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

Receive updates for this collection

Measuring coordination and integration in chronic disease care: tailoring evaluation tools for North Shore Chronic Disease Services

Date created: 
2010-12-15
Abstract: 

Measuring coordination and integration within and between programs in chronic care is an evaluation strategy underutilized in health care. North Shore Chronic Disease Services (NSCDS) is an example of a coordinated approach to chronic disease care in British Columbia. In 2009, NSCDS planned a comprehensive evaluation strategy, including a tool to measure coordination and integration between and within acute, chronic and community programs. This paper extrapolates from this section of evaluation work and proposes a tailored, quantitative evaluation tool to measure the actual degree of coordination and integration of NSCDS to other community programs. The process of tailoring this tool is presented and the implications for population and public health practice in relation to chronic disease management and program evaluation are also discussed.

Document type: 
Graduating extended essay / Research project
File(s): 
Senior supervisor: 
Stephen Corber
Department: 
Health Sciences: Faculty of Health Sciences
Thesis type: 
(Project) M.P.H.

Participatory research with street-involved youth in the Youth Injection Prevention Project (YIP)

Author: 
Date created: 
2010-11-23
Abstract: 

Youth participation in research has become increasingly popular, though there is still a paucity of examples in the literature that offer insight into the challenges and opportunities that such an endeavour offers. This is particularly true of research that includes street-involved populations of youth. This paper explores the experiences of six youth in the Youth Injection Prevention Project (YIP), a community-based research project with street-involved youth in the Metro Vancouver Region, using a positive youth development approach and a resiliency and empowerment framework. Although there were many challenges to the collaboration, including issues of time commitment and expenditure as well as overcoming youth’s personal barriers to participation, the results of the YIP project demonstrate that meaningful participation in research can offer youth important avenues to develop employability skills, promote resiliency, empowerment and wellness.

Document type: 
Graduating extended essay / Research project
File(s): 
Senior supervisor: 
Nicole Berry
Department: 
Health Sciences: Faculty of Health Sciences
Thesis type: 
(Project) M.P.H.

Promoting early childhood development in developing countries: the research and perspectives of experts

Author: 
Date created: 
2010-11-26
Abstract: 

Early childhood is a critical period of human development, during which the rapidly developing brain and nervous system are sensitive to negative exposures, such as malnutrition, toxins, stress, lack of nurturing and brain stimulation. Many risk factors for early childhood development (ECD) have been associated with poverty, and an increased risk of poor health, education, and economic outcomes later in life. Cost-effective interventions do exist, but action in developing countries has been slow. Key informant interviews were conducted to explore the obstacles to promoting ECD in developing countries. The most prominent obstacles identified related to the challenges facing the international ECD field itself, and included: lack of clarity on operationalizing and measuring interventions; lack of health sector involvement; and lack of engagement in political advocacy. This study indicates clear recommendations for the ECD field to build its own capacity to better promote ECD in developing countries.

Document type: 
Graduating extended essay / Research project
File(s): 
Senior supervisor: 
Stephen Corber
Department: 
Health Sciences: Faculty of Health Sciences
Thesis type: 
(Project) M.P.H.

The intervention level framework: using systems thinking to address the complexity of childhood obesity prevention

Date created: 
2010-12-13
Abstract: 

Childhood obesity has generated a considerable response from policymakers in Canada and abroad, resulting in the production of numerous strategies containing recommendations for action. This abundance of proposed activity can be overwhelming for public health practitioners seeking to best invest resources. Complexity science has been proposed as a means to assist public health in moving forward on this issue. The Chronic Disease Systems Modeling Lab at SFU has developed the 5 level Intervention Level Framework (ILF), based on the work of Donella Meadows, as a means of sorting and analyzing recommendations to address complex health problems from a complex systems perspective. In this study the ILF is applied to a sub-set of childhood obesity recommendations in order to assess its strengths and weaknesses for a broader analysis. Finessing the ILF will contribute to the field of systems based methodological inquiry and will further the study of complex public health problems.

Document type: 
Graduating extended essay / Research project
File(s): 
Senior supervisor: 
Stephen Corber
Department: 
Health Sciences: Faculty of Health Sciences
Thesis type: 
(Project) M.P.H.

The association of preterm birth with area-level deprivation and individual-level factors in the Vancouver census metropolitan area

Date created: 
2010-11-23
Abstract: 

Evidence suggests area-level socioeconomic inequalities in adverse birth outcomes including preterm birth (PTB), one of the most important causes of perinatal mortality and morbidity throughout the life-course. This study analyzed inequality in PTB in live, singleton births in the Vancouver Census Metropolitan Area from 2006 to 2009 by area-level deprivation measures, and assessed the degree to which individual-level variables might indicate pathways through which area-level disparities manifest. Area-level material, but not social, deprivation was associated with higher odds of PTB. The relative odds of PTB by area-level material deprivation and known individual-level risk factors were modelled using hierarchical logistic regression. After adjusting for individual-level factors, the inequality in PTB by material deprivation was attenuated but not eliminated. Individual-level risk factors may, in part, be pathways through which this association manifests. However, future research and discussion should consider the potential interactions between individuals, environments and policies, and their possible effects on perinatal health.

Document type: 
Graduating extended essay / Research project
File(s): 
Senior supervisor: 
Scott Venners
Department: 
Health Sciences: Faculty of Health Sciences
Thesis type: 
(Project) M.P.H.

