Celebrating the Results from the PLDI Impact Evaluation in British Columbia: A Message to Stakeholders and a New Webpage

We are excited to announce that the results from Pacific AIDS Network’s (PAN) impact evaluation of the Positive Leadership Development Institute (PLDI) in BC have been shared with BC’s PLDI community in a blog post and a new webpage on the PAN website!Screen Shot 2017-09-07 at 3.24.19 PM

As described in previous blog posts (see here and here), this community-led evaluation project explored the impacts of PLDI training for PLDI participants, PLDI sponsoring agencies and the ASO sector in British Columbia. PAN staff and a Steering Committee of PLDI stakeholders supported four peer evaluators in designing and conducting the impact evaluation, which collected data through an online survey, in-depth interviews with PLDI graduates and key stakeholders, and a focus group with PLDI trainers. The evaluation also included an analysis of the historical program evaluation data collected after each training session.

Click here to see the celebratory message that Jaydee Cossar, PAN’s PLDI Manager, shared with PLDI graduates when sending out the summary of findings from the PLDI impact evaluation. The results of the PLDI impact evaluation can be found on this webpage, which includes links to a final report for the Public Health Agency of Canada, a two-page summary of findings, a conference presentation, and training resources developed during and as a result of the PLDI impact evaluation.

If you have questions or comments about the PLDI impact evaluation, please contact Heather Holroyd, PAN’s CBR and Evaluation Coordinator, at heather@pacificaidsnetwork.org.

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British Columbia’s findings from the Food Security Study: A briefing note and fact sheet

The Pacific AIDS Network is pleased to share findings from the BC component of a CIHR-funded community-based research study that investigated the impact of food insecurity on health outcomes of people living with HIV in Ontario, British Columbia and Quebec.

As part of the knowledge-to-action activities for this project, a briefing note and fact sheet were produced. These documents provide some detail about the study and its key findings. The briefing note proposes the following set of recommendations for BCFoodSecurityStudy image of FactSheetincreasing the health and wellness for people living with HIV by decreasing food insecurity:

  1. Make food security a foundational issue in From Hope to Health: Towards an AIDS-Free Generation and in all future HIV-related strategies and policies. As part of this recommendation, require all health authorities to implement strategies to address food insecurity.
  2. Make funding food security programs and services an essential aspect of provincial STOP HIV/AIDS funding.
  3. Work with policymakers, industry, community-based organizations and consumer groups to develop a provincial strategy to ensure all British Columbians living with HIV receive adequate and nutritious food.
  4. The frontline work to help curb food insecurity is critical. Incorporate food support outreach services with sexual health and harm reduction programs to optimize access to adequate and nutritious food for people living with HIV. It is a fundamental right that anyone accessing HIV prevention or care services should have access to sufficient, safe and nutritious food.

If you have any questions about this study, its findings or recommendations, please contact Janice Duddy at janice@pacificaidsnetwork.org. More information about the study can be found at http://www.foodsecuritystudy.ca/.

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Reflections on CBR Principles: Focus on Outcomes, Self-Reflexivity, Evaluating the Practice of CBR

As part of our ongoing series on the CBR Collaborative CBR Principles we will explore the principle:

Focus on OutCBR Principles Reflexivity and Outcomescomes, Self-Reflexivity, Evaluating the Practice of Community-Based Research (CBR):  In order to ensure that we are working in the most effective way, it is important to step outside of the content of the research to evaluate how successful each project has been in supporting the CBR principles and approaches

Janice Duddy, PAN’s Director of Evaluation and Community-Based Research, had the opportunity to interview Zack Marshall, a member of the REACH Leadership Team and Assistant Professor with the McGill University School of Social Work, who has spent a lot of time thinking about CBR outcomes, self-reflexivity and evaluation and is leading the CBR Cohort Study that is part of the activities listed in the CBR Collaborative grant.

Q- Zack, can you tell me about the CBR Cohort Study?

