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Supplemental Digital Content is Available in the Text. In 2011, the Canadian Academy of Sport and Exercise Medicine released their first position paper on Abuse, Harassment, and Bullying in Sport. Since this time, there have been significant advancements within the global sport landscape, including the emergence of regulatory bodies and initiatives aimed at prioritizing athletes' health and well-being. While the shift to a more proactive approach for safeguarding athletes is evident and promising, athletes continue to be affected by cases of maltreatment. To advance safe sport, it is critical that all supporters of safe and healthy performance are aware of their roles and responsibilities for preventing and addressing maltreatment, including the Canadian sport medicine community. In this updated position statement, recent advancements in research on issues of maltreatment are summarized and specific recommendations are provided on how the medical community can contribute to appropriately identifying, treating, and preventing harm in sport, as well as their role in advocating for the health and well-being of athletes in their care. [ABSTRACT FROM AUTHOR]

What role do texts play in LGBTQ (lesbian, gay, bisexual, transgender, and queer) parents’ experiences of disability service systems? In interviews with 15 LGBTQ parents of disabled children in Toronto, Canada, participants selected documents to be used as a focus for discussion. Parents considered how LGBTQ identity and other intersectional identities influenced their experiences of institutional texts including adoption certificates, intake forms, and assessments. Findings suggest that documentation practices can operate as forms of systemic gatekeeping. LGBTQ identity was sometimes very significant in parents’ accounts, and sometimes less central than other aspects of their families' identities and experiences. [ABSTRACT FROM PUBLISHER]

Background: This manuscript is coauthored by 15 young adult Patient RESearch partners (PARES) with lived and living mental health experiences and three institutional researchers across Canada involved in a patient-oriented research (POR) study called the HEARTS Study: Helping Enable Access and Remove Barriers To Support for Young Adults with Mental Health-Related Disabilities. We share our reflections, experiences and lessons learned as we grapple with the field of POR for its lack of clarity, hierarchical structures, internalized ableism, and accessibility challenges, among others. To mitigate the difficulties of POR, we started by laying the groundwork for equality by embracing the principle of Primus Inter Pares: First Among Equals as the foundation of our approach. In this way, we began with what we know for certain: the inherent worth and dignity of young adults as equal partners, recognizing their expertise, worldviews, creativity, and capacity to contribute meaningfully and intentionally to the research that affects their lives and futures. Main Body: The manuscript underscores the need to reconceptualize meaningful engagement in POR, advocating a shift from traditional, biased paradigms that fail to address the complexities faced by young adults with mental illness. It introduces what we have termed Adaptive and Differential Engagement, underscoring the necessity of tailoring participation to individual preferences and circumstances alongside a Tripartite Compensation model that promotes fair and holistic remuneration in research collaborations. Then we discuss the approaches we have conceptualized, such as Equitable Dialogue, Trust Architecture, Community Continuum, Unity in Diversity, Shared Stewardship, and Agile Frameworks that collectively aim to overcome barriers like language intimidation, power imbalances, framework fatigue, consultation burnout, trust deficits, and systemic discrimination and exclusion. The manuscript does not seek to prescribe any universal or standardized solutions; in fact, it seeks the opposite. Instead, it offers a thoughtful and transparent contribution to the POR canon, providing resources for young adults eager to engage in research and institutional researchers aspiring to collaborate with them. Conclusion: This manuscript is a product of our collective learning and critical self-evaluation. By integrating theoretical insights with practical strategies, we present a justice-oriented blueprint for an inclusive and egalitarian approach to POR. We advocate for applications of POR that are responsive to the individualized contexts of young adult PARES, ensuring their perspectives are central to the research with the resources to take the lead should they choose. Plain Language Summary: Together with a graduate student, co-supervisors, and 15 young people from across Canada who have experience with mental health challenges, this paper looks at how research involving young adults as patient research partners can be better. We feel that the types of research that are supposed to include us are often not clear enough and make it hard to join, especially those with unique life situations and health issues. So, in this paper, we suggest a few new ways of doing things where everyone is treated equally. We call it Primus Inter PARES: First Among Equals. This means young people are just as important as anyone else in research. We want to change the old ways that do not consider our unique experiences as young people with mental health issues. We came up with new ideas like 'Equitable Dialogue' and 'Trust Architecture' to ensure everyone understands the research and feels that they can trust the process. We also suggest ways to make sure different voices are heard and that everyone has a fair chance to contribute. We do not just offer a one-size-fits-all solution; instead, we share many ways to improve research to help young adults who want to be part of research and for the researchers who want to work with us. Our paper is about making research fair and including everyone's point of view. We hope this will make the research better for everyone, especially for young adults. [ABSTRACT FROM AUTHOR]

Purpose: HIV or AIDS remains invisible and dismissed by most South Asians living in Canada as HIV or AIDS issues are perceived as an offshoot of Western lifestyle linked with drug use and promiscuity. This paper aims to look into how people living with HIV or AIDS (PLWHA) cope with prejudice and stigma. Design/methodology/approach: To guide this research, a constructivist grounded theory approach was adopted as the theoretical and methodological framework. The authors reached the participants through a Toronto-based group that works with PLWHA. The authors chose their respondents in a snowball method and interviewed them both in person and online. Findings: This paper identifies how South Asian immigrants and refugees/refugees with HIV or AIDS claimants are vulnerable to discrimination in Canada due to the following factors, which include but are not limited to: a lack of information about HIV and AIDS incidence in the community; and the Canadian health system's inability to respond appropriately to the lack of information. Practical implications: HIV service engagements should take place within the context of a constellation of local traditions, or standardized expectations of patient engagement with HIV services can be counterproductive. Originality/value: It is critical that governmental action prioritizes increasing public understanding of stigma. To minimize the consequences of HIV-related discrimination and stigma, misconceptions about HIV transmission must be debunked. [ABSTRACT FROM AUTHOR]

