Health Sciences - Theses, Dissertations, and other Required Graduate Degree Essays

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A qualitative assessment of barriers to child and maternal health in the Rio Coco region of rural Nicaragua

Peer reviewed: 
No, item is not peer reviewed.
Date created: 
2010
Abstract: 

People living within the Rio Coco region of rural Nicaragua are vulnerable to poor health outcomes as a result of a multitude of barriers within their living environments. The purpose of this study is to understand local health needs and assets within the Rio Coco, and make recommendations for improving health. Local knowledge of health needs was collected through 41 semi-structured interviews with mothers and community health workers. The study describes how health within the communities is greatly constricted by factors within the context and environment, and how community feedback can be used to help identify effective points of action. The case study offers broader lessons learned regarding the importance of prioritizing local knowledge, and having mechanisms to mobilize and allocate funds at the local level. These findings offer insight into how child and maternal health can be better addressed in rural and remote communities.

Document type: 
Thesis
File(s): 
Supervisor(s): 
Nicole Berry
Department: 
Faculty of Health Sciences - Simon Fraser University
Thesis type: 
Project (M.P.H.)

Integrating physical and mental health promotion strategies

Peer reviewed: 
No, item is not peer reviewed.
Date created: 
2010
Abstract: 

While health is defined as ‘a state of complete physical, mental and social well-being’, physical and mental health have traditionally been separated. This paper explores the question: How can physical and mental health promotion strategies be integrated and addressed simultaneously? A literature review on why physical and mental health are separated and why these two areas need to be integrated was conducted. A conceptual framework for how to integrate physical and mental health promotion strategies was developed and applied to The Obesity Reduction Strategy for British Columbia. Through this analysis, it is argued that integrating physical and mental health promotion strategies is necessary to have the greatest impact on public health.

Document type: 
Thesis
File(s): 
Supervisor(s): 
Marina Morrow
Department: 
Faculty of Health Sciences - Simon Fraser University
Thesis type: 
Project (M.P.H.)

Perspectives on health disparities in cancer

Peer reviewed: 
No, item is not peer reviewed.
Date created: 
2010
Abstract: 

Purpose: The purpose of paper is to review the literature that explores health disparities in cancer and, by using the ‘multi-contextual framework’, to make sense of what is in the literature and what are the gaps in research in health disparities in cancer. Methodology: A mixed analysis (quantitative and qualitative) of the 120 selected studies was conducted. Two coding lists- one with inductive codes and one with deductive codes- were developed and used for categorizing the articles and their placement in two matrixes. A quantitative analyzes was conducted for the 59 articles included in ‘multi-contextual matrix’. Results: All 59 articles included in ‘multi-contextual matrix’ focus on contextual factors. Most articles address ‘cultural context’ (56%) and ‘socioeconomic context’ (32%). Less than 50% focus on ‘health care context’ and ‘demographic context’. The disparity types mainly researched are disparities in quality and access to health care (in 70% of studies).

Document type: 
Thesis
File(s): 
Supervisor(s): 
Stephen Corber
Department: 
Faculty of Health Sciences - Simon Fraser University
Thesis type: 
Project (M.P.H.)

Public health costs of electricity shortage: a Ghanaian case study

Peer reviewed: 
No, item is not peer reviewed.
Date created: 
2010
Abstract: 

Health of the population as much depends on health system infrastructure as it does on other factors. Electricity is an important part of a community’s infrastructure. Although the role of electricity in people’s lives has been continuously mentioned in various literatures, the magnitude of its impacts on public health has been mostly ignored. Electricity interruptions results in inefficient healthcare delivery and hinders goals aimed at improving the health of the population. There is no reference to energy in any of the eight Millennium Development Goals (MDGs); however, it has been suggested that “none of the MDGs can be met without major increases in the quality and quantity of energy services in developing countries” (UNDP, 2004). The purpose of this paper is to use Ghana’s case to demonstrate that electricity is an important determinant of health and that it should be included in the list of 150 WHO health indicator.

Document type: 
Thesis
File(s): 
Supervisor(s): 
D
Department: 
Faculty of Health Sciences - Simon Fraser University
Thesis type: 
Project (M.P.H.)

Controlling antibiotic misuse and overuse: a review of campaigns that promote the rational use of antibiotics in the Americas and Spain

Author: 
Peer reviewed: 
No, item is not peer reviewed.
Date created: 
2009
Abstract: 

The project’s objective was to review what types of community educational interventions have been conducted by health ministries, non-governmental organizations, and research teams to improve antibiotic use in countries with significant Spanish-speaking populations. I conducted a web-based survey to retrieve educational campaign materials promoting the appropriate use of antibiotics in communities in the Americas and Spain. Public health agencies in 10 countries (Bolivia, Chile, Ecuador, Nicaragua, Paraguay, Peru, Spain, Venezuela, Canada, USA) and six non-governmental organizations (PAHO, APUA, USAID, SAIDI, ReAct, AIS) produced materials promoting the rational use of antibiotics (RUA). Key campaign messages focused on: explaining bacteria, viruses, bacterial resistance, and antibiotics; outlining risks associated with self-medication; protecting the existing stock of medications; consulting a health-care professional; and handwashing. Although numerous Spanish-speaking countries promote RUA, more comprehensive, multifaceted efforts are needed to address the regulatory and organizational factors that lead to the development of antibiotic resistance.

Document type: 
Thesis
File(s): 
Supervisor(s): 
Kitty Corbett
Department: 
Faculty of Health Sciences - Simon Fraser University
Thesis type: 
Project (M.Sc.)

