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Great Supervisor Week Mentions
It's #greatsupervisor week at #UBC and I want to thank Dr. John Oliffe @MensHealthUBC for challenging me to think critically and creatively.
Graduate Student Supervision
Doctoral Student Supervision (Jan 2008 - Nov 2019)
Background: The mental health of young immigrant and refugee men has drawn much recent attention worldwide. Increased awareness regarding depression and suicide among men has intersected with pressing dialogues around how to best address the health needs of immigrant and refugee populations. Despite this attention, integrated knowledge translation (iKT) research in the field of mental health has yet to engage this group and virtually no studies have focused on their mental health experiences. The purpose of this research was to examine mental health and distress from the perspectives of immigrant and refugee young men living in Greater Vancouver, British Columbia, Canada. Methods: An iKT approach was applied to integrate the perspectives of (1) research collaborators, who were six immigrant and refugee young men, and (2) an advisory group, comprised of service providers and program leaders into the study design and mobilization of the study findings. Narrative analysis methods, informed by the analytical lenses of social context and critical masculinities, were used to collect and examine the data from individual and group interviews with thirty-three immigrant and refugee young men (ages 15-22 years). Participatory video methods were used to facilitate the co-creation of a film with the collaborators based on qualitative data from the research interviews. A reflexive analysis was used to examine ethnographic field notes documenting the iKT design and the participatory video methods.Findings: The results reveal that (1) the participants’ distress-related experiences were shaped in part by masculine discourses; (2) experiences of second-class citizenship, in the context of their everyday life, influenced how young men perceived their mental health; and (3) iKT and participatory video methods can lead to new insights about power and representation. Conclusions: This dissertation contributes to the literature on immigrant and refugee youth mental health and young men’s experiences of distress. It provides insights to guide future iKT and participatory video research. The findings can inform equity-oriented practice, policy, and future research to support the mental health of immigrant and refugee young men in Canada.
The objective of this study was to explore the connections between men’s experiences of work, prostate cancer and radical prostatectomy to develop a grounded theory that describes the processes used by participants to reformulate the worker identity. The research questions that guided the study were:1.How does screening and diagnosis of prostate cancer affect men and their work? and 2. How are participants’ work-related experiences affected following radical prostatectomy? Digitally recorded, in-depth, individual interviews were conducted with 24 English speaking men who were working at the time of prostate cancer diagnosis and subsequently underwent radical prostatectomy. Constructivist grounded theory guided collection and analysis of the data. A masculinities framework highlighted the ways in which gender shaped participants’ experiences. Findings suggest that work was central to participants’ masculine identities and was an activity that benefited men and their families. Related to this, finding prostate cancer emerged as a threat to most men’s health and work, and a stark reminder of their mortality. Choosing radical prostatectomy was viewed as necessary in treating the disease to ensure survival. In preparing the workplace for their absence due to surgery, men made sick leave arrangements with the aim of minimizing disruptions to workplace productivity. The basic social process of Reformulating the Worker Identity after radical prostatectomy was developed. Results indicate that men reformulated worker identities to accommodate treatment side-effects and challenges for fully resuming work responsibilities. This process comprised two parts. First, recovering after radical prostatectomy allowed men to restore physical strength to resume daily activities through processes that included embodying the sick role, contesting side-effects, and conceding new realities wherein men drew on masculine ideals of resilience and responsibility for solving one’s problems, and by reconciling the changes surgery had imposed on their lives. Second, in re-negotiating work expectations, men adjusted work responsibilities to facilitate their return to work by assessing work capacity, re-balancing work and health, and re-setting work obligations, wherein men reevaluated the importance of work in relation to emergent health needs and lobbied for return to work accommodations needed to sustain ongoing recovery.
Smoke-free grounds policies (SFGPs) were introduced in acute psychiatric hospital settings to help improve health among patients, staff, and visitors. However, enacting these policies has been challenging. Recognizing that cultural norms around tobacco use may influence policy enactment, a qualitative ethnographic study was undertaken in Northern British Columbia, Canada to improve understandings about how SFGPs are affected by institutional cultures. Data included participant observation, document analysis, informal fieldwork discussions (n=11), and interviews with patients (n=20), healthcare professionals (n=19), and key informants (n=2) at two hospitals. Data were analyzed using iterative processes to inductively derive thematic findings and develop cultural understandings. Cultural factors supported some healthcare professionals in subverting and resisting the SFGP while advocating and caring for patients. Strong consultative leadership, including input and participation by those most directly responsible for policy implementation, offered the strongest indication that policy-maker intent could be implemented. This study highlights the actions taken and challenges faced by those implementing SFGPs in inpatient psychiatric settings. Consistency in implementing the SFGP across the organization was a significant challenge, influenced by local context, the nature of the policy, resource availability, and healthcare professional discretion under the policy. Patients responded to the SFGP in a variety of ways, but ultimately remained resigned to smoking and believed hospitals had a duty to accommodate them and their smoking. The centrality of smoking was rooted in personal beliefs sustained by both healthcare professionals and patients, and enforced through group norms. The study offers new evidence about the importance of local and cultural contexts to SFGP implementation and reports for the first time how rurality may influence SFGP implementation in psychiatric settings in Canada. Local contexts and cultural factors can be conceptualized in a socio-ecological model of intra-personal, inter-personal, institutional factors, and community/environment spheres of influence, to structure inquiry and analysis of SFGP implementation. It is suggested that policy-makers avoid oversimplified macro-level approaches to SFGP development and implementation in favour of more localized, simultaneous, top-down, bottom-up approaches, with accompanying support for those most directly involved in implementation efforts to improve policy fidelity and any needed shift of cultural norms.