Background: Indigenous children living in high income countries have a consistently high prevalence of mental health problems. We aimed to identify psychosocial risk and protective factors for mental health in this setting. Methods: A systematic review of studies published between 1996 and 2016 that quantitatively evaluated the association between psychosocial variables and mental health among Indigenous children living in high income countries was conducted. Psychosocial variables were grouped into commonly occurring domains. Individual studies were judged to provide evidence for an association between a domain and either good mental health, poor mental health, or a negligible or inconsistent association. The overall quality of evidence across all studies for each domain was assessed using the Grades of Recommendation, Assessment, Development, and Evaluation (GRADE) guidelines. Results: Forty-seven papers were eligible (mainland US 30 [64%], Canada 8 [17%], Australia 7 [15%], Hawaii 4 [9%]), including 58,218 participants aged 4-20 years. Most papers were cross-sectional (39, 83%) and measured negative mental health outcomes (41, 87%). Children's negative cohesion with their families and the presence of adverse events appeared the most reliable predictors of increased negative mental health outcomes. Children's substance use, experiences of discrimination, comorbid internalising symptoms, and negative parental behaviour also provided evidence of associations with negative mental health outcomes. Positive family and peer relationships, high self-esteem and optimism were associated with increased positive mental health outcomes. Conclusions: Quantitative research investigating Indigenous children's mental health is largely cross-sectional and focused upon negative outcomes. Indigenous children living in high income countries share many of the same risk and protective factors associated with mental health. The evidence linking children's familial environment, psychological traits, substance use and experiences of discrimination with mental health outcomes highlights key targets for more concerted efforts to develop initiatives to improve the mental health of Indigenous children. [ABSTRACT FROM AUTHOR]

This paper contributes to the growing body of work on precarious labor, immigration, and social gerontology by examining the racialization of precarious employment across the life course. In particular, the authors examine the impact of precarious employment and discrimination among racialized older immigrants in Canada. Racialized older immigrants are more likely to be disadvantaged by the effects of lifelong intersections of economic and social discrimination rooted in racialization, gender, ageism, and socio-economic status. Drawing from a narrative-photovoice project that focused on the life stories of older immigrants living in Quebec and British Columbia, this paper presents the in-depth stories and photographs of four participants to highlight how intersections of race, gender, age, immigration status, and ability shape and structure experiences of aging, labor market participation and caregiving relationships. [ABSTRACT FROM AUTHOR]

Universities, both in Canada and throughout the global North, are predicated on empiricist and positivist understandings of knowledge and knowledge production which are communicated and strengthened through research practices and protocols. Drawn from a larger study exploring research leadership among accomplished academic staff, this paper examines interviews with eight racialised female academic staff who focus on social justice research predicated on co-producing knowledge with marginalised communities. Building on the rich scholarship which conveys the consequences of systemic discrimination for racialised and Indigenous scholars working in Canadian universities, we explore how participants navigate systems that fail to understand their epistemological and methodological orientation towards research and consider what it reveals about research culture and claims of inclusiveness in the Canadian academy. Drawing on Sara Ahmed's work on performative diversity in academia, we consider how academic structures, protocols and policies associated with research influence the social production of knowledge and resist change toward greater equity and Reconciliation demanded of Canadian higher education. [ABSTRACT FROM AUTHOR]

A substantial minority of adolescents experience and use dating violence in their sexual and/or romantic relationships. Limited attention has been paid to exploring theory-driven questions about use and experience of adolescent dating violence (ADV), restricting knowledge about promising prevention targets for diverse groups of youth. To address this gap, this paper investigates whether factors tied to power imbalances (bullying, risk of social marginalization) are associated with patterns of ADV victimization and perpetration in a large sample of Canadian mid-adolescents. We used data from the 2017/2018 Health-Behavior in School-Aged Children (HBSC) study, a nationally representative sample of Canadian youth. Our study was comprised of adolescents who were in grades 9 or 10, and who had dated in the past 12 months (N = 3779). We assessed multiple forms of ADV and bullying victimization and perpetration. We also included six variables assessing adolescents' risk of social marginalization: gender, race/ethnicity, immigration status, family structure, food insecurity, and family affluence. We used latent class analysis to explore the ways adolescents experience and use different forms of ADV, and then examined whether factors tied to power imbalances (bullying, social marginalization) were associated with classes of ADV. Three ADV classes emerged in our sample: uninvolved (65.7%), psychological and cyber victimization only (28.9%), and mutual violence (5.4%). Bullying was most strongly associated with the mutual violence class, suggesting a transformation of power from peer to romantic contexts. Social marginalization variables were associated with ADV patterns in different ways, highlighting the need to use a critical and anti-oppressive lens in ADV research and prevention initiatives. [ABSTRACT FROM AUTHOR]

Both scholarly and popular accounts of Canada's relatively non-conflictual immigration politics have attributed substantial power to the selectivity of the country's immigration policy. In this paper, we use new measures of knowledge of the fiscally selective elements of the immigration system to demonstrate that individuals who know more about the system are, in fact, more supportive of immigration, and that this impact is strongest among those who consider themselves on the left. We argue that this is evidence of the progressive's dilemma, showing in particular that knowledge of welfare state-relevant selection criteria such as the Canadian system's discrimination against those with chronic illnesses or those who are older is much more important in determining the attitudes of respondents on the left than those on the right. [ABSTRACT FROM AUTHOR]

Migrants, that is people who experience forced displacement or move based on being lesbian, gay, bisexual, trans, two-spirit, queer, and intersex (LGBTQI+), experience increased trauma and stigma when compared to heterosexual and cisgender people. The aim of this paper is to highlight LGBTQI+ migrants' experiences of health and social care encounters in Canada. Gadamerian hermeneutics and an intersectionality lens was used to understand LGBTQI+ migrants' experiences. A total of 16 semi-structured individual interviews were conducted with LGBTQI+ migrants. Themes of stigma and discrimination were identified as (1) "I never went back": Stigma as an exclusionary experience, (2) "Is [your country of birth] really that bad": Fear, safety, and cultural stigma, and (3) "The circle ... is not going to fix my life": LGBTQI+ migrants' call for affirming care. Results suggest that health and social care practices are stigmatizing and discriminatory which negatively impacts LGBTQI+ migrant mental health. Salient practices for promoting mental health included affirming LGBTQI+ identities and orientations through health and social care practices that are culturally safe as well as trauma and violence informed. [ABSTRACT FROM AUTHOR]

