Deborah Norris

In response to inherent occupational and operational stress in public safety personnel (PSP), multiple policies and interventions have been implemented, often with sparse or low-quality research. The National Standard of Canada for Psychological Health and Safety in the Workplace (the Standard) is a comprehensive framework aimed at promoting mental health and preventing psychological harm in Canadian workplaces. This longitudinal multiple-cohort implementation science project describes mental health strategies implemented and associated organizational outcomes across five PSP organizations implementing change within the standard framework. Data were collected at two levels over a three-year span from the five public safety organizations that identified priority areas for improvement within the Standard based on local data and consultations. The organization selected and implemented a range of proactive mental health interventions, including resiliency training. Individual pre-post surveys assessed a variety of mental health disorders and work-related items. Annual organizational data included sick leave hours and extended health benefits for psychological services. Survey responses were aggregated at the organizational level. Rank-based correlation analyses (Kendall’s tau) described associations among occupational stress, work engagement, stigma, and organizational indicators. Organizations demonstrated multiple indicators of progress in meeting the Standard. Post-mental health symptom scores were positively correlated with extended health costs. Higher organizational stress scores were associated with higher extended health costs (psychological) (τ = 1.0 at pre-intervention; 0.67 post-intervention). Positive changes in organizational stress scores and higher engagement scores over the implementation process were both associated with lower average extended health costs (τ = 1.0/−1.0 respectively). Resilience scores were inversely related to health costs (τ = −0.67), consistent with the protective role of resilience. The Standard can serve as a framework for improving workplace health and safety when integrated with multi-modal action plans and structured resilience programs.

Purpose: The nature and cumulative occupational demands imposed on families of public safety personnel (PSP) are substantial, in many cases non-negotiable, and distinct from the general population accentuating risk factors for family well-being. Despite this reality, the contributions of PSP families are not well understood, and a conceptual framework is needed. The aim of this paper is to summarize contextual factors (lifestyle dimensions) that shape the lives of PSP families; factors supported in the existing, albeit limited, body of research. Methods: Grounded in the interpretive/constructivist paradigm, a synthesis was central to understanding the lived experiences of PSP families. An interdisciplinary research team engaged in an iterative process of framework analysis to capture the variability and complexity of PSP family life and distilled the overarching lifestyle dimensions. Results: Three lifestyle dimensions—logistics, risks, and identities—emerged from contextual factors and represent distinct aspects of PSP family life. PSP families play a crucial role in that their capacity to accommodate the lifestyle dimensions (i.e., logistics, risks, and identities), without which the PSP could not meet the demands of the profession. Conclusion: Promoting awareness of these dimensions and their consequent demands underscores the cumulative demands that put PSP families at risk. Responses from governments, public safety organizations, and communities are required to help PSP families manage non-negotiable elements of the public safety occupation that spill over into family life over which they have no control.

LAY SUMMARY The focus of this study was on family and community. Interviews with 23 adult children of Canadian Armed Forces Veterans who served between the Korean War and the Gulf War suggested key capabilities were developed that supported them in meeting demands and contributed to adaptation over the course of their lives. Living on military bases was identified as a significant resource shaping identities, intensifying bonds with others who also grew up as military children in that era. Participants shared insights on how their experiences could inform contemporary military family support programs and policies.

Objective: The objective of this scoping review is to identify and map the currently available peer-reviewed and grey literature exploring Canadian registered dietitians’ (RDs’) perceptions and knowledge of, and experiences with, weight-related evidence in nutrition care. Introduction: Weight, skin fold calipers, body mass index (BMI), and other means of measuring and describing body size, have been associated with risk, progression, and nutrition intervention success with several disease states. Interpretation and application of weight-related evidence can be impacted by several non-medical factors, including practitioner perspective, evidence interpretation and application, lived experience, and bias. Each of these outcomes may differ between RDs and are not easily described or understood. Inclusion Criteria: Original peer-reviewed studies and grey literature published in English that explore Canadian RDs’ perceptions of, knowledge of, and experiences with weight-related evidence in nutrition care will be included. Methods: Following the JBI scoping review design and associated methodology, including the three-step search strategy process, four databases will be searched: CINAHL (EBSCO), MEDLINE (Ovid), Embase (Elsevier), and Scopus (Elsevier). Grey literature will be searched using Google Scholar, Google, and Microsoft Bing, and a search strategy specific to grey literature has been developed in partnership with the research team’s librarian (MR). Screening and extraction will be led by two independent reviewers (RW, AM), and conflicts will be resolved either by discussion or through a third reviewer (SG). Data will be presented using diagrams and/or tables, including a narrative summary. The Delphi method will be used for community consultation, that will occur throughout this study.

