Community Health Nursing

CCAPNR involves a group of multi-disciplinary, university-based researchers dedicated to creating new solutions for problems that challenge health and social services through the use of new models of care and evaluation. The team engages in research and professional education activities to address CCAPNR goals.

CCAPNR goals include:1. To provide a national forum to identify, discuss, consult and debate on important issues relevant to the education, development, and utilization of generalist, specialized and advanced nursing roles in Canada.2. To conduct timely, responsive and meaningful interdisciplinary and cross-jurisdictional research that informs decision-making about the education, development and utilization of generalist, specialized and advanced nursing roles in Canada.3. To lead a broad range of knowledge translation activities that support the design, conduct, dissemination and utilization of high quality research about nursing roles and models of care delivery in Canada.4. To support the development of advanced nursing roles and related research through consultation with key stakeholders and the education and mentorship of undergraduate and graduate students, advanced practice nurse

Faculty Member:

Denise Bryant-Lukosius and Ruth Martin-Misener (Co-Directors), Nancy Carter, Faith Donald, Patti Harbman, Kelly Kilpatrick, Diana Sherifali, Joan Trammer, Ruta Valaitis

Students:

1. Linda Brousseau
2. Erin Ziegler
3. Lindsay Yuille

Research Funding:

More Information:

• Canadian Centre for Advanced Practice Nursing (CCAPNR)

The McMaster University School of Nursing (SON) is dedicated to improving the health of residents in our local communities and fulfilling the School’s mission of community engaged scholarship.

To that end, in 2011 the School launched Health in the Hubs, an ongoing partnership between the SON and the local community planning teams (LPTs) from three Hamilton neighbourhoods: Crown Point, McQuesten, and South Sherman. The LPTs are made up of residents, service providers, places of worship, institutions and local businesses from each neighbourhood hub. A hub brings organizations, businesses and citizens in a community together.

Past Lead: Currently a Team Member :

Semogas D., Rolfe, S., Derbyshire, D., Murray, N., Penner, S., Slotiuk, C., Habib, N., Valaitis, R., Wahoush, O., Harrington, M.

Research Funding:

More Information:

• Website
• Health in the Hubs Phase 1 Report
• Health in the Hubs Think Tank

WHO Collaborating Centers are designated by the Director-General, WHO, as part of an inter-institutional collaborative network of centers worldwide. They are established to provide concrete activities at the national, regional, and global levels, in support of the strategic plans of specific WHO areas of work.

All WHO Collaborating Centers in the Region of the Americas are known as PAHO/WHO Collaborating Centers since the Pan American Health Organization also serves as a WHO regional office.  Currently there are over 180 Centers in 15 countries in the Americas.

Lead:

Valaitis, R.

Research Funding:

More Information:

• PAHO Advanced Practice Nursing Webinar Series 2016 English with Spanish translation
• PAHO Website

Report to Max Bell Foundation, March 2019, regarding KTE Event held with stakeholders on December 10, 2018.

First Author:

Valaitis, R., & Markle-Reid, M.

Research Funding:

EU-GENIE is an online tool that volunteers can use with clients. It can help them describe their support network and can link them to relevant local community resources that are tailored to the interests of the client.

EU-GENIE is a UK-developed, evidence-based online intervention aimed to support self-management for adults living with long-term health and social conditions. It was adapted for use in Canada. It is currently being tested in a sub-group of TAPESTRY clients who are enroled in Health Links. Study Objectives include: 1.      To assess the usability, acceptability, and normalization of the EU-GENIE tool in a primary care environment that is used by providers, clients and volunteers. 2.      To explore if and how EU-GENIE can function as a collaborative practice tool to improve providers’ and clients’ understanding of personal support networks, as well as linkages among primary care team members and between primary care and community-based health and social services (team-based care), within the context of Health TAPESTRY and Health Links programs. 3.      To explore if and how clients perceive the use of EU-GENIE as a tool to support attainment of their health and life goals. 4.      To explore how the size, composition and function of clients’ social networks support attainment of self-identified health goals.    Our Canadian adatped version of EU-GENIE was presented at the EU-WISE Conference, Southhampton, England. November 23, 2015. (http://eu-wise.com/wp-content/uploads/2012/12/EU-WISE-Conference-Southampton-9-R.-Valaitis-21-Nov.pdf) 