This paper draws on studies carried out in Canada (2016-2018) and the UK (2009-18) which explored the experiences of boys and men with Duchenne muscular dystrophy (DMD). Life expectancy with DMD has increased significantly and generations of men lead lives that many did not expect them to be leading. This paper searches our data to see if boys and men with DMD are supported to manage the precariousness of a life shorter than the 'norm'. Our studies had focuses on transition to adulthood, gender, social care, interactions in rehabilitation clinics, and managing conversations about death. The paper discusses how respondents framed DMD within time and the life-course. Our analysis suggests that ableist assumptions about time make the management of a challenging disease such as DMD even more challenging. We found little evidence of boys and men being helped to think through how to plan for a life expectancy that kept shifting. [ABSTRACT FROM AUTHOR]

Gender norms, roles and relations differentially affect women, men, and non-binary individuals' vulnerability to disease. Outbreak response measures also have immediate and long-term gendered effects. However, gender-based analysis of outbreaks and responses is limited by lack of data and little integration of feminist analysis within global health scholarship. Recognising these barriers, this paper applies a gender matrix methodology, grounded in feminist political economy approaches, to evaluate the gendered effects of the COVID-19 pandemic and response in four case studies: China, Hong Kong, Canada, and the UK. Through a rapid scoping of documentation of the gendered effects of the outbreak, it applies the matrix framework to analyse findings, identifying common themes across the case studies: financial discrimination, crisis in care, and unequal risks and secondary effects. Results point to transnational structural conditions which put women on the front lines of the pandemic at work and at home while denying them health, economic and personal security – effects that are exacerbated where racism and other forms of discrimination intersect with gender inequities. Given that women and people living at the intersections of multiple inequities are made additionally vulnerable by pandemic responses, intersectional feminist responses should be prioritised at the beginning of any crises. [ABSTRACT FROM AUTHOR]

The field of Child and Youth Care continues to expand and the foundational theories that have been central to the development of the field continue to de adapted. However, the increasing diversity of Canada's populations requires the inclusion of multiple theoretical frameworks that can address the needs of the children, youth and families that we encounter. This paper examines the ways in which anti-oppression and anti-racism perspectives can be included as an aspect of CYC thought and practice, with particular relevance to service provision for African Canadian families. [ABSTRACT FROM AUTHOR]

In this pa per, we argue for the importance of unsettling dominant narratives in the current terrain of harm-reduction policy, practice and research. To accomplish this, we trace the historical developments regarding the Human Immunodeficiency Virus (HIV), the Hepatitis C Virus (HCV) and harm-reduction policies and practice. We argue that multiple historical junctures rather than single causes of social exclusion engender the processes of marginalisation, propelled by social movements, institutional interests, state legislation, community practices, neo-liberalism and governmentality techniques. We analyse interests (activist, lay expert, institutional and state) in the harm-reduction field, and consider conceptualisations of risk, pleasure, stigma, social control and exclusionary moral identities. Based on our review of the literature, this paper provides recommendations for social workers and others delivering health and social care interested in the fields of substance use, HIV prevention and harm reduction. [ABSTRACT FROM AUTHOR]

COVID-19 has imposed numerous challenges onto Canadians including income insecurity, reduced access to healthcare, and last-minute workplace adaptations. Although these obstacles have altered the lives of thousands, many people in the disability community have been struggling with these challenges for years. This paper outlines how Canada's response to the COVID-19 pandemic uncovers the pervasive ableist attitudes that are present at both the government and societal levels. [ABSTRACT FROM AUTHOR]

Emerging research suggests that students from equity-deserving groups (EDGs) may experience barriers within work-integrated learning (WIL) that other students may not face, and such barriers may negatively impact students’ participation in WIL. Guided by a social justice lens, this study used interviews of co-operative education (co-op) students (n = 30) from EDGs to explore barriers that such students experienced in one Canadian co-op program. Analyses of qualitative data showed that these students experienced non-structural barriers (those that are less explicit, such as internalized discrimination) and structural barriers (those related to policy and practice, both within their co-op program and their host organizations). While some barriers were specific to a given EDG, others were common across EDGs. These findings provide a fuller picture of the kinds of barriers experienced by WIL students within and across EDGs. [ABSTRACT FROM AUTHOR]

Throughout history different practices have attempted to silence the experiences of disabled people. In this paper we explore some of these practices including the medical, familial, and self-subjugating practices English-speaking Canadian polio survivors experienced throughout their lives. We analyze participant’s experiences of silence and silencing through a Foucauldian lens, drawing on the three modes of objectification to explain the institutional and cultural discourses around polio subjects that acted upon and through the polio body to silence it. Participants’ oral history accounts demonstrate how sociocultural and medical practices effectively silenced survivors from speaking about their polio experiences. However, the trope of silence is also uprooted within oral history traditions. We will demonstrate how participants broke their silence and shifted their perspectives on polio and disability, and how this process contributed to their resistance of hegemonic conceptualizations of disability as defective. [ABSTRACT FROM AUTHOR]

