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.