Yes, it is a chance to study CBR from a different perspective. Instead of looking at individual study processes we are going to be looking at CBR across 30-40 studies – building a cohort of studies. Taking a meta-perspective will allow us to answer new questions about CBR. The challenge at the moment is narrowing down the questions or inquiries we want to prioritize. In the proposal we brainstormed a few ideas, including:

  1. What are the roles of peer researchers in CBR projects?
  2. What motivates people with lived experience to get involved with CBR?
  3. What is the impact of participation on peer researchers? How does involvement influence social determinants such as income, education, and housing, or outcomes such as mental health, substance use, and physical health?
  4. What supports do peer researchers find most beneficial?
  5. What human resource approaches do studies use to coordinate and manage CBR teams?
  6. Are there general, agreed upon principles of CBR in Canadian contexts?
  7. Why do people decide to use this approach?

I am really interested in exploring how people with lived experience engage in CBR and looking at some of the learnings across studies on the important role of peer researchers in planning, conducting, analysing and disseminating findings. We also need to understand the impact of CBR structurally. For example, the current structure of employing peer researchers in minimum wage positions with limited opportunities for advancement has been critiqued. The CBR Cohort Study will allow us to explore different models and practices in order to understand the impact of remuneration, training and advancement strategies across studies.

Q – Why do you feel it is important to evaluate how CBR principles and practices are being implemented?

We want to understand how CBR projects and findings are impacting policy and practice. But we also want to emphasize that we are not interested in creating or identifying a cookie-cutter CBR approach. Rather, we want to learn about the nuances related to using this type of research methodology and more fully understand: what works and what doesn’t work; what are the advantages and disadvantages; and what are the costs and benefits related to this approach. Let’s learn from one another, look at the gaps, and then use our creativity to build stronger and more honed models of CBR.

It is important to note that the cohort will include an emphasis on CBR projects related to HIV and harm reduction, but will be open to any CBR projects in Canada. Because we are investigating the impact of participatory engagement, this evidence from a wide range of focus areas is relevant and will allow comparisons across fields while increasing networking and learning across different types of participatory research studies.

Another peripheral benefit of this cohort is the potential to bring together a network of people doing similar work – linking across projects and regions, increasing communication and learning, and working to reduce isolation when doing this important community-based participatory work.

Q – How do you see the practice of self-reflexivity being most effectively used in CBR?

Being a CBR practitioner I believe that many of us engage in self-reflexivity a lot! CBR conferences such as CCPH or CU Expo often provide good opportunities to have larger discussions together, but we have not found many other ways of integrating our experiences beyond individual projects. For me, this is a further potential benefit of a network of studies. I don’t know how to do CBR without being self-reflexive – but being individuals or working in small teams we don’t always have answers and can get really stuck. This can lead to frustration and alienation. Working within a larger community of practitioners with a range of experience could help identify new resources, models, and ways of working.

Q- Do you think that CBR studies have a responsibility to focus on outcomes or learnings that will impact the real world? If yes, how do you see this demonstrated in work that you have done?

YES! It is important that CBR studies are action-oriented and we have a huge responsibility to demonstrate outcomes. If we can’t show that what we are doing has a benefit we need to do it differently. What types of outcomes and benefits are the elements we need to identify as a team. It doesn’t feel respectful to not reflect and change as needed, it is a dishonour and a disservice to CBOs, people with lived experience, and stakeholders who we partner with on research.

It is important to do more meta forms of analysis. Within the CBR field we have a tradition of examining the research process of individual studies. Community members and other stakeholders have invested a great deal of energy and trust in us as community and academic researchers. We need to step beyond one-off process analysis. With a CBR Cohort Study, we will examine these perspectives in a more integrated way that will allow us to gain deeper insights. This will allow us to identify opportunities for change that could more effectively impact systemic and structural factors.

Read our CBR principles here.

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Reflections on CBR Principles: Partnerships, Mentorship and Equity

“Partnerships, Mentorship and Equity: The best CBR is done when community members work closely with researchers who have strong training in methodologies, and when academics work closely with community members who understand the needs/concerns of populations most affected by HIV as well as the challenges of delivering programs and services. Through this process, communities learn more about research while researchers learn more about community. Experts in each context mentor one another. Within this structure, it is essential that power imbalances are actively recognized and addressed between a diverse set of partners.” hands-1939895_1280

On a Tuesday not that long ago, I had the privilege of attending a meeting on next steps for a community-based research (CBR) project led collaboratively by people with lived experience, academic researchers, community-based organization staff, and other key stakeholders. On the same night, I attended a dialogue on community-university engagement that focused on what the organizers described as “co-creating and/or mobilizing knowledge for a complicated world.” Attending both of these events on the same day (!) raised ideas about applying the CBR principle of partnerships, mentorship and equity, as defined above.