Bias pervades every aspect of healthcare including admissions, perpetuating the lack of diversity in the healthcare workforce. Admissions interviews may be a time when applicants to health profession education programs experience discrimination. Between January and June 2021 we invited US and Canadian applicants to health profession education programs to complete a survey including the Everyday Discrimination Scale, adapted to ascertain experiences of discrimination during admissions interviews. We used chi-square tests and multivariable logistic regression to determine associations between identity factors and positive responses. Of 1115 respondents, 281 (25.2%) reported discrimination in the interview process. Individuals with lower socioeconomic status (OR: 1.78, 95% CI [1.26, 2.52], p = 0.001) and non-native English speakers (OR: 1.76, 95% CI [1.08, 2.87], p = 0.02) were significantly more likely to experience discrimination. Half of those experiencing discrimination (139, or 49.6%) did nothing in response, though 44 (15.7%) reported the incident anonymously and 10 (3.6%) reported directly to the institution where it happened. Reports of discrimination are common among HPE applicants. Reforms at the interviewer- (e.g. avoiding questions about family planning) and institution-level (e.g. presenting institutional efforts to promote health equity) are needed to decrease the incidence and mitigate the impact of such events. [ABSTRACT FROM AUTHOR]

The Peel Region of Toronto, Canada is home to over a third of the province's South Asian population. Youth are at a vulnerable time period in terms of their mental health. South Asian youth populations may face additional challenges to their mental health such as acculturative stress, intergenerational conflict, and racism and discrimination. This qualitative study set out to understand the mental health concerns and service access barriers experienced by South Asian youth populations in the Peel Region of Toronto, Canada from the perspective of mental health service providers. In-depth semi-structured interviews were carried out with mental health service providers (n = 22) who work with South Asian youth living in Peel Region. Thematic analysis was used to elucidate themes related to mental health stressors and service access barriers experienced by youth. According to mental health service providers, South Asian youth navigate a number of unique stressors related to the domains of culture, religion, and family dynamics, experiences of discrimination, the impact of migration, beliefs around mental illness and help-seeking, help-seeking trajectories and therapy recommendations, and lastly, sex differences. Mental health service providers outlined steps needed to effectively address the unique mental health challenges, best practice guidelines, and recommendations for working with South Asian youth, families, and communities to provide a practical and nuanced overview on how a multi-level strategy for mental health care can effectively meet the needs of South Asian youth populations. [ABSTRACT FROM AUTHOR]

Amidst a barrage of policy documents, bio-medical research, and press items concerned with the “crisis” of obesity, a growing scholarship is concerned with what has come to be known as “obesity stigma.” This scholarship hails from a range of sources including critical obesity scholars who problematize the idea of obesity as a health concern, as well as from “mainstream” organizations and researchers who, while maintaining obesity is a world-wide health problem, also argue that “obese” people are the targets of discrimination. In this paper, we analyze both interpretations of obesity stigma, particularly as that stigma applies to obese women's experiences of accessing and receiving reproductive care. We describe a qualitative study conducted with 24 overweight and obese women in 2 Canadian cities. Participants related overt and covert experiences of stigma when accessing reproductive care founded in healthcare practitioners' focus on fetal risk and “mother-blame” which, though partially evidence-based, was interpreted by participants as discriminatory. As such, we maintain that any true interruption of obesity stigma in the reproductive healthcare interaction requires a bridge between critical and mainstream scholarship, and careful attention to the risk-based foci in clinical settings which can be interpreted by clients as moralizing. [ABSTRACT FROM AUTHOR]

In Canada and many other countries, voices from across the political spectrum are using the metaphor of "war" to describe contentious debates on a diverse range of topics. While the socalled culture wars are poorly defined, there is certainly evidence of increasing affective polarization (strong negative feelings toward out-group members). Many conflicts prominently feature destructive approaches based on ineffective theories of change. Even social change movements fighting for goals that are closely aligned with those of peace workers--achieving more egalitarian societies that respect the dignity and human rights of all and overcome systemic discrimination based on race, gender, sexual orientation, and other identity characteristics--appear to urgently need the knowledge that exists in fields like peace and conflict studies. The reasons for this, and the particular insights that peace and conflict experts have to offer to those seeking to achieve positive interpersonal and intergroup peace (i.e. peace grounded in justice), will be explored. [ABSTRACT FROM AUTHOR]

Members of racial, ethnic, and Indigenous minorities have long accounted for disproportionate percentages of prison admissions in Western nations and of prison populations. The minorities affected vary between countries. Discriminatory or differential treatment by criminal justice officials from policing through to parole is part of the problem. Much media and professional attention focuses on sentencing, where the decision-making is most public. An emerging body of research identifies sentencing as a cause—or, at the very least, an amplifier—of minority overincarceration. Solutions aiming to reduce it have been implemented, with varying but modest degrees of success, in the United States, England and Wales, Canada, and Aotearoa New Zealand. Progress toward reducing minority overincarceration has been slow. Most US sentencing commissions have failed to determine the extent to which their guidelines contribute to the problem. The Sentencing Council of England and Wales has taken the limited step of warning judges about racial disparities, without suggesting remedial steps to be taken. Courts in Canada and Aotearoa New Zealand have taken more activist approaches, mitigating sentences when offenders adduce evidence of discrimination or abuse by criminal justice officials. [ABSTRACT FROM AUTHOR]

This article reports findings from a large mixed-method study exploring the migration to the United Kingdom (UK) of social workers trained in Australia, Canada, India, Romania, South Africa, the US, and Zimbabwe, and the migration of British trained social workers to Australia. The project aimed at exploring the motivations for migration, the experiences of integration, and the impact of culture on these. This article focuses on the quantitative findings and will use some of the qualitative data to further explain and interrogate the differences between these groups based on their country of origin. The findings show the greater challenges migrants from developing countries have experienced, including lack of recognition of their qualifications and experience, and discrimination. The findings also show that contrary to common assumptions, the migration experiences of social workers coming from Australia, Canada and the US are not as easy as expected. American social workers who migrated to the UK turned out to be the group least professionally satisfied. The British in Australia on the other hand, were the most satisfied. Implications for practice and future research are explored. [ABSTRACT FROM AUTHOR]