Master's Student Supervision (2010 - 2018)
Despite many health promotion efforts to reduce or stop women’s smoking during pregnancy and postpartum, less attention has focused on fathers’ smoking behaviours. This qualitative study examined interviews conducted with 20 new fathers to describe the connections between gender relations and men’s smoking during their partners’ pregnancy and the postpartum period. In addressing the question of what fathers’ perceive as their partners’ strategies to assist them to reduce or quit smoking, three key themes were identified: Supporting autonomy in men’s smoking cessation, nagging to challenge men’s freedom to smoke, and contempt for men’s continued smoking. In addressing the question of how heterosexual gender relations influence fathers’ masculine ideals in the context of smoking, two themes were identified: Reconciling to maintain a smoke-free home and smoking to mediate relationships. Social constructionist gender frameworks were used to theorize the findings. The results reveal the importance of constructing tobacco reduction and smoking cessation as a fathering responsibility amid trading on masculine ideals by appealing to men’s autonomy, willpower and strength to be smoke-free.
Men’s depression is a complex health care issue in Canadian society. Depression has negative impacts on many aspects of men’s lives including work performance, school achievement and relationship success. Adherence to hegemonic masculine ideals including strength and self-reliance lead some men to keep depression hidden amid broader social stigma whereby mental health challenges are often equated with weakness. Heterosexual men who experience depression rely heavily on relationship support from their women partners and often refuse to seek help from health care providers or engage with public health services. In order for men’s depression services to be effective, they must celebrate hegemonic masculine values including leadership and strength while acknowledging the key role women partners play in encouraging depressed men to seek help. Results include how depressed men go to great lengths to keep it hidden, attempt self-management, say that they want help but seldom make efforts to seek it, rely heavily on their women partners for support, make efforts to shield women partners from the most negative aspects of their condition and acknowledge that their women partners are critical to their recovery.
Background: Suicide is a serious health concern worldwide. In 2007, almost 4,000 Canadians took their own lives and among older and middle-age groups, suicide is one of the leading causes of death for both men and women. Given the far-reaching impact on families and societies, suicide has been widely studied; yet, accounts about the connections between suicide and culture in the context of immigrant populations are still poorly understood. Objective: To better understand the connections between suicide and culture, and to provide a foundation on which to build targeted culturally-sensitive suicide prevention programs, this research used qualitative research method to describe the perception and experiences of suicide of fifteen Korean-Canadian immigrants.Results: Three inductively derived themes were identified to detail the study findings: 1) perceptions of and attitudes toward suicide among Korean-Canadian immigrants; 2) narratives around the causes and triggers of their suicidal thoughts and behaviours; and 3) manifestations of and strategies to manage their suicidal thoughts and behaviours. Within these three themes, there are a total of nine sub-themes which are intricately connected. Discussion: While recognising and embodying stigma around suicide, participants understood the hopelessness and despair that could drive immigrants toward suicide. Causes and triggers for suicidal thoughts most often emerged from academic pressures, estranged family, and dis-identities – all of which were intricately connected to participants’ immigration experiences. Noteworthy were deeply embedded Confucian values, which could exert an array of influences on Korean-Canadians. In addition, extensively discussed were dis-identity experiences whereby a sense of self and as well as collectivist familial bonds were challenged, and suicidal ideation could flow toward and/or from these changes. Many participants were unaware of mental health services and programs amid being challenged by language barriers when they did access mental health services. While, it is critical for healthcare providers to understand immigrant patients’ cultural background to fully assess their risk for suicide, also urgently needed are targeted efforts to raise public awareness about suicide and educate immigrants about professional and self-help options to manage their mental health and well-being.
No abstract available.
Few authors have specifically analyzed college men’s help-seeking for depression. Those studies that have focused on the relationship between college men’s attitudes towards seeking psychological help and the male gender role are limited in that they neglect to contextualize help-seeking behaviours. Earlier studies have also assumed that all college men adhere to traditional masculine ideals in their help-seeking decision-making. This qualitative study analyzed 21 interviews with college men who self-reported as having either clinical depression or symptoms of depression. In acknowledging the multiplicity of masculinities, this study used social constructionism to explore the way in which college men enact their masculinities in various help-seeking contexts for depression-related symptoms. Four key themes were identified: conforming to social norms, maintaining stoicism and limiting self-disclosure around friends and peers, family validating the need for professional help, and preserving autonomy. This study also examined the interplay between college men’s masculinities and their perception of help-seeking for depression symptoms. The findings demonstrate the college men’s masculine ideals surrounding help-seeking for mental illnesses.