Samantha Magnus: Internship with Northern Health explores health equity, community engagement

Every Child a Winner/ Northern Health
Northern Health's health promotion initiative "Every Child and Coach a Winner"

During my internship this summer (May-Aug), I had the privilege of engaging with Northern Health’s Population Health team to apply an equity lens to a region-wide health promotion initiative for child and youth called “Every Child and Coach a Winner.” Now in early pilot phases, this initiative aims to improve outcomes for children and youth by encouraging engagement, dialogue and upstream thinking for coaches, teachers and community champions in Northern communities.

Working with an ambitious and new initiative designed for impact through community engagement presented a fantastic learning opportunity. I strove to select a health equity framework that would support incorporating health equity both into the content or ‘curriculum’ of the initiative and the engagement process with communities. With several contenders, my final selection was the Five Building Blocks for Equity in Collective Impact – developed and piloted in the United States for structured strategic and fiercely collaborative equity-based work – to facilitate reflections on the part of the Population Health team across the domains of (1) Shared Language, (2) Disaggregated Data, (3) Structural Analysis, (4) Systematic Application and (5) Effective Communication.

With valuable feedback and support from my supervisor Loraina Stephen at Northern Health, I presented the building blocks framework to the team, planned a two-part workshop (including pre-reading materials), facilitated the workshops in-person in Prince George, conducted several separate interviews (in-person and over the phone), presented final recommendations, and submitted a final report. Ongoing reflection and documentation helped to enrich my learning and preserve the internship process for future use.

As an overall outcome, I am pleased to say that the “Every Child and Coach a Winner” initiative is moving forward with explicit health promotion and health equity goals, as well as a wealth of recommendations for how to get there in both its core content and its engagement or implementation process. Further, the enthusiastic participation of the Northern Health team in conversation about multiple dimensions of health equity promises to have ripple effects throughout the region.

Sarah Wojcik: Peer Engagement and Evaluation Project (PEEP)

During the summer of 2015, I had the privilege of working as an Equity Lens in Public Health (ELPH) Graduate Student on the BC Centre for Disease Control (BCCDC)’s Peer Engagement and Evaluation Project (PEEP). Broadly speaking, PEEP is a research project working towards improving equity in harm reduction services within the five health authorities of British Columbia through a process called peer engagement. Peer engagement acknowledges that peers, or with people who use drugs, have the knowledge and lived experiences to participate as active experts in policy, programming, and decision-making capacities. I was fortunate enough to be mentored by Alissa Greer, a PhD student at UBC’s School of Population and Public Health (SPPH), Dr. Jane Buxton, Harm Reduction Lead at the BCCDC), and Dr. Bernie Pauly, Associate Professor, School of Nursing at UVic and Principal Investigator of the ELPH project (and my current MSc. thesis supervisor!). The role I played as an Intern was to conduct an environmental scan of different practices of engagement between peers and harm reduction service providers at an international, national, and local level. The environmental scan I conducted throughout May and June included a review of peer-reviewed and grey literature, websites, and social media sources of various drug user organizations and other peer groups. The Project Report I completed as my main ELPH Internship deliverable highlighted the main findings from this scan. It is relevant to policy makers and researchers who seek to better understand peer engagement more broadly, and user involvement as it pertains to drug-user organizations specifically, with the hopes that it will catalyze the development of better harm reduction interventions involving people who use drugs in British Columbia. Findings from my scan yielded four main themes. These themes include: factors and facilitators contributing to the success of peer engagement; challenges and barriers   associated with peer engagement; examples of unique peer engagement practices; and finally, factors   contributing to the sustainability of peer engagement and drug-user organizations. Overall, my experience as an ELPH Intern working with the PEEP team has been a tremendously positive one. I was able to expand my knowledge of health equity and the barriers to health that people who use drugs often experience as a historically marginalized and disenfranchised population. Most importantly, I learned how peer engagement can act to uphold and promote the health equity of people who use drugs with the hopes of improving their overall health outcomes.

2013/2014 ELPH Internships

In 2013/14 ELPH supported four Research/Policy Internships linking graduate students and other interested researchers with knowledge-user partners in the health authorities.

