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Research Thrust

Social Analysis of Risk: Security, Environment and Population Health

Abstract
This planned initiative would develop a national and international network for an interdisciplinary synthesis of social aspects of risks, and the development of a framework for social innovation to strengthen resilience towards contemporary risks such as security, environment and health. Case studies would build on terrorism, natural disasters, pandemic forecasts, food safety, pollution and climate change. The program would be based on qualitative and quantitative methodologies examining the dynamics of social appraisal and social management of risk at the individual and collective (community and institution) levels, which would inform public policy development. A 3D matrix could illustrate the research space: Level (Individual, Community, Institution) x Theme (Security, Environment, Health) x Processes (Evaluation, Management), covering various time phases, pre and post-occurrence, across phenomena of perception, anticipation, communication, mobilization, adaptation, identity, leadership, coordination and governance.

Aim
We aim to bring synthesis and lead innovation in risk analysis.

Objectives

• The identification and characterization of social features of threats that affect populations;
• Analyzing and modelling 'behaviours' and 'wellness' of individuals, communities and organizations, in their ripple response to threats;
• Simulating coordination activities and shared decision-making of field responders, organization planners and community leaders from various sectors: public, private, military and humanitarian; and
• Applying and transferring social knowledge into actual training, planning, decision-making, and policy development.

Target an integrative, multi-dimensional, multi-level analysis to achieve a better appraisal and understanding, as well as more efficient management of risks. Our examination would follow three main areas of interest:

• Social consequences of risks, and the risk ripple effects through social tiers;
• Anticipation and uncertainty, dealing with threats and forecasts; and
• Coping and problem-solving at the individual level, management and resilience at the collective level.

Research Program
The research could be represented by a 3D matrix. On the vertical axis, three levels of analysis: Individual Dynamics (and their family), Community Dynamics (associations and neighbourhoods), Institutional Dynamics (organizations and policies). On the depth dimension, three domains of hazards: Security (terrorism and natural disasters), Environment (climate change and pollution), Health (pandemics and food risks). On the horizontal axis are the processes which we organize in two broad categories: Social Assessment (appraisal-focused) and Social Management (action-focused).

Time

Through analyzing the relationships between the three axes of the matrix above, deliverables would include the following:

• The social analysis of a set of case studies along the cascade of effects across tiers of impact: direct damage, death and casualties; social services and utilities; societal fabric, trust, order, political and economic sustainability;
• Carry out mapping, modeling and simulation of social consequences;
• Analyze social vulnerability factors as well as protective factors such as resilience;
• Develop tools and scenarios to rehearse response, help coordination, and to train;
• Establish a generic comprehensive framework to assess and respond to various hazards, yet that is to be customized to specific characteristics of the hazard and of the target group, context and circumstances; and
• Derive useful tools to support the transfer of social risk knowledge to decision-makers, policy planners and risk managers.

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Research Thrust

Stress  / Stress and Immunity

The general theoretical framework we developed is based on a biopsychosocial model of stress that includes environmental parameters and individual processes of perception and coping with stressors. Developed outside the field of psychopathology, this model is ideal for assessing psychological stress in primary care and population health research. The state of stress depends on the interaction between an individual’s environment and his or her representation of that environment. It can result in physical or mental illness through the agency of neuron-endo-immune mediators and depends on various structural or functional vulnerabilities. Stress disorders occur only as a result of stress of great intensity or long duration or when other pathogenic processes are present. Psychological stress is, therefore, a hinge construct associated with both psychological phenomena and factual parameters.

It is well accepted that stress has a detrimental effect on the immune system. Medical evidence supports the hypothesis that individuals suffering from long-term stress are much more likely to demonstrate an associated depression of the immune system. It is also known however, that radiation causes a similar suppression of the immune system. An interesting question is whether or not the systemic changes in the immune system can be profiled and used for the identification of biomarkers of radiation exposure. For this purpose, the difference in the immune system responses to the two variables (radiation and stress) requires further investigation. Can the induced effects by stress and radiation be distinguished based on their immune system profiles?

This research project seeks to answer part of this question by monitoring blood samples from stressed individuals for changes in the immune system proteins.

The Psychosocial Stress Measure
First introduced by Hans Selye, the term stress is now widely used to describe a state of tension often seen as being related to modern life. In the context of primary care, a definition integrated into a conceptual model with a validated measurement instrument would help to ensure that this term is used appropriately. This article is designed to provide primary care researchers with a concept, a model, and a psychological stress measurement tool adapted to their context and needs.

