Two-Spirit, lesbian, gay, bisexual, trans, queer, intersex, and asexual (2SLGBTQIA+) people experience discrimination in their daily lives that contributes to poorer health and well-being. Health service settings are common sites of discrimination for 2SLGBTQIA+ people, who often feel unsafe and fear poor treatment within the health system, which leads to an unwillingness to access essential health services altogether.
In response to the need for safe and meaningful health services for 2SLGBTQIA+ people, Island Health has launched a revolutionary role: the 2SLGBTQIA+ Liaison Nurse. To our knowledge, Island Health is the first health authority in Canada to develop a role specifically designed to offer support and guidance for 2SLGBTQIA+ people accessing and navigating the health system.
This feasibility project will use community-engaged mixed-methods to (i) explore how the Liaison Nurse supports 2SLGBTQIA+ community members (including specific approaches and strategies), and (ii) learn about the experiences of 2SLGBTQIA+ community members who have received support from the Liaison Nurse during their health care journey within Island Health. We will host a Community Forum to share project findings and engage in conversations about directions for potential growth to support implementing the role across other health authorities in B.C.
This project has been generously supported by the Health Research BC Health Equity Grants Program and is led by Dr. Ingrid Handlovsky and Dr. Allie Slemon, Assistant Professors in the School of Nursing at the University of Victoria and Chandra Berkan-Hozempa, Director of Diversity, Equity and Inclusion at Island Health. For more information on the project, visit the AdJust Research Collective website.
Youth with complex mental health and neurodevelopmental differences benefit from diverse opportunities to practice using coping strategies. These youth also benefit from therapeutic opportunities that leverage internal motivation to participate, so it’s important for them to have fun in therapy. It’s also important for these youth to trial the use of strategies in peer-based environments that offer flexible levels of instruction and support.
Current service formats do not meet these needs, so Sonya’s team will evaluate the use of tabletop roleplaying games (TTRPGs) for therapeutic purposes in outpatient youth mental health settings. TTRPGs are saturated with humour, risk-taking, and creativity. TTRPGs bring players together to solve problems. The problems evolve and are shaped based on participant choices and interests, and solving the problems is an inherently social task. This means that TTRPGs manifest many of the same social demands and challenges that youth encounter at home and at school. In this sense, TTRPGs are a natural vehicle for bridging the gap between outpatient treatment and real-life function.
Together with youth and their families and carers, the team will explore TTRPGs as a natural creative space in which youth can learn to self-monitor, self-regulate, and advocate for themselves.
Parkinson disease (PD) is a chronic and progressive neurodegenerative condition. The wait time to see a provider at the Parkinson’s and Movement Disorders Clinic at the Royal Jubilee Hospital in Victoria, BC is 24 months. Because PD is progressive, changing symptoms can be difficult to manage in between appointments, leaving individuals feeling unsupported and adjusting their medications without guidance.
To address this need, this research project will evaluate the impact of integrating a pharmacist into the interdisciplinary team at the Parkinson’s and Movement Disorders Clinic at the Royal Jubilee Hospital in Victoria. A committee of individuals with PD and care partners/caregivers will be fully engaged throughout the project to help ensure that the integration of the pharmacist into clinic operations will effectively address the health needs of the PD community.
Prior to initiating the pilot phase, individuals affected by PD and team members of the clinic will be providing their input and feedback on the gaps that need to be addressed pertaining to the provision of care. The pilot phase will then implement the integration of the pharmacist on the team. Finally, the research team will evaluate the impact on workflow and efficiency from both the patients’ and clinic staff perspectives, enabling them to identify effective and meaningful solutions.
