Monthly Bulletin of the Alliance's Learning Health System
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Taking Stock
in Taylor-Massey
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Funding for Vaccine Communications
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Learning Events & Opportunities
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Get Involved: Research & Sharing
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Taking Stock in Taylor-Massey:
Assessing needs and identifying opportunities to improve
care integration in an underserved neighbourhood
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To support better health outcomes for their communities, OHTs need to properly understand the experiences of people who live there and the barriers they face to health and wellbeing. From December 2020 through April 2021, the East Toronto Health Partners (ETHP) developed the Taylor-Massey Healthy Communities (TMHC) Network, a community engagement project and report that would help them understand healthcare needs and assets in Taylor-Massey (TM), one of Toronto’s neighbourhood improvement areas (NIA) in East Toronto.
The goal of the project was to strengthen engagement and collaboration. Key deliverables were a framework to identify steps for improved access to social and health supports, as well as to inform ETHP’s approach to neighbourhood planning, design, and service delivery. Nancy LaPlante, seconded from the RDSS role to the Taylor-Massey Project Facilitator role at South Riverdale Community Health Centre, with guidance and oversight from the TMHC Steering Committee, employed a multi-pronged approach which included community and agency engagement and an environmental scan.
Engagement activities
- A collaborative readiness survey and over 50 one-on-one community engagement interviews with residents and health/social care agencies.
- Group planning sessions and co-design with primary care, home and community care, the East Toronto CHC Network, neighbourhood organizations
Environmental scan
- Qualitative analysis of interviews and group sessions; quantitative data from Statistics Canada, ICES Ontario Community Health Profiles, and provider data.
- Examination of previous research and reports addressing needs of Taylor-Massey residents
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[Insufficient access to care in Taylor-Massey] is an example of systemic racism in health planning. The collaborative impact work of the OHT is an opportunity to make real change.
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Like other NIAs in Toronto, Taylor-Massey is home to many newcomers. Nearly a third of its residents live on an income below the 2016 low-income cut-off for Toronto. Despite high levels of education, many are forced to take “survival” jobs, which can lead to anxiety, material deprivation, and declining wellness. Compared to the rest of Toronto, there are disproportionately higher rates of premature mortality, multi-morbidity, and mental health challenges resulting in higher visits to the Emergency Department. Access to care for these issues is insufficient to meet community needs. As one of the organization leaders says, this lack of access to health and social supports in the community is “an example of systemic racism in health planning. The collaborative impact work of the OHT is an opportunity to make real change in this community.”
Key opportunities for change and improvement that emerged during the project included a need to build trust and eliminate competition amongst community agencies and build capacity for dedicated leadership. The momentum of partnership development that materialized during the COVID-19 pandemic was also identified as a foundation to build on, as organizations have found new ways to work together.
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The proposed framework that has emerged from this study employs a collective impact approach and requires structural and organizational culture change. The result would be a network of supports that includes peer support and outreach, coordinated care pathways, and interdisciplinary care for health and the social determinants of health. The first step recommended would be the establishment of a system for accountability and governance. Priorities for improvement include better access to coordinated and integrated team-based care.
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Homelessness Counts:
Using a learning algorithm to identify who’s at risk
and how to support them
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Computers are already predicting the future. Learning algorithms dive into huge datasets to make predictions about what each of us is going to want, need, and do, based on what we’ve liked, shared, and looked up on social media and search engines. Corporations use these predictions to sell their products and experiences and to influence public discourse. But what if this technology could be used for good? What if we could combine other datasets and use them to address complex and devastating health issues like homelessness? Homelessness Counts is a four-year project that aims to do just this.
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Homelessness Counts is led by Dr. Cheryl Forchuk and Dr. Richard Booth at the Lawson Health Research Institute and Western University, with research partners from multiple research and health agencies. It builds on the foundation of an earlier project (2015-2019) which developed a validated pragmatic algorithm that could flag individuals with diagnostic codes for homelessness in health administrative databases. While that tool is helpful, it only gives a “zero or one” indication – either a person is identified as experiencing homelessness, or they are not – and it only finds those who have accessed the healthcare system. It leaves some people uncounted, and it doesn’t reflect the diversity of their experiences.
