COLLABORATIONS AND SOLUTIONS IN HIV, HCV AND STI RESEARCH

British Columbia

How Do We Measure Success? Developing Shared Outcome Tools for HIV Supportive Housing Services in Western Canada

A multi-province team spanning Western Canada has utilized a participatory program evaluation approach to develop shared outcome tools for HIV supportive housing programs. The team developed the tools to demonstrate how their programs improve not just the physical health of people living with HIV, but also their quality of life.

Baseline intake and follow-up tools were developed through a series of participatory workshops, interviews, and meetings that included frontline staff, clients, and the family members of service users. The aim of this process was to collaboratively build relevant outcome measures that were useful to services users and front-line staff, and were capable of demonstrating change over time among clients.

Led by Floyd Visser (The SHARP Foundation) and Dr. Cathy Worthington (University of Victoria), this project brought together service providers from across Western Canada. Service providers included Sanctum Group from Saskatoon, and McLaren Housing Society and the Dr. Peter AIDS Foundation from Vancouver. Additional partners included Dr. Brent Oliver (Mount Royal University), Dr. Hart Krentz (Southern Alberta HIV/AIDS Clinic), Janice Duddy (Pacific AIDS Network), and an HIV positive peer.

In addition to developing useful tools, the collaborative nature of this project enhanced provider-provider relationships in Western Canada. The project facilitated opportunities for providers to learn from each other, and to work together in strengthening supportive housing programs for people living with HIV.

Read more about this project, and other REACH 2.0 initiatives here.

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BC’S Work to Build Evaluation Capacity and Improve Community-Based HIV and HCV Services – REACH Significant Change Story

In BC, the Pacific AIDS Network (PAN) have been making progress on the objectives of REACH 2.0 by developing internal evaluation capacity, knowledge and skills.

Creating foundational structures and human resource expertise has allowed PAN to support other member and partner organizations’ evaluation needs. Extensive evaluation work has taken place with and on behalf of a number of BC health authorities (including Northern Health); community-based organizations; and PHAC-funded community alliances and grant holders. PAN was also able to leverage REACH’s infrastructure and to support several evaluation projects through fee-for-service contracts.  This work has created a stronger culture of evaluation in BC and has created focus and enhanced collective capacity for evidence-informed program planning and implementation especially at the level of community-based services and programs.

 To highlight this evaluation work in more depth, PAN has worked collaboratively with three different BC health authorities to build shared measurement frameworks for their community-based, contracted HIV and HCV organizations. The consistent collection of information (data) across all members of the group allowed each agency/organization to learn more about their own programming and the gains made collectively.  It also allowed the group to identify gaps and opportunities for improvement at higher levels (e.g., sectoral or geographical levels) within each health authority region. This approach allowed for a stronger network to be built among partners, which has facilitated ongoing learning and quality improvement across sectors. Evaluation data have been used to inform decision-making, improve services, and build on successful practices.

You can read more about this change story on PAN’s website.

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Shared Measurement Evaluation and Network Approach to Working Together

We have written a blog post and hosted a webinar about shared measurement evaluation framework. In continuing to share our work in this area, we are pleased to share with you a project we undertook in northern British Columbia (BC).

In 2016, Northern Health (NH) undertook a request for proposals to increase the geographic reach of community-based HIV and hepatitis C (HCV) services beyond one urban area, where most of these services had been located historically. NH provides health services to nearly 300,000 people dispersed across an area of 600,000 square kilometre in the northern two-thirds of BC. A total of $1.56M was awarded to 11 community-based not-for-profit and First Nations health organizations who now offer education, prevention/harm reduction, testing, case management, treatment and support services across the region. NH also established the HIV/HCV Specialized Support Team (SST) in effort to support and integrate primary, community and specialized services for HIV and HCV across northern BC.

NH took a unique and innovative approach by developing the Northern HIV & HCV Network (i.e. the Network) to facilitate sharing of learnings and best practices amongst the contracted organizations. The Network members included NH staff including members of the SST, and representatives from the eleven NH-contracted organizations, the First Nations Health Authority, and the Pacific AIDS Network (PAN). The Network meets on a quarterly basis to provide program updates, share information/tips, and strategize around common issues faced by NH-contracted organizations.

NH contracted PAN to develop and implement a shared measurement framework to evaluate the important work community-based organizations and the SST have conducted and the impacts they have created on their clients (e.g. in relation to quality of life and social connectedness). This evaluation also assessed the network approach to working together and built evaluation capacity of HIV/HCV community-based organizations in northern BC. A shared measurement evaluation framework was developed and data was collected using two survey tools: a survey for the NH-contracted organizations and the SST, and a client survey for people living with or at risk of acquiring HIV and/or HCV.

