Implementation and impact of an online tool to improve the income security of patients
Funders: CIHR, St. Michael’s Hospital Foundation, Intuit Foundation, Research Manitoba
Summary: We have collaborated closely with Prosper Canada and others to design and build an online tool to help individuals access financial benefits. We are studying whether health providers and patients find this tool acceptable and feasible for use in health settings and what is the short-term impact on awareness of benefits and community resources.
Why this matters: Electronic tools may play an important role in addressing social needs. However, significant obstacles are faced when integrating such interventions into clinical care. Lessons learned will inform the development of future tools, including those that bring together data from the electronic health record with online information.
addressInG iNcome securITy in primary carE (IGNITE) Study: a pragmatic, randomized controlled trial
Funder: TD Financial Literacy Grant Fund, AFP Innovation Fund, PSI Foundation
Summary: We have developed an Income Security Health Promotion service at the St. Michael’s Hospital Academic Family Health Team. We have studied the implementation of this service and are carrying out qualitative studies to better understand how and why the service works. The IGNITE study will examine the impact of the service on financial and health outcomes.
Why this matters: This study will be one of only a few to rigorously evaluate an income security intervention based within a clinical setting. The findings will inform policy on whether such services should be expanded more broadly, as well as inform other interventions to address income as a key social determinant of health.
EMPLOYMENT AND WORKING CONDITIONS
Effective interventions within health care settings for assisting patients to gain employment: A systematic review
Funder: Atkinson Foundation
Project Summary: We are conducting a systematic review of interventions that are based in health care settings that assist people gain employment.
Why this matters: This systematic review will inform future interventions that aim to help people who are dealing with unemployment, precarious work and violations of their working conditions.
EMployment and Better Employment through Relationships (EMBER): A pilot intervention
Funder: Atkinson Foundation
Summary: We are developing and testing a novel intervention to assist patients who are dealing with precarious work. Our aim is to help primary care patients by linking them to community and social resources.
Why this matters: Precarious work is a growing phenomenon, with full-time, unionized jobs being replaced with low paying part-time, temporary, contract positions that lack benefits or security. Our findings will help inform the development of a larger study and a tool for use in health provider education.
MULTIPLE SOCIAL DETERMINANTS
Using electronic medical record data on health and social determinants to improve HIV primary care: an audit and feedback study
Funder: AFP Innovation Fund
Summary: This project will use electronic medical record (EMR) data, include robust social needs data, to examine whether the quality of HIV care provided to patients can be improved through an audit and feedback intervention. Our objective is to examine whether audit and feedback targeting family physicians caring for people living with HIV and AIDS can improve a) retention in care, b) laboratory monitoring, and c) uptake of preventive interventions. We hypothesize that this intervention will lead to small but significant improvements in these domains of care.
Why this matters: By using EMR data, such interventions can quickly bring together the required information and present it in a graphical format that is easy to interpret. The findings will inform care at our centre, at the other 15 dedicated HIV clinics in Ontario, and at centres nationally as well as influencing how we improve care in diabetes, ischemic heart disease, COPD and other chronic diseases.
Evaluating the implementation and impact of a medical-legal partnership in a Canadian primary care setting
Funder: Legal Aid Ontario, St. Michael’s Hospital Translational Innovation Fund
Summary: With the support of Legal Aid Ontario, a medical-legal partnership has been established at the St. Michael’s Hospital Academic Family Health Team. This evaluation will include multiple parts, including a review of all cases to date; in-depth interviews with patients, providers and legal partners; and a prospective study.
Why this matters: Our findings will help inform the delivery of legal services and provide policy makers with a robust understanding of the added benefit of situating legal services within health spaces.