This project aims to encourage women using inpatient psychiatric services to identify their intimacy and sexual expression needs and aims to implement and evaluate a strategy to increase women's opportunity for healthy sexual expression. Adults living with mental illness have higher rates of STD, unprotected sex, and multiple short-term sex partners. Women face higher risks of sexual assault if they are living with mental illness, making sexual health promotion among women living with mental illness a priority. When women enter inpatient psychiatric services, some hospital policies endorse patients’ sexual intimacy but also limit patients’ rights or deem them in need of protection, despite a limited evidence-base for assessing need for “protection.” We will evaluate a sexual health strategy on one inpatient unit that aims to provide a safe and dignified process for addressing intimacy needs and sexual expression, including a privacy suite and a tool to help clinicians assess competence to consent to sexual activity. We will use a before-after and control-group design, using semi-structured interviews to address the research questions, “Do women express unmet needs for intimacy and sexual expression?” and “Do they perceive they have the right to healthy sexual expression?” For a third research question, "What is the reliability and validity of a sexual competency assessment tool?", we will examine inter-rater reliability between a clinician and research interviewer, concurrent validity between the tool and related interview questions, and change in use of the tool before vs. after implementation and on the implementation vs. comparison unit.
Zoe Hilton (Waypoint Centre for Mental Health Care)
Glenn Robitaille (Waypoint Centre for Mental Health Care), Cyndi Rowntree (Patient/Client and Family Council), Nick West (Waypoint Centre for Mental Health Care), Tracy Frost (Waypoint Centre for Mental Health Care), Beth Hamer (Waypoint Centre for Mental Health Care), Joan Bishop (Waypoint Centre for Mental Health Care)
Each of the antiretroviral (ARV) drugs that are used in combination to treat HIV infection causes a range of side effects. Women living with HIV (WLWH) metabolize and react to these medications differently than men and experience side effects that are unique to their bodies. These side effects carry a strong social, psychological, emotional, and physical burden that can negatively impact treatment adherence, treatment outcomes, health outcomes, quality of life, and the overall well-being of WLWH. The main goal of this project is to shed light on women’s experiences of HIV treatment side effects using a grassroots, arts-based approach (i.e., body mapping). Through this project, we want to answer the following question: What can we learn from the stories of women (as told through body mapping) and how can this contribute to new ways of understanding, talking about, and dealing with HIV treatment side effects. The project will include 4 key components: 1) Literature Review and Synthesis, 2) Body Mapping Workshop, 3) Data Integration and Analysis, and 4) Knowledge Translation (KT) Plan. The KT plan will be developed in light of the data emerging from the workshops, the outcomes of the work session, the feedback of participants, and the literature review. Target audiences will include WLWH, service providers and health care providers, and researchers. KT strategies and products will include: a side effect survival kit developed in partnership with the International Community of Women Living with HIV/AIDS (ICW), an exhibit, a video, a webinar, a conference presentation, and a publication.
Marilou Gagnon (University of Ottawa)
Jessica Whitbread (International Community of Women Living with HIV/AIDS), Carmen Logie (University of Toronto)
HIV-positive African, Caribbean, and Black (ACB) women are vulnerable to HIV re-infection and co-infection with sexually transmitted infections (STIs). They are also more vulnerable to acquiring STIs than their HIV-negative counterparts. This vulnerability is due to biological and social challenges impacting their ability to prevent HIV/STI transmission and acquisition. To address these issues, we have identified WILLOW, an evidence-based, small-group intervention based on social cognitive theory of gender and power. WILLOW facilitates acquisition of knowledge and skills through social interactions, sharing experiences and media. This project will assess WILLOW’s effectiveness when administered to Women’s Health in Women’s Hands Community Health Centre’s (WHIWH) clients. We will conduct a focus group to advise us in adapting WILLOW for WHIWH clients. This will be followed by a pre-program survey before administering WILLOW and three post-program surveys after. Survey responses from WILLOW participants and comparators will be compared over time to ascertain if WILLOW was associated with improved outcomes. Additionally, a post-implementation focus group will provide additional information to guide WILLOW’s implementation. The findings from this study will be used within WHIWH and disseminated widely. If WILLOW is effective, the management team at WHIWH will implement it as a standard program for their clients. Findings from this project will be: presented at local, national, and international conferences and meetings; and summarized in a community fact sheet and two peer-reviewed academic journals. This study will also inform a larger one to test WILLOW provincially.
Shamara Baidoobonso (Ontario HIV Treatment Network)
Marvelous Muchenje (Women’s Health in Women’s Hands), Wangari Tharao (Women’s Health in Women’s Hands)
Women who experience domestic violence are more likely to use or become dependent on substances; however, their health and safety is at greater risk when Violence Against Women (VAW) shelters have policies prohibiting admission of abused women if noticeably impaired. These policies were replaced with a harm reduction approach at Huronia Transition Homes’ (HTH) La Maison Rosewood Shelter. Harm reduction does not require abstinence but rather uses non-judgmental strategies to help reduce harms caused by substance use. Such strategies have been found to improve health. Minimal research was found about the impact of integrating hARM REDUCTION IN VAW SHELTERS. The intent of this project is to examine the implementation of a harm reduction service delivery model within the context of a VAW shelter and to identify the benefits and challenges of harm reduction as experienced by the women served. We will qualitatively explore abused women’s experiences with harm reduction strategies. Interviews will be conducted with 20-25 women who attended the HTH shelter after the 2008 integration. The interviews will be transcribed and analyzed using qualitative thematic analysis. Our knowledge translation target audience will include academic communities, VAW and harm reduction advocacy groups and associations, VAW organizations, and women who access service. The findings and recommendations will be shared in document and video format on the HTH website, at relevant conferences and meetings, and in academic and other publications.