Breaking down barriers by knocking on doors: an innovative health intervention in Vancouver's downtown eastside.

Peer reviewed: 
No, item is not peer reviewed.
Date created: 
2009
Abstract: 

In August 2007 Vancouver Coastal Health Authority (VCH) implemented the Clinical Housing Team (CHT) intervention aimed at improving the health of tenants residing in low barrier housing in Vancouver’s downtown eastside (DTES). In April 2008 a preliminary program evaluation was carried out in order to assess the impact of the intervention. The resulting report was intended for use within VCH and was focused on the specific intervention that was evaluated. Hence, the report did not provide an in depth discussion of findings beyond the specific intervention that was evaluated. The current paper aims to provide a more in depth examination of findings from the evaluation from a population health perspective. Included is a review of relevant literature, an overview of the original CHT evaluation, and a discussion including areas for future research, implications of findings from the CHT evaluation, and recommendations.

Document type: 
Thesis
File(s): 
Supervisor(s): 
Julian Somers
Department: 
Faculty of Health Sciences - Simon Fraser University
Thesis type: 
Project (M.P.H.)

Being open: exploring primary health care services for women who sell sex and do high risk drugs in Vancouver

Author: 
Peer reviewed: 
No, item is not peer reviewed.
Date created: 
2009
Abstract: 

Women who sell sex and do high risk drugs in Vancouver’s Downtown Eastside have comprehensive primary health care needs. There is evidence that primary health care agencies can also be loci of social capital building in communities with a large multiply-marginalized population. This research identifies how agency-level determinants act as barriers and facilitators to the uptake of care as well as to identify how these can enable or impede the development of social capital among women clients who sell sex and do high risk drugs. Fifteen interviews were conducted with primary health care providers and key informants. Data were analyzed using a modified warranted assertion method. Eleven agency-level determinants were identified. The study offers valuable insights into how sex workers who do high risk drugs can become agents in their own care and community experience, and how agencies can be reconfigured to facilitate uptake of primary care by these women.

Document type: 
Thesis
File(s): 
Supervisor(s): 
J
Department: 
Faculty of Health Sciences - Simon Fraser University
Thesis type: 
Project (M.P.H.)

Supporting indoor commercial sex worker’s (CSW) access to HIV/STI services.

Peer reviewed: 
No, item is not peer reviewed.
Date created: 
2009
Abstract: 

Background: Indoor CSW are at high risk for HIV/STI. They are invisible to the public and often ignored by service and research. Many CSW in Vancouver are migrant therefore it is critical to recognize their unique cultural characteristics determining risk. Community led initiative supports indoor CSW access to health services. Methods: In collaboration with a local AIDS service organization a survey was developed to elicit sociodemographic information, HIV/STI knowledge, and health information. Results: From Aug‘06 - Sept ’08, 129 surveys were completed by indoor CSW. 59% were migrant women primarily from Asia (79%). Inconsistent condom use, high rates of unplanned pregnancy, together with low HIV/STI knowledge scores show that indoor CSW in the sample are not adequately protected against HIV/STI. Conclusions: The development of community partnerships has been critical in gaining access and trust with the indoor CSW population. Local community organizations serve as an important bridge to public health.

Document type: 
Thesis
File(s): 
Supervisor(s): 
Bob Hogg
Department: 
Faculty of Health Sciences - Simon Fraser University
Thesis type: 
Project (M.Sc.)

The justice system as a public health instrument: does the Drug Treatment Court of Vancouver change patterns of health services utilization for drug-addicted criminal offenders?

Peer reviewed: 
No, item is not peer reviewed.
Date created: 
2009
Abstract: 

It is well established that despite a broad range of complex health needs, substance-abusing individuals do not use health services in a consistent, efficient manner. While drug courts have proliferated across North America as a means of addressing substance abuse and reducing criminality, their potential role in improving the health of drug-addicted criminal offenders has remained largely ignored. The current study examines the Drug Treatment Court of Vancouver’s impact on participants’ patterns of health services utilization for those entering the court between December 2001 and March 2004. While results suggest that drug court participants were alienated from health services, and generally remained so even after involvement with the drug court, they also indicate that the court may have influenced the way in which participants engaged with the health system, particularly in relation to substance-use related health services. Further research into the potential health benefits of this judicial intervention is required.

Document type: 
Thesis
File(s): 
Supervisor(s): 
J
Department: 
Faculty of Health Sciences - Simon Fraser University
Thesis type: 
Thesis (M.P.H.)

Child labour in tobacco production: children's experiences and tobacco companies' corporate social responsibility initiatives

Author: 
Peer reviewed: 
No, item is not peer reviewed.
Date created: 
2009
Abstract: 

An estimated 78,000 children are working under hazardous conditions in tobacco production in Malawi. Without access to protective clothing or cleaning facilities, these children are suffering from the effects of pesticides, fertilizers and nicotine whilst working on tobacco farms for 12 hours a day. Two of the main multinational tobacco companies with production interests in Malawi, British American Tobacco and Philip Morris International, have responded to the public demand for ethical operating standards by developing business codes and corporate social responsibility (CSR) initiatives. This project, comparing the two tobacco companies' CSR initiatives with the lived experience of former child labourers in Malawi, shows that tobacco companies' statements of compliance with universal standards on health and safety and statements addressing the child labour issue have not translated into better child health outcomes.

Document type: 
Thesis
File(s): 
Supervisor(s): 
S
Department: 
Faculty of Health Sciences - Simon Fraser University
Thesis type: 
Project (M.P.H.)