Bulletin of the Alliance's Learning Health System |
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Links2Wellbeing
at Rexdale CHC
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Register now for our 2023 conference |
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A Call to Standardize SDoH Data |
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Get Involved: Research & Sharing |
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Learning Events & Programs |
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Social Prescribing for Older Adults:
Links2Wellbeing at Rexdale Community Health Centre
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Community health centres across Ontario are providing social prescribing programs for older adults in their communities. Many of those centres are part of Links2Wellbeing, a partnership program between the Alliance for Healthier Communities and the Older Adult Centres' Association of Ontario (OACAO). Rexdale Community Health Centre is one of these. Crystal Tunnillie recently spoke with staff members at OACAO and Rexdale Community Health Centre about the program.
What is Links2Wellbeing?
Links2Wellebing is a social prescribing project designed to help connect socially isolated older adults with community programs and services offered by Seniors Active Living Centres (SALCs) across Ontario. Primary health care providers refer their clients directly to the closest Seniors Active Living Centre. At Rexdale, it works like this: The referral typically comes from a primary care team, an allied health team, or a client support worker who is working with an older adult experiencing social isolation who would benefit from participating in a senior active living centre. Once the volunteer at the SALC receives the referral, they reach out to the client to find out more about their interests and help them connect with an activity they would enjoy.
Social Connections.. and So Much More
Social prescribing has shown multiple benefits for older adults, including reducing social isolation and improving mental health. As Wendy Caceres-Speakman, a community worker at Rexdale who supports the Links2Wellbeing program there, notes, “When engaging people in a social recreation environment that is less formal, there’s opportunities for great relationships to develop. And within that safe space there is a lot more disclosure around what that clients' specific circumstances and where the areas of needs are. When you work in this way there is more opportunity to connect seniors to a lot more social care supports.”
460 older adults are registered in the social prescribing program at Rexdale. The referrals they have been receiving have highlighted the need not only for social recreation but also for food security programs and supports for older adults to access the digital environment. Pre-COVID, Rexdale offered several daily social recreational activities on site, from fitness classes to food access programs. Noticing that a lot of their older adult clients were experiencing food insecurity and that 48% of their social prescribing participants live alone, Rexdale integrated congregated dining to combat social isolation and food access. During COVID-19 Rexdale transferred their programming online. Through partnerships with Human Endeavour, they provided senior friendly tablets for participants to engage online. The centre’s work helps ensure that they have an informed and empowered community. They provide health and wellbeing information and access to local resources including multiple health promotion and wellness information sessions.
Sustainability Matters
Some of the challenges to providing social prescribing to seniors are sector-wide, such as accessing human resources and securing core funding. Community-based primary health care organizations need funding to understand and reduce barriers to access. Community members become used to new services and expect them to continue. Sustainability is a challenge with limited, project-based funding. Another challenge of doing this work is supporting very vulnerable communities and the impact it has on staff. Many of the older adults clients face barriers such as living in poverty, speaking languages other than English or French, living with a disability, or chronic health conditions. The front line staff in this sector may experience a high workload and are at risk of burnout.
Although there are challenges to doing social prescribing, Rexdale has noticed a positive impact in their members lives. Through social prescriptions and programing, staff at Rexdale have witnessed how these interventions have reduced dependency on pharmacology and have improved health outcomes. Their members are making social connections and discovering (or re-discovering) leisure activities, arts activities and movement. Another positive outcome of doing social prescribing is feedback from physicians and primary health care providers. They appreciate having a tangible social care program for their patients and can see the impact in their patients.
By Crystal Tunillie. Special thanks to Dena Silverberg and Pat Spadafora from Ontario Adults Centres’ Association of Ontario and Wendy Caceres-Speakman and Albesa Aliu from Rexdale Community Health Care for providing the information for this article.
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As we enter the final year of this three-year project, we're still actively recruiting Alliance member organizations to be part of Links2Wellbeing.
If you would like to sign up to build a strong relationship & clear referral pathway to a local Seniors Active Living Centre, please contact Natasha Beaudin.