Kathy Willis (Huronia Transition Homes)
Angela Hovey (Lakehead University), Susan Scott (Lakehead University)
Mothers with intellectual and developmental disabilities (IDD) are increasingly common in the maternity population. In Ontario, there were 430 live births to women with IDD in 2009. Many mothers with IDD face significant mental health challenges; in fact, more than 50% of pregnant women with IDD have pre-existing mental health issues. Mental health issues have significant implications for maternal well-being and parenting abilities. Yet, there has been little previous research on factors that affect the mental health of pregnant and mothering women with IDD and on the unique services required to meet these women’s mental health needs. Our objectives are to: (1) identify key barriers and resilience factors that affect mental health among pregnant and mothering women with IDD; (2) describe how these factors change at different stages of parenthood; and (3) assess the types of mental health services mothers with IDD and their families, support workers, and clinicians feel are most helpful and in what format. We will conduct focus groups with pregnant and mothering women with IDD and their families as well as support workers and clinicians. This research will enable us to better understand the needs of pregnant and mothering women with IDD and the services and supports that may be most helpful in optimizing their mental health. Findings will lead to an improved ability to recognize emerging mental health issues in pregnant and mothering women with IDD and to proactively respond to these issues. Our work will also improve ongoing mental health treatment for these women.
Marina Heifetz (Centre for Addiction and Mental Health) and Hilary Brown (Women’s College Research Institute)
Simone Vigod (Women’s College Research Institute), Yona Lunsky (Centre for Addiction and Mental Health), Deborah Bluestein (Surrey Place Centre), Jayne Carnwell (Surrey Place Centre)
Women across Ontario are leading change in women’s health – at local, provincial and national levels, in grassroots and professional roles and within and outside of the health care system. Among them are women who participated in women’s health leadership programming carried out by the Ontario Women’s Health Network (OWHN) between 2010 and 2013. These leaders are instrumental in advancing women’s health and health care in communities across the province. With Women’s Xchange funding, OWHN will survey and interview program alumni to assess the long-term impacts of their leadership activities, the facilitators and barriers to their roles as leaders and what they believe to be the key components of effective leadership development. The alumni include almost 200 women from across Ontario of diverse backgrounds and interests who are engaged with women’s health in grassroots, volunteer, professional and academic capacities. This project builds on OWHN’s leadership programming, including the Women’s Health Leadership Program (2010-2012) and Women’s Health Leadership Regional Forums (2013). This programming was designed to advance and strengthen the capacity of women in Ontario to take action on women’s health-related issues and to address systemic health inequities. Program objectives included building understanding of the ways sex, gender and other determinants impact health and health care and offering the leadership tools and skills to work towards improving the quality of women’s health and health care. The project will deliver a report and video that highlight women’s voices with the goal of supporting the continued development of cross-sectorial women’s health leadership in Ontario.
Julie Maher (Ontario Women's Health Network)
Christina Lessels (Ontario Women’s Health Network), Sara Mohammed (Ontario Women’s Health Network)
This project will explore the impact of education and interpersonal interaction on community members’ perceptions of the sex trade and women doing sex work in their community. STREET (Sex Trade Resource Empowerment Education Team) will engage community volunteers to pilot a drop-in, safe space program for sex workers and street involved women in the small city of Brantford. This pilot project is based on an identified need that emerged in STREET’s Trillium-funded needs assessment. Community volunteers will be provided with specialized “Sex Trade 101” training to sensitize them to the needs and issues faced by women doing sex work. Qualitative research will be conducted to assess the impact of the training on volunteers’ perceptions of women working in the sex industry and on their understanding of the diversity of the sex industry in our community. The project aims to meet the needs of sex workers for safe space and access to health information, but also to foster inclusive community and break down the stigma that often poses a barrier to women seeking needed services. Focus groups will be used to evaluate the impact of the program on the women’s sense of well-being, community, and access to services, as well as the fit of the program to their needs. Research will be used to refine the program and to seek sustainable funding for continued service to this marginalized group of women in our community.
Joanna Brant (Sexual Assault Centre of Brant)
Stacey Hannem (Wilfred Laurier University), Christina Bodine (Sexual Assault Centre of Brant), Sarah Stevens (Nova Vita Women’s Shelter)
This project builds on earlier grassroots participatory research in the Oromo-Canadian Community Association of Metropolitan Toronto. The previous project developed and implemented the Heal and Connect (HAC) programs in response to the escalating youth violence in the community. In the current proposed research, we place women and girls at the centre by asking the overarching research question: How can the principles of HAC work to enhance the health and wellbeing of Oromo-Canadian women and girls? Our goal is to identify the social determinants of health that are unique to Oromo women and girls and to strengthen the initiatives they take to tap into the Oromo indigenous knowledge and enhance their capacity. This is a two-phased Participatory Action Research where women and girls participate in both phases of knowledge production and knowledge translation. It employs qualitative research methods. From previous studies in this community, we have identified the cultural methodology of ‘maree’ (circle talks), storytelling, one-to-one intimate talks and talks around the kitchen table as effective data-generation strategies. We employ all of these in our proposed research. We use thematic analysis of the narratives and organize our findings into thematic categories. Previous research in this community also identified performance-based evocative and creative ways of presenting findings as powerful and effective. For the purpose of knowledge translation, therefore, we use performance ethnography, videos, spoken word, skits, music-making, and other forms of creative expression in conjunction with academic publications, conference presentations, workshops, blogs, website postings, and social media engagements. We conduct process evaluation throughout and outcome evaluation at the end of the project.