LGBTQ+ people experience mental health challenges due to their minoritized status, systemic inequities and structural disparities. For LGBTQ+ asylum seekers, refugee claimants and refugees the impact on their mental health can be compounding. This study, which featured a series of focus groups with LGBTQ+ asylum seekers, refugee claimants and refugees in Toronto, Canada, was part of a larger international study 'Envisioning Global LGBT Human Rights' that looked at colonising effects on LGBTQ people in the Commonwealth. The migration process, – often forced due to persecution in their country of origin based on sexual orientation or gender identity and expression – produced traumatic experiences involving life-changing decisions, accessing information and resources, cultural shifts, conceptualisation of identities, and navigating the refugees claims process. The specialised experiences of LGBTQ+ asylum seekers, refugee claimants and refugees can have a deleterious effect on their mental health that a critical psychology perspective can address clinically by recognising the particularised needs of this population and systemically by addressing the structural inequities. [ABSTRACT FROM AUTHOR]

Background: LGBTQIA+ migrants may have experienced discrimination and victimization related to ethnicity, culture, and race over the course of their migration journey, as well as in relation to their sexual orientation, gender identity and expression. Despite the work of some nurses in education, practice, policy, and research, there is a scarcity of literature investigating the experiences of LGBTQIA+ migrants with nurses and healthcare professionals in Canada. Methods: By utilizing Gadamerian hermeneutics research methodology with intersectional analysis, this study draws on 16 semi‐structured individual interviews with LGBTQIA+ migrants who received care from nurses and other healthcare professionals (NHCPs) in Canada. Results: Two overarching areas of intersecting experiences were identified: (a) challenges and (b) supports. Four interwoven interpretations emerged from experiences of challenges: (a) unwanted visibility, (b) hearing a dead name and being misgendered, (c) cultural stigma, and (d) being asked intrusive hetero‐cis‐normative questions. Supportive experiences were evident when NHCPs accepted the unique needs of LGBTQIA+ migrants and acted as advocates. Conclusions: Nursing interactions should not be traumatic for LGBTQIA+ migrants, but rather should be encounters where care providers ask relevant nonhetero‐cis‐normative questions, offer inclusive safe sex education for people's diverse identities, avoid dead naming and misgendering, and provide supportive and affirming care. To support the provision of safe care and mitigate trauma, systemic changes in nursing practice must include the experiences of LGBTQIA+ migrants. [ABSTRACT FROM AUTHOR]

Background: Occupational therapy professes commitment to equity and justice, and research is growing concerning the experiences of clients from marginalized groups. To date, almost no research explores the professional experiences of therapists from marginalized groups. This qualitative study explores how exclusion operates in the profession among colleagues. Method: Grounded in critical phenomenology, semi-structured in-depth interviews were conducted with 20 occupational therapists who self-identified as racialized, disabled, ethnic minority, minority sexual/gender identity (LGBTQ+), and/or from working-class backgrounds. Iterative analysis was conducted using constant comparison and employing ATLAS.ti for team coding. Results: Across identity groups, four processes of exclusion were identified: isolation, abrasion, presumptions of incompetence, and coerced assimilation. Garland-Thompson’s (2011) concept of “misfit” is employed to analyze how therapists are constructed as not-quite-fitting the professional space delimited by occupational therapy’s white, able-body-minded, Western, heterosexual, middle-class, cisgender norms. Conclusions: Misfits are constructed by contexts, by expectations and material arrangements that assume particular bodies. Misfits make visible the inequities built into business-as-usual, an illumination that comes at often-painful cost. Yet there is possibility for change toward equity and justice for therapist colleagues: we can all choose to do differently, enacting change at micro and macro levels. [ABSTRACT FROM AUTHOR]

The overall goal was to synthesize knowledge on actions that need to be taken to promote health equity and the mental health of Black refugees in Canada. Group concept mapping systems were applied to generate and organize action-oriented statements related to the different social determinants of health. A total of 174 participants from the cities of Calgary and Edmonton with experience working with Black Canadians participated in four focus groups: (a) 2 focus groups that engaged 123 participants in brainstorming 84 statements guided by the following focus prompt: 'A specific action that would improve the mental health equity of Black refugees living in Canada is ... ' and (b) 2 focus groups of 51 participants who sorted the generated statements and rated them by order of 'importance' and 'ideas seen in action.' Data was further computed and analysed by the research team and a select advisory group from the participants. A 10-cluster map generated included the following clusters: (1) promoting cultural identity, (2) promoting ways of knowing, (3) addressing discrimination and racism, (4) addressing the criminalization of Black Canadians, (5) investing in employment for equity, (6) promoting equity in housing, (7) facilitating self-determination, (8) improving (public) services, (9) promoting appropriate and culturally relevant mental health services, and (10) working with and addressing faith and belief related issues. Clusters 4 and 9 ranked as the most important clusters in promoting health equity and the mental health of Black Canadians. Addressing the criminalization of Black Canadians through a range of rehumanizing interventions at institutional levels will provide a platform from which they can participate and engage others in developing appropriate and culturally relevant mental health services. [ABSTRACT FROM AUTHOR]

This study highlights technology use in community development showing how social workers, police, and neighborhood residents promote safer neighborhoods. The approach used was geographic information systems (GIS) to target specific neighborhoods characterized as needing timely interventions. GIS is a technological sub-specialty and form of spatial cartography allowing data to be stored, manipulated, and visually displayed. This article focuses on how social workers can apply such approaches to enhance their communities and neighborhood residents. We offer a case study of a hate crimes project in Canada that brought together university researchers and a local police service into a research project, designed to identify specific neighborhood places where hate crimes were occurring. We propose that community social workers can form meaningful partnerships with technology experts and leverage this relationship into an expanded practice skill with tangible improvements to the communities they work with. [ABSTRACT FROM AUTHOR]