- Interviewing providers and people experiencing homelessness across Canada to better understand what homelessness looks like. This has already begun in five Ontario communities.
- Combining data from interviews, administrative datasets, Statistics Canada, health records, and shelter records to develop a more complete picture of homelessness.
- Incorporating machine learning into the algorithm to find patterns in that data. With so much information, it would be impossible for a human brain to do this thoroughly.
A more robust understanding of homelessness will help providers and policymakers mitigate the inequitable impacts of public health crises on those experiencing homelessness. Although the project won’t be completed until 2024, it has already produced useful knowledge. A recent paper showing that people with recent experiences of homelessness are at a higher risk of contracting or experiencing negative outcomes from COVID-19 received significant media attention and may have helped motivate a policy shift that led to them being prioritized for vaccination.
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"With incremental moves forward,
you can move glaciers."
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The end of the Homelessness Counts project won’t be the end of the research. It will advance our capacity to ethically and safely gather, combine, and learn from complex, multi-sectoral data on housing, homelessness, and health. It will create tools that can encode rich, qualitative data in a numerical format that computers can use. Questions like “Where did you sleep last night?” and “How long have you been sleeping rough?” will then be able to inform not just the individual’s care, but our understanding of the problem and our approaches to tackling it. It will most likely be the first of many incremental changes, with the ultimate goal being to end homelessness. As Booth says, “with incremental moves forward, you can move glaciers. You can move ships.”
Photo Credit: Justin Langille
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Community Vaccination Promotion
Funding Available for Alliance Members
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The Alliance for Healthier Communities is embarking on a new project titled Community Vaccination Promotion – Ontario (CVP-ON), funded by the Public Health Agency of Canada’s Immunization Partnership Fund (PHAC IPF). This funding will enable interested Alliance members to:
- Give providers the tools, training, and information they need to counsel individuals on the importance of vaccines.
- Increase the capacity of community-based and front-line staff to improve clients' and community members' knowledge about the importance of vaccination, build confidence in vaccines and address barriers to accessing vaccination services.
Alliance members are invited to submit a brief Letter of Intent (LOI) to access funding to achieve these goals, either through a new project or enhancing existing activities. The LOI form includes 5 questions on the purpose and proposed activities of your project and an estimated budget.
Funds may be used to resource activities between April 15, 2021 and August 31, 2022. They may be used to fund:
- Resource community outreach workers to build vaccine confidence.
- The development of communication materials and resources to meet specific needs or gaps in the community.
- Programs and activities that build vaccine confidence, such as Town Halls and webinars or community partnerships including engagement with faith communities..
The Alliance has total funding of $500,000 to support member activities. We expect that projects will range between $20,000 and $50,000, and exceptions will be considered.
If interested, please return the completed LOI by Monday, June 21, 2021 at 5:00 pm EDT to [email protected]. Please let us know if you have any questions or require support in this process.
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For the Children
a Poem by Abigail Echo-Hawk
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June is Indigenous History Month. This is a time for all of us, especially those whose ancestors came here as settlers, to recognize and honour the First Nations, Inuit, and Metis people who have lived in these lands since time immemorial.
It is a time to learn more about our interconnected histories and to celebrate the many accomplishments and contributions of Indigenous people to Canada. However, with the tragic discoveries of 215 children on the site of a residential school in Kamloops and another 104 in Brandon, this is also a time of mourning. The poem below was written by Indigenous artist and poet Abigail Echo-Hawk, in honour of these children those yet to be found. It was shared with EPIC by an Alliance member.
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When they buried the children
What they didn’t know
They were lovingly embraced
By the land
Held and cradled in a mother’s heart
The trees wept for them, with the wind
they sang mourning songs their mother’s
didn’t know to sing
bending branches to touch the earth
around them. The Creator cried for them
the tears falling like rain.
Mother Earth held them
Until they could be found.
Now our voices sing the mourning songs.
