Brenda Beagan

Dalhousie University | Dal

Introduction: Despite human rights protections for lesbian, gay, bisexual, transgender, and queer (LGBTQ+) people, LGBTQ+ professionals may continue to experience discrimination working in heteronormative systems and spaces. Methods: In this qualitative study 13 health professionals (nurses, occupational therapists, and physicians) from across Can...

Open access here: https://journals.sagepub.com/doi/10.1177/03080226231153345

Disclosure of LGBTQ+ identities at work may reap benefits, but may also exacerbate harms. Faced with ambiguous outcomes, people engage in complex concealment/disclosure decision-making. For health professionals, in contexts of pervasive heteronormativity where disclosure to patients/clients is deemed to violate professional boundaries, stakes are h...

Systemic racism within health care is increasingly garnering critical attention, but to date attention to the racism experienced by health professionals themselves has been scant. In Canada, anti-Black racism may be embodied in structures, policies, institutional practices and interpersonal interactions. Epistemic racism is an aspect of systemic ra...

Introduction Post-secondary institutions are increasingly promoting equity, diversity and inclusion (EDI) in health professions education. Yet, institutions continue to be spaces of exclusion and marginalization for health professional students from marginalized groups. Purpose To explore the education experiences of health professionals from marg...

In the power-laden context of the health professions, disclosure of LGBTQ+ (or queer) identities carries particular risks, with disclosures to patients/clients seen as ‘unprofessional.’ Pervasive heterosexism and heteronormativity regulate professionals toward conformity, leaving them with ongoing strategic decision-making regarding identity concea...

Background: Client-centeredness is foundational to occupational therapy, yet virtually no research has examined this aspect of practice as experienced by therapists from marginalized groups. The discourse of client-centeredness implicitly assumes a “dominant-group” therapist. Professional power is assumed to be accompanied by social power and privi...

Abstract Background: Occupational therapy professes commitment to equity and justice, and research is growing concerning the experiences of clients from marginalized groups. To date, almost no research explores the professional experiences of therapists from marginalized groups. This qualitative study explores how exclusion operates in the profess...

As health and social service professions increasingly emphasize commitments to equity, advocacy and social justice, non-traditional entrants to the professions increasingly bring much-needed diversity of social backgrounds and locations. Long the domain of elite social classes, the professions are not always welcoming cultures for those from lower...

Background: Alongside declarations against racism, the nursing profession in Canada needs examination of experiences of racism within its ranks. Racism at multiple levels can create a context wherein racialized nurses experience barriers and ongoing marginalization. Purpose: This critical interpretive qualitative study asks how interpersonal, in...

Introduction We draw on activity theory of concepts to examine ‘meaning of occupation’ and ‘substance use’ beyond preconceived notions of inherent positive or negative experiences. Objective To explore nuanced meanings of substance use and associated occupations. Method An online survey and semi-structured interviews were used to collect data from...

Objective Epistemic racism establishes the knowledges and ways of knowing of a dominant group as legitimate, invalidating those of groups marked by racialization. Professions are demarcated by their knowledge claims, making epistemic racism a powerful mechanism of exclusion within professions. This paper examines experiences of epistemic racism in...

In this reflection essay, the authors explore how meaning is represented in occupational therapy literature. A review of occupational therapy and occupational science literature uncovers framings of meaning, meaningful, and meaningfulness that are almost exclusively ‘positive’. Positioning of occupations as inherently ‘positive’ and assuming univer...

In the health professions, altruism is a foundational value upon which professional privilege is built. This imperative towards self-sacrifice for the benefit of others is a key component of what it means to be professional. This paper explores how altruism operates as a coded mechanism of exclusion and oppression for disabled health professionals....

Introduction This study was undertaken to explore the use of substances by professionals in Canada. A non-problem-focussed approach informed study design, with participants recruited outside treatment programs or professional monitoring programs and data collection including indicators of ‘positive’ or desired effects. Methods Participants were 19...

Background. Research on racism within occupational therapy is scant, though there are hints that racialized therapists struggle. Purpose. This paper examines experiences of racism in occupational therapy, including coping strategies and resistance. Method. Ten therapists from racialized groups (not including Indigenous peoples) were recruited for c...

Background. Occupational therapy and occupational science literature include growing attention to issues of justice, marginalization, and rights. In contrast, the concept of oppression has scarcely been employed. Purpose. This paper investigates how adding the concept of oppression may enhance occupational therapy approaches to injustice, prioritiz...

Given contemporary attention to diversity and inclusion on Canadian university campuses, and given human rights protections for sexual orientation and gender identity, it is tempting to believe that marginalization is a thing of the past for lesbian, gay, bisexual, transgender and queer (LGBTQ) academics. Our qualitative study (n = 8), focusing on...

