Home injuries in British Columbia: patterns across the deprivation spectrum.

The significant burden of home injuries has become a growing concern that affect thousands of people every year across Canada. This study examined the relationship between neighbourhood deprivation and unintentional injuries occurring at home leading to hospitalizations in British Columbia (BC) between 2015 and 2019. This study used de-identified hospitalization data on unintentional home-related injuries from the Discharge Abstract Database (DAD) and population data for each dissemination area from Statistics Canada's 2016 Census Profiles. Hospitalization rates were computed for unintentional home-related injuries across four dimensions specified in the Canadian Index of Multiple Deprivation (CIMD) for BC. For three CIMD dimensions (situational vulnerability, economic dependency, and residential instability), unintentional home injury rates were higher in areas with higher deprivation, while the inverse was observed for ethno-cultural diversity. Understanding socio-economic disparities within neighbourhoods enables injury prevention partners to identify vulnerable populations and prioritize the development and implementation of evidence-based injury prevention interventions.

Building CapaCITY/É for sustainable transportation: protocol for an implementation science research program in healthy cities.

INTRODUCTION: Improving sustainable transportation options will help cities tackle growing challenges related to population health, congestion, climate change and inequity. Interventions supporting active transportation face many practical and political hurdles. Implementation science aims to understand how interventions or policies arise, how they can be translated to new contexts or scales and who benefits. Sustainable transportation interventions are complex, and existing implementation science frameworks may not be suitable. To apply and adapt implementation science for healthy cities, we have launched our mixed-methods research programme, CapaCITY/É. We aim to understand how, why and for whom sustainable transportation interventions are successful and when they are not. METHODS AND ANALYSIS: Across nine Canadian municipalities and the State of Victoria (Australia), our research will focus on two types of sustainable transportation interventions: all ages and abilities bicycle networks and motor vehicle speed management interventions. We will (1) document the implementation process and outcomes of both types of sustainable transportation interventions; (2) examine equity, health and mobility impacts of these interventions; (3) advance implementation science by developing a novel sustainable transportation implementation science framework and (4) develop tools for scaling up and scaling out sustainable transportation interventions. Training activities will develop interdisciplinary scholars and practitioners able to work at the nexus of academia and sustainable cities. ETHICS AND DISSEMINATION: This study received approval from the Simon Fraser University Office of Ethics Research (H22-03469). A Knowledge Mobilization Hub will coordinate dissemination of findings via a website; presentations to academic, community organisations and practitioner audiences; and through peer-reviewed articles.

'I keep forgetting them': Lacrosse, indigenous women and girls and reconciliation in Canada.

In Canada, the Truth and Reconciliation Commission (TRC) released its list of Calls to Action (CTA) in 2015, and five Calls were directly related to reconciliation and sport. Within these five sport-related CTA, there was no specific reference to gender. Lacrosse, as an Indigenous cultural practice that has been culturally appropriated by white settlers, is a complex site to investigate how the TRC's CTA is (or are not) being implemented and the ways in which these efforts are gendered. In this paper, we examined how staff at Canadian lacrosse organizations address the CTA and Indigenous women's and girls' participation in lacrosse. Through the use of Indigenous feminist theory, feminist methodologies informed by the tenets of Indigenous methodologies, semi-structured interviews and reflexive thematic analysis, our findings demonstrate that Indigenous women and girls are commonly overlooked, and gender is typically an afterthought within the implementation of sport-related CTA by lacrosse organizing bodies in Canada - if they are implemented at all. As a result, we argue that there is a need to make gender a central organizing principle when lacrosse organizations within Canada implement the TRC's CTA.

Fatherhood and Elite Athletics: Sacrifice, Selfishness, and Gaining "Dad Strength".

This study contributes to a growing body of scholarly discussions around the many aspects and challenges of combining parenthood with elite-level sport, with a particular focus on the experiences of male elite athletes who are fathers. We used a caring masculinities theoretical framework, community-based participatory research, and semi-structured interviews to explore the experiences of 10 elite/international and world-class athletes (n = 9 fathers, n = 1 expectant father). Through reflexive thematic analysis, we identified three main themes: fatherhood can (1) improve and (2) impede elite athlete-fathers' athletic performance; and (3) athlete-fathers experience a trade-off between athletic performance and fatherhood responsibilities. Our findings underscore the ways in which male athletes' experiences with parenthood reflect the new era of involved fatherhood and are analogous to some of the identity tensions that have been reported with regard to the experiences of elite female athletes who are pregnant and/or mothers. Recognizing the impact of children on male athletes' athletic careers and the parallels between fatherhood, motherhood, and elite sport may lead to better support for athlete-fathers while also contributing to diminishing the expectation that women are primary caregivers to children.

