Understanding racialised older adults' experiences of the Canadian healthcare system, and codesigning solutions: protocol for a qualitative study in nine languages.

INTRODUCTION: Racialised immigrant older adults (RIOAs) in Canada have poorer self-rated health and are more likely to report chronic conditions, while they concurrently experience well-documented challenges in navigating and accessing the healthcare system. There is strong evidence that patient and caregiver engagement in their healthcare leads to improved management of chronic disease and better health outcomes. International research suggests that engagement has the potential to reduce health disparities and improve quality of care. We aim to (1) describe what role(s) RIOAs are/are not taking in their own healthcare, from the perspectives of participant groups (RIOAs, caregivers and healthcare providers (HCPs)); and (2) develop a codesign process with these participants, creating linguistically aligned and culturally aligned tools, resources or solutions to support patient engagement with RIOAs. METHODS AND ANALYSIS: Using a cross-cultural participatory action research approach, our work will consist of three phases: phase 1, strengthen existing partnerships with RIOAs and appropriate agencies and cultural associations; phase 2, on receipt of informed consent, in-depth interviews with RIOAs and caregivers (n=~45) and HCPs (n=~10), professionally interpreted as needed. Phase 3, work with participants, in multiple interpreted sessions, to codesign culturally sensitive and linguistically sensitive/aligned patient engagement tools. We will conduct this research in the Waterloo-Wellington region of Ontario, in Arabic, Bangla, Cantonese, Hindi, Mandarin, Punjabi, Tamil and Urdu, plus English. Data will be transcribed, cleaned and entered into NVivo V.12, the software that will support team-based analysis. Analysis will include coding, theming and interpreting the data, and, preparing narrative descriptions that summarise each language group and each participant group (older adults, caregivers and HCPs), and illustrate themes. ETHICS AND DISSEMINATION: Ethics clearance was obtained through the University of Waterloo Office of Research Ethics (ORE #43297). Findings will be disseminated through peer-reviewed publications, presentations and translated summary reports for our partners and participants.

#BodyPositive? A critical exploration of the body positive movement within physical cultures taking an intersectionality approach.

Feminist activists and critical sport scholars in the global north have advocated for more inclusive representation of bodies and more accessible physical cultures. Body positivity, a contentious movement and concept, has been taken up in various ways by different groups. Some scholars believe it holds power to liberate individuals from patriarchal, neoliberal, capitalist, and colonial ideologies of what constitutes a "good" body. On the contrary, critics assert this movement has been gentrified by white-centered politics. Intersectionality has a similar genealogy as body positivity, with a rich history in Black feminist thought but now considered by many as coopted and whitened. In this article, we trace the rich and divergent legacies of both movements and explore at the structural level how body positivity is represented within physical cultures on Instagram. We use a social-justice oriented intersectionality framework exploring #BodyPositivity and #BodyPositive across a total of 141 posts using reflexive thematic analysis. We organize our findings into four themes: 1) Disclosure-Privilege of Body-Related Journeys; 2) The Absent-Present; 3) Consuming Positivity; and 4) Disrupting Normative Body Positivity Posts. Overall, we found that only certain bodies (and transformations) were visible within the data: those of (now) lean, white, cis-gendered individuals, many of whom were engaged in bodybuilding, and who were sharing their bodily transformation. We observe a remarkable absence of BIPOC, 2S LGBTQAI+, fat/thick/thicc/curvy, older, gender-nonconforming, and/or disabled representations. We also note the myriad ways that body positivity has been commodified and packaged into a product or service for consumption. Lastly, we outline and celebrate the exceptions to this norm where a minority of posts align more closely with the original intentions of the body positivity movement. We conclude with our position on how to do intersectionality research, and call on researchers to honor Black feminist origins and rich social justice history in these movements.

The Impact of COVID-19 on Older Adults' Perceptions of Virtual Care: Qualitative Study.

BACKGROUND: In response to the COVID-19 pandemic, older adults worldwide have increasingly received health care virtually, and health care organizations and professional bodies have indicated that virtual care is "here to stay." As older adults are the highest users of the health care system, virtual care implementation can have a significant impact on them and may pose a need for additional support. OBJECTIVE: This research aims to understand older adults' perspectives and experiences of virtual care during the pandemic. METHODS: As part of a larger study on older adults' technology use during the pandemic, we conducted semistructured interviews with 20 diverse older Canadians (mean age 76.9 years, SD 6.5) at 2 points: summer of 2020 and winter/early spring of 2021. Participants were asked about their technology skills, experiences with virtual appointments, and perspectives on this type of care delivery. Interviews were digitally recorded and transcribed. A combination of team-based and framework analyses was used to interpret the data. RESULTS: Participants described their experiences with both in-person and virtual care during the pandemic, including issues with accessing care and long gaps between appointments. Overall, participants were generally satisfied with the virtual care they received during the pandemic. Participants described the benefits of virtual care (eg, increased convenience, efficiency, and safety), the limitations of virtual care (eg, need for physical examination and touch, lack of nonverbal communication, difficulties using technology, and systemic barriers in access), and their perspectives on the future of virtual care. Half of our participants preferred a return to in-person care after the COVID-19 pandemic, while the other half preferred a combination of in-person and virtual services. Many participants who preferred to access in-person services were not opposed to virtual care options, as needed; however, they wanted virtual care as an option alongside in-person care. Participants emphasized a need for training and support to be meaningfully implemented to support both older adults and providers in using virtual care. CONCLUSIONS: Overall, our research identified both perceived benefits and perceived limitations of virtual care, and older adult participants emphasized their wish for a hybrid model of virtual care, in which virtual care is viewed as an addendum, not a replacement for in-person care. We recognize the limitations of our sample (small, not representative of all older Canadians, and more likely to use technology); this body of literature would greatly benefit from more research with older adults who do not/cannot use technology to receive care. Findings from this study can be mobilized as part of broader efforts to support older patients and providers engaged in virtual and in-person care, particularly post-COVID-19.