Browsing by Author "Waite, Nancy"

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Incorporating sex, gender and vulnerable populations in a large multisite health research programme: The Ontario Pharmacy Evidence Network as a case study
(BioMed Central, 2017-03-20) Cooke, Martin; Waite, Nancy; Cook, Katie; Milne, Emily; Chang, Feng; McCarthy, Lisa; Sproule, Beth
Background: Funders now frequently require that sex and gender be considered in research programmes, but provide little guidance about how this can be accomplished, especially in large research programmes. The purpose of this study is to present and evaluate a model for promoting sex-and gender-based analysis (SGBA) in a large health service research programme, the Ontario Pharmacy Evidence Network (OPEN). Methods: A mixed method study incorporating (1) team members' critical reflection, (2) surveys (n = 37) and interviews (n = 23) at programme midpoint, and (3) an end-of-study survey in 2016 with OPEN research project teams (n = 6). Results: Incorporating gender and vulnerable populations (GVP) as a cross-cutting theme, with a dedicated team and resources to promote GVP research across the programme, was effective and well received. Team members felt their knowledge was improved, and the programme produced several sex-and gender-related research outputs. Not all resources were well used, however, and better communication of the purposes and roles of the team could increase effectiveness. Conclusions: The experience of OPEN suggests that dedicating resources for sex and gender research can be effective in promoting SGBA research, but that research programmes should also focus on communicating the importance of SGBA to their members.
Pharmacy patron perspectives of community pharmacist administered influenza vaccinations
(Elsevier, 2019-02) Alsabbagh, Mhd. Wasem; Church, Dana; Wenger, Lisa; Papastergiou, John; Raman-Wilms, Lalitha; Schneider, Eric; Waite, Nancy
One approach to boost influenza vaccination coverage has been to expand immunization authority. In 2012, the province of Ontario gave community pharmacists the authority to administer the influenza vaccine.
Shades of gray in vaccine decision making: Understanding, exploring, and addressing the challenges of influenza vaccine hesitancy in Ontario community pharmacies
(University of Waterloo, 2019-12-19) Pullagura, Gokul Raj; Waite, Nancy
Background: Two-thirds of Canadian adults currently do not receive the annual influenza vaccine. Vaccine hesitancy (VH), the voluntary delay or refusal of vaccination services despite availability is a significant contributor to the poor uptake of several vaccines including the influenza vaccine. The overarching intent of this thesis was to gain a nuanced understanding of the community pharmacists’ experiences with influenza VH and explore means to best address it. Methods: This thesis is comprised of three studies. The first study was a quantitative descriptive analysis of an exploratory cross-sectional online survey of 885 pharmacists. This study aimed to provide an overview of pharmacists’ perceived knowledge, attitudes and practices pertaining to influenza VH. The second study was a qualitative interpretive analysis of in-depth semi-structured interviews with 22 pharmacists. An implementation science lens was then used to examine the results from the first two studies to guide the selection of a behavioural target and inform intervention design. Based on these findings, the third study included a cost-utility analysis of a novel remunerated community pharmacist consultation service on influenza vaccination for Ontario seniors from a provincial payer perspective. Results: Pharmacists’ self-reported knowledge of influenza vaccine and disease, their confidence and ability to identify and address influenza VH was generally high. Pharmacists’ engagement with patients on the influenza vaccine was found to be modulated by a complex and mutually reinforcing constellation of attitudes and behaviours which included: a binary (pro-vaccine or anti-vaccine) perception of patient vaccination decisions; a conflation of those expressing hesitancy with those that are anti-vaccine; and a passive approach to patient engagement. Despite possessing the requisite knowledge and skills, workflow barriers such as limited time, inadequate staffing, and poor remuneration were found to restrict optimal patient engagement on influenza vaccinations. Offering pharmacists a CAD $15 consultation fee to engage with seniors on the influenza vaccine was estimated to be both cost-effective and clinically effective. Conclusion: Facilitating optimal practice scope for pharmacists, and capitalizing the additional convenience and accessibility offered through the community pharmacy setting presents a promising means to address influenza VH. Conventional tools to aid health professionals in addressing influenza VH rely on augmenting the vaccine provider’s knowledge and skills; however, our analysis suggests that reorienting efforts to enhance the provider’s motivation and opportunity to engage with patients on influenza vaccine conversations are likely to be more effective in the community pharmacy setting.
