Health Sciences Capstone Projects

Receive updates for this collection

Mixed Methods Evaluation of Community-Run Water Desalination Plant Project in Coastal Bangladesh

Author: 
Peer reviewed: 
No, item is not peer reviewed.
Date created: 
2016-08
Abstract: 

The effects of climate change on water security have become increasingly apparent with the increasing salt contamination of freshwater sources in coastal Bangladesh. In 2011, the Climate Change and Health Promotion Unit (CCHPU) of the Bangladesh Ministry of Health and Family Welfare began its response to this problem through the installation of small-scale reverse osmosis desalination plants in 10 villages of Satkhira district, using a Community Based Adaptation Private-Public Partnership model (CBA-PPP) with support from World Bank. The purpose of this paper is to evaluate the implementation of this model in terms of clean water accessibility, health impact and long-term sustainability of operations. Primary data was collected from focus group discussions with water collectors and project committee members at plants in Nalta Sharif and Nowapara villages. Secondary data on sub-district waterborne diarrhea admission rates were obtained from the Institute for Epidemiology, Disease Control and Research (IEDCR) and total diagnosis rates of waterborne illnesses in the sub-district of Debhata were acquired from Debhata Health Complex. In Nalta Sharif, participants found supply of water, long wait times and limited hours at which water could be retrieved to be the most significant barriers to accessibility. However, in Nowapara, it was found that financial constraints, largely due to electricity costs, were the main barrier to access. In both villages, participants observed a noticeable reduction in waterborne illness rates since the plants became operational. This was supported by the surveillance data from Debhata, which showed significant reductions in rates of all waterborne illness rates that were monitored. Thus, the intervention was found to be effective in reducing waterborne illness rates, but was inadequate in meeting the drinking water demand for the communities. Long-term sustainability was a major issue in both communities, emphasizing the importance of financial planning for the survival of such projects.  

Document type: 
Graduating extended essay / Research project
File(s): 
Supervisor(s): 
Tim Takaro
Department: 
Health Sciences

Somali Women's Experiences with Obstetrician Care Providers During Childbirth in Canada

Author: 
Peer reviewed: 
No, item is not peer reviewed.
Date created: 
2016
Abstract: 

Introduction: In the context of international migration, an increasing number of women from countries that traditionally practice FGC have immigrated to Canada (Perron et al., 2013). Given these demographic shifts, it is necessary to provide appropriate reproductive care to newcomer women who have undergone FGC, and to do this it is important to understand women’s perceived childbirth experiences Methods: The purpose of this study was to explore how Somali women who have undergone FGC perceive their experiences with childbirth and their interaction with obstetrician care providers in British Columbia. The study used qualitative method of focus group interviews. Results: Thematic analysis was conducted and 5 main themes were identified, including: preference for a natural birth; health care provider interaction; clinical care for FGC including vaginal examinations, de-infibulation, re-infibulation; desire for greater decision making capacity and differences in biomedical and Somali cultural practices. Discussion: The results show that there still remain largely unmet needs regarding appropriate clinical care for FGC and provider-patient interaction. In particular, there is tension between Somali women’s preference for a natural birth and perceived extra interventions by obstetricians. Furthermore, the Somali women reported dissatisfaction with aspects of the clinical management of FGC during delivery, particularly the timing of de-infibulation. Improving patient-provider communication and addressing issues of power-asymmetry could mitigate tensions, improve trust and reduce dissatisfaction experienced by Somali women during the childbirth experience. 

Document type: 
Graduating extended essay / Research project
File(s): 
Supervisor(s): 
Nicole S. Berry
Department: 
Health Sciences

An Analysis of the Differences in the Canadian and US Guidelines for Depression Screening Among Adults in the General Population: Potential Impact of These Different Recommendations at the Population Level

Author: 
Peer reviewed: 
No, item is not peer reviewed.
Date created: 
2016-06
Document type: 
Graduating extended essay / Research project
File(s): 
Supervisor(s): 
Michel Joffres
Department: 
Health Sciences

Developing Effective HIV Prevention, Treatment and Support Programs for African, Caribbean and Black (ACB) Communities in Canada

Peer reviewed: 
No, item is not peer reviewed.
Date created: 
2016-06
Abstract: 