Background Indigenous peoples experience health inequities linked in part to lack of access to culturally-relevant health care. The Truth and Reconciliation Commission of Canada (TRC) calls on all health professionals, including occupational therapists, to reduce health inequities through improved work with Indigenous communities. Purpose This int...

Introduction Substance use, as an occupation, is typically portrayed as problematic and the target of occupational therapy intervention and remediation. At the same time, psychoactive substances may be used to enhance mood, cognition, occupational performance, and/or experience, a perspective that is largely absent from occupation scholarship. Obj...

Debates surrounding class inequality and social mobility often highlight the role of higher education in reducing income inequality and promoting equity through upward social mobility. We explore the lived experience of social mobility through an analysis of 11 semistructured interviews with Canadian academics who self-identified as having working-...

Introduction. Attending to the nuanced meanings of non-sanctioned occupations holds the potential to better grasp the influences of occupational contexts at multiple levels. We examined the recreational use of methamphetamine (meth) by gay men, attending to potential benefits without undermining potential risks for harm. Our intention was to broade...

Background.: The Canadian Association of Occupational Therapists and the Truth and Reconciliation Commission recommend change within the Canadian health care system, respecting and valuing Indigenous health and healing practices. Adjusting the lens through which occupational therapists practice to incorporate Indigenous views of health and wellnes...

Purpose The purpose of this paper is to explore the prevalence and patterns of substance use among Canadian social workers. With legalisation of can professional regulatory bodies are pressed to consider implications of substance use for their members. Design/methodology/approach An online survey collected data about demographics and substance u...

While qualitative inquiry has been a part of the Canadian Journal of Public Health (CJPH) for many years, CJPH does not yet have the reputation as a home for qualitative research that has a critical focus and that is cqqqonversant with contemporary developments in social theory and qualitative methodology. This paper describes efforts to establish...

This paper is based on a larger qualitative study of exclusion and belonging as experienced by members of marginalized groups in the professions. The current analysis draws on a subsample of 13 racialized and Indigenous academics at Canadian universities to examine their experiences of both everyday racism – subtle, almost intangible micro-level in...

Occupational science has made tremendous strides in establishing a theoretical and empirical knowledge base grounded in the study of occupation. Yet given its origins in occupational therapy, a health profession aimed at enhancing health and well-being through engagement in meaningful and purposeful occupation, there has been sustained focus on the...

Occupational science has made tremendous strides in establishing a theoretical and empirical knowledge base grounded in the study of occupation. Yet given its origins in occupational therapy, a health profession aimed at enhancing health and well-being through engagement in meaningful and purposeful occupation, there has been sustained focus on the...

Though cultural competence dominates as an approach to diversity, it has important conceptual limitations. “Culture” is reduced to race and ethnicity, ignoring other identities and framing race and ethnicity as residing only in the “Other,” leaving dominant cultures unproblematized. Culture is presented as unchanging, uniform, and overdetermining o...

Processes of professional socialization influence types of substances used, patterns of use, and estimation of normalization. This project explores psychoactive substance use among professionals and students in professional programs in Canada, rationales for use, strategies to manage use and potential consequences, and factors within professional e...

Purpose: This pilot study was designed to deliberately examine the enhancement effects and experiences of substances used among professionals and students in professional programs. Methods: A mixed methods design was implemented, involving ecological momentary assessment (EMA) and interviews. The analysis presents interpretations about the perceive...

Background: Gender parity is frequently raised as an equity issue in occupational therapy, with strategies proposed to recruit more men. Purpose: This article explores whether this is a legitimate equity concern. Key issues: Most employment is gender segregated; when gender balances change, the field either re-genders feminine or creates gende...

Processes of professional socialization influence types of substances used, patterns of use, and estimation of normalization. This project explores psychoactive substance use among professionals and students in professional programs in Canada, rationales for use, strategies to manage use and potential consequences, and factors within professional e...

Though Canadian universities are legally required to accommodate disabled employees, disabled faculty still experience difficulties navigating neoliberal performance standards and medicalized conceptualizations of disability. Drawing on data from a qualitative study with Canadian university faculty, this paper explores the experiences of five disab...

Food-related occupations connect people with family, community, tradition, ritual, and culture. They are a means of producing and conveying social identities, as they are rife with symbolic meaning. Food provisioning occupations require complex knowledges and skills, particularly for those living on low income. This qualitative analysis explores th...