Lead:

Ruta Valaitis, Cathy Risdon, Jenny Ploeg, Anita Kothari, Lisa Dolovich, Laura Cleghorn, Anne Kennedy, Anne Rogers, Ivo Vassilev, Dale Guenter, and James Gillett

Research Funding:

• Exploring the Use of Personal Network Mapping as a Component of the TAPESTRY Program

More Information:

• Website
• Conference

This paper aims to explore community members' stories of their experiences with a Nurse Navigator programme serving an urban neighbourhood and primary care practice to address persistent health and social barriers adversely affecting health equity and well-being.

The relational process of navigation as an antecedent to barrier reduction has direct implications for programme development, continuing education of navigators and quality improvement of existing navigation services. Study findings have implications for development of navigation competencies for nurses working with priority populations to address health inequities.

Co-author:

Feather, J., Carter, N., Valaitis, R., Kirkpatrick, H.

Students:

1. Janice Feather

Research Funding:

More Information:

• Link to paper

This article reports on the development and psychometric testing of a learning needs assessment questionnaire related to the Canadian community health nursing Standards of practice.

Professional competencies have been widely used as a basis for the development of learning needs assessment. The Canadian Community Health Nursing Standards of Practices (CCHN Standards) were released in 2003. However, it is not known whether community health nurses (CHNs) have the educational background to enable them to meet these standards. This article reports on the development of a learning needs assessment questionnaire for CHNs. Exploratory and confirmatory factor analyses were conducted to examine the consistency of factors underpinning the CCHN Standards. Also, validity and reliability of the questionnaire were evaluated using appropriate techniques. This process resulted in a valid and reliable CHN learning needs assessment questionnaire to measure learning needs of large groups of practitioners, where other forms of measurement cannot be feasibly conducted.

Co-author:

Akhtar-Danesh, N., Valaitis, R., Schofield, R., Underwood, J., Martin-Misener, R., Baumann, A., Kolotylo, C.

Research Funding:

• A Pan-Canadian Survey of Community Health Nurses’ Learning Needs

More Information:

• Publication

This paper examines advanced practice nursing (APN) roles internationally to inform role development in Latin America and the Caribbean to support universal health coverage and universal access to health.

We examined literature related to APN roles, their global deployment, and APN effectiveness in relation to universal health coverage and access to health. Results: given evidence of their effectiveness in many countries, APN roles are ideally suited as part of a primary health care workforce strategy in Latin America to enhance universal health coverage and access to health. Brazil, Chile, Colombia, and Mexico are well positioned to build this workforce. Role implementation barriers include lack of role clarity, legislation/regulation, education, funding, and physician resistance. Strong nursing leadership to align APN roles with policy priorities, and to work in partnership with primary care providers and policy makers is needed for successful role implementation. Conclusions: given the diversity of contexts across nations, it is important to systematically assess country and population health needs to introduce the most appropriate complement and mix of APN roles and inform implementation. Successful APN role introduction in Latin America and the Caribbean could provide a roadmap for similar roles in other low/middle income countries. 

Co-Author:

Denise Bryant-Lukosius; Ruta Valaitis; Ruth Martin-Misener; Faith Donald; Laura Morán Peña; Linda Brousseau

Students:

1. Linda Brousseau

Research Funding:

More Information:

• Link to paper

A technical report commissioned by the Canadian Nurses Association, 1-116, 2014. This report summarizes the issues and policy options and will inform CNA’s future role and strategies for advancing a pan-Canadian primary care framework that optimizes the role of registered nurses (RNs) and advanced practice nurses in primary care interprofessional teams.

Research, practice, education and policy information and input from key stakeholders relevant to nursing roles in the delivery of primary care services from national, provincial and territorial perspectives were synthesized to provide policy guidance and actionable recommendations. The key components of this project included a scoping literature review and key informant interviews with nurses and other stakeholders.

