Sari Tudiver

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In Search of the Right Prescription

University of Manitoba Press eBooks, Nov 30, 1990

Canadian Women's Health Network: One Step Back, Two Steps Forward

Canadian Woman Studies, Jun 1, 1994

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The challenges of including sex/gender analysis in systematic reviews: a qualitative survey

Systematic Reviews, Apr 10, 2014

Background: Systematic review methodology includes the rigorous collection, selection, and evalua... more Background: Systematic review methodology includes the rigorous collection, selection, and evaluation of data in order to synthesize the best available evidence for health practice, health technology assessments, and health policy. Despite evidence that sex and gender matter to health outcomes, data and analysis related to sex and gender are frequently absent in systematic reviews, raising concerns about the quality and applicability of reviews. Few studies have focused on challenges to implementing sex/gender analysis within systematic reviews. Methods: A multidisciplinary group of systematic reviewers, methodologists, biomedical and social science researchers, health practitioners, and other health sector professionals completed an open-ended survey prior to a two-day workshop focused on sex/gender, equity, and bias in systematic reviews. Respondents were asked to identify challenging or 'thorny' issues associated with integrating sex and gender in systematic reviews and indicate how they address these in their work. Data were analysed using interpretive description. A summary of the findings was presented and discussed with workshop participants. Results: Respondents identified conceptual challenges, such as defining sex and gender, methodological challenges in measuring and analysing sex and gender, challenges related to availability of data and data quality, and practical and policy challenges. No respondents discussed how they addressed these challenges, but all proposed ways to address sex/gender analysis in the future. Conclusions: Respondents identified a wide range of interrelated challenges to implementing sex/gender considerations within systematic reviews. To our knowledge, this paper is the first to identify these challenges from the perspectives of those conducting and using systematic reviews. A framework and methods to integrate sex/ gender analysis in systematic reviews are in the early stages of development. A number of priority items and collaborative initiatives to guide systematic reviewers in sex/gender analysis are provided, based on the survey results and subsequent workshop discussions. An emerging 'community of practice' is committed to enhancing the quality and applicability of systematic reviews by integrating considerations of sex/gender into the review process, with the goals of improving health outcomes and ensuring health equity for all persons.

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Sex and Gender Appraisal Tool-Systematic Reviews-2 and Participation-To-Prevalence Ratio assessed to whom the evidence applies in sepsis reviews

Journal of Clinical Epidemiology, Feb 1, 2022

Objectives: To revise a sex and gender appraisal tool for systematic reviews (SGAT-SR) and apply ... more Objectives: To revise a sex and gender appraisal tool for systematic reviews (SGAT-SR) and apply it to Cochrane sepsis reviews. The revision process was informed by existing literature on sex, gender, intersectionality, and feedback from an expert advisory board. We revised the items to consider additional factors associated with health inequities. We appraised sex and gender considerations using the SGAT-SR-2 and female Participation-to-Prevalence Ratio (PPR) in Cochrane sepsis reviews. Results: SGAT-SR-2 consists of 19 questions appraising the review's sections and use of the terms sex and gender. Among 71 SRs assessed, 50.7% included at least one tool item. The most frequent item was the number of participants by sex or gender at included study-level (24/71 reviews). Only four reviews provided disaggregated data for the full set of included trials, while two considered other equity-related factors. Reviews rarely appraised possible similarities and differences across sex and gender. In at least half of a subset of reviews, female participants were under-represented relative to their share of the sepsis population (PPR<0.8). The SGAT-SR-2 tool and the PPR can support the design and appraisal of systematic reviews to assess sex and gender considerations, address to whom evidence applies, and determine future research needs.

