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The 2016 Alberta wildfires resulted in widespread destruction of property and displacement of residents. Research aimed to identify the roles and responsibilities of social work practitioners and human service professionals in long-term disaster recovery. This article presents the findings from interviews, focus groups, and a survey with a total of 140 participants in Alberta, Canada. Implications for disaster social work planning, and response and recovery efforts in Canada and internationally, will inform the development of programs and policies to support and make visible the contribution of social workers and human service professionals in long-term disaster recovery. [ABSTRACT FROM AUTHOR]

Transgender and nonbinary (TNB) people experience elevated rates of posttraumatic stress (PTS) due to transphobic violence, discrimination, microaggressions, and minority stress. Nonbinary people in particular experience unique chronic minority stressors (e.g., misgendering, interpersonal invalidation) because of the assumption that gender is inherently binary. Such examples of oppression against TNB people could contribute to complex PTS (c-PTS) symptoms, which arise due to exposure to chronic, cumulative, and interpersonal trauma. This study aimed to examine how misgendering and invalidation may be associated with PTS and c-PTS symptoms among nonbinary people and whether this association is moderated by pride and community connectedness. Cross-sectional data from 610 nonbinary people living in the United States and Canada were analyzed using hierarchical linear regressions. Misgendering and invalidation had significant positive associations with PTS and c-PTS symptoms. However, pride and community connectedness were not significant moderators of these associations. Findings from this study contribute to the conceptualizations of traumatic stress among nonbinary people and provide considerations for more affirming trauma-informed care. Public Significance Statement: The findings of this study suggest that misgendering and invalidation are associated with trauma symptoms among nonbinary people. Results can be applied to inform nonbinary-affirming clinical practice and advocacy. [ABSTRACT FROM AUTHOR]

Purpose: This study examined the mediating role of resilience and living in care experiences between risk exposure (victimization by community and adverse childhood experiences) and psychosocial outcomes (housing instability, delinquency, and post-traumatic stress reactions) for youth receiving child welfare and community services. Method: Two hundred and fifty-one youths (14–19 years old) who are receiving interventions from the Department of Community Services in Nova Scotia, Canada, were recruited. Multiple measures were administered to the youth. Results and conclusion: Resilience and experiences of living in care significantly mediated the relationship between risk factors and outcomes, with youth demographic characteristics influencing the pattern of these relationships. Findings suggested that resilience and living in care experiences could reduce the effects of risk factors on psychosocial outcomes. These findings demonstrate a role for Child Welfare agencies in promoting youth access to the resilience-enabling resources necessary to sustain well-being. [ABSTRACT FROM AUTHOR]

In this study, we applied an intersectional framework to explore service providers' perspectives on the mental health needs of newcomer young men. We conducted focus groups and interviews with 26 service providers in Edmonton, Calgary, and Vancouver, Canada. Findings show that service providers made sense of young men's mental health needs and service access in the context of systems. We identified three interconnected themes: newcomer young men's senses of self in relation to macro-systems, including racism and economic marginalization; settling well as a determinant of mental health; and systems capacities and interdependent resilience. While service providers are engaged in cross-sectoral work in support of newcomer young men's mental health, this work is not being sufficiently supported. Further work is needed around cross-sector capacity bridging and advocacy, as well as the tailoring of services to young men without the assumption and reinforcement of gender stereotypes. [ABSTRACT FROM AUTHOR]

This study sheds light on the personal characteristics of older Canadians self-identifying as severely anxious and the coping strategies that they gravitated to mitigate their anxiety. Our studied sample consisted of 606 Canadians aged 60 and above who took part in an e-survey across all 10 of Canada's provinces, launched in July 2022, when social distancing was lifted across the country. Participants completed a personal characteristics questionnaire, the Geriatric Anxiety Scale or GAS-10, and a checklist of everyday coping strategies for mitigating anxiety. A seemingly greater number of severely anxious Canadians were born female, self-identified as a cisgender woman, and were in their 60s and in poor to fair health. A univariate logistic regression analysis revealed that all such personal characteristics were associated with statistically significantly greater odds of experiencing severe anxiety. In our multivariate logistic regression analysis, no significant differences were observed between the sexes (AOR = 0.590, p = 0.404), and non-binary and cisgender men (AOR = 0.689, p = 0.441) and women (AOR = 0.657, p = 0.397). Nor were there statistically significant differences in the odds of experiencing severe anxiety for those living with versus without a life partner and chronic illnesses. Older Canadians experiencing severe anxiety were far more likely to normalize their fear and anxiety (AOR = 4.76, p < 0.001), challenge their worries (AOR = 5.21, p < 0.001), and to relax or meditate (AOR = 2.36, p = < 0.001). They were less inclined to decrease other sources of stress in their lives, to stay active, and to get enough sleep. We offer anticipatory guidance for mental health program planners and practitioners, and fruitful avenues of inquiry for researchers. [ABSTRACT FROM AUTHOR]

Whilst adolescence is often discussed as a challenging time, it is also a stage of life with tremendous potential for building positive skills that will support current and future mental health. This paper presents results from a pilot study of a mental health and stigma reduction program called The Inquiring Mind Youth, which is based on a series of programs that have previously demonstrated effectiveness in adult and workplace samples. The program was developed in collaboration with experts and youth and piloted in nine secondary schools across Canada (Calgary area and Eastern Coast). Data from 293 adolescent participants were collected using a pre-post-follow-up design. An overall medium effect size was found for both improved resilience skills (SMD = 0.49) and decreased stigmatizing attitudes (SMD = 0.38) pre-post program. An additional multi-level modelling analysis also showed improved resilience skills and decreased stigmatizing attitudes pre-post program, with more robust shifts in one geographic region (Calgary area). Further analysis showed that resilience improvements were retained at follow-up, with smaller effects. The results of this pilot study support ongoing work and development of programming that aims to foster resilience and reduce stigmatizing attitudes in young people. Highlights: A novel mental health promotion and stigma reduction program (The Inquiring Mind Youth) was developed and piloted in Canadian schools. Participants showed increased resilience skills, decreased stigmatizing attitudes, and increased willingness to seek help after participating in the program. Males saw more improvements than females on resilience, while the opposite was found with stigmatizing attitudes, with females decreasing significantly more. Results support efforts in program development aimed at fostering resilience and reducing stigmatizing attitudes in youth. [ABSTRACT FROM AUTHOR]

Multiple and continuous traumatic events experienced by Black men impose altering effects on their identities, and their mentalization and presentation of themselves in society. However, the unique dynamics of the impact of trauma in shaping Black men's identities are not well understood, because their experiences with trauma are not well documented. This paper is a secondary analysis of the qualitative component of a mixed method study that explored trauma, social support, and resilience among 103 racialized youth survivors of gun violence in Toronto, Canada. The analysis for this paper specifically focused on young Black male participants in the study to understand their disproportional experiences with gun violent trauma. Thematic analysis of their narrative demonstrated three themes: 1) trapped by the trauma of systemic oppression; 2) identity marred by the trauma of systemic oppression; and 3) masculinity shifted by the trauma of systemic oppression. The thematic mapping of themes and subthemes yielded the trauma-altered identity (TAI), a concept coined to represent the intersections of trauma, systemic oppression, masculinity, and the identity of Black male survivors. Using a metaphoric artwork to conceptualise the TAI, we explore its psychosocial impacts and set strategies for deconstructing its influence on Black men. While we acknowledge that trauma experiences may vary among Black males, we recognise that understanding intersections of risks associated with trauma among young Black males presents opportunities for policy discussions, advocacy, and social justice reforms. [ABSTRACT FROM AUTHOR]