The Concept of Stress
Psychological stress concerns the state of “normal” tension, preoccupation, and agitation reported by many people. Sometimes extreme and sometimes an energy booster, its statistical distribution is normal, and it is considered a precipitating factor in the development of various physical and mental disorders. It is, however, different from distress and psychopathology, which are dysfunctional and morbid.

All too often, researchers and clinicians use clinical psychiatric measurement tools (such as the Present State Examination, the Brief Symptom Inventory, or the Beck Depression Inventory) to assess stress. These were designed for pathologic disorders and validated using dysfunctional clinical populations. Their statistical distributions are not normal, and they are not particularly sensitive below the critical diagnostic threshold. In contrast, the concept of stress refers to a set of affective, cognitive, somatic, and behavioural manifestations within the range of functional integrity.

Measuring Psychological Stress
In our qualitative studies, stress was recognized as a target construct in the process of adapting to life events and circumstances; it appeared socially acceptable. For this reason, it warranted a measurement instrument validated for the specific concept of stress that is reliable, responsive, user-friendly, and economical.

The Psychological Stress Measure (PSM) was designed using 49 items drawn from descriptors generated by focus groups on stress. For content validity, we conducted a quantitative analysis of items selected as the best indicators of stress. We then tested for internal consistency, retaining the indicators that had inter-item and item-total correlations of between .35 and .85, a Cronbach a coefficient of approximately .95, and the normality of distribution that is at the core of the definition of the construct. The scale is unifactorial in structure and maintains a test-retest stability of .68 to .80 under apparently constant conditions.

To validate the tool, we compared groups that differed in social and economical status and urban density, school examinations and holidays, and benign and malignant diagnostic biopsies. Convergence validity was established with classic depressive or anxiety scales; divergence validity was established by distinct factorial scores on these measurements. Concomitant validity with immune competency was demonstrated in a double before-after design of school stress and holidays, using salivary immunoglobulin concentrations. The discriminatory power of the PSM was also tested on a clinical sample of patients with schizophrenia and major depression. Finally, the predictive power of the PSM over an 8-month period, with respect to indicators of physical health among child-care workers, was significant.

The PSM’s responsiveness and normality of distribution give it statistical power in analysis, hence its usefulness in research designs. For longitudinal follow-up protocols with repeated measurements, two parallel 25-item versions were developed using the original long version, and each showed a Cronbach a coefficient of .92 and .93.

For general surveys of health and well-being in the workplace, an abridged 9-item version was developed (Table 1) to meet a variety of research needs and applications. The PSM-9 version is used at Hydro-Québec and Renault (France) as well as in public service, hospitals, community services, and private practice. Having been translated into English, Japanese, Spanish, Portuguese, and Italian, it can be used for international comparisons. It has the same psychometric qualities of reliability, validity, and internal consistency (.89) and maintains the same heuristic value for statistics: normality of distribution and responsiveness.

Psychological stress is an important factor in health, and tools that are generally available are inadequate for studying the “normal” population. We believe, therefore, that the PSM is a critical measurement instrument for those conducting research in family medicine.

• Lemyre, L., & Tessier, R. (2003). Concept et mesure du stress psychologique. Médecin de famille canadien, 49, 1166-1169.
• Psychological Stress Measure Manual.
• Information sheet
• PSM9 Tool

The Psychological Stress Measure has been used extensively by researchers from various fields examining stress-related topics. Below are some of these publications:

• Vazquez, E.L. (2001). Risk perception interactions in stress and coping facing extreme risks. Environmental Management and Health, Vol. 2 (2): 122-133.
• Dion, G., Tessier, R. (1994). Validation de la traduction de l’inventaire d’e´puisement professionnel de Maslach et Jackson. Canadian Journal of Behavioural Science, 26:210–227.
• Brajac, I., Tkalcic, M., Dragojevic, D.M., & Gruber, F. (2003). Role of stress, stress perception and trait-anxiety in the onset and course of alopecia areata. The Journal of Dermatology, 30: 871-878.
• Nyssen, A. S., Hansez, I., Baele, P., Lamy, M., & De Keyser, V. (2003). Occupational stress and burnout in anaesthesia. British Journal of Anaesthesia, 90(3): 333-337.
• Ippoliti F, De Santis W, Volterrani A, Canitano N, Frattolillo D, Lucarelli S, Frediani S, Frediani T. (2006). Psychological stress affects response to sublingual immunotherapy in asthmatic children allergic to house dust mite. Pediatric Allergy and Immunology 17: 337–345.

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Research Project

R. Samuel McLaughlin Research Chair on Psychosocial Aspects of Risk and Health

2003 – 2013, R.S. McLaughlin Foundation, $300 000
The R. Samuel McLaughlin Research Chair on the psychosocial aspects of risk on population health focuses on innovative transdisciplinary research regarding the role of the social environment in the management of health.