Selling vs. Supporting Motherhood: How Corporate Sponsors Frame the Parenting Experiences of Elite and Olympic Athletes.

Recently, motherhood and pregnancy in elite sport have received increased attention in sport media. Through a comprehensive news media search across Factiva as well as a gray literature search using Google search engine, we analyzed 115 articles using feminist framing analysis. We developed two primary frames: 1) empowerment versus exploitation, and 2) proactivity versus reactivity. Our results show that many pregnant and parenting athletes frame their respective sponsors as exploitative for recognizing and capitalizing upon their unique marketing value, while these same corporate sponsors frame themselves as industry leaders who empower pregnant and parenting athletes. These two frames show that pregnant/parenting elite athletes commonly face discriminatory policies and practices and that there is often a lack of congruence between marketing and actual corporate practices and policies. These findings arguably reflect larger societal issues related to gender equity and highlight the importance of action over rhetoric to ensure motherhood is supported-rather than marketed-for elite athletes.

Are sport and traditional Inuit games identified as tools in current Inuit suicide prevention strategies?: A content analysis.

Eekeeluak Avalak, an 18-year-old Inuk wrestler who won the first-ever gold medal for Nunavut at the Canada Summer Games in 2022, dedicated his win to his late brother who died by suicide in 2015. Avalak openly attributed sport - specifically wrestling - to saving his own life. This story raises important questions about the role of sport and traditional games in Inuit suicide prevention strategies. Few studies have examined the role of sport or traditional games in Inuit suicide prevention strategies. In an attempt to reduce Inuit suicide rates, in addition to the National Inuit Prevention Strategy, three of the four land claim regions that constitute Inuit Nunangat have suicide prevention strategies. In this study, we used settler colonial theory, critical Inuit studies, and content analysis to examine if and how sport and Inuit traditional games are identified as prevention tools in these Inuit suicide prevention strategies. The results demonstrate that sport and traditional games have largely been overlooked as protective factors in current Inuit-wide and land-claim specific suicide prevention strategies. Moving forward, evidence-based and community-driven approaches could be funded, created, implemented, and evaluated as culturally-safe Inuit mental health intervention models to address the disproportionately high suicide rates among Inuit in Inuit Nunangat.

Road safety, health equity, and the built environment: perspectives of transport and injury prevention professionals in five Canadian municipalities.

BACKGROUND: Concerns regarding health equity (HE) and the built environment (BE) are well established in the Canadian urban context. Transport and injury prevention professionals across sectors, such as transportation and public health, are involved in designing and implementing BE interventions that enhance the safety of vulnerable road users (VRUs). Results from a larger study examining barriers and facilitators to BE change are used to illustrate how transport and injury prevention professionals perceive HE concerns in their work in five Canadian municipalities. Broadening our understanding of how HE influences the professional BE change context is crucial when advocating for modifications that enhance the safety of equity-deserving VRUs and groups who experience marginalization. METHODS: Interview and focus group data were gathered from transport and injury prevention professionals working in policy/decision-making, transport, police services, public health, non-profit organizations, schools/school boards, community associations, and private sectors across five Canadian urban municipalities: Vancouver, Calgary, Peel Region, Toronto, and Montréal. Data were analyzed using thematic analysis (TA) to illustrate how equity considerations were perceived and applied in participants' BE change work. RESULTS: The results of this study illustrate transport and injury prevention professionals' awareness of the varying needs of VRUs, as well as the inadequacies of current BEs in the Canadian urban context and consultation processes utilized to guide change. Participants emphasized the importance of equitable community consultation strategies, as well as specific BE changes that would support the health and safety of VRUs. Overall, the results highlight how HE concerns inform transport and injury prevention professionals' BE change work in the Canadian urban context. CONCLUSION: For professionals working in urban Canadian transport and injury prevention sectors HE concerns influenced their perspectives of the BE and BE change. These results illustrate a growing need for HE to guide BE change work and consultation processes. Further, these results contribute to ongoing efforts in the Canadian urban context to ensure that HE is at the forefront of BE policy change and decision-making, while promoting existing strategies to ensure that the BE, and related decision-making processes, are accessible and informed by a HE lens.