Developing effective HIV prevention, treatment and support programs for African, Caribbean and Black (ACB) communities in Canada is of increasing importance. While ACB communities comprise only 2.5% of Canada’s population, they account for 14% of all HIV infections (PHAC, 2014). In addition, people from HIV-endemic countries living in Canada have HIV incidence rates six times higher than the general population (ACCHO, 2009). Research shows that people from HIV-endemic countries living with, and affected by, HIV/AIDS face unique cultural and social barriers beyond those experienced by Canadian-born individuals affected by the epidemic (African and Caribbean Council on HIV/AIDS, 2003). African and Caribbean communities in Canada are also more likely to experience barriers to successful implementation of HIV treatment, prevention and risk-reduction programs (Campbell, 2009). The majority of research on African, Caribbean and Black communities in Canada has focused on understanding the risk factors for HIV infection (Shimeles et al., 2010). Relatively few studies have examined effective strategies for improving prevention and treatment efforts and engaging ACB communities in the design and delivery of HIV/AIDS programs and services. The purpose of this literature review was to critically appraise the academic and grey literature to identify strategies for improving HIV prevention, treatment and support services among ACB communities in Canada. Eleven strategies were identified: formation and strengthening of government strategies; expand outreach to ACB communities; address stigma and discrimination; address the criminalization of HIV non-disclosure; improve involvement of ACB communities and PLHIV specifically; enhance collaboration within the HIV service sector; address the social determinants of health; ensure resources available for work needed; expand and enhance service provision; and collection of ethno-specific surveillance data. The findings from this review can be used to inform policies, programs, service delivery and further research that strengthen our response to the HIV/AIDS epidemic among African, Caribbean and Black communities in Canada.

Document type: 
Graduating extended essay / Research project
File(s): 
Supervisor(s): 
John O'Neil
Department: 
Health Sciences

Reframing "Aging in Place" to "Aging in Community": Exploring Innovative Models to Support Aging in Place in British Columbia

Author: 
Peer reviewed: 
No, item is not peer reviewed.
Date created: 
2016-06
Abstract: 

British Columbia (B.C.) currently has the fastest growing rate of seniors compared to any other jurisdiction across Canada. While the senior population is diverse, a commonality that exists among seniors is their desire to continue to age within their homes and communities. However, the accessibility and availability of home support services, as well as issues in housing are creating barriers, and continue to contribute to premature placement into residential care, caregiver burnout, and overuse of acute care services. A literature review was conducted to assess the current state of home support and housing in B.C., and possible solutions are explored drawing on two innovative community based models of aging in place (Village model and Naturally Occurring Retirement Communities, Supportive Service Program). Reframing ‘aging in place’ to ‘aging in community’ by emphasizing social capital offers possible solutions to support B.C seniors to age healthily and safely with in their homes and communities.

Document type: 
Graduating extended essay / Research project
File(s): 
Supervisor(s): 
Julian Somers
Department: 
Health Sciences

A Process Evaluation of the Newcomer Women's Health Clinic

Author: 
Peer reviewed: 
No, item is not peer reviewed.
Date created: 
2016-06
Abstract: 

The Newcomer Women’s Health Clinic (NWHC) was opened in 2014 to bridge a gap in services for newcomer women to Canada residing in Metro Vancouver. Since opening, the NWHC has been underutilized, operating at 50% capacity. A process evaluation was conducted to understand clinic utilization and what potential barriers exist for newcomer women accessing health services. Evaluation data was collected via patient intake forms (N=107), patient feedback surveys (N=31), and one to one interviews with newcomer women (N=7) and with service providers who work with newcomer women (N=8). Quantitative data from intake forms and surveys provided an overview of the sociodemographic characteristics of patients, while qualitative data from open-ended survey questions and interviews provided more nuanced insight into barriers that may contribute to the underutilization of the clinic. Overall, newcomer women and service providers consider the clinic a valuable service, but lack of knowledge and promotion of the NWHC arose as a common theme in surveys and interviews. Additional themes identified through interviews include language and location barriers, differing perspectives of health and health seeking behaviours, difficulty navigating health systems and services, and social isolation and social networks. With approximately 40,000 newcomer women immigrating to BC from out of country every year, the NWHC has the potential to meet a substantial need and provide health services to a population commonly experiencing individual, social, and structural barriers to health. Recommendations are provided to help improve the delivery of services and contribute to a rich and ongoing dialogue concerning the diversity of experiences of newcomer women in Canada.

Document type: 
Graduating extended essay / Research project
File(s): 
Supervisor(s): 
Denise Zabkiewicz
Department: 
Health Sciences

Night Shift Work and Female Cancers, A Literature Review

Peer reviewed: 
No, item is not peer reviewed.
Date created: 
2017
Document type: 
Graduating extended essay / Research project
File(s): 
Supervisor(s): 
Tim Takaro
Department: 
Health Sciences: Faculty of Health Sciences

Estimating the Joint Effect of Endocrine Disrupting Chemical Mixtures on Fetal Growth Using Bayesian Hierarchical Linear Regression Modeling: The HOME Study

Author: 
Peer reviewed: 
No, item is not peer reviewed.
Date created: 
2016-04
Abstract: 