Reporting of sex and gender in randomized controlled trials in Canada: a cross-sectional methods study

Research integrity and peer review, Sep 1, 2017

Background: Accurate reporting on sex and gender in health research is integral to ensuring that ... more Background: Accurate reporting on sex and gender in health research is integral to ensuring that health interventions are safe and effective. In Canada and internationally, governments, research organizations, journal editors, and health agencies have called for more inclusive research, provision of sex-disaggregated data, and the integration of sex and gender analysis throughout the research process. Sex and gender analysis is generally defined as an approach for considering how and why different subpopulations (e.g., of diverse genders, ages, and social locations) may experience health conditions and interventions in different or similar ways. The objective of this study was to assess the extent and nature of reporting about sex and/or gender, including whether sex and gender analysis (SGA) was carried out in a sample of Canadian randomized controlled trials (RCTs) with human participants. Methods: We searched MEDLINE from 01 January 2013 to 23 July 2014 using a validated filter for identification of RCTs, combined with terms related to Canada. Two reviewers screened the search results to identify the first 100 RCTs that were either identified in the trial publication as funded by a Canadian organization or which had a first or last author based in Canada. Data were independently extracted by two people from 10% of the RCTs during an initial training period; once agreement was reached on this sample, the remainder of the data extraction was completed by one person and verified by a second. The search yielded 1433 records. We screened 256 records to identify 100 RCTs which met our eligibility criteria. The median sample size of the RCTs was 107 participants (range 12-6085). While 98% of studies described the demographic composition of their participants by sex, only 6% conducted a subgroup analysis across sex and 4% reported sex-disaggregated data. No article defined "sex" and/or "gender." No publication carried out a comprehensive sex and gender analysis. Conclusions: Findings highlight poor uptake of sex and gender considerations in the Canadian RCT context and underscore the need for better articulated guidance on sex and gender analysis to improve reporting of evidence, inform policy development, and guide future research.

Women's Health Surveillance: Implications for Policy

BMC Women's Health, 2004

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Gender-based analysis, women’s health surveillance and women’s health indicators – Working together to promote equity in health in Canada

International Journal of Public Health, Feb 1, 2007

Summary Objectives: This paper examines some of the ways gender-based analysis can be applied to... more Summary Objectives: This paper examines some of the ways gender-based analysis can be applied to health surveillance systems and to the development of gender-sensitive health indicators. Methods: Several initiatives in Canada are described to show how gender-sensitive mechanisms for tracking and monitoring health trends at the population level can be used to identify and begin to address health disparities and promote equity

Development and Evaluation of ‘Briefing Notes’ as a Novel Knowledge Translation Tool to Aid the Implementation of Sex/Gender Analysis in Systematic Reviews: A Pilot Study

PLOS ONE, Nov 5, 2014

Background: There is increasing recognition of sex/gender differences in health and the importanc... more Background: There is increasing recognition of sex/gender differences in health and the importance of identifying differential effects of interventions for men and women. Yet, to whom the research evidence does or does not apply, with regard to sex/gender, is often insufficiently answered. This is also true for systematic reviews which synthesize results of primary studies. A lack of analysis and reporting of evidence on sex/gender raises concerns about the applicability of systematic reviews. To bridge this gap, this pilot study aimed to translate knowledge about sex/gender analysis (SGA) into a user-friendly 'briefing note' format and evaluate its potential in aiding the implementation of SGA in systematic reviews. Methods: Our Sex/Gender Methods Group used an interactive process to translate knowledge about sex/gender into briefing notes, a concise communication tool used by policy and decision makers. The briefing notes were developed in collaboration with three Cochrane Collaboration review groups (HIV/AIDS, Hypertension, and Musculoskeletal) who were also the target knowledge users of the briefing notes. Briefing note development was informed by existing systematic review checklists, literature on sex/gender, in-person and virtual meetings, and consultation with topic experts. Finally, we held a workshop for potential users to evaluate the notes. Results: Each briefing note provides tailored guidance on considering sex/gender to reviewers who are planning or conducting systematic reviews and includes the rationale for considering sex/gender, with examples specific to each review group's focus. Review authors found that the briefing notes provided welcome guidance on implementing SGA that was clear and concise, but also identified conceptual and implementation challenges. Conclusions: Sex/gender briefing notes are a promising knowledge translation tool. By encouraging sex/gender analysis and equity considerations in systematic reviews, the briefing notes can assist systematic reviewers in ensuring the applicability of research evidence, with the goal of improved health outcomes for diverse populations.

