Indigenous men’s pathways to ‘living the right kind of life and walking the right path’: Understanding impacts of systemic oppression and guidance for healing and (w)holistic sexual health.

Citation:

Rand, J., Melro, C., Biderman, M., McMillian, J., Miller, A., Lekas, S., Numer, M (2022). Indigenous men’s pathways to ‘living the right kind of life and walking the right path: Understanding impacts of systemic oppression and guidance for healing and (w)holistic sexual health. Culture, Health, and Sexuality. Open Access: https://www.tandfonline.com/doi/full/10.1080/13691058.2022.2055149

Abstract:

Indigenous men around the world hold expertise over their own lives. Informed by this perspective, this study centres this experience to better understand what is needed to improve sexual health outcomes among a group of men with a history of incarceration. Semi-structured interviews were conducted with 10 Indigenous men with such a history. Through thematic analysis the study identified two major themes: 1) the impacts of systemic oppression; 2) the value of guidance in walking the right path. Men identified colonial trauma and the associated mental, physical, emotional and spiritual wounds stemming from systemic oppression as continuing to impact their wellbeing. Men also described the systems of support necessary to help guide them on their journeys through incarceration, rehabilitation and building strong and nurturing relationships. Findings from the study provide important guidance from Indigenous men for future more holistic sexual health intervention programming.

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Pathways for Sexual Health Promotion Among Indigenous Boys and Men: Stakeholder Perspectives

Citation

Biderman, M., Doria, N., Sinno, J., Rand, J., Hackett, L., Miller, D., McMillan, L.J., Lekas, S. & Numer, M. (2021). Pathways for Sexual Health Promotion Among Indigenous Boys and Men: Stakeholder Perspectives. AlterNative. 1(10). DOI 10.1177/11771801211023207 

Abstract

The sexual health of Indigenous Peoples in Canada has been identified as an important community and public health concern; however, there is a lack of research on the sexual health needs of Indigenous boys and men. This article shares results from interviews conducted with six stakeholders to explore pathways for sexual health promotion and considers the impacts of colonialism and other socio-political contextual factors on Indigenous boys’ and men’s sexual health. The study employed thematic analysis, and the findings indicate the following three pathways for sexual health promotion of Indigenous boys and men: (1) developing healthy relationships and highlighting role models, (2) providing access to comprehensive sexual health information, and (3) fostering open communication among Indigenous boys and men. Sexual health promotion with Indigenous boys and men in Atlantic Canada should include addressing the impacts of colonization and their unique socio-cultural contexts.

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Attitudes and Practices of Nova Scotian Physicians for the Implementation of HIV Pre-Exposure Prophylaxis.

Citation

Sinno, J., Cochkanoff, N., Doria, N., Numer, M., Neyeldi, H., & Tan, D. (2021). Attitudes and Practices of Nova Scotian Physicians for the Implementation of HIV Pre-Exposure Prophylaxis. HIV/AIDS - Research and Palliative Care.13(1). DOI: 10.2147/HIV.S287201

Abstract

Introduction: Pre-exposure prophylaxis (PrEP) is an effective HIV prevention tool that requires the ongoing support of physicians to be accessible. Recently, Nova Scotia experienced a 100% increase in HIV diagnoses. The purpose of this study is to explore the relationship between physicians’ support of PrEP, knowledge of PrEP, and PrEP prescribing history using the information-motivation-behavioral (IMB) skills model.

Methods: An online survey was distributed to physicians in Nova Scotia, Canada, and eighty physicians participated. Two exploratory factor analyses were conducted with items from the Support of PrEP scale and Knowledge of PrEP scale. A mediation analysis was conducted to assess if knowledge of PrEP mediated the relationship between support of PrEP and whether physicians have prescribed PrEP in the past.

Results: On average, physicians reported strong support for PrEP, and as support for PrEP increased so did knowledge of PrEP. Further, physicians who had prescribed PrEP demonstrated strong knowledge of PrEP and physicians who had not prescribed PrEP reported feeling neutral. The 95% bootstrap confidence interval indirect effect of Support for PrEP on prescription history did not include zero (B = 1.59, 95% BsCI [0.83, 3.57]) demonstrating that the effect of support for PrEP is mediated by knowledge of PrEP. The most commonly identified barrier to prescribing PrEP was the lack of drug coverage among patients.

Conclusion: The results of the mediation analysis support the IMB skills model regarding support for PrEP, Knowledge of PrEP, and having prescribed PrEP in the past. Our findings suggest that to improve PrEP uptake in Nova Scotia, educational interventions for physicians and universal coverage of the drug would be necessary.

Keywords: HIV pre-exposure prophylaxis, health care providers, attitudes, knowledge, barriers, accessibility, health care access, information-motivation-behavior skills model

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Women’s Experiences of Safety Apps for Sexualized Violence: A Narrative Scoping Review.

Citation

Doria, N., Ausman, C., Wilson, S., Consalvo, A., Sinno, J., & Numer, M. (2020) Women’s Experiences of Safety Apps for Sexualized Violence: A Narrative Scoping Review. BMC Public Health. (Open Access)

Abstract

Background

Sexualized violence against women is a significant human rights problem worldwide. Safety apps have the capacity to provide women with resources to prevent or respond to experiences of sexualized violence. The aim of the following study was to review the scope of the literature on women’s experiences of safety apps related to sexualized violence and identify if there is a current gap in this literature.

