Lindsay P Allen | University of Manitoba (original) (raw)
Papers by Lindsay P Allen
Australian and New Zealand journal of public health, Jun 1, 2024
The complexity of global public health requires increasing sophistication and cooperation across ... more The complexity of global public health requires increasing sophistication and cooperation across research designs. Understanding core beliefs and values in diverse populations, incentives and demotivators, barriers and facilitators – all processes that sway public health behaviour, uptake, adherence, and thus outcomes – are in the QHR realm of expertise. Indeed, there are some public health issues that can only be understood with a qualitative approach, yet there are still issues of methodological marginalization within biomedical and public health fields. By critically examining the role of QHR in public health, and particularly arising from the COVID-19 pandemic, we present a vision for moving beyond defending QHR as valid and rigorous, to championing the use of qualitative methods as a standard of excellence in certain research areas, such as community-engaged studies on urgent emerging infectious diseases affecting socially marginalized populations. When other methods are more appropriate to a given research question, QHR is still, at the very least, an essential complement that can bolster or dialogue with even the most quantitative, clinical studies.
Alternative, May 22, 2024
This study analyzes the literature on Indigenous sacred sites within the larger topic areas of la... more This study analyzes the literature on Indigenous sacred sites within the larger topic areas of land-based education and healing, as per the guidance of Anishinaabe (a group of Indigenous Peoples from the Great Lakes and the Great Plains areas of contemporary Canada and USA) Elders and community leaders in eastern Manitoba, Canada. A scoping review was conducted to identify the size, scope, nature, and key themes of existing research in seven databases, inclusive of gray literature which is a key source for Indigenous organizations. In total, we analyzed 35 articles and documents. The emerging themes included: (1) sacred sites and the promotion of health and wellness; (2) sacred sites as places of knowledge; (3) the desecration and protection of sacred sites; and (4) legal battles between Indigenous Peoples and the state. Recommendations to advance understandings and correct colonially imposed imbalances are discussed, and health and legal implications are outlined.
International Journal for Equity in Health, Aug 23, 2023
Belize has the highest national prevalence of type 2 diabetes (T2D) of Central and South America,... more Belize has the highest national prevalence of type 2 diabetes (T2D) of Central and South America, and fifth direst in the world. T2D is the leading cause of death in Belize, a country facing burdens of increasing prevalence with few resources. Since March of 2020, the COVID-19 pandemic has exacerbated the difficulties of those living with T2D in Belize. To address T2D issues in Belize, our interdisciplinary research team explored the barriers to care and selfmanagement for adult patients with T2D in Belize prior to and during the COVID-19 pandemic. Research relationships between Canadian (ARH) and Belizean (LE) authors have been ongoing since 2016. Together we used a qualitative Constructivist Grounded Theory design generating knowledge through 35 semi-structured patient interviews, 25 key informant discussions, and participant observation with field notes between February 2020 to September 2021. We used Dedoose analysis software for a systematized thematic coding process, as well as iterative verification activities. Findings revealed several barriers to care and self-management, including: 1) the tiered health and social care system with major gaps in coverage; 2) the unfulfilled demand for accurate health information and innovative dissemination methods; and 3) the compounding of loss of community supports, physical exercise, and health services due to COVID-19 restrictions. In the post-pandemic period, it is necessary to invest in physical, nutritional, economic, and psychosocial health through organized activities adaptable to changeable public health restrictions. Recommendations for activities include sending patients informational and motivational text messages, providing recipes with accessibly sourced T2D foods, televising educational workshops, making online tools more accessible, and mobilising community and peer support networks. Keywords Type 2 diabetes, Barriers to care, Belize, Central and South America, COVID-19 What is known about this topic • Social, familial, and peer supports are key to sustaining type 2 diabetes self-management, but these were confined during the COVID-19 pandemic. • Regular glucose monitoring, physical exams, and lifestyle behavior modification are part of the standard of care for patients, but these became even less accessible during the COVID-19 pandemic. • Without adequate screening, treatment, and selfmanagement education and support, patients are at increased risk for co-morbidities and mortality;
PLOS ONE
Background Type 2 Diabetes Mellitus (T2DM) is a primary cause of death in Belize, a low-income co... more Background Type 2 Diabetes Mellitus (T2DM) is a primary cause of death in Belize, a low-income country with the highest rates in Central and South America. As many people in Belize cannot consistently access biomedical treatment, a reality that was exacerbated by the COVID-19 pandemic, plant medicine usage is estimated to have increased in recent years. This exploratory study seeks to understand which plants are being used, patterns of usage, and the state of patient-provider communication around this phenomenon. Methods Implementing a Constructivist Grounded Theory qualitative design, the research team conducted 35 semi-structured interviews with adults living with T2DM, 25 informant discussions, and participant observation with field notes between February 2020 and September 2021. Data analysis followed systematized thematic coding procedures using Dedoose analytic software and iterative verification processes. Results The findings revealed that 85.7% of participants used plants i...