International migration to North America continues to rise, and with it the meeting of different cultural norms surrounding child caregiving and supervision. Previous research shows that high rates of reporting of supervisory neglect involving migrant families may partly result from these different norms and challenges particular to the migrant context. In this study, five focus groups were conducted with migrant caregivers (n = 19) and children aged 12–17 years (n = 25) to explore their experiences surrounding caregiving changes in migration as well as factors that help and hinder child supervision in migrant communities in Montreal, Canada. Results following thematic analysis indicate that family roles change in migration, but that caregivers and children perceive these changes differently. Families perceive and experience discrimination and judgment of their parenting practices from community members and fear that those will be labelled neglectful. Change in families' social support, especially at the neighbourhood level, has an important influence on caregiving practices. Results also show that parents' preparation of children to provide care for siblings and others is often not recognised as a strength by service providers in direct contact with families. Directions for future research and implications for practice are discussed. [ABSTRACT FROM AUTHOR]

Introduction: Culture-sensitive (CS) and patient-centered (PC) care are considered essential to achieve high-quality equitable care. The purpose of this study was to determine how expert nurses incorporate CS/PC care into their assessment and care planning practices, especially for culturally diverse and marginalized patients. Methodology: Using a qualitative, descriptive design, we conducted a focus group at the October 2019 Transcultural Nursing Society Conference. Participants (n = 9) discussed how they instilled cultural sensitivity and patient-centeredness into their assessment and care planning skills. Results: Participants revealed attitudes, knowledge, and skills associated with CS/PC assessment and care planning. They also identified specific strategies for translating CS/PC theory into assessment and care planning practices. Discussion: Three principles and many pragmatic strategies for incorporating CS/PC care into daily practice emerged from the data. Nurses may find these principles and strategies helpful in integrating CS/PC care into their daily care of patients in busy clinical settings. [ABSTRACT FROM AUTHOR]

Two-spirit, lesbian, gay, bisexual and transgender (2SLGBTQ+) people are disproportionately represented among those experiencing poverty. Both 2SLGBTQ+ people and people experiencing poverty face poorer health outcomes and greater difficulty accessing healthcare. Evidence of intersectional impacts of 2SLGBTQ+ status and poverty on health can help to inform economic and health policy. The objective of this review is to determine what is known about the health of 2SLGBTQ+ people in Canada experiencing poverty. Following the PRISMA framework, we searched and summarized Canadian literature on 2SLGBTQ+ poverty indexed in Medline, Sociological Abstracts, PsycInfo and EconList (N  = 33). 2SLGBTQ+ poverty-related literature remains sparse but is expanding as illustrated by the fact that most (31/33) studies were published in the past decade. Half the studies analysed poverty as a focal variable and half as a covariate. Intersectionality theory assists in understanding the three health-related themes identified—healthcare access, physical health and mental health and substance use—as these outcomes are shaped by intersecting social structures that result in unique forms of discrimination. Those at the intersection of poverty and 2SLGBTQ+ status face poorer health outcomes than other 2SLGBTQ+ people in Canada. Discrimination was an overarching finding that explained persistent associations between 2SLGBTQ+ status, poverty and health. Research that directly interrogated the experiences of 2SLGBTQ+ populations experiencing poverty was sparse. In particular, there is a need to conduct research on underrepresented 2SLGBTQ+ sub-groups who are disproportionately impacted by poverty, including transgender, bisexual and two-spirit populations. [ABSTRACT FROM AUTHOR]

Given growing concerns of im/migrant women's access to sexual and reproductive health (SRH) services, we aimed to (1) describe inequities and determinants of their engagement with SRH services in Canada; and (2) understand their lived experiences of barriers and facilitators to healthcare. Using a comprehensive review methodology, we searched the quantitative and qualitative peer-reviewed literature of im/migrant women's access to SRH care in Canada from 2008 to 2018. Of 782 studies, 38 met inclusion criteria. Ontario (n = 18), British Columbia (n = 6), and Alberta (n = 6) were primary settings represented. Studies focused primarily on maternity care (n = 20) and sexual health screenings (n = 12). Determinants included health system navigation and service information; experiences with health personnel; culturally safe and language-specific care; social isolation and support; immigration-specific factors; discrimination and racialization; and gender and power relations. There is a need for research that compares experiences across diverse groups of racialized im/migrants and a broader range of SRH services to inform responsive, equity-focused programs and policies. [ABSTRACT FROM AUTHOR]

This study explores nurses' experiences of workplace conflict with patients and their family members, how it differs by ethnic/racial identity, and highlights the coping strategies engaged to lessen these conflicts. Using a qualitative research design, this study draws on phenomenology and in‐depth interviews of 66 registered nurses and registered practical nurses from multiple sites in two Canadian cities to explore the experiences of nurses with multiple marginalized identities in relation to nurse–patient and nurse–patient's family member conflicts in direct care practice. The results show that horizontal conflicts, especially, ones involving nurses, patients, and their family members are quite pervasive in the nursing profession. Direct care nurses, especially, ethnic minorities relative to majority groups experience excessive physical assaults, verbal aggressive behaviors, racial stereotyping and discrimination, and sexual harassment from patients and patients' family members. Institutional support through policies and practices designed to de‐escalate aggressive behavior from patients and their family members were identified as important support systems. We conclude that policies aimed at creating a safe and strong health‐care system call for holding patients and th'eir family members legally responsible for uncivil and aggressive behavior against caregivers. [ABSTRACT FROM AUTHOR]

Progress in reducing health inequalities through public policy action is difficult in nations identified as liberal welfare states. In Canada, as elsewhere, researchers and advocates provide governing authorities with empirical findings on the sources of health inequalities and document the lived experiences of those encountering these adverse health outcomes with the hope of provoking public policy action. However, critical analysis of the societal structures and processes that make improving the sources of health inequalities difficult—the quality and distribution of living and working conditions, that is the social determinants of health—identifies limitations in these approaches. Within this latter critical tradition, we consider—using household food insecurity in Canada as an illustration—how polemics and anger mobilization, usually absent in health inequalities research and advocacy—could force Canadian governing authorities to reduce health inequalities through public policy action. We explore the potential of using high valence terms such as structural violence, social death and social murder, which make explicit the adverse outcomes of health‐threatening public policy to force government action. We conclude by outlining the potential benefits and threats posed by polemics and anger mobilization as means of promoting health equity. [ABSTRACT FROM AUTHOR]