Key findings from this evaluation, and lessons learned from employing network approach and utilizing shared measurement framework were presented at the 2018 Canadian Association for HIV Research (CAHR) Conference. Please have a look at the Nurturing an Innovative Network in Northern British Columbia: Building Connections and Learning from a Novel Shared Measurement Evaluation poster.

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BC CBR Quarterly — CAHR 2018 Ancillary Event

The BC Community-Based Research (CBR) Quarterly Meetings (referred to as the CBR Quarterly Meetings hereon) is a community of practice that gathers three to four times a year to share learnings, challenges, and best practices related to CBR, evaluation, and knowledge translation/sharing initiatives. Meetings are organized by Pacific AIDS Network (PAN) staff, hosted by McLaren Housing Society, and attended by community members and researchers (including peers), community-based organizations, students, and academic researchers.

At the 2018 Canadian Association for HIV Research (CAHR) Conference, this diverse group held a demo, participant-observation CBR Quarterly Meeting as an ancillary event to inspire others to think about the value of peer work in research and the benefit of collaborative spaces in the uptake and integration of research findings into practice. The ultimate hope for this event was to excite others to consider modeling similar communities of practices in other regions of Canada.

So on the morning of April 26, a group of 21 participants gathered for this event. A background document outlining the history and timeline of the CBR Quarterly Meetings developed by PAN representatives was shared, demonstrating the impacts and accomplishments of this community of practice since its inception in 2010. Some of the high-level impacts shared included peer mentorship and support, networking, access to academics, capacity building, and collaborative brainstorming/problem-solving.

Peers of two CBR projects shared their experiences and perspectives, and it was incredible to document the positive impacts peer work has had on both the CBR projects and the Peer Research Associates (PRAs) themselves. PRAs from the SHAWNA Project highlighted building skills in various areas of research and meaningfully contributing to all stages of the project, while feeling well supported within their own team and also through the CBR Quarterly Meetings. Similarly, the team from the Oral History Project (that started with a community meeting, HIV in My Day: Reflecting Back, Looking Forward) emphasized the importance of embodying CBR principles from the beginning stages of CBR, allowing for a balance between academic and peer voices. PRAs from this project said they were honored to gather and listen to the stories of long-term survivors and caregivers of the early days of HIV/AIDS epidemic, and found this experience meaningful in terms of continuing to engage in the battle against HIV.

PAN staff used two CBR studies – Positive Living Positive Homes (PLPH) and The BC People Living with HIV Stigma Index Project (Stigma Index) – to showcase how CBR findings can influence programming/future work and be mobilized into action. The PLPH peer knowledge translator shared how the study findings increased people’s awareness around the important link between HIV, health, and housing; provided evidence of various advocacy efforts by PAN and partner organizations; and are being translated into useful resources and tools for people living with HIV (PLHIV) and communities (including service providers). The Stigma Index peer knowledge translator shared how the project team is using the gaps identified to inform the project’s future directions (i.e. gathering qualitative data to complement its quantitative data), and how learnings from this BC project (the first in Canada) are now being shared with/informing the national project.

Following the usual format of the CBR Quarterly Meetings the meetings participants were provided with time to network and the AHA Centre and the Dr. Peter Centre exemplified project/program updates – providing a brief summary of the program and sharing one success, one challenge, and one lesson learned. Overall, the event was well-received by the participants, who shared that BC folks know how to make CBR fun and that they are excited and inspired to go do research. The agenda and minutes from this meeting can be found here.

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PAN Presents: Positive Living, Positive Homes at CAHR 2018

Mona Lee from PAN

The 2018 Canadian Association for HIV Research (CAHR) conference was held in Vancouver this year, and representatives from our community-based research team were on hand to share data from some of our work.

Data from Positive Living Positive Homes was presented at an oral abstract session and in poster format.

To see the the poster in greater detail.

 

Learn more:

Positive Living, Positive Homes project page
Community-Based Research and Evaluation at Pacific AIDS Network

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PAN Presents: The BC People Living with HIV Stigma Index Project at CAHR 2018

Tabitha Steager (Research Coordinator) and Antonio Marante (Knowledge Translator) from PAN

The 2018 Canadian Association for HIV Research (CAHR) conference was held in Vancouver this year, and representatives from our community-based research team were on hand to share data from some of our work.