Informing Services through Patient Perspectives of Living with Type 2 Diabetes Mellitus in Belize, 2020
Type 2 diabetes mellitus (T2DM) is the leading cause of death in Belize, and its prevalence is ra... more Type 2 diabetes mellitus (T2DM) is the leading cause of death in Belize, and its prevalence is rapidly increasing. The purpose of this study is to understand the everyday realities of people living with T2DM in Belize (e.g., barriers to care, strengths, health practices), how these affect diabetes self-management (DSM), and implications for health care. Data generation methods include interviews with T2DM patients, discussions with key informants, field notes, and participatory observation which took place in February and March of 2020. Principal findings were categorized into three main themes. The first is that patients experience numerous difficulties, including a tiered health care system privileging those with more resources, communication barriers with health care providers, and major gaps in prevention, education, and social supports. Secondly, many Belizeans with T2DM engage in spiritual practices that provide for mental strength, stress relief, lifestyle guidance, overcoming addictions, overcoming denial, and building determination toward health promoting, life-affirming attitudes and actions. Further, geographies can empower DSM. Home is a domain where personal power is most focused. A community domain that is conducive to active living is crucial. People use a plethora of local plant medicines instead of, alongside of, or to complement pharmaceuticals for DSM without disclosure to HCPs. Plant medicine usage and cultural-spiritual healing is pervasive in this population; therefore, health care can optimize T2DM outcomes through open dialogue and collaboration with patients, herbal doctors, traditional Indigenous medicine practitioners, community leaders, and faith leaders. Integrating these understandings will be key for moving forward to improve DSM education and support, as well as culturally safe care.
Conference Presentations by Lindsay P Allen
Plos One, 2023
Background Type 2 Diabetes Mellitus (T2DM) is a primary cause of death in Belize, a low-income co... more Background Type 2 Diabetes Mellitus (T2DM) is a primary cause of death in Belize, a low-income country with the highest rates in Central and South America. As many people in Belize cannot consistently access biomedical treatment, a reality that was exacerbated by the COVID-19 pandemic, plant medicine usage is estimated to have increased in recent years. This exploratory study seeks to understand which plants are being used, patterns of usage, and the state of patient-provider communication around this phenomenon.
International Journal of Equity in Health, 2023
Belize has the highest national prevalence of type 2 diabetes (T2D) of Central and South America,... more Belize has the highest national prevalence of type 2 diabetes (T2D) of Central and South America, and fifth direst in the world. T2D is the leading cause of death in Belize, a country facing burdens of increasing prevalence with few resources. Since March of 2020, the COVID-19 pandemic has exacerbated the difficulties of those living with T2D in Belize. To address T2D issues in Belize, our interdisciplinary research team explored the barriers to care and selfmanagement for adult patients with T2D in Belize prior to and during the COVID-19 pandemic. Research relationships between Canadian (ARH) and Belizean (LE) authors have been ongoing since 2016. Together we used a qualitative Constructivist Grounded Theory design generating knowledge through 35 semi-structured patient interviews, 25 key informant discussions, and participant observation with field notes between February 2020 to September 2021. We used Dedoose analysis software for a systematized thematic coding process, as well as iterative verification activities. Findings revealed several barriers to care and self-management, including: 1) the tiered health and social care system with major gaps in coverage; 2) the unfulfilled demand for accurate health information and innovative dissemination methods; and 3) the compounding of loss of community supports, physical exercise, and health services due to COVID-19 restrictions. In the post-pandemic period, it is necessary to invest in physical, nutritional, economic, and psychosocial health through organized activities adaptable to changeable public health restrictions. Recommendations for activities include sending patients informational and motivational text messages, providing recipes with accessibly sourced T2D foods, televising educational workshops, making online tools more accessible, and mobilising community and peer support networks. Keywords Type 2 diabetes, Barriers to care, Belize, Central and South America, COVID-19 What is known about this topic • Social, familial, and peer supports are key to sustaining type 2 diabetes self-management, but these were confined during the COVID-19 pandemic. • Regular glucose monitoring, physical exams, and lifestyle behavior modification are part of the standard of care for patients, but these became even less accessible during the COVID-19 pandemic. • Without adequate screening, treatment, and selfmanagement education and support, patients are at increased risk for co-morbidities and mortality;
Books by Lindsay P Allen
Spiritual, Religious, and Faith-Based Practices in Chronicity; An Exploration of Mental Wellness in Global COntext, 2021
This book explores how people draw upon spiritual, religious, or faith-based practices to support... more This book explores how people draw upon spiritual, religious, or faith-based practices to support their mental wellness amidst forms of chronicity. From diverse global contexts and spiritual perspectives, this volume critically examines several chronic conditions, such as psychosis, diabetes, depression, oppressive forces of colonization and social marginalization, attacks of spirit possession, or other forms of persistent mental duress. As an inter- and transdisciplinary collection, the chapters include innovative ethnographic observations and over 300 in-depth interviews with care providers and individuals living in chronicity, analyzed primarily from the phenomenological and hermeneutic meaning- making traditions. Overall, this book depicts a modern global era in which spiritualty and religion maintain an important role in many peoples’ lives, underscoring a need for increased awareness, intersectoral collaboration, and practical training for varied care providers. This book will be of interest to scholars of religion and health, the sociology and psychology of religion, medical and psychological anthropology, religious studies, and global health studies, as well as applied health and mental health professionals in psychology, social work, cultural psychiatry, and medicine.
