Christine Kelly

• PhD
• Professor (Associate) at University of Manitoba

Background Adults with intellectual or developmental disability (IDD) are at higher risk for incomplete cancer staging. Aim To compare unknown stage data between those with and without IDD. Materials and Methods We used the Ontario Cancer Registry linked to administrative health data between 2007 and 2019. Results Adults with IDD diagnosed with...

Directly funded (DF) home care, also referred to as direct payments or cash-for care, gives clients (self-managers) or unpaid caregivers (family-managers) a budget to choose their own home support services. DF research tends to be dominated by the assumption that choice is inherently beneficial, and rarely attends to the circumstances or experience...

The social movements of #metoo and #notokay illuminated the extent of sexual violence. By providing a safe platform the movement enabled victims/survivors opportunity to share their own experiences of victimization, often in a delayed disclosure, years after the violence occurred. With new disclosures of sexual violence, also comes a growing awaren...

Psychiatric and mental health (PMH) nurses integrate the concept of trauma-informed care into practice, policy, and education. Despite the frequency of PMH nurses practicing in a trauma-informed manner, there is a paucity of literature focused on integrating trauma-informed principles into research methods. Professions outside of the nursing sphere...

Directly-Funded (DF) home care allows users to organize and purchase their own care services and is expanding globally. Little is known about the career pathways of home care workers. Our study asks, what experiences and factors do home care workers consider when choosing a work setting? And, specifically, what influences their decisions to work di...

The complexity of global public health requires increasing sophistication and cooperation across research designs. Understanding core beliefs and values in diverse populations, incentives and demotivators, barriers and facilitators – all processes that sway public health behaviour, uptake, adherence, and thus outcomes – are in the QHR realm of expe...

Background Maximizing quality of life (QoL) is a major goal of care for people with dementia in nursing homes (NHs). Social determinants are critical for residents' QoL. However, similar to the United States and other countries, most Canadian NHs routinely monitor and publicly report quality of care, but not resident QoL and its social determinants...

Cancer is a leading cause of death among people living with intellectual or developmental disabilities (IDD). There is little empirical evidence documenting survival or comparing outcomes to those without IDD. This study investigated the association between IDD and cancer survival among adults with breast (female), colorectal, or lung cancer. A pop...

Nova Scotia's Supportive Care Program (SCP) is an individualized funding program that provides funds for people living with dementia (PLWD) or acquired brain injuries to purchase basic home care services such as personal care, respite, cleaning and cooking. The SCP has the potential to address the Quintuple Aim of enhancing care experience, improvi...

Background Cancer is a leading cause of death among people living with intellectual or developmental disabilities (IDD). Although studies have documented lower cancer screening rates, there is limited epidemiological evidence quantifying potential diagnostic delays. This study explores the risk of metastatic cancer stage for people with IDD compare...

Background: Medical invalidation is a well-documented phenomenon in the literature on chronic illnesses, yet there is a paucity of research capturing the perspectives of young adults living with chronic illnesses, and especially of those who are gender diverse or from groups that face broader societal marginalization. Our study sought to answer th...

Background Maximizing quality of life (QoL) is a major goal of care for people with dementia in nursing homes (NHs). Social determinants are critical for residents' QoL. However, similar to the United States and other countries, most Canadian NHs routinely monitor and publicly report quality of care, but not resident QoL and its social determinants...

Catherine Frazee has been a central figure in the disability rights landscape in Canada for decades. Her reasoned and passionate insights are topical and often ahead of their time. Always bold, always progressive, and frequently provocative, Frazee’s work presents an unwavering, fierce commitment to engage in public debate from a position that cent...

Genetic assistant positions are now widely integrated in genetic services to address genetic counselor shortages and ultimately improve efficiency. While over 40% of genetic counselors report working with a genetic assistant ("NSGC Professional Status Survey: Work Environment," 2022), there is limited information about the genetic assistant workfor...

