Presentations
Pragmatic strategies supporting multi-site community-based research: responding to local context while ensuring methodological coherence across contexts
CAHSPR Conference, Halifax
May 30, 2019
Importance and Relevance: Many attempts have been made to facilitate team-based, collaborative service delivery models to address the access needs of vulnerable populations. These approaches are often designed and implemented by health service authorities for application in communities. Increasingly, it is recognized that community must be engaged in designing sustainable solutions to overcome barriers to access. The IMPACT research intentionally designed strategies to ensure interventions across six sites were tailored to local context while ensuring consistency in overall implementation approach across sites. The lessons learned from this research will inform future scale and spread of sustainable interventions through linking research, policy and practice innovation.
Objectives: Through this panel we aim to:
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Familiarize participants with the approaches and tools that supported cross-case coherence and integration of intervention design, implementation and evaluation
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Share concrete examples of tools and approaches for continuous improvement interventions throughout implementation
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Share tips for developing partnerships among researchers, decision-makers and patients to facilitate community-based design and implementation of interventions
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Stimulate discussion regarding balancing the need for contextual relevant interventions with the desire to achieve common outcomes across contexts
Approach: Following a brief overview of the approaches and tools used throughout the IMPACT program of research, each panelist describes the innovation implemented in their region and the strategies for designing interventions with communities so that they are responsive to context while measuring common outcomes and adhering to the overarching research design. The presentation wraps up with a summary of the elements the panel proposes are essential to effective, acceptable, and potentially scalable interventions. The presentation is followed by a facilitated discussion with the audience members; seeking the input about the panelists’ experiences.
Invited Experts: The three panelists have worked together over the past six years under an international program to address gaps in access to PHC funded $5 million under the CIHR SPOR initiative, and each have successfully implemented an innovative approach that responded to the needs of a population in a Including someone from policy
Properties of a provider questionnaire of acces to primary health care by vulnerable groups
NAPCRG conference, Chicago
November 12, 2018
The objective of this study was to assess the psychometric properties of a provider questionnaire on access to primary health care by vulnerable groups in Australia, an instrument that may be useful in measuring provider confidence in managing vulnerable populations and their referral practices.
How Family Physicians Perceive Access Needs of Vulnerable Populations and Act to Address These Needs
NAPCRG Conference, Chicago
November 12, 2019
This study sought to understand family physicians' perspectives on barriers for vulnerable people to access primary care and on strategies that family physicians have explored to address these barriers.
How policy changes influenced the design of an organizational innovation to improve access to primary care for vulnerable populations: a participatory action research
CAHSPR Conference, Montreal
May 29, 2018
The objective of this presentation was to describe how policy changes influenced the design of an organizational innovation to improve access to primary care for vulnerable populations. Results show that policy changes in Quebec heavily influenced the intervention’s design.
The feasibility of integrating a non-clinical patient navigator in primary care practices to enhance Access to Resources in the Community (ARC) – the ARC study
CAHSPR Conference, Montreal
May 29, 2018
No standard process exists to facilitate “referrals” to health enabling community resources (CR) by primary care providers (PCP), or to support their patients to access these resources. This is especially problematic for individuals with social complexities. We studied the feasibility of a multipronged approach to improve equitable access to CRs.
The integration of a non-clinical patient navigator in primary care practices is feasible on many levels. A randomized controlled trial of this model is starting in March 2018. This model of navigation offers many advantages and may help mitigate inequities for individuals with social complexities.
Access to Resources in the Community (ARC): Provider and Patient Perspectives of a Non-Clinical Patient Navigator in Primary Care.
CAHSPR Conference, Montreal
May 29, 2018
Through this presentation our objective is to determine the effectiveness of a non-clinical patient navigator in optimizing access to community resource from the perspective of primary care providers and patients.
Access to Resources in the Community: Patient Profile, Resource Referrals, and Social Barriers to Access
CAHSPR Conference, Montreal
May 29, 2018
This presentation describes 1) the socio-demographic characteristics of patients referred to a non-clinical navigator for support as part of the Access to Resources in the Community (ARC) feasibility study 2) the type of community resources recommended to patients and 3) the access barriers reported to the Navigator.
Pattern of Patients' Experience of Primary Care Access in Australia, Canada, New Zealand, and Switzerland: A Comparative Study
NAPCRG Conference, Montreal
November 18, 2017
This presentation focuses on patient's experience of primary care access in a complex and multifactorial matter. It can be both assessed through the accessibility of care (supply side factors: e.g. density of GPs, hours of openings) and the ability for patients to get the required care (demand side factors: e.g. patient mobility, ability and willingness to pay).