Martha Kuwee Kumsa (Wilfred Laurier University)
Abebe Challa (Statistics Canada), Benga Dugassa (Toronto Public Health), Nardos Tassew (University Health Network), Bektu Abidta (University of Toronto), Baredu Abraham (Oromo-Canadian Cultural Association), Dammee Sero (Wildfred Laurier University)
Can we improve the health of Indigenous women and children, and restore Birth Justice, by building an Ontario Indigenous Full-spectrum Doula Network? First Nations, Inuit and Metis (FNIM) women experience disproportionately high rates of poor sexual and reproductive health outcomes. Recent research has demonstrated that offering appropriate ‘cultural care’ and “continuous support for women during childbirth” can significantly improve neonatal outcomes and maternal health for Indigenous women. We want to establish an Indigenous full-spectrum doula network in Ontario by developing, piloting and evaluating a free training program for doulas. This would be the first implementation in Ontario. Our project is unique because we are adopting an Indigenous framework to health promotion, supporting all reproductive outcomes (not just childbirth) and seek to work with other professionals and agencies to decolonize reproduction for Indigenous families. Bi-monthly on-going booster network activities will be held. We will follow up with doula trainees nine months after the initial training and invite them to participate in a qualitative evaluation of our efforts. We will share final results (including a video and brief report/feasibility plan for expansion) with Ontario’s two Birth Centres that follow an Indigenous framework, the Association of Ontario Midwives and Association of Ontario Health Centers, the Ministry of Health and Long Term Care, Health Canada’s First Nations & Inuit Health Branch, as well as via social media.
Sarah Flicker (York University)
Jessica Danforth (Native Youth Sexual Health Network)
Chinese women with breast cancer report high levels of psychosocial distress and unmet psychosocial support needs. Yet they often cope with serious illnesses without seeking social support from their family or discussing concerns with their health care providers. This may be attributed to the Chinese cultural emphasis on self-reliance, self-sacrifice and saving face. Language barriers further inhibit uptake of health information and psychosocial services. Thus, very few Chinese immigrant women utilize mainstream psychosocial services because they do not match their cultural and linguistic needs. To address this service gap, we will translate qualitative research findings into a culturally tailored online self-help program using an internet-based e-Counselling platform. The program will consist of two 5-minute docudrama videos and self-care educational materials delivering three key messages: 1) I realize I am not alone; 2) What I can do to help myself; and 3) It is possible to return to life post-treatment. The platform will provide interactive features to reinforce these messages facilitating recovery post-treatment. Usability testing of this program will be assessed in terms of navigation, presentation, content and satisfaction, using semi-structured, audio-taped interviews and observation by a trained staff with iterative cycles to refine the prototype. Purposeful sample of 10 Chinese-speaking women post-treatment will be recruited and asked to "think aloud" as they work through the program. Content analysis will be performed after each iterative cycle with categories and themes identified. The results will inform the expansion of the platform to include other interactive features and content areas.
Terry Cheng (Princess Margaret Cancer Centre)
Jennifer Jones (Princess Margaret Cancer Centre), Karen Fergus (York University), Penny Ng (York University), Tsorng-Yeh Lee (York University), Ada Payne (Toronto General Hospital), Robert Nolan (Toronto General Hospital), Ping-Chuan Hsiung (National Taiwan University), Grace Ho (South Riverdale Community Health Centre), Sarafina Hui (St. Paul’s L’Amoreaux Centre)
Our agencies exist to support families through some of the most difficult experiences of their lives. When a mother has cancer, anytime from diagnosis through to bereavement, the Nanny Angel Network provides care for children aged 12 and under, to support the whole family's needs to care for themselves and one another. When a parent or child is dying or has died, the Dr. Jay Children's Grief Centre provides counselling and support to help family members communicate, grieve and care for themselves and one another. We hear from many of our clients that our services have helped them and for that they are grateful. However, as relatively young agencies, we have not yet conducted strategic, comprehensive reviews of our clients' needs, priorities, wishes, and examined how these fit with our program goals, strengths and outcomes. By developing our understanding of how our services are helping our clients across the trajectories of illness and grief, as well as recognizing their unmet needs, we can make informed, strategic decisions as we develop and improve our programs and services.
Mitchell Praw (Nanny Angel Network)
Ceilidh Eaton Russell (Dr. Jay’s Children’s Grief Centre)
Every year thousands of Canadian women experience intimate partner violence (IPV) potentially causing permanent traumatic brain injuries (TBI), a connection left largely unexplored. This pilot project surveys existing TBI specific knowledge and services in the Toronto IPV survivor support community and begins to bridge the divide between research and practice by developing a knowledge-to-practice network specific to this vulnerable population. Our research question seeks to better understand the current knowledge of TBI in the IPV support community and identify ways to improve the health and wellbeing of women survivors. Our research objectives will be accomplished through an online survey (phase 1) and a networking/education workshop (phase 2). Organizations supporting women survivors of IPV will be asked about their understanding of TBI in their client population and their ability to offer TBI sensitive services. Next, a network building workshop will be held gathering key stakeholders together to disseminate findings, generate recommendations for ‘next steps’ in research and practice, and offer relevant TBI/IPV education. Our team of TBI and IPV researchers and service providers is uniquely positioned to address this gap through expansion of current networks and agendas. We also have existing avenues for continued knowledge translation in TBI and IPV clinical and community health and support agencies, the TBI research community, and in policy arenas. The project is feasible, cost effective, and critical to improving our understanding of TBI and IPV and is the foundation for an extensive program of research intended to significantly improve TBI/IPV survivors’ health and wellbeing.