Four main themes are investigated:

• the psychosocial aspects of exposure to risks
• the integration of risk perception in the psychosocial management of risks, and in particular, in risk communication strategies
• the systematic and contextual analysis of risk in the community social environment
• stress as a risk factor

The Research Chair will support research development initiatives and help consolidate fruitful research collaborations.

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Organizational Stress and Health

The Federal Public Function as a Learning Organization: A National Survey of White Collar Employees Regarding Stress and Learning

Ongoing, APEX, SSHRC
This research project examines how work conditions affect stress and learning as well as ensuing individual and organizational health. The project encompasses:

• a series of national surveys of Canadian senior officials regarding learning in the context of stress in the workplace (1997, 2002, 2007, 2012)
• a study of organizational work characteristics that facilitate learning
• an analysis of the correspondence between optimal individual and organizational variables for learning and health

The dissemination of the research results to employees and administrative authorities helps contribute to the development of plans and enhanced support for workers.

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Management, Stress, Health and Organizational Learning: Follow-up on Senior Executives of the Federal Public Service

2008 – 2011, SSHRC, $139 000
To help protect and promote the well-being of Canadians in the context of today’s information based society, globalization, new economy, technological advancements, and innovation pressures, the public service sector and the system of government must perform its operations and management as a “learning organization”. Integrating information, innovating, inventing, initiating, coordinating, and self-regulating all require healthy, open-minded, flexible and resilient senior executives, as well as structures and processes that facilitate adaptation, decision-making and coordination.  

Based on the SSHRC-INE 2002-2006 grant, our research program entitled “Management, Stress, Health and Organizational Learning: Follow-up on Senior Executives of the Federal Public Service” examines how work conditions affect stress and learning and, as a result, individual and organizational health. Our work plan proposes to:

• analyze and describe the work context and the management responsibilities of Canadian senior public servants as well as, through the third national survey on Work and Health (1997; 2002; 2007), their evolution over the last 10 years;
• proceed to an ecological analysis of case studies on best practices;
• conduct experimental simulation exercises that would allow us to analyze in-situ the essential processes and parameters of effective risk or crisis management.
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Inter-Organizational Collaboration

In-Vivo Simulation of Shared Decision Making

2009 – 2011, DRDC, TIF, $400 000
 Research Using in Vivo Simulation of Meta-Organizational Shared Decision Making (SDM), is one component of the Technology Innovation Fund (TIF) project that has been designed to assist in understanding the inter-organizational collaboration challenges faced by the Canadian Forces (CF). The objective of the stream is to conduct basic research into shared decision making through the analysis of case studies, exercises and simulations.

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Risk and Stress

Risk and Stress: Uncertainty Management and Empowerment

2008 – 2011, SSHRC, $110 000
This research program furthers our SSHRC work on psychological stress and risk by examining in depth the concept of uncertainty, as well as its management, at the individual and community levels in order to enhance empowerment, personal and collective sense of efficiency, adaptation, preparation, and resilience. The perception and the communication of uncertainty among the public, organizations, and communities will be integrated into a general psychosocial risk management framework based on contemporary and applied hazards such as terrorism, environmental events, and health risks.

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Risk and Stress: Anticipation and Perception in Psychosocial Management of Terrorist Threats

2004 – 2007, SSHRC, $81 000
The terrorism threat is a current risk and source of stress for Canadians. This research project seeks to examine the psychological processes of the general public in managing the psychosocial aspects of the threat of terrorism. This project aims to:

• investigate the strongest and most feared aspects of terrorism by the general public
• document the important dimensions of risk as they relate to actual and perceived risks
• validate these findings in the context of different terrorism threats for four target groups: traditional first responders, non-traditional first responders, government officials, and the general public
• test a psychosocial intervention and its impacts on perceptions of risk, vulnerability, stress and distress as well as on beliefs and attitudes

Project Relevant Publications:

• Lemyre, L., Turner, M., Lee, J.E.C., Krewski, D. (2006). Public Perception of Terrorism Threats and Related Information Sources in Canada: Implications for the Management of Terrorism Risks. Journal of Risk Research, 9, 7, 755-774.

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Risk Perception, Assessment, and Management

Public Perceptions and Acceptable Levels of Health Risk Among Canadians

2011 - 2015, The McLaughlin Center $100,000 with PrioNet, NSERC, SSHRC, CIHR, CSS
Following on the 2002-2005 Health Canada $250 000 project, this research program examines the factors shaping public perceptions of risk and risk acceptability regarding health. Specifically, a psychosocial model for understanding the factors influencing attitudes and opinions about risk is being developed. Established guidelines of risk acceptability is reviewed in detail, and psychosocial values underlying acceptability of risk examined. The project includes the creation of commonsense benchmark risk scales to assist in understanding and communicating scientific information on health risks, particularly small risks difficult to identify and comprehend.

