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Key Achievements

CQ Fellows have advanced the field of qualitative health research through their numerous research contributions and key achievements.

Through their work, Fellows have promoted the consideration of health issues from different perspectives:

  • Joan Eakin's works provide a new lens through for rethinking abuse discourse;
  • Denise Gastaldo has made significant advances in looking at nursing through the lens of governmentality;
  • Pia Kontos' work focuses on rethinking the self in Alzheimer’s through the lens of embodiment as well as understanding traumatic brain injury in the context of therapeutic landscape theory;
  • Barbara Gibson leads an international consortium to rethink core assumptions about independence, quality of life and disability that underpin rehabilitation practices.

CQ fellows have applied and advanced qualitative research with implications for various facets of health and health care:

  • P-C Hsiung’s article “Qualitative Research from Feminist Perspectives” was published in the official journal of the Chinese Sociological Association, and was the first article published in China which raised the issue of critical perspectives in qualitative research. It has been cited 41 times.
  • Janet Parsons’ Brokered Dialogue has received funding from provincial and federal agencies (Canadian Agency for Drugs and Technologies in Health as well as the Ministry of Health and Long Term Care). This method is also of interest to the Bill and Melinda Gates Foundation, and opportunities to apply this method in addressing important topics in global health are currently under exploration.

CQ Fellows have developed partnerships with community organizations, increasing the profile of qualitative research and promoting its utility for program development and implementation in the community:

  • Joan Eakin’s research on the experience of workers and employers with workplace injury generated an influential new concept that that has been widely cited and used in the occupational health, safety, rehabilitation and compensation community, locally and internationally: the notion of the ‘discourse of abuse’ and its damaging effect on injured worker recovery, rehabilitation and post injury lives and prospects. This research-generated concept and related research findings became the basis for a collaboration between Dr. Eakin and the injured worker activist community in Ontario that led to the production with a playwright and professional theatre director of a play called “Easy Money”. The production was performed in various forms and locations in Ontario and was funded by labour organizations and private donations. A video of the live production was also made and widely circulated in the injured worker, legal and rehabilitation communities. Dr Eakin’s research on work injury and occupational health in small workplaces also contributed in a significant way to organizational service changes made at the Ontario Workplace Safety and Insurance Board, resulting from a collaboration between researchers, injured workers and WSIB administrators (between 2009 and 2012).
  • Barbara Gibson conducted a study of adequate home environments as enabling or disabling places for adults with significant mobility disabilities living in Ontario; presentation to patients, family members and staff at West Park Health Care Centre informed the development of a new on-site independent living residence.
  • Brenda Gladstone's thesis was used by community groups as a guideline in implementing and improving several components of children’s support groups, including, but not limited to: changes in the group set-up and scheduling, tailoring to needs and wants of the children, providing one on one support to children, improved training for group facilitators, and improved community partnerships.
  • Ellen MacEachen conducted research that was turned into a practice guide that is now one of the most popular downloaded items from the Institute of Work and Health website, and was requested by the Workplace Safety and Insurance Board for each of their 400 case managers. This research also resulted in advisory reports to the Occupational Health and Safety group and the Workplace Safety and Insurance Board, as well as presentations to community groups.
  • Janet Parsons collaborated with the Catholic Children’s Aid Society of Toronto on the “Picturing Foster Care” grant, which will be informative in their service provision to young families.
  • Debbie Rudman collaborated with the Canadian National Institute for the Blind on a constructivist grounded theory study that explored service and other environmental influences on the social participation, activity engagement and social inclusion of seniors with age-related vision loss, recruiting seniors at the time of their intake into CNIB services. Results informed the re-design of service pathways for seniors with age-related vision loss at the CNIB, and were also used to develop a webinar for service providers and managers that is designed to enhance their sensitivity to and awareness of environmental barriers encountered by seniors with age-related vision loss. Dr. Rudman is now also a member of the Research Advisory Committee at the CNIB and provides input into approaches for examining service needs and impacts.
  • Izumi Sakamoto conducted a community based participatory research study titled “Coming together: Homeless women, housing and social support” that used “staged photography” as a method of data collection. This work received the honorary mention of the CBR Award of Merit by the Wellesley Institute and the Centre for Urban Health Initiative.