Co-author:

Martin-Misener R, Bryant-Lukosius D, Bullard C, Campbell D, Carter N, Donald F, Kilpatrick K, McKinlay J, Parks C, Sherifali D, Tranmer, J, Valaitis, R. Viscardi V., Yuille L.P.

Research Funding:

• Advancing a pan-Canadian primary care framework: optimizing the role of Registered Nurses and Nurse Practitioners.

More Information:

• Final Report

Canadian Community health nurses (CHNs) work in diverse urban, rural, and remote settings such as: public health units/departments, home health, community health facilities, family practices, and other community-based settings.

Research into specific learning needs of practicing CHNs is sparsely reported. This paper examines Canadian CHNs learning needs in relation to the 2008 Canadian Community Health Nursing Standards of Practice (CCHN Standards). It answers: What are the learning needs of CHNs in Canada in relation to the CCHN Standards? What are differences in CHNs’ learning needs by: province and territory in Canada, work setting (home health, public health and other community health settings) and years of nursing practice? CHN educators and practice leaders need to consider these results in determining where to strengthen content in graduate and undergraduate nursing programs, as well as professional development programs. For practicing CHNs educational content should be tailored based on learner’s years of experience in the community and their employment sector.

First Author:

Valaitis, R.K., Schofield, R., Akhtar-Danesh, N., Baumann, A., Martin-Misener, R., Underwood, J., Isaacs, S.

Research Funding:

More Information:

• Publication
• Community Health Nurses of Canada (CHNC)

Youth are often disenfranchised in their communities and may feel they have little voice. Since computers are an important aspect of youth culture, they may offer solutions to increasing youth participation in communities. This study involved public health nurses to support the school-based community development project.

This qualitative case study investigated the perceptions of 19 (predominantly female) inner-city school youth about their use of computers and the Internet in a school-based community development project. Overall, youth perceived computers and the Internet to be empowering tools, and they should be encouraged to use such technology to support them in community initiatives related to health promotion.

Author:

Valaitis, R.

Research Funding:

More Information:

• Publication

Schools are a main setting for health promotion for youth. A one year qualitative case study was undertaken in an inner-city, Canadian school. It explored factors that enabled and constrained youth in the process of a school-based computer-supported community development (CD) project. This paper reports on Dr. Ruta Valaitis' PhD thesis results.

Nineteen grade seven and eight students worked with four adult facilitators for 12 weeks. They completed a community assessment, planned and implemented actions to improve their school environment. Data were collected by: youth and adult interviews, participant observation, content analysis of online postings and two surveys. Constant comparison and triangulation from various data sources and methods were used to verify themes. Themes were categorized as intrinsic or extrinsic enabling and constraining factors. Intrinsic enabling factors were youth' s perceptions that they were making a difference, and feeling recognized for and having ownership of their work. Extrinsic enabling factors included flexibility inyouth's choice of activities, supportive adults and community members and the use of incentives. Intrinsic constraining factors were the perceived slow pace of the CD process, and difficulties in getting group consensus/decision-making. Extrinsic constraining factors included: school disruptions and schedules, a lack of 'buy-in' from teachers and parents, and resource demands-people and computers. Relationships between these factors are noted. Research and practice implications regarding school-based CD to promote youth resiliency are discussed.

First Author:

Valaitis, R., O’Mara, L.

Research Funding:

More Information:

• Publication

The purpose of the study on which this article is based was to determine the current extent of linkages among Canadian community health nursing researchers and decision makers and to identify perceptions around the structure and function of potential networks.

A qualitative research design was utilised to develop common themes across focus groups, a workshop and key informant interviews. The findings suggest that there is a need for a formal community health network to provide an efficient and timely means to link the expertise required to tackle complex community health policy problems, and to create supports for advancing community health science with relevant and high quality research. This work was foundational to the development of a public health network- CHNET WORKS! (http://www.chnet-works.ca/)

Co-author:

Kothari, A., Edwards, N., Brajtman, S., Campbell, B., Hamel, N., Legault, F., Mill, J., Valaitis, R.

Research Funding:

• Networking Infrastructure for Community Health Nursing Researchers and Decision-makers

More Information:

• Publication

Final report submitted to the Ontario Ministry of Health and Long-Term Care, pp. 1-53, July 2017.

