Emma Wilkins - Academia.edu (original) (raw)

Papers by Emma Wilkins

Public Health Research, 2015

Health Education Journal, 2014

Background: Comprehensive School Health (CSH) approaches to developing a healthy school community... more Background: Comprehensive School Health (CSH) approaches to developing a healthy school community can be effective in supporting chronic disease prevention while positively impacting on student behaviour and academic performance. Although a CSH framework provides principles for action, there is a lack of evidence regarding the processes that best facilitate CSH work, and enable action. Objective: The purpose of this study was to identify and describe the elements of practice-based evidence that contribute to the success and sustainability of healthy school communities, through the identification of positive practices and lessons learned from a sample of projects in Alberta, Canada. Setting: School communities in Alberta, Canada. Design and methods: Key individuals from a list of operating CSH projects were invited for interview. An exploratory, qualitative design examined the perspectives of these 'school health champions'. A total of 12 one-on-one interviews and one focus group with seven participants were completed, resulting in input from 19 individuals in total. Results: Elements to develop and sustain a healthy school community fall into one of two categories: (1) stakeholder buy-in and (2) adequate resources in the form of human resources, partnerships and peer support. Participants identified successful strategies for establishing buy-in from administrators, teachers, parents and students. Conclusion: To effectively mobilise a comprehensive school health framework, practical strategies for implementation are needed. While some of these strategies are context-specific, practice-based evidence that transcends the local context does exist and can be used more widely to support the development of a healthy school community.

BMC Medical Research Methodology, 2013

Background: Systematic review methodologies can be harnessed to help researchers to understand an... more Background: Systematic review methodologies can be harnessed to help researchers to understand and explain how complex interventions may work. Typically, when reviewing complex interventions, a review team will seek to understand the theories that underpin an intervention and the specific context for that intervention. A single published report from a research project does not typically contain this required level of detail. A review team may find it more useful to examine a "study cluster"; a group of related papers that explore and explain various features of a single project and thus supply necessary detail relating to theory and/or context. We sought to conduct a preliminary investigation, from a single case study review, of techniques required to identify a cluster of related research reports, to document the yield from such methods, and to outline a systematic methodology for cluster searching.

BMC Family Practice, 2011

Background: Little information is available on the problem of chronic pain among homeless individ... more Background: Little information is available on the problem of chronic pain among homeless individuals. This study aimed to describe the characteristics of and treatments for chronic pain, barriers to pain management, concurrent medical conditions, and substance use among a representative sample of homeless single adult shelter users who experience chronic pain in Toronto, Canada. Methods: Participants were randomly selected at shelters for single homeless adults between September 2007 and February 2008 and screened for chronic pain, defined as having pain in the body for ≥ 3 months or receiving treatment for pain that started ≥ 3 months ago. Cross-sectional surveys obtained information on demographic characteristics, characteristics of and treatments for chronic pain, barriers to pain management, concurrent medical conditions, and substance use. Whenever possible, participants' physicians were also interviewed. Results: Among 152 homeless participants who experienced chronic pain, 11 (8%) were classified as Chronic Pain Grade I (low disability-low intensity), 47 (32%) as Grade II (low disability-high intensity), 34 (23%) as Grade III (high disability-moderately limiting), and 54 (37%) as Grade IV (high disability-severely limiting). The most common selfreported barriers to pain management were stress of shelter life, inability to afford prescription medications, and poor sleeping conditions. Participants reported using over-the-counter medications (48%), street drugs (46%), prescribed medications (43%), and alcohol (29%) to treat their pain. Of the 61 interviewed physicians, only 51% reported treating the patient's pain. The most common physician-reported difficulties with pain management were reluctance to prescribe narcotics due to the patient's history of substance abuse, psychiatric comorbidities, frequently missed appointments, and difficulty getting the patient to take medications correctly. Conclusions: Clinicians who provide healthcare for homeless people should screen for chronic pain and discuss barriers to effective pain management with their patients.

Participatory approaches to research are gaining popularity in health and wellness disciplines be... more Participatory approaches to research are gaining popularity in health and wellness disciplines because of their potential to bridge gaps between research and practice and promote health equity. A number of guidelines have been developed to help research-practitioners gauge the quality of participatory health research (PHR). In light of the increasing popularization of this approach in the field of public health, there is a need to check in with current practitioners to see if their practices are still reflective of past guidelines. The aim of this study was to understand how research-practitioners currently conceptualize the quality of participatory health research in particular. Using phenomenographic inquiry, we interviewed 13 researchers who described their experience of PHR. We identified 15 categories of description and visually represented the relationship between the categories using an outcome space. Our findings suggest that conceptualizations of what is considered high quality PHR have remained consistent. This reliability bodes well for the development of quality criteria for participatory health research. We discuss implications for scaling up this study to compare quality criteria beyond a North American context.