Typology of Primary Care Practices: Analysis of the Qualicopc Data of Canada, New-Zealand, Australia and Switzerland
NAPCRG Conference, Montreal
November 19, 2017
This presentation is focused on the definition of a general typology of PC practices using data from the QualicoPC study from four countries: Australia, Canada, New-Zealand and Switzerland.
Effective Teamwork for Collaborative Primary Health Care Research: Coordination Strategies to Achieve Shared Goals and Outcomes in Multi-Sites, 5-Year International Participatory Research Programme
NAPCRG Conference, Montreal
November 18, 2017
The goals of this workshop was to learn useful strategies to coordinate activities in complex research programs and gain simulated experience using these strategies to face challenges of multi-components and multi-sites, international participatory research programme.
Why Do Nations Differ in Their Ability to Provide Equitable Access to Primary Care for People Living With a Mental Health Condition?
NAPCRG Conference, Montreal
November 20, 2017
The goal of this presentation is to examine how–and why nations vary in the provision of access to primary care for people with mental health problems. We generate hypotheses explaining international variations in access to PC for individuals with MH conditions.
Multiple Barriers to Access to Primary Care for Vulnerable Groups: An International Analysis
NAPCRG Conference. Montreal
November 18, 2017
In this presentation, we try to understand more about concentration of multiple barriers to access to PC across countries. Using a reanalysis of surveys we analysed ten questions related to barriers to access to PC before reaching care (no regular provider, long waits for appointments or for response to a call, difficult access after-hours or foregoing care due to cost), and after reaching care (feeling that the doctor did not know their history, explain things clearly, coordinate their care or spend enough time with them) were selected.
Do Patients and Providers Agree on How Healthcare Systems Perform? Comparing Healthcare Performance Assessment in International Surveys of Patients and Providers
NAPCRG Conference, Montreal
November 21, 2017
This study aims to assess the agreement between patient and provider perspectives. Methods: Using 16 pairs of questions from the 2014 commonwealth fund international health policy survey of older adults and the 2015 survey of primary care physicians, patients and providers' responses were compared across 11 participating countries.
Data Sharing in Multi-Site, Multi-Country Trials
NAPCRG Conference, Montreal
November 21, 2017
This presentation describes the data-sharing issues managed by IMPACT. Each site used a common protocol to design and evaluate its own intervention, with the aim of pooling data across the sites. Ethics applications were submitted in each site. Sharing data across the sites proved a challenge.
Marching to the Beat of the Same Drum(s). An Insight into the Real World Challenges of Participatory Action Research
PHCRIS Conference, Sydney
August 07, 2017
This workshop gave participants skills in dealing with some of the problems faced in implementation research conducted with clinicians, policy makers and members of vulnerable communities.
Developing Qualitative Data Collection Tools to Evaluate a Participatory Intervention in Primary Care
PHCRIS Conference, Sydney
August 07, 2017
This paper presents our approach for developing qualitative tools and collection of qualitative data across the six sites.
The challenge to the IMPACT intervention evaluation rests in the manifold expressions taken by interventions in each region. The evaluation tools had to be flexible yet rigorous to account for the local variability. To learn about the impact of the intervention on patient and provider experience, we use semi-structured interviews with patients, PHC providers, research committees and intervention staff. To study the interventions' fidelity to their local logic models and potential scalability, we perform document analysis of intervention staff diaries, meeting minutes, and other documents that allow to understand decisions made by the local implementation team. IMPACT Logic Map provides an overarching framework for the intervention and supported the design of common qualitative tools to be used in all regions. To ensure quality and consistency of qualitative data, two national qualitative researchers oversee data collection.
Our approach to the development of qualitative tools highlights challenges and opportunities in evaluation of a participatory intervention in PHC.
Improving Research Outcomes on an International PHC Participatory Action Research Program using a Project Management Approach
PHCRIS Conference, Sydney
August 07, 2017
To maximize outcomes, IMPACT contextualizes standard project management tools to a participatory, patient-oriented research setting. Interactive and formative in its design, this approach includes: activity and study plans, productivity tools such as staff diaries and status reports, and embedded evaluation procedures.
Status reports and study plans provided greater accountability and contributed to uniformity and common terminology across sites. Activity plans help kept the study on schedule, facilitated the monitoring of its multifaceted components and ensured communication flows. Our project relies on the creation of working groups and thematic committees, which spread the work load. Online video-conferencing increased the quality and clarity of communication, while annual face-to-face meetings built momentum and contributed to the quality and meaningfulness of engagement. Our project management approach provides an opportunity to balance management with research creativity, PAR and formative evaluation processes. It also has the potential to improve the quality of partnerships, and works toward sustainable relationships and scalability.