First Author:

Valaitis. R., Markle-Reid, M., Ploeg, J., Butt, M., Ganann, R., *Bookey-Bassett, S., Kennedy, L., Murray, N., & Yousif, C.

Research Funding:

Social capital has shown potential for its ability to improve physical and mental health, although findings about social capital’s impact in rural areas have been less promising. The aim of this study was to shed light on how adults in two small towns of rural Ontario experience social capital in their daily lives, and to contribute to the broader literature about the relationship between social capital and rural health.

  The qualitative findings shed light on the experience of social capital and issues of accessing it from the perspective of adults in two rural communities. The social and structural context shaped individuals’ experiences in ways that benefited some community members while marginalizing others. Familiarity, friendliness, and supportive social norms suggest that the rural idyll is not all myth. Yet the structural context left youth and young adults, seniors without transportation, and low-income residents challenged with accessing social capital. Investing in programs and policies that target the structural context may have the greatest impact on rural social capital development and health promotion. The qualitative findings shed light on the experienc e of social capital and issues of accessing it from the perspective of adults in two rur al communities. The soci al and structural context shaped individuals’ experiences in ways that benefited some community members while marginalizing others . Familiarity, friendliness, and supportive social norms suggest that the rural idyll is not all myth. Yet the structural context left youth and young adults , seniors without transportation , and low - income residents challenged with accessing social capital . I nvest ing in programs and policies that target the structural context may have the greatest impact on rural social capital development and health promotion. The qualitative findings shed light on the experienc e of social capital and issues of accessing it from the perspective of adults in two rur al communities. The soci al and structural context shaped individuals’ experiences in ways that benefited some community members while marginalizing others . Familiarity, friendliness, and supportive social norms suggest that the rural idyll is not all myth. Yet the structural context left youth and young adults , seniors without transportation , and low - income residents challenged with accessing social capital . I nvest ing in programs and policies that target the structural context may have the greatest impact on rural social capital development and health promotion. The qualitative findings shed light on the experienc e of social capital and issues of accessing it from the perspective of adults in two rur al communities. The soci al and structural context shaped individuals’ experiences in ways that benefited some community members while marginalizing others . Familiarity, friendliness, and supportive social norms suggest that the rural idyll is not all myth. Yet the structural context left youth and young adults , seniors without transportation , and low - income residents challenged with accessing social capital . I nvest ing in programs and policies that target the structural context may have the greatest impact on rural social capital development and health prom eff of social capital and issues of accessing it from the perspective of adults in two rur al communities. The soci al and structural context shaped individuals’ experiences in ways that benefited some community members while marginalizing others . Familiarity, friendliness, and supportive social norms suggest that the rural idyll is not all myth. Yet the structural context left youth and young adults , seniors without transportation , and low - income residents challenged with accessing social capital . I nvest ing in programs and policies that target the structural context may have the greatest impact on rural social capital development and health promotion.

Senior Author:

Buck-McFadyen, E., Isaacs, S., Strachan, P., Akhtar-Danesh, N., Valaitis, R.

Students:

1. Ellen Buck-McFadyen

Research Funding:

More Information:

• Publication

This paper fills a gap in knowledge to reveal what is known about motivators and factors influencing implementation and maintenance of patient navigation programs in primary care that link patients to community-based health and social services. It also reports on outcomes from these studies to help identify gaps in research that can inform future studies.

This scoping literature review involved: i) electronic database searches; ii) a web site search; iii) a search of reference lists from literature reviews; and, iv) author follow up. It included papers from Canada, the United States, the United Kingdom, Australia, New Zealand, and/or Western Europe published between January 1990 and June 2013 if they discussed navigators or navigation programs in primary care settings that linked patients to community-based health and social services.   Of 34 papers, most originated in the United States (n = 29) while the remainder were from the United Kingdom, Canada and Australia. Motivators for initiating navigation programs were to: a) improve delivery of health and social care services; b) support and manage specific health needs or specific population needs, and; c) improve quality of life and wellbeing of patients. Eleven factors were found to influence implementation and maintenance of these patient navigation programs. These factors closely aligned with the Diffusion of Innovation in Service Organizations model, thus providing a theoretical foundation to support them. Various positive outcomes were reported for patients, providers and navigators, as well as the health and social care system, although they need to be considered with caution since the majority of studies were descriptive.

