinities among adolescents has received limited quantitative attention. Research is needed to better understand shifts in adolescent masculinities in contemporary Western settings. Methods: In this paper, we investigate the application of one newer approach to explore masculinities in context - hybrid masculinities - in a sample of cisgender, heterosexual, mid-adolescent boys in one province in Western Canada (N = 873, mean age (SD) = 14.39 (0.37)). Data were collected from nine cohorts of grade 9 youth over a 10-year period (2013-2022) as part of the baseline survey of an ongoing evaluation of a gender-transformative healthy relationships program. Results and discussion: We hypothesized that if the ideas of hybrid masculinities held in our sample, we would find that overt homophobic attitudes and adherence to related patriarchal norms (e.g., avoidance of femininity) would decline over this period, but that the use of homophobic name-calling would remain differentiated in terms of to whom it was directed (e.g., a friend, someone they thought was gay). We did find a significant decline in homophobic attitudes and norms related to emotional restriction and avoidance of femininity over the 10-year period, but also found that homophobic name-calling remained differentiated, with significantly higher name-calling toward a friend than toward someone the youth thought was gay. Thus, our hypotheses were supported. We discuss the implications of our findings for future theory and research on understanding adolescent masculinities in context.

Thinking and Enacting the Patient Medical Home Under Pandemic Conditions: A Qualitative Study From Primary Care in Alberta, Canada.

BACKGROUND: The COVID-19 (C19) pandemic shocked primary care systems around the world. Those systems responded by supporting patients in the community, and acute care facilities in crisis. In Canada, the Patient Medical Home (PMH) is a widely adopted care model that aims to operationalize the tenets and principles of Primary Health Care (PHC) as developed since the Alma-Ata Declaration. This paper describes how personnel working in and with Primary Care Networks (PCNs) in Alberta, Canada deployed the PMH model and its underlying PHC principles to frame and respond to the C19 shock. METHODS: Using purposive and snowball sampling techniques, we interviewed 57 participants who worked in public health and primary care, including community-based family physicians. We used interpretive description to analyze the interviews. RESULTS: PCN staff and physicians described how the PMH model was foundational to normal operations, and how C19 responses were framed by the patient-centric, team-delivered, and continuous care principles the model shares with PHC. Specifically, participants described ensuring access to care, addressing the social determinants of health, being patient centered, and redeploying and expanding PHC teams to accomplish these goals. DISCUSSION: Delivering PHC through the PMH allowed physicians and allied health staff to deliver patient-centered, team-based, holistic bio-medical services to Albertans. In tailoring services to meet the specific social and health needs of the populations served by each PCN, healthcare providers were able to ensure relevant support remained available and accessible.

Building a Data Bridge: Policies, Structures, and Governance Integrating Primary Care Into the Public Health Response to COVID-19.

PURPOSE: The effective integration of primary care into public health responses to the COVID-19 pandemic, particularly through data sharing, has received some attention in the literature. However, the specific policies and structures that facilitate this integration are understudied. This paper describes the experiences of clinicians and administrators in Alberta, Canada as they built a data bridge between primary care and public health to improve the province's community-based response to the pandemic. METHODS: Fifty-seven semistructured qualitative interviews were conducted with a range of primary care and public health stakeholders working inside the Calgary Health Zone. Interpretive description was used to analyze the interviews. RESULTS: SARS-CoV-2 test results produced by the local public laboratory were, initially, only available to central public health clinicians and not independent primary care physicians. This enabled centrally managed contact tracing but meant primary care physicians were unaware of their patients' COVID-19 status and unable to offer in-community follow-up care. Stakeholders from both central public health and independent primary care were able to leverage a policy commitment to the Patient Medical Home (PMH) care model, and a range of existing organizational structures, and governance arrangements to create a data bridge that would span the gap. CONCLUSIONS: Primary care systems looking to draw lessons from the data bridge's construction may consider ways to: leverage care model commitments to integration and adjust or create organization and governance structures which actively draw together primary care and non-primary care stakeholders to work on common projects. Such policies and structures develop trusting relationships, open the possibility for champions to emerge, and create the spaces in which integrative improvisation can take place.

Exploring risk and protective factors for adolescent dating violence across the social-ecological model: A systematic scoping review of reviews.