The ‘Strong Black Woman’ (SBW) construct has been well-documented in the United States as both an aspirational icon and a constricting burden for African-heritage women. It has not been examined among African Canadians. Drawing on qualitative interviews and standardized measures with 50 African-heritage women in Eastern Canada, our analysis reveals...

Background: Although the idea of occupational injustice pervades the occupational therapy literature, there has been little scholarly debate concerning this construct or the parameters of the five identified forms of occupational injustice. Purpose: The aims of this paper are to highlight conceptual confusions, foreground some inherent questions...

This article explores imagined geographies of health care among Lesbian, gay, bisexual, transgender and queer (LGBTQ) women in Halifax and Vancouver. In expressing the possibilities and limitations of accessing care, participants frame their own experiences through spatialized narratives of how LGBTQ people are thought to be treated elsewhere. Part...

This paper uses a Bourdieusian theoretical framework to explore how thirty-nine Canadian families shop for food. Based on two qualitative interviews with at least two members of each family, in seven sites across Canada, we explore how high and low-income families describe their food shopping practices and priorities. For low-income households, eco...

This paper explores how individuals experienced transition regarding spiritual or religious occupations after acknowledging identities as lesbian, gay, bisexual, transgender or queer (LGBTQ). Based on qualitative interviews with 35 self-identified LGBTQ people, it explores experiences of identity conflict and processes of transition, as well as mea...

Drawing from a qualitative study with 105 families across Canada, this paper focuses on 16 households in which one or more adults experienced significant social class trajectories in their lifetimes. Using semi-structured interviews and two photo-elicitation techniques, adults and teens articulated their perceptions of healthy eating, eating well,...

open access at http://www.cmej.ca Background: Medical students and physicians report feeling under-prepared for working with patients who identify as lesbian, gay, bisexual, transgender or queer (LGBTQ). Understanding physician perceptions of this area of practice may aid in developing improved education. Method: In-depth interviews with 24 genera...

Processes of navigating intersections between spiritual/religious identity and lesbian, gay, bisexual, transgender or queer (LGBTQ) identity are just beginning to be explicated. In-depth interviews with 35 LGBTQ adults from a range of backgrounds explore experiences with both religion and spirituality. While not all participants experienced conflic...

Background The 2007 position statement on diversity for the Canadian occupational therapy profession argued discussion was needed to determine the implications of approaches to working with cultural differences and other forms of diversity. In 2014, a new position statement on diversity was published, emphasizing the importance of social power rela...

This qualitative study used interpretative phenomenological analysis to explore the transition from smoking to non-smoking as an occupational transition. Face-to-face, in-depth interviews were conducted with seven women, aged 35-55, living in New Brunswick, Canada, who had quit smoking 12-24 months prior to recruitment. Five major themes emerged fr...

Despite increased attention to “culturally competent” practice with diverse populations, lesbian, gay, bisexual, transgender, and queer (LGBTQ) people remain relatively invisible within medicine and other health professions. Health care providers (HCPs) frequently dismiss sexual and gender identity as irrelevant to care. This study uses interviews...

Aims: While disability is the focus of much attention in occupational therapy, there has been little attention paid to disability within the profession. Disabled therapists not only bring valuable perspectives on disability, but also pose important challenges to taken-for-granted assumptions about impairment and disability within the profession. A...

In the context of religious and spiritual communities that may marginalize those who identify as lesbian, gay, bisexual, transgender, or queer (LGBTQ), we explore how 11 women reconfigured potentially conflicting spiritual and sexual/gender identities. Interviews with women in Halifax, Nova Scotia, on Canada's East coast, indicated some used faith...

Food has long been understood as a potent marker of cultural identity In the context of transnational migrant communities, food practices express group and individual identities as well as multiple social positionings within the current environment. At the same time, food practices are part of navigating between local and global attachments. This a...

Background Gender identity disorder and the process of transitioning involve both mental and physical health, yet there is virtually no discussion of transgender health care in occupational therapy. Purpose This study draws on interviews with primary-care nurses and physicians about their experience with transgender health care, extending the insi...

Gender identity disorder and the process of transitioning involve both mental and physical health, yet there is virtually no discussion of transgender health care in occupational therapy. This study draws on interviews with primary-care nurses and physicians about their experience with transgender health care, extending the insights gleaned there t...

Resting on the notion that rural spaces are "food deserts," rural adolescents are increasingly regarded as a "problem population" in Western obesity narratives. Using qualitative data gleaned from interviews with 51 teenage participants from rural areas across Canada, this paper focuses on the ways in which obesity is constructed as a rural disease...

Occupational therapists who are religious are more likely to address spirituality in practice; however, little is known regarding the practice experience of therapists who hold particular faith perspectives. To examine the practice experience of evangelical Christian occupational therapists in the context of professional emphasis on spirituality as...

