Monthly Bulletin of the Alliance's Learning Health System |
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Peer counselling: #SafeHandsSafeHearts
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New iOAT advocacy tools from AMHO
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KM Learning Event recordings |
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Learning Events & Opportunities |
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Get Involved: Research & Sharing |
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#SafeHandsSafeHearts: Peer-delivered eHealth care for marginalized communities |
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#SafeHandsSafeHearts is a participatory eHealth research project that delivers virtual peer counselling to help marginalized people navigate the COVID-19 pandemic. A partnership between the University of Toronto and Women’s Health in Women’s Hands (WHIWH) CHC, it brings together researchers, social workers, and WHIWH-certified peer counsellors, with a twofold aim: Address a critical gap in mental health care services for LGBTQIA people, especially those who are racialized, and shed light on the effectiveness of virtual mental health care.
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Monte-Angel Richardson is the research coordinator for #SafeHandsSafeHearts and one of the project’s peer counsellors. A second-year PhD student in social work, she focuses in her research on collective trauma and community violence. Specifically, she is developing predictive models for understanding the causes of mass violence and the roots of community resilience. #SafeHandsSafeHearts is not part of her PhD program, but there is a connection: Both mass violence and the COVID-19 pandemic are examples of collective trauma. As she notes, “whenever a collective trauma happens to society, marginalized people experience it the most and have the most barriers to recovery.” As a Latinx person who identifies as LGBTQIA+ and has worked with marginalized communities since 2017, she felt compelled to contribute her skill-set and experience to the project.
For clients and community members, participating in #SafeHandsSafeHearts begins with online registration and a screening survey. Those who are eligible attend three virtual appointments, by video or phone, with a peer counsellor. The first of these focuses on public health measures related to the pandemic and the other two on its mental health impacts. Participants answer questionnaires about their wellbeing and their knowledge of COVID-19 prevention upon enrolment (to establish a baseline) and again after each session, along with questions about their experiences in the program. Data from these questionnaires, as well as notes taken by peer counsellors, will help the research team evaluate the program’s impact and inform future eHealth interventions.
Early findings of the project indicate that for LGBTQIA people, loneliness outweighs both anxiety and depression as the major mental health impact of COVID-19, a result of the closure of Queer spaces and loss of in-person social support networks. They also show that the eHealth intervention is helping to alleviate some of that pain. Participants have expressed gratitude for this project because it helps them feel seen. It also connects them with peer counsellors they can identify with, as most of the research team and peer counsellors identify as racialized and LGBTQIA+. This knowledge that they share experiences and perspectives helps build empathy and trust.
How do we protect marginalized communities from the impacts of collective trauma? Richardson says it starts with recognition. Collecting sociodemographic data that includes information about race, sexual orientation, and gender identity ensures that marginalized people are seen. This is the first step to developing truly inclusive programs that address their needs and lower barriers to care.
#SafeHandsSafeHearts is still looking for participants! Recruitment is open until August 1, 2021, or until program capacity is reached. Participants will be compensated $30 per session. To sign up, visit www.safehandssafehearts.com/ca. To learn more, see the recruitment flyer or email shshstudy@whiwh.com. Anyone 18+ who is LGBTQIA+ and lives in the GTA is welcome to participate, but preference will be given to racialized people and those who are Transgender or nonbinary. Several of the counsellors are able to provide counselling in Spanish to those who prefer.
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iOAT Advocacy Toolkit: Help Support Access
to a Life-Saving Medical Intervention
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Over the last few years, opioid-related mortality and morbidity have risen dramatically due to a toxic supply of street drugs. This has spiked during the COVID-19 pandemic. Injectable opioid agonist treatment (iOAT) is an evidence-based, cost-effective medical intervention that can help. It is recommended for people with severe opioid dependence for whom oral opioid agonist treatment is not appropriate, including those who have not responded to oral opioid agonist treatment (i.e., buprenorphine/naloxone and or methadone). Despite research supporting its effectiveness, and in the face of the growing opioid epidemic, few iOAT programs are available in Canada, including Ontario. In response, Health Canada funded AMHO to help determine whether such programs should be expanded and to develop resources that would support system-level expansion as needed.