Simple Summary: The cancer journey is often characterized by significant physical and mental health challenges for people with cancer during and after treatment; LGBTQ2S+-identifying people with cancer may face additional issues surrounding their identity and discrimination in health care settings. However, there is limited research that explores the unique experiences of LGBTQ2S+ people with cancer. This study investigates the resilience of LGBTQ2S+-identifying people with cancer to understand how they experienced and coped with cancer. Most participants' cancer journeys were characterized by a 'Second Coming-Out' phenomenon, where LGBTQ2S+ people with cancer use coping strategies, similar to those used when coming out, to produce resilience throughout their cancer journey. Identifying this phenomenon is critical to providing comprehensive care for LGBTQ2S+ people with cancer that draws on their unique strengths. We propose the LGBTQ2S+ Cancer Care Model where the individual is centered and the influences of personal support, professional support, and queer representation are integrated in an accessible and clinically relevant way. People with cancer may suffer negative psychosocial outcomes due to the challenges of cancer. LGBTQ2S+ people routinely experience negative psychosocial outcomes in health care settings, but have showcased resilience in the face of discrimination; however, this has never been studied in a cancer context. Thus, this study aims to assess coping and resilience in LGBTQ2S+-identifying people diagnosed with cancer using a strengths-based approach. A qualitative exploratory design was used. Ten self-identified LGBTQ2S+ people who have completed their cancer treatment were recruited. Participants completed clinical, health, and demographic questionnaires and, subsequently, semi-structured qualitative interviews. Conceptualizations of coping and resilience in the semi-structured interviews were analyzed using interpretative phenomenological analysis (IPA). Participants were members of various gender identities and sexual orientations. In addition to identifying needed LGBTQ2S+-specific resources, four narratives emerged: support networks, regaining control in life, conflicting identities, and traditional coping methods. Most participants' cancer journeys were characterized by a 'Second Coming-Out' phenomenon, where LGBTQ2S+ people with cancer use coping strategies, similar to those used when coming out, to produce resilience throughout their cancer journey. This work provides exploratory insight into LGBTQ2S+ people with cancer, but more research is required with a larger sample. [ABSTRACT FROM AUTHOR]

Human service organizations can support leaders through training to become resilient, adaptive, and innovative during rapid complex changes. This qualitative descriptive exploratory research study reports findings on a leadership resilience training program using online evaluation surveys of 56 directors and managers in a large Canadian not-for-profit mental health/substance abuse agency. Thematic data analysis and descriptive statistics revealed positive training outcomes on four levels: satisfaction; knowledge/skills; work/team performance; and organizational resilience/sustainability. Leaders identified adaptive, resilient, and authentic leadership styles, clan/adhocracy organizational cultures, psychological safety and innovation, and organizational preparedness as important to successfully manage the pandemic and future extraordinary organizational challenges. Practice Points: Leaders' satisfaction with training structure/content was high; ensuring topic relevance, including small group discussions and team-building opportunities are valuable. Leaders' knowledge/skills improvements were very/mostly high; they learned coping and resilience strategies to build with their staff and nurture organizational sustainability. Anticipated positive impacts on work/team performance were extremely/very/mostly high, including change management abilities, supporting the goal of training transfer. Organizational resilience/sustainability was very/mostly high, with planned meeting restructuring, although intentional implementation of actionable steps is required. Leaders endorsed adaptive, resilient, and authentic leadership styles, clan, and adhocracy organizational cultures, psychological safety/innovation for organizational sustainability. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic undeniably impacted population health and several aspects of community organization, including service delivery and social cohesion. Intersectoral collaboration and equity, two key dimensions of community resilience, proved central to an effective and equitable response to the pandemic. Yet the factors that enabled or constrained communities' capacity to enact intersectoral collaboration and equity-focused action in such times of urgency and uncertainty remain poorly understood. This descriptive qualitative study aimed to (1) describe the processes through which intersectoral collaboration and equity-focused action were deployed during the first wave of COVID-19 and (2) identify factors enabling and constraining these processes. We conducted semi-directed interviews with 35 representatives of the governmental, institutional, and public and third sectors from four municipal regional counties of the Estrie region (Québec, Canada). We coded detailed interview notes following a codebook thematic analysis approach. We identified three processes through which intersectoral collaboration and equity-focused action were deployed: (1) networking; (2) adaptation, creation and innovation; and (3) human-centred action. Examples of levers which supported the deployment of these processes included capitalizing on pre-existing networks, adapting practices and services, and investing in solidarity and mutual aid. The influencing factors we describe represent concrete targets for resilience-building action. Although focused on the COVID-19 pandemic, our findings are relevant to other types of health, social, environmental or economic crises, and may guide health promotion and community development practitioners towards more effective community resilience-building responses. [ABSTRACT FROM AUTHOR]

Lesbian, gay, bisexual, transgender, queer, intersex, and asexual (LGBTQIA+) Black, Indigenous, and People of Color (BIPOC) live at the intersection of marginalized identities, resulting in unique experiences of exclusion within their various communities. Despite experiences of community exclusion, LGBTQIA+–BIPOC find ways to resist such structures to thrive in the face of adversity and strive for transformative change. The present study uses an intersectional framework to explore LGBTQIA+–BIPOC's experiences with community exclusion and acts of resistance. Fourteen LGBTQIA+–BIPOC participated in semistructured interviews to explore their experiences of exclusion and acts of resistance. Findings supported two broad categories with subthemes: (a) "on the fringes" (i.e., invalidation of LGBTQIA+–BIPOC experiences; White supremacy, colonization, and Western imperialism; "out and proud" dynamics) and (b) resistance: "we're here, and I'm gonna let you know" (i.e., resisting intersectional oppression; intersectional identity cohesion; coalition building). Utilizing an intersectional framework, we critique larger oppressive structures that disenfranchise LGBTQIA+–BIPOC while offering implications for social justice interventions and transformational change to best serve LGBTQIA+–BIPOC. [ABSTRACT FROM AUTHOR]