Exploring the stress of olympic postponement due to COVID-19 on elite/international and world-class parenting and pregnant runners.

The primary objective of this community-based participatory research is to explore the impacts of COVID-19 and the delayed Tokyo 2020 Olympic Games on world-class and elite/international-class parenting and pregnant athletes. Participants in this study include 11 female and 10 male parenting and/or pregnant middle and distance runners. Combined, the participants have competed at 26 Olympic Games and 31 World Championships. Drawing on the general concepts of stressors and psychological resilience, we use thematic analysis to develop four themes to understand the stressors for world-class and elite/international-class parenting and pregnant athletes due to COVID-19 and the delayed Tokyo 2020 Olympic Games: (1) lack of childcare support, (2) family planning, and (3) needing to stay away from sources of COVID-including their children. Despite the stressors identified in the aforementioned themes, we identified a fourth theme: (4) participants demonstrated adaptability to stress in spite of-or due to-their athlete-parent identities.

Absent and Problematic: The Representation of Fathers in the Program Policies of Organizations that Provide Family-Centred Services in Vancouver's Downtown Eastside.

Parenting education interventions and parenting programs are important for health promotion efforts among children and families; however, the majority of parenting programs are directed towards and attended by mothers. This is problematic because research has consistently demonstrated that fathers' active participation in the family can have a positive influence on mothers' well-being, children's self-esteem, success in school, and interpersonal relationships. In this paper, using an intersectional poststructuralist framework, document analysis, and Bacchi and Goodwin's "What's the problem represented to be" approach (WPR), we analyzed the program policies of 12 organizations that provide family-centred services in the Downtown Eastside of Vancouver, British Columbia, Canada. We identified the following three discourses: organizations strive to be client-centred and provide choices; organizations want to empower their participants; and women need safe place to raise their families. Our analysis revealed that fathers are absent or represented as problems in program policies, and that this has consequences for not only fathers but also mothers and children.

Effect of Pregnancy in 42 Elite to World-Class Runners on Training and Performance Outcomes.

PURPOSE: The International Olympic Committee expert group on pregnancy has identified a paucity of information regarding training and performance in truly elite athletes. Thus, the purpose of this study was to quantify elite runners' training volume throughout pregnancy and postpartum competition performance outcomes. METHODS: Forty-two elite (>50% competed at the World Championships/Olympic) middle-/long-distance runners' training before, during, and after pregnancy (quality/quantity/type) data (retrospective questionnaire) and competition data (published online) were collected. RESULTS: Running volume decreased significantly ( P < 0.01) from the first trimester (63 ± 34 km·wk -1 ) to the third trimester (30 ± 30 km·wk -1 ). Participants returned to activity/exercise at ~6 wk postpartum and to 80% of prepregnancy training volumes by 3 months. Participants who intended to return to equivalent performance levels postpregnancy, there was no statistical decrease in performance in the 1 to 3 yr postpregnancy compared with prepregnancy, and ~56% improved performances postpregnancy. CONCLUSIONS: This study features the largest cohort of elite runners training and competition outcomes assessed throughout pregnancy, with training volumes being approximately two to four times greater than current guidelines. For the first time, performance was directly assessed (due to the quantifiable nature of elite running), and study participants who intended to return to high-level competition did so at a statistically similar level of performance in the 1- to 3-yr period postpregnancy. Taken together, this article provides much needed insights into current training practices and performance of elite pregnant runners, which should help to inform future training guidelines as well as sport policy and sponsor expectations around return to training timelines and performance.

You're carrying so many people's stories: vicarious trauma among fly-in fly-out mental health service providers in Canada.