Angela Colantonio (University of Toronto) and Halina Haag (University Health Network)
Nneka MacGregor (WomenatthecentrE), Vivien Green (WomenatthecentrE), Shirley Broekstra (WomenatthecentrE), Dayna Jones (University of Toronto), Sandra Sokoloff (University of Toronto), Tracey Joseph (University of Toronto), Nora Cullen (University of Toronto)
Child welfare policies and practices have had a profoundly devastating impact on the lives of Indigenous families and communities in Canada (Allan & Smylie, 2015). Following on the heels of residential schools, child welfare became yet another instrument of the state used to separate Indigenous children from their families. Mass apprehensions of Indigenous children, beginning in the late fifties (and now know as the Sixties Scoop), resulted in nearly 1 in 3 Indigenous children being apprehended into foster care and transracial adoption by the 1970s (Fournier & Crey, 1997, as cited in Sinclair, 2007). While Indigenous children currently represent less than 5% of the child population in Canada, they account for nearly half (48%) of all children in the care of child welfare agencies nationally (Statistics Canada, 2013). The fear of child apprehension has been identified as a barrier to accessing healthcare for Indigenous women, including prenatal care (Denison, Varcoe & Browne, 2014; Kurtz et al., 2008). In fact, the most recent practice guidelines for working with Indigenous women issued by the Society of Obstetricians and Gynaecologists of Canada (SOGC), note that practitioners ought to be aware that some Indigenous women may choose to terminate their pregnancy rather than carry to term for fear of apprehension of their baby by child welfare authorities (Wilson et al., 2013). The proposed project aims to develop applied research through the creation and application of knowledge in the service of pregnant Indigenous women who are intersecting or at risk of intersecting with child welfare.
Ellen Blais (National Aboriginal Council of Midwives) and Billie Allan (Ryerson University)
Cheryllee Bourgeois (Seventh Generation Midwives of Toronto), Raven Sinclair (University of Regina), Joanne Dallaire (Healing Works), Jessica Danforth (Native Youth Sexual Health Network)
The Community Academic Reciprocal Engagement (CARE) program of the African Canadian Association and Wilfrid Laurier University seeks to inspire Black middle-school girls through the transformative power of arts. Exploring gender and race issues that impact health and identity will enhance visibility and honour their lived realities. CARE counteracts deficit views of Blacks by involving African elders in cultural training, thus valuing the resources and cultural capital the youth already have in their lives. Integrating social justice and employing community-based participatory model, the Black girls working with social work students will tell their stories and represent their narratives in art forms as social action with the aim of: 1) enhancing their agency to generate solutions to self-identified issues; 2) empowering and promoting healthy identity; and, 3) contributing to immediate and long-term positive health and well-being. The project employs social and ethical imagination to nurture emergent ideas, and community partnerships and social innovation framed by a critical thinking lens that centers African people and their realities. Knowledge generated from surveys, arts and story-telling will be shared through presentations, exhibitions, performances, and social media to enhance visibility of an ignored population because of public focus on Black masculinity and criminality. Creative enterprise (marketing of artwork) will promote sustainability and tangible validation of the girls’ value-added contributions. Evaluation of both process and outcomes has potential to facilitate skill building, inform expansion of the pilot program and development of culturally relevant curriculum to equip practitioners to better promote health and wellbeing of Black girls .
Funke Oba (African Canadian Association)
David Mchaina (African Canadian Association), Laura Mae Lindo (Wilfred Laurier University), Carrie Wright (Wilfred Laurier University), Linda Norton (Wilfred Laurier University), Tamon Scarlett (Wilfred Laurier University)
Breastfeeding is the optimal source of infant nutrition with protective health effects for both women and children. Despite the World Health Organization recommendation of exclusive breastfeeding for the first 6 months, many women discontinue breastfeeding well before. Nipple pain associated with breastfeeding is a primary contributor to the breastfeeding cessation; however there is minimal literature exploring postpartum women’s experiences with breastfeeding pain. As such, our purpose is to explore the experience and meaning of women’s breastfeeding-related pain in a gendered, social and cultural context. Design: A descriptive qualitative design will be used. Using maximum variation sampling, 20-30 women will be recruited from Well Baby/Breastfeeding clinics at the Middlesex-London Health Unit. Sample: Breastfeeding postpartum women reporting breastfeeding-related pain and are able to read, understand, and speak English. Methods: Individual interviews (60-90 minutes) will be conducted using a semi-structured interview guide. Interviews will be audiotaped, transcribed verbatim along with field notes. Data analysis: A feminist, intersectional framework will situate the results. Qualitative descriptive methods will guide data analysis. Multi-level coding, constant comparison techniques and content analysis will identify key data themes using NVivo 10. Significance: This novel research has the potential to improve knowledge of women’s lived experience of breastfeeding-related pain, increase public awareness, promote social support and inform clinical practice – targeting education and development of preventative and treatment interventions for childbearing women. Research team: The multidisciplinary team has an extensive and collective depth of clinical and research expertise in women’s health, pain science, knowledge translation strategies and qualitative research methods.