Background: Difficulties accessing health care services can result in delaying in seeking and obtaining treatment. Although these difficulties are disproportionately experienced among vulnerable groups, we know very little about how the intersectionality of realities experienced by immigrants and visible minorities can impact their access to health care services since the pandemic. Methods: Using Statistics Canada's Crowdsourcing Data: Impacts of COVID-19 on Canadians—Experiences of Discrimination, we combine two variables (i.e., immigrant status and visible minority status) to create a new variable called visible minority immigrant status. This multiplicative approach is commonly used in intersectionality research, which allows us to explore disadvantages experienced by minorities with multiplicative identities. Results: Main results show that, compared to white native-born, visible minority immigrants are less likely to report difficulties accessing non-emergency surgical care (OR = 0.55, p < 0.001), non-emergency diagnostic test (OR = 0.74, p < 0.01), dental care (OR = 0.71, p < 0.001), mental health care (OR = 0.77, p < 0.05), and making an appointment for rehabilitative care (OR = 0.56, p < 0.001) but more likely to report difficulties accessing emergency services/urgent care (OR = 1.46, p < 0.05). Conclusion: We conclude that there is a dynamic interplay of factors operating at multiple levels to shape the impact of COVID-19 related needs to be addressed through changes in social policies, which can tackle unique struggles faced by visible minority immigrants. [ABSTRACT FROM AUTHOR]

In this article, we draw on a recent review of the Canadian literature on poverty in lesbian, gay, bisexual, transgender, queer, two-spirit, and other sexual and gender minority (LGBTQ2S+) communities to conceptualize social work interventions that may be used to address material inequities among these groups. Our literature review, which was based on a total of 39 works, revealed distinctive expressions of poverty among younger and older LGBTQ2S+ groups, as well as racialized, newcomer, and Indigenous sexual and gender minorities. Drawing on these insights, together with theoretical frameworks grounded in intersectionality and relational poverty analysis, we conceptualize these expressions of material inequity as salient sites of social work practice and propose interventions targeting these manifestations of LGBTQ2S+ poverty at various levels. Given the centrality of anti-poverty work as part of the social work profession's commitment to social justice, and the dearth of social work literature on LGBTQ2S+ poverty, this article promises to make significant contributions to social work scholarship and professional practice. [ABSTRACT FROM AUTHOR]

Transgender (trans) women experience barriers to access to HIV care, which result in their lower engagement in HIV prevention, treatment and support relative to cisgender people living with HIV. Studies of trans women's barriers to HIV care have predominantly focused on perspectives of trans women, while barriers are most often described at provider, organisation and/or systems levels. Comparing perspectives of trans women and service providers may promote a shared vision for achieving health equity. Thus, this qualitative study utilised focus groups and semi‐structured interviews conducted 2018–2019 to understand barriers and facilitators to HIV care from the perspectives of trans women (n = 26) and service providers (n = 10). Barriers endorsed by both groups included: (a) anticipated and enacted stigma and discrimination in the provision of direct care, (b) lack of provider knowledge of HIV care needs for trans women, (c) absence of trans‐specific services/organisations and (d) cisnormativity in sexual healthcare. Facilitators included: (a) provision of trans‐positive trauma‐informed care, (b) autonomy and choice for trans women in selecting sexual health services and (c) models for trans‐affirming systems change. Each theme had significant overlap, yet nuanced perspective, between trans women and service providers. Specific recommendations to improve HIV care access for trans women are discussed. These recommendations can be used by administrators and service providers alike to work collaboratively with trans women to reduce barriers and facilitators to HIV care and ultimately to achieve health equity for trans women. [ABSTRACT FROM AUTHOR]

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Discrimination against caregivers is a topic of interest for the public sector workplace. This study assesses the degree to which family responsibilities discrimination (FRD) can diminish work satisfaction and lead to intentions of leaving the public service. It also examines the effects of flexible work arrangements on work satisfaction and intentions to leave. Applying Mahalanobis Distance Matching, we examine the Canadian Public Service Employee Survey and find evidence that family status discrimination has some impact on employees' intention to leave the public service and can diminish satisfaction with work arrangements. We also find that federal public servants who feel like work and family/personal obligations adversely affected their career progression were less satisfied with their work arrangements and were more likely to want to leave their positions. [ABSTRACT FROM AUTHOR]

Globally, individuals with psychiatric disorders experience an increased risk for homelessness and frequent migration. The present qualitative study used intersectionality and thematic analysis to examine how male and female psychiatric survivors experienced the phenomenon of frequent migration in Canada. The study findings underscored aspects of frequent migration, including negative experiences associated with poverty, as well as increased risks for homelessness and mental health, stigma, and discrimination. The present findings call for bespoken services and programs to address male and female psychiatric survivors' specific needs; thereby alleviating pathways to frequent migrations among psychiatric survivors. [ABSTRACT FROM AUTHOR]

This article draws on work in Critical Disability Studies (CDS) to trace continuities between ableism and colonialism in Canada, and illuminates three ways in which ableist violences have historically functioned, and still function, as colonial tools. These violences include: subtle and obvious pathologizing of indigenous bodies rooted in a logic of purification/elimination of defects; tropes of 'inspirational disability' which have ongoing material, colonial effects, including the exaltation of white settler Canada; and eugenic institutions – a naturalized part of our national context – which subjugate indigenous ways of life while creating and reproducing white settler space. We challenge CDS scholars – especially those who, like ourselves, enjoy white and settler privilege – to call attention to the colonial effects of eugenic, ableist assumptions and to remain accountable to the colonial impulses inherent in their/our work. We conclude by charting possibilities of what decolonizing in CDS might mean. [ABSTRACT FROM AUTHOR]