Home care is the preferred care option for most people who need support; yet abuse exists in these settings toward both home care workers and clients. There are no existing reviews that assess the scope of current research on abuse in home care, and tangentially related reviews are dated. For these reasons, a scoping review is warranted to map the...

This article explores whether isolation and control observed during COVID-19 are a pandemic effect or a perpetual socio-spatial feature of long-term care (LTC) culture. We use narrative analysis to foreground the experiences of two women with dementia trying to leave LTC: one before and the other during the pandemic. Using the lens of affective cit...

Background Directly-funded home care (DF) provides government funds to people who need assistance with the activities of daily living, allowing them to arrange their own services. As programs expand globally, many allow DF clients to hire home care agencies to organize their services rather than finding their own workers. In Canada, half of the DF...

The long-term care environments in which older persons with dementia live could have an effect on residents and staff. The purpose of this study was to evaluate renovations to a long-term care center for individuals with advanced dementia using a multi-method approach. Renovations included lighting, design elements to reduce noise, and exit-seeking...

Many countries adopted comprehensive national initiatives to promote equity in higher education with the goal of transforming the culture of research. Major health research funders are supporting this work through calls for projects that focus on equity, resulting in a proliferation of theoretical frameworks including “intersectionality,” “health e...

Background Models, theories, and frameworks (MTFs) provide the foundation for a cumulative science of implementation, reflecting a shared, evolving understanding of various facets of implementation. One under-represented aspect in implementation MTFs is how intersecting social factors and systems of power and oppression can shape implementation. Th...

Background The field of knowledge translation (KT) has been criticized for neglecting contextual and social considerations that influence health equity. Intersectionality, a concept introduced by Black feminist scholars, emphasizes how human experience is shaped by combinations of social factors (e.g., ethnicity, gender) embedded in systemic power...

Objectives: Our study aimed to (1) identify barriers to equitable access to COVID-19 vaccines for Canadians with disabilities and (2) present recommendations made by study participants to improve immunization programs in terms of inclusivity and equitable access. Methods: We invited Manitobans living with disabilities to participate in online fo...

Directly funded (DF) home care provides funding to home care recipients to coordinate their own care and supports, and is available across all Canadian provinces. Current research on DF home care focuses on the experiences of adults with disabilities self-directing their own care, but less is known about the experiences of family members managing s...

Directly funded (DF) home care, or consumer directed home care, gives program users a budget to choose their own services. Set in the Canadian province of Manitoba, our study examines the local DF program “Self and Family Managed Care”, which does not allow program users to hire and pay a family member. Incorporating a disability lens into care and...

Intersectionality is a widely adopted theoretical orientation in the field of women and gender studies. Intersectionality comes from the work of black feminist scholars and activists. Intersectionality argues identities such as gender, race, sexuality, and other markers of difference intersect and reflect large social structures of oppression and p...

Violence can lead to physical and psychological harm, emotional exhaustion, and burnout for paid and unpaid carers. Concomitantly, being regarded as violent, aggressive, or difficult can have a direct impact on older adults’ sense of self, care relationships, and quality of care. Current research on violence and aging lacks systemic understanding o...

Emerging evidence suggests adults with intellectual and/or developmental disabilities (IDD) may be at risk of inequities in cancer experiences and outcomes. Individuals with IDD may experience multiple barriers that could worsen outcomes and experience. These barriers may be connected to features of IDD or the healthcare system overall. Future rese...

Ageism is arguably one of the least challenged forms of discrimination globally and manifests in many obvious and subtle ways. Situating our conversation within the context of COVID-19, we discuss peculiar and unchallenged forms of ageism in current times as well as the intersections with other forms of discrimination such as ableism, racism, sexis...

Disability, mad and d/Deaf arts are motivated to transform the arts sector and beyond in ways that foreground differing embodiments. But how do we know if such arts-based interventions are actually disrupting conventional ways of experiencing and consuming art? This article presents three themes from a critical literature review relevant to curatin...

