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Title: Accessing HAART in northern BC: Understanding the barriers and supports to medication adherence and engagement in HIV-related care.
Contributors: Michael David Jordan (author), Jos~e Lavoie (Thesis advisor), University of Northern British Columbia (Degree granting institution)
Abstract: Highly active antiretroviral therapy (HAART) has significantly improved the health and well-being of many people living with HIV. Successful treatment with HAART requires a very high level of adherence, and continued engagement with health care services. Particular challenges to successful treatment with HAART exist in northern BC, but little research has been done in this region. This study investigated the experiences of those prescribed HAART who live in northern BC in order to identify what barriers and supports exist to optimal adherence, and engagement in HIV-related care. In-depth interviews indicated the complex and intersecting factors which affect adherence and engagement in care. Proximal, intermediate and distal social determinant of health which are relevant to adherence and engagement in HIV-related care were identified. Depression and stress, prioritization, and access to medications and care were identified as mechanisms in which various factors acted as barriers to adherence and engagement in care. --Leaf ii.
Discipline: Community Health
Content Model: info:fedora/ir:thesisCModel
Date added: 2014

Title: Analysis of an early intervention disability program.
Contributors: Laura Zaparinuk (author), Jos~e Lavoie (Thesis advisor), University of Northern British Columbia (Degree granting institution)
Abstract: Analyzing the cost benefit of early intervention in disability management is a challenging area of study due to the overall lack of standardized programs and measures. The purpose of this study was to determine if early intervention is an effective way to manage disability related costs, to assess data quality and provide recommendation to the Corporation on how best to measure its return on investment into the early intervention program (EIP). The study is a mixture of quantitative based analysis combined with an exploratory research design approach. Basic descriptive and inferential statistics where utilized in conjunction with gathering other key indicators to determine if an EIP is an effective means of managing disability related costs. This research demonstrates the benefits and challenges of capturing data in order to measure the overall value of investing in EIP. The study concludes with recommendations on how to improve data collection and the importance of being able to show a statistically significant positive change as a result of the EIP to ensure future investment on the health and wellness of employees. --Leaf ii.
Discipline: Disability Management
Content Model: info:fedora/ir:thesisCModel
Date added: 2013

Title: The development and validation of a Televisitation Attitude Scale (TAS).
Contributors: Katherine Wood (author), Jos~e Lavoie (Thesis advisor), University of Northern British Columbia (Degree granting institution)
Abstract: The 12 item Televisitation Attitude Scale (TAS) was developed in this study using the method of factor analysis. The prototype Televisitation Attitude Scale (TAS) was administered to UNBC students (N=204) in an on-line format. Kaiser-Meyer-Olkin’s (KMO) test was .900 and Barlett’s test was χ² (66) = 1198.500, p<.001, confirming the validity of the obtained data. The Chronbach’s alpha test reliability for the final TAS was .91. It was found that the students’ attitudes toward televisitation were one-dimensional (Evaluation dimension) and had a positive tendency (M = 1.29 on -3 +3 scale). Independent sample t-tests (p ≲ .05) found significant differences in attitudes toward televisitation among subpopulations of UNBC students distinguished by gender, presence of children, and place of birth. TAS and its methodology can help researchers and televisitation investors to predict with some degree of accuracy whether a support person would televisit a patient in a hospital or a nursing home.
Discipline: Community Health
Content Model: info:fedora/ir:thesisCModel
Date added: 2011

