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Eliciting critical hope in community-based HIV research with transgender women in Toronto, Canada: methodological insights.

ABSTRACT: Critical hope centres optimism and possibilities for change in the midst of struggles for social justice. It was a central tenet of early participatory pedagogy and HIV research. However, critical hope has been overlooked in contemporary HIV research that largely focuses on risk and biomedical interventions in ways that obscure collective agency and community strengths. We conducted a community-based study with transgender (trans) women of colour in Toronto, Canada to adapt an evidence-based HIV prevention intervention. Participants resisted a focus on HIV, instead calling researchers to centre journeys to self-love in contexts of social exclusion. In response, we piloted three arts-based, participatory methods generated with community collaborators: (i) affirmation cards sharing supportive messages with other trans women, (ii) hand-held mirrors for reflecting and sharing messages of self-acceptance and (iii) anatomical heart images to visualize coping strategies. Participants generated solidarity and community through shared stories of self-acceptance within contexts of pain, exclusion and loss. Narratives revealed locating agency and self-acceptance through community connectedness. Critical hope was a by-product of this participatory process, whereby participants shared personal and collective optimism. Participatory and arts-based methods that centre self-acceptance and solidarity can nurture resistance to pathologizing discourses in HIV research. Centring critical hope and participant-generated methodologies is a promising approach to transformative health promotion and intervention research. These methodological insights can be engaged in future participatory work with other marginalized groups facing dominant biomedical risk discourses. Critical hope holds potential as a participatory health promotion strategy for envisioning possibilities for sustainable change.

SUBMITTER: Logie CH

PROVIDER: S-EPMC9226654 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:BackgroundFalls impose significant health and economic burdens on community-dwelling older persons. Decision modelling can inform commissioning of alternative falls prevention strategies. Several methodological challenges arise when modelling public health interventions including community-based falls prevention. This study aims to conduct a systematic review (SR) to: systematically identify community-based falls prevention economic models; synthesise and critically appraise how the models handled key methodological challenges associated with public health modelling; and suggest areas for further methodological research.MethodsThe SR followed the 2021 PRISMA reporting guideline and covered the period 2003-2020 and 12 academic databases and grey literature. The extracted methodological features of included models were synthesised by their relevance to the following challenges: (1) capturing non-health outcomes and societal intervention costs; (2) considering heterogeneity and dynamic complexity; (3) considering theories of human behaviour and implementation; and (4) considering equity issues. The critical appraisal assessed the prevalence of each feature across models, then appraised the methods used to incorporate the feature. The methodological strengths and limitations stated by the modellers were used as indicators of desirable modelling practice and scope for improvement, respectively. The methods were also compared against those suggested in the broader empirical and methodological literature. Areas of further methodological research were suggested based on appraisal results.Results46 models were identified. Comprehensive incorporation of non-health outcomes and societal intervention costs was infrequent. The assessments of heterogeneity and dynamic complexity were limited; subgroup delineation was confined primarily to demographics and binary disease/physical status. Few models incorporated heterogeneity in intervention implementation level, efficacy and cost. Few dynamic variables other than age and falls history were incorporated to characterise the trajectories of falls risk and general health/frailty. Intervention sustainability was frequently based on assumptions; few models estimated the economic/health returns from improved implementation. Seven models incorporated ethnicity- and severity-based subgroups but did not estimate the equity-efficiency trade-offs. Sixteen methodological research suggestions were made.ConclusionExisting community-based falls prevention models contain methodological limitations spanning four challenge areas relevant for public health modelling. There is scope for further methodological research to inform the development of falls prevention and other public health models.