Home care systems have undergone major transformation in the last twenty years, manifesting as a volatile series of policy changes in Ontario, Canada. This includes increasing attention to direct funding (DF) home care where individuals receive cash transfers to arrange their own services. Through a textual analysis of 101 media and grey literature...

RÉSUMÉ La pandémie de la COVID-19 et l’état d’urgence publique qui en a découlé ont eu des répercussions significatives sur les personnes âgées au Canada et à travers le monde. Il est impératif que le domaine de la gérontologie réponde efficacement à cette situation. Dans la présente déclaration, les membres du conseil d’administration de l’Associa...

Background: A key component of the implementation process is identifying potential barriers and facilitators that need to be addressed. The Theoretical Domains Framework (TDF) is one of the most commonly used frameworks for this purpose. When applying the TDF, it is critical to understand the context in which behaviours occur. Intersectionality, w...

The COVID-19 pandemic and subsequent state of public emergency have significantly affected older adults in Canada and worldwide. It is imperative that the gerontological response be efficient and effective. In this statement, the board members of the Canadian Association on Gerontology/L'Association canadienne de gérontologie (CAG/ACG) and the Cana...

Direct Funding (DF) provides individuals with a budget to arrange their own home care instead of receiving publicly arranged services. DF programs have evolved in a number of countries since the 1970s. In Canada, while small-scale DF programs have existed since the early 1970s, the research on these programs remains limited. Responding to gaps iden...

This study examined the elevated risk of intimate partner violence (IPV) among persons with mental health-related disabilities (MH-RD) and the extent to which known risk factors accounted for this phenomenon. Data were drawn from a nationally representative sample of 33,127 Canadians collected in 2014 as part of Statistics Canada’s General Social S...

Background A key component of the implementation process is identifying potential barriers and facilitators that need to be addressed. The Theoretical Domains Framework (TDF) is one of the most commonly used frameworks for this purpose. When applying the TDF, it is critical to understand the context in which behaviours occur. Intersectionality, whi...

Background: A key component of the implementation process is identifying potential barriers and facilitators that need to be addressed. The Theoretical Domains Framework (TDF) is one of the most commonly used frameworks for this purpose. When applying the TDF, it is critical to understand the context in which behaviours occur. Intersectionality, wh...

Background A key component of the implementation process is identifying potential barriers and facilitators that need to be addressed. The Theoretical Domains Framework (TDF) is one of the most commonly used frameworks for this purpose. When applying the TDF, it is critical to understand the context in which behaviours occur. Intersectionality, whi...

Background: A key component of the implementation process is identifying potential barriers and facilitators that need to be addressed. The Theoretical Domains Framework (TDF) is one of the most commonly used frameworks for this purpose. When applying the TDF, it is critical to understand the context in which behaviours occur. Intersectionality, wh...

Background A key component of the implementation process is identifying potential barriers and facilitators that need to be addressed. The Theoretical Domains Framework (TDF) is one of the most commonly used frameworks for this purpose. When applying the TDF, it is critical to understand the context in which behaviours occur. Intersectionality, whi...

Directly funded home care provides funds to individuals to arrange their own services. We ask, what is unique about being a directly funded home care worker? Our qualitative case study in Manitoba, Canada, included an online survey of 95 directly funded workers and interviews with 13 key informants, 24 clients and/or family managers, and 23 workers...

Introduction There is increasing attention on the cancer burden for adults with intellectual and developmental disabilities (IDD). Emerging evidence suggests there are differences in cancer experiences and outcomes for individuals living with IDD, from risk through survivorship. These differences may be attributed to features of the IDD, such as co...

Directly funded (DF) home care is a policy mechanism where individuals are given funds to arrange their own services by hiring people in their communities or by subcontracting to service provider organizations. In 2017, the Ontario Ministry of Health and Long-Term Care briefly established a crown agency called Self-Directed Personal Support Service...

