Theses (Studies in Policy and Practice)

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    Developing a cultural safety intervention for clinicians: process evaluation of a pilot study in the Northwest Territories
    (2019-04-30) Hall, Karen Edohai Blondin; Prince, Michael J.; Reading, Charlotte Loppie
    The purpose of this study was to (1) explore the experiences and perceptions of clinicians who participated in a pilot cultural safety intervention in the Northwest Territories and (2) to make recommendations to pilot intervention in terms of design, content, and delivery. Indigenous and process evaluation research principles underlined this qualitative research project. Data was collected through semi-structured interviews with eight clinicians who participated in the pilot intervention. Findings, identified through thematic analysis, reveal that participants were satisfied with many aspects of the pilot intervention, including key learnings, but also experienced challenges. Among these challenges were dominant discourses that suppress conversations about power and privilege. These research results will inform the sponsors of this project to further refine the pilot training model to enhance clinician learning and engagement. This study may be insightful to researchers and program developers in other jurisdictions.
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    The cost-effectiveness of community based long term care services for the elderly compared to residential care : a British Columbia perspective
    (2017-12-15) Hollander, Marcus J.; Prince, Michael J.
    Growth in the elderly population and restraint in the health sector have led to decision makers placing an increasing priority on home care services. In Canada, there are three models of home care: a preventive and maintenance model which is designed to reduce the rate of deterioration for persons with relatively low level care needs; an acute care substitution model where home care substitutes for hospital care; and a long term care substitution model which uses home care as a substitute for facility care. This study focuses on the long term care substitution model. The research question is: In the British Columbia continuing care sector, is home care for the elderly a cost-effective alternative for government funders to care in long term care facilities, by level of care? To answer this question, data were obtained on three cohorts of clients for one year prior to initial assessment and three years post-assessment. The cohorts were new admissions to the British Columbia continuing care system in the 1987/88, 1990/91 and 1993/94 fiscal years. Costs to government for home care services, residential services, pharmaceuticals, fee-for-service physician services and hospital services were analyzed. The central finding of this study was that, on average, the overall health care costs to government for clients in home care are about one half to three quarters of the costs for clients in facility care, by level of care. A related finding was that costs differ by the type of client. The lowest home care costs were for individuals who were stable in their type and level of care. For clients who died the costs for home care were higher, compared to clients in long term care facilities. It was also found that some one half of the overall health care costs for home care clients were attributable to their use of acute care hospital services and that a significant portion of the health costs for home care clients occur at transition points, that is, when there is a change in the client's type, and/or level, of care. These findings are compared to the American literature which indicates that home care is not a cost-effective substitute for residential care. Possible reasons for the differences in findings are discussed. The study concludes with a discussion of the implications of the findings for a series of potential, future, policy agendas regarding: the organization and management of continuing care services; legislation and administrative policy; service delivery; resource allocation; information systems; and research.
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    “I see big gaps”: the Community Volunteer Supplement and disability income policy in British Columbia
    (2016-09-02) Witkowskyj, Candace Larissa; Prince, Michael J.; Teghtsoonian, Katherine Anne
    This research explores a disability community’s success in drawing public attention to an unlawful development of policy, that community’s efforts in resistance, and the experiences of those individuals in relation to subsequent neoliberal silencing. Specifically, this study examines the experiences of people on disability assistance in British Columbia who successfully appealed the Ministry’s unjust denial of the Community Volunteer Supplement (CVS) and documents participants’ reactions to the government’s later repeal of the CVS program. Five individuals were interviewed about their experiences in resisting the Ministry of Social Development and Social Innovation’s practice to wait list CVS applicants, a benefit they were legislatively entitled to receive. Of the participants interviewed, three identified as women and two identified as men. Utilizing a post-structural feminist theory, influenced by critical disability theory and Foucault, a key finding of this research is that participants’ experiences with the CVS is connected to their experiences of poverty, resistance, and community.