First Author:

Ruta K. Valaitis; Nancy Carter; Annie Lam; Jennifer Nicholl; Janice Feather; Laura Cleghorn

Students:

1. Jennifer Nicholl
2. Janice Feather

Research Funding:

• Evaluation of a Community Nurse Navigator in a Priority Hamilton Neighbourhood

More Information:

• Link to paper

From 2006 - 2009, Dr. Ruta Valaitis was a member of the Advisory Committee for the design and development of an Orientation Program for new nurses transitioning into public health careers.

The orientation package was developed with funding from HealthForceOntario through the Nursing Secretariat. The funding was sought through the leadership of Algoma Public Health and Ontario Association of Public Health Nursing Leaders ANDSOOHA: Public Health Nursing Management. The Ontario Association of Public Health Nursing Leaders (OPHNL- formerly known as ANDSOOHA) is a part of the collective voice, shaping and enhancing public health nursing administration and practice.

Algoma Public health and ANDSOOHA:

Simpson, J. L.

Research Funding:

More Information:

• Public Health Orientation Toolkit

From 2004 to 2012, Dr. Ruta Valaitis was a member of the CASN Subcommittee for Public Health.

CASN/ACESI (Canadian Association of Schools of Nursing/Association canadienne des écoles de sciences infirmières) is the national voice for nursing education, research, and scholarship and represents baccalaureate and graduate nursing programs in Canada. The CASN Subcommittee for Public Health was supported by the Public Health Agency of Canada to support community health nursing education programs to prepare nurses towards the Canadian Community Health Nursing Standards of Practice. 

Canadian Nursing Education Leadership :

CASN-ACESI

Research Funding:

More Information:

• CASN-ACESI

Expert advisory committee member of Ontario’s Ministry of Health and Long-term Care’s “Optimization of the Nursing Workforce Working Group” for the Nursing Secretariat reporting to the Joint Provincial Nursing Council (JPNC).

The Optimization of the Nursing Workforce Working Group, which is a working group of the Joint Provincial Nursing Committee (JPNC).  This group systematically explored opportunities to optimize the home health-care nursing workforce and presented a report to JPNC. 

Committee member :

Ministry of Health and Long-term Care: Joint Provincial Nursing Council Sub-committee

Students:

1. Dr. Rebecca Ganann

Research Funding:

We conducted a scoping literature review following established methods to explore the existing evidence on system navigation in primary care. To be included, studies had to be published in English between 1990 and 2013, and include a navigator or navigation process in a primary care setting that involves the community- based social services beyond the health care system. We make an important contribution to the literature by highlighting navigation models that address both health and social service navigation. T

Co-Author:

Nancy Carter, Ruta K. Valaitis, Annie Lam, Janice Feather, Jennifer Nicholl and Laura Cleghorn

Students:

1. Jennifer Nicholl
2. Janice Feather

Research Funding:

• Evaluation of a Community Nurse Navigator in a Priority Hamilton Neighbourhood

More Information:

• Link to paper

To identify recommendations for determining patient panel/caseload size for nurse practitioners in community-based primary health care settings. There are few systems in place to track and measure community-based primary health care nurse practitioner activities. The development of such mechanisms is an important next step to assess community-based primary health care nurse practitioner productivity and determine patient panel/caseload size.

We identified 111 peer-reviewed articles and grey literature documents. Most of the papers were published in Canada and the United States after 2010. Current methods to determine panel/caseload size use large administrative databases, provider work hours and the average number of patient visits. Most of the papers addressing the topic of patient panel/caseload size in community-based primary health care were descriptive. The average number of patients seen by nurse practitioners per day varied considerably within and between countries; an average of 9–15 patients per day was common. Patient characteristics (e.g., age, gender) and health conditions (e.g., multiple chronic conditions) appear to influence patient panel/caseload size. Very few studies used validated tools to classify patient acuity levels or disease burden scores. Decisions about panel/caseload size must take into account the effects of nurse practitioner activities on outcomes of care.