Background: Food insecurity is a social determinant of health linked with elevated HIV exposure. Safer sex efficacy (SSE), the ability to navigate sexual decision-making and condom use, is an important marker of sexual wellbeing. Pathways from food insecurity to SSE are understudied, particularly among adolescents in Arctic regions who are at the nexus of food insecurity and sexual health disparities. We examined pathways from food insecurity to SSE among adolescents in the Northwest Territories (NWT), Canada. Methods: We implemented cross-sectional surveys with adolescents aged 13–18 recruited through venue-based sampling in 17 NWT communities. We conducted multivariable logistic regression to assess socio-demographic factors associated with food insecurity. We then conducted structural equation modeling (SEM) using maximum likelihood estimation to assess direct effects of food insecurity on SSE and indirect effects via resilience, depression, and relationship power inequity. We assessed both condom use SSE (e.g., confidence in using condoms) and situational SSE (e.g., SSE under partner pressure). Results: Most participants (n = 410) identified as Indigenous (79%) and 45% reported experiencing food insecurity. In SEM, we did not find a significant direct effect from food insecurity to SSE; however, we found indirect effects from food insecurity to condom use SSE through resilience and depression and from food insecurity to situational SSE through resilience. Conclusions: Findings call for structural interventions to address food insecurity, alongside resilience-focused strategies that address the intersection of sexual and mental health. Sexual health strategies focused on individual behavior change are insufficient to address larger contexts of poverty among Northern youth. [ABSTRACT FROM AUTHOR]

Purpose: The bond between mother and child is biological, genetic, spiritual, and unique. In times of intimate partner violence (IPV), mothering continues with efforts to protect and care for their children. The purpose of this project is to understand Indigenous mothering within the contexts of Indigenous identities, IPV, and rural, remote, and northern (RRN) places. Method: A secondary analysis of the Canadian Domestic Homicide Prevention for Vulnerable Populations Phase 3 Database revealed 16 cases identified as Indigenous mothers residing in RRN places. Grounded theory analyses explicated a preliminary theory of 'Colonial Pathways In, Indigenous Pathways Through' the social process of Indigenous mothering through IPV experiences in RRN places. Results: Indigenous mothering through IPV in RRN places is a responsive and embodied experience within a storied space, occurring through three pathways: Colonial pathways' into IPV; survival pathways during IPV; and recovery of cultural identity as providing an escape from IPV, expressed through themes of 1. comparative mothering, 2. continuous hypervigilance, protective nurturance, pursuit of safety, and 3. cultural recovery. Indigenous mothers demonstrates resilience in striving for safety while caring for their children within an IPV context. Conclusions: Indigenous mothering occurs even in the worst of times, such as during IPV. 'Colonial Pathways In, Indigenous Pathways Through' theory increases our understanding of Indigenous mothering in RRN places. Of significance is the occurrence of traumatic brain injury, pointing to the need for recognition that it is occurring and screening and treatment is required. Most of all, the study highlights the resilience, resistance, and resourcefulness of Indigenous mothers striving to keep themselves and their children safe. [ABSTRACT FROM AUTHOR]

It is important to understand the unique experiences and perspectives of older adults who were required to incorporate critical adaptive behaviors during the onset of the COVID-19 pandemic. An anonymous, cross-sectional survey was administered online through Qualtrics Survey Software in June 2020 to 1405 adults between the ages of 18 and 86. Differences in adaptability between older adults and young/middle-aged adults were analyzed. This study found that older adults (n = 132) utilized different sources of information than young/middle-aged adults; they were more likely to read the newspaper or listen to the radio, and less likely to rely on social media for information. Older respondents in this study reported coping with the COVID-19 outbreak better than young/middle-aged respondents, were less likely to report that they were personally affected by the virus, and were less likely to feel overwhelmed by the amount of information about COVID-19. The findings of this study highlight adaptability and resilience in older adults not found in young/middle-aged adults and provide an important step in identifying policy and practice suggestions to reduce negative repercussions for older adults experiencing the current crisis, as well as future generations of older adults who might experience similar events. [ABSTRACT FROM AUTHOR]

Background: There is an urgent need for culturally and contextually relevant mental health support for First Nations, Inuit and Métis youth. Objective: Our aim was to identify mental health and wellness services that are currently available to Indigenous youth across Canada. Methodology: As a first step, we conducted a web-based environmental scan of services tailored to Indigenous youth. Specific factors were examined for each program, including organization type and mission, types of services, and who provides services. Results: One hundred and seventeen programs were found, with 54% being non-profits and 34% being on-reserve. Four core features were identified. The first was a strengths-based focus, rather than a pathology/deficit-focus, in programs' vision and mission statements, reflected in words like wellness and resilience. The second (87% of included programs) was the integration of mental health services with a range of other services and supports (e.g., health, employment, housing). The third was the provision of land-based programming (in 34% of programs) such as camps or hunting. Such programs were framed as promoting wellness and healing and strengthening identity. The fourth was the role of community members without formal mental health professional training (in 42% of programs), for example, as youth workers or knowledge keepers. This stems not only from the dearth of specialists in many Indigenous settings, but also a valuing of Indigenous knowledge. Conclusion: These core features in mental health services for Indigenous youth may be promising avenues for communities seeking to strengthen the services they offer to First Nations, Inuit and Métis youth. [ABSTRACT FROM AUTHOR]

One's health security (i.e., the ability to minimize risks and respond to public health threats) is a conferred right of citizenship but individuals construct identities during the process of securing their health. However, how this occurs, in relationship to the state, remains largely implicit or taken‐for‐granted. The Coronavirus Disease 2019 (COVID‐19)' provided a unique opportunity to explore the relationship between oneself and governing social norms of health citizenship. We drew on secondary analysis of data from a previous (published) qualitative descriptive study that was conducted during May to September 2020 of COVID‐19, to explore 72 immigrants' experience (from 21 countries) of health security in the Greater Toronto Area, Canada. Data were collected through semi‐structured interviews and analysed using critical realism. The majority of participants were women. We demonstrate how individuals implicitly engaged in 'extra' work—gendered and driven by mechanisms of good citizenship—connected to the will to health, against ethopolitical work to regulate risks, of and for themselves, in public discourse. Public discourse tended to follow racialized hegemonic norms, which also reproduced systemic cultural racism. We argue that empathetic understanding of this process is conducive to enhancing one's resistance to stereotypes, and to bolstering immigrants' resilience to seeking health security during public health emergencies. [ABSTRACT FROM AUTHOR]

Social work is a practice-based profession with social justice as a core value and ethical principle. Social work programs incorporate social justice into both the explicit and implicit curricula. However, there has been a longstanding divide in how to address social justice at systemic levels while fostering socially just and competent practice. The aim of this qualitative study was to examine how MSW students describe their learning about social justice and social work practice. To explore this area of inquiry, we conducted three focus groups (N = 16) with current MSW students or recent MSW graduates from Canadian social work programs. Participants described the following five themes that either facilitated or created barriers in their learning about social justice and social work practice: 1) reflection on practice, 2) negotiating discomfort, uncertainty, and safety, 3) learning from lived experiences, 4) learning how to embody social justice in practice, and 5) receiving support, supervision, and coaching. We discuss the implications for social work education and practice. [ABSTRACT FROM AUTHOR]

Since the full-scale war in Ukraine began in February 2022, many Ukrainians have migrated abroad. Canada, with its tradition of welcoming refugees and other displaced persons and its large Ukrainian community, has accepted thousands of Ukrainian migrants. After arriving in Canada, some decided to enroll in community colleges to improve their labormarket skills and to facilitate their transition to life in Canada. This empirical study draws on the psychological resilience theory and the social support theory to examine the challenges these students face, the coping mechanisms they use, and the support they receive from their colleges and Canadian society. The findings reveal that the participants experience stress, anxiety, helplessness, and isolation, owing to concerns about family members in Ukraine and difficulty adapting to a foreign environment. Financial worries also loom large because of their families' loss of property and income, as well as their limited job opportunities in Canada. [ABSTRACT FROM AUTHOR]