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    Reconceptualizing bodies and pleasure: considerations by and for sex-positive service workers
    (2016-04-27) Henderson, Charlotte; Moss, Pamela
    Human sexuality has been overrun with narratives that limit the possibilities of pleasure. Sex-positive workers have the potential to challenge the ways in which these limitations become embodied. In this research I explore narratives of sex education and youth, pleasure as prevention, and the medicalization of sexuality. I engage in collective biography as a way to identify how these narratives shape the way bodies and pleasure get taken up in specific places. Drawing from poststructural feminist theory I propose three ways of reconceptualizing bodies and pleasure as emergent sites of change and potential. Through an analysis of the experiences of sex-positive service workers in Canada, I consider what else, and for whom, bodies, pleasure, and sex education might look like.
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    School access: children with motor disabilities in rural Uganda
    (2015-05-13) Penny, Anne Marie; Molzahn, Anita E.
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    The Space Between Us: An Inquiry Into Belonging
    (2015-04-17) Lyster, Kim Pamela Boutwell; Boyd, Susan C.
    This thesis explores the topic of belonging: both the sense and experience of it as well as the relationship to individual and collective well-being. Through in-depth interviews with five leaders and advocates in the social justice community, I explore their perspectives on the topic, significant influences, the power of the experience, and the relationship between inclusion and belonging. Further, the capacity for belonging to influence and impact social issues such as marginalization, discrimination, and poverty are explored. Methods for fostering belonging are also considered with a view to suggesting recommendations for promoting a lens of belonging as a means for renewing a commitment to the beloved community.
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    Manageable Problems/Unmanageable Death: The Social Organization of Palliative Care
    (2014-08-15) Miller, Rena; Campbell, Marie L.
    This thesis is an exploration of the social construction and organization of community palliative care. The author's personal experience as the wife of a dying person is used to explicate the social relations of palliative care, through the feminist and constructivist methodology of institutional ethnography. The data analyzed includes a personal journal, working texts of the palliative care team (e.g. recording and reporting forms) obtained through Freedom of Information, and the Palliative Care at Home manual.
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    A Child's "Terminal Illness": An Analysis of Text Mediated Knowing
    (2014-08-15) Bell, Nancy Marie; Campbell, Marie L.
    Several years ago a ten year child with a disability died from "severe malnutrition" according to a Coroners Service inquest jury. The inquest evidence shows that approximately one week prior to this child's death three health care providers conducted individual assessments of the child. Using institutional ethnography as a theoretical and methodological framework, the author conducts a textual analysis of the health care providers' documents generated during their provision of service to this child. Obtained as public documents from the Coroners Service, this data includes: the hospital form, the hospice society records and home care nursing records.
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    The Inequity of Employment Equity: An Intersectional Examination of Black Men and Employment Related Racism
    (2013-08-26) Metz, Jessie-Lane; Brown, Leslie Allison; Prince, Michael J.
    Racism is a serious barrier to achieving employment equity in Canada. The intersectional nature of oppression creates a situation where, based on various characteristics including gender, place of birth, and ethnic group membership, individuals experience employment related racism differently from one another. This intersectionality indicates that policies that may protect one marginalized group may not protect all groups equally. Through an examination of current employment equity research and reports, an overview of employment equity and human rights legislation in Canada, and an analysis of data collected in three interviews with Black men living in Victoria, British Columbia, a series of recommendations are made for employers, allies, and policy changes. This research illuminates the inequity of employment experiences in Canada, and provides suggestions for next steps forward from members of a population currently underserved by existing employment equity measures.
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    Taking on Water: A Discourse Analysis of Drinking Water Policy and Practices at the University of Victoria
    (2013-04-19) Brulotte, Jayna; Teghtsoonian, Katherine Anne
    In recent years, universities, municipalities, and other public and private organizations throughout Canada have banned the sale of bottled water from their facilities. To explore how such bans are linguistically and textually framed, proposed, and debated, this thesis analyzes drinking water policy and practice at the University of Victoria. Using Maarten Hajer’s approach to discourse analysis, discourses, story-lines, and discourse coalitions are identified. Through interviews with key players as well as textual analysis, I identify several discourses being mobilized to discuss drinking water at the University of Victoria, including that drinking water is an environmental issue, a public resource, a human right, a commodity, a health issue, and a revenue issue. The key discourse coalition working to define the issue of drinking water is a student coalition comprising the University of Victoria Sustainability Project and the University of Victoria Students’ Society. This coalition is promoting the argument that the sale of bottled water should be banned on campus.