Co-Author:

R. Martin-Misener, K. Kilpatrick, F. Donald, D. Bryant-Lukosius, J. Rayner, R. Valaitis, N. Carter, P.A. Miller, V. Landry, P. Harbman , R.Charbonneau-Smith, J. McKinlay , E. Ziegler, S. Boesveld , A. Lamb

Students:

1. Erin Ziegler

Research Funding:

More Information:

• Publication

This study explored community health nurses' viewpoints about a Canadian online community of practice to support their practice with homeless or under-housed populations.

Generally, nurses viewed the community of practice as a place to share stories, validate practice and adapt best practices to their work context. Online communities of practice can be valuable to nurses in specialized fields with limited peer support and access to information resources. Tacit knowledge development is important to nurses working with homeless populations: this needs to be valued in conjunction with scientifically based knowledge.

First Author:

Valaitis, R., Akhtar-Danesh, N., Brooks, F., Binks, S., Semogas, D.

Research Funding:

• Creating a Virtual Community of Practice for Street Nursing

More Information:

• Publication

The Internet is an innovative strategy to increase public participation. It is important to include pregnant and parenting teens' perspectives when planning programs to meet their needs. This qualitative study explored online discussions as a strategy to enhance participation by this population.

Findings showed that online communication was preferred over face-to-face group discussions. Being anonymous online encouraged open and honest feedback. Participants experienced various forms of social support, however, there was an overall lack of teen involvement online. Strategies to engage adolescents in online discussions and reduce barriers are discussed. Strategies included the use of teen moderators, home computer access, technical support, and engagement in naturally flowing online discussions to meet social support needs. Blending researchers' with teens' needs for social support in an online environment is encouraged. With careful planning and design, online communications can result in mutual benefits for researchers, service providers, and pregnant and parenting adolescents.

First Author:

Valaitis R., Sword, W.

Research Funding:

More Information:

• Publication

To address increasing pressures for cancer survivorship care, provincial cancer agencies have introduced new models of post-treatment follow-up involving earlier transition of cancer survivors back to primary care (PC) providers. It is unknown how nurses in PC settings have responded to this practice change. The purpose of this qualitative descriptive study was to examine registered nurses' (RNs) perspectives of the strengths, gaps, barriers and opportunities for optimizing nursing roles in the delivery of cancer survivorship care within PC settings.

Participants completed a demographical questionnaire and semi-structured, in-depth telephone interview. Data collection and analysis were conducted concurrently. Data were analyzed using content analysis approaches. The sample included 18 RNs working in diverse PC settings across Ontario. Participants' involvement in cancer survivorship care was limited, but it could be categorized into the following three themes: care coordination and system navigation, emotional support and facilitating access to community resources. Individual, practice setting and PC team factors influenced nurses' involvement in cancer survivorship care. To the best of our knowledge, this is the first Canadian study to examine RN roles in PC settings related to cancer survivorship care. There is wide variability and opportunity to enhance RNs' roles and involvement in cancer survivorship care.

Co-Author:

Lindsay Yuille, Denise Bryant-Lukosius, Ruta Valaitis & Lisa Dolovich

Students:

1. Lindsay Yuille

Research Funding:

More Information:

• Link to publication

Report to Labarge Optimal Aging Initiative, pp. 1-5, November 2016.

First Author:

Valaitis, R., Markle-Reid, M., Ploeg, J., McAiney, C., & Ganann, R.

Research Funding:

Report to the Gift Board, Labarge Foundation, pp.1-6, November 2018.

First Author:

Valaitis, R., Markle-Reid, M., Ploeg, J., McAiney, C., & Ganann, R.

Research Funding:

The purpose of this second phase of the study was to identify current practice activities of CHNs across all Canadian Provinces and Territories and to measure their continuing education needs in relation to the CCHN Standards.