PURPOSE: The purpose of this article is to examine the factors that influence fly-in and fly-out (FIFO) mental health service providers' experiences of vicarious trauma as they deliver services to communities in Inuit Nunangat through a constructivist self-development theory (CSDT) lens. METHOD: Using a participatory action research methodology, we conducted eight semi-structured interviews with providers to understand their perspectives on the risk of developing vicarious trauma and potential mitigation strategies. RESULTS: We identified three themes through thematic analysis: 1) vicarious trauma is a risk associated with working in communities with high rates of trauma; 2) establishing individual and organizational strategies to reduce risk of vicarious trauma may improve FIFO providers' well-being and career longevity; and 3) FIFO models of care may offer protective benefits for mental health service providers against vicarious trauma. CONCLUSIONS: We conclude that FIFO models of care may help mental health service providers to manage the risk of vicarious trauma through reduced caseload and less time spent in community.

The adaptation of the beyond cold water bootcamp course for Inuvialuit communities in Northwest Territories, Canada.

Boating-related fatalities in the Northwest Territories (NWT) are well above the national average. These fatalities are exacerbated by very cold water, and water and boating safety resources that lack relevance to residents of northern communities. We utilised an iterative, participatory approach to create a plain language, culturally and geographically adapted version of a cold water survival course, "Beyond Cold Water Bootcamp". The purpose of this research was to determine what adaptations are necessary to create appealing and pertinent boating safety interventions for Inuvialuit communities in the NWT and to demonstrate the value of generating such interventions. First, we conducted a focus group with boating safety experts to gain feedback on the first draft of the adapted course. We then subsequently completed a pilot of the course with community members in Tuktoyaktuk, NWT, and we obtained their feedback and suggestions. We then trained a local community member to deliver the course and conducted another focus group with residents. Using reflexive thematic analysis, our results demonstrated the value of culturally and geographically adapted boating safety interventions for Inuvialuit communities and the importance of relinquishing colonial power structures and enabling community members to independently adapt and disseminate knowledge.

Plan A, Plan B, and Plan C-OVID-19: adaptations for fly-in and fly-out mental health providers during COVID-19.

Mental health providers have rapidly pivoted their in-person practices to teletherapy and telehealth interventions to address the increased demand for mental health services during the COVID-19 crisis. The change to service delivery has emphasised challenges for mental health service providers, particularly in regions that rely on fly-in and fly-out (FIFO) mental health service providers who are no longer able to travel to their places of work. In this qualitative study, we examined the impact of COVID-19 on the delivery of mental health services in Inuit Nunangat. Using a participatory action research methodology, we conducted semi-structured interviews with eight FIFO mental health service providers to understand their experiences and implement strategies to effectively deliver mental health services in a pandemic. We identified three themes through thematic analysis: 1) Service providers identify the challenges in adapting their practices to meet individual and community needs; 2) Service providers recognise the opportunities for enhancements to service delivery; 3) Service providers identify telemental health services as a potentially effective adjunct to in-person sessions. The findings support reconceptualising post-pandemic mental health service delivery to include both face-to-face and telemental health services.

Categorizing mothers' and fathers' conceptualizations of children's serious play-related injuries: "You won't grow a finger back".

BACKGROUND: There is inconsistency across child development and care literature in operationalizing serious play-related injury and also a lack of understanding of how mothers and fathers conceptualize serious play-related injury. The current study explores parents' perspectives of their 2- to 7-year-old children's serious play-related injuries in urban and rural areas of British Columbia and Québec, Canada, and provides an urban/rural and gender analysis of the results. METHODS: We conducted semistructured interviews with 41 mothers and 63 fathers from 57 families, a total of 104 participants, in urban and rural locations in British Columbia and Québec, Canada. We used a social constructionist approach to the research and reflexive thematic analysis to construct themes from participant responses and to inform the consequent categorizations of serious play-related injury. RESULTS: The results indicate four categories of parents' conceptualizations of serious play-related injury: (a) injury requiring medical intervention, (b) injury resulting in head trauma, (c) injury resulting in debilitation, and (d) broken bones. CONCLUSIONS: Child development and care advocates can use these categories to strengthen their communications with parents and to improve understanding of parents' conceptualizations of children's serious play-related injury.

Equity as the fourth 'E' in the '3 E's' approach to injury prevention.

