Michelle Wyndham-West

Virtual care: a design research discovery and strategic futures model for the Canadian healthcare system

Design for Health

Published: December 31st 2022

View Article »

Unpacking the potential of developmental evaluation in codesign work

Health Expectations

Published: December 21st 2022

View Article »

A narrative-based exploration of aging, precariousness and housing instability among low-income older adults in Canada

Cities & Health

Published: December 31st 2022

View Article »

Gender and dementia national strategy policymaking: Working toward health equity in Canada through gender-based analysis plus

Dementia

Published: December 21st 2021

View Article »

Are you really doing ‘codesign’? Critical reflections when working with vulnerable populations

BMJ Open

Published: December 21st 2020

‘Codesign’ and associated terms such as ‘coproduction’ or ‘patient engagement’, are increasingly common in the health research literature, due to an increased emphasis on the importance of ensuring that research related to service/systems development is meaningful to end-users.  However, there continues to be a lack of clarity regarding the key principles and practices of codesign, and wide variation in the extent to which service users are meaningfully engaged in the process. These issues are particularly acute when end-users include populations who have significant health and healthcare disparities that are linked to a range of intersecting vulnerabilities (eg, poverty, language barriers, age, disability, minority status, stigmatised conditions).  The purpose of this paper is to prompt critical reflection on the nature of codesign research with vulnerable populations, including key issues to consider in the initial planning phases, the implementation process, and final outputs.  Risks and tensions will be identified in each phase of the process, followed by a tool to foster reflexivity in codesign processes to address these issues.

View Article »

Chapter 11: Evolution of Health Care Policy: Deconstructing Divergent Approaches

Staying Alive: Critical Perspectives on Health, Illness and Health Care

Published: December 31st 2019

Betwixt and Between Well and Sick in Cervical Precancer: Canadian Women’s Experiences of Recurring HPV Infections and HPV Vaccination

Canadian Journal of Nursing Research

Published: December 21st 2018

Background This research fuses the experiences of a precancer diagnosis with the decision-making surrounding a vaccine that can protect against human papillomavirus strains that women may not have been exposed to. The interviewee cohort is of note as half the women were in their 30s and 40s and 75% were over the age of 26. These groupings are often overlooked in media discourses and narrative research surrounding human papillomavirus and the human papillomavirus vaccine. Purpose Womens’ diagnoses and treatment experiences, including colposcopies, biopsies, and Loop Electrosurgical Excision Procedures, are chronicled to highlight a liminal, precancerous state—one in which they are not deemed healthy, but nor have they been diagnosed with cancer. These are emotion-filled experiences that are ridden with anxiety and fear, but also ones that are structured with self-care strategies to contain human papillomavirus infections and the risk of cervical cancer. Methods Twenty women who attended Sunnybrook Health Sciences Centre’s human papillomavirus vaccination clinic were interviewed and their narratives were documented and analyzed to determine their experiences surrounding human papillomavirus infections and precancer as well as their motivations for human papillomavirus vaccination. Results The decision to undergo human papillomavirus vaccination was a self-care strategy that accompanied treatment procedures and was a means to reduce cervical cancer risk. While encouraged with the human papillomavirus vaccine’s potential to curb cervical cancer, they had a tempered view of the vaccine and its effectiveness in their cases, given their medical histories. Conclusions The research provides an in-depth accounting of an often overlooked grouping in human papillomavirus and human papillomavirus vaccination research and media discourse which, generally, focuses upon middle-school-aged girls and university-/college-aged women. In addition, the research provides recommendations for practice for cervical precancer diagnoses going forward.

View Article »

Power and culture in emerging medical technology policymaking: the case of the human papillomavirus (HPV) vaccine in Canada

Evidence and Policy

Published: December 21st 2018

This article captures how scientific uncertainty is negotiated and its implications on public health policy. Through the case study of the Human Papillomavirus vaccine in Canada, we investigated how policymakers engage in ‘sensemaking’, the process whereby policymakers mediate shifting informational terrain to come to an understanding of what events and information mean, how they become significant and how they are acted upon. Key informant interviews reveal that policymakers make decisions amidst uncertainty by invoking public health cultural ideologies and by actively managing interactions with the manufacturer. This reflects a non-linear dispositif that is influenced by the co-production of culture and power.

View Article »

“What’s a Mom to Do?” Negotiating Public Health Literacies Through the Traffic Between Motherhood and Mothering in School-Based HPV Vaccination Programming.

Mothering and Literacies

Published: December 31st 2013