Vancouver Coastal Health: Assessing Community Needs and Assets – a Prototype Protocol for the SMART Fund with Intern Peter Greenwell.vch smart fund logo

Vancouver Coastal Health’s SMART Fund is a health promotions community grants program aimed at reducing health inequities by supporting the most vulnerable and marginalized populations in the region.

Internship Objectives:

  1. Develop a self-assessment tool on leadership and adaptive capacities for organizations funded through the SMART fund
  2. Identify relevant community health data for decision-making and planning

Peter met with a representative group of funded programs for the development and testing of an organizational capacity assessment tool and identified the Vancouver Coastal Health Population Health Surveillance Unit’s My Health My Community  survey as a key data source as it provides neighbourhood level health data that considers social, economic and physical aspects of the neighbourhood. The internship provided Peter with an opportunity to develop an applied research tool to assist organizations doing work focused on reducing health inequities. 

Provincial Health Services Authority: Health Equity Assessment of the Sexually Transmitted Infections Assessment Decision Support Tool with intern Cheryl Prescott.

Check out the Prezi for this project!

cheryl's presentation
This project has a Prezi. A Prezi is a recorded presentation you can watch online.

Working with the Provincial Health Services Authority and the BC Centre for Disease Control Cheryl applied ELPH’s 2013 Inventory of Health Equity Tools to determine an applicable framework to complete a health equity assessment of the College of Registered Nurses of BC Sexually Transmitted Infections Assessment Decision Support Tool.This tool is an overarching clinical guideline for mandatory use by practicing Certified Registered Nurses across the province to guide nurses through the sexually transmitted infections screening process, outline issues specific to scope of practice, health history taking, risk assessment and diagnostic testing.

The purpose of the project was to discern aspects of the tool that either ameliorate or exacerbate sexual health inequities

as they relate to sexually transmitted infections. Cheryl’s internship included a literature review of sexually transmitted infections, health equity, nursing and clinical practice guidelines, a review of the tools in the ELPH inventory to determine an appropriate tool to assess health equity in clinical practice guidelines, a

nd conducting a health equity assessment of the Sexually Transmitted Infections Assessment Decision Support Tool.

The project contributed substantively to the integration of an equity lens in Sexually Transmitted Infections Decision Support Tool development and will inform future reviews of nursing decision support tools for sexually transmitted infections practice. An area of particular interest for the future is developing community advisories to assist in sexually transmitted infections guidelines development. The advisories would be a way to include the voices of those affected who have unique knowledge regarding how services can be structured.

Fraser Health Authority: A Health Equity Assessment Toolkit (HEAT) with Intern Erin Cusack

Erin worked with Samantha Tong and Tobie Patterson from Fraser Health Authority on their Health Equity Assessment (HEAT) Toolkit that is intended to help Fraser Health managers and planners assess how their current programs, policies and services impact health (in)equity, and to identify strategies to promote health equity and/or reduce health inequities.

The goal of the internship was to finalize the revisions and incorporate the feedback from the pilot tests and develop several “worked through” examples of the toolkit to highlight health equity issues and possible strategies to address health equity that are relevant to various departments in Fraser Health. Erin’s challenge was “packaging” health equity in the toolkit with language that captured the complexity of health equity in ways that Fraser Health managers would find it useful, practical and important to address in their work. The internship provided Erin with experience in contextualizing the theoretical aspects of health equity in ways that facilitate health service providers to address it in their work.

Provincial Health Services Authority: Developing Mental Health Equity Indicators for Use in British Columbia with Intern Amanda Ng.

This internship with the Provincial Health Services Authority (PHSA) sought to provide an assessment of the evidence on mental health equity indicators and measures to inform the situation in BC and make recommendations for possible indicators, data sources and processes that are inclusive of vulnerable populations.

Amanda conducted a review of the literature for publications related to mental health and indicators or measures. This initial work will be continued by ELPH as we seek to develop new knowledge and health equity indicators to enable the application of a proportionate universality approach in future public health work in the area of mental health. Our review of the literature will seek to determine:

  • What data is being used?
  • Is population level data capturing vulnerable populations?
  • What is being considered in the definition of vulnerabilities?
  • What can we learn for BC?

In collaboration with PHSA, this work could directly inform the BC 10 Year mental health plan as well as potentially contribute to national research through the Mental Health Commission of Canada and others.