Janine Wiles is an Associate Professor in Population Health at The University of Auckland, and has been employed there since 2006. Previously, she held positions in Geography at McGill University (Montreal, Canada), and in Geography
This qualitative narrative correspondence study investigates older adults’ experiences of physica... more This qualitative narrative correspondence study investigates older adults’ experiences of physical activity (PA) during the 2020 COVID-19 pandemic lockdowns in Aotearoa, New Zealand. This paper presents a reflexive thematic analysis of 501 letters received from 568 participants that discussed PA. Participants described PA as bringing joy and rhythm to daily life under stay-at-home measures. The most frequently discussed forms of PA included exercising, gardening, and housework. Four interconnected conceptual themes identified were as follows: (a) renegotiating environmental relationships, (b) social connection, (c) pleasure and PA, and (d) navigating active aging discourses. This paper emphasizes the important environmental and social motivations for becoming and remaining physically active despite restrictions on movement. Older adults’ understandings and performance of PA were heavily shaped by active aging discourses. As such, we suggest that initiatives seeking to promote PA should foreground older adults’ feelings of connection, productivity, and pleasure and recognize their diversity. This is contrary to current recommendations focused on duration or intensity of older adults’ PA.
Resilience means doing well in the context of difficulty; it is both process and outcome, individ... more Resilience means doing well in the context of difficulty; it is both process and outcome, individual and collective, and it relates to inequities because it is about accessing resources. Resilience helps understand and improve health and wellbeing because it incorporates adversity and challenges. In this report, I argue resilience is also inherently geographical, and operates at interconnected scales. I highlight health geographers are well-placed to help understand and enhance resilience through critically-aware and contextualized approaches. Moreover, resilience offers a way to connect and further develop health geographical scholarship on both wellbeing and addressing health and other inequalities.
The relationship between gender and health is complex, and is mediated by and shapes many social ... more The relationship between gender and health is complex, and is mediated by and shapes many social relations (age, sexuality, and socioeconomic status) and various sociospatial contexts (environmental, political, social, and economic). While we can observe a number of gendered patterns of health and health outcomes across space, there are a wide variety of ways to conceptualize and explain these, drawing on different ways of understanding gender itself, in addition to increasingly complex approaches to health. In entry, four main arguments are covered: (1) there are gendered differences in health experiences and outcomes, (2) access to and use of services is gendered, (3) roles in provision of healthcare are gendered, and (4) gender differences in health occur at a range of interrelated scales.
ABSTRACT The starting point for this paper is a review of the literature, which seeks to explain ... more ABSTRACT The starting point for this paper is a review of the literature, which seeks to explain the use of alternative medicines, therapies and practices in developed countries. Using the Statistics Canada 1996–97 National Population Health Survey—Health File, we then examine the profile of alternative service users. Our analysis shows that use of alternative health care is still limited to a relatively small segment of Canadians whose profile is similar to those in other developed countries. Women are more likely than men to use alternative medicines, therapies and practices, as are those who have higher incomes and are better educated. To move what has been an essentially empirical discussion forward, we explore critiques of conventional medical practice and propose that the analysis of alternative health care be situated within the geographies of consumption.
Background Knowledge of the challenges unpaid caregivers faced providing care to older people dur... more Background Knowledge of the challenges unpaid caregivers faced providing care to older people during the COVID-19 pandemic is limited. Challenges may be especially pronounced for those experiencing inequitable access to health and social care. This participatory action research study, located in New Zealand, has four main objectives, (i) to understand the challenges and rewards associated with caregiving to older care recipients during the COVID-19 pandemic restrictions; (ii) to map and collate resources developed (or mobilised) by organisations during the pandemic; (iii) to co-produce policy recommendations, identify useful caregiver resources and practices, prioritise unmet needs (challenges); and, (iv) to use project results in knowledge translation, in order to improve caregivers access to resources, and raise the profile and recognition of caregivers contribution to society. Methods and analysis Māori, Pacific and rural-dwelling caregivers to 30 older care-recipients, and 30 re...
Background: Internationally, efforts are being made to promote equity in palliative and end-of-li... more Background: Internationally, efforts are being made to promote equity in palliative and end-of-life care for Indigenous peoples. There is a need to better understand the experiences of Indigenous service users and staff. Aim: To explore the views of Māori health practitioners and whānau (family group) caregivers regarding barriers and enablers to culturally safe palliative and end-of-life care. Design: A Kaupapa Māori qualitative study. Setting/participants: Interviews were conducted with 103 participants from four areas of the North Island of Aotearoa New Zealand. Participants comprised bereaved whānau (family) of Māori with a life limiting illness and Māori health practitioners. Results: Māori health practitioners undertake cultural and connecting work to promote culturally safe palliative and end-of-life care for Māori patients and their whānau. This work is time-consuming and emotionally and culturally demanding and, for most, unpaid and unrecognised. Non-Māori staff can support...