The education, engineering and enforcement (3 E's) approach to injury prevention is grounded in assumptions that it is effective for everyone; however, evidence demonstrates that it fails to consider opportunities for all populations to experience safe and injury-free lives. In this way, the 3 E's approach does not support health equity in the injury prevention field. In this brief report, we argue that a fourth E, equity, must also be used with the 3 E's approach to injury prevention.

Community-based risk messaging in Inuvik, Northwest Territories, Canada.

Unintentional injuries are one of the leading causes of death worldwide, yet they are predictable and avoidable events. Community-based approaches to injury prevention are those where researchers and/or injury prevention specialists work alongside the target population to identify injury prevention issues and then co-create strategies that are relevant to the population. Community-based strategies differ from other approaches as they strive to conduct research with, rather than on marginalized groups. A community-based approach to social marketing, injury prevention and risk messaging was applied in Inuvik, Northwest Territories, Canada, to examine and address men's boating safety behaviours. Community participants identified the need for northern-based safety resources and a community-wide education campaign. As demonstrated through this example, community-based strategies should be considered for injury prevention, as the involvement of local community members may lead to more effective risk messaging that reflects the needs, culture, and experiences of the target group, while promoting healthy behaviours.

"This policy sucks and it's stupid:" Mapping maternity care for First Nations women on reserves in Manitoba, Canada.

First Nations women who live on rural and remote reserves in Canada leave their communities between 36 and 38 weeks gestational age to receive labor and birthing services in large urban centers. The process and administrative details of this process are undocumented despite decades of relocation as a routine component of maternity care. Using data from 32 semistructured interviews and information from peer-reviewed literature, grey literature, and public documents, I constructed a descriptive map and a visual representation of the policy. I present new and detailed information about Canada's health policy as well as recommendations to address the health care gaps identified.

Community-level factors that contribute to First Nations and Inuit older adults feeling supported to age well in a Canadian city.

Despite the proliferation of age-friendly cities in Canada that are intended to support older adults to age well, there are still many inequalities between groups of older adults, particularly, and of concern for this paper, between Indigenous older adults, who experience colonialism's ongoing impacts, and non-Indigenous older adults. A better understanding of factors that inform these inequalities will help in the development of policies and programs that better support Indigenous older adults to age well and, thus, will contribute to ameliorating the inequalities that they face. Using a community-based participatory research approach, informed by a postcolonial theoretical lens, in this paper we addressed the question, "what community-level factors contribute to Indigenous older adults (aged 55 years and over) feeling supported to age well in the city of Ottawa?" We specifically examined this question in relation to the age-friendly communities framework, which guides the City of Ottawa's Older Adult Plan. Thematic analysis of semi-structured interviews, focus groups, and photovoice with 32 First Nations and Inuit older adults revealed that the participants felt both supported and unsupported to age well. More specifically, there were two main areas in which they felt they could be better supported to age well: the social environment and physical environment. There were three subthemes within the social environment theme: responsive health and community support services, respect and recognition, and communication and information. Within the physical environment theme there were four subthemes: transportation, housing, accessibility, and gathering space. The results demonstrate that despite there being similarities in the areas that the participants felt they needed support and the areas on which the Older Adult Plan focuses, if the domains of aging well initiatives do not better account for the impacts of colonialism, it is unlikely that they will be effective in supporting Indigenous older adults' health and well-being.

"RIP KFC": Public Perceptions of a Fast-Food Restaurant Closure.

This paper used netnography and thematic analysis of the comments made in online news articles to understand better the public response to the closure of the only KFC restaurant in Yellowknife, Northwest Territories, Canada, in 2015. While the popular media often cover fast-food restaurant closures, past academic research has not examined the public response to these closures. To begin to fill this gap, we examined the comments sections of five online news articles from the Canadian news outlet, CBC.ca, and reactions shared on Facebook. 239 commenters made 308 publicly available online comments addressing the closure. Key themes in commenter perceptions included pro-closure reactions, which were based on the perceived public health benefits of reduced fast-food consumption, and anti-closure reactions to such factors as the loss of a local landmark and a source of positive memories. The unfavorable reactions appeared to pose a significant barrier to public acceptance of the KFC closure. This paper argues that it is important to examine public perceptions of fast-food closures to understand better what these restaurants mean to individuals and communities. This information, in turn, can be used to promote healthier restaurant-eating in ways that will complement efforts to encourage healthier food choices.