Multi-site Research and Data Sharing
PHCRIS Conference, Sydney
August 07, 2017
This paper outlines the data-sharing issues managed by IMPACT, a 6-site Canadian-Australian collaborative research program designed to improve access to primary health care for vulnerable individuals. Each site used a common protocol to evaluate its own intervention, with the aim of pooling data across the sites. Ethics applications were submitted in each site.
Application of the RE-AIM Framework to Evaluate Electronic, Mobile and Telehealth Interventions and Inform Design of a Real-world Intervention
PHCRIS Conference, Sydney
August 07, 2017
This review highlights some major considerations when developing e/m/telehealth interventions for vulnerable groups. Within South-Western Sydney, pragmatism limits the ability to conduct recruitment in a way to measure or enhance reach. However, the intervention will be low intensity to enhance sustainable implementation and fidelity will be assessed using the Template for Intervention Description and Replication (TIDieR) framework.
Les soins de santé et les populations vulnérables
Présentation du PLI-Québec auprès des cliniques participantes
December 05, 2016
This presentation [in French only] was given by the PLI-Quebec research team, led to Christine Loignon, to present IMPACT and its intervention in one of their participant Groupes de Médecins de Famille (GMFs). It also includes a 'cultural sensitive training' that explores the health challenges that vulnerable patients face.
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Cette présentation, donnée par l'équipe de recherche du PLI-Québec lors de la presentation d'IMPACT et de l'intervention dans l'un des Groupes de Médecins de Famille (GFM) au Québec, apporte les enjeux de santé que rencontrent les patients issus de populations vulnérables.
Piecing together ways to improve access to primary care for vulnerable populations at a local level: A typology of components of organizational interventions
Haggerty et al.: NAPCRG 2016, Colorado Springs
November 14, 2016
Despite many national primary healthcare (PHC) reforms in OECD countries, meaningful gaps in equitable access remain. These gaps particularly affect vulnerable populations, such as the poor, refugees and indigenous communities. While current classifications of healthcare interventions exist, they are not specific to access to PHC, often include macro or meso level interventions that cannot be implemented at a primary care level and/or are not tailored for vulnerable populations. This paper presents a typology of components of interventions that can inform organizations seeking to improve access to PHC for vulnerable populations.
Marching to the beat of the same drum(s). An insight into the real world challenges of Participatory Action Research.
NAPCRG Annual Meeting, Colorado Springs
November 14, 2016
IMPACT is a 5 year Canadian-Australian research program based on the principles of Participatory Action Research. Our team is working with 6 regional communities to help vulnerable individuals gain access to needed primary care. Now, on the threshold of program implementation, we are confronting the realities of: competing regional interests, diverse (and sometimes conflicting) research skills, limited local resources, and the need to keep everyone “on the same page”. This workshop gave participants an increased awareness, and new skills, in dealing with some of the challenges inherent in conducting Participatory Action Research within vulnerable communities.
Copy Of -"Does this seem surprising to you?" Learning how to contextualise international survey data with a mixed methods knowledge exchange approach
PHC Research Conference, Canberra
June 08, 2016
This workshop has introduced participants to the mixed methods approach used to explore the influence of context on equitable access to primary care. Attendees gained insights into innovative approaches to the interpretation and translation of comparative primary care performance data (i.e. 2013 and 2014 Commonwealth Fund International Health Policy Survey) on health services and health systems to engage policy makers and health service managers.
Context, needs & opportunities: Co-creating an intervention to improve primary health care access for vulnerable commu
PHC Research Conference, Canberra
June 08, 2016
This presentation focuses on lessons from one Australian region’s experience of designing an intervention in partnership with academic and community based stakeholders.
The partnership settled on an intervention that would a) identify vulnerable clients of large social welfare organisations who lacked access to enduring primary care; and b) use a health broker to support linkage with appropriate primary care. We secured in-kind commitment from two of six potential implementation partners and will commence implementation in May 2016. We learned lessons about partner engagement, how to be flexible to changes in the local context, working with organisational priorities, and, developing sustainable interventions.
Cultural Sensivity Training
A presentation by the Alberta-LIP for their Pop-Up Intervention
January 01, 2020
This presentation was developed by the Alberta LIP team to promote awareness about vulnerable populations' and patients' needs and realities. We are proud to their amazing work and happy to share with the wider team. All comments are welcome!
Access to primary care: Cumulative barriers and disparities across 11 countries.