Information from The BC People Living with HIV Stigma Index Project was presented in two poster  sessions. We presented one poster about the experience of the study process for peer research associates, and one that noted some key findings about confronting stigma and discrimination (scroll down to see a preview).

To see greater detail in “From Darkness to Light,” about the process of the research.

To see greater detail in “Confronting Stigma and Discrimination” with some initial results from BC’s study.

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New Implementation Science Research Design Tool

The Centre for Implementation Science at King’s College London has recently developed the ImpRes Tool. Its purpose is to support research teams who are in the process of designing implementation research and work to implement evidence-based interventions into practice.See: http://www.kingsimprovementscience.org/files/ImpRes_Guide_April_2018.pdf?utm_source=EIC+Stakeholders&utm_campaign=7c2e35f8b4-EMAIL_CAMPAIGN_2018_04_22&utm_medium=email&utm_term=0_ea81bd44fe-7c2e35f8b4-295895941

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MB HIV Collective Impact Network April Symposium Great Success!

A Great Success!
The Symposium was an overwhelming success with over 95 people in attendance on April13. The purpose of the event was for knowledge exchange, idea generation and for network building. We had people from Saskatchewan, Ontario, Nova Scotia as well as people from all over Manitoba!
We were pleased to have 18 posters including a quilt as a poster!
We particularly appreciated the many out-of-town presenters and participants who were able to attend.
Many thanks to all the helpers who made this happen: including volunteers, staff, students, & our Stewardship Team.
We will be preparing a report. Watch for it in our next Monthly e-news in June!

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Pets a Key to Health, Positive Living Positive Home Study Confirms

The Positive Living, Positive Homes (PLPH) study in BC has been actively sharing its findings in its final research phases. One of the ways we have been sharing findings is through holding gatherings at various community-based organizations that helped and supported us throughout the study. We recruited participants living with HIV at these organizations, and service providers of these organizations participated in the study too. Some of these organizations also kindly hosted us by providing us with private and confidential spaces so our participants felt safe and secure in doing in-depth interviews.

Pets came up as one of the key themes out of the interviews with people living with HIV (PLHIV).  Not surprisingly, pets were a very popular topic at the recent community gatherings amongst attendees (including people with lived experience, people from communities who are interested in and are advocates for HIV and/or housing, and service providers). When we asked folks in the room to raise their hands if they owned a pet, close to half (at one meeting) and more than half (at another meeting) raised their hands. As the rooms spoke and as our data speak, pets are a huge part of people’s lives.

For the PLPH participants living with HIV, pets promoted health in many ways. Some of our participants said that their pets, especially dogs, keep their physical health in check because they have to go outside to walk the dog and let the dog do its business. This meant that the participants were also walking too. Also, our participants who own a pet shared that their pets are critical to their mental health. Their pets allowed them to feel less isolated, and the connection and love they have with their pets really helped them feel better. One participant shared,

“I’ve had depression my whole life. I go through cycles. And I know that my dogs keep me from isolating myself, because they have to go out to go to the bathroom, so they keep me engaged in the world, and just their company is really quite comforting. So they’re very important to me.”

But sometimes, having pets mean being denied for housing. Here is what one participant said,

“I went to go try another [rental], they said ‘No,’ they won’t let my dog. I love, love my dog.”

This participant was not able to rent because of a “no pets” policy. This is an important area of advocacy for our sector and beyond – our system should support us to keep those facilitators of health close to us and one should not be denied housing because of pets. There is a petition to “End “No Pets” Policies in British Columbia” if you are interested in adding your voice to this movement.

Watch for more PLPH findings in the coming weeks on PAN’s website!

Written By: Mona Lee

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Positive Living, Positive Homes: Presenting Community Research with Data Placemats

The Positive Living, Positive Homes study is now in its final phases of knowledge sharing! Over the next several weeks, look on the PAN website and in your PAN e-news for findings from this innovative, community-based research study that’s been active in Prince George, Kamloops, and Greater Vancouver since 2015.

Today we present the “data placemats” generated throughout 2017 for our consultations with the site communities.

These placemats are based on PLHIV (people living with HIV) participant responses to initial interviews, conducted between 2015 and 2016 in the three case study communities. Participants living with HIV were interviewed a second time (2016-2017) and we are currently generating findings about housing experiences over time. We look forward to sharing those results in future blogs, and at the 2018 Canadian Association for HIV Research (CAHR) conference in Vancouver on Friday, April 27.

 

View data placemat from Prince George

View data placemat from Kamloops

View data placemat  from Vancouver

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