Purpose: Refugee and immigrant youth (RIY) experience multifaceted challenges, but also have the potential to become resilient. Most of the existing literature focuses on the challenges these RIY face with limited attention to their agency and resilience. This study aims to assess the factors that predict RIY's resilience among refugee and immigrant youth in Montreal, Canada. Design/methodology/approach: A sample of 93 RIY in Montreal was surveyed. A questionnaire consisting of validated scales was used for data collection. Findings: The study found a positive correlation between educational level, personal resilience and relational resilience (p < 0.001). However, ethnicity did not have a significant correlation with the participant's general level of resilience (p > 0.001). Cultural, religious, family, community ties, age and time lived in Montréal were found to be predictors of general resilience, relational resilience and personal resilience of the RIY (p < 0.001). Originality/value: The study concluded that factors such as cultural, religious and community ties are major predictors of the resilience of RIY in Montreal. Hence, the need for mental health practitioners and resettlement organizations that work with RIY to focus on reconceptualizing resilience to incorporate the cultural, religious and community ties of RIY. This will help in developing services and programs that are culturally sensitive and effective in fostering the resilience of RIY. [ABSTRACT FROM AUTHOR]

This essay is an introduction to the thematic issue of Transcultural Psychiatry in honor of the work of Michael Chandler and Christopher Lalonde, developmental psychologists who made essential contributions to the study of identity and wellness among Indigenous youth in Canada and internationally. We outline their major contributions and illustrate the ways their innovative theory and methods have inspired decades of research, including the recent work presented in this issue, which addresses four broad themes: (1) the importance of a developmental perspective in mental health research; (2) the role of individual and collective continuity of identity in suicide prevention and mental health promotion; (3) Indigenous perspectives on trauma and resilience; and (4) Indigenous knowledge and values as a basis for culturally adapted and culturally grounded mental health services and interventions. [ABSTRACT FROM AUTHOR]

The well-being of Indigenous peoples continues to be affected by intergenerational effects of numerous harmful government policies, which are considered root causes for bullying and cyberbullying that exist in some communities. Despite ongoing stressors, Indigenous youth demonstrate resilience, which often appears grounded in connecting to their cultural identities and traditional practices. However, few studies have tested the direct and stress-buffering role of various aspects of culture in relation to well-being among First Nations youth. Analyses of the 2015–16 First Nations Regional Health Survey (RHS) revealed that bullying and cyberbullying were associated with increased psychological distress among youth aged 12–17 living in First Nations communities across Canada (N = 4,968; weighted = 47,918), and that these links were stronger for females. Feelings of community belonging were directly associated with lower distress and buffered the relationships between bullying/cyberbullying and distress. Among youth who experienced cyberbullying, those who participated in community cultural events at least sometimes reported lower distress compared to those who rarely or never participated. Those who disagreed that traditional cultural events were important reported the highest levels of distress, but perceived importance of such events failed to buffer the associations between bullying/cyberbullying and distress. These national data highlight the importance of certain culture-related variables as key factors associated with the well-being of youth living in First Nations communities across Canada. [ABSTRACT FROM AUTHOR]

Newcomer women and children are less likely to access and utilize mental health support services as compared to the general Canadian population, despite reporting experiences of mental health issues. This review aimed to map out the social support interventions that are available for promoting the mental well-being of newcomer women and children living in Canada. A search using Medline, Cumulative Index for Nursing and Allied Health Literature, PsycINFO, and the Cochrane library was conducted to identify published studies. Studies were screened, extracted, and synthesized by two independent reviewers in line with the methodological approach for scoping reviews. Fourteen articles published in English between 2012–2023 were reviewed. Results identified five types of interventions: art and sand play interventions, support groups and workshops, assessment of existing support services, social media interventions, and short-term cognitive behavioral therapy. Our results suggest that culturally appropriate social support interventions increase mental well-being outcomes, such as self-esteem and social support, and reduce peri-migratory traumas for newcomer women and children in Canada. However, findings from this review underscore the need for more quantitative and participatory research approaches so that newcomer women's and children's needs are adequately explored and addressed. [ABSTRACT FROM AUTHOR]

This study aimed to understand the experiences of compassion fatigue and compassion fatigue resilience among peer mentors within Canadian spinal cord injury (SCI) community service organizations. Eight experienced peer mentors completed two online daily diary reflections and participated in one semistructured interview. Using abductive thematic analysis, constructs within the compassion fatigue resilience model and self-compassion theory guided our interpretation of the peer mentors' experiences. We found consequences associated with compassion fatigue and compassion fatigue resilience and describe the internal and external factors contributing to each. Peer mentors whose experiences aligned with compassion fatigue felt physically, psychologically, and emotionally exhausted. These feelings appeared to have a negative influence on the peer mentors' perception of their effectiveness, affecting their ability to help their mentees or even leading them to avoid their mentees altogether. Factors such as shared lived experience, exposure to mentee suffering/stress, traumatic memories, lack of self-compassion, and other mentorship/life demands contributed to peer mentors' compassion fatigue. Conversely, factors such as self-care, self-compassion, detachment from mentee suffering/stress, satisfaction from mentoring, and social support promoted resilience to compassion fatigue. Compassion fatigue (resilience) was experienced by peer mentors as being a complex and multifaceted process including both internal and external factors. These findings highlight warning signs of compassion fatigue among peer mentors and identify the factors—and their interrelationships—that could build resilience to combat this fatigue. Organizations can use the information to tailor self-compassion programs for SCI peer mentorship. [ABSTRACT FROM AUTHOR]

To examine the prevalence of major racial discrimination (MRD) in healthcare services and its association with COVID-19 vaccine mistrust and uptake, conspiracy theories, COVID-19-related stressors, community resilience, anxiety, depression, and stress symptoms. The study used a population-based cross-sectional design. Data from the BlackVax dataset on COVID-19 vaccination in Black individuals in Canada was analyzed (n = 2002, 51.66% women). Logistic regression analyses were performed to examine the association between MRD and independent variables. 32.55% of participants declared having experienced MRD in healthcare services. Participants with MRD were less vaccinated against COVID-19, presented higher scores of vaccine mistrust, conspiracy beliefs, COVID-19 related stressors, depression, anxiety, and stress, and had lower scores of community resilience. They were more likely to experience depression (AOR = 2.13, P < 0.001), anxiety (AOR = 2.00, P < 0.001), and stress symptoms (AOR = 2.15, P < 0.001). Participants who experienced MRD were more likely to be unvaccinated (AOR = 1.35, P = 0.009). Racial discrimination experienced by Black individuals in health services is a major public health concern and threat to population health in Canada. Federal, provincial, and municipal public health agencies should adapt their programs, strategies, tools, and campaigns to address the mistrust created by racial discrimination. [ABSTRACT FROM AUTHOR]