Despite growing attention to occupational justice issues, there has been very little research examining the everyday occupations of those marginalised by sexual orientation or gender identity. Building on a small body of literature concerning the occupations of gay men and lesbians, this paper explores the occupations of five transgendered persons....

Reporting the results of semi-structured interviews with adults and teenagers in twentytwo urban and rural families in British Columbia, Canada, this paper explores how gendered divisions of food consumption continue to exist within a supposedly “non-sexist” ideological context. With a photo elicitation technique used to stimulate discussions of fo...

Informed by critical feminist and queer studies approaches, this article explores nurses' perceptions of practice with patients who identify as lesbian, gay, bisexual, transgender, or queer (LGBTQ). Qualitative in-depth, semi-structured interviews with 12 nurses in Halifax, Nova Scotia, illuminate a range of approaches to practice. Most commonly, p...

This paper draws on findings from qualitative interviews with queer and trans patients and with physicians providing care to queer and trans patients in Halifax, Nova Scotia, Canada, to explore how routine practices of health care can perpetuate or challenge the marginalization of queers. One of the most common "measures" of improved cultural compe...

Introduction Literature in occupational therapy, although paying increased attention to cultural differences and diversity, has largely ignored the situation of therapists who are themselves members of social and cultural minority groups. ‘Difference’ is assumed to be exclusively an attribute of the client. Method This qualitative study explored t...

Objective: Most research on food, ethnicity and health in Canada is focused on the dietary acculturation of first of second generation migrants. 'Failure' to adopt nutritional guidelines for healthy eating is generally understood as lack of education or persistence of cultural barriers. In this study we explore the meanings of food, health, and we...

This mixed-methods study explored the racism-related experiences of 50 mid-life African-heritage women living in Nova Scotia, Canada, along with their use of spirituality as a coping strategy for dealing with racism-related stress. Four standardised instruments, along with qualitative in-depth interviews, were used to examine women's experiences of...

Foodwork and women's primary responsibility for foodwork have long been interpreted by feminist scholars as a site of gender oppression for women; yet the gendered meanings of foodwork are complicated when race, diaspora and ethnic identity are also taken into account. This article examines the meaning of food and foodwork for Goan women in Toronto...

This article explores the meanings and functions of spiritually-related occupations for 50 African Canadian women in Nova Scotia, Canada. All but two women were affiliated with a Christian church. Using qualitative in-depth interviews, several spiritual occupations were identified by participants: prayer, Bible study, reading other sacred texts, pr...

Food-related occupations connect people with bodies, traditions, rituals, community, family, and caring. Food holds sensate memories and may vividly evoke the past. For those who live in a diaspora, sharing an ethnic heritage yet displaced from a homeland, food may comprise a major means of cultural transmission. This qualitative study explores the...

Recently, public health agents and the popular media have argued that rising levels of obesity are due, in part, to "obesogenic" environments, and in particular to the clustering of fast food establishments in Western urban centers that are poor and working class. Our findings from a multi-site, cross-national qualitative study of teenaged Canadian...

Objective: South Asians living in western countries have increased risk for developing diet-related chronic disease compared to Caucasians of European heritage. To increase understanding of social and cultural factors associated with their food habits, this study examined the meanings of food, health and well-being embedded in the food practices of...

Despite recent critiques of contemporary obesity discourses that link 'modern Western lifestyles' to an 'obesity epidemic', the population's weight remains a central concern of current dietary guidelines. Food choices that are considered beneficial to maintaining a certain weight are understood to play a key role in one's health. This concern refle...

In this qualitative study with three ethnocultural groups in two regions of Canada, we explore how official dietary guidelines provide particular standards concerning 'healthy eating' that marginalize other understandings of the relationship between food and health. In families where parents and youth held shared ways of understanding healthy eatin...

In this qualitative study with three ethnocultural groups in two regions of Canada, we explore the ways reflexivity and tradition may help explain regional differences concerning ‘ethical consumption’ in relation to food. We argue that ‘reflexive modernity’ cannot be said to apply unambiguously in contemporary Canada. The food concerns of Punjabi B...

Occupational therapy has increasingly explored the impact of cultural differences on occupations but has not yet begun to explore the impact of racism on human occupation. This study with 50 African Canadian women used mixed methods to explore the effects of racism on their occupational experiences. Women aged 40-65 were interviewed in-depth about...

To explore family physicians' perceptions of and experiences with patient diversity, including differences in sex, race, ethnicity, social class, sexual orientation, and abilities or disabilities. Semistructured, in-depth, qualitative interviews. SETTING Halifax metropolitan region, Nova Scotia. Twenty-two family physicians who ranged in age (25 to...