With the trees. The wind. Light sacred fire
ensure they are never forgotten as we sing
JUSTICE
~Abigail Echo-Hawk
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Celebrating and Resisting with Pride
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This year marks the 40th anniversary of Operation Soap bathhouse raids and, more importantly, the community protest movement that followed. The ensuing year of protests and rallies led to a shift in public and political discourse about the rights of 2SLGBTQ+ people.
This shift, in turn, led to the recognition by the Supreme Court of Canada that freedom from discrimination on the basis of sexual orientation is a protected right under the Charter of Rights and Freedoms, to the legalization of same-sex marriage in 2004, and the official extension of human rights protections to Transgender people in 2013.
While there is a lot to celebrate, however, there is still a lot of work to do. That is why Pride is both a party and a protest. People from the 2SLGBTQ+ communities continue to experience violence, discrimination, and poorer health outcomes than others. This is especially true for Transgender people and those with intersectional identities.
Celeste Turner is an LGBTQ2S+ support coordinator at Niagara Falls CHC and a member of the Alliance's Lesbian, Gay, Bisexual, Transgender and Two-Spirit advisory committee at the Alliance. Turner is presenting a curated session, "Making the Invisible visible: How can we get support if no one thinks we are there?" on Day 2 of this year's Power in Community Virtual Conference. They spoke about their work and gave a preview of the presentation in a recent episode of Voices Lifting the Community, a podcast series sponsored by HIROC. Listen here.
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Happening Now
This Month
Free symposium on harm reduction and safe supply: Hitting the Mark: Ending the HIV pandemic by realizing rights for people who use drugs is the HIV Legal Network’s 9th Annual Symposium on HIV, Law, and Human Rights. It’s a free, day-long event that will consider decriminalization, harm reduction, and the safe supply of drugs as key strategies for protecting human rights and saving lives. June 17. Program and link to register here: English | French.
Breathing Easier: air quality, climate change, an lung health outcomes in Canada. The Canadian Lung Association and Abacus Data are co-hosting a panel discussion to address the growing concern of air quality and climate on the lung health of Canadians. Free - register here. Wednesday, June 23, 12:00-1:15pm.
Webinar: Cancer Screening During the Pandemic and Onwards. Co-hosted by the Alliance, AFHTO, Ontario Health, the NPLCA, and OCFP. In just the first few months of the pandemic, screening rates for certain cancers dropped by 73-97% across Ontario. This webinar can help you start getting back on track. The Alliance’s Dr. Jennifer Rayner is a panelist. Monday, June 21, 8:00-9:00 am. Register here.
Webinar: Interdisciplinary Palliative Care. The Palliative Care Quality Standard indicates that people with palliative care needs should receive integrated care from an interdisciplinary team. This webinar from the Palliative Care QI Support Community of Practice will help build your team’s capacity for community-based palliative care. Thursday, June 24, 2:00-1:00pm, the Register here.
Celebrate (Virtual) Pride with the Black Queer Youth Collective. This 2-day virtual event for Black Queer and Trans youth, family, friends, and allies takes place on Thursday, June 24 and Friday, June 25. Day 1 is a closed group for Black Nonbinary folks and Queer and Trans women. Day 2 is a virtual Pride event and youth showcase. Email [email protected] to register.
August
Early bird registration extended for the Nurse Practitioners/Advanced Practice Nursing Network Conference. This is the largest international meeting on advanced practice nursing, with over 50 interactive live sessions, and round-the-clock activities including 200 on-demand presentations, 120 e-posters, networking functions and a virtual exhibit hall. Early bird rates end June 30; 10% discount for groups of 5+. Program and other information here. Register here. August 29 – September 1.
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Get Involved: Research & Sharing Opportunities
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Share your knowledge about substance use and its impacts to help develop new capacity-building tools. The Canadian Public Health Association is working on a new project to help build knowledge and capacity for a public health approach to substance use. As part of this work, they're asking healthcare professionals to complete this 30-minute survey about their experiences and perspectives and to help understand the impacts of substance use and opportunities for a public health response. Open until June 30.