Sexual and mental health disparities are reported in Arctic Canada as in other Arctic regions that experience shared challenges of insufficient healthcare resources, limited transportation, and a scarcity of healthcare research. Lesbian, gay, bisexual, transgender, and queer persons (LGBTQ+) report sexual and mental health disparities in comparison with their heterosexual and cisgender counterparts, and these disparities may be exacerbated in rural versus urban settings. Yet limited research has explored sexual healthcare experiences among LGBTQ+ persons in the Arctic who are at the juncture of Arctic and LGBTQ+ health disparities. We conducted a qualitative study from May 2015 to October 2015 with LGBTQ+ persons in the Northwest Territories, Canada that involved in‐depth individual interviews with LGBTQ+ youth (n = 16), LGBTQ+ adults (n = 21), and key informants (e.g. coaches, teachers, nurses, social workers, and healthcare providers) (n = 14). We conducted thematic analysis, a theoretically flexible approach that integrates deductive and inductive approaches, to identify and map themes in the data. Findings reveal geographical, social, and healthcare factors converge to shape healthcare access. Specifically, the interplay between heterosexism and cisnormativity, intersectional forms of stigma, and place limited LGBTQ+ persons' sexual healthcare access and produced negative experiences in sexual healthcare. Limited healthcare facilities in small communities resulted in confidentiality concerns. Heteronormativity and cisnormativity constrained the ability to access appropriate sexual healthcare. LGBTQ+ persons experienced LGBTQ+, HIV, and sexually transmitted infections stigma in healthcare. Participants also discussed healthcare provider recommendations to better serve LGBTQ+ persons: non‐judgment, knowledge of LGBTQ+ health issues, and gender inclusivity. Findings can inform multi‐level strategies to reduce intersecting stigma in communities and healthcare, transform healthcare education, and build LGBTQ+ persons' healthcare navigation skills. [ABSTRACT FROM AUTHOR]

Brym's article critically reviews data and the small body of published research on the relationship between antisemitic and anti-Israel attitudes in Canada and internationally with the aim of identifying key questions that Canadian and non-Canadian researchers who are interested in this contentious issue might profitably address. It derives a series of hypotheses from the literature review and discusses methodological approaches to testing them. [ABSTRACT FROM AUTHOR]

Background Transgender (trans) women are overrepresented among people living with HIV, yet trans women living with HIV (WLWH) experience lower access to HIV care. Access to medical transition may facilitate access to HIV care among trans WLWH. This study sought to describe barriers and facilitators to access to medical transition among trans WLWH.Methods: This convergent parallel mixed-methods study drew on cross-sectional quantitative data from 48 trans WLWH analysed using descriptive and bivariate analyses, as well as qualitative semistructured interview data from a subsample of 11 participants analysed using framework analysis. The primary outcome was self-reported transition experience (completed or in the process of medical transition vs planning to but have not begun medical transition). Quantitative and qualitative results were merged and analysed for convergence, divergence and/or expansion of understanding.Results: Just over half the participants reported being fully completed medical transition or in the process of medical transition (52.1% (25/48); 95% confidence interval (CI) 37.5-67.6%), with one-fifth reporting planning to but not having begun medical transition (18.8% (9/48); 95% CI 8.3-29.2%). Factors significantly associated with not having begun one's medical transition included housing instability, transphobia, HIV-related stigma and barriers in access to care. Qualitative findings revealed varied transition experiences, influenced by community norms, passing and class privilege, HIV and structural barriers. Mixed-methods results showed positive relationships between trans WLWH and HIV care providers in terms of trans and HIV health care.Conclusions: HIV-related stigma and social determinants of health limit access to medical transition for trans WLWH. Stigma must be addressed in a broad range of healthcare settings, in addition to structural barriers, to increase access to gender-affirming HIV care and medical transition for trans WLWH. [ABSTRACT FROM AUTHOR]

In the current era of citizenship politics, both legal citizenship and cultural citizenship have become highly contested social categories and new bases for social discrimination. Psychological studies of migration thus need to consider more explicitly how shifting sociopolitical contexts shape migrant life opportunities and how migrants respond to their shifting circumstances. Cultural psychologists have much to contribute to this project given their focus on the ways cultural experiences are shaped at once by broader social determinants and the intentional acts of social agents who navigate diversely organized worlds. However, we argue that cultural psychologists need to integrate critical concepts into cultural psychological studies of migration to avoid both overlooking important determinants of migrant lives and inadvertently perpetuating social inequalities and discriminatory policies. Drawing upon qualitative research conducted with Polish "irregular" migrants in Canada and Sikh Americans, we show how critical concepts such as "illegalization," "deportability," and "cultural citizenship" can help expand cultural psychological inquiry to better understand contemporary immigrant experiences. We conclude with discipline-specific recommendations for building a cultural psychology fit for the study of migration in the 21st-century. [ABSTRACT FROM AUTHOR]

The study aimed to validate the Health Care Provider HIV/AIDS Stigma Scale among medical staff in China. The validation was conducted in four steps from March to December 2017: translation and back-translation; content validity test with six experts; test–retest reliability testing with 63 medical staff with 2 weeks interval; and structural validation with 349 medical staff from 52 hospitals with a convenience sample,using exploratory factor analysis,including principal component analysis and varimax rotation. The scale content validity index average was 0.88, while for test–retest reliability, the ICC was 0.87. Three factors of "discrimination", "prejudice" and "stereotype" with 16 items were extracted and explained 59.61% variance. The Cronbach's alpha value for the total scale was of 0.88, and for the three factors, the values were 0.89, 0.86 and 0.74, respectively. The discrimination factor showed identical means between Canadian medical students and Chinese medical staff, while the prejudice and stereotype factors had higher mean scores in the Chinese sample. The three-factor structure of Health Care Provider HIV/AIDS Stigma Scale was confirmed in Chinese medical staff with a simpler solution. This could provide a basis for trans-cultural application and comparison. [ABSTRACT FROM AUTHOR]