Qualitative interviews were conducted with 20 nurses in a Canadian city to explore the moral experience of nurses in their working lives. The participants were asked what they valued in their profession and how well their work lives enabled them act on their values. Almost uniformly, they expressed commitment to the values of helping others, caring...

While women continue to do the lion's share of foodwork and other housework, they and their families appear to perceive this division of labour as fair. Much of the research in this area has focused on families of European origin, and on the perceptions of women. Here we report findings of a qualitative study based on interviewing multiple family m...

Encouraging a teenager to have a conversation in a semistructured research interview is fraught with difficulties. The authors discuss the methodological challenges encountered when interviewing adolescents of European Canadian, African Canadian, and Punjabi Canadian families who took part in the Family Food Decision-Making Study in two regions of...

We explored how adolescents and parents negotiate adolescents' increasing food choice autonomy in European Canadian, Punjabi Canadian and African Canadian families. Data were collected through semi-structured interviews with 47 adolescents and their parents, participant observation at a family meal and a grocery shopping trip with the family shoppe...

Purpose This paper aims to investigate grocery list use in the lives of participant families in a study on decision making about food choices and eating practices. Design/methodology/approach A total of 46 families from three ethno‐cultural groups living in two regions in Canada participated in the study: in British Columbia, 12 Punjabi Canadian a...

The aim of this study was to increase our understanding of how people make sense of healthy eating discourses by exploring the 'ways of knowing' about healthy eating among members of three different ethnocultural groups in Canada: African Nova Scotians, Punjabi British Columbians and Canadian-born European Nova Scotians and British Columbians. Data...

Qualitative interviews were conducted with 20 nurses in a Canadian city to explore the moral experience of nurses in their working lives. The participants were asked what they valued in their profession and how well their work lives enabled them act on their values. Almost uniformly, they expressed commitment to the values of helping others, caring...

The authors critically examined the quantitative measures of cultural competence most commonly used in medicine and in the health professions, to identify underlying assumptions about what constitutes competent practice across social and cultural diversity. A systematic review of approximately 20 years of literature listed in PubMed, the Cumulative...

Despite the potential in occupational therapy models, there has been little investigation of the ways social class may affect occupations or occupational therapy. This paper explores the occupational impacts of poverty. Essays by 17 occupational therapy students, who identify as lower class, were coded and analyzed inductively. Class-based shame an...

Qualitative interviews were conducted with 20 nurses in a Canadian city to explore the moral experience of nurses in their working lives. The participants were asked what they valued in their profession and how well their work lives enabled them act on their values. Almost uniformly, they expressed commitment to the values of helping others, caring...

Based on qualitative interviews with 11 male medical students at one Canadian university, this paper explores the values influencing current and anticipated participation in family- and employment-related occupations. Men increasingly express desire for greater family involvement, yet participation has not necessarily altered. In this study we foun...

Continuing professional development is essential for professionals to remain competent, and for effective recruitment and retention. This paper reports a qualitative study of the effects of workplace policy on continuing professional development on a small, dispersed profession in a resource-challenged province, using the case example of occupation...

While gender shapes engagement in occupations, occupations are also means through which we construct gender. Based on qualitative interviews with 11 young men in Newfoundland, Canada, this paper explores the ways they produce masculinity through particular occupations focused on bodies. They strive to construct muscular bodies through cardiovascula...

To explore the medical school experiences of students who self-identify as coming from a working-class or impoverished family background. A questionnaire was administered to Year 3 medical students at a Canadian medical school and in-depth interviews were held with 25 of these students (cohort 1). The same methods were repeated with another Year 3...

In the midst of continuing debates about the role of spirituality in occupational therapy, this research asked how descriptions of the daily work of occupational therapists and pastoral care professionals indicate attention to spiritual concerns in similar and distinctive ways. Qualitative interview data revealed therapist commitment to holistic pr...

To explore women's perceptions of family influences on food decision-making in the context of having had breast cancer or not having had breast cancer. Individual interviews exploring women's perceptions of their eating habits, health status, and diet, health, and breast cancer beliefs. In Vancouver, a large, multicultural, Canadian city, interview...

To explore the values and assumptions underlying problem-based learning (PBL) cases through narrative analysis, in order to consider the ways by which paper cases may affect student attitudes and values. Randomly chosen PBL cases from the first year curriculum at Dalhousie University medical school (n = 10) were coded by 3 independent reviewers att...

To explore women's dietary actions after a breast cancer diagnosis and the factors influenc