The project team began by documenting the current state of iOAT, drawing especially on the work of the Canadian Research Institute in Substance Misuse (CRISM). Specific implementation issues were then explored with over 100 stakeholders across the province, including people with lived experience of substance use and iOAT. These consultations confirmed that much of the key infrastructure needed to increase access to iOAT is already in place here, including guidelines for different service delivery models that can be adapted to local contexts, professional training and regulations, and a number of service provider agencies interested in offering iOAT. |
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“Why wait until there’s irreversible damage? It’s like having lifeguards to prevent drowning. Don’t wait until they are at the bottom of the pool…” |
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While there are additional areas that require further consideration, particularly those related to health equity and the need to integrate iOAT into the broader continuum of care, there is general consensus amongst experts that these should not be a reason to delay increasing access to iOAT. The one significant barrier that will require attention before iOAT can be expanded is the current lack of public funding of the medications used for iOAT. This imperative is reflected in the words of an iOAT client consulted as part of the project: “Why wait until there’s irreversible damage? It’s like having lifeguards to prevent drowning. Don’t wait until they are at the bottom of the pool…”
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In Case You Missed It: Synopses and Links from February's Knowledge Management PLE Series |
In February, the Information Management team at the Alliance for Healthier Communities hosted a four-morning series of professional learning events on the theme of using knowledge for to improve care and decision-making.
Although this was a paid series, we are pleased to share FREE access to the recorded sessions with you. Please use the password LearningHealth (case-sensitive) at each of the links below.
Digging deeper: how data on social determinants
are helping challenge assumptions about COVID-19 transmission
Dr. Sharamistha Mishra, an infectious disease physician and epidemiologist, from the University of Toronto and St. Michael's Hospital shares early findings from a CIHR-funded research project, which explores what census and administrative data can tell us about:
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How the risk of acquiring, transmitting, and experiencing severe illness with COVID-19 varies with the social and structural determinants of health.
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How clinical and public health interventions affect outcomes for people and populations differently.
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Lessons for an equitable public-health response to COVID-19.
A Centre-Based Approach to a Learning Health System:
Bringing Continuous Quality Improvement to Life at the Guelph CHC.
Administrative and program staff from Guelph Community Health Centre shared three of their recent quality improvement projects, describing how they progressed from concept to fruition.
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Enhancing Access to Primary Care: Navjot Thandi, Manager of Strategy and Quality Improvement describes how Guelph CHC Clients have been engaged in improving access to care, using a data-informed approach and continuous tests of change.
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Bringing Joy to the Workplace: Raechelle Devereaux, CEO, describes the centre's journey to improve provider and staff satisfaction and engagement through data-driven focuses on improving trust, and work-life balance.
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Engaging Clients to Improve Overdose Prevention Services: Melissa Kwiatkowski, Director of Primary Care, showcases how the centre used data gathered directly from its Consumption and Treatment Centre service users to implement iterative program and space changes that have enhanced access to care, client privacy, and staff and client safety.
Using decision-analytic modeling and public health administrative data
to support COVID-19 policy-making in Ontario
Stephen Mac is a research associate at the THETA collaborative at Toronto General Hospital, one of the six co-founding members of the COVD-19 Modelling Collaborative, and a PhD student in health services at the University of Toronto. He introduces us to epidemiological modelling, describing:
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Major types of modelling that have been used to predict the progress of COVID-19 and support public health decision-making.
- How the Collaborative developed the COvid Resource Estimator (CORE) model to estimate the demand for acute care resources.
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Evaluation of the model through comparison of predicted and observed outcomes.
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Other examples of models developed by the collaborative to inform public health policy.
Reflecting on a lesson-learned data improvement journey
Dr. Tara Kiran, a physician with the St. Michael's Hospital Family Health Team (FHT) and an associate professor at the University of Toronto, reflects on her experiences leading data-informed quality improvement at the FHT from 2011 through 2018. She focuses on five main lessons for a learning health system:
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Listen to and involve patients through surveys and experience-based co-design.
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Focus on the fundamentals, ensuring that the foundational elements of a high-performing organization, such as engaged leadership, are in place before pursuing outcome improvements.
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Take an equity lens. Who is left behind in our improvement efforts, and why? How can performance measures and QI approaches be adapted to close these gaps?
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Prioritize what matters: Choose QI projects according to the impact they could have on client and community health outcomes.