Action research and grounded theory are popular methodologies in qualitative health research. The... more Action research and grounded theory are popular methodologies in qualitative health research. The aim of this structured narrative review was to develop a contemporary understanding of combining action research and grounded theory. We searched Web of Science Core Collection and Google Scholar for empirical peer-reviewed articles that used both methodologies in a health- or healthcare-focused study. We identified 28 studies published from 2004 to 2022 that combined various types of action research and interpretations of grounded theory in innovative ways. Our results highlighted that combining the two methodologies is feasible and growing in use. Benefits identified by the study authors were opportunity to work with participants, methodological compatibility, enhancement of action, theoretical understanding, and perceived legitimacy of research processes and outputs. Key challenges were compromising on both methodologies, and conceptual and practical limitations. Our findings also highlighted that important synergies and tensions exist between the two methodologies, but tensions are not insurmountable. We suggest a combined action research and grounded theory approach underpinned by pragmatism as a methodologically congruent path forwards. In an academic environment which increasingly implores health researchers to translate new-found knowledge to timely real-world change, innovative approaches to research methodologies and design are required.
We examined the importance of understanding and incorporating cultural context within Aotearoa/Ne... more We examined the importance of understanding and incorporating cultural context within Aotearoa/New Zealand when engaging in clinical research and practice. This paper reports on the qualitative findings of a mixed methods study aimed at determining what effect a cardiac risk reduction exercise and lifestyle management programme, embedded within a kaupapa Māori methodological approach, had on Māori participants. This methodology saw participants able to redevelop a western model cardiac risk reduction programme by introducing a Māori worldview. Our study revealed how the kaupapa Māori approach empowered participants to examine and evaluate not only their own health and lifestyle choices, but those of family and the wider community. Combining biomedical and kaupapa Māori components into the programme was found to benefit participants’ mental, physical, spiritual and family well-being.
This qualitative narrative correspondence study investigates older adults’ experiences of physica... more This qualitative narrative correspondence study investigates older adults’ experiences of physical activity (PA) during the 2020 COVID-19 pandemic lockdowns in Aotearoa, New Zealand. This paper presents a reflexive thematic analysis of 501 letters received from 568 participants that discussed PA. Participants described PA as bringing joy and rhythm to daily life under stay-at-home measures. The most frequently discussed forms of PA included exercising, gardening, and housework. Four interconnected conceptual themes identified were as follows: (a) renegotiating environmental relationships, (b) social connection, (c) pleasure and PA, and (d) navigating active aging discourses. This paper emphasizes the important environmental and social motivations for becoming and remaining physically active despite restrictions on movement. Older adults’ understandings and performance of PA were heavily shaped by active aging discourses. As such, we suggest that initiatives seeking to promote PA should foreground older adults’ feelings of connection, productivity, and pleasure and recognize their diversity. This is contrary to current recommendations focused on duration or intensity of older adults’ PA.
Resilience means doing well in the context of difficulty; it is both process and outcome, individ... more Resilience means doing well in the context of difficulty; it is both process and outcome, individual and collective, and it relates to inequities because it is about accessing resources. Resilience helps understand and improve health and wellbeing because it incorporates adversity and challenges. In this report, I argue resilience is also inherently geographical, and operates at interconnected scales. I highlight health geographers are well-placed to help understand and enhance resilience through critically-aware and contextualized approaches. Moreover, resilience offers a way to connect and further develop health geographical scholarship on both wellbeing and addressing health and other inequalities.
The relationship between gender and health is complex, and is mediated by and shapes many social ... more The relationship between gender and health is complex, and is mediated by and shapes many social relations (age, sexuality, and socioeconomic status) and various sociospatial contexts (environmental, political, social, and economic). While we can observe a number of gendered patterns of health and health outcomes across space, there are a wide variety of ways to conceptualize and explain these, drawing on different ways of understanding gender itself, in addition to increasingly complex approaches to health. In entry, four main arguments are covered: (1) there are gendered differences in health experiences and outcomes, (2) access to and use of services is gendered, (3) roles in provision of healthcare are gendered, and (4) gender differences in health occur at a range of interrelated scales.
