Research Overview


Gender-Based Violence: Generating and Mobilizing Knowledge to Effect Change

My primary research goal is to understand the interplay between gender (and other social identities and locations) and experiences of violence, with a specific focus on intimate partner violence against women and ways to reduce it and it's impacts on women, families, and society. In addition to generating new knowledge through a variety of research methods and processes, I work closely with partners of various kinds to ensure that the research has a pathway to policy, practice and the public. Using an integrated knowledge mobilization approach, a first question is always: "Is this a timely and relevant question, and are the right people involved to make sure it's asked, answered and shared to maximize impact?"

I also study the process of mobilizing knowledge in this "wicked" problem area. For example, asking "how does "evidence" interact with values and context to shape decisions?" "What do we mean by "evidence" in different decision-making contexts?". "How do we acknowledge and work within the "messiness" of real decision processes with imperfect knowledge?".  These and other questions problematize the entire "knowledge translation/mobilization" discourse, and try to recognize and value different forms of knowledge and knowledge processes for different tasks and contexts.

health equity & social justice

As Academic Director of the Centre for Research on Health Equity and Social Inclusion (CRHESI), I work closely with community partners, other researchers, and learners of various kinds to identify, examine and address key social and health inequities in London and beyond. This work draws on related activities of the Gender, Trauma & Violence Knowledge Incubator @Western, which I first convened in 2018 to work collaboratively with community and policy partners on enabling trauma-and violence-informed care approaches in organizations, communities and systems. This work also links to research-based resources from EQUIP Healthcare, where we’ve developed and tested approaches to embedding equity-oriented health care into primary care settings and emergency departments, and are adapting and evaluating the model for various community contexts (see Current Projects).

An Information Science Lens

Many claims – largely untested - have been made about the benefits of living in an ‘information age’ including the potential for health information – made widely accessible through the Internet and other information and communication technologies (ICTs) - to inform and ultimately ‘empower’ citizens to make better decisions that will improve their health and well-being.   

Another goal of my research is to answer the overarching question “does ‘information’ assist in making health-related decisions,” and, if so, “do these decisions lead to improved health and well-being?”  Broadly framed, my goal is to understand how, on the one hand, to critically develop and evaluate knowledge resources in ways that are meaningful, while on the other, explore how and why people seek information, what they plan to do with it, and whether it ‘works’.  Importantly, I am also committed to developing ways to take the knowledge generated by this research and effectively communicate it to those who might use it in their daily decision-making, including policy-makers, those providing services to women (including health and social service providers, and information professionals), advocates, and women themselves.  This involves a parallel process of “doing” knowledge mobilization (KMob), while also researching the effectiveness of different types of KMob strategies on uptake, use and impact of new knowledge by different audiences. My primary content area, as described above, is violence against women/gender-based violence.

Brief Chronology

My post-PhD academic career began in 2004 with a postdoctoral fellowship, funded by the Canadian Institutes of Health Research (CIHR)-Ontario Women’s Health Council, at McMaster University (Department of Psychiatry & Behavioural Neurosciences), followed by a tenure-track position at the University of Toronto’s Faculty of Information before moving to Western’s Faculty of Information & Media Studies (FIMS; 2007-2020). I’m now a tenured (2010) Full Professor (2016) in the Arthur Labatt Family School of Nursing, with cross-appointments in FIMS, and the Faculty of Education, and an affiliate appointment in the Department of Gender, Sexuality & Women’s Studies. The first five years of my appointment were supported by a CIHR New Investigator Award (Women’s Health), and from July 2014 to June 2016 I was a FIMS Western Faculty Scholar, an award designated by the University.  In 2019 I became the Canada Research Chair in Mobilizing Knowledge on Gender-Based Violence,

It was during my post-doctoral work that I established many of the research partnerships that have evolved into long-term collaborations.  My approach to research is highly interdisciplinary and team-oriented, in part due to the nature of the studies I lead or otherwise participate in (large clinical trials, KMob studies with policy partners, etc.).  This is reflected in the many co-authored publications found in my CV, and also in the size of the teams involved in my research grants.  Most of my work would not be possible without these collaborations, nor would it be as fulfilling.