Methods

This scoping review employed a systematic methodology guided by the Arksey and O’Malley framework. The search for this scoping review was conducted in January 2020 and four electronic databases were searched: Embase, MEDLINE, PsycINFO, and Scopus. Reference lists of systematic reviews, scoping reviews, and literature reviews that were found through the search of databases were also checked to ensure all relevant studies had been screened. Last, the table of contents for the last five years (2015–2020) were hand searched in four key journals (Journal of Technology in Human Services, Violence Against Women, BMC Public Health, and Health Promotion International) to identify any articles that may have been missed in the database search. Covidence was used to complete the screening. All data that met inclusion criteria was charted, extracted and synthesized.

Results

Across the four databases searched, a total of 389 studies were identified; 127 duplicates were removed, resulting in 262 studies screened. In total, 6 studies were included from the search of databases and 1 study was included from hand-searching, for a total of 7 included studies. Thematic analysis identified the following themes in the literature, which are summarized narratively: (1) security; (2) accessibility; and (3) knowledge. Recommendations and barriers found in relation to each theme are also presented.

Conclusions

This review confirms that the qualitative literature on women’s experiences of sexualized violence safety apps is scarce and exposes that a gap in the literature on this topic. The gaps in the literature were identified and implications and recommendations for future research are discussed.

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Interactive e-texts and university student learning experiences: A scoping review.

Citations

Spencer, R., Comeau, E., Matchett, B., Biderman, M., Joy, P., Doria, N., & Numer, M. (2020). Interactive e-texts and university student learning experiences: A scoping review. Canadian Journal of Education/Revue Canadienne De l’éducation, 43(1), 258-287. (Open Access)

Abstract

The purpose of this article is to explore the scope of available evidence regarding the use of interactive e-texts and their relationship to student learning experiences in post-secondary education. Following the framework of Arksey and O’Malley, this scoping review identified and reported on 33 articles. Study characteristics are presented alongside four themes that were found across the included articles: (1) the effect of interactive e-texts on student learning experiences; (2) the relationship between interactive e-texts and academic performance; (3) factors influencing student adoption and experience of interactive e-texts; and (4) roles, responsibilities, and recommendations. While the adoption of interactive e-texts is becoming increasingly common in post-secondary education, their effect on student learning experiences remains complex. This review emphasizes the importance of user-friendliness, affordability, accessibility, portability, and the role of educators. Using interactive e-texts shows promise, though future research should explore how barriers might be minimized and benefits might be maximized to have the strongest impact on student learning experiences.

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Graphic facilitation as a tool to guide community-based research on Indigenous boys’ and men’s sexual health.

Citation

Doria, N., Biderman, M., Miller, D., Prosper, A., & Numer, M. (2019). Graphic facilitation as a tool to guide community-based research on Indigenous boys’ and men’s sexual health. Journal of Indigenous HIV Research, 10, 20-27. Retrieved from https://www.ahacentre.ca/uploads/9/6/4/2/96422574/
graphic_facilitation.pdf (Open Access)

Abstract

The sexual health of Indigenous1 boys and men is becoming increasingly recognized as an important area of research (Bingham et al., 2014; Grace 2003; Healey & Meadows, 2007). To date, however, much of the research exploring the sexual health of Indigenous Peoples has focused on women and girls. While further research is needed to explore the sexual health of Indigenous boys and men, future research must consider how interacting and dimensional factors such as colonization, racism, discrimination and prejudice contribute to poor sexual health outcomes (Bird et al., 2016; George et al., 2016; Hallett et al., 2017; Negin, Aspin, Gadsden, & Reading, 2015; Reading, Wien, & National Collaborating Centre for Aboriginal Health, 2009; Reading, Loppie, & O’Neil, 2016). It is important to recognize that generations of trauma and abuse have produced the poor social conditions in which Indigenous Peoples experience worse sexual health compared to the national average, such as higher rates of HIV and other STBBIs (Haddad et al., 2018). This paper describes our experience of conducting a community consultation to explore the current state of Indigenous boys and men’s sexual health and wellness. We also discuss our experience of using graphic facilitation as a culturally responsive tool to collect qualitative data on this subject matter. The community consultation is an outcome of a larger program of research that ultimately aims to decrease HIV rates within the Indigenous community across Atlantic Canada and beyond. Ethical approval for this project was obtained from both the Dalhousie Research Ethics Board and Mi’kmaw Ethics Watch

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Constituting the ideal body: A poststructural analysis of “obesity” discourses among gay men.

Citation

Joy, P., & Numer, M. (2018). Constituting the ideal body: A poststructural analysis of “obesity” discourses among gay men. Journal of Critical Dietetics, 4(1), 47-58. (open access)

Abstract

Ideal bodies are constituted through various social and cultural discourses. One such discourse that constitutes bodies is the “obesity” discourse. The term obesity is a contested and medicalizing term that constitutes a view of fat people as unhealthy, immoral, and undesirable. Obesity discourses, therefore, also constitute notions of the bodies and body types that are thought to be healthy, acceptable, and attractive. The effects of obesity discourses can be prominently observed in gay men’s culture where muscular, white, thin bodies are glorified. This paper employs a poststructural framework to examine how desired bodies are constituted in gay culture. This paper also explores how some gay men resist dominant obesity discourses. A critical review of the literature on fatness, body dissatisfaction, and the influence of gay culture on eating practices among gay men informs this work. Various studies have shown that gay culture can constitute experiences of body dissatisfaction, rejection, and isolation for many men, especially for those that fall outside the idealized version of male bodies or who are labelled as “obese”. Implications for critical dietitians who are working with gay men are discussed.

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