Jacqueline Gahagan | Dalhousie University (original) (raw)
Papers by Jacqueline Gahagan
LGBT older adults are more likely to age with limited support in stigmatizing environments often ... more LGBT older adults are more likely to age with limited support in stigmatizing environments often poorly served by traditional social service, which challenges their preparedness for end of life. Seventeen focus groups (total N = 93) were conducted in five Canadian cities with gay/bisexual men (5 groups; 40 participants), lesbian women (5 groups; 29 participants), and transgender persons ; 24 participants). The following six themes underscore the challenges to preparatory conversations about life's end: (a) end-of-life preparations, including document completion); (b) relationship challenges with both chosen and biological families;
While the concepts of both " sex " and " gender " are widely recognized as important consideratio... more While the concepts of both " sex " and " gender " are widely recognized as important considerations in health research, the presence of these and other key determinants of health in research findings remains quite variable in the published literature. In an effort to close this knowledge gap in relation to the implications of both sex and gender in the public health research evidence base, the Canadian Journal of Public Health (CJPH) has recently adopted an editorial policy requiring authors to ensure that their manuscripts speak to these concepts, where applicable. In keeping with the international trend in sex and gender reporting in health research, the aim of this policy shift is for CJPH to continue to advance excellence in the field of public health research, policy and practice in Canada and internationally.
Canadian Woman Studies, 2001
Heterosexual women are at increased risk of exposure to HIV through gender and power relations re... more Heterosexual women are at increased risk of exposure to HIV through gender and power relations relative to sexual decision making. Cet article nous assure que les statistiques sur le VIH Isida ne sont pas flables parce qu 'elles ne refletent pas la realite des risques encourus par les femmes. L 'evaluation des risques est baste sur des modeles masculins et ne saisitpas I'influence des relations de pouvoir quand il s'agit de mesurer les risques des femmes exposees au virus. D'autre part, les chercheurEs du sida n 'ontpas encore exploreadequatement les risques associes a la vulnirabilite sociale ou economique des femmes et des groupes minoritaires.
Canadian Woman Studies, 2001
Journal of homosexuality, Jan 4, 2016
Health research traditionally has focused on the health risks and deficits of lesbian, gay, bisex... more Health research traditionally has focused on the health risks and deficits of lesbian, gay, bisexual, transgender, and queer (LGBTQ) populations, obscuring the determinants that can promote health across the life course. Recognizing, appropriately measuring, and rendering visible these determinants of health is paramount to informing appropriate and engaging health policies, services, and systems for LGBTQ populations. The overarching purpose of this article is to provide an overview of the findings of a scoping review aimed at exploring strengths-based health promotion approaches to understanding and measuring LGBTQ health. Specifically, this scoping review examined peer-reviewed, published academic literature to determine (a) existing methodological frameworks for studying LGBTQ health from a strengths-based health promotion approach, and (b) suggestions for future methodological approaches for studying LGBTQ health from a strengths-based health promotion approach. The findings of...
Public health reports (Washington, D.C. : 1974)
We developed and validated a set of self-administered, multi-dimensional indicators of sexual hea... more We developed and validated a set of self-administered, multi-dimensional indicators of sexual health among Canadians aged 16-24 years. This study used a mixed-method qualitative and quantitative approach to develop and validate indicators of sexual health. We used the four-stage Dillman method to identify, focus-test, pilot-test, and validate key metrics to measure sexual health. We collected quantitative data to validate the measures through a computer-assisted self-interviewing program among a purposive sample of 1,158 people aged 16-24 years recruited from four Canadian provinces. The survey contained 75 items measuring five dimensions of sexual health: (1) physical, mental, emotional, and social well-being in relation to sexuality; (2) approach to sexuality; (3) sexual relationships; (4) sexual experiences; and (5) discrimination, coercion, and violence. Principal components analysis for composite measures found seven components with eigenvalues ≥1. The factor structure was stab...
Journal of Empirical Research on …, Jan 1, 2012
JSTOR is a not-for-profit service that helps scholars, researchers, and students discover, use, a... more JSTOR is a not-for-profit service that helps scholars, researchers, and students discover, use, and build upon a wide range of content in a trusted digital archive. We use information technology and tools to increase productivity and facilitate new forms of scholarship. For more information about JSTOR, please contact support@jstor.org.