Public and expert perceptions of risks to health are being evaluated through representative national surveys. The use of the research results in informing national policies for health risk management is explored on various current issues such as radiation, climate change, food risks, pandemics and disasters.

Project Relevant Publications:

• Krewski, D., Turner, M.C., Lemyre, L., Lee, J.E.C.(2012). Expert vs. Public Perception of Population Health Risks in Canada. Journal of Risk Research, 1591), 1-25..
• Krewski, D., Lemyre, L., Turner, M., Lee, J.E.C., Dallaire, C., Bouchard, L. (2006). Public Perception of Population Health Risks in Canada: Health Hazards and Sources of Information. Human and Ecological Risk Assessment, 12, 626-644.
• Lee, J.E.C., Lemyre, L., Mercier, P., Bouchard, L., Krewski, D. (2005). Beyond the Hazard: The Role of Beliefs in Health Risk Perception. Human and Ecological Risk Assessment, 11, 1111- 1126.
• Lemyre, L., Lee, J.E.C., Mercier, P., Bouchard, L., Krewski, D. (2006). The Structure of Canadians’ Health Risk Perceptions: Environmental, therapeutic and social health risks. Health, Risk and Society, 8, 2, 185-195.

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Psychosocial Risk Manager: PRiMer

2007 – 2011, CRTI, PHAC, $2 000 000
Based on a previous CRTI project RD 02-0080 that yielded to the Psychosocial Risk Assessment and Management (P-RAM) framework, the goal of this Technology Demonstration project is to transfer - via technology and multimedia - a bilingual a user-friendly knowledge base to assist responders and planners in preparation, planning and response for CBRNE threats or attacks. Five components constitute the core of our multimedia training package (PRiMer): a) a multimedia interactive session using computer-assisted teaching, b) the design and development of psychosocial oriented exercises and tasks, c) preparation of a web-based self-study guide, d) provision of an on-line decision-support tool, and e) a one-day training session, sustainable over time via a Train-the-Trainer component.

The PRiMer project is funded by the Centre for Security Science - the Chemical, Biological, Radiological/Nuclear, Explosive (CBRNE) Research and Technology Initiative (CRTI). The project was also made possible with contributions from Public Health Agency of Canada (PHAC) and with the support of SSHRC and the McLaughlin Chair in Psychosocial Risk.

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Psychosocial Risk Assessment and Management: P-RAM Tools to Enhance Response to CBRN Attacks and Threats in Canada

2003 – 2007, CRTI, PHAC, CFIA, $2 200 000

"The Psychosocial Risk Assessment and Management (RAM) Tools project is funded by the Chemical, Biological, Radiological and Nuclear Research and Technology Initiative (CRTI) led by Drs. Louise Lemyre, Daniel Krewski and Robert Clarke in partnership with the Public Health Agency Canada and the Canadian Food Inspection Agency.

The project seeks to understand and mitigate the psychosocial impacts arising from social disruption, stress, distress, and the anticipated behavioural changes as a result of Chemical, Biological, Radiological, or Nuclear (CBRN) terrorist threats and/or attacks. The project provides an integrated framework for managing psychosocial aspects of CBRN risks with specific guidelines for CBRN agent risk assessment, perception and evaluation as well as guidelines for risk communication. It develops practical, bilingual field-based training tools to enhance the capability of first-responders in Canada to mitigate the psychosocial and human health impacts of CBRN threats and attacks.

Related publications

• Krewski, D., Turner, M.C., Lemyre, L., & Lee*, J. E. C. (2012). Expert vs. public perception of population health risks in Canada. Journal of Risk Research, 15(1), 1-25. .
• Lemyre, L., Clément, M., Corneil, W., Craig, L., Boutette, P., Tyshenko, M., et al. (2005). A Psychosocial Risk Assessment and Management Framework to Enhance Response to CBRN Terrorism Threats and Attacks. Biosecurity and Bioterrorism: Biodefense Strategy, Practice, and Science, 3, 4, 316-330.
• Lemyre, L., Lee, J.E.C., Turner, M., Krewski, D. (2007) Terrorism preparedness in Canada: A public survey on perceived institutional and individual response to terrorism. International Journal of Emergency Management, 4, 2, 296-315.
• Lemyre, L., Turner, M., Lee, J.E.C., Krewski, D. (2006). Public Perception of Terrorism Threats and Related Information Sources in Canada: Implications for the Management of Terrorism Risks. Journal of Risk Research, 9, 7, 755-774.
• Gibson, S., Lemyre, L., Clément, M., L. Markon, M.P., Lee, J.E.C. (2007). Terrorism Threats and Preparedness in Canada: The perspective of the Canadian public. Biosecurity and Bioterrorism: Biodefense Strategy, Practice, and Science, 5, 2, 1-11.