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Change how we learn by shifting from seeing data as evaluation to seeing it as a tool for self-reflection and by providing learning supports to help providers turn insights into practice.
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Learning Events and Opportunities |
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Reminder: There's still time to sign up for our special webinar, When Grief Comes to Work: Loss in Community Health Care. Facilitators Chris Leonard and Yvette Perreault will help attendees develop a deeper awareness of the impact of and diverse responses to grief and traumatic loss among workers in community health. Participants will learn tools for holding steady in the work, and there will be an opportunity for attendees to share experiences and provide mutual support in breakout rooms. Friday, April 23, 12:00-1:00 pm. Register here.
Special Guest Panel: Research and Evaluation of Safer Supply Programs. The Safer Opioid Supply (SOS) Community of Practice supported by the Alliance and our partners at the Canadian Mental Health Association (CMHA) and Addictions & Mental Health Ontario (AMHO) is hosting its first session on research and evaluation, with more to follow. Join us here on Thursday, April 29 from 12:00-1:00pm.
Lunch 'n' Learn Webinar: Understanding the Differences between Rural and Urban Healthcare Needs. Natalie Pallisco, a student at Western University, is using EMR data from Ontario CHCs, supplemented with local sociodemographic data from Statistics Canada, to explore the differing needs of rural and urban clients, and how CHCs respond to them. Understanding these differences will help our sector advocate and plan for the specific supports needed by clients in rural communities. Wednesday, May 12, 12:00-1:00pm. Register here.
Starting soon: ECHO group learning series on managing liver disease and chronic pain. Free to join; participants get CPD credits and interprofessional specialist support. Register for both at uhn.echoontario.ca.
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Get Involved: Research & Sharing Opportunities |
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Want to learn more about practice-based research, network with peers, and nourish your curiosity? If you are a clinician or interprofessional healthcare worker at an Alliance-member agency, consider joining the EPIC PBLN and the POPLAR Network (see the flyer in French here). We know pandemic response and vaccination efforts are a priority for most of our members, so we’ve put EPIC PBLN meetings on hiatus until fall. But if you sign up now, we can all hit the ground running together when the time is right! Email Sara.Bhatti@AllianceON.org for more information.
Early bird registration ends April 30! Register now for Power in Community! Even though it's virtual this year -- don't expect a two-day Zoom call. The platform we're using has lots of great features, including a virtual exhibit hall, poster session, and ample chances to connect with colleagues across Ontario - in addition to plenaries and breakout learning sessions. Bonus: No travel expenses this year! Learn more and register here.
June 16-17, 2021.Attention Ottawa-area clinicians: Get practice support to improve care for older adult clients! SPIDER - short for Structured Process Informed by Data, Evidence, and Research - is a tool designed to empower client-provider conversations and decision-making. Its aim is to reduce polypharmacy and deprescribe dangerous combinations of drugs. The project team are in search of CHC clinicians from the Ottawa area to participate in testing and evaluating SPIDER. Participating clinicians will get individualized support from practice coaches and a network of peers. To learn more, see this recruitment poster (also available in French), or email Maddie Venables at open@uottawa.ca.
Abstract submissions open: 1st North American Conference on Integrated Care. The overarching theme of this virtual conference is “Co-designing for health and wellbeing with individuals and communities.” October 4-7. Submit your abstract by May 31.
You and your clients can help shape new national standards for long-term care. The Standards Council of Canada, Health Standards Organization, and Canadian Standards Association are developing two new national standards for long-term care (LTC). They’re looking for input from families, residents, and the LTC workforce to help shape these standards. More information and link to the survey here in (also available in French).
Do you work at an SCS Site with a Health Canada Exemption? University of Alberta researchers are conducting a new project called Supporting SCS Sustainability in Canada: Through COVID-19 and Beyond, and they are looking for people to join an expert advisory group to guide the work. Participants will be compensated. Please email kspeed@ualberta.ca for more information.
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Is your race-based data collection advancing health equity? The Black Health Equity Working Group has just published a data-governance framework for health care data collected from Black Communities in Ontario. The Engagement, Governance, Access, and Protection (EGAP) Framework seeks to ensure that data from Black communities is properly collected, protected, and used to promote equity. Download it here in English and French.
What's happening in community health around the world? Find out in the latest edition of the International Federation of Community Health Centres newsletter.
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