Publications by Lindsay P Allen
Journal of Ethnicity in Substance Abuse, 2022
This study reviews and synthesizes the literature on Indigenous women who are pregnant/early pare... more This study reviews and synthesizes the literature on Indigenous women who are pregnant/early parenting and using substances in Canada to understand the scope and state of knowledge to inform research with the Aboriginal Health and Wellness Centre of Winnipeg in Manitoba and the development of a pilot Indigenous doula program. A scoping review was performed searching ten relevant databases, including one for gray literature. We analyzed 56 articles/documents. Themes include: (1) cyclical repercussions of state removal of Indigenous children from their families; (2) compounding barriers and inequities; (3) prevalence and different types of substance use; and (4) intervention strategies. Recommendations for future research are identified and discussed.
Canadian Medical Association Journal, 2022
KEY POINTS • Indigenous Peoples in Canada benefit from regaining access to and strengthening t... more KEY POINTS
• Indigenous Peoples in Canada benefit from regaining access to
and strengthening traditional cultural ways of life, including
health and healing practices.
• Many Indigenous communities are working to strengthen
cultural healing practices that were marred through
colonization and oppressive government policies.
• Indigenous-led health care partnerships provide innovative
models of interprofessional collaboration, be it in communitybased healing lodges, remote clinics or urban hospitals.
• Emerging evidence suggests that Indigenous-led health service
partnerships improve holistic (inclusive of mind, body, emotion
and spirit) health outcomes for Indigenous Peoples, as well as
access to care, prevention uptake and adherence to care plans
This book explores how people draw upon spiritual, religious, or faith-based practices to support... more This book explores how people draw upon spiritual, religious, or faith-based practices to support their mental wellness amidst forms of chronicity. From diverse global contexts and spiritual perspectives, this volume critically examines several chronic conditions, such as psychosis, diabetes, depression, oppressive forces of colonization and social marginalization, attacks of spirit possession, or other forms of persistent mental duress. As an inter- and transdisciplinary collection, the chapters include innovative ethnographic observations and over 300 in-depth interviews with care providers and individuals living in chronicity, analyzed primarily from the phenomenological and hermeneutic meaning- making traditions. Overall, this book depicts a modern global era in which spiritualty and religion maintain an important role in many peoples’ lives, underscoring a need for increased awareness, intersectoral collaboration, and practical training for varied care providers. This book will be of interest to scholars of religion and health, the sociology and psy- chology of religion, medical and psychological anthropology, religious studies, and global health studies, as well as applied health and mental health professionals in psychology, social work, cultural psychiatry, and medicine.
Australian and New Zealand Journal of Public Health, 2024
The complexity of global public health requires increasing sophistication and cooperation across ... more The complexity of global public health requires increasing sophistication and cooperation across research designs. Understanding core beliefs and values in diverse populations, incentives and demotivators, barriers and facilitators – all processes that sway public health behaviour, uptake, adherence, and thus outcomes – are in the QHR realm of expertise. Indeed, there are some public health issues that can only be understood with a qualitative approach, yet there are still issues of methodological marginalization within biomedical and public health fields. By critically examining the role of QHR in public health, and particularly arising from the COVID-19 pandemic, we present a vision for moving beyond defending QHR as valid and rigorous, to championing the use of qualitative methods as a standard of excellence in certain research areas, such as community-engaged studies on urgent emerging infectious diseases affecting socially marginalized populations. When other methods are more appropriate to a given research question, QHR is still, at the very least, an essential complement that can bolster or dialogue with even the most quantitative, clinical studies.