Title: Intergenerational knowledge transmission from aboriginal female elders to youth regarding preventative and self-care knowledge of urinary tract infections in Prince George, BC.
Contributors: Jennifer Nguyen (author), Jos~e Lavoie (Thesis advisor), Tina Fraser (Thesis advisor), University of Northern British Columbia (Degree granting institution)
Abstract: This study examines the factors influencing intergenerational knowledge transmission of Aboriginal women in Prince George, BC regarding preventative and self-care practices for urinary tract infections. The research questions were: What is the level of intergenerational knowledge exchange between female Aboriginal elders and youth, and what are the factors influencing this transmission? Interviews were conducted with seven Aboriginal youth and three elders living in Prince George and analyzed using the combined methods of narrative inquiry and interpretive phenomenological analysis. The results indicate that there are both historical and contemporary factors influencing the level of intergenerational knowledge transmission. Some participants discussed the complexities of finding their footing in a new territory, and the cultural tensions they felt as Aboriginal outsiders within a new Aboriginal community. Participants offered recommendations for improving the level of Aboriginal knowledge transmission and implications for future research were discussed. --Leaf ii.
Discipline: Community Health
Content Model: info:fedora/ir:thesisCModel
Date added: 2015

Title: Impact of general practitioner payment scheme on health care system in avoidable hospitalization for ambulatory care sensitive conditions.
Contributors: Ukeme E. U. Eka (author), Jos~e Lavoie (Thesis advisor), Peter MacMillan (Thesis advisor), University of Northern British Columbia (Degree granting institution)
Abstract: This study compares the effectiveness of primary care interventions provided by general practitioners (GP) remunerated under the fee-for-service (FFS) or alternative payment plan (APP), using hospitalization rates for ambulatory care sensitive conditions (ACSC) in select Northern British Columbia (BC) communities. This study used BC Ministry of Health hospital separation data held at Population Data BC. Bivariate statistics were used to compare hospitalization rates for ACSC between both groups. The results indicate overall hospitalization rates of ACSC were higher in APP than FFS communities. Further, several ACSC showed varying hospitalization rates (asthma, pneumonia, COPD, diabetes, angina, gastroenteritis/dehydration and convulsion/epilepsy) and length of hospitalizations (convulsion/epilepsy and dental conditions) between both groups. In summary, this research informs policy on the effectiveness of GP remuneration adopted in Northern BC using hospitalization rates for ACSC. Further research is needed to further validate the findings of this study. --P. ii.
Discipline: Community Health
Content Model: info:fedora/ir:thesisCModel
Date added: 2011

Title: Don't call me crazy: Re-envisioning mental health services for Aboriginal peoples in Prince George.
Contributors: Sarah Elizabeth Nelson (author), Jos~e Lavoie (Thesis advisor), University of Northern British Columbia (Degree granting institution)
Abstract: This study explored Aboriginal clients', Elders', and health care providers' perspectives on mental health to see how mental health services might better serve Aboriginal populations. The study used phenomenology and principles of Indigenous research, in partnership with the Central Interior Native Health Society, a primary health care clinic in Prince George. The Aboriginal Caucus, a cultural advisory board for the clinic, acted in an advisory capacity. Two talking circles and twelve semi-structured qualitative interviews provided the information the study draws on. Findings support the literature in saying that a broad approach to mental health, with attention to the whole person and the formation of healthy, supportive relationships, is most appropriate for Aboriginal peoples also that decolonization will enhance the mental health of Aboriginal peoples and communities. The study also introduces the idea of mental health as energy, which may be a useful alternative way of framing mental health discourse. --P. 2.
Discipline: First Nations Studies
Content Model: info:fedora/ir:thesisCModel
Date added: 2012