Background: Couples HIV counselling and testing (CHCT) is a key preventive strategy used to reduc... more Background: Couples HIV counselling and testing (CHCT) is a key preventive strategy used to reduce the spread of HIV. In Uganda, HIV prevalence among married or cohabiting couples is 5.6%, compared to 2.2% among those never married. CHCT can help ease disclosure of HIV positive status, which in turn may help increase opportunities to obtain social supports and reduce new infections. The purpose of this study was aimed at exploring the possible reasons for the low uptake of CHCT in Mukono district, a rural in setting in Uganda.
Background: Community-based research has gained increasing recognition in health research over th... more Background: Community-based research has gained increasing recognition in health research over the last two decades. Such participatory research approaches are lauded for their ability to anchor research in lived experiences, ensuring cultural appropriateness, accessing local knowledge, reaching marginalized communities, building capacity, and facilitating research-to-action. While having these positive attributes, the community-based health research literature is predominantly composed of small projects, using qualitative methods, and set within geographically limited communities. Its use in larger health studies, including clinical trials and cohorts, is limited. We present the Canadian HIV Women's Sexual and Reproductive Health Cohort Study (CHIWOS), a large-scale, multi-site, national, longitudinal quantitative study that has operationalized community-based research in all steps of the research process. Successes, challenges and further considerations are offered. Discussion: Through the integration of community-based research principles, we have been successful in: facilitating a two-year long formative phase for this study; developing a novel survey instrument with national involvement; training 39 Peer Research Associates (PRAs); offering ongoing comprehensive support to PRAs; and engaging in an ongoing iterative community-based research process. Our community-based research approach within CHIWOS demanded that we be cognizant of challenges managing a large national team, inherent power imbalances and challenges with communication, compensation and volunteering considerations, and extensive delays in institutional processes. It is important to consider the iterative nature of community-based research and to work through tensions that emerge given the diverse perspectives of numerous team members.
We describe salient individual and organizational factors that influenced engagement of registere... more We describe salient individual and organizational factors that influenced engagement of registered nurses in a 12-month clinical mentorship intervention on HIV care in Canada. The intervention included 48 nurses and 8 people living with HIV (PLWH) who were involved in group-based and one-on-one informal mentorship informed by transformative learning theory. We evaluated the process of implementing the mentorship intervention using qualitative content analysis. The inclusion of PLWH as mentors, the opportunities for reciprocal learning, and the long-term commitment of individual nurses and partner organizations in HIV care were major strengths. Challenges included the need for multiple ethical approvals, the lack of organizational support at some clinical sites, and the time commitment required by participants. We recommend that clinical mentorship interventions in HIV care consider organizational support, adhere to the Greater Involvement of People Living with HIV/AIDS principles, and explore questions of professional obligations.
8 Background: Currently, there is a dearth of baseline data on the health of lesbian, gay, bisexu... more 8 Background: Currently, there is a dearth of baseline data on the health of lesbian, gay, bisexual, transgender, and
While the concepts of both " sex " and " gender " are widely recognized as important consideratio... more While the concepts of both " sex " and " gender " are widely recognized as important considerations in health research, the presence of these and other key determinants of health in research findings remains quite variable in the published literature. In an effort to close this knowledge gap in relation to the implications of both sex and gender in the public health research evidence base, the Canadian Journal of Public Health (CJPH) has recently adopted an editorial policy requiring authors to ensure that their manuscripts speak to these concepts, where applicable. In keeping with the international trend in sex and gender reporting in health research, the aim of this policy shift is for CJPH to continue to advance excellence in the field of public health research, policy and practice in Canada and internationally.
Background: Couple HIV Counseling and Testing (CHCT) is one of the key preventive strategies used... more Background: Couple HIV Counseling and Testing (CHCT) is one of the key preventive strategies used to reduce the spread of HIV. In Uganda, HIV prevalence among married/living together is 7.2% among women and 7.6% among men. CHCT can help ease disclosure of HIV-positive status, which in turn may help increase opportunities to get social support and reduce new infections. The uptake of CHCT among attendees of health facilities in rural Uganda is as high as 34%. The purpose of this study was to explore the motivators of CHCT uptake in Mukono district, a rural setting in Uganda. Methods: The study was conducted in two sub-counties in a rural district (Mukono district) about 28 km east of the capital Kampala, using a descriptive and explorative qualitative research design. Specifically, we conducted focus group discussions and key informant interviews with HIV focal persons, village health team (VHT) members, religious leaders and political leaders. We also interviewed persons in couple relationships.