Association between the density of food environment and obesity in eight communities in and around Vancouver

Author: 
Date created: 
2010-12-13
Abstract: 

Obesity is a growing health concern in Canada and worldwide. The role of environmental factors in obesity has recently been the centre of attention of some researchers. The purpose of this study was to examine whether the density of food environment is associated with BMI and WC of adults aged 35 to 70 years who reside in eight communities in and around Vancouver. In this cross-sectional study, a total of 1393 men and women were recruited. Multiple linear regression analysis adjusted for socio-demographic factors were run to test the associations between the density of food environment and BMI and WC. The density of convenience stores and baked goods stores had a significant positive association with adult BMI while the density of limited-service restaurants showed negative association with BMI. Further, the density of convenience stores was positively associated with WC, while the density of specialty stores and limited-service restaurants were negatively associated with WC.

Document type: 
Graduating extended essay / Research project
File(s): 
Senior supervisor: 
Scott Lear
Department: 
Health Sciences: Faculty of Health Sciences
Thesis type: 
(Project) M.P.H.

Addressing smoking cessation among pregnant Aboriginal women: challenges and gaps in knowledge

Author: 
Date created: 
2010-12-20
Abstract: 

The high prevalence of smoking among pregnant Aboriginal women – including First Nations, Inuit and Métis women - has been identified as a public health concern in Canada. There is a paucity of research exploring socio-cultural influences on maternal smoking cessation and culturally appropriate interventions for Aboriginal women. Aboriginal people embrace a holistic view that reflects the interrelatedness of the physical, spiritual, emotional and mental dimensions of health. These must be acknowledged when addressing smoking cessation. In order to address the high prevalence of Aboriginal women who smoke during pregnancy there is a need for a better understanding of women’s experiences of smoking during pregnancy and their own knowledge, beliefs and personal barriers with regard to quitting smoking. The purpose of this paper is to identify the challenges and knowledge gaps in addressing Aboriginal maternal smoking cessation, in addition to proposing specific culturally appropriate recommendations for future research.

Document type: 
Graduating extended essay / Research project
File(s): 
Senior supervisor: 
Stephen Corber
Department: 
Health Sciences: Faculty of Health Sciences
Thesis type: 
(Project) M.P.H.

Becoming Baby-Friendly: Increasing breastfeeding exclusivity and duration rates through Vancouver's community health services

Date created: 
2010-12-06
Abstract: 

Despite recent gains in breastfeeding initiation and ongoing public health recommendations for exclusive breastfeeding during the first six months of an infant’s life, breastfeeding exclusivity and duration rates remain suboptimal in Vancouver and across Canada. In an effort to establish breastfeeding as the cultural norm for women, children, and families, Vancouver Coastal Health (VCH) recently developed a VCH-wide policy and guidelines about the feeding of healthy term infants. This paper describes what is known about breastfeeding rates in Vancouver, the research evidence on effective breastfeeding promotion activities in community settings, and Vancouver Community (VC) considerations related to promotion of breastfeeding to inform the planning process for policy implementation in VC health services. Recommendations include maintaining and enhancing targeted programs emphasising lay support and culturally relevant programming, developing advocacy strategies on the social determinants of health including the promotion of supportive labour market policies, and collaborative data collection strategies.

Document type: 
Graduating extended essay / Research project
File(s): 
Senior supervisor: 
Michael Hayes
Department: 
Health Sciences: Faculty of Health Sciences
Thesis type: 
(Project) M.P.H.

In search of reason: prevention of mother-to-child transmission (PMTCT) failures in the era of programmatic scale-up in Soweto, South Africa

Date created: 
2010-10-04
Abstract: 

The 2008 scale-up of South African public sector prevention of mother-to-child transmission (PMTCT) to an AZT/sdNVP regimen led to significant reductions in vertical HIV transmission, yet incident paediatric infections continue. The objectives of this study were to 1) identify mothers of newly HIV-infected infants, and assess whether they received per-guideline PMTCT antiretroviral (ARV) regimens, and 2) qualitatively explore contextual factors contributing to these prescription failures and MTCT risk. Eligible women included birthmothers of HIV-infected infants in Soweto. Participants (n=45) first completed a questionnaire, and then a focus group or structured interview. Through triangulation of data, it was determined that 29 mother-infant pairs (64%) did not receive per-guideline PMTCT ARV regimens. Identified issues of importance include preterm birth, delayed antenatal care attendance, operational difficulties implementing PMTCT, and HIV-related stigma. While improved PMTCT regimens are available, social and structural factors must be addressed to ensure access to and uptake of prevention services.

Document type: 
Graduating extended essay / Research project
File(s): 
Senior supervisor: 
Cari Miller
Department: 
Health Sciences: Faculty of Health Sciences
Thesis type: 
(Project) M.P.H.

The evaluation of Vancouver Coastal Health's strategic plan to reduce head injuries on the North Shore: how does it measure up to accepted standards?

Date created: 
2010-12-01
Abstract: 

In 2010, Vancouver Coastal Health’s (VCH) North Shore (NS) division and the NS Injury Prevention Community Action Committee created a Strategic Plan to reduce head injuries on the NS, but planning for an evaluation of the program was not completed. Evaluation is a vital component in any public health program and this project aims to generate an evaluation for VCH’s Strategic Plan. This project outlines what program evaluation entails, including the types, steps and standards of evaluation. It considers the components of previous injury prevention program evaluations to better inform the design of an appropriate evaluation for the head injury program. The paper presents an evaluation plan based on Patton’s utilization-focused approach (Patton 2008) and designed using the US Center for Disease Control’s (CDC) evaluation framework. The evaluation plan is then examined against the CDC’s four evaluation standards recommended by the CDC: utility, feasibility, propriety, and accuracy.

Document type: 
Graduating extended essay / Research project
File(s): 
Senior supervisor: 
Stephen Corber
Department: 
Health Sciences: Faculty of Health Sciences
Thesis type: 
(Project) M.P.H.