Responding to COVID-19 with integrative health and sheltering models for persons experiencing homelessness in Southern Ontario, Canada: protocol for a qualitative study exploring implementation and sustainability

There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

Abstract

Introduction

COVID-19 has disproportionately impacted persons experiencing homelessness in Canada, who are at an increased risk of infection and severe outcomes. In response to the pandemic, several regions have adopted programmes that aim to address the intersecting nature of health and social challenges faced by persons facing homelessness. These programmes adopted during the pandemic may contribute to broader health and social impacts beyond limiting COVID-19 transmission, but the processes involved in developing and implementing these types of programmes and their sustainability after the pandemic are unknown. Our overall goal is to understand the processes of developing and implementing integrative health and sheltering initiatives in Ontario during COVID-19, as well as their sustainability post-pandemic.

Methods and analysis

This study will use a multiple case study design—two cases over 1 year—enabling us to investigate how integrative health and sheltering approaches have been implemented in two mid-sized cities in Ontario, Canada. Each case will offer a unique narrative; through cross-case analysis, the cases will highlight programme operations, successes and challenges. Data will be collected using semi-structured interviews with programme staff and managers, and document analysis. Project partners will be brought together to further explore and interpret findings, along with co-creating a sustainability action plan and policy documents.

Ethics and dissemination

Ethics clearance was obtained through the Western University Research Ethics Board and the University of Waterloo Office of Research Ethics. Findings will be disseminated through publications, conference presentations and lay summary reports.

Related collections

Most cited references 25

Record: found
Abstract: not found
Article: not found

Using thematic analysis in psychology

Virginia Braun, Victoria Clarke (2016)

0 comments Cited 23138 times – based on 0 reviews      Review now

Record: found
Abstract: found
Article: found

Is Open Access

Fostering implementation of health services research findings into practice: a consolidated framework for advancing implementation science

Laura Damschroder, David Aron, Rosalind E Keith … (2009)

Background Many interventions found to be effective in health services research studies fail to translate into meaningful patient care outcomes across multiple contexts. Health services researchers recognize the need to evaluate not only summative outcomes but also formative outcomes to assess the extent to which implementation is effective in a specific setting, prolongs sustainability, and promotes dissemination into other settings. Many implementation theories have been published to help promote effective implementation. However, they overlap considerably in the constructs included in individual theories, and a comparison of theories reveals that each is missing important constructs included in other theories. In addition, terminology and definitions are not consistent across theories. We describe the Consolidated Framework For Implementation Research (CFIR) that offers an overarching typology to promote implementation theory development and verification about what works where and why across multiple contexts. Methods We used a snowball sampling approach to identify published theories that were evaluated to identify constructs based on strength of conceptual or empirical support for influence on implementation, consistency in definitions, alignment with our own findings, and potential for measurement. We combined constructs across published theories that had different labels but were redundant or overlapping in definition, and we parsed apart constructs that conflated underlying concepts. Results The CFIR is composed of five major domains: intervention characteristics, outer setting, inner setting, characteristics of the individuals involved, and the process of implementation. Eight constructs were identified related to the intervention (e.g., evidence strength and quality), four constructs were identified related to outer setting (e.g., patient needs and resources), 12 constructs were identified related to inner setting (e.g., culture, leadership engagement), five constructs were identified related to individual characteristics, and eight constructs were identified related to process (e.g., plan, evaluate, and reflect). We present explicit definitions for each construct. Conclusion The CFIR provides a pragmatic structure for approaching complex, interacting, multi-level, and transient states of constructs in the real world by embracing, consolidating, and unifying key constructs from published implementation theories. It can be used to guide formative evaluations and build the implementation knowledge base across multiple studies and settings.