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    Treatment as Prevention (TasP) and governing Human Immunodeficiency Virus (HIV) in British Columbia
    (2012-12-03) Mollison, Ashley; Boyd, Susan C.
    In 2010, the government of British Columbia (B.C.) dedicated $48 million to stop the spread of HIV. The STOP HIV/AIDS pilot project promotes the uptake of HIV testing in the general population, and the use of antiretroviral therapy amongst those living with HIV/AIDS. This project operates with the rationale of ‘treatment as prevention’ (TasP), meaning that antiretroviral therapy is beneficial for the person living with HIV/AIDS, and has the secondary benefit of reducing the spread of HIV in the general population. Public health discourses are constructed via particular worldviews and involve the creation and delineation of societal problems. Undertaking a discourse analysis, I identify eight dominant discourses of TasP and STOP HIV/AIDS that include: provincial and international support for TasP and lack of federal leadership in HIV/AIDS; TasP, a ‘paradigm shift’ and a ‘game changer;’ TasP as beneficial to the individual and society; human rights and harm reduction; proof and certainty; failure of current prevention efforts; risk discourses; and, finally, universal treatment. I also identify five alternative discourses: holistic understanding/social determinants of health; stigma and discrimination; rights discourse: GIPA, informed consent and self-determination; coercion/criminalization and alternative risk discourse. Through a lens of governmentality, I explicate two overarching and simultaneous discursive strategies in realizing the objective of decreasing the spread of HIV in B.C. The first strategy acts on individuals living with HIV/AIDS, encouraging individuals to take up antiretroviral therapy. The second strategy acts on the general population, informing the population that HIV is a problem, and that treating people living with HIV/AIDS is the best way to protect society as a whole. There are various techniques within these two strategies. These discursive events have immense consequences for the uptake of health policies and programs by the public. The dominant and alternative discourses of TasP impact HIV policy and practice and specifically the individuals living with HIV and AIDS who are the subjects and targets of these initiatives.
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    The social organization of mothers' work: managing the risk and the responsibility for Fetal Alcohol Spectrum Disorder
    (2012-08-29) Schellenberg, Carolyn; Purkis, Mary Ellen; Campbell, Marie L.
    This institutional ethnography relies on observations, interviews, and textual analyses to explore the experiences of mothers and children who attend a women-centered agency in Vancouver, Canada where a hot lunch, child care in the emergency daycare, and participation in group activities are vital forms of support. Mothers who come to the centre have many concerns related to their need for safe housing, a sustainable income, adequate food, child care, and support. And like mothers anywhere, they have concerns about their children. While many of the children, the majority of them First Nations, have never had a diagnostic assessment for fetal alcohol syndrome (FAS) or for the relatively new umbrella category, ‘fetal alcohol spectrum disorder’ (FASD), a number of the mothers were concerned or even knew that their children had FAS. This thesis asks – how does it happen that mothers have come to know their children in this way? The study critically examines how FASD knowledge and practices actually work in the setting and what they accomplish. My analysis traces how ruling practices for constructing and managing ‘problem’ mothers and children coordinate work activities for identifying children deemed to be ‘at risk’ for FASD. In their efforts to help their children and improve their opportunities for a better life, mothers become willing participants in group activities where they learn how to attach the relevancies of the FASD discourse to their children’s bodies or behaviours. They also gain instruction which helps them to confess their responsibility for children’s problems. While maternal alcohol use as the cause of FASD is contested in literature and in some work sites it is, in this setting, taken as a fact. This study discovers how institutional work processes involving government, medicine, and education actually shape and re-write women’s and children’s experiences into forms of knowledge that make mothers and children institutionally actionable. It is only by exposing the relations of power organizing mothers’ work that it may be possible to re-direct attention to mothers’ and children’s embodied concerns and relieve mothers of the overwhelming responsibility for which they are held and hold themselves to be accountable.
