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Item Open Access Access & Equity in Home Care: Enhancing Access for Diverse & LGBT Populations(LGBTTQI Home Care Access Project, 2011) Daley, Andrea; MacDonnell, Judith A.Item Open Access Examining the Development of Positive Space in Health and Social Service Organizations: A Canadian Exploratory Study(Taylor & Francis, 2015) MacDonnell, Judith A.; Daley, AndreaAll health care sectors are currently examining factors that influ- ence delivery of high-quality services for diverse groups with an understanding that minority populations experience barriers to service access that contribute to well-documented ill health and health inequities. with a goal of understanding dynamics that can improve access to care in the home care sector, this qual- itative exploratory study examined processes to create inclusive, positive space for diverse lesbians, gay men, bisexuals, transgen- der, and queer (lgbtq) people in community-based health and social service agencies. a purposeful sample of eight key infor- mants from agencies in toronto, ontario, canada, which offer programs and services to lgbtq communities, completed in-depth interviews. conventional content analysis and a critical lens were used. themes offered insight into the histories, challenges, and turn- ing points which shaped the development of lgbtq-positive spaces in these organizations. community engagement and leadership emerged as relevant, as did strategies to embed lgbtq voices and visibility within everyday organizational functioning. given the gap in literature addressing lgbtq access to home care and the unique dynamics that shape care in the home, implications address the application of these study findings for creating positive space in the home care sector.Item Open Access Gender, sexuality and the discursive representation of access and equity in health services literature: Implications for LGBT communities(BioMed Central, 2011) Daley, Andrea; MacDonnell, Judith A.Background This article considers how health services access and equity documents represent the problem of access to health services and what the effects of that representation might be for lesbian, gay, bisexual and transgender (LGBT) communities. We conducted a critical discourse analysis on selected access and equity documents using a gender-based diversity framework as determined by two objectives: 1) to identify dominant and counter discourses in health services access and equity literature; and 2) to develop understanding of how particular discourses impact the inclusion, or not, of LGBT communities in health services access and equity frameworks.The analysis was conducted in response to public health and clinical research that has documented barriers to health services access for LGBT communities including institutionalized heterosexism, biphobia, and transphobia, invisibility and lack of health provider knowledge and comfort. The analysis was also conducted as the first step of exploring LGBT access issues in home care services for LGBT populations in Ontario, Canada. Methods A critical discourse analysis of selected health services access and equity documents, using a gender-based diversity framework, was conducted to offer insight into dominant and counter discourses underlying health services access and equity initiatives. Results A continuum of five discourses that characterize the health services access and equity literature were identified including two dominant discourses: 1) multicultural discourse, and 2) diversity discourse; and three counter discourses: 3) social determinants of health (SDOH) discourse; 4) anti-oppression (AOP) discourse; and 5) citizen/social rights discourse. Conclusions The analysis offers a continuum of dominant and counter discourses on health services access and equity as determined from a gender-based diversity perspective. The continuum of discourses offers a framework to identify and redress organizational assumptions about, and ideological commitments to, sexual and gender diversity and health services access and equity. Thus, the continuum of discourses may serve as an important element of a health care organization's access and equity framework for the evaluation of access to good quality care for diverse LGBT populations. More specfically, the analysis offers four important points of consideration in relation to the development of a health services access and equity framework.Item Open Access LGBTTQI Communities and Home Care in Ontario: Project Report(2016-06) Daley, Andrea; MacDonnell, Judith A.; St. Pierre, MelissaItem Open Access ‘That would have been beneficial’: LGBTQ-specific training for home care service providers(Wiley, 2015) Daley, Andrea; MacDonnell, Judith A.This paper reports qualitative findings from a pilot study that explored the lesbian, gay, bisexual, transgender and queer (lgbtq) education needs of home-care service providers working in one large, urban canadian city. the pilot study builds upon research that has documented barriers to health services for diversely situated lgbtq people, which function to limit access to good- quality healthcare. lgbtq activists, organisations and allies have underscored the need for health provider education related to the unique health and service experiences of sexual and gender minority communities. however, the home-care sector is generally overlooked in this important body of research literature. we used purposeful convenience sampling to conduct four focus groups and two individual interviews with a total of 15 professionally diverse homecare service providers. data collection was carried out from january 2011 to july 2012 and data were analysed using grounded theory methods towards the identification of the overarching theme, ‘provider education’ and it had two sub-themes: (i) experiences of lgbtq education; and (ii) recommendations for lgbtq education. the study findings raise important questions about limited and uneven access to adequate lgbtq education for home-care service providers, suggest important policy implications for the education and health sectors, and point to the need for anti-oppression principles in the development of education initiatives.