CQ fellows have conducted work that has direct implications for improved care pathways through training and preparing health care providers, as well as increasing understanding of care needs, and quality service and care provision:

  • Paula Gardner's findings from research on the health and social impact of computer training with older adults was used by the Older Adults Technology Services (OATS) organization to help obtain $2 million in funding from the City of New York. The funds are being used to establish a training facility and enhance computer training programs across the city.
  • Barbara Gibson's CIHR study at the U of T Joint Centre for Bioethics investigated the adequacy of home environments as enabling or disabling places for adults with significant mobility disabilities living in Ontario. Findings suggest that provincial policies and practices continue to focus narrowly on the basic physical needs of disabled people without consideration to broader notions of citizenship, rights, dignity and social inclusion. Output included a framework of seven conditions for assessing the adequacy of home environments using social dignity as a guiding principle. Also included in community participation, policy and methodological innovations. Dr. Gibson’s research investigating the social exclusion of young men with Duchenne Muscular Dystrophy was featured at a consortium of Parent Project Muscular Dystrophy (USA) who are launching a major initiative to improve transitions experiences of boys with DMD.
  • Corinne Hart's study at CAMH relevant to nurses and their perceptions and realities of power and status within a broader inter-professional team on one particular unit resulted in the implementation of a “nursing supervision” group, co-led by Dr. Hart and a social worker colleague. The group meets every 4-6 weeks with nurses on the unit to discuss issues related to their roles on the broader inter-professional team, particularly issues related to perceptions of power and control over their work.
  • Pia Kontos' dramatized vignettes featuring examples of embodied selfhood (a theoretical notion of selfhood that emphasizes the importance of bodily movements and gestures for self-expression by persons living with Alzheimer’s disease) were incorporated into a 12-week educational program about person-centered care, developed for dementia care practitioners. A qualitative evaluation of the educational program affirmed the efficacy of drama as a knowledge translation strategy and the importance of embodied selfhood for individualizing care, reducing agitation, and improving the time efficiency of practice. These dramatized vignettes were incorporated into an e-learning course offered by the Registered Nurses’ Association of Ontario (RNAO) on best practice guidelines for person-centered care, which has had 1700 registrants since its launch. Course evaluations demonstrated improved understanding of the principles of client-centered care and practitioners’ perception that the course will improve their ability to implement the knowledge-based recommendations about client-centred care into practice. A play was developed based on a focus group study of survivors of traumatic brain injury, their families, and health care practitioners concerning experiences with the health care system, and day-to-day challenges and coping strategies. An evaluation study demonstrated its effectiveness in improving client-centred brain injury rehabilitation. The play has been publicly performed 36 in cities across Canada (in rehabilitation hospitals, and at conferences in the field of rehabilitation science). It also ran at the Toronto Fringe Festival. Audience members have approximated 3,000.
  • Janet Parsons' research in health disparities and maternal-and-child health explored the impact of child custody loss on perinatal child health care provision amongst young parents who are homeless or marginally housed. “Picturing Foster Care” will also provide important evaluative data on three different models of foster care and their intersection with perinatal health care delivery.
  • Debbie Rudman's CNIB study resulted in re-design of service pathways for seniors with age-related vision loss. Also resulted in development of case modules regarding low vision that have been implemented within Occupational Therapy curricula at Western University and McMaster University.

CQ fellows have conducted work with important health policy implications, and have been called upon to lend their expertise in policy development processes:

  • Joan Eakin's qualitative research was used as evidence/basis of discussion in numerous policy arenas, including the Ontario Workplace Safety and Insurance Board and a consultation with the federal Minister of Labour.
  • Barbara Gibson's findings from a study on the adequacy of home environments was used in the development of a white paper by the Ontario Community Living Association, regarding the problems of inadequate attendant care support for people with disabilities in Ontario.
  • Janet Parsons employed the “Brokered Dialogue” method to evaluate a new initiative on drug system reform by the Ontario Citizens’ Council. This report was delivered to the Ontario Ministry of Health and Long Term Care.
  • Elizabeth Peter developed a novel approach to policy analysis using a critical ethics perspective, which is currently being used to analyze policy changes occurring in Spain as a result of austerity measures. The findings from this research have also been used to inform Health Canada and by a parent with a disabled child to lobby the BC Ministry of Health.
  • Izumi Sakamoto conceptualized/problematized the notion of “Canadian Experience” for immigrant employment, and and has worked with the Ontario Human Rights Commission on a policy on Canadian Experience as a requirement for immigrant employment. This policy, “ Policy on removing the ‘Canadian experience’ barrier” was released in July 2013, and calls into question the discriminatory hiring and accreditation practice of using 'Canadian experience' as a strict requirement for immigrants.
  • Fiona Webster has participated in numerous policy reports for the Ontario Ministry of Health and Long Term Care, including the Ontario’s Emergency Department Process Improvement Program, the American Society of Regional Anesthesia (Knowledge Translation piece), CIHR Institute of Circulatory and Respiratory Health (Knowledge Translation Framework).