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    "Being the best": a critical discourse analysis of a series of BC Public Service strategic human resource plans
    (2012-08-29) Gauvin, Katia; Moss, Pamela
    In 2006, the BC Public Service published the first of a series of corporate human resource plans entitled “Being the Best”. One of the key goals of these plans is to improve employee engagement at the BC Public Service. Critical Discourse Analysis (CDA) is used to uncover the ideas and assumptions that underlie the employee engagement construct at the BC Public Service as well as better understand the influence these beliefs have on power relationships within the organization. Because there is a paucity of critical literature specifically focused on employee engagement discourse, the critical discourse analysis considers the broader discourse of human resource management. The analysis reveals that values and assumptions associated with the discourse of New Public Management (NPM) are woven into and across the texts. Three themes emerge from the analysis: transformational change is necessary and there is only one ‘right’ way to solve the crisis; the public servant identity is reshaped around the entrepreneurial spirit; and the organizational culture is redefined to align with NPM values. The effect of this discourse is to maintain and intensify managerial control over front line employees.
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    A passive revolution?: constructing a municipal alternative to carbon markets in British Columbia.
    (2012-08-24) Greeno, Matthew; Boyd, Susan C.
    Using a Foucault-inspired critical analysis of discourse within a Gramscian framework of hegemony, this thesis analyzes how patterns of international climate change policy relate to climate policy in British Columbia (BC), Canada, and explores the patterns of resistance to carbon neutrality in a single municipality. The BC Carbon Neutral Government Strategy and the Provincial Crown Corporation responsible for stimulating the growth of the BC carbon-offset market are characterized by neo-liberalism ideology and dispossession. The District of Saanich’s policy, which establishes a local and public form of carbon offset alternative, is characterized as a form of resistance. Saanich’s policy represents a passive revolution. This thesis suggests that the discourse of ecological modernization exists within both the hegemonic climate policy structure as well as the alternative found in Saanich. This thesis also suggests that municipalities represent a political space in which a Gramscian war of position may be waged.
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    The d/Deaf social worker body as multiplicity: a feminist poststructural autoethnography of deafness and hearing.
    (2012-07-19) Jezewski, Meghan Maria Jadwiga; Moss, Pamela
    As a feminist poststructural autoethnography of deafness in social work workplaces, this thesis sets out to map d/Deafness as a cracked subjectivity. Using the work of Rosi Braidotti and Gilles Deleuze and Félix Guattari, I draw out configurations of d/Deafness as lack or cultural minority and split them apart. By positioning d/Deafness on a plane of immanence and employing specificity, I explore d/Deafness as a subjectivity constituted through space, place, time and encounters with other bodies. I argue that the constitution of material and cultural experiences of d/Deafness as specific allows for the articulation of spaces in between Deafness and hearing, disability and ability as spaces in and of themselves in order to think the new as well as to crack up fixed binaries informing traditional notions of what specific bodies can do.
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    Space to think: engaging adolescent girls in critical identity exploration.
    (2012-04-18) Woolgar, Sarah; Boyd, Susan C.
    Canadian females grow up in a sociocultural environment full of contradictory discourses that rarely reflect the social reality they experience. Adolescent girls face abject forms of objectification, sexualization, unequal power relations and high levels of violence in their communities, yet these experiences remain largely unexamined with adolescent girls themselves. In the following thesis I describe a research project I undertook with seven girls between the ages of twelve and fifteen. Using the method biomythography, I ask the girls to tell me who they are in an attempt to determine how these girls relate their social environment to their identity. An analysis of the discourses emerging in the biomythographies as well as in discussion in the research space demonstrates that the girls recognize links with sociocultural environment, yet they do not highlight the effects of this culture on their identity in their biomythographies. Instead, they used the space of the biomythographies to resist, dream, and focus on the best aspects of themselves and those in their social world. At the same time, the physical creation space became an important secondary site of analysis. The analysis of both the biomythographies and the project space demonstrates the importance of girl-only space in the community. Such space allows girls to come together as girls to critique and analyse what it means to grow up female in Canadian society. This space must also provide opportunities for girls to self-reflect on their own social position and identity.