The results of this pan-Canadian survey will inform the Public Health Agency of Canada (PHAC), the Community Health Nurses Association of Canada, community health nursing employers, and others who are involved in continuing education program development in order to build capacity in the community health nursing workforce in Canada. The 2009 report outlines methods, results, the development of an online version of the survey, implications for practice and research, limitations and conclusions.

Co-author:

Schofield, R., Valaitis, R., Ahktar-Danesh, N., Baumann, A., Martin-Misener, R., Underwood, J.

Research Funding:

• A Pan-Canadian Survey of Community Health Nurses’ Learning Needs

More Information:

• Report

The Canadian Schools of Nursing (CASN) Task Force on Public Health was mandated to facilitate Schools of Nursing to provide students with the foundation required to meet the Canadian Community Health Nursing Standards of Practice. As a member of this Task Force Dr. Valaitis led this paper which reports on an environmental scan that explored barriers and enablers influencing the integration of community health nursing content in baccalaureate education in Canada.

Data was collected over three phases including: 1) a pan-Canadian survey of nursing schools, 2) completion of open-ended workbook questions by educators, policy makers, administrators, and community health nursing managers attending a pan-Canadian symposium on community health nursing, and 3) recorded notes from the symposium. The response rate for the survey was 72.5% (n = 61 schools) and approximately 125 stakeholders participated in symposium activities. Internal and external enablers and challenges as well as recommendations for practice and education are presented.

First Author:

Valaitis, R., Rajsic, C., Cohen, B., Stamler, L., Meagher-Stewart, D., Froude, S.

Research Funding:

• A Pan-Canadian Survey of Community Health Nursing Content Taught in Schools of Nursing: Are We Preparing Students for the New Standards of Practice

More Information:

• Publication
• Community Health Nurses of Canada (CHNC)

Report to the WHO, Series Number 16, March 2009. Primary health care (PHC) is a philosophy and an educational practice approach. Nursing is one of the key services for the delivery of PHC. The purpose of this background paper is to examine PHC education for nurses in the globalized world.

A case study approach is used to provide information about PHC education. The paper will define and describe PHC, nursing education in Canada and curriculum development. Challenges will be discussed and a policy framework will be provided. In addition, recommendations specific to PHC nursing education will be made.

Co-author:

Baumann, A., Valaitis, R., Kaba, A.

Research Funding:

More Information:

• Report

The goal of the Aging, Community and Health Research Unit (ACHRU) is to promote optimal aging at home for older adults with multimorbidity (≥2 chronic conditions) and to support their family/friend caregivers. This protocol paper reports the rationale and plan for this patient-oriented, cross-jurisdictional research program.

BACKGROUND: The goal of the Aging, Community and Health Research Unit (ACHRU) is to promote optimal aging at home for older adults with multimorbidity (≥2 chronic conditions) and to support their family/friend caregivers. This protocol paper reports the rationale and plan for this patient-oriented, cross-jurisdictional research program. OBJECTIVES: The objectives of the ACHRU research program are (i) to codesign integrated and person-centered interventions with older adults, family/friend caregivers, and providers; (ii) to examine the feasibility of newly designed interventions; (iii) to determine the intervention effectiveness on Triple Aim outcomes: health, patient/caregiver experience, and cost; (iv) to examine intervention context and implementation barriers and facilitators; (v) to use diverse integrated knowledge translation (IKT) strategies to engage knowledge users to support scalability and sustainability of effective interventions; and (vi) to build patient-oriented research capacity. DESIGN: The research program was informed by the Knowledge-to-Action Framework and the Complexity Model. Six individual studies were conceptualized as integrated pieces of work. The results of the three initial descriptive studies will inform and be followed by three pragmatic randomized controlled trials. IKT and capacity building activities will be embedded in all six studies and tailored to the unique focus of each study. CONCLUSIONS: This research program will inform the development of effective and scalable person-centered interventions that are sustainable through interagency and intersectoral partnerships with community-based agencies, policy makers, and other health and social service agencies. Implementation of these interventions has the potential to transform health-care services and systems and improve the quality of life for older adults with multimorbidity and their caregivers.