Objective: This qualitative study explores the experiences of 26 family members supporting Canadian Armed Forces veterans living with mental health problems including operational stress injuries (OSIs).Background: The research focusing on military‐connected families emphasizes the impacts of service on the families. Little is known about how families impact military veterans, particularly those diagnosed with OSIs. This research addresses that gap by revealing the capabilities and demands characterizing their everyday lives.Method: Semistructured interviews with 26 individuals identifying as family members of Canadian Armed Forces (CAF) veterans and three focus groups (three participants in each group for a total of nine) with family members of CAF veterans released within the preceding 10 years were conducted. The veterans were living with broadly defined diagnosed and undiagnosed mental health problems including OSIs. Using the family adjustment and adaptation (FAAR) model as an organizational framework, demands and capabilities embodied within the everyday lives of the family members were revealed.Results: Monitoring the well‐being of the veteran, managing daily life, accessing and mobilizing resources, and caregiving were discussed as capabilities by participants in this study. These capabilities buffer the demands associated with the veteran's mental health problems.Conclusions: Results of this study endorse recommendations for family‐centered program and service development, modeled on approaches that recognize the systemic and relational contexts instrumental in supporting positive outcomes for veterans with OSIs.Implications: Further research exploring the complex, interdependent, and interactional role of families supporting veterans with OSIs is warranted.

The families of public safety personnel (PSP) face demands that are unique to these occupations. Nonstandard work, trauma exposure, and dangerous work environments affect both workers and the families who support them. This narrative review aims to identify the stressors that PSP families experience and the support and resources needed to enhance family resilience. Due to a lack of research on PSP families, this review is a necessary first step to summarizing and interpreting a diverse body of research. The studies included addressed structural and emotional work-family conflict with reference to PSP sectors. A framework from the military family resiliency literature interprets the findings. Factors influencing family functioning and the availability and accessibility of resources provide clues about the type of skills and supports that PSP families rely on. Meaning-making, collaboration, a sense of coherence, and communication were identified as themes associated with intrafamilial processes. Extrafamilial themes included public perceptions, a lack of recognition for the roles families fulfill, and the need for information and education. The results suggest that the vulnerability of PSP families is variable and extrafamilial resources in the form of formal and informal supports are necessary to enhance family resiliency.

Research emphasizing the negative psychosocial impacts of service-related post-traumatic stress disorder (PTSD) for military members, veterans, and their families is well established. Post-traumatic growth (PTG), positive psychological change resulting from managing adverse life events and situations, is an alternate outcome considered in research focusing on the impacts of serious illness and other life-altering circumstances on families. Little is known, however, about the processes that create and sustain PTG within military and veteran family systems. This paper will review conceptualizations of PTG and consider its relevance as a construct for analysis of outcomes related to the experiences of partners of military members and veterans living with PTSD and other operational stress injuries.

Background: Public safety occupations are well-recognized to be dangerous and stressful. Despite recent attention on post-traumatic stress injuries among public safety personnel, there has been considerably less attention paid to the ongoing ways in which the risks and requirements associated with those occupations shape family life, and how families respond and adapt to those lifestyle dimensions. This systematic review aims to understand how day-to-day family life is affected and shaped when a family member works in a public safety sector, such as fire, police, paramedic, corrections, and emergency communications. Methods: Qualitative studies that examine the experiences of families or family members of public safety personnel will be included in this review, with no date or language restrictions. An initial search of Embase and CINAHL will be conducted, followed by an analysis of text words contained in the title and abstract, and of the index terms used to describe the articles. Databases to be searched for published studies include MEDLINE, Embase, Web of Sciences, CINAHL, PsycINFO, and Sociological Abstracts. Titles and abstracts will be screened by two independent reviewers. The full texts of selected studies will be assessed in detail, and findings and their illustrations will be extracted and aggregated. Any disagreements between the reviewers that arise at each stage will be resolved through discussion, or by a third reviewer. Further analysis of the synthesized findings will be informed by family systems theory. Discussion: The ways that occupational risks and requirements shape family life have been better investigated within other high-risk occupation groups, which has led to productive advancements in organizational policies and supports in the respective sectors. An understanding of the experiences which typify family life ongoing within PSP sectors is a critical gap in the development of meaningful family-informed occupational initiatives and supports. Systematic review registration: Submitted to PROSPERO for systematic review registration: CRD42020208126