Author: Arun Jentrick

We are delighted to share a recent article shedding light on an intriguing intersection: mindfulness and HIV risks. Dr. Roula Hawa, Executive Member of CRHESI, contributed to this thought-provoking piece, offering insights that could shape our understanding and interventions in public health.

Published on Western University’s news platform, the article delves into the potential role of mindfulness practices in addressing HIV risks, particularly among vulnerable populations. Dr. Hawa’s expertise in this area enriches the discourse, highlighting the importance of holistic approaches in health promotion and risk reduction strategies.

In addition to her insightful contributions, Dr. Hawa is currently leading a pivotal study titled “Promoting Mental Health and Reducing HIV Risk Behaviours through Self-compassion, Mindful Acceptance & Resilience Transformation (SMART).” This pilot study focuses on the diaspora MENA (Middle Eastern and North African) gay, bisexual, and trans youth in Ontario.

The SMART study is part of the broader Youth Sexual Health and Human Immunodeficiency Virus / Sexually Transmitted Infections (HIV/STI) Prevention in Middle Eastern and North African Communities (YSMENA) initiative. This mindfulness-based intervention aims to enhance mental health, self-compassion, psychological resilience, and collective empowerment among participants. For more information, you can contact the Research Coordinator at ysmenastudy@gmail.com.

To read the full article and delve into the discussion, visit the link below:

Read the Article

We extend our gratitude to Dr. Roula Hawa for her contributions to this vital conversation and look forward to further collaborations in advancing health equity.

 High Level Summary of Key Discussions & Next Steps

 On February 16th, 2024 CRHESI hosted an event on the importance of generating and mobilizing research and evaluation knowledge in ways informed by trauma-and violence informed care (TVIC) and equity principles. Panel discussions and small groups centered on the creation and implementation of rigourous and impactful evaluation methods, while also exploring strategic, respectful and effective approaches to knowledge sharing and use. 

This synthesis highlights the importance of building relationships, managing expectations, and effectively communicating narratives surrounding health and homelessness. It emphasizes the need for community involvement, TVIC approaches, and equitable representation in research and storytelling. Through respectful engagement, diverse perspectives, and transparent communication, efforts can be made to counter stigma, shift negative perceptions, and promote positive change in addressing health and homelessness in London. 

Trauma and Violence-Informed Care 

Trauma-informed care establishes a safe environment for service users by recognizing the effects of trauma and its close association with health and behaviour, focusing on understanding rather than eliciting or treating individual trauma. Expanding on this approach, trauma- and violence-informed care (TVIC) acknowledges the intersecting impacts of systemic and interpersonal violence, as well as structural inequities, on a person’s life. It emphasizes both historical and ongoing violence and their traumatic effects, shifting the focus to encompass a person’s experiences of past and present violence, including marginalized social circumstances. 

Embedding TVIC Principles in Producing & Sharing Evaluation Knowledge: Overarching Considerations

• Collaborate to design questions, and collect and use data efficiently, effectively and safely. 
• Evaluation questions and designs should focus on addressing structural and systemic violence and be analysed and interpreted to show the impact of these factors on individuals and groups. 
• Shift from identifying problems to understanding ongoing issues and traumatic impacts. 
• Acknowledge trauma’s complexity influenced by genetic, biological, and social factors and how it can look in research interactions – prepare all staff accordingly. 
• Recognize substance use as a continuum and address stigma as it often causes the most harm. 

What to Evaluate about London’s New Housing Support Interventions: 

(Hubs, Highly Supportive Housing, Encampment Strategy, etc.) 

• Emphasis on critical role of these supports in connecting with and meeting people where they’re at and moving them to the kind of housing they need:
  • describe and evaluate these pathways and outcomes across intervention types;
    • importance of individual and intersectional experiences, and collective action;
    • use data purposefully and transparently;
  • demonstrate (cost-)effectiveness of interventions to influence public policy and to highlight barriers.
• Examine the impact of new approaches and spaces on staff transitions, wellbeing and job satisfaction.
• Initial Hubs (youth, women, Indigenous) aim to fill most pressing needs exacerbated by the COVID-19 pandemic – include this framing in interpretation of findings.

Managing Expectations, Hopes and Fears: 

• Manage expectations about what can and might be found by maintaining communication.
• Collaboration between academia and the community to address biases in data interpretation.
• Concerns about political manipulation of data and importance of honesty in evaluation.
• Significance of telling accurate stories to reflect realities of marginalized communities.

Specific Strategies for Safe & Inclusive Participation: 

• Use existing relationships to help recruit; ensure fair payment, though people should not feel they can’t afford to decline to get money or service (i.e., recruitment arms’ length from staff but using their advice).
• Address concerns about privacy and confidentiality during recruitment; build data protection into all practices and strategies.
• Let participants tell their stories but ensure support is available during data collection, interpretation (e.g., member checking) and when data are made public (anticipatory guidance to avoid surprises).
• Train all research staff in TVIC, cultural safety & humility, and inclusive and respectful communication with all participants; emphasize (e.g., role play) strategies to build trust and comfort.