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The conference will focus on ways to centre community voices and needs and how to build our system on a firm foundation of comprehensive primary health care that includes health promotion, chronic disease prevention and management, and active support for all the social and structural determinants of health.
The 24 learning sessions and poster presentations at Connected Communities will demonstrate how community-led and evidence-informed actions are already having an impact on health system integration and population health. These innovations and practices are ready for scale and spread among primary health care organizations and Ontario Health Teams.
There will also be plenty of opportunities for participants to connect with Alliance members and diverse array of stakeholders in order to build new connections, strengthen existing ones, and exchange knowledge and ideas. Plenary speakers, to be announced shortly, will build on our conference theme and situate it the broader context of challenges and opportunities that we face in this moment. At the Transformative Change Awards gala, we’ll share moments of joy as we celebrate and honour champions for transformative change and health equity within our sector.
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Standardizing SDoH Data Stewardship:
A key step towards an equity-oriented learning health system
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Jennifer Lawson, a health researcher at McMaster University, published a state-of-the-art literature review last September calling for standardization in how data about the social determinants of health (SDoH) is collected, managed, and used in Ontario. EPIC News spoke with her about key learnings and recommendations that emerged from this work.
SDoH data collection in Ontario has been led primarily – and separately – by the Alliance for Healthier Communities and Upstream Labs, both of which are implementing the We Ask Because We Care framework. The Alliance has included SDoH metrics in its sector-wide evaluation framework and has made a number of quality improvement supports available to help its members collect and use SDoH data in their practices. Upstream Labs has engaged in a CIHR-funded study known as SPARK. SPARK has developed and is validating, and spreading a tool to implement SDoH data collection in various health care settings. The implementation project has yielded important insights and several scientific publications but as an academic process is a slower approach for spread and scale.
Jennifer describes two initiatives in US that are advancing the collection and use of SDoH data on a large scale: the Gravity Project, which seeks to develop consistent data standards, and The Oregon Community Health Information Network (OCHIN) framework, which guides data collection and use in practice. The Gravity Project is a national public collaborative that has engaged over 1800 stakeholders to collaboratively standardize codes and create new ones where gaps exist; it has also delivered a SDOH-specific technical implementation guide which is being continually updated. OCHIN is a primary health care network that includes over 1000 Community Health Centres serving over 6 million clients in 45 states. They share a single EMR (EPIC), a shared SDoH screening tool, and a standardized data-collection process.
Noting the strengths and barriers in Ontario’s health-data landscape as well as the promising practices of Gravity and OCHIN, Jennifer makes seven key recommendations for policymakers:
- Leverage and support early adopters, such as the Alliance and SPARK;
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Formalize the development of SDoH standards, uniting the efforts of groups such as the Canadian Institutes for Health Research (CIHI), Canada Health Infoway, PHAC, StatsCanada, Canadian Primary Care Research Network and others;
- Take the time to test promising practices and support stakeholder engagement and continuous quality improvement before proceeding with mandates;
- Provide meaningful incentives to engage the various stakeholders in this collective project;
- Train and hire data stewards who will assume responsibility for appropriate collection, storage, and use of SDoH data in organizations;
- Use SDoH data to build a learning health system; and
- Support Canadian research into the issue with funding and guidelines.
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Recent Publications
New research from the Alliance and TAIBU CHC demonstrates the value of collecting race-based data. Check out this case study, published last month in Longwoods Healthcare Quarterly, about how TAIBU Community Health Centre engaged with their community to advance race-based data collection and how they used this data to understand the unequal impacts of the pandemic, to develop culturally safe and community-based responses to it, and measure the impact of those responses.
In Case You Missed It: Recent Webinars and Podcasts
Trauma and Resiliency Informed Practice. This webinar was hosted by Healthcare Excellence Canada on March 7. Key learnings included a practice change story about how Fraser Health implemented a Trauma and Resiliency Informed approaches (TRIP) program at the individual, team, and systems levels. Watch the recording in English and French.