While social media can present unique opportunities for sexual health promotion interventions tha... more While social media can present unique opportunities for sexual health promotion interventions that target social ecological levels beyond the intrapersonal, health promotion as a discipline has not yet fully realized the potential of these platforms. The following scoping review focuses on the use of social media in the delivery of sexual health interventions targeting the interpersonal, institutional, community, and public policy levels of the social ecological model for change. A total of 398 articles on social media-based sexual health promotion interventions were identified. From this, 67 articles were reviewed in-depth, and 24 met the criteria for inclusion. Of these, four articles described interventions that focused on changing the knowledge, attitudes or behaviour of participants at the intrapersonal level. The remaining 20 articles targeted levels beyond the intrapersonal, with an emphasis on promoting change at broader levels to create environments that support sustained behavioural change. The examples provided by the 24 studies reviewed in this scoping review demonstrate how social media can offer unique health promotion tools for creating social networks and communities to support or deliver intervention activities, as well as for connecting individuals with appropriate and contextually responsive sexual health services. This scoping review provides valuable insights into potential strategies for developing and conducting multi-level social media-based sexual health promotion interventions and identifies areas where outcome and evaluative data are needed to demonstrate impact and potential for scale-up of intervention strategies.
Background: Currently, there is a dearth of baseline data on the health of lesbian, gay, bisexual... more Background: Currently, there is a dearth of baseline data on the health of lesbian, gay, bisexual, transgender, and
Work (Reading, Mass.), 2005
Much has been written since the first appearance of HIV/AIDS in 1981 about its effects on the Can... more Much has been written since the first appearance of HIV/AIDS in 1981 about its effects on the Canadian health care and social services systems. However, researchers have given limited attention to issues of entry or re-entry to the competitive job market for HIV positive individuals. The emergence of highly active antiretroviral therapies (HAART) has allowed a significant number of persons who are HIV positive to experience a major recovery in health and energy. This increase in physical health has in turn led to a re-examination of the possibility of returning to former types and levels of activity, including the prospect of going back to work or entering the competitive workforce for the first time. The purpose of this paper is to outline some of the issues and concerns that impact HIV positive individuals' attempts to return to or enter the competitive workforce, particularly those relating to disability policies and public insurance. Data from in-depth interviews with a samp...
LGBT older adults are more likely to age with limited support in stigmatizing environments often ... more LGBT older adults are more likely to age with limited support in stigmatizing environments often poorly served by traditional social service, which challenges their preparedness for end of life. Seventeen focus groups (total N = 93) were conducted in five Canadian cities with gay/bisexual men (5 groups; 40 participants), lesbian women (5 groups; 29 participants), and transgender persons ; 24 participants). The following six themes underscore the challenges to preparatory conversations about life's end: (a) end-of-life preparations, including document completion); (b) relationship challenges with both chosen and biological families;
While the concepts of both " sex " and " gender " are widely recognized as important consideratio... more While the concepts of both " sex " and " gender " are widely recognized as important considerations in health research, the presence of these and other key determinants of health in research findings remains quite variable in the published literature. In an effort to close this knowledge gap in relation to the implications of both sex and gender in the public health research evidence base, the Canadian Journal of Public Health (CJPH) has recently adopted an editorial policy requiring authors to ensure that their manuscripts speak to these concepts, where applicable. In keeping with the international trend in sex and gender reporting in health research, the aim of this policy shift is for CJPH to continue to advance excellence in the field of public health research, policy and practice in Canada and internationally.
Canadian Woman Studies, 2001
Heterosexual women are at increased risk of exposure to HIV through gender and power relations re... more Heterosexual women are at increased risk of exposure to HIV through gender and power relations relative to sexual decision making. Cet article nous assure que les statistiques sur le VIH Isida ne sont pas flables parce qu 'elles ne refletent pas la realite des risques encourus par les femmes. L 'evaluation des risques est baste sur des modeles masculins et ne saisitpas I'influence des relations de pouvoir quand il s'agit de mesurer les risques des femmes exposees au virus. D'autre part, les chercheurEs du sida n 'ontpas encore exploreadequatement les risques associes a la vulnirabilite sociale ou economique des femmes et des groupes minoritaires.
