Evaluating Novel Approaches that enGage And support vulnerable patient Groups to Equitably access primary care (ENGAGE): Building the foundation for a national adaptive platform trial

Population Health Management
In Progress
Primary Care, Primary Health Care, Social Determinants of Health


Canadians are facing a serious crisis in access to primary care, with 1 in 5 lacking a primary care provider. The federal, provincial and territorial governments have announced billions of dollars to address this crisis. However, without planning and the engagement of patient groups facing vulnerabilities, these new investments and related policies may widen inequities in health care access.

The ENGAGE project is made up of two objectives that will take place at the same time.

Objective 1

We will assess current approaches and resources to engage patients facing vulnerabilities in primary care across Canada through an environmental scan of policy documents, reports, and publicly available information from the last decade. We will also conduct in-depth interviews with policymakers and people with lived experience of vulnerability in four provinces (British Colombia, Alberta, Ontario, and Quebec) to gather their insights on existing initiatives and their views on interventions.

Objective 2

We will conduct a pilot cluster randomized controlled trial (cRCT) in the Toronto region in collaboration with the Office of Health System Partnerships (U of T) and Ontario Health. The trial will focus on connecting adults facing vulnerabilities with primary care either through a navigator-lead intervention or through multilingual written information in different sub-regions of Toronto.


A comprehensive understanding of current approaches and gaps: By systematically evaluating the existing strategies and policies in each province and territory and examining four provinces in depth, we will establish a robust evidence base on current approaches. We will also identify gaps and best practices across the country, which will inform future interventions.

Evidence-based policy recommendations: The insights from our policy analysis and stakeholder interviews will feed into policy recommendations. We will guide government and health system leaders toward adopting proven strategies and interventions that support the engagement of vulnerable patients.

Pilot study results: The pilot study will provide the necessary data to support a future APT. The results will shape the design and implementation of this national study to continuously and efficiently evaluate approaches to engage and support people facing vulnerabilities in accessing primary care.

Building the ENGAGE team: This work will catalyze a new collaboration among researchers, patient partners, health providers, and system leaders to identify the best approaches to address the crisis in access to primary care.

Team Members

Advisory Members

  • Kimberly Strain (Collaborator/Patient Partner)
  • Alexander Zsager (Collaborator/Co-Principal Investigator)
  • Veronika Kiryanova (Collaborator/Patient Partner)
  • Donna Rubenstein (Collaborator/Patient Partner)
  • Mike Warren (Collaborator/Patient Partner)
  • Gabriela Covaci (Collaborator/Patient Partner)

Contact Information