Kimberley Jackson (Western University)
Tara Mantler (Western University), Sheila O’Keefe-McCarthy (Canadian Pain Society), Tristin Squire Smith (Middlesex-London Health Unit)
This project seeks to explore the unmet needs of women who have experienced domestic or sexual violence in York Region. We will conduct an assessment of needs to greater comprehend of survivors’ perspectives of gaps in service, discover the barriers encountered, explore survivor-identified solutions. With this knowledge, a community action plan will be made for York Region’s Violence Against Women Coordinating Committee (YRVAWCC) to initiate strategies to better support survivors of gender-based violence. The target population for this project includes 1) girls and women who have experienced sexual or domestic violence in York Region and 2) service providers in sectors that support girls and women in York Region. There will be extra efforts include women from marginalized communities – such as, Aboriginal reserves, LGBTQ groups and women with disabilities. Key activities will include a review of literature, both academic and community-based, qualitative interviews and focus groups with survivors, and a survey for survivors and service providers. Evaluation will monitor and assess inclusion of 120 self-identified survivors, 30 service provides, a gender-based analysis of data, identified themes of positive and negative aspects of current service delivery, and a developed community action plan that details recommendations for improvement. Knowledge gained from this research will be translated through the following means: a final report, a 3-minute video, a well-developed social media strategy, a media release, service provider training, and findings will be shared through our networks (including the Building a Bigger Wave Network and Ontario Coalition of Rape Crisis Centres. Examining the needs of survivors, from their own perspective, is increasingly imperative as York Region. Now more than ever, we need to engage in quality, community-based research that explore these regularly unheard voices and establish a remedy to move forward with.
Janelle Anderson (Women’s Support Network)
Ashley Dunn (Women’s Support Network), Louise Gardiner-Vahey (Belinda’s Place), Jaspreet Gill (Social Services Network)
The purpose of this investigation is to determine the effectiveness of Mindfulness Based Therapy (MBT) in reducing the risk for postpartum depressive symptoms in a Northern Ontario community, Thunder Bay. As well, we aim to determine if MBT during pregnancy increase the overall wellbeing and quality of life (QoL) of first time mothers during their pregnancy and the postpartum period. In total, 116 participants will be enrolled. Participants will have an equal probability of being assigned to a brief mindfulness group (MG) or a Social Group (SG) through random assignment. The women in the MG will participate in four sessions of MBT during pregnancy, while the women in the SG will participate four theme based session (recipes, painting, scrapbooking, candle-making). Primary outcome measures pertaining to mental health symptoms, QoL, wellbeing, and mindfulness will be assessed pre- and post-intervention as well as at 2,4 and 6 weeks postpartum. It is expected that depression scores will be lower and QoL and wellbeing will be higher for women in the MG compared to the SG at the post-intervention assessment visit. As well it is expected that these trends will continue into the postpartum period. Knowledge translation of the intervention and study results will be done via workshops, meetings, telecommunication, conference presentations, and peer-reviewed publications.
Dwight Mazmanian (Lakehead University)
Carley Pope (Lakehead University), Abi Sprakes (Thunder Bay Counselling Centre)
Findings from numerous studies reveal that Aboriginal women continue to experience significantly higher rates of all types of violence when compared to non-Aboriginal women. Intimate Partner Violence (IPV) is particularly prevalent. The cycle of IPV is intergenerational and impacts on rates of depression, addictions, cervical and breast cancer screening rates, STDs, sexual abuse and violence, as well as child apprehensions and increased high school drop-out rates. Despite these enormous inequities, little research has focused on IPV in Aboriginal communities. In this study we propose community-based participatory methods based on partnership between five First Nations communities in Northern Ontario, a First Nations health agency and three academic researchers at the Northern Ontario School of Medicine (NOSM) to identify community and cultural strengths related to the prevention of IPV. With our depth and breadth of experiences, the research team is ideally suited for this project. We will use Photovoice, a methodology that invites research participants to use photographs as a way to share their narratives. This methodology stimulates social action, promotes group discussion on cultural facilitators and teachings, and identifies community strengths for healthy intimate relationships. Photovoice is a participatory research process, which fits with our overall research approach and also opens up a dialogue on IPV prevention. We will collaborate with a local advisory group. Our long term goal is to foster local empowerment to address IPV from a community perspective, reduce the serious issue of IPV in Aboriginal communities and to share these findings across Ontario.
Marion Maar (Northern Ontario School of Medicine)
Annie Kingston-Miller (Laurentian University), Belinda Bartlett (Mnaamodzawin Health Services), Leona Nahwegahbow (Mnaamodzawin Health Services), Debbie Selent (Mnaamodzawin Health Services), Iris Waboose (Whitefish River First Nation), Beaudin Bennett (Laurentian University)
Breast cancer (BC) is the most frequent cause of female cancer deaths worldwide. However although BC death rates have significantly declined globally in the past 20 years, women of African ancestry (WAA) have a disproportionately high BC mortality rate despite a lower overall BC incidence rate than Caucasian women. Intriguingly, one of the most aggressive and often fatal BC subtypes, triple negative BC (TNBC), is most common in young WAA but the reason for this racial disparity in TNBC prevalence is currently unknown and hints at unidentified ancestral genetic risk factors as the cause. The Olive Branch of Hope (TOBOH) Cancer Support Services conducted a survey of WAA) living in the Greater Toronto Area (GTA) on their understanding of breast health and BC in a project called "Shine the Light on Breast Health". WAA reported that they often didn't practice good breast health because of lack of information/understanding, and because the currently available resources were not culturally relevant to them as WAA. In this proposal, we seek to develop and conduct a community-based cancer awareness and education campaign for young premenopausal (18-45 years old) WAA using a multi-pronged approach – culturally relevant print and social media, weekend workshops etc. Our campaign seeks to influence change in WAA health practices by educating them about the importance of breast health, the signs of BC, the benefits of BC screening, early intervention, and prevention. We will also partner with physicians, and healthcare centers (hospitals, community clinics etc.) to provide insight regarding the unique cultural perspectives and needs of WAA.