0 comments Cited 3403 times – based on 0 reviews      Review now

Record: found
Abstract: found
Article: found

Is Open Access

Achieving Research Impact Through Co‐creation in Community‐Based Health Services: Literature Review and Case Study

TRISHA GREENHALGH, Claire Jackson, Sara Shaw … (2016)

Policy Points: Co‐creation—collaborative knowledge generation by academics working alongside other stakeholders—is an increasingly popular approach to aligning research and service development. It has potential for “moving beyond the ivory towers” to deliver significant societal impact via dynamic, locally adaptive community‐academic partnerships. Principles of successful co‐creation include a systems perspective, a creative approach to research focused on improving human experience, and careful attention to governance and process. If these principles are not followed, co‐creation efforts may fail. Context Co‐creation—collaborative knowledge generation by academics working alongside other stakeholders—reflects a “Mode 2” relationship (knowledge production rather than knowledge translation) between universities and society. Co‐creation is widely believed to increase research impact. Methods We undertook a narrative review of different models of co‐creation relevant to community‐based health services. We contrasted their diverse disciplinary roots and highlighted their common philosophical assumptions, principles of success, and explanations for failures. We applied these to an empirical case study of a community‐based research‐service partnership led by the Centre of Research Excellence in Quality and Safety in Integrated Primary‐Secondary Care at the University of Queensland, Australia. Findings Co‐creation emerged independently in several fields, including business studies (“value co‐creation”), design science (“experience‐based co‐design”), computer science (“technology co‐design”), and community development (“participatory research”). These diverse models share some common features, which were also evident in the case study. Key success principles included (1) a systems perspective (assuming emergence, local adaptation, and nonlinearity); (2) the framing of research as a creative enterprise with human experience at its core; and (3) an emphasis on process (the framing of the program, the nature of relationships, and governance and facilitation arrangements, especially the style of leadership and how conflict is managed). In both the literature review and the case study, co‐creation “failures” could often be tracked back to abandoning (or never adopting) these principles. All co‐creation models made strong claims for significant and sustainable societal impacts as a result of the adaptive and developmental research process; these were illustrated in the case study. Conclusions Co‐creation models have high potential for societal impact but depend critically on key success principles. To capture the nonlinear chains of causation in the co‐creation pathway, impact metrics must reflect the dynamic nature and complex interdependencies of health research systems and address processes as well as outcomes.

0 comments Cited 356 times – based on 0 reviews      Review now

All references

Author and article information

Journal

Journal ID (nlm-ta): BMJ Open

Journal ID (iso-abbrev): BMJ Open

Journal ID (hwp): bmjopen

Journal ID (publisher-id): bmjopen

Title: BMJ Open

Publisher: BMJ Publishing Group (BMA House, Tavistock Square, London, WC1H 9JR )

ISSN (Electronic): 2044-6055

Publication date Collection: 2022

Publication date (Electronic): 20 December 2022

Volume: 12

Issue: 12

Electronic Location Identifier: e069945

Affiliations

[1 ]Lawson Health Research Institute , London, Ontario, Canada

[2 ]departmentSpecialized Geriatric Services , St Joseph's Health Care London , London, Ontario, Canada

[3 ]departmentParkwood Institute Research , Lawson Health Research Institute , London, Ontario, Canada

[4 ]departmentSchool of Public Health Sciences , University of Waterloo , Waterloo, Ontario, Canada

[5 ]departmentArthur Labatt Family School of Nursing , Western University , London, Ontario, Canada

[6 ]House of Friendship , London, Ontario, Canada

Author notes

[Correspondence to ] Dr Jacobi Elliott; jacobi.elliott@ 123456sjhc.london.on.ca

Author information

Jacobi Elliott http://orcid.org/0000-0001-8740-4638

Catherine E Tong http://orcid.org/0000-0002-1214-0591

Paul Stolee http://orcid.org/0000-0002-5685-0843

Article

Publisher ID: bmjopen-2022-069945

DOI: 10.1136/bmjopen-2022-069945

PMC ID: 9772633

SO-VID: d8ded5cf-6934-46c1-aece-b49b8555ba39

License:

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

History

Date received : 07 November 2022

Date accepted : 05 December 2022

Funding

Funded by: FundRef http://dx.doi.org/10.13039/501100000024, Canadian Institutes of Health Research;

Award ID: EG7-179462

Custom metadata

special-feature unlocked

ScienceOpen disciplines: Medicine

Keywords: covid-19,qualitative research,organisation of health services

Data availability: