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Janina Krabbe
Doctor of Philosophy in Interdisciplinary Studies (PhD)
Research Topic
Stories of Resistance: identifying sites of change towards decolonizing research practices with women affected by violence
Everyone who has gone through the difficult journey of completing doctoral studies knows how important good supervision and support are. Dr. Susan Cox is not my primary supervisor. She is a member of my supervisory committee but she has inspired and encouraged my research. She has guided me into the fascinating world of qualitative research illuminating my pathway to dissertation and helping me in every stage of it. I will be thankful to Dr. Cox forever!
I'm so lucky to be supervised by two amazing researchers - Happy Supervisor Appreciation Week to Dr. Susan Cox and Dr. Paul Yong @ubcspph @womensresearch @PelvicPainEndo #GreatSupervisor #UBC
Dissertations completed in 2010 or later are listed below. Please note that there is a 6-12 month delay to add the latest dissertations.
The full abstract for this thesis is available in the body of the thesis, and will be available when the embargo expires.
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This dissertation comprises three papers examining the historical, ethical, and social aspects of public health errors. My first paper explores how US health authorities responded to the discovery of the late health effects of radiation treatment. Based on the examination of multiple primary and secondary sources of evidence; archival research conducted at the National Archive in Washington, DC; and research conducted through media web-archives, I show how efforts by Michael Reese hospital in Chicago to locate and examine former patients (and the media attention these efforts attracted) led to a nationwide campaign by the National Cancer Institute (NCI) to warn those who underwent radiation treatment during childhood. My second paper investigates the ethics of evidence and post-market surveillance of pharmaceuticals in Canada. Drawing on philosophical discussions of inductive risk, the paper examines what evidence should have been sufficient for Health Canada (HC) to revise the misleading information that appeared in the product monograph for OxyContin. Given the stakes involved, I argue that a less strict standard of evidence would have been appropriate, yet HC in fact took the opposite course, insisting on a higher standard of evidence than it normally requires. The time it took for Health Canada to revise the monograph may have contributed to the prescription opioid epidemic in Canada. This paper also contributes to existing philosophical work by demonstrating that inductive risks in the post-approval stage are important and linked to pre-approval inductive risks. My third paper provides a new concept of public health errors—defined as acts of commission or omission, culpable or not, by public health officials, whose consequences for population health were clearly worse than those of an alternative that could have been chosen instead. This conception better corresponds to the task of public health, compared to policy failure literature, where achievement of political objectives is often used to measure success, and has practical and theoretical advantages. It also serves as a valuable analytical lens for understanding general mechanisms leading to public health errors, with utility for scholars who study policy errors as well as for public health actors interested in preventing them.
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Theses completed in 2010 or later are listed below. Please note that there is a 6-12 month delay to add the latest theses.
This thesis presents an interpretive description of twelve primary antenatal care providers’ (PACP) attitudes and perspectives towards anxiety and depression (AD) during pregnancy.In British Columbia (BC), pregnant people (PP) can choose to be cared for throughout the perinatal period by a Family Physician (FP), Registered Midwife (RM), and/or Obstetrician-Gynecologist (ObGyn). Each profession operates under different mandates and care modalities. Thus, a purposive sample of twelve English-speaking PACPs (n=12) participated in one-on-one semi-structured interviews, including five FPs, four RMs, and three ObGyns. Interviews were transcribed verbatim and analyzed inductively using thematic analysis. Current practices in identifying and managing AD with PP, existing resources to support mental health during pregnancy, PACP’s perceived capacity to address AD during pregnancy, what could help address AD, and considerations for implementation in perinatal care settings are described. The knowledge constructed throughout interviews, analysis, and reporting portrays complex phenomena with significant implications for research, practice and policy.Anxiety and depression in the antenatal period are associated with short and long-term morbidity for PP and families. As the main and most constant point of contact with the healthcare system, PACPs are instrumental in shaping healthy pregnancy outcomes. With increasing calls to integrate mental health in perinatal care, this thesis explores and describes the perspectives of those on the frontline of care and offers insights to how we can improve responsiveness to needs. The latter focuses on organizational and system-level supports needed to facilitate the integration of mental health in perinatal care in the interest of healthy pregnancy outcomes.
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