Leila Springer (The Olive Branch of Hope)
Juliet Daniel (McMaster University), Dalon Taylor (Black Health Alliance), Winsome Johnson (A-Supreme Wellness Solutions), Blessing Bassey-Archibong (McMaster University), Shawn Hercules (McMaster University)
The Rural Women’s Heath Support Initiative (RWHSI) will develop, pilot and evaluate new resources for rural women volunteer leaders who in turn will support other rural women struggling with the burdens of caregiving and the high risk of burn out related health consequences. The project aims to promote family well-being by increasing coping strategies for caregivers at the core of family health who are often looking after their children, spouses, aging parents and/or other family members/friends. It will assist socially isolated community members to better navigate the complicated health and support services system. Education modules designed for community members/volunteer leaders will introduce the principles of health coaching, peer advocacy and health system navigation. Four one-day interactive skill development workshops will be facilitated in four communities across Grey-Bruce who have demonstrated interest in the project and have helped recruit the volunteer team for their area. Gateway and FWIO will work with their membership and other partner organizations to develop referral strategies to connect struggling caregivers with RWHSI volunteers. Social media, such as Facebook, will be used to engage volunteers in continuing education as well as to provide a virtual support group and resources for caregivers. The initiative is a `neighbours helping neighbours' approach to caregiving. Rural women caregivers will have a trained community `coach' to help them explore how to better look after themselves and the loved ones they care for. RWHSI evaluation research will provide valuable outcome feedback and help inform future programs promoting the health of rural women and their families.
Sheila Schuehlein (Gateway Centre of Excellence in Rural Health)
Andrea Morrison (Federated Women’s Institutes of Ontario), Feng Chang (University of Waterloo), Genevieve Obarski (The Change Foundation)
Housing First is a proven model to enhance health and social outcomes for people experiencing homelessness. Although gender is an important consideration within the homeless serving sector, Housing First has not been implemented with a focus on the unique needs of women, and participation in existing Housing First programs for women has been low. The Homes 4 Women program is a community service collaboration that aims to provide Housing First for 50 chronically homeless women in London, Ontario. Grounded in critical feminist theory, the purpose of this study is to conduct an evaluation of the Homes 4 Women program utilizing both community and individual level assessment. Research questions include community level: How has the community implemented Housing First for women? What are the benefits and challenges of service collaborations? How has implementation impacted the homeless serving system in London as it relates to women? Research questions also include individual level: What are the impacts on: housing stability, housing status, income and income source, health, access to healthcare, access to other supports, and community integration. This evaluation involves a trauma-informed participatory mixed methods design, and replicates a successful evaluative design used with a Housing First evaluation. Community level research questions will be addressed with qualitative methods including key informant interviews and focus groups with community stakeholders. Individual level outcomes will be assessed using both qualitative (i.e. interviews) and quantitative methods (i.e. questionnaires). A participatory approach will include women with lived experience throughout the study.
Abram Oudshoorn (Western University)
Shelley Yeo (Women’s Community House), Susan Macphail (CMHA Middlesex), Cheryl Forchuck (Western University), Tracy Smith-Carrier (Kings University College), Jodi Hall (Fanshawe College), Amy Van Berkum (Lawson Health Research Institute)
There is unequivocal evidence to show that participation in sport is lower among adolescent girls when compared to age-matched boys, and that among girls, ethnic minorities are particularly underrepresented in sport. Although constraints to sport participation among adolescent girls have been identified, little is known about the interaction of these constraints in diverse milieus where a wide range of factors interplay. Durham Region has recently experienced population growth largely as a result of the influx of newcomers, many of which are representative of ethnic minorities. The successful design of sport participation promotion programs for ethnic-minority girls that reside in the Durham region is dependent on research that examines interactions of sport constraints at the local level, and seeks to address them. In order to gain in-depth knowledge of this research area, our project aims to i) compile a list of previously identified constraints for sport participation among adolescent girls, ii) develop and administer a data collection tool on a sample of ethnic-minority adolescent girls (n=100) from Durham region, iii) incorporate Geographical Information Systems (GIS) analyses in order to objectively measure geographical and environmental features for each participant’s neighborhood, iv) conduct focus groups to gather in-depth understanding of potential programs or needs that have the capacity to increase sport participation, and v) disseminate this knowledge to end-users and policy makers. Knowledge translation will be used to increase sport participation among female adolescents who are of groups with additional constraints, for example, ethnic minority girls with low motivation and low self-efficacy.
Caroline Barakat-Haddad (University of Ontario Institute of Technology)
Shilpa Dogra (University of Ontario Institute of Technology), Nick Wattie (University of Ontario Institute of Technology), Melanie Stewart (BBBS Ajax-Pickering)
Wellington-Dufferin-Guelph Public Health (WDGPH) has developed, in collaboration with Boston Medical Centre, a patient-driven electronic preconception health (PCH) risk assessment tool called “My Health eSnapshot” using OceanWave software for primary care settings. The purpose of the research is to determine whether or not a patient-driven electronic PCH risk assessment tool for use during health care visits will increase PCH knowledge and behavior change among women of reproductive age (15-49 years). Participants will complete a 10-min PCH risk assessment prior to their healthcare provider (HCP) appointment using tablet technology. Participant responses are uploaded into their electronic medical record (EMR). The HCP will review the results reported in their EMR, and facilitate a discussion about their results and health recommendations. The HCP will print a patient handout from the EMR workstation for the patient to take home. This will include customized information and recommendations based on the participants’ response to the risk assessment tool questions. HCPs may also recommend a follow-up appointment to continue the conversation. Two follow-up surveys will be emailed to participants to evaluate the risk assessment tool, patient handout, and changes in participants’ knowledge and behavior for PCH risk factors identified in the risk assessment tool. Key informant interviews will also be conducted with each primary care site staff to identify the benefits, challenges and sustainability of implementing the tool. Results of the study will be shared with key stakeholders in public health, primary care and the Ministry through a variety of knowledge exchange activities. We will also explore implementation of this model across the province in primary care and public health settings.