It is well-established that Two-Spirit, lesbian, gay, bisexual, trans, queer, intersex, and asexual (2SLGBTQIA+) people are subject to discrimination within healthcare settings, leading to poor health outcomes. In fact, these instances of discrimination are growing in context of rising hate toward the 2SLGBTQIA+ community. In response, the Island Health Authority has recently launched a revolutionary role: the 2SLGBTQIA+ Liaison Nurse. This Liaison Nurse works directly with 2SLGBTQIA+ patients in the healthcare system to support: navigating the system, advocating for services, ensuring a safe and respectful healthcare encounter, and accessing gender-affirming care. Our larger project will involve scaling up and implementing this role across additional healthcare sites in BC, and evaluating the role to ensure safe, quality, and equitable care for 2SLGBTQIA+ people across the province. Funding through a C2 grant will support bringing together health authority, community, and researcher representatives to develop a comprehensive research plan for implementing and evaluating this role. In particular, funds will support a 2-Day Intensive in Vancouver to support necessary conversations in support of the project’s next steps.
Young people living with mental health challenges are often hospitalized as a part of their journey in engaging with supports and services to improve their mental health. These experiences of hospitalization can be traumatizing, however, especially if young people experience seclusion: confinement of a person in an isolated, locked room to minimize harm and promote safety. There is a growing need to prevent the use of seclusion among young people in inpatient mental health settings. Our project will build on knowledge gained from a previous research study exploring the perspectives of healthcare providers and young people with mental health challenges to better integrate seclusion prevention strategies in inpatient mental health settings. To achieve this, we will host a one-day session that will bring together healthcare providers, young people, and researchers to identify seclusion prevention strategies. These strategies will then be directly embedded within a new Young Adult Mental Health Inpatient Unit within Island Health, in Victoria. They will also be shared with healthcare providers and students nationally and globally through a webinar, educational module, and an academic publication and conference presentation.
Using as a focus-point one of the Walk With Me team’s recommendations identified in multiple of its research reports — to strengthen Peer Leadership within Island Health — the Project Team will:
a) Co-create a knowledge translation workshop for Island Health managers focused on Peer Leadership (ie: why Peer Leadership is an essential ingredient in the pursuit of an equity-conscious health system; how Peer Leadership might be incorporated and supported by Island Health; strategies to ensure success of Peer Leaders, etc.)
b) Co-deliver this presentation to at least 5 teams of Island Health managers, and
c) Work with managers to strategize the implementation of Peer Leadership plans.
This project aims to support meaningful collaboration with Island Health and the Nanaimo Division of Family Practice in order to co-develop a social prescribing program. Social prescribing is a model of patient-centered, team-based care that aims to link individuals with community services to address their non-clinical health needs.[1] By leveraging social prescribing, Island Health and the Nanaimo Division of Family Practice aim to address social and material determinants of health by building low-barrier referral pathways for “social prescriptions” within the Nanaimo region. Examples of social prescriptions include Parks and Recreation passes, referrals to job programs, and other types of social and material support. In order to implement social prescribing in the Nanaimo region, we propose the co-design of Connect Rx, an online platform that will facilitate social prescribing (See prototype at www.casch.org/connect-rx). To accomplish this, we will (1) identify community assets and social prescriptions in Nanaimo, (2) convene health and community service providers to participate in the co-design of Connect Rx, and (3) co-develop an evaluation that can be used to assess the acceptability, feasibility, and efficacy of Connect Rx.
Nurse Practitioners (NPs) have practiced in BC since 2005, predominantly in primary care settings. Our completed C2 grant addressed the facilitators and challenges for integration of NPs into primary care in Island Health from the perspective of Island Health NPs, family practitioners, the MOH Nursing Policy Secretariat and Nurse and Nurse Practitioners Association of BC (NNPBC). During that grant, the health care environment in BC became more resource depleted in both primary and acute care settings. Demand for NPs in acute care are driven by shortages of hospitalist physicians, gaps in integrated care models, patients utilizing emergency departments for primary care, and unresolved challenges related to alternative level of care (ALC) patients occupying acute care beds. This environment has created unprecedented demand for NPs and CNSs within acute care settings. A MOH strategy for optimal NP utilization in acute care settings does not currently exist, and NP education programs in BC have curriculum gaps preparing NPs for acute care roles. We aim to leverage established relationships between NPs, Island Health, UVic, MOH & NNPBC to map the model of care, resource supports and educational preparation for NPs in acute settings.