The Future of Healthcare with Dr. Victoria Lee & Dr. Danielle Martin. In this podcast from Public Policy Forum, Drs. Lee and Martin discuss what it will take to mend the health-care system - and why money is only part of the solution. Broadcast January 23 along with the release of the report, Taking Back Health Care.
Tools for Improvement and Highest-Quality Care
The 2022 CHC Practice Profile Report is out now! The report, appendices, and supplementary data file are in the same format we debuted last year, with data up to March 31, 2022. You can find all three of these resources on the Alliance portal along with a technical appendix, FAQ, and a recorded webinar from when we introduced the new format last April. Last year’s report is there, too, so you can see how your organization is progressing.
New Quality Standard from Ontario Health for
UPDATED: Five great things community spaces can do right now (or any time) to improve indoor air quality and reduce airborne transmission of COVID-19. Looking for ways to invest in better indoor air quality for your community spaces? Check out this updated list from MAP Urban Health Solutions. Free consultations are also available with air quality experts from the Universities of Toronto and Waterloo; email Pearl Buhariwala to schedule an appointment.
Ontario Health’s virtual care tools now available in more languages. Ontario Health worked with an expert panel of primary health care providers and clients to develop provider- and client-facing virtual care guidance and tools. They’re now available in an expanded range of languages, including French, Arabic, Bengali, Chinese (Simplified and Traditional), Greek, Gujarati, Pashto, Persian, Slovak, Spanish, Tagalog and Urdu. If you have used or considered using these tools, please take a moment to provide feedback through this evaluation survey.
New Website: Health Network for Uninsured Clients (HNUC). HNUC is a network of over 70 health and community services and organizations who have been working together for 16 years to improve access to healthcare for people living in the Greater Toronto Area without public health insurance. Their new website includes information about the problem and the solutions they're calling for, as well as resources to help newcomers with and without documents navigate the system and access the care they need.
A harm-reduction app that reduces the risk of using drugs alone. LifeguardConnect Digital Harm Reduction Solution is a mobile application designed to enable safer drug use and reduce the risk of opioid-related death when people must use drugs alone. If the person becomes unresponsive within a short time of consuming a drug, the app directs emergency first responders to their location. No personal data is collected or retained. This app is currently used provincially in BC and has been successfully piloted for two years at NorWest CHC in Thunder Bay. NorWest is now looking other CHCs to pool resources and fund provincial implementation in Ontario. See the full app and costed proposal here. If interested, contact Juanita Lawson.
Solutions for Rapid Implementation of MHA funding for Primary Care Teams. Together with our Primary Care Collaborative partners, we’ve developed a list of options to consider when deciding how to utilize the one-time funding your organization recently received for Mental Health and Addictions care. Where possible, we’ve included links to potential vendors who are aware of your timelines for service delivery, along with individual and group pricing. No specific vendors are endorsed, and we encourage you to seek out local vendors and partners who are engaged in your community.
Data Resources from Ontario Health (Cancer Care Ontario): Ontario Cancer Statistics 2022 and Ontario Cancer Profiles. Reporting on over 30 years of data, Ontario Cancer Statistics 2022 is the fourth in a series of reports which provide comprehensive information on the burden of cancer in Ontario, organized around 4 main types of indicators: incidence, mortality, survival and prevalence. Ontario Cancer Profiles is a self-serve, interactive set of dashboards. It gives you the ability to export data and create custom graphs, maps and tables that show recent provincial and regional statistics on cancer burden, cancer screening, risk factors, and socio-demographic factors.
Free Workplace Mental Health Training for Community Health Centre Staff. CMHA Ontario's Your Health Space is a free program that provides metal health training to support CHCs in addressing burnout and moral injury experienced by their staff. Executive leaders and HR directors of Ontario CHCs van visit www.YourHealthSpace.ca to learn more and register.