Canadian Woman Studies, 2001
Journal of homosexuality, Jan 4, 2016
Health research traditionally has focused on the health risks and deficits of lesbian, gay, bisex... more Health research traditionally has focused on the health risks and deficits of lesbian, gay, bisexual, transgender, and queer (LGBTQ) populations, obscuring the determinants that can promote health across the life course. Recognizing, appropriately measuring, and rendering visible these determinants of health is paramount to informing appropriate and engaging health policies, services, and systems for LGBTQ populations. The overarching purpose of this article is to provide an overview of the findings of a scoping review aimed at exploring strengths-based health promotion approaches to understanding and measuring LGBTQ health. Specifically, this scoping review examined peer-reviewed, published academic literature to determine (a) existing methodological frameworks for studying LGBTQ health from a strengths-based health promotion approach, and (b) suggestions for future methodological approaches for studying LGBTQ health from a strengths-based health promotion approach. The findings of...
Public health reports (Washington, D.C. : 1974)
We developed and validated a set of self-administered, multi-dimensional indicators of sexual hea... more We developed and validated a set of self-administered, multi-dimensional indicators of sexual health among Canadians aged 16-24 years. This study used a mixed-method qualitative and quantitative approach to develop and validate indicators of sexual health. We used the four-stage Dillman method to identify, focus-test, pilot-test, and validate key metrics to measure sexual health. We collected quantitative data to validate the measures through a computer-assisted self-interviewing program among a purposive sample of 1,158 people aged 16-24 years recruited from four Canadian provinces. The survey contained 75 items measuring five dimensions of sexual health: (1) physical, mental, emotional, and social well-being in relation to sexuality; (2) approach to sexuality; (3) sexual relationships; (4) sexual experiences; and (5) discrimination, coercion, and violence. Principal components analysis for composite measures found seven components with eigenvalues ≥1. The factor structure was stab...
Journal of Empirical Research on …, Jan 1, 2012
JSTOR is a not-for-profit service that helps scholars, researchers, and students discover, use, a... more JSTOR is a not-for-profit service that helps scholars, researchers, and students discover, use, and build upon a wide range of content in a trusted digital archive. We use information technology and tools to increase productivity and facilitate new forms of scholarship. For more information about JSTOR, please contact support@jstor.org.
Background: Couples HIV counselling and testing (CHCT) is a key preventive strategy used to reduc... more Background: Couples HIV counselling and testing (CHCT) is a key preventive strategy used to reduce the spread of HIV. In Uganda, HIV prevalence among married or cohabiting couples is 5.6%, compared to 2.2% among those never married. CHCT can help ease disclosure of HIV positive status, which in turn may help increase opportunities to obtain social supports and reduce new infections. The purpose of this study was aimed at exploring the possible reasons for the low uptake of CHCT in Mukono district, a rural in setting in Uganda.
Background: Community-based research has gained increasing recognition in health research over th... more Background: Community-based research has gained increasing recognition in health research over the last two decades. Such participatory research approaches are lauded for their ability to anchor research in lived experiences, ensuring cultural appropriateness, accessing local knowledge, reaching marginalized communities, building capacity, and facilitating research-to-action. While having these positive attributes, the community-based health research literature is predominantly composed of small projects, using qualitative methods, and set within geographically limited communities. Its use in larger health studies, including clinical trials and cohorts, is limited. We present the Canadian HIV Women's Sexual and Reproductive Health Cohort Study (CHIWOS), a large-scale, multi-site, national, longitudinal quantitative study that has operationalized community-based research in all steps of the research process. Successes, challenges and further considerations are offered. Discussion: Through the integration of community-based research principles, we have been successful in: facilitating a two-year long formative phase for this study; developing a novel survey instrument with national involvement; training 39 Peer Research Associates (PRAs); offering ongoing comprehensive support to PRAs; and engaging in an ongoing iterative community-based research process. Our community-based research approach within CHIWOS demanded that we be cognizant of challenges managing a large national team, inherent power imbalances and challenges with communication, compensation and volunteering considerations, and extensive delays in institutional processes. It is important to consider the iterative nature of community-based research and to work through tensions that emerge given the diverse perspectives of numerous team members.
We describe salient individual and organizational factors that influenced engagement of registere... more We describe salient individual and organizational factors that influenced engagement of registered nurses in a 12-month clinical mentorship intervention on HIV care in Canada. The intervention included 48 nurses and 8 people living with HIV (PLWH) who were involved in group-based and one-on-one informal mentorship informed by transformative learning theory. We evaluated the process of implementing the mentorship intervention using qualitative content analysis. The inclusion of PLWH as mentors, the opportunities for reciprocal learning, and the long-term commitment of individual nurses and partner organizations in HIV care were major strengths. Challenges included the need for multiple ethical approvals, the lack of organizational support at some clinical sites, and the time commitment required by participants. We recommend that clinical mentorship interventions in HIV care consider organizational support, adhere to the Greater Involvement of People Living with HIV/AIDS principles, and explore questions of professional obligations.