Title: The Experience of Active Injection Drug Use on Adherence to Antiretroviral Treatment in Aboriginal People Living in Prince George - A Qualitative Perspective.
Contributors: Robert Sam Milligan (author), Jos~e Lavoie (Thesis advisor), University of Northern British Columbia (Degree granting institution)
Abstract: In Canada the incidence rates of HIV in Aboriginal populations continue to grow, despite an overall reduction in HIV prevalence of the Canadian population as a whole. Reasons for the increased Aboriginal HIV incidence are varied including structural components such as socio-economic issues, and limited access to healthcare. In addition, personal coping strategies such as addiction and mental health issues increase incidence rates of HIV. With this context in mind, it is not surprising that the difficulties of managing HIV - a disease which involves complex treatment regimens and wide variations in health status - can create unbearable burdens on people infected (and affected) by HIV/AIDS. The complicated treatment regimens associated with HIV can pose great problems for Aboriginal people, but are exacerbated when active injection drug use is factored in. The purpose of this study is to gain insight into how active injection drug use impacts adherence to antiretroviral treatment in Aboriginal people living in Prince George, British Columbia. The study asked participants what they felt could be done by healthcare providers to better support them in their struggles to maintain the high levels of adherence needed for maximal HIV viral suppression. Eight interviews were conducted and analyzed using a Grounded Theory methodology. Analysis and interpretation revealed that healthcare providers need to me [sic] more caring and consistent in their approach. Adherence is facilitated by the knowledge of the health consequences of non-adherence trust in healthcare providers incorporating HAART into daily routines receiving support from AIDS services organizations, friends, and family and that combining HAART administration with methadone is an effective pathway to increase adherence. On the other hand, the most common barrier to adherence identified by the participants was being high'. Finally the study found that the majority of participants expressed a feeling of disconnection from Aboriginal culture. --P
Discipline: Community Health
Content Model: info:fedora/ir:thesisCModel
Date added: 2011

Title: Reclaiming overall well-being: an analysis of individual- and community-level characteristics contributing to well-being in Yukon First Nations
Contributors: Wilhelmina Stappers (author), Jos~e Lavoie (Thesis advisor), Martha MacLeod (Thesis advisor), University of Northern British Columbia (Degree granting institution)
Abstract: This collaborative study implemented a new conceptual framework for health research relevant to Yukon First Nations people and actively involved Yukon First Nations as partners into all steps of the research. Selected characteristics from the Yukon Adult RHS data-set (individual-level characteristics) and the ecological variable survey (community-level characteristics) underwent a sequence of bivariate and multivariate comparisons to explore associations with three outcome measures for overall well-being: no depression, no suicidal thoughts and no suicide attempts. Six individual-level characteristics were identified that had a significant association with the outcome measures: traditional foods modern and traditional health care emotional supports and loving relationships spirituality physical well-being and socio-economic characteristics. The following community-level characteristics emerged as being significantly associated with the outcome measures: geographic characteristics community control community engagement and cultural continuity. Limitations of the study, implications for practice and policy and recommendations for future research and summary comments are identified and discussed.
Discipline: Community Health
Content Model: info:fedora/ir:thesisCModel
Date added: 2007

Title: Assessing vocational rehabilitation practices at Employment Action in Prince George
Contributors: Azusa Hori (author), Jos~e Lavoie (Thesis advisor), University of Northern British Columbia (Degree granting institution)
Abstract: No abstract available.
Discipline: Disability Management
Content Model: info:fedora/ir:thesisCModel
Date added: 2009

Title: Exploring Barriers to Primary Health Care Services on First Nations Reserves in Manitoba.
Contributors: Geoffrey Johnson (author), Jos~e Lavoie (Thesis advisor), University of Northern British Columbia (Degree granting institution)
Abstract: This study examines some of the barriers facing the delivery of effective, culturally appropriate primary health care services to First Nations people living on reserves in Manitoba. The data for this study comes from a data set made up of the responses to the Manitoba portion of the First Nations Regional Longitudinal Health Survey (RHS). The relationships between reported barriers to accessing health care and self-rated health were used to inform this work. Analysis relied on the use of Chi-square, Cramer's V, and adjusted residuals to determine statistically significant relationships and their respective strengths. The results indicate that barriers to access to primary health care on-reserve could be classified as: underfunding, limited human resources, lack of culturally appropriate care, and inadequate levels of local control over service delivery. --P. ii.
Discipline: Community Health
Content Model: info:fedora/ir:thesisCModel
Date added: 2012

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