A Missing Part of Me: A Pan-Canadian Report on the Licensure of Internationally Educated Health Professionals. This report was recently published by the National Newcomer Navigation Network (N4). It describes the barriers faced by internationally-trained doctors and nurses in Canada looking for opportunities to practice. It also describes facilitators, promising practices, and potential actions to support them: These include personalized navigation, mentorship and peer support, and pre-arrival preparation.
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Looking for more?
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Research & Sharing Opportunities |
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Research Partners Needed
Looking for primary health care organizations who help vulnerable people get ID. Not having ID is a significant barrier to many of the social and structural determinants of health including shelter, income, and health care. The Thunder Bay ID Action Group, a collective of organizations in Thunder Bay who are working together to help low-income and other vulnerable individuals to get ID. They’re looking for other organizations doing similar work in order to exchange knowledge. If this is you, please email Anita Jean, Manager of Community Digital Health Equity. Want to learn more? Check out their research-informed calls to action regarding access to birth certificates.
Primary care clinicians needed: Help guide comparative research about the care and outcomes in different PC models for people living with dementia. A research team from Arizona State University and Dalla Lana school of Public Health want to understand what enables effective communication and diagnoses with primary care clients who have mild cognitive impairment (MCI) or early-stage Alzheimer disease or related dementia (ADRD). They're comparing different models in Ontario, Arizona, and New York State. Interested? Consider joining the project's steering committee. For more information, please email Allie Peckham email Allie Peckham at Arizona State University.
Clinical Trials and Participatory Research
Recruitment in Ontario is now open for the CanTreatCOVID Adaptive Platform Trial. Adults aged 18-49 with one or more chronic conditions and all adults aged 50+ years are eligible to participate if they have had a positive diagnosis of COVID in the past five days. Learn more here or contact the study team to sign up. This pan-Canadian study is based at MAP Centre for Urban Health Solutions, Unity Health Toronto and funded by the Canadian Institutes of Health Research, Health Canada, and the Public Health Agency of Canada. Dr. Jennifer Rayner, the Alliance’s Director of Research and Evaluation, is one of the co-investigators.
Research opportunity for Alliance member organizations: Goal-oriented care in Community Health Centres. A research team at the Lunenfeld-Tanenbaum Research Institute is recruiting primary health care teams (6-8 clinicians and interprofessional providers) from four CHCs to participate in this study. If you are familiar with goal-oriented care and have either used this approach or are willing to try it, you can help them understand how it’s implemented in a real-world setting. They’ll use what they learn to make the model more accessible and feasible. Participants will be asked to reflect on their experiences with goal-oriented care in interviews. Check out the infosheet or email Carolyn Steele Gray or Dagje Boeykens for more information.
Do you have older adult clients who are experiencing loneliness? A research team at Baycrest is studying the use of a virtual, at-home program aimed at promoting brain health. Participants will engage in either mindfulness meditation or brain training for 8 weeks and complete online sessions and surveys to assess the impact of the interventions. Compensation will be provided. To be eligible, participants must be over 60, live in Ontario, and have access to a mobile device or computer with an internet connection. Full details and contact information here. Register here.
Need help with client engagement and communication? Get access to the Canadian Primary Care Information Network (CPIN), tailored messages for your vaccine-hesitant clients, and up to three additional communications and survey campaigns on topics of your choice. Family physicians at the University of Ottawa and Monfort Hospital are studying how automated patient engagement systems like CPIN can improve communications with clients about COVID-19 vaccines. Get more information here or email the study team.
Interviews and Focus Groups
Racialized stroke survivors and family members/caregivers: Your lived-experience expertise can help develop knowledge about the needs and goals of racialized people after a stroke, as well as the gaps in support and services available to them. Researchers at the University of Toronto are looking for people who are Black/African, South Asian, or Chinese to share their experiences in meetings and through photovoice. Participants will be compensated. See the flyers linked above or email Hardeep Singh for more information.