AlterNative, 2024
This study analyzes the literature on Indigenous sacred sites within the larger topic areas of la... more This study analyzes the literature on Indigenous sacred sites within the larger topic areas of land-based education and healing, as per the guidance of Anishinaabe (a group of Indigenous Peoples from the Great Lakes and the Great Plains areas of contemporary Canada and USA) Elders and community leaders in eastern Manitoba, Canada. A scoping review was conducted to identify the size, scope, nature, and key themes of existing research in seven databases, inclusive of gray literature which is a key source for Indigenous organizations. In total, we analyzed 35 articles and documents. The emerging themes included: (1) sacred sites and the promotion of health and wellness; (2) sacred sites as places of knowledge; (3) the desecration and protection of sacred sites; and (4) legal battles between Indigenous Peoples and the state. Recommendations to advance understandings and correct colonially imposed imbalances are discussed, and health and legal implications are outlined.
International Journal for Equity in Health, 2023
Belize has the highest national prevalence of type 2 diabetes (T2D) of Central and South America,... more Belize has the highest national prevalence of type 2 diabetes (T2D) of Central and South America, and fifth direst in the world. T2D is the leading cause of death in Belize, a country facing burdens of increasing prevalence with few resources. Since March of 2020, the COVID-19 pandemic has exacerbated the difficulties of those living with T2D in Belize. To address T2D issues in Belize, our interdisciplinary research team explored the barriers to care and selfmanagement for adult patients with T2D in Belize prior to and during the COVID-19 pandemic. Research relationships between Canadian (ARH) and Belizean (LE) authors have been ongoing since 2016. Together we used a qualitative Constructivist Grounded Theory design generating knowledge through 35 semi-structured patient interviews, 25 key informant discussions, and participant observation with field notes between February 2020 to September 2021. We used Dedoose analysis software for a systematized thematic coding process, as well as iterative verification activities. Findings revealed several barriers to care and self-management, including: 1) the tiered health and social care system with major gaps in coverage; 2) the unfulfilled demand for accurate health information and innovative dissemination methods; and 3) the compounding of loss of community supports, physical exercise, and health services due to COVID-19 restrictions. In the post-pandemic period, it is necessary to invest in physical, nutritional, economic, and psychosocial health through organized activities adaptable to changeable public health restrictions. Recommendations for activities include sending patients informational and motivational text messages, providing recipes with accessibly sourced T2D foods, televising educational workshops, making online tools more accessible, and mobilising community and peer support networks. Keywords Type 2 diabetes, Barriers to care, Belize, Central and South America, COVID-19 What is known about this topic • Social, familial, and peer supports are key to sustaining type 2 diabetes self-management, but these were confined during the COVID-19 pandemic. • Regular glucose monitoring, physical exams, and lifestyle behavior modification are part of the standard of care for patients, but these became even less accessible during the COVID-19 pandemic. • Without adequate screening, treatment, and selfmanagement education and support, patients are at increased risk for co-morbidities and mortality;
Background Type 2 Diabetes Mellitus (T2DM) is a primary cause of death in Belize, a low-income ... more Background
Type 2 Diabetes Mellitus (T2DM) is a primary cause of death in Belize, a low-income country with the highest rates in Central and South America. As many people in Belize cannot consistently access biomedical treatment, a reality that was exacerbated by the COVID-19 pandemic, plant medicine usage is estimated to have increased in recent years. This exploratory study seeks to understand which plants are being used, patterns of usage, and the state of patient-provider communication around this phenomenon.
Methods
Implementing a Constructivist Grounded Theory qualitative design, the research team conducted 35 semi-structured interviews with adults living with T2DM, 25 informant discussions, and participant observation with field notes between February 2020 and September 2021. Data analysis followed systematized thematic coding procedures using Dedoose analytic software and iterative verification processes.
Results
The findings revealed that 85.7% of participants used plants in their T2DM self-management. There were three main usage patterns, namely, exclusive plant use (31.4%), complementary plant use (42.9%), and minimal plant use (11.4%), related to factors impacting pharmaceutical usage. Almost none of participants discussed their plant medicine usage with their health care providers.