Co-author:

Markle-Reid, M., Ploeg, J., Valaitis, R., Duggleby, W., Fisher, K., Fraser, K., Ganann, R., Griffith, L., Gruneir, A., McAiney, C., and Williams, A. for the Aging, Community and Health Research Unit Team

Research Funding:

More Information:

• Link to paper

In 2002, Dr. Valaitis was a representative for CASN at the National Summit for Ontario Health Information Highway. This conference was related to health Informatics and held at the University of Victoria, British Columbia.

CASN/ACESI (Canadian Association of Schools of Nursing/Association canadienne des écoles de sciences infirmières) is the national voice for nursing education, research, and scholarship and represents baccalaureate and graduate nursing programs in Canada.

National Summit for ON Health Information Highway:

CASN

Research Funding:

More Information:

• CASN/ACESI

This paper reports on the quantitative phase of a sequential explanatory mixed methods study using data from Canada's 2013 General Social Survey (data collected 2013–14) to explore mechanisms that link social capital and health..

The concept of social capital shows great promise for its potential to influence individual and population health. Yet challenges persist in defining and measuring social capital, and little is known about the mechanisms that link social capital and health. This paper reports on the quantitative phase of a sequential explanatory mixed methods study using data from Canada's 2013 General Social Survey (data collected 2013–14). An exploratory factor analysis revealed six underlying dimensions of social capital for 7,187 adults living in Ontario, Canada. These factors included trust in people, neighbourhood social capital, trust in institutions, sense of belonging, civic engagement, and social network size. A logistic regression indicated that having high Trust in People and Trust in Institutions were associated with better mental health while high Trust in Institutions, Sense of Belonging, and Civic Engagement were associated with better physical health. When comparing rural and urban residents, there were no differences in their self‐reported health, nor did social capital influence their health any differently, despite rural residents having higher social capital scores. The study findings are important for understanding the nature of social capital and how it influences health, and provide direction for targeted health promotion strategies.

Senior Author:

Elen Buck McFayden, Akhtar‐Danesh Sandy Isaacs Beverly Leipert Patricia Strachan and Ruta Valaitis

Students:

1. Ellen Buck-McFadyen

Research Funding:

More Information:

• Link to Paper

This article describes the development, implementation, and evaluation of an interdisciplinary undergraduate course embedded within a campus–community partnership initiative involving McMaster University School of Nursing, and three urban priority neighborhoods in Hamilton, Ontario, Canada. The experiential course focuses on building knowledge and skills in community participation and community improvements for health and continues to be offered today. This primary health care collaboration between the campus and three Hamilton neighbourhoods was led by Dr. Valaitis and supported by the Health in the Hubs team.

Students worked together with community residents and faculty to address selected priority community issues identified by neighborhood members. Using the qualitative interpretive description method, the evaluation explored different partners’ (students, community residents, and faculty) perceptions of the course (SWOT analysis: strengths, weaknesses, opportunities, and threats, as well as outcomes) as a community engagement and knowledge exchange intervention. Results provide lessons learned and recommendations for future campus–community engaged courses that can be transferred to similar contexts.

First Author:

Ruta Valaitis,Olive Wahoush, Nancy Murray, Sandy Isaacs, David Derbyshire, Dyanne Semogas, and Steven Rolfe

Research Funding:

• Street Smarts Book Smarts: Evaluation of a Knowledge Exchange Intervention (Health in the Hub Phase 2)

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Most adults with chronic conditions live at home and rely on informal caregivers to provide support. The purpose of this rapid evidence review was to assess the impact of Web-based interventions on mental health, general caregiving outcomes, and general health for informal caregivers of persons with chronic conditions living in the community.

Study results suggest that Web-based interventions may result in reduced depressive symptoms, anxiety, and stress or distress among informal caregivers of adults with chronic conditions in the community.  This is the first review assessing the impact of Web-based technologies on mental health, general caregiving outcomes, and general health for caregivers of adults with chronic conditions living in the community. Further rigorous research is needed that includes adequately powered studies examining the critical components of the intervention and the dosage needed to have an effect.

Co-author:

Ploeg, J., Markle-Reid, M., Valaitis, R., McAiney, C., Duggleby, W., Bartholomew, A., Sherifali, D.

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