8 Background: Currently, there is a dearth of baseline data on the health of lesbian, gay, bisexu... more 8 Background: Currently, there is a dearth of baseline data on the health of lesbian, gay, bisexual, transgender, and
While the concepts of both " sex " and " gender " are widely recognized as important consideratio... more While the concepts of both " sex " and " gender " are widely recognized as important considerations in health research, the presence of these and other key determinants of health in research findings remains quite variable in the published literature. In an effort to close this knowledge gap in relation to the implications of both sex and gender in the public health research evidence base, the Canadian Journal of Public Health (CJPH) has recently adopted an editorial policy requiring authors to ensure that their manuscripts speak to these concepts, where applicable. In keeping with the international trend in sex and gender reporting in health research, the aim of this policy shift is for CJPH to continue to advance excellence in the field of public health research, policy and practice in Canada and internationally.
Background: Couple HIV Counseling and Testing (CHCT) is one of the key preventive strategies used... more Background: Couple HIV Counseling and Testing (CHCT) is one of the key preventive strategies used to reduce the spread of HIV. In Uganda, HIV prevalence among married/living together is 7.2% among women and 7.6% among men. CHCT can help ease disclosure of HIV-positive status, which in turn may help increase opportunities to get social support and reduce new infections. The uptake of CHCT among attendees of health facilities in rural Uganda is as high as 34%. The purpose of this study was to explore the motivators of CHCT uptake in Mukono district, a rural setting in Uganda. Methods: The study was conducted in two sub-counties in a rural district (Mukono district) about 28 km east of the capital Kampala, using a descriptive and explorative qualitative research design. Specifically, we conducted focus group discussions and key informant interviews with HIV focal persons, village health team (VHT) members, religious leaders and political leaders. We also interviewed persons in couple relationships.
While social media can present unique opportunities for sexual health promotion interventions tha... more While social media can present unique opportunities for sexual health promotion interventions that target social ecological levels beyond the intrapersonal, health promotion as a discipline has not yet fully realized the potential of these platforms. The following scoping review focuses on the use of social media in the delivery of sexual health interventions targeting the interpersonal, institutional, community, and public policy levels of the social ecological model for change. A total of 398 articles on social media-based sexual health promotion interventions were identified. From this, 67 articles were reviewed in-depth, and 24 met the criteria for inclusion. Of these, four articles described interventions that focused on changing the knowledge, attitudes or behaviour of participants at the intrapersonal level. The remaining 20 articles targeted levels beyond the intrapersonal, with an emphasis on promoting change at broader levels to create environments that support sustained behavioural change. The examples provided by the 24 studies reviewed in this scoping review demonstrate how social media can offer unique health promotion tools for creating social networks and communities to support or deliver intervention activities, as well as for connecting individuals with appropriate and contextually responsive sexual health services. This scoping review provides valuable insights into potential strategies for developing and conducting multi-level social media-based sexual health promotion interventions and identifies areas where outcome and evaluative data are needed to demonstrate impact and potential for scale-up of intervention strategies.
Background: Currently, there is a dearth of baseline data on the health of lesbian, gay, bisexual... more Background: Currently, there is a dearth of baseline data on the health of lesbian, gay, bisexual, transgender, and
Work (Reading, Mass.), 2005
Much has been written since the first appearance of HIV/AIDS in 1981 about its effects on the Can... more Much has been written since the first appearance of HIV/AIDS in 1981 about its effects on the Canadian health care and social services systems. However, researchers have given limited attention to issues of entry or re-entry to the competitive job market for HIV positive individuals. The emergence of highly active antiretroviral therapies (HAART) has allowed a significant number of persons who are HIV positive to experience a major recovery in health and energy. This increase in physical health has in turn led to a re-examination of the possibility of returning to former types and levels of activity, including the prospect of going back to work or entering the competitive workforce for the first time. The purpose of this paper is to outline some of the issues and concerns that impact HIV positive individuals' attempts to return to or enter the competitive workforce, particularly those relating to disability policies and public insurance. Data from in-depth interviews with a samp...