Project description:BackgroundAnimal research (AR) findings often do not translate to humans; one potential reason is the poor methodological quality of AR. We aimed to determine this quality of AR reported in critical care journals.MethodsAll AR published from January to June 2012 in three high-impact critical care journals were reviewed. A case report form and instruction manual with clear definitions were created, based on published recommendations, including the ARRIVE guidelines. Data were analyzed with descriptive statistics.ResultsSeventy-seven AR publications were reviewed. Our primary outcome (animal strain, sex, and weight or age described) was reported in 52 (68%; 95% confidence interval, 56% to 77%). Of the 77 publications, 47 (61%) reported randomization; of these, 3 (6%) reported allocation concealment, and 1 (2%) the randomization procedure. Of the 77 publications, 31 (40%) reported some type of blinding; of these, disease induction (2, 7%), intervention (7, 23%), and/or subjective outcomes (17, 55%) were blinded. A sample size calculation was reported in 4/77 (5%). Animal numbers were missing in the Methods section in 16 (21%) publications; when stated, the median was 32 (range 6 to 320; interquartile range, 21 to 70). Extra animals used were mentioned in the Results section in 31 (40%) publications; this number was unclear in 23 (74%), and >100 for 12 (16%). When reporting most outcomes, numbers with denominators were given in 35 (45%), with no unaccounted numbers in 24 (31%), and no animals excluded from analysis in 20 (26%). Most (49, 64%) studies reported >40, and another 19 (25%) reported 21 to 40 statistical comparisons. Internal validity limitations were discussed in 7 (9%), and external validity (to humans) discussed in 71 (92%), most with no (30, 42%) or only a vague (9, 13%) limitation to this external validity mentioned.ConclusionsThe reported methodological quality of AR was poor. Unless the quality of AR significantly improves, the practice may be in serious jeopardy of losing public support.

Project description:Traffic is a significant pollution source in cities and has caused various health and environmental concerns worldwide. Therefore, an improved understanding of traffic impacts on particle concentrations and their components could help mitigate air pollution. In this study, the characteristics and sources of trace elements in PM2.5 (fine), and PM10-2.5 (coarse), were investigated in dense traffic areas in Toronto and Vancouver, Canada, from 2015-2017. At nearby urban background sites, 24-h integrated PM samples were also concurrently collected. The PM2.5 and PM10-2.5 masses, and a number of elements (i.e., Fe, Ba, Cu, Sb, Zn, Cr), showed clear increases at each near-road site, related to the traffic emissions resulting from resuspension and/or abrasion sources. The trace elements showed a clear partitioning trend between PM2.5 and PM10-2.5, thus reflecting the origin of some of these elements. The application of positive matrix factorization (PMF) to the combined fine and coarse metal data (86 total), with 24 observations at each site, was used to determine the contribution of different sources to the total metal concentrations in fine and coarse PM. Four major sources were identified by the PMF model, including two traffic non-exhaust (crustal/road dust, brake/tire wear) sources, along with regional and local industrial sources. Source apportionment indicated that the resuspended crustal/road dust factor was the dominant contributor to the total coarse-bound trace element (i.e., Fe, Ti, Ba, Cu, Zn, Sb, Cr) concentrations produced by vehicular exhaust and non-exhaust traffic-related processes that have been deposited onto the surface. The second non-exhaust factor related to brake/tire wear abrasion accounted for a considerable portion of the fine and coarse elemental (i.e., Ba, Fe, Cu, Zn, Sb) mass at both near-road sites. Regional and local industry contributed mostly to the fine elemental (i.e., S, As, Se, Cd, Pb) concentrations. Overall, the results show that non-exhaust traffic-related processes were major contributors to the various redox-active metal species (i.e., Fe, Cu) in both PM fractions. In addition, a substantial proportion of these metals in PM2.5 was water-soluble, which is an important contributor to the formation of reactive oxygen species and, thus, may lead to oxidative damage to cells in the human body. It appears that controlling traffic non-exhaust-related metals emissions, in the absence of significant point sources in the area, could have a pronounced effect on the redox activity of PM, with broad implications for the protection of public health.

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Eliciting critical hope in community-based HIV research with transgender women in Toronto, Canada: methodological insights.

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