The working group meeting was an example of partnerships, mentorship and equity in action, as the group was actively brainstorming next steps for the research project based on their different sets of expertise. This group was coming together before launching the next phase of the project, in order to pool their skills and experience to collectively determine how they should proceed with the project in order to best meet the next set of research objectives. While there is always room to self-reflect and challenge the power imbalances that we bring to these encounters, this meeting was an example of what it can look like to co-create knowledge through research.

The more theoretical discussion that same evening revealed the power of language in framing these relationships. A participant asked the facilitator at our table of four participants to define knowledge mobilization, and she replied with “moving research from labs into community, for example.” The co-creation of knowledge, the other key term in the discussion question, went largely untouched; instead, the dialogue focused on knowledge mobilization as a tool to build more active community-university partnerships. This approach to knowledge mobilization, as the table was discussing it, seemed more oriented on sharing research findings with community after the fact and less so on involving community members throughout the process as equitable partners with potential interest in both mentoring and being mentored. Knowing that this group was committed and excited enough about community-university engagement to be meeting on a warm summer evening, I left the dialogue thinking how far we have to go in promoting the CBR principle of partnership, mentorship and equity as something to consider throughout the research process.

How can we decenter the concept of knowledge as being something that is mostly created by researchers and then shared back into community? Even with the best of intentions, it seems that the relationship between researchers and the communities involved in the production and application of research findings can leave much to be desired in terms of who is considered to know and who is considered as needing knowledge. Can changing our language about research partnerships shift our research practices, so that we reshape power-laden encounters between researchers and community members?

At an ancillary event for the 2017 Canadian Association of HIV Research, I heard the term ‘capacity-bridging’ for the first time and was deeply influenced by its meaning. Originally proposed by the Aboriginal HIV & AIDS Community-Based Research Collaborative Centre (AHA Centre), this term is an alternative to ‘capacity-building,’ in that it refocuses on the need to train all partners engaging in CBR projects, not just community members. While the term ‘capacity-building’ implies that community member involvement in research is a one-way mentorship of community members by researchers, the term ‘capacity-bridging’ reframes our understanding of the research (or evaluation!) encounter as being one that occurs between individuals who each bring a set of skills, knowledge and experience to the table. Superbly, the event captured the value of adopting a participatory, capacity-bridging approach even in bio-medical research projects where most of the research takes place in laboratory settings.

Reframing our understanding of community-academic partnerships as presenting the opportunity for mutual capacity-bridging raises our awareness of the extent to which projects are strengthened when we all come to the table ready, willing and enthused about bringing together diverse sets of experience and applying these learnings to the research process. In turn, this awareness facilitates projects that promote the principle of partnerships, mentorship and equity. While we have a way to go in seeing this principle applied as a widespread standard of research, REACH and the CBR Collaborative Centres are modelling the process and its valuable impact on research outcomes.

Read our CBR principles here.

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PAN at CAHR 2017: PLPH Shares Findings on Housing Services and the Importance of Stable Housing for Health

This post is our last of three in our series about Pacific AIDS Network’s (PAN) poster and oral presentations at this year’s Canadian Association for HIV Research (CAHR) Conference in Montreal, QC. The first post in the series focused on our impact evaluation of the Positive Leadership Development Institute and can be found here, and the second post discussed Jaydee Cossar’s oral presentation of the BC People Living with HIV Stigma Index’s research methodology and can be found here.Screen Shot 2017-06-15 at 10.00.30 AM

Co-led by Pacific AIDS Network and the University of Victoria, the Positive Living, Positive Homes (PLPH) study was invited to present two posters at CAHR 2017.

Darren Lauscher, a PLPH community consultant who has been involved with the study since its early days, presented a poster titled “A Critical Examination of Housing Services for People Living with HIV and Recommendations for Action.” This poster focused on study participants’ access and use of housing programs and services in the three PLPH research sites (Greater Vancouver, Kamloops, and Prince George). It also listed the recommendations that PLPH community partners suggested in response to issues that participants identified with some of these services, the foremost being confusion and frustration with navigating the subsidized and rental markets.