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Stress and Social Environment in Population Health

2002 – 2005, SSHRC, $144 000
With the emerging field of research on Population Health comes the need for the social sciences to position themselves and consolidate their approach regarding the impact of social dynamics on health and well-being. This research and development initiative will:

• constitute a group, a network, a place and a interdisciplinary forum for the study of the social environment: the Vector S.E.S. (Stress and Social Environment)
• articulate current conceptual, methodological and empirical knowledge in an integrated model of the role of the social environment in health
• generate a portfolio of assorted protocols and methodologies
• create partnerships to establish a research agenda as well as promote knowledge transfer

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E=MC²Engagement=Mobilizing Communities and Collaboration

2012 – 2016, HRSDC, UOttawa and partners $1.2 million
A major interdisciplinary research initiative is underway to help mobilize and improve community involvement in Canada. This collaborative project is a model of partnership in both the Faculties of Social Sciences and Education, as well as with the Centre for Research on Educational and Community Services, the Centre on Governanace, the University Centre for Global and Community Engagement Services, and GAP-Santé. The research will examine the challenges identified by key Canadian organizations and sectors with respect to increasing rates of volunteering and giving. It will also assess the data available to help address these challenges and how they can be integrated into innovative sector activities in increase contribution and engagement of citizens in their communities.

Supported by the federal government, Human Resources and Skills Development Canada (HRSDC) contributed $660,000 towards this project, in addition to contributions from the university of Ottawa and other external partners for an overall budget of $1.2 million.

Visit project website for more details.

http://www.socialsciences.uottawa.ca/engagement/eng/index.asp

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Risk, stress and resilience

2012 – 2017, SSHRC Insight

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Selected Research Projects

With uninterrupted funding for thirty years from the Social Sciences and Humanities Research Council (SSHRC), Dr. Lemyre’s  work involves developing unique qualitative and quantitative methodologies for the subjective appraisal and contextual evaluation of social environment, especially with respect to stress, risk, adaptation and organizational learning, in either health or work settings. Dr. Lemyre’s interdisciplinary projects involve the major determinants of population health and their interaction, especially as they relate to Sense of Mastery, Uncertainty and Threat. The psychosocial aspects of public safety, public health, terrorism, emergency preparedness and psychosocial management of risks are at the core of her applied research program. For more information on the research thrust of the unit see below:

• Social Analysis of Risk: Security, Environment and Population Health
• Stress / Stress and Immunity
• Risk, stress and resilience: Individual, organization and community strategies mobilization

Current holder of:

• R. Samuel McLaughlin Research Chair on Psychosocial Aspects of Risk and Health

Lead on

• E=MC²: Engagement=Mobilizing Communities and Collaboration
• Organizational Stress and Health
• Inter-Organizational Collaboration
• Risk Perception, Assessment, and Management
• Risk and Stress
• Stress and Social Environment in Population Health

Collaborator with

• EnRiCh Collaboration: Enhancing Resilience Among High-Risk Populations to Maximize Diaster Preparedness, Response, and Recovery, with Dr. T. O'Sullivan
• The Engineering of Organizational Resilience, with Dr. B. Robert
• PrioNet-NCE; Theme: Integrated Risk Management, with Dr. D. Krewski
• Enabling the SOS (Self-Organizing Security) Network, with Dr. P. Chouinard, Dr. M. Ulieru and Dr. A. Okros
• Establishing an Integrated National CBRNE Training System for Health, Psychosocial and Communication Responders
• Radiological/nuclear emergency response guidelines for vulnerable (at higher-risk) populations (children)
• Simulation Training and Exercise Collaboratory (SIMTEC): Enhancing Chemical, Biological, Radiological, Nuclear and Explosive (CBRNE) Capacity and Capability Management
• Caring About Healthcare Workers as First Responders: Enhancing Capacity for Gender-Based Support Mechanisms in Emergency Preparedness Planning
• Genetic Testing and Services, with Dr. B. Wilson et al.
• Developing International Transdisciplinary Knowledge Translation Collaboration, with Dr. J. Grimshaw
• Evidence-Based Practice Centre, with Dr. J. Grimshaw
• European Union Assessment of Vulnerability of Societies to RBC Terrorism

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