Do you have an RN in your primary care team? If so, a research team based at Western University wants to hear from you. They’re studying the role of RNs in various primary health care models across Canada, including CHCs in Ontario. Their findings may help optimize the role of family practice nursing within primary health care. If your organization participates, they’ll interview a physician, an RN, and an administrative lead, and the RN will be asked to complete a workload survey. Participants will be compensated. If you are interested or would like to know more, please email Leslie Meredith at Western University.
Social workers in primary health care: Your insights are needed. Researchers at the U of T are inviting you to help inform recommendations on how best to organize social work practice in interprofessional primary care settings. In this phase of a mixed-methods study, social workers from primary health care teams across Ontario will participate in semi-structured, 60-minute group conversations about their daily practice during the pandemic. All data collected will be kept confidential, and you will not be identified in study results. Dr. Rachelle Ashcroft, an Associate Professor of Social Work at the University of Toronto, is leading this study. For more information or to get involved, email Simon Lam, Research Coordinator.
Primary Care Providers: Is at least 60% of your practice made up of clients who experience marginalization in some way? Do you have high (70%+) cancer screening rates for these clients? Consider sharing your insights and approach through a 1/2-to-1-hour interview with researchers from Women's College Hospital. Learnings will be used to develop targeted cancer-screening interventions. Remuneration will be provided. For info, see this flyer and email Arlinda Ruco at WCH.
Surveys
Seeking diverse women with osteoarthritis (OA) AND family physicians for a study funded by the Arthritis Society and led by Dr. Anna Gagliardi. Participation involves two rounds of an online survey (approximately 30 minutes) to rate strategies that could improve OA care for diverse women. Women must be over 40 years old, speak and understand English, have lived in Canada for 10 years or more, and belong to one or more of the following ethnocultural groups: African, Caribbean, Chinese, Filipino, Indian, or Pakistani. Family physicians must be practicing in Canada. If interested, email Angelina Abbaticchio at [email protected]
Survey for your older adult clients: A graduate student at the University of Toronto is surveying older adults about how they use the Internet for health information, and how they would like to learn new information for their health maintenance and improvement. Anyone aged 55+ is welcome to participate, especially those who are Indigenous, racialized, 2SLGBTQ+; have disabilities; or live in rural/remote areas. Consent form and survey here. For further information, please reach out to Mary Hynes by email or at (416) 597-3422 ext. 7775.
Survey for People on Safer Supply and/or OAT: The National Safer Supply Community of Practice is conducting a survey to gather information from people living in Canada currently on OAT and/or safer supply about their experiences with take-home doses (aka: carries) and urine drug screenings. Responses will inform recommendations for clinical guidance for health care providers. Please complete this survey before March 31. It should take roughly 10–15 minutes and is completely confidential.
Does your organization provide health care or other supports to refugees and asylum seekers? Researchers at the University of Calgary are looking for people working in clinical, public health, or settlement organizations to answer some questions via an online survey. They want to understand who provides care to refugees and asylum seekers in Canada, how this care is coordinated and delivered, how it differs among jurisdictions, and how COVID-19 has impacted it. Participate by completing this short survey. In lieu of an honorarium, the research team will donate $10 to support refugee student scholarships. See flyer (English or French) for more information.
Collaborative Learning
ECHO at UHN: ECHO is a virtual community that links primary care providers across Ontario with peers and specialists. Through lessons and case studies, participants gain knowledge, skills, and support. Participation is free, and providers earn professional development credits. Learn more about UHN’s ECHO program and about all 25+ Ontario ECHO projects.
SPIDER Learning Collaborative: De-prescribing dangerous medications. Can data-driven QI activities help de-prescribe potentially harmful medications, for medically complex senior clients? Help answer this question and improve health outcomes for your clients by participating in a 12-month learning collaborative. EMR queries will be provided to help participating Alliance members identify clients who would benefit. Contact Jennifer Rayner for more information.
Advocacy
Action for Safer Supply, a working group composed exclusively of people who use drugs who are all members of the National Safer Supply Community of Practice, is submitting an open letter to the federal government about the sustainability of safer supply and harm reduction programs across the country. The working group invites all people who use drugs, drug user organizations, associations, and groups, and any community-led harm reduction initiatives to sign on.