Screen Shot 2017-06-15 at 10.02.10 AMDevyn Flesher, PLPH’s Prince George Site Coordinator, presented a poster titled “HIV and Housing Histories: Using Timelines to Trace Connections between Housing and Health.” Devyn and the other site coordinators played a crucial role in honing the PLPH interview schedule to facilitate the creation of timelines to trace participant housing history. The site coordinators mapped the many housing transitions that study participants described in their interviews onto a simple linear timeline and added information about the points in time at which participants experienced illness episodes and/or periods of very good health. The timelines showed that unstable, unaffordable or inappropriate housing contributed to illness for study participants, while safe, affordable, appropriate housing contributed to better physical and mental health.

For more information on Positive Living, Positive Homes, please email Heather Picotte, the PLPH Study Manager who designed the posters, at plph@pacificaidsnetwork.org.

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A New Evaluation Resource: Peer Evaluator Training Manual

PAN is excited to introduce a new comprehensive resource on evaluation – the Peer Evaluator Training Manual! We hope this will be a good resource for PAN, REACH and other teams doing participatory evaluation work around the country. This resource will particularly be useful to those seeking to build evaluation capacity including teams that are working with people with lived experience and/or community-based organizations who haven’t done a lot of evaluation work to date. It was developed and piloted as a manual to train a team of peer evaluators at PAN for the PLDI program impact evaluation. Screen Shot 2017-05-08 at 1.15.39 PM

The Positive Leadership Development Institute (PLDI) is a well-recognized program in BC to support people living with HIV and AIDS (PLWHA) to realize their leadership potential and to increase their capacity to meaningfully participate in the community. PLDI is an exemplary model of implementing GIPA and MIPA principles, as the program is run by a team of PLWHA for their peers. Thus, an evaluation project to measure the impact of PLDI program also followed the GIPA and MIPA approach by hiring and training peer evaluators.

Using the Peer Evaluator Training Manual, the peer evaluators learned about  evaluation and different types, approaches, and methods used in evaluation. Peer evaluators also gained skills on how to: build an evaluation plan, develop and execute data collection tools; conduct data analysis; and share evaluation findings.

For those who are interested in engaging deeper into and learning more about any of the topics, the References and Resources document provides additional resources, broken down into the same chapters as the manual.

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PAN at CAHR 2017: The power of inclusive research methodologies, as presented by the BC People Living with HIV Stigma Index

This post is one of three in our series about Pacific AIDS Network’s (PAN) poster and oral presentations at this year’s Canadian Association for HIV Research (CAHR) Conference in Montreal, QC. The first post in the series focused on our impact evaluation of the Positive Leadership Development Institute aPAN CAHR Stigma Post Imagend can be found here.

PAN’s BC People Living with HIV Stigma Index Research Steering Committee was excited to give an oral presentation titled Emancipatory Participation: Active Change Agents in the Fight Against Stigma in the multidisciplinary session focused on community-based research and participatory approaches. The Research Steering Committee thought it apt to expound the methodological virtues of integrating GIPA/MEPIA vertically and horizontally across all aspects of the research design and implementation. As such, the presentation by Jaydee Cossar, PAN’s Stigma Index Project manager, highlighted the role PLHIV in conceptualizing the Stigma Index methodology and research schema, a level of involvement that adds a new twist to a core principle of community based research. The presentation stressed how the Stigma Index went one step further in the GIPA/MEIPA process by not only consulting PLHIV but by centring those living with HIV as active participants engaged meaningfully in all research activities: as research team members, core staff, interviewers, interviewees, and as drivers of the data collection, analysis, and dissemination. The main crux of the presentation postulated, vis-à-vis the Stigma Index research process of meaningful inclusion, that when efforts are made to embrace the unique and specific needs of PLHIV, individuals can break the layered and intersectional bonds of HIV stigma, becoming active change agents for their communities and themselves.

Keep your eyes out for our next post, which will focus on the Positive Living, Positive Homes study’s poster presentations at CAHR!