Residential treatment programs for eating disorders (EDs) have gained popularity in recent years, expanding beyond the United States to countries such as Canada, Italy, and the United Kingdom. These programs offer a "home-like" environment where individuals reside for several weeks or months, emphasising both physical restoration and psychological recovery. This scoping review aimed to provide an update since the most recent reviews on the literature regarding outcomes of residential treatment programs for EDs and to explore clinical features that were associated with these outcomes. Methods used followed the Joanna Briggs Institute guidelines for scoping reviews. A systematic search of electronic databases was conducted, and 12 studies met the inclusion criteria. All studies reported improvements in various outcomes from admission to discharge, including changes in eating psychopathology, weight restoration, depression, anxiety, and quality of life. Additionally, three studies reported positive outcomes at intervals after discharge and three predictive factors (self-compassion, personality organisation, and resistance to emotional vulnerability) were reported in a small number of studies. While residential treatment facilities consistently showed positive outcomes, the review highlights the need for randomised controlled studies to establish the efficacy of these programs for EDs. Future research should include controlled studies comparing residential facilities to other treatment settings and incorporate long-term follow-up outcomes and further studies of emergent predictive factors identified in this review. [ABSTRACT FROM AUTHOR]

Background: Indigenous patients often present with complex health needs in clinical settings due to factors rooted in a legacy of colonization. Healthcare systems and providers are not equipped to identify the underlying causes nor enact solutions for this complexity. This study aimed to develop an Indigenous-centered patient complexity assessment framework for urban Indigenous patients in Canada. Methods: A multi-phased approach was used which was initiated with a review of literature surrounding complexity, followed by interviews with Indigenous patients to embed their lived experiences of complexity, and concluded with a modified e-Delphi consensus building process with a panel of 14 healthcare experts within the field of Indigenous health to identify the domains and concepts contributing to health complexity for inclusion in an Indigenous-centered patient complexity assessment framework. This study details the final phase of the research. Results: A total of 27 concepts spanning 9 domains, including those from biological, social, health literacy, psychological, functioning, healthcare access, adverse life experiences, resilience and culture, and healthcare violence domains were included in the final version of the Indigenous-centered patient complexity assessment framework. Conclusions: The proposed framework outlines critical components that indicate the presence of health complexity among Indigenous patients. The framework serves as a source of reference for healthcare providers to inform their delivery of care with Indigenous patients. This framework will advance scholarship in patient complexity assessment tools through the addition of domains not commonly seen, as well as extending the application of these tools to potentially mitigate racism experienced by underserved populations such as Indigenous peoples. [ABSTRACT FROM AUTHOR]

Many studies focusing on childhood sexual abuse (CSA) may have neglected the consequences related to experiencing other types of childhood maltreatment, such as psychological maltreatment. Moreover, the literature has focused more on negative consequences related to CSA, hence potentially leaving out more adaptive and resilient trajectories. This qualitative study aimed to explore childhood psychological maltreatment and CSA, mindfulness, sexuality, and intimate relationships in adult survivors. The interview data from 19 individuals who experienced CSA and psychological maltreatment were analyzed using conventional content analysis. Four conceptual categories developed: (a) an unsafe family environment that hindered the development of positive experiences and relationships; (b) impaired mindfulness dispositions: the reliving of trauma, the avoidance of suffering, and feeling engulfed; (c) impaired intimacy: instability, codependence, emotional distance, and self-silencing; and (d) mindfulness dispositions and posttraumatic growth (PTG) in participants' intimate lives. These findings highlight that mindfulness, sexuality, and intimate relationships are often poor among survivors of psychological maltreatment and CSA. Yet opportunities to develop mindfulness dispositions appear to enhance PTG in survivors' intimate relationships, significantly contributing to survivors' healing processes. [ABSTRACT FROM AUTHOR]

Healthcare systems and health professionals are facing a litany of stressors that have been compounded by the pandemic, and consequently, this has further perpetuated suboptimal mental health and burnout in nursing. The purpose of this paper is to report select findings from a larger, national study exploring gendered experiences of mental health, leave of absence (LOA), and return to work from the perspectives of nurses and key stakeholders. Given the breadth of the data, this paper will focus exclusively on the qualitative results from 53 frontline Canadian nurses who were purposively recruited for their workplace insight. This paper focuses on the substantive theme of "Breaking Point," in which nurses articulated a multiplicity of stress points at the individual, organizational, and societal levels that amplified burnout and accelerated mental health LOA from the workplace. These findings exemplify the complexities that underlie nurses' mental health and burnout and highlight the urgent need for multipronged individual, organizational, and structural interventions. Robust and timely interventions are needed to restore the health of the nursing profession and sustain its future. [ABSTRACT FROM AUTHOR]

The climate crisis significantly impacts the health and well-being of older adults, both directly and indirectly. This issue is of growing concern in Canada due to the country's rapidly accelerating warming trend and expanding elderly population. This article serves a threefold purpose: (i) outlining the impacts of the climate crisis on older adults, (ii) providing a descriptive review of existing policies with a specific focus on the Canadian context, and (iii) promoting actionable recommendations. Our review reveals the application of current strategies, including early warning systems, enhanced infrastructure, sustainable urban planning, healthcare access, social support systems, and community engagement, in enhancing resilience and reducing health consequences among older adults. Within the Canadian context, we then emphasize the importance of establishing robust risk metrics and evaluation methods to prepare for and manage the impacts of the climate crisis efficiently. We underscore the value of vulnerability mapping, utilizing geographic information to identify regions where older adults are most at risk. This allows for targeted interventions and resource allocation. We recommend employing a root cause analysis approach to tailor risk response strategies, along with a focus on promoting awareness, readiness, physician training, and fostering collaboration and benchmarking. These suggestions aim to enhance disaster risk management for the well-being and resilience of older adults in the face of the climate crisis. [ABSTRACT FROM AUTHOR]

Objectives: Approximately 30% of children diagnosed with attention-deficit/hyperactivity disorder (ADHD), the most prevalent mental health disorder in children worldwide, do not respond to conventional pharmaceutical treatments. Previous studies of homeopathic treatment for ADHD have been inconclusive. The objectives of this study were to determine if there (a) is an overall effect of homeopathic treatment (homeopathic medicines plus consultation) in the treatment of ADHD; (b) are any specific effects the homeopathic consultation alone in the treatment of ADHD; and (c) are any specific effects of homeopathic medicines in the treatment of ADHD. Design: The design was a randomized double-blind placebo-controlled clinical trial. Setting/Location: Toronto, Canada. Subjects: Children aged 6–16 years diagnosed with ADHD. Interventions: Participants were randomized to one of three arms: Arm 1 (Remedy and Consultation); Arm 2 (Placebo and Consultation); or Arm 3 (Usual Care). Outcome Measures: Primary Outcome was the change of CGI-P T score between baseline and 28 weeks. Results: There was an improvement in ADHD symptoms as measured by the Conner 3 Global Index-Parent T-score in the two groups (Arms 1 and 2) that received consultations with a homeopathic practitioner when compared with the usual care control group (Arm 3). Parents of the children in the study who received homeopathic consultations (Arms 1 and 2) also reported greater coping efficacy compared with those receiving usual care (Arm 3). There was no difference in adverse events among the three study arms. Conclusions: In this study, homeopathic consultations provided over 8 months with the use of homeopathic remedy was associated with a decrease in ADHD symptoms in children aging 6–16 years when compared with usual treatment alone. Children treated with homeopathic consultations and placebo experienced a similar decrease in ADHD symptoms; however, this finding did not reach statistical significance when correcting for multiple comparisons. Homeopathic remedies in and of themselves were not associated with any change in ADHD symptoms. Clinical Trial Registration: This trial was registered on ClinicalTrials.gov; NCT02086864. [ABSTRACT FROM AUTHOR]

