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British Columbia's Women's Hospital and Health Centre Foundation

Changing Perceptions: Reimagining Sexual Assault to Better Support Survivors

In BC (2014) there were ~70,000 self-reported incidents of sexual assault (SA). In contrast only 2,341 SA were reported to police in the same year. Victim-blaming contributes to a culture where SA survivors’ credibility is undermined, evidenced by a reluctance to disclose or report to authorities. Low conviction rates and well-publicized SA case rulings reinforce public perceptions that minimize the severity of SA. Systemic re-victimization compounds survivors’ trauma and creates barriers that reduce willingness to disclose and access support services. Never has public awareness about SA in Canada been so high, creating an opportunity for changes in both public attitude and policy. The social innovation this research project will explore is how to stimulate a shift in the public discourse around SA toward less victim-blaming and more trauma-informed responses across multiple systems (health, justice and education). BCW and EVA BC will work with survivors, community-based organizations, and SA response systems, to investigate how power holders influence public perceptions of SA and how public perceptions of SA influence survivors’ willingness to disclose and access support. Knowledge generated from this project will facilitate safer environments for survivors to disclose and access support services and improve trauma-informed responses to SA across multiple sectors in BC.

Crisis Intervention and Suicide Prevention Centre of British Columbia

Advancing Lifesaving Enhancements to the Follow-up of Suicidal Individuals

Suicide is an important public health issue where an average of 10 people die by suicide each day in Canada. As identified in The Cost of Injury in Canada, a study funded by the Public Health Agency of Canada (June 2015), in 2010 there were 510 deaths by suicide in BC alone. In the same year, suicide and self-harm also resulted in 4539 emergency visits and 2855 hospitalizations, resulting in indirect and direct costs totalling $410M within the province. While the human cost of pain, grief and suffering are intangible, the economic costs of suicide are tangible and have resulted in significant economic challenges to the healthcare system. With a comprehensive case-managed 24/7 continuum of community support, the research shows that many of the 500+ deaths in BC can be prevented. Many suicidal people often do not seek support due to stigma around suicide. Crisis line contact, with its 24/7 accessibility and safety to reach out, can increase engagement and establish trust and further help seeking. With the already established rapport, our extended follow up process will help suicidal clients to better manage their own safety; however, phone and online service may not be sufficient to meet clients’ needs and face to face services are often required. Currently, fragmented service delivery processes exist for suicidal individuals. We are researching the impact of a structured follow up process over a period of time to determine the impact on connectedness and continuity of care.

Douglas College

Inclusive practice and upstream change in community mental health

In Imagining Inclusion, a project funded by the Vancouver Foundation, we explored experiences of community inclusion for diverse individuals with lived experience of mental illness (MI). With the collaborative involvement of research participants, the ‘Creating Upstream Change’ Model (an upstream-downstream model of community mental health) was created from project findings. This new project proposes three interconnected social innovations to take up Imagining Inclusion’s evidence-based Model to investigate the potential for organizational and systemic change in community mental health using peer leadership as a central lever. In the first social innovation we will test the effectiveness of the Model in creating upstream (systemic), midstream (organizational) and downstream (individual) change in community mental health. The second social innovation is the use of indicators of excellence in community-based participatory research (CBPR) for documenting the change that results from piloting the Model. Insights from the change processes will be transferable to other community mental health sites. The use of peer leadership in all project activities is the third social innovation. This involves establishing a training curriculum for the research team that explores the role of peers in research, the value of lived experience, and skill development in methods, facilitation, project management, and public speaking.

Fraser Health Authority

Community-Based Program to Support Women and Families in Pregnancies after Stillbirth

This community-based participatory research project seeks to address the systematic challenge of stigma and fatalism in the area of stillbirth with a focus on the care of families who are pregnant after stillbirth. With an intersectoral team of researchers, clinicians and bereaved community members, the components of group care within a primary health care (PHC) setting will be explored using focus group discussions with bereaved families. This information will be used to develop and test a group program to address psychosocial support as an adjunct to regular antenatal care with the goal of expanding this program to satellite sites outside of the city centre. The introduction of this innovation would trigger change in several ways. Firstly, the bulk of research on prevention and care conducted in the area of stillbirth occurs in academic and tertiary care settings. By situating the study in PHC with an intersectoral team of researchers and collaborators who are representative of community and hospitals, this study aims to ensure that care and support will match the longitudinal nature of grief and reproductive trajectories of bereaved families. Secondly, by placing this program within a PHC clinic, such as South Community Birth Program and its satellite clinics makes the invisible visible and counters the societal stigma and fatalism associated with stillbirth. Grief and loss will be made visible and acknowledged within a maternity clinic setting.