 

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PAN presents the PLDI Impact Evaluation and more at CAHR 2017

PLDI Impact Eval Poster imageThe Pacific AIDS Network (PAN) had the good fortune of presenting several research and evaluation projects at the recent Canadian Association for HIV Research (CAHR) Conference in Montreal, QC. It was a wonderful opportunity to meet, reconnect, and learn from a diverse group of researchers, people with lived experiences, funders, partners, advocates from across Canada (and we even met a few people from the United States!). Over the next several weeks, we’ll be providing a short series of blog posts describing PAN’s posters and presentation offerings at CAHR 2017. 
One of the three posters PAN presented at CAHR focused the peer-led impact evaluation of the Positive Leadership Development Institute (PLDI). This poster included preliminary findings from the survey, interview, and focus group data collected from PLDI participants, people living with HIV, and key stakeholders at PAN and partner agencies, as well as information about the participatory evaluation approach that guided the project. Thanks to funding from REACH 2.0 and the CBR Collaborative Centre, Paul Kerber and Heather Holroyd were able to travel to Montreal to present the poster. Poster visitors were especially interested to learn more about the PLDI program and its objectives, the impacts revealed by the evaluation, and about the method of participatory evaluation. Many visitors recognized the value of a leadership training program by and for people living with HIV (PLHIV) and commented that such a training program would be well-received in their region. Several visitors also expressed interest in accessing the ‘just-in-time’ training manual produced by the community based research and evaluation team at PAN to train the peer evaluators hired for this project. The training manual has been posted in English on the PAN website and will be posted on the Evaluation Toolkit on the REACH website. The training manual can be translated into French upon request. Please email Janice Duddy, PAN’s Director of Evaluation and Community-Based Research, with any questions or comments about the training manual.

 

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New Resource: Introduction to Realist Evaluation

The BC team is beginning to implement the Making It Work study funded through a CIHR CBR Catalyst Grant. The team has decided to use a Realist Evaluation approach to this work and as part of the team’s capacity building PAN has pulled together an introductory primer on Realist Evaluation.

What is Realist Evaluation?

Realist Evaluation is a theory-based approach that asks “How or why does this work, for whom and in what circumstances?” rather than just “what works?” The goal is to develop a detailed theory on how a program works and unpack the processes that are normally non-observable.

Realist-Eval-Figure-1

 

When to Use Realist Evaluation

  • New initiatives or pilot programs (or programs that seem to work, but for whom and how is not yet understood)
  • Programs for scale-up (to understand how to adapt the intervention to new contexts)
  • Programs that have previously demonstrated mixed patterns of outcomes (to understand how and why this is).

Visit PAN’s website to learn more.

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Responding to the Overdose Crisis in BC: A Rapid Assessment of Frontline and Advocacy Organizations’ Capacity- and Skills-Building Needs

Report coverOn April 14, 2016, Dr. Perry Kendall, the Provincial Health Officer, declared a public health emergency under the Public Health Act as a result of a dramatic increase in the number of opioid-related overdose deaths across British Columbia (BC) since the beginning of 2016. Because PAN’s member agencies and partners have been on the frontlines of responding to, reversing, and managing grief and loss related to overdoses, substantial time was spent discussing the opioid crisis and national drug policy at the PAN Fall Conference in October 2016. After the conference, PAN staff put together a Drug Policy Report summarizing these conversations.

Building on momentum from the conference and a strong desire to support the work already happening in community-based organizations (CBOs) across the province, PAN and the BC Centre for Disease Control (BCCDC) started a conversation about how PAN can best support progress on this issue. The discussion put into motion a rapid assessment to determine key capacity- and skills-building activities that would support frontline organizations responding to BC’s overdose crisis.

Key stakeholders from across the province, including people with lived experience, CBO staff, outreach nurses, and Regional Harm Reduction Coordinators, were invited to participate in the rapid assessment. Most invitees were eager to make time to schedule these 20- to 30-minute phone calls despite their stretched resources, commenting that they had prioritized this invitation as an opportunity to report on what they were experiencing in their organizations and to voice the needs of their staff, members and clients. This high level of stakeholder engagement in the rapid assessment speaks to a province-wide need for capacity- and skills-building activities, as well as other forms of sustained support, in response to this crisis.

The responses provided by the key stakeholders were analyzed and summarized in a report that will guide PAN’s next steps. If you are interested in reading the results of the rapid assessment, please click here to download the report.

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