Liz Robson (Wellington-Dufferin-Guelph Public Health)
Cynthia Montanaro (Wellington-Dufferin-Guelph Public Health), Lyn Lacey (Wellington-Dufferin-Guelph Public Health), Alexandra Fournier (Wellington-Dufferin-Guelph Public Health), Jennifer MacLeod (Wellington-Dufferin-Guelph Public Health), Patrick Seliske (Wellington-Dufferin-Guelph Public Health)
Refugee women and their children are among the most vulnerable migrants. Posttraumatic stress disorder (PTSD), anxiety, and depression are common mental health disorders in these women; yet remain unaddressed. They are at increased risk for adverse short- and long-term health outcomes. They are often single mothers, or very young women resettling on their own, or part of a family with several young children. Their risk status is further magnified by the lack of access to health care that they have endured during their migration trajectory, often over a lengthy period and through several countries. A study implementing a mental health screening tool among multiethnic, newly arrived refugee women receiving routine medical care in a dedicated community walk-in clinic for refugees is proposed. The UCLA PTSD Reaction Index for DSM V (UCLA-RI) is a widely used, culturally responsive, efficient, validated screening instrument that detects symptoms of emotional distress and PTSD across diverse populations and languages. An already established interdisciplinary community partnership (St. Michael’s Hospital and the medical clinic of the Canadian Centre for Refugee and Immigrant Health Care) can facilitate screening of refugee women in a manner that is sensitive to both culture and gender/sex needs. Given the large influx of refugee women to the Toronto area, and their unique physical, mental, economic and social concerns related to health, it is imperative that their individual health needs be fully understood in order to support delivery of optimal health care now as they begin to attempt a healthy resettlement in Canada.
Morton Beiser (Li Ka Shing Knowledge Institute)
Anne Mantini (Li Ka Shing Knowledge Institute), Paul Caulford (The Canadian Centre for Refugee and Immigratn Health Care)
Social inclusion has been identified as an essential aspect of recovery for people experiencing issues with mental health and addictions. Social inclusion connects people to essential services and economic, educational, recreational, and cultural opportunities. Recommendations for increased social inclusion recognize the importance of leadership opportunities, the effectiveness of peer programming, and opportunities for supportive employment. There is significant evidence that the arts serve to increase social inclusion by facilitating social engagement, increasing self-esteem and social skills, and by building social networks. This project explores the impact of peer-led arts programming on the social inclusion of women who have experiences with issues of mental health and addiction. The research will focus on 3 specific indicators of social inclusion: social connectedness; improved self-esteem; access to social and economic resources. The research will engage and train 6 peers to lead arts-based programming with other women who use drop-in services. The arts-based programming will be once a week for 6 weeks and each peer facilitator will co-facilitate 2 art workshops. Impacts will be examined from the perspectives of peer facilitators and workshop participants. A set of materials will be developed to further knowledge distribution between peers, including a training manual, sample arts curriculum, best practices for facilitation of peer-led arts programming, and an exhibit held in the drop-in. Learnings from this research will be shared via web and video platforms with other peer-led groups and organizations serving women and transgendered people experiencing mental health and addictions issues.
Tekla Hendrickson (Sistering)
Erin Howley (Artist), Theresa Morin (Sistering)
Breast cancer is a common illness, affecting over 25,000 women across Canada last year. Surgical decision-making can be a difficult, complex and personal process. Patients who are well informed about their treatment options are more likely to actively participate in the decision-making process. Current patient educational resources consist of text-based brochures and discussions in the clinic setting. There is a need for state-of-the-art online educational content to assist in explaining the indications, risks and benefits, preoperative preparation, and post-operative outcomes for surgery. The goal of this project is to develop and evaluate the use of an online educational video for breast surgery decision-making. This short video will incorporate illustrations and animations based on 3D models of the breast and axilla and depict different surgical options including nipple sparing and skin sparing mastectomy with reconstruction. The video will be freely available on the Internet, and patients can view the video at home or in conjunction with their surgical consultation. We anticipate that exposure to the video will improve patients’ understanding of their treatment options, allowing them to be better prepared to engage in the decision-making process, as well as improve their satisfaction after making their treatment decision.
Tulin Cil (Women’s College Hospital)
John Semple (Women’s College Hospital), Gordon Tait (Toronto General Hospital), Linda Kurjanczyk (Willow Breast Hereditary Cancer Support), Albert Fung (Toronto General Hospital)
The health of nail salon workers (NSW) is at a critical juncture, with the number of salons in Toronto expanding rapidly. Their workplaces are under-regulated and the health risks are significant. Many NSW in Toronto are female immigrants from either China or Vietnam. They are regularly exposed to chemicals known to cause cancer, respiratory and reproductive problems. Issues such as gender, language, income, and immigration status increase vulnerabilities. NSW are exposed to volatile solvents like toluene and phthalates but regulatory standards are lacking. The proposed project builds on the work of Queen West - Central Toronto Community Health Centre's (Queen West) previous WCH-funded project, peer-led workshops in salons, and the literature review of chemical exposures by the National Network on Environments and Women's Health (NNEWH). Reproductive health was identified as an issue of concern by Toronto NSW in our previous research; little research has been done about chemically influenced reproductive effects or harm mitigation. We have demonstrated that peer-led workshops can be an effective way of providing health and safety training to NSW. Research from California also supports the effectiveness of owner and worker trainings in salons. We will explore reproductive health issues facing NSW, and develop a training module to be delivered through peer-led workshops. Consultations and pilot testing will further improve the resources. Our project resources will be shared through partner agencies in communities across Ontario.