Public Health Research, 2015

Health Education Journal, 2014

Background: Comprehensive School Health (CSH) approaches to developing a healthy school community... more Background: Comprehensive School Health (CSH) approaches to developing a healthy school community can be effective in supporting chronic disease prevention while positively impacting on student behaviour and academic performance. Although a CSH framework provides principles for action, there is a lack of evidence regarding the processes that best facilitate CSH work, and enable action. Objective: The purpose of this study was to identify and describe the elements of practice-based evidence that contribute to the success and sustainability of healthy school communities, through the identification of positive practices and lessons learned from a sample of projects in Alberta, Canada. Setting: School communities in Alberta, Canada. Design and methods: Key individuals from a list of operating CSH projects were invited for interview. An exploratory, qualitative design examined the perspectives of these 'school health champions'. A total of 12 one-on-one interviews and one focus group with seven participants were completed, resulting in input from 19 individuals in total. Results: Elements to develop and sustain a healthy school community fall into one of two categories: (1) stakeholder buy-in and (2) adequate resources in the form of human resources, partnerships and peer support. Participants identified successful strategies for establishing buy-in from administrators, teachers, parents and students. Conclusion: To effectively mobilise a comprehensive school health framework, practical strategies for implementation are needed. While some of these strategies are context-specific, practice-based evidence that transcends the local context does exist and can be used more widely to support the development of a healthy school community.

BMC Medical Research Methodology, 2013

Background: Systematic review methodologies can be harnessed to help researchers to understand an... more Background: Systematic review methodologies can be harnessed to help researchers to understand and explain how complex interventions may work. Typically, when reviewing complex interventions, a review team will seek to understand the theories that underpin an intervention and the specific context for that intervention. A single published report from a research project does not typically contain this required level of detail. A review team may find it more useful to examine a "study cluster"; a group of related papers that explore and explain various features of a single project and thus supply necessary detail relating to theory and/or context. We sought to conduct a preliminary investigation, from a single case study review, of techniques required to identify a cluster of related research reports, to document the yield from such methods, and to outline a systematic methodology for cluster searching.

BMC Family Practice, 2011

Background: Little information is available on the problem of chronic pain among homeless individ... more Background: Little information is available on the problem of chronic pain among homeless individuals. This study aimed to describe the characteristics of and treatments for chronic pain, barriers to pain management, concurrent medical conditions, and substance use among a representative sample of homeless single adult shelter users who experience chronic pain in Toronto, Canada. Methods: Participants were randomly selected at shelters for single homeless adults between September 2007 and February 2008 and screened for chronic pain, defined as having pain in the body for ≥ 3 months or receiving treatment for pain that started ≥ 3 months ago. Cross-sectional surveys obtained information on demographic characteristics, characteristics of and treatments for chronic pain, barriers to pain management, concurrent medical conditions, and substance use. Whenever possible, participants' physicians were also interviewed. Results: Among 152 homeless participants who experienced chronic pain, 11 (8%) were classified as Chronic Pain Grade I (low disability-low intensity), 47 (32%) as Grade II (low disability-high intensity), 34 (23%) as Grade III (high disability-moderately limiting), and 54 (37%) as Grade IV (high disability-severely limiting). The most common selfreported barriers to pain management were stress of shelter life, inability to afford prescription medications, and poor sleeping conditions. Participants reported using over-the-counter medications (48%), street drugs (46%), prescribed medications (43%), and alcohol (29%) to treat their pain. Of the 61 interviewed physicians, only 51% reported treating the patient's pain. The most common physician-reported difficulties with pain management were reluctance to prescribe narcotics due to the patient's history of substance abuse, psychiatric comorbidities, frequently missed appointments, and difficulty getting the patient to take medications correctly. Conclusions: Clinicians who provide healthcare for homeless people should screen for chronic pain and discuss barriers to effective pain management with their patients.

Participatory approaches to research are gaining popularity in health and wellness disciplines be... more Participatory approaches to research are gaining popularity in health and wellness disciplines because of their potential to bridge gaps between research and practice and promote health equity. A number of guidelines have been developed to help research-practitioners gauge the quality of participatory health research (PHR). In light of the increasing popularization of this approach in the field of public health, there is a need to check in with current practitioners to see if their practices are still reflective of past guidelines. The aim of this study was to understand how research-practitioners currently conceptualize the quality of participatory health research in particular. Using phenomenographic inquiry, we interviewed 13 researchers who described their experience of PHR. We identified 15 categories of description and visually represented the relationship between the categories using an outcome space. Our findings suggest that conceptualizations of what is considered high quality PHR have remained consistent. This reliability bodes well for the development of quality criteria for participatory health research. We discuss implications for scaling up this study to compare quality criteria beyond a North American context.