The nine Coast Salish and Nuu-Chah-Nulth nations of southern Vancouver Island have supported diabetes prevention and management with a variety of programs; however, the rate of diabetes continues to rise. Our goal is to engage with the nine First Nations communities through one-day gatherings to identify the assets, experiences, barriers, and gaps within each community, and integrate culture and language into a community-led model for diabetes prevention, treatment and management. We aim to co-create a framework for a diabetes prevention and care model that is community-driven, improves diabetes services at the local level, and supports nation-based self-determined approaches to diabetes prevention and management. It is imperative that we prioritize this work and align our efforts to explore a collaborative, decolonized approach to diabetes care. Our model will enhance the culture and resilience that is already present within our communities and bridge gaps in care to develop a diabetes strategy that can support our question of “How can we be who we are as First Nations people while integrating our Traditional knowledge with the best of Western approaches to diabetes care?”.
Team members: Valerie Bob (Simon Fraser University); Gwen Underwood (Saanich First Nations Adult Care Society); Marie Va’a (Tsartlip First Nation); Emily Doehnel (Tsartlip First Nation); Lois Williams (Tsawout First Nation); Kelli Telford (Tseycum First Nation); Kinsey Goertz (Tseycum First Nation); MaryAnn Daniels (Pauquachin First Nation); Jessie Jim (Songhees Nation); Hayley Moreau (Songhees Nation); Chris McElroy (Songhees Nation); Jeneen Hunt (Esquimalt Nation); Stephanie McMahon (Esquimalt Nation); Krista Johnny (Scia’new First Nation); Angie Gibson (Scia’new First Nation); Rose Dumont (T’sou’ke Nation); Jennifer Routhier (T’sou’ke Nation); Grant Robinson (Island Health); Penny Cooper (Island Health); Ashley Simpson (University of Victoria); Jennifer Murray (UBC); Brenda Bartleman (Tsartlip First Nation); Judith Atkin (Island Health); Amanda Henry (Island Health); Carol Hill (Pacheedaht Nation); Tara Claxton (Pacheedaht Nation); Rachel Dickens (Nuu-Chah-Nulth Tribal Council); Mathew Dueck (First Nations Health Authority)
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Co-lead:
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Team members:
- William Cunningham
Island Health
- Patti Telford
Nurse & Nurse Practioners of BC
- Zachary Matieschyn
BC Ministry of Health
- Christina Berlanda
Island Health
- Shelley Tice
Island Health
- Danielle Daigle
Nurse & Nurse Practioners of BC
- Angela Wignall
Island Health
- Jinelle Woodley
Island Health
- Steve Goodchild
Island Health
- Brenda Warren
Island Health
- Leanne Rowand
Main Island Health Centre
- Lorine Scott
FNHA
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Nurse Practitioners (NPs) have practiced in BC since 2005, and are qualified to provide holistic primary care across the life span, similar to primary care physicians. Until 2018, NPs were health authority employees in salaried positions; in 2018 the MOH announced 200 new community NP positions and a contract payment structure option. Numerous contracted NP positions have since been introduced in Island Health. Integrating contracted NPs into an established primary care model traditionally provided by doctors has exposed unique challenges, opportunities and unintended outcomes. Although all stakeholders have generally worked well together, unanticipated conflicts and inefficient work flow impacts have arisen. Integrating inter-professional scopes of practice into an efficient and seamless system of innovative primary care in context of mixed expectations has been challenging. Published evidence suggests that full NP role optimization is affected by practice environments. We aim to develop a research plan to identify the enablers, challenges and unexpected outcomes, and determine how innovative processes enabling focused collaboration, clear scope of practice and improved teamwork can improve flow and access in primary care.
