An exploration of policy options to assist district health authorities in attending to the health needs of African Canadians: a case study
Bibliographic record
Abstract
Purpose The purpose of this paper is to examine the governing boards responsible for health care in Nova Scotia to determine the extent to which they facilitate and/or impede efforts to attend to the health needs of African Canadians. Design/methodology/approach A case study method was employed. Qualitative interview and documentary data were interpreted by means of a hybrid of methods including discourse analysis, thematic analysis, reflexive ethnography and ethnography. Findings Key findings from this study suggest that the complex mandate of DHAs, a lack of processes to assess need and limited data (including a lack of research) to support decision‐making contribute to a limited understanding of the health needs of African Canadians among DHA board members and executive management. Policy options include improving access to, and development of, culturally competent health services, conducting research and improving access to data to facilitate decision‐making, and educating board members and executive management about black culture. DHAs need to explore new and innovative ways to engage and include the black community in decision‐making. Practical implications Continued public and political emphasis on the maintenance of the acute care system, limited resources devoted to “population health” and internal and external constraints that serve to limit the capacity for health boards to make independent decisions pose significant challenges for DHAs as they seek to fulfill their legislated mandate to improve the health of their catchment population. Policy options are presented to address issues such as research and information management, education and awareness, representation and building meaningful opportunities for inclusion. Originality/value There is a dearth of literature examining the roles and responsibilities of governing boards in attending to the health needs of minority populations.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.006 | 0.010 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.002 | 0.003 |
| Science and technology studies | 0.039 | 0.008 |
| Scholarly communication | 0.006 | 0.002 |
| Open science | 0.003 | 0.005 |
| Research integrity | 0.004 | 0.003 |
| Insufficient payload (model declined to judge) | 0.005 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".