Religion and spirituality (RS) are integral to counseling and health but their incorporation into the curricula of these professions is still lacking. Limited literature is available on how to effectively teach such courses. This article presents a promising experiential, interactive model for an RS course designed for undergraduate students pursuing careers in addictions counseling, therapeutic recreation, and public health. An online course conducted during the COVID-19 pandemic adopted a social constructivist framework that encompassed four key components in its design and delivery: assessing prior knowledge, creating cognitive dissonance, applying new knowledge with feedback, reflecting on learning. Students' feedback in the course indicated their broadened understanding of the plurality of RS orientations and their acquisition of foundational skills with an increased confidence in bringing RS conversations into their practice. This article provides a conceptual and practical framework for educators to develop an RS course for a diverse representation of students and encourages further evaluation of the proposed model to assess its impact on learning outcomes. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic caused a global health crisis directly impacting the healthcare system. Healthcare leaders influence and shape the ability of an organization to cope with and recover from a crisis such as the COVID-19 pandemic. Their actions serve to guide and support nurses' actions through unpredictable health service demands. The purpose of this paper was to examine frontline managers' experiences and organizational leadership responses that activated organizational resilience during the COVID-19 pandemic, and to learn for ongoing and future responses to healthcare crises. Fourteen managers participated in semi-structured interviews. We found that: (1) leadership challenges (physical resources and emotional burden), (2) the influence of senior leader decision-making on managers (constant change, shortage of human resources, adapting care delivery, and cooperation and collaboration), and (3) lessons learned (managerial caring behaviours and role modelling, adaptive leadership, education and training, culture of care for self, and others) were evidence of managers' responses to the crisis. Overall, the study provides evidence of managers experiences during the early waves of the pandemic in supporting nurses and fostering organizational resilience. Knowing manager's experiences can facilitate planning, preparing, and strengthening their leadership strategies to improve work conditions is a high priority to manage and sustain nurses' mental health and wellbeing. [ABSTRACT FROM AUTHOR]

Background: The COVID‐19 pandemic has had a negative impact on the mental health of people with intellectual and developmental disabilities. Numerous pandemic‐related stressors experienced by people with intellectual and developmental disabilities may have impacted their ability to thrive, which has been linked to mental health outcomes. The current study examined the associations among COVID‐19 stressors, thriving, and mental health problems among youth and adults with intellectual and developmental disabilities. Method: Caregivers of 159 people with intellectual and developmental disabilities between 12 and 35 years of age from Canada completed an online questionnaire. Results: A mediation analysis revealed that COVID‐19 stressors were positively associated with mental health problems, and that thriving partially mediated this association. Conclusion: Our findings suggest that experiences of thriving may be an important target for mental health support for people with intellectual and developmental disabilities. [ABSTRACT FROM AUTHOR]

Ceasing driving is associated with many negative outcomes. We examined the perceived impact of driving cessation among current older drivers. Transcripts from 92 interviews with participants from several locations across Canada were analyzed using inductive thematic analysis. We identified five themes: planning for mobility change, mobility supports and neighborhoods, financial security, fearing loss of control and independence, and coping and acceptance as a part of aging. Findings highlight diverse attitudes toward driving cessation, ranging from avoidance to acceptance, and emphasize the importance of tailored resources for drivers at various stages of behavior change. [ABSTRACT FROM AUTHOR]

Canadian social workers were surveyed about early adversities, mental health, and resilience. Bivariate analysis (n = 236) was conducted to understand relationships between predictor and outcome variables; and logistic regression analyses were conducted for depression, post-traumatic stress disorder, anxiety, and resilience. The impact of pandemic-related factors was also investigated. The results indicate that social workers are experiencing concerning levels of mental health issues, with significantly lower levels of resilience in younger social workers. A trauma and resilience informed approach to workplace policies and practices is urgently required to support social workers' mental health needs. [ABSTRACT FROM AUTHOR]

Research infrequently includes the perspectives of vulnerable and marginalized youth. As the population of newcomer youth in Canada continues to grow, it is imperative that attention is devoted not only to challenges they experience, but also to resilience factors they perceive to support their adjustment and well-being. To address this gap, this qualitative research explored newcomer youths' experiences and advice for other newcomer youth who have recently arrived in Canada. Thirty-seven newcomer youth from two medium-sized cities in Ontario participated in focus groups. Participants ranged from 14 to 22 in age and identified mostly as female refugees from the Middle East. Through thematic analysis, five overarching themes were found across groups: (1) moving to a new country is hard, (2) maintain a healthy mindset, (3) take an active role in the adjustment process, (4) stay true to who you are, (5) and you are not alone. Youth described hardships that make moving to a new country difficult including lack of belonging due to racism and bullying, insufficient orientation to new systems, language barriers, and high levels of stress. Findings demonstrated youths' resilience, coping skills, and strategies to lead meaningful lives. Youth discussed resilience strategies such as maintaining a connection with home culture and religion, reframing thinking to be positive, receiving emotional support, accessing community support at newcomer agencies, and building language proficiency. Findings provide implications for professionals working with newcomer youth and reflect the importance of addressing structural barriers and racism. The opportunity for newcomer youth to share experiences as experts in research may also help to promote resilience. [ABSTRACT FROM AUTHOR]

We used concept-mapping methods to gain insights into promising HIV prevention intervention strategies from the collective experience of heterosexual Black men (HBM) in four cities of Ontario. We engaged 60 HBM in online group concept-mapping sessions. First, we held a brainstorming session where the HBM generated 226 statements anonymously on strategies to reduce HIV vulnerabilities. The statements were condensed to 123. Second, the HBM (n = 45) sorted the 123 statements into self-created categories. Third, the HBM rated the strategy statements by importance (n = 45) and feasibility (n = 41). Finally, cluster analysis and multidimensional scaling were used to describe data patterns. The statements cluster tagged "family and individual level interventions" had the highest mean rating in importance (4.061) and feasibility (3.610). The policy interventions cluster solution was rated second highest in importance (IR = 4.058) and the sixth in feasibility (FR = 3.413). Other cluster solutions ratings were addressing racism (third highest in importance [IR = 4.030] and fourth highest in feasibility [FR = 3.514]); healthcare, research, and economic opportunities (fourth highest in importance [IR = 4.018] and third highest in feasibility [FR = 3.526]); sexual health awareness strategies (fifth highest in importance [IR = 3.993] and highest in feasibility [FR = 3.611]) and sex/HIV education (sixth highest in importance [IR = 3.975] and fifth highest in feasibility [FR = 3.442]); and individual and community empowerment (lowest in importance [IR = 3.846] and lowest in feasibility [FR = 3.375]). Intergenerational (family and individual), policy, and anti-racism interventions are the top three priority strategies for HIV prevention and care for HBM and communities in Ontario. [ABSTRACT FROM AUTHOR]

