Better Together: Impact Evaluation Shows How to Improve Care in Our Community
Often growth is assumed to be local to global, but the lessons we learn from around the world are just as important to bring back home. As Alison Krentel, PhD, knows well from her work with neglected tropic disease eradication, working together to get everyone on board to participate in health initiatives is often an essential part of healthy community outcomes. The collective efforts of a community are crucial to healthcare; without community-wide education and adoption of health programs, eliminating even a single disease can become impossible.
Across many countries, Krentel’s projects use implementation research as a framework to guide the development of good community engagement. The implementation research framework helps to identify the barriers and bottlenecks to community engagement and works with the healthcare providers and community members to craft feasible solutions and strategies. With this approach, communities hear tailored messages and healthcare delivery is better suited to local context and reality. The team has learned that taking time to listen – whether it is healthcare professionals or community leaders – provides opportunities to learn, grow, and adapt so that our health programs have greater success.
Taking the implementation research lessons from this global work to Ottawa neighbourhood, Vanier, Bruyère’s researchers worked with the program implementers at the Vanier Community Research Centre and pediatricians at the Children’s Hospital of Eastern Ontario (CHEO) to plan and evaluate the Vanier Social Pediatrics Hub – the first of its kind in Ontario. In a community where families live in marginalized or vulnerable situations, the hub was developed to serve children and youth under 18 by providing a child-focused service that addresses health as well as social determinants of health.
Krentel’s team and co-evaluator, Vivien Runnels, PhD, worked closely with the Vanier Social Pediatrics Hub and CHEO to evaluate its strengths, weaknesses, and impact. Using research methodology validated in Indonesia, Cote d’Ivoire, and Uganda, they captured the stories that hub children and their families had while attending clinics. What our investigators saw was a program that enabled youth to access a comprehensive system of care that they may not have received otherwise. Using the stories, the Bruyère research team was able to provide feedback to the hub staff for further improvement of the service delivery. Listening to the voices of the communities we serve is key to successfully transforming care for a better quality of life.
Understanding and defining the barriers some of our most vulnerable community members face and finding ways to address them is how we continue to achieve better care. The many health and social needs of youth, especially with complex conditions and challenges, can only be met if we continue to actively listen to, identify, and evaluate the gaps our patients and communities face. Improving care means improving access, and this research is shows the short-term benefits are clear. As the program continues to adapt and improve from this year’s findings, we look forward to seeing the long-term impacts to health our community, and sharing our local experiences elsewhere in the world.
Watch Better Together: What We Learned in Three Years at the Vanier Social Pediatrics Hub, co-hosted by the Bruyère Research Institute and the Vanier Community Service Centre in November 2020.