Background: Adolescent dating violence (ADV) is a serious issue that affects millions of youth worldwide. ADV can be any intentional psychological, emotional, physical, or sexual aggression that occurs in adolescent dating and/or sexual relationships, and can occur both in person and electronically. The mental health consequences of ADV can be significant and far reaching, with studies finding long-term effects of dating violence victimization in adolescence. Preventing ADV so that youth do not experience negative mental health consequences is thus necessary. To be effective, however, prevention efforts must be comprehensive and address more than one domain of the social-ecological model, incorporating risk and protective factors across the individual level; relationship level; community level; and societal level. To support researchers and practitioners in designing such prevention programs, an understanding of what risk and protective factors have been identified over the past several decades of ADV research, and how these factors are distributed across levels of the social-ecological model, is needed. Methods: This study was conducted in accordance with PRISMA guidelines. We included peer-reviewed articles published in English between January 2000 and September 2020. The search strategy was developed in collaboration with a research librarian. Covidence was used for title and abstract screening and full text review. Data were extracted from included articles using a standardized charting template, and then synthesized into tables by type of factor (risk or protective), role in ADV (victimization or perpetration), and level(s) of the social-ecological model (individual, relationship, community, societal). Results: Our initial search across six databases identified 4,798 potentially relevant articles for title and abstract review. Following title and abstract screening and full text review, we found 20 articles that were relevant to our study objective and that met inclusion criteria. Across these 20 articles, there was a disproportionate focus on risk factors at the individual and relationship levels of the social-ecological model, particularly for ADV perpetration. Very little was found about risk factors at the community or societal levels for ADV victimization or perpetration. Furthermore, a very small proportion of articles identified any protective factors, regardless of level of the social-ecological model. Conclusion: Despite best practice suggesting that ADV prevention strategies should be comprehensive and directed at multiple levels of an individual's social ecology, this systematic scoping review of reviews revealed that very little is known about risk factors beyond the individual and relationship level of the social-ecological model. Further, past research appears steeped in a risk-focused paradigm, given the limited focus on protective factors. Research is needed that identifies risk factors beyond the individual and relationship levels, and a strengths-based focus should be used to identify novel protective factors. In addition, a more critical approach to ADV research - to identify structural and not just individual risk and protective factors - is needed.

A Systematic Review of Adolescent Masculinities and Associations with Internalizing Behavior Problems and Social Support.

Interest in the connection between masculinities and mental health continues to grow. However, no previous systematic review has explored this association for adolescents. We present the systematic review of 29 articles that explore the connection between adherence to stereotypical male gender role norms (e.g., emotional restriction), attributes (e.g., "ambitious"), and identity (most commonly, gender "typicality") and internalizing behavior problems and social support. A total of 24,795 adolescent boys (6th-12th grade) were included in the reviewed studies from 1997-2017. In the quantitative articles (n = 20), associations varied by aspect of masculinity assessed. Specifically, we found that greater endorsement of "masculine" traits (e.g., ambitious, assertive) was generally associated with fewer internalizing behavior problems and greater social support. However, lower gender "typicality" and higher adherence to stereotypical gender role norms were generally associated with more internalizing behavior problems and lower social support. In the qualitative articles (n = 9), the most predominant theme was emotional restriction (i.e., a gender role norm) and consequences for mental health. While research in this area is newer for community psychologists, the connection between masculinities and mental health is directly relevant to the field. Given the focus on individual-level conceptions of masculinity and mental health found in our review, we describe key future directions for masculinities research in community psychology.

The use of Outcome Harvesting in learning-oriented and collaborative inquiry approaches to evaluation: An example from Calgary, Alberta.

The Community Development Learning Initiative (CDLI) in Calgary, Alberta, Canada aims to be a network that brings together neighbourhood residents, community development practitioners and other supporters to learn and act on neighbourhood-based, citizen-led community development projects. In 2013, the CDLI initiated The Evaluation for Learning and Dialogue Project to provide the opportunity for organizations and supporters to work together to establish a shared vision and goals through discussions about evaluation learning and outcomes. It was intended that the project would be a useful learning tool for participating organizations by enabling them to engage in an evaluative methodological process, and record relevant information and to compare and learn from each other's projects. Outcome Harvesting was chosen as the evaluation methodology for the project. This article reviews critical learning from the project on the use of Outcome Harvesting methodology in the evaluation learning and outcomes of local community development projects, and it provides lessons for other jurisdictions interested in implementing this methodology.