Angela Robertson (Queen West – Central Toronto Community Health Centre)
Cate Ahrens (Queen West – Central Toronto Community Health Centres), Anne Rochon Ford (York University), Mark Manh Nguyen (Vietnamese Association of Toronto), Caryn Thompson (South Riverdale Community Health Centre), Erica Phipps (Canadian Partnership for Children’s Health and Environment), Lyba Spring (Lyba Spring Sexual Health Education and Consulting Services)
This research aims to investigate health concerns of African women in Toronto with lived experiences of Female Genital Mutilation (FGM) and how their health can be improved through education. Uzima aims to improve the sexual and reproductive health outcomes for this group of women through exploring the needs of the women using focus groups and key informant interviews as well as testimonials to understand the factors affecting this population of women. By generating new knowledge, service providers, Educators and the wider community will have an increased understanding of ways to more effectively support this group of women. Objectives include learning about the experiences and health concerns of these women and creating awareness about the health risks among cultural communities and through various media to the wider Canadian society. Exploring perceptions and disparities affecting women living with FGM experience will help to address the health needs of these women more appropriately. It is anticipated that recommendations emerging from the research will include education, programming, and access to better health services. Understanding the sexual and reproductive needs of this population will lead to reduced stigma through sensitized culturally appropriate information sharing. The research team will work with a Community Health Centre offering services to African women in the community to ensure a continuum of services to these women through the CHC's Health promotion program. As well, this study may provide a foundation for future projects and policy implementations to reduce risks that women in FGM practicing communities may be subjected to.
Jacobet Edith Wambayi (Uzima Women Relief Group International)
Gillian Einstein (University of Toronto), Ebby Madera (Uzima Women Relief Group International), Fatuma Swaleh (Strategic AR Advisory Inc), Falastin Yassin (Horn of Africa Organization for Seniors), Esther Simon (Globalnet Community Foundation), Jennifer Muyia (Uzima Women Relief Group International)
Approximately 25,000 Syrian refugees will be granted refugee status in Canada; over 10,000 will settle in Ontario. The majority will be women and children, many of whom have been exposed to various forms of gender-based violence. In the context of limited or disrupted access to timely and appropriate supports and health services, such violence can result in long-term physical, mental, and reproductive health problems. We will address this concern by developing and evaluating a web-based portal to provide health-specific information and social support to this population in Ontario. The guiding research question is: What is the acceptability, accessibility, and usefulness of a web-based informational and social support portal by/for Syrian refugee women in Ontario? The portal, presented in Arabic, will comprise: information and links to resources; articles on women’s health topics; a community blog moderated by peers; and a health forum moderated by a nurse practitioner. Guided by principles underlying feminist research, this mixed methods study will incorporate community stakeholder involvement across all phases: Phase 1 includes focus group discussions with Syrian refugee women to identify their health and social support needs; Phase 2 focuses on developing, testing, and launching the portal; and Phase 3 evaluates the preliminary effects of the portal using a pre-and post-test design. This project will allow for improved access to informational and social support to Syrian refugee women in Ontario. We will work with stakeholders to disseminate results widely within the Syrian community in Ontario and the health, social, and settlement sectors in the province.
Sepali Guruge (Ryerson University)
Sarah Sharpe (QoC Health), Raja Khouri (Canadian Arab Institute), Suzanne Fredricks (Ryerson University), Joan Samuels-Dennis (Humber Institute of Technology and Advanced Learning), Meb Rashid (Crossroads Clinic), Souraya Sidani (Ryerson University)
Colonial forces, including the Indian Residential Schools (IRS) system, have changed the fabric of Aboriginal communities, through the erosion of relational, cultural and spiritual practices which allowed Aboriginal peoples to live healthful lives in the past. The violence perpetuated by colonial systems has had a significant impact on familial relationships in Aboriginal communities, leading to high rates of intimate partner violence (IPV). Aboriginal women are four times more likely to experience IPV than non-Aboriginal women. For women living on reserve, geographic and cultural isolation magnify barriers to access supportive services dramatically. Often, the only system that can provide support is an alien one, AWAY FROM FAMILY AND FRIENDS. IPV affects many facets of life of Aboriginal women and impacts on depression, addictions, low cervical and breast cancer screening rates, STDs, sexual abuse and violence, as well as child apprehensions and elevated high school drop-out rates. Our research question focuses on improving our understanding of IPV based on the lived experience of young Aboriginal people. In addition we seek to explore the impact of IPV on the health of Aboriginal women, their children, and their partners. The proposed research project involves community-based participatory research with Aboriginal women on Manitoulin Island. We use ethnographic and interview research methods to explore IPV in local context and begin a regional community dialogue. Knowledge translation involves a partnership with an Aboriginal theatre troupe. Using Improve theatre the team will help to erode the stigma surrounding IPV and its current status as a taboo topic.
Marion Maar (Northern Ontario School of Medicine)
Annie Kingston-Miller (Laurentian University), Belinda Bartlett (Mnaamodzawin Health Services), Leona Nahwegahbow (Mnaamodzawin Health Services), Debbie Selent (Mnaamodzawin Health Services), Iris Waboose (Whitefish River First Nation)
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