ABSTRACT The starting point for this paper is a review of the literature, which seeks to explain ... more ABSTRACT The starting point for this paper is a review of the literature, which seeks to explain the use of alternative medicines, therapies and practices in developed countries. Using the Statistics Canada 1996–97 National Population Health Survey—Health File, we then examine the profile of alternative service users. Our analysis shows that use of alternative health care is still limited to a relatively small segment of Canadians whose profile is similar to those in other developed countries. Women are more likely than men to use alternative medicines, therapies and practices, as are those who have higher incomes and are better educated. To move what has been an essentially empirical discussion forward, we explore critiques of conventional medical practice and propose that the analysis of alternative health care be situated within the geographies of consumption.
Background Knowledge of the challenges unpaid caregivers faced providing care to older people dur... more Background Knowledge of the challenges unpaid caregivers faced providing care to older people during the COVID-19 pandemic is limited. Challenges may be especially pronounced for those experiencing inequitable access to health and social care. This participatory action research study, located in New Zealand, has four main objectives, (i) to understand the challenges and rewards associated with caregiving to older care recipients during the COVID-19 pandemic restrictions; (ii) to map and collate resources developed (or mobilised) by organisations during the pandemic; (iii) to co-produce policy recommendations, identify useful caregiver resources and practices, prioritise unmet needs (challenges); and, (iv) to use project results in knowledge translation, in order to improve caregivers access to resources, and raise the profile and recognition of caregivers contribution to society. Methods and analysis Māori, Pacific and rural-dwelling caregivers to 30 older care-recipients, and 30 re...
Background: Internationally, efforts are being made to promote equity in palliative and end-of-li... more Background: Internationally, efforts are being made to promote equity in palliative and end-of-life care for Indigenous peoples. There is a need to better understand the experiences of Indigenous service users and staff. Aim: To explore the views of Māori health practitioners and whānau (family group) caregivers regarding barriers and enablers to culturally safe palliative and end-of-life care. Design: A Kaupapa Māori qualitative study. Setting/participants: Interviews were conducted with 103 participants from four areas of the North Island of Aotearoa New Zealand. Participants comprised bereaved whānau (family) of Māori with a life limiting illness and Māori health practitioners. Results: Māori health practitioners undertake cultural and connecting work to promote culturally safe palliative and end-of-life care for Māori patients and their whānau. This work is time-consuming and emotionally and culturally demanding and, for most, unpaid and unrecognised. Non-Māori staff can support...
Action research and grounded theory are popular methodologies in qualitative health research. The... more Action research and grounded theory are popular methodologies in qualitative health research. The aim of this structured narrative review was to develop a contemporary understanding of combining action research and grounded theory. We searched Web of Science Core Collection and Google Scholar for empirical peer-reviewed articles that used both methodologies in a health- or healthcare-focused study. We identified 28 studies published from 2004 to 2022 that combined various types of action research and interpretations of grounded theory in innovative ways. Our results highlighted that combining the two methodologies is feasible and growing in use. Benefits identified by the study authors were opportunity to work with participants, methodological compatibility, enhancement of action, theoretical understanding, and perceived legitimacy of research processes and outputs. Key challenges were compromising on both methodologies, and conceptual and practical limitations. Our findings also highlighted that important synergies and tensions exist between the two methodologies, but tensions are not insurmountable. We suggest a combined action research and grounded theory approach underpinned by pragmatism as a methodologically congruent path forwards. In an academic environment which increasingly implores health researchers to translate new-found knowledge to timely real-world change, innovative approaches to research methodologies and design are required.
We examined the importance of understanding and incorporating cultural context within Aotearoa/Ne... more We examined the importance of understanding and incorporating cultural context within Aotearoa/New Zealand when engaging in clinical research and practice. This paper reports on the qualitative findings of a mixed methods study aimed at determining what effect a cardiac risk reduction exercise and lifestyle management programme, embedded within a kaupapa Māori methodological approach, had on Māori participants. This methodology saw participants able to redevelop a western model cardiac risk reduction programme by introducing a Māori worldview. Our study revealed how the kaupapa Māori approach empowered participants to examine and evaluate not only their own health and lifestyle choices, but those of family and the wider community. Combining biomedical and kaupapa Māori components into the programme was found to benefit participants’ mental, physical, spiritual and family well-being.
Towards Enabling geographies: ‘Disabled’ bodies and minds in society and space , 2010
Book chapter which explores intersections of gerontological theories about old age and disability... more Book chapter which explores intersections of gerontological theories about old age and disability theory
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Papers by Janine Wiles