As our understanding of the process of resilience has become more culturally and contextually grounded, researchers have had to seek innovative ways to account for the complex, reciprocal relationship between the many systems that influence young people's capacity to thrive. This paper briefly traces the history of a more contextualized understanding of resilience and then reviews a social–ecological model to explain multisystemic resilience. A case study is then used to show how a multisystemic understanding of resilience can influence the design and implementation of resilience research. The Resilient Youth in Stressed Environments study is a longitudinal mixed methods investigation of adolescents and emerging adults in communities that depend on oil and gas industries in Canada and South Africa. These communities routinely experience stress at individual, family, and institutional levels from macroeconomic factors related to boom-and-bust economic cycles. Building on the project's methods and findings, we discuss how to create better studies of resilience which are able to capture both emic and etic accounts of positive developmental processes in ways that avoid the tendency to homogenize children's experience. Limitations to doing multisystemic resilience research are also highlighted, with special attention to the need for further innovation. [ABSTRACT FROM AUTHOR]

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(1) Purpose: To examine associations between subjective quality of life and other socio-demographic variables and to explore differences in experiences of people with different levels of quality of life (low, moderate, high). (2) Materials and methods: Semi-structured interviews and standardized measures of mobility, function, health-related quality-of-life, and quality-of-life were used to collect the data for this mixed-method study. (3) Results: Twenty-four participants were interviewed with an average age of 55 years and 54% were male. High quality of life, according to quantitative analysis, was strongly associated with being male, attending rehabilitation, and being married. The qualitative findings supported the quantitative findings and also revealed that people with a low quality of life felt the neighborhood-built environment was not supportive of people with incomplete spinal cord injury who can walk. Participants who reported a low/moderate quality of life reported feeling devalued by able-bodied people and that their mobility was getting worse over time. (4) Conclusion: Findings suggest that those with incomplete spinal cord injuries who can walk could benefit from improved quality of life by modifying their social support and neighborhood's built environment. For instance, sensitivity training for the general population could help to reduce negative attitudes and misperceptions about invisible impairments and promote inclusion. [ABSTRACT FROM AUTHOR]

BACKGROUND: Care partners are essential supports to individuals with multiple sclerosis (MS). Both negative and positive outcomes associated with the caregiving role have been reported. Psychological resilience may be an important factor influencing the MS caregiving experience, but an MS-specific model of care partner resilience has yet to be established. This study sought to explore an explicit model of MS care partner resilience. METHODS: Cross-sectional data from 471 Canadian MS care partners were collected via an online survey. Confirmatory factor analysis (CFA) and structural equation modeling (SEM) were used to test measures within a hypothesized model of resilience. Resilience was measured using the 25-item Connor-Davidson Resilience Scale. RESULTS: Following CFA, the hypothesized model was simplified due to the poor fit of several variables. The final model yielded a moderate SEM fit (χ² = 6030.95, P < .01). Being a woman was associated with greater caregiving tasks (β = 0.53, P < .001) and poorer spiritual health (β = --0.35, P < .001). Spiritual health, but not caregiving tasks, had a positive impact on both positive (β = 0.48, P < .01) and negative coping (β = 0.49, P = .01). Quality of life and resilience did not have relationships with other variables in the model. However, quality of life had a positive, unidirectional influence on resilience (β = 0.83, P < .01). CONCLUSIONS: Our findings indicate that spiritual health is an important predictor of coping and should be further explored in MS care partners. Quality of life may act as a precursor to resilience within MS care partners. Further research and exploration into MS care partner resilience is warranted to confirm this exploratory model. [ABSTRACT FROM AUTHOR]

Epidemiological evidence suggests that regular physical activity (PA) positively impacts individuals' mental health (MH). The PA-MH relationship may be critical among immigrants owing to psycho-social-cultural influences. This scoping review of 61 studies employed a holistic bio-psycho-socio-cultural framework to thoroughly investigate the complex relationship between PA (across life domains) and immigrants' MH in Western countries. A systematic search of five electronic databases (Medline, PubMed, Embase, PsycINFO and Anthropology Plus) was conducted to locate relevant articles. No limitations were applied to study design, age, gender, home country, MH condition or PA type. A bio-psycho-socio-cultural-informed conceptual model guided the analysis of the multi-domain PA-MH relationship. Immigrant PA-MH studies were conducted and reported most commonly in the USA (38%), Australia (18%), and Canada (11%). Overall, PA was positively related to MH. Each domain-specific PA appeared to be associated with unique MH-promoting pathways/mechanisms. Leisure-related PA may support MH by enhancing self-agency and minimizing risky behaviors, whilst travel- and domestic-related PA may promote self-accomplishment and physical engagement. Ethnic sports appeared to enhance resilience. Occupational-related PA was associated with either positive or negative MH, depending on the type of occupation. A bio-psycho-socio-cultural-informed model is required to gain an encompassing and integrated understanding of immigrants' health. The first iteration of such a model is presented here, along with an illustration of how the model may be used to deepen analysis and understanding of the multi-domain PA-MH relationship among immigrants and inform public health planners and practitioners. [ABSTRACT FROM AUTHOR]

Art therapy is one rehabilitation treatment which enables youth in secure care to express unresolved conflicts, increase self-esteem, and gain insight to personal experiences in a creative and supportive therapeutic space. This study investigated hope and resilience outcomes following art therapy for youth residing in a secure care centre located in Canada. In this pre–post experimental design study, thirteen (N = 13) youth, ages 12–19, received 12 weekly individual art therapy sessions. Hope, resilience, and goals were measured using the Children's Hope Scale (CHS), the Resilience Scale (RS-25), and the Bridge Drawing with Path (BDP) art-based assessment. Results indicated that the 12 weekly individual art therapy sessions enhanced hope and resilience in youth residing in secure care by 29% and 16%, respectively. Secure care environments may benefit from incorporating art therapy as a rehabilitation treatment to improve youths' levels of hope, resilience, self-determination, and future pathways. Future studies should utilise a group design with a control group to evaluate the effects of art therapy on youth residing in secure care environments. Art therapy is one rehabilitation treatment which enables youth in secure care to express unsettled conflicts, increase self-esteem, and gain understanding of personal experiences in a creative and supportive therapeutic space. This study investigated the effectiveness of art therapy on the levels of hope and resilience in youth residing in a secure care centre located in Canada. In this pre–post experimental design, thirteen youth, ages 12–19, received 12 weekly individual art therapy sessions. Hope, resilience, and goals were measured using the Children's Hope Scale (CHS), the Resilience Scale (RS-25), and the Bridge Drawing with Path (BDP) art-based assessment. Results showed that the 12 weekly art therapy sessions enhanced hope and resilience in youth residing in secure care by 29% and 16%, respectively. Secure care environments may benefit from including art therapy as a rehabilitation treatment to improve youths' levels of hope, resilience, self-determination, and future pathways. Future studies should use a group design with a control group to measure the effects of art therapy on youth residing in secure care environments. [ABSTRACT FROM AUTHOR]