Conclusions
Plant species are outlined, as are patients’ reasons for not disclosing usage to providers. There are implications for the advancement of understanding ethnobotanical medicine use for T2DM self-management and treatment in Belize and beyond.
Australian and New Zealand journal of public health, Jun 1, 2024
The complexity of global public health requires increasing sophistication and cooperation across ... more The complexity of global public health requires increasing sophistication and cooperation across research designs. Understanding core beliefs and values in diverse populations, incentives and demotivators, barriers and facilitators – all processes that sway public health behaviour, uptake, adherence, and thus outcomes – are in the QHR realm of expertise. Indeed, there are some public health issues that can only be understood with a qualitative approach, yet there are still issues of methodological marginalization within biomedical and public health fields. By critically examining the role of QHR in public health, and particularly arising from the COVID-19 pandemic, we present a vision for moving beyond defending QHR as valid and rigorous, to championing the use of qualitative methods as a standard of excellence in certain research areas, such as community-engaged studies on urgent emerging infectious diseases affecting socially marginalized populations. When other methods are more appropriate to a given research question, QHR is still, at the very least, an essential complement that can bolster or dialogue with even the most quantitative, clinical studies.
Alternative, May 22, 2024
This study analyzes the literature on Indigenous sacred sites within the larger topic areas of la... more This study analyzes the literature on Indigenous sacred sites within the larger topic areas of land-based education and healing, as per the guidance of Anishinaabe (a group of Indigenous Peoples from the Great Lakes and the Great Plains areas of contemporary Canada and USA) Elders and community leaders in eastern Manitoba, Canada. A scoping review was conducted to identify the size, scope, nature, and key themes of existing research in seven databases, inclusive of gray literature which is a key source for Indigenous organizations. In total, we analyzed 35 articles and documents. The emerging themes included: (1) sacred sites and the promotion of health and wellness; (2) sacred sites as places of knowledge; (3) the desecration and protection of sacred sites; and (4) legal battles between Indigenous Peoples and the state. Recommendations to advance understandings and correct colonially imposed imbalances are discussed, and health and legal implications are outlined.
International Journal for Equity in Health, Aug 23, 2023
Belize has the highest national prevalence of type 2 diabetes (T2D) of Central and South America,... more Belize has the highest national prevalence of type 2 diabetes (T2D) of Central and South America, and fifth direst in the world. T2D is the leading cause of death in Belize, a country facing burdens of increasing prevalence with few resources. Since March of 2020, the COVID-19 pandemic has exacerbated the difficulties of those living with T2D in Belize. To address T2D issues in Belize, our interdisciplinary research team explored the barriers to care and selfmanagement for adult patients with T2D in Belize prior to and during the COVID-19 pandemic. Research relationships between Canadian (ARH) and Belizean (LE) authors have been ongoing since 2016. Together we used a qualitative Constructivist Grounded Theory design generating knowledge through 35 semi-structured patient interviews, 25 key informant discussions, and participant observation with field notes between February 2020 to September 2021. We used Dedoose analysis software for a systematized thematic coding process, as well as iterative verification activities. Findings revealed several barriers to care and self-management, including: 1) the tiered health and social care system with major gaps in coverage; 2) the unfulfilled demand for accurate health information and innovative dissemination methods; and 3) the compounding of loss of community supports, physical exercise, and health services due to COVID-19 restrictions. In the post-pandemic period, it is necessary to invest in physical, nutritional, economic, and psychosocial health through organized activities adaptable to changeable public health restrictions. Recommendations for activities include sending patients informational and motivational text messages, providing recipes with accessibly sourced T2D foods, televising educational workshops, making online tools more accessible, and mobilising community and peer support networks. Keywords Type 2 diabetes, Barriers to care, Belize, Central and South America, COVID-19 What is known about this topic • Social, familial, and peer supports are key to sustaining type 2 diabetes self-management, but these were confined during the COVID-19 pandemic. • Regular glucose monitoring, physical exams, and lifestyle behavior modification are part of the standard of care for patients, but these became even less accessible during the COVID-19 pandemic. • Without adequate screening, treatment, and selfmanagement education and support, patients are at increased risk for co-morbidities and mortality;
PLOS ONE
Background Type 2 Diabetes Mellitus (T2DM) is a primary cause of death in Belize, a low-income co... more Background Type 2 Diabetes Mellitus (T2DM) is a primary cause of death in Belize, a low-income country with the highest rates in Central and South America. As many people in Belize cannot consistently access biomedical treatment, a reality that was exacerbated by the COVID-19 pandemic, plant medicine usage is estimated to have increased in recent years. This exploratory study seeks to understand which plants are being used, patterns of usage, and the state of patient-provider communication around this phenomenon. Methods Implementing a Constructivist Grounded Theory qualitative design, the research team conducted 35 semi-structured interviews with adults living with T2DM, 25 informant discussions, and participant observation with field notes between February 2020 and September 2021. Data analysis followed systematized thematic coding procedures using Dedoose analytic software and iterative verification processes. Results The findings revealed that 85.7% of participants used plants i...