Background: Pregnant women are exposed to endocrine disrupting chemicals (EDCs) through prolonged contact with personal care products, food containers and plastics. Gestational exposure to EDCs may be associated with changes in birth weight and fetal growth, placing children at risk for negative outcomes later in life. Objective: To examine the association between gestational exposure to four EDC classes (phthalates, polychlorinated biphenyls (PCBs), polyfluorinated compounds (PFCs) and polybrominated diphenyl ethers (PBDEs)) and infant birth weight. Methods: Using data from the Health Outcomes and Measures of Environment (HOME) study, 2003-2006 (n=387), we used Bayesian Hierarchical Linear Regression Modeling (BHLM) to examine the associations between four EDC classes and birth weight. Results: Colinearity among the chemical concentrations was severe with correlations as large as 0.98. In BHLM analyses that shrunk the beta coefficients towards the class-specific mean. We found that no individual metabolites from any of the four EDC classes were associated with birth weight. In the BHLM, the parameter μβ was the average beta coefficient within a chemical class (e.g. phthalates) in relation to birth weight. For a 10-fold increase in chemical concentration, the μβ values were respectively, 0.89g for phthalates, -1.48g for PCBs, -15.8g for PFCs and -2.14 for PBDEs. In order to put these effect sizes in context, we examined the relative impact of chemical exposure on birth weight versus the effect of poverty on birth weight, based on a Bayesian analysis of four socioeconomic (SES) indicators: low income, low education, no private health insurance, and unemployment. For SES, the estimated value of μβ was -63.1g. Thus poverty had a larger association with lower birth weight than gestational chemical exposure as measured by a multiplicative factor of x121 for phthalates, x193 for PCBs, x36.1 for PFCs, and x157 for PBDEs. Conclusion: Gestational exposure to phthalates, PCBs, PFCs or PBDE had only small associations with differences in birth weight among the HOME study participants. In particular, the average association between gestational EDC exposure and birth weight is approximately 36.1 to 193 times smaller than the effect of poverty on birth weight. While no μβ values attained significance, three were negative. PFCs and phthalates have the greatest associations with birth weight (one negative, one positive). The phthalate and PFC EDC classes, taken within the context of SES, should be considered for closer study.

Document type: 
Graduating extended essay / Research project
File(s): 
Department: 
Health Sciences: Faculty of Health Sciences

From Words to Action: Comparing the Disparities Between National Drug Policy and Local Implementation in Tijuana, Mexico and Vancouver, Canada

Peer reviewed: 
No, item is not peer reviewed.
Date created: 
2016-04
Abstract: 

In 2009, Mexico passed a national drug policy reform decriminalizing the possession of small amounts of certain drugs for personal use with the aim of diverting drug-dependent individuals from prison and towards addiction treatment. However, the public health approach codified by the reform has not yet led to a meaningful change in local police practices nor contributed to the meaningful scale-up of harm reduction and addiction treatment services in many Mexican cities. Specifically, in Tijuana, Baja California, there continues to be a variety of local level barriers – including arbitrary police behaviours – that hinder the ability of people who inject drugs (PWID) from accessing vital harm reduction services. This has implications for the growing HIV epidemic in Mexico’s northern border region, given that access to harm reduction interventions has been shown to effectively reduce the risk of HIV infection among PWID. In contrast to the largely enforcement-based local response seen in Tijuana, the municipal Four Pillars approach implemented in Vancouver, Canada in 2001 was passed as a public-health oriented response to the rising prevalence of HIV/AIDS among PWID in the Downtown Eastside of Vancouver. Centered on the balancing of four approaches – harm reduction, treatment, prevention and enforcement – the Four Pillars approach in Vancouver has led to a well-resourced local harm reduction and addiction treatment system. This local emphasis on harm reduction contrasts with the Canadian Conservative federal government’s opposition to harm reduction approaches. However, police-public health partnerships along with strong political support have led to the substantial scale up of harm reduction services as well as the reduction of HIV/AIDS among PWID in Vancouver, unlike what has been observed in Tijuana. This commentary therefore aims to assess the discrepancies between federal policy and local responses to drug-related harms in order to fully understand the impact and implications of national drug policies in shaping local response to drug related harms among populations of PWID. Through a comparison of the drug policy landscape in two cities linked by a large North American drug trafficking route - Tijuana, Mexico and Vancouver, Canada, - this commentary suggests that drug policy reform in and of itself will have little impact at the local level unless it is appropriately resourced and meaningfully supported by key stakeholders.

Document type: 
Graduating extended essay / Research project
File(s): 
Supervisor(s): 
Robert Hogg
Department: 
Health Sciences: Faculty of Health Sciences

BC's change in methadone formulation: A metanarrative review of the literature

Author: 
Peer reviewed: 
No, item is not peer reviewed.
Date created: 
2016-04
Abstract: 

British Columbia’s Opioid Substitution Treatment (formerly Methadone Maintenance Therapy1 ) made a switch in formulation from generic methadone to a proprietary medication called Methadose™ (BC Ministry of Health, 2013) effective February 1 of 2014. The switch to Methadose™ in British Columbia (BC) offers an opportunity to examine the literature about methadone, MMT, and opioids and trace the evolution of policy and practice that inform this substitution therapy. A metanarrative review of the literature demonstrates the evolving perspective on MMT and offers insights to how a society views substance use, as well as future medication changes that affect a particular patient population, especially when that population is comprised of individuals who face structural inequities in mainstream Canadian society

Document type: 
Graduating extended essay / Research project
File(s): 
Supervisor(s): 
Marina Morrow
Department: 
Health Sciences: Faculty of Health Sciences