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UBC Theses and Dissertations

A community-based participatory approach to planning child and youth health services in north west British Columbia : finding common ground Lindstrom, Ronald Raymond


A growing recognition of the need for participatory health services research requires multiple stakeholder collaboration between researchers, clinical service providers, managerial and policy decision-makers, and the public. Recent Canadian provincial and federal reports support the need for participatory inquiry, yet little is being done in practice. This thesis explores a community-based participatory research process for planning child and youth health services and proposes methods to close the gap between research and practice. The study took place in the North West Health Service Delivery Area of British Columbia. This large geographic region represents over one-quarter of the provincial land mass, yet is home to <90,000 people. Approximately 30% are children and youth 19 years of age and under. Approximately 22% of the residents are Aboriginal. A participatory research approach was used with a mixed methods design. The priority component was qualitative. Qualitative data were collected and integrated through a unique sequence of methods, including semi-structured interviews, focus groups, and a search conference. Qualitative data were analyzed using a constructivist grounded theory method. The nested component was quantitative. Quantitative data were accessed from a provincial health services utilization database. Geographic information systems (GIS) software was used as a tool to map selected data, which was incorporated into the search conference. Three general conceptual categories emerged from the data: perceptivity about, emotivity generated by, and inclusivity in, the health system. Two core conceptual categories emerged: boundaries and boundary objects. Three knowledge boundaries were introduced: syntactic, semantic, and pragmatic, building upon and supporting empirical research on innovation and technology development. This study proposes a fourth knowledge boundary: phronetic. The characteristics of boundary objects occupying this phronetic boundary are fluid, real-time, participatory, and collaborative in locally-situated, multi-stakeholder, boundary-crossing settings. These boundary objects facilitate the melding of knowledge and action in ways that are relevant to stakeholders in their local realities. A conceptual framework is proposed to guide and unify participatory research and planning processes. This research is expected to lead to more effective multi-stakeholder, community-based approaches to the planning and development of network models for child and youth health services.

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