Gitga'at First Nation

Empowering a Nation: Reconnecting to 'Old Town' - The Ancestral Home of The Gitga'at

Gitga’at First Nation, in Northern British Columbia, has a deep physical, emotional, and spiritual connection to its ancestral lands. Ensuring the continuity of this connection is fundamental to community health, cultural survival, supporting rights and title, and our unique relationship with our territory. By creating an interactive storyboard and web site rich in cultural and ecological details, our project seeks to strengthen Gitga’at First Nation’s connection to one important place: Laxgalts'ap or “Old Town”. This project is an outgrowth of the Nation’s on-going efforts to revitalize title, language, environmental stewardship, and spirituality. Old Town is 32km north of the remote village of Hartley Bay where many Gitga’at live today. Old Town is the birthplace of the Gitga’at and the ancestral village where they lived for thousands of years; yet few Gitga’at today are able to visit Old Town. This inability to physically connect with a place so central to Gitga’at identity weighs heavily on many in the community. There is immediacy to the project due to the age of our elders and the potential impact of climate change on our landscape. Our team of researchers from Hartley Bay and BC Universities will document the cultural and natural history of Old Town by collating community interviews, old and recent video and audio footage, archival documents, oral traditions, place names, and archaeological and eco-cultural data in a web site and touch screen placed in the community.

Shuswap Association for Community Living

Community Building Now!

The Community Building Now project will engage people with and without disability to work together to research and identify civic issues that can be addressed to build a better community through action influencing positive civic change in Salmon Arm and area. We plan to accomplish this with Participatory Action Research bringing together a diverse group of participants to co-research what they and other community members would like to see change in their community to better meet the needs of a broad community. The project team will work collaboratively to develop methodologies to survey the community of Salmon Arm utilizing Photovoice, written surveys and interviews to gather data related to community development possibilities and analyze the results to develop actions to promote change to support the needs of a diverse community. Participants in the project will develop their personal and collective capacities by working together exchanging mentorship to increase personal capacities to effect ongoing change in their community that positively impacts the quality of life in our community. The project will create long lasting mutually beneficial social relationships; build essential community building skills and valuable roles & working partnerships that include people with intellectual & other disabilities sustaining long term, ongoing influence leaving a legacy of an inclusive community that embraces diversity, quality of life and full civic engagement for all citizen

The Good Samaritan Society

The Imagination Network

What roles do people living with the experience of dementia want to play in our communities? This is the question at the heart of The Imagination Network. While rates of dementia rise in our communities [1], the voices of individuals with lived experience of dementia - their thoughts, stories, and ideas—fade into the background. In the emerging field of dementia advocacy, Swaffer (2014) coined the term “prescribed disengagement” to connote how once a person is diagnosed with dementia they are expected to disengage from society and to prepare for the inevitable decline in their cognitive abilities [2]. Current care practices for dementia focus almost exclusively on mitigating the biomedical “losses” for the individual and their caregivers. The Imagination Network shifts this focus towards creativity and citizenship by proposing a rigorous exploration of “prescribed engagement”. As a social innovation, The Imagination Network is centered on valuing people with the lived experience of dementia as contributors to society with important stories to tell. The Imagination Network combines Community Based Participatory Research (CBPR) with Community-Engaged Arts Practice (CEAP) to engage participants with lived experience of dementia in the development of an evidence-based interdisciplinary theatrical production that tells their collective story. The ultimate goal is to foster engagement and build social inclusion for people living with the experience of dementia.