Supporting student development through a cooperative education coaching program
(International Journal of Work-Integrated Learning, 2016) Armstrong, Lisa; Waite, Nancy; Rosenthal, Meagen
Uptake of new scopes of practice by pharmacists has been slow and inconsistent, which the literature suggests may be related to disconnects between pharmacists' established professional identities and the identities needed to adopt these new practices. This study evaluated the use of coaches to help pharmacy students during their cooperative education work terms develop professional identities more aligned with the new scopes of practice. In this longitudinal cross-sectional survey, trained pharmacist coaches met individually and in groups with students in the intervention arm of the study. Students and coaches in the intervention arm completed reflective questions and student intervention and control groups completed a self-assessment survey. Reflective comments indicated that both students and coaches identified student gains in career and professional planning, workplace navigation skills, ability to reflect on professional development topics, and contextualizing classroom learning within practice. Work-integrated learning combined with coaching can contribute to students' career and professional identity development.
Understanding the Relationship Between Pharmacists’ Implicit and Explicit Bias and Perceptions of Pharmacist Services Among Arab and Black Individuals
(University of Waterloo, 2019-11-27) Alzahrani, Fahad; Waite, Nancy
Background. Recent studies suggest that Health Care Professionals’ (HCPs) unconscious bias about race contributes to health care disparities. The objective of this research was to estimate unconscious racial bias among pharmacists in order to understand its relationship with Black and Arab individuals’ perceptions and experience of pharmacist services and their interaction with pharmacists in Ontario. Methods. Multi-method research combining both quantitative and qualitative methods was employed. A secure, web-based survey was administered to Ontario community pharmacists. The survey included two Implicit Association Tests (IATs) to assess unconscious preferences and direct questions regarding community pharmacists’ explicit attitude to race. In a qualitative study using purposive sampling, face-to-face semi-structured interviews with 27 Black and Arab individuals were conducted to explore their interactions with pharmacists and their opinions, perceptions, attitudes, and experiences about community pharmacist services. Results. A total of 407 community pharmacists (40% male, mean age 47, 57% white) completed the survey. Evidence of race/ethnicity bias toward Black and Arab individuals was evident, as determined by both explicit and implicit measures. Moderate to high levels of implicit pro-white bias were found among Ontario community pharmacists on average. Explicit pro-white bias was less evident, but apparent for measures of racial/ethnic preference and, relative warmth (amount of warmth felt toward Black/Arab individuals subtracted from the amount of warmth felt toward whites). In addition, implicit bias appeared to be associated with pharmacist characteristics such as age, racial/ethnic background, years as a pharmacist, years as a licensed pharmacist in Canada practice location, and place of birth, and explicit preferences had a weak positive correlation. The qualitative data revealed that most Black and Arab individuals felt comfortable interacting v and seeking advice from their pharmacists. However, some Black and Arab participants experienced discrimination from community pharmacists. The data also provided information about some personal and systemic issues encountered by Black and Arab individuals when they interacted with community pharmacist. Conclusions. Race and ethnicity bias exists among most Ontario community pharmacists and may be associated with Black and Arab individuals’ perceptions of pharmacist services and their interaction with pharmacists. Future work needs to employ more rigorous approaches to explore whether, and under what conditions, community pharmacists’ implicit bias about race/ethnicity affect the quality of their services toward visible minority individuals, including Black and Arab people. Interventions to reduce bias may need to be comprehensive so that they can ultimately influence an individual’s implicit and explicit biases in all measured areas.