This article explores the economic and political landscape involved in the shifting policies of directly funded home care in Ontario, including organizational structures, agenda-setting, actors, and interest groups.

In many developed contexts, home‐care services have been overhauled with the intent of increasing control and flexibility for those using social and health services. This change is associated with providing funds directly to individuals, and sometimes their families and supports, to arrange at home‐care assistance with the activities of daily livin...

Drawing on the turn in feminist disability studies toward notions of time and futurity, this article presents themes from a study of disability and health-related organizations and youth engagement in Ottawa, Canada. This article asks: what types of futures are imagined by youth with disabilities? How do they resemble or differ from the future visi...

Using a grounded theory approach, this article contends that violence should be considered a part of, rather than in opposition to, care. This conceptualisation is empirically supported by themes from a qualitative study of personal support worker education in Ontario, Canada: one on violence against workers; another on abuse; and a third on sentim...

There is growing attention to the training and education of Personal Support Workers, or PSWs, who work in community, home and long-term care settings supporting older people and people with disabilities. In Ontario, Canada, amid a volatile policy landscape, the provincial government launched an effort to standardise PSW education. Using qualitativ...

Personal support workers (PSWS) provide hands-on assistance in a variety of long-term care and community settings. The question of whether psws should become regulated similar to other self-regulating health professions is a perennial concern in policy circles, especially because of the intimate nature of their work and the potential for abuse of c...

Following the 2008 financial crisis, all levels of Canadian government implemented austerity measures that dramatically restructured welfare, employment, and social service infrastructures. This has significantly affected how disabled people access services. We argue that this restructuring has been an impetus for new forms of disability activism a...

In July 2014, the Ontario Ministry of Training, Colleges and Universities (MTCU) released the Personal Support Worker (PSW) Program Standard. Prior to this, there were three educational standards, inconsistently applied across a multitude of education and employment settings, governed by three distinct pieces of legislation. The primary goal of the...

Professional encounters bestow moral esteem upon professional helpers while denigrating those who access services. Yet society is arranged in such a way that professional services are indispensable for many to survive, and service users can experience them as simultaneously helpful and oppressive. We explore the ambivalent figure of the professiona...

This article enters into conversations about "care" among feminist and disability scholars through a qualitative study on the Ontario Direct Funding program. In some ways, the findings reflect Independent Living perspectives as the program and interactions between attendants and self-managers are positioned as "not care." Yet, there are areas that...

This article uses elements of autoethnography to theorize an in/formal support relationship between a friend with a physical disability, who uses attendant services, and me. Through thinking about our particular “frien-tendant” relationship, I find the common scholarly orientations toward “care” are inadequate. Starting from the conversations betwe...

There are a limited number of academic accounts of disability movements in Canada; however, the existing literature provides relatively consistent descriptions. According to this literature, the disability movement seeks incremental, rather than radical, change through government-led policy, legislation and legal challenges. This work explicitly or...

As with many movements operating in neoliberal regimes, Canadian disability movements struggle to maintain momentum and engage youth leadership. Drawing on feminist disability studies, this article presents the findings of a participatory research project on the Youth Activist Forum, an event which brought together 38 youth with and without disabil...

Disability scholars and activists argue that ‘care’ is a complex form of oppression and reject it as a term and concept. I explore the possibility of salvaging care from its oppressive medical and charitable legacies through a discussion of personal assistance. While not arguing for a return to terming personal assistance ‘care’, I argue care can b...

With disability representing a diverse array of experiences and identities, it seems unlikely that advocacy groups would be able to agree on concrete policy issues. And yet, there does appear to be consensus in the global North on a number of topics. This paper explores one such example, advocacy around direct funding models of personal assistance...

Support provision is a personal and important element of daily life for many disabled people. This study examines the ways in which organisational mandates and philosophies shape interactions between disabled people and support providers at two unique organisations in Winnipeg, Canada: a L’Arche community for people with intellectual disabilities a...