Informing Services through Patient Perspectives of Living with Type 2 Diabetes Mellitus in Belize, 2020
Type 2 diabetes mellitus (T2DM) is the leading cause of death in Belize, and its prevalence is ra... more Type 2 diabetes mellitus (T2DM) is the leading cause of death in Belize, and its prevalence is rapidly increasing. The purpose of this study is to understand the everyday realities of people living with T2DM in Belize (e.g., barriers to care, strengths, health practices), how these affect diabetes self-management (DSM), and implications for health care. Data generation methods include interviews with T2DM patients, discussions with key informants, field notes, and participatory observation which took place in February and March of 2020. Principal findings were categorized into three main themes. The first is that patients experience numerous difficulties, including a tiered health care system privileging those with more resources, communication barriers with health care providers, and major gaps in prevention, education, and social supports. Secondly, many Belizeans with T2DM engage in spiritual practices that provide for mental strength, stress relief, lifestyle guidance, overcoming addictions, overcoming denial, and building determination toward health promoting, life-affirming attitudes and actions. Further, geographies can empower DSM. Home is a domain where personal power is most focused. A community domain that is conducive to active living is crucial. People use a plethora of local plant medicines instead of, alongside of, or to complement pharmaceuticals for DSM without disclosure to HCPs. Plant medicine usage and cultural-spiritual healing is pervasive in this population; therefore, health care can optimize T2DM outcomes through open dialogue and collaboration with patients, herbal doctors, traditional Indigenous medicine practitioners, community leaders, and faith leaders. Integrating these understandings will be key for moving forward to improve DSM education and support, as well as culturally safe care.
Plos One, 2023
Background Type 2 Diabetes Mellitus (T2DM) is a primary cause of death in Belize, a low-income co... more Background Type 2 Diabetes Mellitus (T2DM) is a primary cause of death in Belize, a low-income country with the highest rates in Central and South America. As many people in Belize cannot consistently access biomedical treatment, a reality that was exacerbated by the COVID-19 pandemic, plant medicine usage is estimated to have increased in recent years. This exploratory study seeks to understand which plants are being used, patterns of usage, and the state of patient-provider communication around this phenomenon.
International Journal of Equity in Health, 2023
Belize has the highest national prevalence of type 2 diabetes (T2D) of Central and South America,... more Belize has the highest national prevalence of type 2 diabetes (T2D) of Central and South America, and fifth direst in the world. T2D is the leading cause of death in Belize, a country facing burdens of increasing prevalence with few resources. Since March of 2020, the COVID-19 pandemic has exacerbated the difficulties of those living with T2D in Belize. To address T2D issues in Belize, our interdisciplinary research team explored the barriers to care and selfmanagement for adult patients with T2D in Belize prior to and during the COVID-19 pandemic. Research relationships between Canadian (ARH) and Belizean (LE) authors have been ongoing since 2016. Together we used a qualitative Constructivist Grounded Theory design generating knowledge through 35 semi-structured patient interviews, 25 key informant discussions, and participant observation with field notes between February 2020 to September 2021. We used Dedoose analysis software for a systematized thematic coding process, as well as iterative verification activities. Findings revealed several barriers to care and self-management, including: 1) the tiered health and social care system with major gaps in coverage; 2) the unfulfilled demand for accurate health information and innovative dissemination methods; and 3) the compounding of loss of community supports, physical exercise, and health services due to COVID-19 restrictions. In the post-pandemic period, it is necessary to invest in physical, nutritional, economic, and psychosocial health through organized activities adaptable to changeable public health restrictions. Recommendations for activities include sending patients informational and motivational text messages, providing recipes with accessibly sourced T2D foods, televising educational workshops, making online tools more accessible, and mobilising community and peer support networks. Keywords Type 2 diabetes, Barriers to care, Belize, Central and South America, COVID-19 What is known about this topic • Social, familial, and peer supports are key to sustaining type 2 diabetes self-management, but these were confined during the COVID-19 pandemic. • Regular glucose monitoring, physical exams, and lifestyle behavior modification are part of the standard of care for patients, but these became even less accessible during the COVID-19 pandemic. • Without adequate screening, treatment, and selfmanagement education and support, patients are at increased risk for co-morbidities and mortality;
Spiritual, Religious, and Faith-Based Practices in Chronicity; An Exploration of Mental Wellness in Global COntext, 2021
This book explores how people draw upon spiritual, religious, or faith-based practices to support... more This book explores how people draw upon spiritual, religious, or faith-based practices to support their mental wellness amidst forms of chronicity. From diverse global contexts and spiritual perspectives, this volume critically examines several chronic conditions, such as psychosis, diabetes, depression, oppressive forces of colonization and social marginalization, attacks of spirit possession, or other forms of persistent mental duress. As an inter- and transdisciplinary collection, the chapters include innovative ethnographic observations and over 300 in-depth interviews with care providers and individuals living in chronicity, analyzed primarily from the phenomenological and hermeneutic meaning- making traditions. Overall, this book depicts a modern global era in which spiritualty and religion maintain an important role in many peoples’ lives, underscoring a need for increased awareness, intersectoral collaboration, and practical training for varied care providers. This book will be of interest to scholars of religion and health, the sociology and psychology of religion, medical and psychological anthropology, religious studies, and global health studies, as well as applied health and mental health professionals in psychology, social work, cultural psychiatry, and medicine.