CQ fellows are innovators, bringing qualitative research to the health field and promoting methodological advancement in qualitative research:

  • Joan Eakin was one of the first qualitative researchers in the medical sciences in Canada. She is a pioneer trail blazer of the application of qualitative research methodology in the field of occupational health and safety research.
  • Paula Gardner developed a methodological strategy for collecting and analyzing multisensory data that is of use in hospitals where senses are heightened and play a role in patient experience.
  • Barbara Gibson developed innovative methods for optimizing single interviews with children with disabilities, led by a student; integrated the use of solicited audio diaries, photography and interviews to illuminate intersectionality of gender, disability and generation (life stages) identities in a study with disabled young men transitioning into adulthood; developed a unique methodology that combines empirical qualitative research and normative ethical analysis in a process of “reflective equilibrium”.
  • Brenda Gladstone employed Critical Dramaturgy using Discourse Analysis to consider the program manual used to educate and support children of mentally ill parents as a particular kind of health care text; publication on Qualitative Secondary Analysis: an innovation in thinking about the potential of re-using qualitative data for different theoretical, methodological purposes.
  • Corinne Hart is exploring the notion of “emotion management” as a methodological tool rather than simply an area of substantive research.
  • P-C Hsiung's teaching innovation, Lives and Legacies: A Guide to Qualitative Interviewing is invaluable for freeing up class time to teaching/learning higher order skills of analysis and critical thinking.
  • Pia Kontos used drama as an innovative method for translating prominent examples of “embodied selfhood” (a theoretical notion of selfhood that emphasizes the importance of bodily movements and gestures for self-expression by persons living with Alzheimer’s disease) into a framework meaningful and relevant to dementia care practitioners. Drama was also used to challenge assumptions of loss that define current conceptions of dementia, and to advocate a new ethic of care premised on the importance of bringing relationships to the forefront, supporting embodied self-expression, and ensuring the humanity of those living with dementia is fully supported. Also used drama to foster cultures of best practice in brain injury rehabilitation and renal rehabilitation.
  • Janet Parsons brokered the Dialogue method, which is designed to study and understand contested dialogic spaces (i.e. those where dialogue either does not occur naturally or where it is charged with controversy); invites participants into respectful dialogue with one another, using the medium of film and a participatory editing process.
  • Debbie Rudman introduced the use of critical discourse analysis into the fields of occupational therapy and occupational science and, building on this work, has helped to facilitate a ‘critical turn’ in the study of occupation that shifts the lens from individual coping/adjustment/impairment to consideration of the socio-political shaping of disability, marginalization and health inequity.
  • Fiona Webster introduced the use of institutional ethnography to surgery and medical education research. She is now using IE to develop innovative approaches to the evaluation of interventions for the care of patients with chronic pain.

CQ fellows are influential in the health field, and have published landmark work that has been taken up widely:

  • Joan Eakin's paper, cited below, is a signature publication which is widely cited on the evaluation of qualitative health research.
    Eakin, J. and Mykhalovskiy, E. “Reframing the evaluation of qualitative health research: Reflections on a review of appraisal guidelines in the health sciences”, Journal of Evaluation of Clinical Practice, 2003, 9 (2) 187-194.
  • Elizabeth Peter's paper, cited below, is one of first papers to address the unique ethical issues in PAR, and has been cited many times.
    Khanlou, N. & 
    Peter, E. (2005). Participatory action research: considerations for ethical review. Social Science & Medicine, 60, 2333-2340.