Health (Faculty of)

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The Faculty was known as the Faculty of Applied Health Sciences prior to its name change in January 2021.

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Developing a More Culturally Appropriate Approach to Surveying Adverse Childhood Experiences Among Indigenous Peoples in Canada
(University of Waterloo, 2019-02-22) Luther, Alexander; Mielke, John; Anthony, Kelly
Introduction: Adverse childhood experiences (ACE) are (in a dose-dependent manner) associated with both health-risk behaviours and the development of chronic disease, and thus pose a significant threat to health and well-being. However, current ACE survey methods fail to adequately capture the adversities that some social, or ethnic groups have experienced. In particular, very few investigations have studied ACE among Indigenous populations, and those that have tended to focus on the prevalence of ACE, not on the appropriateness, or precision of the tools used for its measurement. The study was an attempt to answer two primary research objectives. The first was to investigate whether Indigenous people living in Canada would endorse domains of adverse childhood experiences not currently captured by the conventional ACE survey instrument. The second was to understand the factors or sources of resiliency and healthy coping strategies in regard to reducing the effects of childhood adversities and traumas among Indigenous people. Methods: Qualitative interview and focus group methodologies were utilized and adapted to integrate aspects of the nominal group technique (NGT) and of First Nations Sharing Circles. A total of 16 participants were recruited for the study (focus group n=4, interviews n=12). Thematic analysis was applied to the qualitative data generated from the interviews and focus group, and quantitative descriptions of the data generated through the NGT process were used to compare within group differences based on demographic characteristics. Results: Study findings highlighted five domains of ACE, each with numerous subthemes, relevant to Indigenous children living in Canada, including exposure to historical trauma, a lack of infrastructure and basic public services, household and community dysfunction, gender-based adversities, and racial discrimination. Although there were some similarities in the themes and subthemes in comparison to conventional ACE domains, many experiences shared were not currently captured by conventional ACE surveys. Additionally, four domains of healthy coping mechanisms and/or resiliency factors with many subthemes were identified, including healing from trauma, improving cultural connections, strong social networks, and a bevy of personal attributes. Conclusions: When undertaking such investigations an appreciation for the sociological and historical factors in many Indigenous communities and families, regardless of direct personal exposure, is required. Investigating exposure to additional adversities, such as historical traumas, a lack of public infrastructure and services, and events of racial discrimination is necessary to include when surveying ACE among Indigenous children as well. This is in addition to the conventional domains captured by ACE surveys, including sexual assault, gender-based violence, and household dysfunction items. Program planning, and resources should be directed to service providers that can offer Indigenous-based counselling, cultural programming, networking opportunities, and skill development for Indigenous people with exposure to ACE to further build healthy coping mechanisms and greater resiliency. Study findings point to the need for shift in approach to acknowledge and address the socioecological and historical factors in the health, social, and legal service sectors that engage with Indigenous individuals or communities with ACE exposure. Further investigation is necessary into other potentially relevant domains of adversity, as well as testing of an expanded ACE survey measure among different Indigenous communities or groups.
Impacts of Alternative Policing on Officer Health: The Community Engagement Unit (CEU)
(University of Waterloo, 2025-01-21) Fenton, Arden; Mielke, John; Anthony, Kelly
Created by the Waterloo Regional Police Service (Ontario-Canada), the Community Engagement Unit (CEU) links high-needs community members with specially trained police and to appropriate social services. Whether living with homelessness, poor mental health, domestic violence, or substance use, and often with several of these challenges simultaneously, high-needs community members often require greater police attention. Indeed, CEU officers act as a “911 calls diversion centre” by redirecting high-needs individuals away from traditional law enforcement approaches and towards relevant social service agencies. However, due to their unique work environment, CEU officers likely experience additional/unique stressors that may impact their health. As a result, when developing alternative policing units like the CEU, recognizing the potential stressors of such work and their impact on the police service is essential. This mixed methods study utilizes semi-structured interviews and surveys to assess the work environment of CEU officers relative to traditional police officers to improve our understanding of stress-related health risk factors within alternative policing units. Five CEU officers were recruited via email to participate in a 1-hour semi-structured interview. Thematic analysis of semi-structured interviews developed the CEU ‘phenotype’ by assessing the unique work environment, roles, and responsibilities of CEU officers. The CEU officers were asked to reflect on these aspects of their work compared to previous units (primarily patrol). The experience of stress in CEU is more prolonged and chronic, given the continuous nature of their interactions with high-needs individuals, as opposed to the fast-paced, case-to-case stress nature of patrol units. This ‘slow-burn’ stress, combined with the frustration of navigating under-resourced community social support systems and moral distress when cases lack resolution, is likely to present unique challenges to the officers' health and well-being. Surveys collected standard demographic information and included validated scales to measure self-reported health, health-risk behaviours, given and received social support, and varying levels and types of police-specific stressors using the operational and organizational police stress questionnaires (PSQ-Op, PSQ-Org). Seven CEU officers (14.0%) and 43 traditional (TRAD) officers (86.0%) were recruited via e-mail to participate in the survey. CEU officers had lower levels of fatigue (-42.5%), shiftwork (-57.6%), working alone at night (-58.3%) and internal investigations (-63.3%) compared to TRAD officers. This study reveals distinct differences between CEU and TRAD officers. CEU officers report lower fatigue and less shiftwork but experience prolonged "slow-burn" stress due to ongoing interactions with high-needs individuals and frustrations with under-resourced support systems. These findings emphasize the need for tailored support systems in alternative policing units like the CEU. Improved mental health resources, decompression opportunities, and clear mandates can help reduce health risks associated with their unique stressors. This study adds to the research on alternative policing, highlighting the importance of understanding occupational health in non-traditional police roles.

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Browsing Health (Faculty of) by Author "Anthony, Kelly"