Journal of Ethnicity in Substance Abuse, 2022
This study reviews and synthesizes the literature on Indigenous women who are pregnant/early pare... more This study reviews and synthesizes the literature on Indigenous women who are pregnant/early parenting and using substances in Canada to understand the scope and state of knowledge to inform research with the Aboriginal Health and Wellness Centre of Winnipeg in Manitoba and the development of a pilot Indigenous doula program. A scoping review was performed searching ten relevant databases, including one for gray literature. We analyzed 56 articles/documents. Themes include: (1) cyclical repercussions of state removal of Indigenous children from their families; (2) compounding barriers and inequities; (3) prevalence and different types of substance use; and (4) intervention strategies. Recommendations for future research are identified and discussed.
Canadian Medical Association Journal, 2022
KEY POINTS • Indigenous Peoples in Canada benefit from regaining access to and strengthening t... more KEY POINTS
• Indigenous Peoples in Canada benefit from regaining access to
and strengthening traditional cultural ways of life, including
health and healing practices.
• Many Indigenous communities are working to strengthen
cultural healing practices that were marred through
colonization and oppressive government policies.
• Indigenous-led health care partnerships provide innovative
models of interprofessional collaboration, be it in communitybased healing lodges, remote clinics or urban hospitals.
• Emerging evidence suggests that Indigenous-led health service
partnerships improve holistic (inclusive of mind, body, emotion
and spirit) health outcomes for Indigenous Peoples, as well as
access to care, prevention uptake and adherence to care plans
This book explores how people draw upon spiritual, religious, or faith-based practices to support... more This book explores how people draw upon spiritual, religious, or faith-based practices to support their mental wellness amidst forms of chronicity. From diverse global contexts and spiritual perspectives, this volume critically examines several chronic conditions, such as psychosis, diabetes, depression, oppressive forces of colonization and social marginalization, attacks of spirit possession, or other forms of persistent mental duress. As an inter- and transdisciplinary collection, the chapters include innovative ethnographic observations and over 300 in-depth interviews with care providers and individuals living in chronicity, analyzed primarily from the phenomenological and hermeneutic meaning- making traditions. Overall, this book depicts a modern global era in which spiritualty and religion maintain an important role in many peoples’ lives, underscoring a need for increased awareness, intersectoral collaboration, and practical training for varied care providers. This book will be of interest to scholars of religion and health, the sociology and psy- chology of religion, medical and psychological anthropology, religious studies, and global health studies, as well as applied health and mental health professionals in psychology, social work, cultural psychiatry, and medicine.
Australian and New Zealand Journal of Public Health, 2024
The complexity of global public health requires increasing sophistication and cooperation across ... more The complexity of global public health requires increasing sophistication and cooperation across research designs. Understanding core beliefs and values in diverse populations, incentives and demotivators, barriers and facilitators – all processes that sway public health behaviour, uptake, adherence, and thus outcomes – are in the QHR realm of expertise. Indeed, there are some public health issues that can only be understood with a qualitative approach, yet there are still issues of methodological marginalization within biomedical and public health fields. By critically examining the role of QHR in public health, and particularly arising from the COVID-19 pandemic, we present a vision for moving beyond defending QHR as valid and rigorous, to championing the use of qualitative methods as a standard of excellence in certain research areas, such as community-engaged studies on urgent emerging infectious diseases affecting socially marginalized populations. When other methods are more appropriate to a given research question, QHR is still, at the very least, an essential complement that can bolster or dialogue with even the most quantitative, clinical studies.