UBC - BC Centre for Excellence in HIV/AIDS

Through our own eyes – Disclosure, Stigma and Criminalization of HIV in British Columbia

Canada stands out globally in its assertive approach to the criminalization of HIV non-disclosure. The emphasis on criminal law in regulating HIV non-disclosure continues despite increasing evidence that the criminal law is an ineffective tool to prevent HIV transmissions. While frequently represented as a law that ‘protects’ women, to date there is limited understanding of how this law uniquely shapes the lived-experiences of women living with HIV/AIDS (WLWH) and the severe stigmatization they face. To gain a better understanding of the gendered impact of this law, we propose a group-based participatory photovoice project, where WLWH in a group setting collaborate to depict how the criminalization of HIV non-disclosure shapes the negotiation of intimate relationships, HIV disclosure, HIV-related stigma and access to care. At the end of the project, together with the photovoice participants and with our community partner Positive Women’s Network (PWN), we will organize a public exhibition of the photographs and stories that WLWH generate. The proposed project follows up on key research and advocacy priorities that were identified by WLWH, academics, AIDS support organizations, clinicians, and legal experts at a Roundtable event organized by the Gender and Sexual Health Initiative (GSHI) in collaboration with PWN and the Canadian HIV Legal Network in October, 2015.

UBC - Department of Medicine Department of Medicine

Addiction treatment engagement among youth: Community-researcher-practice partnerships

In Greater Vancouver, youth (14 to 26 years of age) who engage in higher intensity drug use are vulnerable to numerous harms. Addiction treatment remains a cornerstone of addressing these harms. However, we continue to experience difficulties connecting youth with addiction treatment in our setting, even when services are available. A more in depth understanding of both the challenges and opportunities that shape youth’s access to a rapidly evolving landscape of addiction treatment in Greater Vancouver is urgently needed. Addressing this knowledge gap is particularly salient for vulnerable subpopulations of youth who use drugs, including street involved youth, gender variant and sexually diverse youth, and Indigenous youth. The aim of the proposed activities is to catalyze a new program of qualitative and ethnographic research that explores youth’s engagement with addiction treatment, care and recovery in Greater Vancouver, both across time, and across institutional settings. The goal of this new program of research is to inform and advocate for innovative addiction treatment services for youth in our setting. We request financial support in order to: 1. Host two planning meetings with local knowledge users, community stakeholders and members of the research team in Vancouver 2. Conduct exploratory interviews with local youth who engage in higher intensity drug use and local addiction care providers 3. Develop and submit a research funding proposal

UBC - Office of Research Services

Promoting access to care for women affected by intimate partner violence in the Downtown Eastside

The research project will test an innovative trauma informed outreach intervention to promote access to support services among highly isolated and vulnerable women experiencing intimate partner violence (IPV) in Vancouver’s Downtown Eastside (DTES). Our team’s earlier research identified many women experienced limited access to anti-violence and other health and social services necessary to prevent IPV and reduce its deleterious effects (e.g., poverty, homelessness, HIV, mental illness). Although supports exist barriers remain due to isolation, control by partners, knowledge gaps about services, and negative care encounters in formal clinical settings. Outreach activities are needed to connect support workers with women in ways that are non-harmful or re-traumatizing. This reflects a growing body of international inter-disciplinary research calling for trauma-informed care and services for vulnerable populations. Other research with women experiencing IPV demonstrated trauma-informed outreach facilitated access and uptake of services with direct health and wellbeing benefits. Through a participatory action research (PAR) approach involving researchers, health and social service leaders/staff and women experiencing IPV we will build on the capacity of current services to learn if and how integrating a trauma informed approach to outreach services facilitates women’s connections with health and social services and improves service coordination to address the populations’ needs.

University of British Columbia School of Social Work

Sexual Health Knowledge and Adults with Intellectual Disabilities: A Participatory Theatre Project

This project focuses on improving sexual health knowledge and positive sexuality among adults with intellectual disability(ID). Using community-based participatory methods, we will use mixed methods to create, produce and evaluate a participatory theatre project on sexual health, sexuality and ID. The origins of participatory theatre are in community development, arts and social movements. Practitioners of participatory theatre are committed to innovation, collaboration, capacity building and social transformation. As such, it is a well-suited approach for addressing the sexual rights of adults with ID who are often constructed as asexual and childlike and/or lacking sexual boundaries. Our participatory theatre will be developed using arts-based qualitative methods to identify what information and tools are needed to achieve successful sexual health and sexuality. These findings will inform the development of sexual health educational tools and resources as well as the creation, delivery and evaluation of three participatory theatre performances. These products are aimed at increasing knowledge about sexual health and sexuality for individuals with ID and aimed at minimizing barriers and social stigma associated with sexuality and ID. The performances will be delivered in New Westminster. It is anticipated that the performance will be replicated in other communities adding to the project's ongoing scope of influence to advance positive change related to sexuality and ID.