Support the Fresh Start Coalition. The Fresh Start Coalition is advocating for a spent regime in Canada, which means people’s criminal records would be automatically sealed after they have completed their sentence, and only unsealed for specific purposes, such as vulnerable sector checks. This change will remove barriers to employment, housing, and other supports that are disproportionately faced by marginalized communities. Consider signing their parliamentary petition (deadline: April 29) or submitting a written brief in support of Bill S-212. Email Laura Berger and Shakir Rahim at the Canadian Civil Liberties association for more information.
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Learning Events & Programs |
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March
Tuesday, March 28, 8-9 am | Bring Your Own Breakfast Webinar: Be a Part of the CanTreatCOVID Clinical Trials. CanTreatCOVID is a clinical trial taking place all across Canada. It is looking at a variety of different treatment options for COVID-19, with a goal of understanding which treatments work best and for whom. Over 30 universities and research organizations are taking part in this study. This webinar will provide a brief overview of the project, an update on its progress, and information on how Alliance-member primary health care organizations can participate. Learn more here. Register here.
Wednesday, March 29, 1:00-2:30pm | NCCDH Webinar Series on Anti-Black Racism in Public Health, Part 3: Uprooting Anti-Black Racism. The National Collaborating Centre on the Determinants of Health (NCCDH) has partnered with the Black Health Education Collaborative (BHEC) to present a 3-part webinar series on anti-Black racism and public health. This interactive series will explore how anti-Black racism impacts health and identify concrete opportunities for public health action. Learn more and register for all sessions here.
April
Tuesday, April 18, 9:00 am – 5:00 pm | QI Innovations: Better Data, Better Decisions, Better Outcomes. This free, virtual conference is for mental health and addiction providers and system planners who are interested in data-informed decision-making and quality improvement. It will offer networking opportunities, poster presentations, concurrent sessions, wellness activities and more.
Thursday, April 20 – Friday, April 21 | Canadian Healthcare Navigation Conference. CHNC 2023 will provide a forum to share and discuss how navigation can support the integration of care through the lens of research, practice, education, and administration. This virtual conference features keynote speakers Tracey Addison, a patient advocate with lived experience, and Onil Bhattacharyya, a primary care physician and health researcher based in Toronto. Information and registration here.
Tuesday, April 25, 10:00 am – 5:15 pm EST | Health Data for All of Us: Sharing Ideas and Priorities. This is a hybrid in-person and online forum for researchers and members of the public to learn about the work of Health Data Research Network (HDRN) Canada and to share their thoughts and concerns about how health data in Canada should be used. Online via Zoom; in person at the Fairmont Winnipeg (9:00 am – 4:15 pm CST). Free. More info here. Register here.
May
Friday, May 5, 12:00 – 1:00 pm | Webinar – Eating Disorders: A New Quality Standards for High-Quality Care in Ontario. This session will introduce Ontario Health’s recently released Eating Disorders quality standard and describe how it can drive quality improvement and improve care for Ontarians across the health system. Certified for Mainpro+ credits. Register here.
Thursday, May 11, 9:30 am – 3:30 pm | 2023 ICES Research Forum - Way forward: advancing health equity through data. This year’s forum will explore data’s role in driving a more equitable healthcare system for people in Canada. Dr. Kate Mulligan, Senior Director of the Canadian Institute for Social Prescribing is the keynote speaker. Join ICES and over 700 attendees, including researchers, policymakers, and decision-makers for this free online event. Register here.
June
October
October 5-7 | Stimulus 2023. This two-and-a-half day event is the largest national harm reduction and drug policy gathering in Canada. Over 1500 people are expected to attend, including substance use experts, nurses, social workers, physicians, corrections staff, frontline workers, people involved in sex work, researchers, and other key stakeholders. Early bird rates $300-720 until June 15. Shaw conference centre, Ottawa. Learn more here and register here.
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