This study evaluated the association between resilience and PrEP use among a population-based sample of Canadian gay, bisexual, and other men who have sex with men (GBM). Sexually active GBM aged ≥ 16 years old were recruited via respondent-driven sampling (RDS) in Toronto, Montreal, and Vancouver from 02/2017 to 07/2019. We conducted a pooled cross-sectional analysis of HIV-negative/unknown GBM who met clinical eligibility for PrEP. We performed multivariable RDS-II-weighted logistic regression to assess the association between scores on the Connor-Davidson Resilience-2 Scale and PrEP. Mediation analyses with weighted logistic and linear regression were used to assess whether the relationship between minority stressors and PrEP use was mediated by resilience. Of 1167 PrEP-eligible GBM, 317 (27%) indicated they took PrEP in the past six months. Our multivariable model found higher resilience scores were associated with greater odds of PrEP use in the past six months (aOR = 1.13, 95%CI = 1.00, 1.28). We found that resilience reduced the effect of the association between heterosexist discrimination and PrEP use. Resilience also mediated the relationship between internalized homonegativity and PrEP use and mediated the effect of the association between LGBI acceptance concern and PrEP use. Overall, PrEP-eligible GBM with higher resilience scores had a greater odds of PrEP use in the past six months. We also found mixed results for the mediating role of resilience between minority stress and PrEP use. These findings underline the continued importance of strength-based factors in HIV prevention. [ABSTRACT FROM AUTHOR]

Background: Alcohol use in early adolescence is associated with increased health concerns and other negative consequences. Given the needs of this vulnerable population, it is critical to understand their risk factors and clinical characteristics. Objective: This cross-sectional study explores the clinical and demographic characteristics of serviceseeking youth with and without early alcohol use onset. Method: 655 youth seeking services at a Canadian substance use and concurrent disorder service participated. Evaluations of mental health, substance use, demographic characteristics, and other risk factors were collected and compared among youth who reported an age of onset for alcohol use of under 14 years of age versus 14 years or older. Results: Youth who started using alcohol before age 14 were significantly more likely to report mental health difficulties, indicate use of a greater number of substances, and report experiencing more crime and violence problems. They also reported exposure to more types of trauma. Notably, more problems with crime and violence were significantly, and uniquely associated with an earlier age of alcohol use onset in a multivariate model. Conclusion: The present study identifies unique and clinically significant differences among youth who initiated alcohol use in early adolescence compared to later in adolescence. Stronger integrations between mental health and substance use services for youth with early alcohol use should be considered, given the vulnerability and concurrent difficulties they tend to face. [ABSTRACT FROM AUTHOR]

Introduction: Successful completion of clinical education experiences is a graduation requirement for students in occupational therapy and physical therapy programmes. A scoping review was conducted to determine what is known about possible clinical experience performance predictors and to find associated research gaps. Methods: The search included one hand‐searched journal and seven databases, which were used to identify related relevant studies: CINAHL, Education Database, Education Source, Education Resources Information Center (ERIC), PubMed, REHABDATA, and Web of Science. A research librarian guided the search process, and the review's reporting is structured by the Preferred Reporting Items for Systematic reviews and Meta‐Analyses extension for Scoping Reviews (PRISMA‐ScR) Checklist. Studies were included if they contained predictors of clinical experience success indicated by validated performance evaluation tools that were scored by clinical instructors. A multidisciplinary team reviewed the title, abstract, and full text for inclusion and conducted thematic data synthesis to categorise findings. Findings: Twenty‐six articles met the inclusion criteria. The majority of articles were of correlational design and included single institutions. Seventeen articles included occupational therapy, eight included physical therapy, with only one article including both programmes. Four categories of predictors of clinical experience success were identified: pre‐admission variables, academic preparation, learner characteristics, and demographics. Each of the main categories included three to six subcategories. Key findings included the following: (a) The most common cited predictors in clinical experiences are academic preparation and learner characteristics, (b) more experimental design studies are needed to determine the causal relationship between predictors and clinical experience success, and (c) future research is needed on ethnic disparities and clinical experience success. Conclusion: Findings from this review show that possible predictors of clinical experience success include a wide range of factors when correlating success with a standardised tool. Academic preparation and learner characteristics were the most investigated predictors. There were only a small number of studies that found a correlation with pre‐admission variables. The findings of this study suggest that students' academic achievement may be a critical element of clinical experience preparation. Future research using experimental designs and across institutions is needed to determine the main predictors for student success. [ABSTRACT FROM AUTHOR]

Most of what researchers know about the challenges students with learning disabilities (LDs) experience during postsecondary education is based on experiences during face-to-face learning on campus. Less is known about challenges students with LD face during learning online—the mode of instruction students had to navigate during the COVID-19 pandemic. Therefore, the purpose of our research was to examine the lived experience of undergraduate students with LD during their first full semester of online instruction as a result of the pandemic. We interviewed six students in Western Canada and used a phenomenological approach to analyze their experiences. Overall, we extracted six main themes from their interviews. Two of these themes, (a) the broad impact of having LD and (b) accommodations during COVID-19, were specific to being a student with LD. The remaining four themes were more generally related to their overall student experience: (c) online learning is different, (d) the role of others, (e) emotional impact, and (f) resilience and perseverance. We discuss these results in terms of recommendations for future research and teaching in online learning environments. [ABSTRACT FROM AUTHOR]

Child sexual abuse (CSA) impacts individuals and communities in numerous ways, including their faith. This study's aim was to learn from individuals who have an interest and/or expertise in spirituality and CSA about how various groups can support those impacted by CSA. The participants (n = 76) took part in a symposium focused on this topic and responded to an online survey with open-ended questions. Three themes emerged: negative impacts, direct response, and institutional changes. Using these responses, a model for Spiritually Informed Care is described, and implications for practice for those who work with those who have been impacted by CSA. [ABSTRACT FROM AUTHOR]

Disease-based models of health often fail to consider socio-economic models that perpetuate optimal health. The promotion of human thriving, rather than merely surviving, can be achieved by promoting optimal health indicators that facilitate overall wellbeing. Such interventions are those that promote a high quality of life, otherwise conceptualized as a "life worth living," and can consist of life activities that exist outside of traditional health care intervention. Despite the continuous rise of health outcomes in Canada, it is likely that the cost associated with thriving may reduce the likelihood that optimal health will be achieved by many. Previous studies have generated the cost of thriving calculated for a single individual living in the Greater Toronto Area and have found that the cost of thriving is below the median annual income for this region. In the current study, this framework has been applied to three additional communities in Northwestern Ontario. Results indicated that when costs of thriving in Thunder Bay, Sioux Lookout, and a small remote community were compared, costs of thriving were highest in more rural and remote areas. Given the limited availability of regional data, it was not possible to generate specific total costs for all communities in this review. Overall, health promotion and wellbeing approaches can be diversified by using evidence-based, strength-based health interventions. Such approaches can be offered in conjunction with traditional public health initiatives, to better foster individual-level health (through disease reduction) and wellbeing (such as promoting hope, belonging, meaning, and purpose) within community. [ABSTRACT FROM AUTHOR]