Sharing and Mobilizing Knowledge: 

• Emphasize inclusivity, respect, timeliness and collaboration in communication and engagement efforts.
• Use clear, concise and destigmatizing language and point to systems and structures that need to change (i.e., don’t use data to blame staff or service users for their individual circumstances or behaviours).
• Use data enhanced with narrative and share in multiple formats (including photos, art, poetry, videos, song, etc.) to tell the story of the work in ways accessible and safe for all involved.
• Proactively understand public concerns and expectations and develop a communications plan to prepare the public (and politicians) for various types of findings.
• Continuously evolve and iterate knowledge-sharing strategies.
• Actively create and “field test” de-stigmatizing, equity-promoting messages for the London community, particularly regarding health and homelessness, regardless of study findings.

Engaging Indigenous & Racialized People and Groups Across Activities: 

• Listen, build relationships, and support people and groups (as they’re willing) in decision-making.
• Include diverse perspectives, decolonizing approaches, and ensure benefit for those facing most harm.

Next Steps for CRHESI’s H&H Facilitators

1. Convene first 4 research/evaluation teams and outline key evaluation questions with input from Tables:
   • Experiences and Outcomes of Defined Groups
   • Experiences and Outcomes of Direct Service Workers
   • Systems, Structures, Processes, and Cost of Care
   • Overall WCR Process Review
2. Support each team in developing research/evaluation plans, ethics protocols, funding applications, etc.
3. Support London CARES and LHSC to document their outcomes in the new Dundas St. highly supportive housing site.
4. Develop templates, guides and trainings for researchers/evaluators to ensure safety, consent, privacy, confidentiality, and community engagement in research, evaluation and knowledge sharing processes.
5. Continued efforts towards inclusive and respectful communication and engagement, especially with local Indigenous partners and the new Indigenous Reference Table

A knowledge exchange forum on peer work in housing and homelessness took place on November 27, 2023. Strummed in by local musician, Dan Crow, led by the Peer Navigator Project with support from CRHESI, peer workers from multiple organizations, their co-workers and leaders, and researchers gathered at Innovation Works, in downtown London.

The afternoon was buzzing with shared insights about the unique value of peer work to support people accessing health and social services, passion to address challenges and a keen urgency to mobilize efforts to support the growth of peer work.

The following summarizies key issues raised by event participants with recommendations for action.

The Peer Navigator Project is a community-based research project that works alongside key community partners to engage Peer Navigators (PN) in Canada: London, Toronto, and Vancouver, and Kenya: Eldoret, Huruma, and Kitale. The goal of this study is to determine how well PNs meet the needs of street connected youth, particularly in facilitating access to HIV and AIDS prevention, testing, and treatment. The Peer Navigator Project (PNP) is funded by the Canadian Institute for Health Research. Please click the following weblink to read the full interim report: https://pnpstudy.net/peer-navigator-project-18-month-progress-report-toronto-2/

Below is an introduction to peer work and the PNP with a focus on the London, ON site.

Creating an On-Going Community of Peer Workers

This event, Peer Driven Work in Housing and Homelessness for Health Equity, fostered meaningful discussions and shed light on the dedication of peer workers, and their leaders and colleagues in community.

Envisioning the future of peer work, participants called for ways to continue their connection, to continue to support each other and advocate for peer work.

Plans are in progress for a peer-led community of practice to begin in early 2024!

For more information please contact:
Abe Oudshoorn
aoudsho@uwo.ca

Thanks to the event planning committee: Abe Oudshoorn, Amy Van Berkum, Arun Jentrick, Christine Garinger, Jenna Pogue, Kaitlyn Widdup, and Katie MacEntee.

Are you passionate about making a positive impact on community health? Middlesex-London Health Unit is currently seeking dedicated individuals to join their team and contribute to improving the well-being of the community. This blog post presents two exciting employment opportunities at Middlesex-London Health Unit: Health Promotion Specialist, Indigenous Health, and Health Promotion Specialist. Read on to discover more about these positions and how you can become a part of this dynamic organization.

1. Health Promotion Specialist, Indigenous Health (1 Permanent Full-Time)
2. Health Promotion Specialist (1 Permanent Full-Time)

How to Apply:

To apply for these exciting opportunities, please visit the Middlesex-London Health Unit’s website and submit your application, including your resume and cover letter, highlighting your relevant experience and qualifications.

The deadline for applications is May 23, 2023

Please refer to the Middlesex-London Health Unit’s official website for the most accurate and up-to-date information regarding the job opportunities mentioned.