Canadian Association for Health Services and Policy Research
May 11, 2016
As part of the Innovative Models Promoting Access-to-Care Transformation (IMPACT) research program — a Canadian–Australian collaboration to improve access to primary care for vulnerable populations, we did a secondary analysis of the 2013 and 2014 Commonwealth Fund International Health Policy Surveys to highlight patterns of disparities in access to primary care across 11 countries, including Canada and Australia. This analysis discusses incremental barriers to access in different countries. Results may inform innovations aimed at improving access for vulnerable populations
International variation in access to care for chronic conditions: patient and provider perspectives
International Primary Health Care Reform Conference, Brisbane
March 15, 2016
Using recent international health policy surveys from the Commonwealth fund on patients and from primary care physicians, we analysed the international variation in access to PHC through a recognised conceptual framework of access to care and by triangulating patient and provider perspectives.
Disparities in access to primary healthcare in Australia and Canada: evidence from the Commonwealth Fund International Health Policy Survey
Health Services and Policy Research Conference, Melbourne
December 07, 2015
This presentation focuses on understanding the specific characteristics associated with access barriers to primary health care. The Commonwealth Fund International Health Policy surveys (2013-2014) were used to compare different access barriers in Canada and Australia.
IMPACTing on primary health care for the vulnerable: prioritizing access related need in 3 Australian regions.
Health Services and Policy Research Conference, Melbourne
December 07, 2015
This presentation focuses on differences between the primary health care systems of Canada and Australia. By the end of the presentation, you will find some examples of interventions implemented in Australia.
A real-time approach to improving primary health care implementation: Accounting for complexity through developmental planning and evaluation
Health Services and Policy Research Conference, Melbourne
December 07, 2015
Through this presentation we have shared what IMPACT have learned about the practical aspects of applying this innovative approach to planning and evaluation within complex primary health care contexts across six settings in two countries. We also shared early examples of the benefits of real-time learning for design and implementation of interventions.
Learning Across Health Care Systems: A Canadian Comment on Cost barriers and Timely Access
Health Services and Policy Research Conference, Melbourne
December 07, 2015
This presentation highlights recent evidence that provides insight into the Australian-Canadian differences in cost-related access, timeliness and equity. It begins with a brief history of the establishment of the universal healthcare system in Canada which reveals that the publicly-funded universal system is limited principally to medical services provided in hospitals and by physicians. Results from a wide variety of studies shed further light on the issues of access and equity.
Engaging local organisations and stakeholders in developing interventions to improve access for vulnerable groups in PHC
Health Services and Policy Research Conference, Melbourne
December 07, 2015
This presentation describes the engagement of local primary health care organisations in the development of health system interventions to improve access to primary health care for vulnerable groups as part of the IMPACT study.
Grass roots development of interventions to improve access to primary health care: using logic models to sharpen the design
North American Primary Care Research Group Conference, Cancun
October 25, 2015
The goal of this presentation was to describe the benefits and challenges experienced using logic models for the dual purpose of intervention planning and guiding a realist review to inform how to optimize that intervention for the local context. The presentation showed that logic models enabled geographically dispersed stakeholders to remain on common ground throughout the process and was helpful in the intervention and review planning.
Singing from the same song sheet: Deliberative processes for engagement and collective decision-making
North American Primary Care Research Group Conference, Cancun
October 26, 2015
This workshop aimed to introduce participants to the foundations of deliberative processes and their value for engagement of and collective decision-making, and to share a range of group facilitation strategies we used to facilitate dialogue among diverse stakeholders.
Modelling the logic within a learning network: A workshop from the IMPACT collaboration
PHC Research Conference, Adelaide
July 31, 2015
The IMPACT team workshop began by presenting a case study of how one of our partnerships evaluated access related need, fostered community dialogue around priority setting and reached consensus on a relevant problem suitable for a future intervention. The identified problem has been a focus for the rest of the workshop to support the development of the logic model.
Organisational interventions improving access to community-based primary health care for vulnerable populations
Institute for Health and Social Policy, Montreal
February 03, 2015
This seminar presents the methods and results of the environmental scan to identify organizational innovations directed towards vulnerable populations, and their organization into a typology of interventional components that can be combined into an intervention to be administered. Examples of various interventions have been presented as well as how the typology of interventions is being applied by the local Quebec partnership.
Transforming PHC organisations to improve access to appropriate care in Australia and Canada
PHC Research Conference, Canberra
July 24, 2014
The cafe has engaged conference delegates in the goals of the IMPACT and create the foundation to promote further integrated knowledge exchange. The aim of the cafe was to promote knowledge exchange around interventions in organisations delivering primary health care in the community that may improve equity in access to primary health care in Australia and Canada.
