PRP054: Comparative Case Study of the COVID-19 Response for Canadian Urban Underserved Patients Experiencing Care Transitions

Ginetta Salvalaggio, MD, MSc, CCFP (AM); Cara Brown, PhD, OTReg(MB); Brynn Kosteniuk, MSc, BA&Sc.; Shanell Twan; Aisha Lofters, MD, PhD; Elaine Hyshka; FRANCESCO MOSAICO; Lee Green, MD, MPH; Melissa Perri, BHSc, MPH; Nathaniel Le Chalifoux, BCJ, MSW Student; TERESA CAVETT, MD, BSc CCFP FCFP MEd


Context: Urban underserved populations—a group living with unstable housing, low income, and/or chronic conditions such as addiction and mental illness—experience poor care integration, in particular during care transitions. The COVID-19 pandemic is disrupting the usual continuum of care, and exacerbating their risk of illness and illness severity. The pandemic has highlighted existing strengths and fault lines within the urban underserved system of care. Objectives: 1) Describe COVID-19 response policies for urban underserved populations across three provinces; 2) Examine how these policies impact continuity of care, in particular during care transitions; 3) Determine how urban underserved community members have been engaged in the policy process; and 4) Study Design: Comparative case study using Walt and Gibson’s Policy Triangle framework. Methods include document review, qualitative interviews with key informants, and triangulation of text-based and interview findings. Urban underserved community members are engaged throughout the study, contributing to study design, interpretation, and knowledge translation. Setting/Dataset: Three Canadian cities (Edmonton, Winnipeg, Toronto) serving large urban underserved populations. Text-based data sources include 1) local, regional, and national policies developed to support urban underserved populations during the COVID-19 response, and 2) media accounts of policy announcements and implementation. Population studied: Front line clinicians, urban underserved community members, and health and social system policy actors implicated in each city’s COVID-19 response. Outcome Measures: Inductive latent content analysis will be used to explore the content, context, actors, and processes involved in policy development, specifically exploring how well policies worked, what would have worked better, how continuity of care was addressed, and how urban underserved populations themselves were engaged. Anticipated Results: Using an integrated KT approach, findings will enable our team to co-develop recommendations for optimizing continuity of care for urban underserved populations within and across jurisdictions in Canada, during the pandemic response and beyond.
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Viv Ramsden 11/21/2020

Ginetta et al, thanks for your poster and its attention to engagement. I am interesting in learning more about how the patient advisors/partners were integrated into the research processes as it was unclear to me on the poster. Enjoy NAPCRG.

Ginetta Salvalaggio 11/21/2020

Hi Viv - sad not to connect in person! Re: community member integration they were involved in study inception and we have been connecting regularly for guidance on where to search, who are the key actors, construction of timeline, development of interview guide, interpretation etc. It has been hard with pandemic precautions, grieving, connectivity issues etc. but hoping to mindfully co-message as well.

Viv Ramsden 11/22/2020

Ginetta, thanks for your reply and for sharing your participatory approaches so that I could better understand the process. I agree that it is sad that we are unable to connect in person and I miss that. Enjoy the conference....

Donna Manca 11/22/2020

NIce poster Ginetta and good work!

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