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    “Our authority is community based”: funding, power and resistance in community-based organizations.
    (2011-12-19) Amyot, Sarah; Prince, Michael J.
    This thesis explores the relationship between funding practices and the non-profit sector through a case study of one community-based organization, called Ma Mawi wi Chi Itata Centre, located in Winnipeg, Manitoba. The thesis traces implications of the shift to project funding models and outcomes-based management for the communitybased organizations (CBOs). The research draws on Foucault’s governmentality analytic to illuminate how funding practices relate to neoliberal discourses and traces the tensions and resistances that are created by funding policy interventions at the point of practice. I argue tensions arise between: competition and collaboration; textual accountability and community need; reporting, learning, and teaching; different problem solving approaches; and individualism and community building practices. CBOs are intimately wrapped up in the project of governing. They are not either, a symbol of citizen engagement or a symptom of a decimated state; rather they are both, part and parcel of a system in which we are both governed and govern.
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    Dialogue: understanding the process of collaborative policy making in Aboriginal education.
    (2011-12-01) Lowen, Corrine; Prince, Michael J.; Williams, Lorna
    Since 1999, Aboriginal Education policy in British Columbia requires School Districts to collaborate with their local Aboriginal communities to establish appropriate definitions of success, set measureable goals and actions plans to enhance Aboriginal student’s educational achievement. Together these groups produce five-year Aboriginal Education Enhancement Agreements. This study employs Indigenous Methodology and Institutional Ethnography to learn whether and how process of working together to create these agreements contributes to relationship-building between Aboriginal and non-Aboriginal peoples. Key findings demonstrate that an engaged a dialogue between Indigenous peoples and education policy-makers changes the way that Aboriginal education is approached in BC school districts. Participants reported that the process changed them, touched their soul, and left them feeling humbled and renewed. The Enhancement Agreements hold promise as a process that works from within the institutional processes to address the unequal social relations of education for Aboriginal students.
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    Streetlight people: perspectives of Street Outreach Services staff on the loss of harm reduction services in Victoria, BC.
    (2011-06-29) Hobbs, Heather; Boyd, Susan C.
    On May 31, 2008, one of Canada’s oldest needle exchange programs was forced to close its doors. Street Outreach Services (SOS), run by AIDS Vancouver Island, was evicted from its fixed site location in downtown Victoria, BC, due to years of inadequate funding and resources, and pressure from community members who blamed SOS for “public disorder” on the city streets. Without a new location from which to house the program, SOS has since operated as a mobile service. This case study documents the context surrounding the closure of SOS and the perspectives of outreach staff regarding the transition from fixed site to mobile services-only. Specifically, this study addresses the question: How have service delivery changes and restrictions impacted SOS outreach work? In addition to participant-observation, media and report analysis, primary data are derived from six semi-structured interviews with SOS outreach workers and a thematic analysis highlights common experiences of loss, isolation and changes in relationships with clients. A discussion of strategies for collective responses to ethical distress includes social justice perspectives.
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    Lateral violence as a process in First Nations institutions
    (2011-05-26) James, Gil Rocky Konrad; Brown, Leslie
    This thesis paper was written to meet the requirements for a master's degree in the Studies in Policy and Practice Program through the University of Victoria. British Columbia. A grounded theory was developed studying lateral violence as a process in First Nations institutions in Coast Salish territory. The research question was how does lateral violence function as a process in First Nations institutions? To answer this question, one-on-one interviews were conducted, digitally recorded, transcribed, and analysed using grounded theory techniques. What came from the research findings was a theory on the effects of fear based learning on lateral violence. This research paper looks at the evolution of fear based learning from the Indian Residential School system, into the home of First Nations people, and it's progression from the home into community, and into First Nations institutions. Nine properties of fear based learning were identified. This project contributes as a solution to lateral violence the process of identifying conditions for the perfect storm. Identifying conditions for the perfect storm help administrators navigate developing episodes of lateral violence. Furthermore, this project contributes framing solutions within the Coast Salish cultural and political act of witnessing. Witnessing is seen as providing a cultural foundation for justice.