Share your learnings on COVID-19 and collaborate with partners to discover more. CanCOVID, a federally-funded open science network of researchers, providers, patient partners, and others, has room at the table for you! Members get access to data and a community of researchers and partners to collaborate with.
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 [email protected] for more information.
Are you experienced in partnering for healthcare quality improvements? Do you want to participate in an international study that will help refine a Capability Framework for successful partnerships in healthcare quality improvement? Researchers in Queensland are convening a an expert panel of people with healthcare quality improvement partnership experience to participate through an eDelphi survey process. Each round of the survey will take about 30 minutes to complete; the first round will begin in July. See the invitation & info sheet for more information. To get involved, download and fill in in the expression of interest form, and submit it by email to Ruth Cox.
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Social Determinants of Health
FUNDING AVAILABLE: The Public Health Agency of Canada (PHAC) is seeking proposals for community-based projects that support collective impact on the social determinants of health. Deadline to apply is 3pm, July 12. To apply, email [email protected] and reference “Intersectoral Action Fund” in the subject line to request an application package and template. More information here. Register now for informational webinars on June 8 (English) and June 11 (French)
Supporting LGBTQ+ and Two-Spirit Communities
Post-Secondary Scholarship Available for LGBTQ2S+ students: The Bill 7 Award Trust provides scholarships to post-secondary students starting, or currently pursuing, their first post-secondary program of study at a college, university or post-secondary training program in Ontario. Students must demonstrate financial need and identify as LGBTQ2S+ to qualify. Full details and application here. Deadline 5 p.m. on Friday, August 6.
June Reading List: Caring for LGBTQ2S+ Elders. This reading list from the Seniors Health Knowledge Network and the Centre for Studies in Aging and Health consists of 13 peer-reviewed articles covering a range of topics about clinical care; social networks and informal linkages; mental health; cultural safety; and more. For more resources and learning opportunities to help you support your older clients, subscribe to their newsletter, Linkages.
Harm Reduction and Care for People Who Use Substances
New video to support iOAT advocacy: A few weeks ago, we shared some resources from Addictions & Mental Health Ontario (AMHO) that can support your advocacy for making injectable opioid agonist treatment (iOAT) available in Ontario. AMHO has now added a 7-minute video to supplement these print resources. You can find them all here.
Tools for supporting people who parent and use substances. Here are recordings and resources from two recent Stimulus Connects webinars:
Splitting and Sharing in SCS & OPS Sites: A national working group of providers at Safer Consumption & Overdose Prevention sites has conducted a survey about the impacts of restrictions on splitting and sharing of drugs at these sites. Results demonstrate that these restrictions pose a barrier to people accessing live-saving services and increase the risk of harm for people who use drugs. A final report has been published and shared which can support advocacy for regulation change.
Rebuilding after COVID-19
Get your cancer screening backlog under control! The Canadian Partnership Against Cancer has curated a suite of resources outlining best practice and expert guidance to support and optimize screening restoration. Find them here. Don't forget to register for the Alliance/AFHTO/NPLCA/OCFP webinar described above under "Learning Events!" For more intensive coaching and peer support, consider joining our cancer screening learning collaborative, set to launch in September! Email [email protected] for more info or to sign up
Learn, connect, and build your capacity for vaccine-related communications: The Lab for Knowledge Translation in Health is offering a series of monthly learning and connecting sessions tfor public health leaders and researchers to connect, reflect, and vision together as we emerge from the pandemic. Each month features a different theme, addressed by guest experts, followed by time for networking and discussion.
Staff Wellness
Working with marginalized and vulnerable people may put your staff at risk of vicarious trauma. This is especially true during times of pandemic and crisis. We’ve heard good things from Alliance members about vicarious trauma training available through the Crisis and Trauma Resource Institute (CRT Institute). In addition to paid training, they offer numerous free resources, including handouts, recorded webinars, a free e-book on trauma-informed workplaces, and 1-minute video insights. Check them out!
Virtual Care for Clients with Disabilities
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