AlterNative, 2024
This study analyzes the literature on Indigenous sacred sites within the larger topic areas of la... more This study analyzes the literature on Indigenous sacred sites within the larger topic areas of land-based education and healing, as per the guidance of Anishinaabe (a group of Indigenous Peoples from the Great Lakes and the Great Plains areas of contemporary Canada and USA) Elders and community leaders in eastern Manitoba, Canada. A scoping review was conducted to identify the size, scope, nature, and key themes of existing research in seven databases, inclusive of gray literature which is a key source for Indigenous organizations. In total, we analyzed 35 articles and documents. The emerging themes included: (1) sacred sites and the promotion of health and wellness; (2) sacred sites as places of knowledge; (3) the desecration and protection of sacred sites; and (4) legal battles between Indigenous Peoples and the state. Recommendations to advance understandings and correct colonially imposed imbalances are discussed, and health and legal implications are outlined.
International Journal for Equity in Health, 2023
Belize has the highest national prevalence of type 2 diabetes (T2D) of Central and South America,... more Belize has the highest national prevalence of type 2 diabetes (T2D) of Central and South America, and fifth direst in the world. T2D is the leading cause of death in Belize, a country facing burdens of increasing prevalence with few resources. Since March of 2020, the COVID-19 pandemic has exacerbated the difficulties of those living with T2D in Belize. To address T2D issues in Belize, our interdisciplinary research team explored the barriers to care and selfmanagement for adult patients with T2D in Belize prior to and during the COVID-19 pandemic. Research relationships between Canadian (ARH) and Belizean (LE) authors have been ongoing since 2016. Together we used a qualitative Constructivist Grounded Theory design generating knowledge through 35 semi-structured patient interviews, 25 key informant discussions, and participant observation with field notes between February 2020 to September 2021. We used Dedoose analysis software for a systematized thematic coding process, as well as iterative verification activities. Findings revealed several barriers to care and self-management, including: 1) the tiered health and social care system with major gaps in coverage; 2) the unfulfilled demand for accurate health information and innovative dissemination methods; and 3) the compounding of loss of community supports, physical exercise, and health services due to COVID-19 restrictions. In the post-pandemic period, it is necessary to invest in physical, nutritional, economic, and psychosocial health through organized activities adaptable to changeable public health restrictions. Recommendations for activities include sending patients informational and motivational text messages, providing recipes with accessibly sourced T2D foods, televising educational workshops, making online tools more accessible, and mobilising community and peer support networks. Keywords Type 2 diabetes, Barriers to care, Belize, Central and South America, COVID-19 What is known about this topic • Social, familial, and peer supports are key to sustaining type 2 diabetes self-management, but these were confined during the COVID-19 pandemic. • Regular glucose monitoring, physical exams, and lifestyle behavior modification are part of the standard of care for patients, but these became even less accessible during the COVID-19 pandemic. • Without adequate screening, treatment, and selfmanagement education and support, patients are at increased risk for co-morbidities and mortality;
Background Type 2 Diabetes Mellitus (T2DM) is a primary cause of death in Belize, a low-income ... more Background
Type 2 Diabetes Mellitus (T2DM) is a primary cause of death in Belize, a low-income country with the highest rates in Central and South America. As many people in Belize cannot consistently access biomedical treatment, a reality that was exacerbated by the COVID-19 pandemic, plant medicine usage is estimated to have increased in recent years. This exploratory study seeks to understand which plants are being used, patterns of usage, and the state of patient-provider communication around this phenomenon.
Methods
Implementing a Constructivist Grounded Theory qualitative design, the research team conducted 35 semi-structured interviews with adults living with T2DM, 25 informant discussions, and participant observation with field notes between February 2020 and September 2021. Data analysis followed systematized thematic coding procedures using Dedoose analytic software and iterative verification processes.
Results
The findings revealed that 85.7% of participants used plants in their T2DM self-management. There were three main usage patterns, namely, exclusive plant use (31.4%), complementary plant use (42.9%), and minimal plant use (11.4%), related to factors impacting pharmaceutical usage. Almost none of participants discussed their plant medicine usage with their health care providers.
Conclusions
Plant species are outlined, as are patients’ reasons for not disclosing usage to providers. There are implications for the advancement of understanding ethnobotanical medicine use for T2DM self-management and treatment in Belize and beyond.