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Signes et prodiges: il y a plus d’une façon d’écouter une histoire

Canadian Medical Association Journal, Sep 25, 2022

Signs and wonder: There’s more than one way to hear a story

Canadian Medical Association Journal, Jul 10, 2022

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Integrating Gender-based Analysis (GBA) into policy, evidence and practice for cardiovascular health

Country Roads Take Me Home

Canadian Museum of History eBooks, Apr 29, 2018

The Canadian Family

Canadian Museum of History eBooks, May 4, 2018

Signes et prodiges: il y a plus d’une façon d’écouter une histoire

Canadian Medical Association Journal

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Signs and wonder: There’s more than one way to hear a story

Canadian Medical Association Journal

Political Economy and Culture in Central Appalachia: 1790-1977

This study offers alternate interpretations of several common views about Central Appalachia, a r... more This study offers alternate interpretations of several common views about Central Appalachia, a region rich in natural resources, but whose inhabitants are among the poorest in the United States. In particular, it challenges the assumptions that geographic isolation and the culture of mountaineers were initial causes of poverty and major barriers to development of the region; and that mountaineers were culturally and socially homogeneous, devoid of differing class interests. The study places the region's history in the broader context of the expansion of capitalism and the development of class relations in the U.S. from the late 18th century on. I argue that fluctuations in the national economy and competing interest groups outside the region shaped the course of the region's development from earliest times. Development of the region's vast resources of timber and coal in the late 19th century produced underdevelopment in the region. New class relations formed as the mod...

Country Roads Take Me Home

The Canadian Family

Women’s Health Clinic

Review of the Literature 4 Methods 18 Procedures Key Themes in the Data 18 Limitations in the Stu... more Review of the Literature 4 Methods 18 Procedures Key Themes in the Data 18 Limitations in the Study 19 Findings Physicians Conclusions II. Nurses in Primary Health Care Conclusions III. Dental Providers Conclusions IV. Breast Screening: Mammographers and Nurse Examiners 51 Conclusions V. Sonographers Conclusions Dissemination of Research Final Conclusions and Recommendations 81 References Appendix 1 --Interview Guide 90 Appendix 2 --Consent Form . Researching and writing this report has been a process based on collegiality, friendship, and support from many people and institutions. We would like to acknowledge the following people and institutions for their help: Jackie Pantel, who, as before, efficiently provided accurate transcripts of the interviews, as well as other technical and moral support for the project; Lori Calimente, M.N., A.P.N. student, who helped greatly with the literature review and contributed valuable comments to our team discussions; Klinic Community Health Centre, Inc. and especially Paula Lewis and Maureen Daeninck who oversaw the financial and administrative arm of the project; Women's Health Clinic, Inc., which provided meeting space and other in-kind support. We appreciate the Faculties of Medicine, Nursing, Dentistry, Medical Rehabilitation, and the Departments of Mammography and Dental Hygiene for their help with the informal survey. Special thanks go to our funders, the Women's Health Bureau of Health Canada through the Prairie Women's Health Centre of Excellence. We particularly acknowledge the Centre's Executive Director, Linda Dubick; our past Project Officer, Jennifer Howard, and Administrative Coordinator Sharon Jeanson who nurtured us along this lengthy path with patience and understanding. The Centres of Excellence in Women's Health Program is an important initiative that brings community groups and academic researchers together. We feel that our project attests to the value and strength of collaborations between health care providers, community activists, and academic researchers. Of course, the study could not have gone forward without the good will and interest of the health care providers to discuss sensitive issues pertaining to their practices. We are very grateful to these individuals for their thoughtful comments and suggestions. We hope this study will contribute to quality health care for women survivors of childhood sexual abuse, and indeed for all women and men.

Sex and Gender Appraisal Tool-Systematic Reviews-2 and Participation-To-Prevalence Ratio assessed to whom the evidence applies in sepsis reviews

Journal of Clinical Epidemiology, 2021

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