 

Research Area 1: The health care response to violence against women and children - an equity perspective

I have been studying violence against women for over 20 years, with previous professional experience in related areas. I am motivated by principles of social justice and the need not only to find better ways to support women, and their children, exposed to violence, but also to address the systemic and social structures that perpetuate violence and its harmful and ongoing consequences - this critical approach ensures that we examine the structures of society, from policies to practices, that may themselves be harmful and cause inequities. My focus is on developing better evidence to support the health and social service sector response to survivors of violence. Those experiencing violence are affected in a number of ways including a toll on their short- and long-term physical and mental health.

We know quite a lot about the risks for, and consequences of, violence and how it interacts with quality of life and well-being. We know less about what we should actually be doing to prevent violence and its consequences at the policy level and when providing direct service. I am strongly committed to developing and then mobilizing research knowledge so that it can be taken up in the “real world” – I develop and test knowledge mobilization processes so we can keep pushing ourselves to conduct relevant research and make sure it has the best chance of being used to make a difference. I founded a graduate program at the University of Western Ontario that has as main themes “knowledge translation” and “evidence-informed policy and practice”; this program develops highly qualified personnel in these areas, and I am privileged to supervise a number of students and post-doctoral fellows in cognate areas.

You can see and hear more from me about this here. An exemplar open access publication from 2022 reviewing the evidence for intimate partner violence interventions and why a trauma- and violence-informed, equity-oriented approach is needed is:

Wathen, C.N., Mantler, T. (2022). Trauma- and Violence-Informed Care: Orienting Intimate Partner Violence Interventions to Equity. Current Epidemiology Reports. Online first Oct 3/22: https://doi.org/10.1007/s40471-022-00307-7

Research Area 2: Knowledge Mobilization

Effective knowledge mobilization (KMob) requires a better understanding of the contexts and constraints of both the producers and users of knowledge, but also what happens at this interface.  A key research stream of mine has been developing and evaluating ways to translate research evidence into practice.  One of my main research questions, therefore, is: how have and will our research findings influence decision-making among the key stakeholders in the violence against women and children sector?  To achieve some of these ends, we have continued using techniques I developed in a project funded by the Ontario Women’s Health Council, Ontario Ministry of Health and Long-Term Care, to synthesize research reports into brief, policy-relevant research summaries (published in Healthcare Policy).

You can hear me speak briefly about my thinking around KMob here. For a slightly longer discussion, see our Fall 2017 Western University Royal Society Canada 150 Wave Event video here [I speak from ~1:22 to 1:43].

To hear a keynote I gave in Australia at the 2022 ANROWS Conference about KMb for GBV research, followed by a panel discussion, please visit: https://anrows.joyn-us.app/speakers/c-nadine or just my keynote on YouTube: https://youtu.be/R8ff3laMnTU

Research Area 3: Women's health decision-making - an Information Science perspective

My third main research stream – highly integrated with the first two both conceptually as well as in some aspects of content - has focused on women’s health decision-making, including studies examining hormone therapy decisions, whether and how women who have experienced intimate partner violence use information provided in health care settings, and how rural women seek and use health information. 

Several themes have emerged from this work: 1) there is a huge amount of health information available, from many and diverse sources with often competing interests; 2) a growing expectation is that people will use information and communication technologies (ICTs) to access health information, but many may not have the literacies or social locations required to search for, assess and apply the right information for their situation; 3) people, and women in particular, want those who provide health information to care about their problem, and they seek out sources that do this – sometimes to the detriment of information quality; the types and roles of these ‘info(r)mediators’ was the topic of an edited book I published with my colleagues [see below]; 4) while many studies look at the utility of ICTs to improve delivery of information and in some cases assess whether knowledge improves, very few studies are designed to determine whether having information actually makes a difference in key health and well-being outcomes.

My research therefore asks the questions: 1) How do women - especially those with identified concerns, including exposure to violence - search for and use information?  What are the roles of ICTs and formal and informal ‘info(r)mediators’? How do these sources interact? What literacies are required for women to effectively search for, find, understand and use information?  How do various social locations and structural factors intersect to enable or prevent women from achieving their knowledge goals? 2) Does access to and use of health information improve women’s health and well-being? What woman-centred outcomes are appropriate to include in an analysis of the potential impact of health information?  

Methodology

Methodologically, I am committed to selecting the research method that best answers the specific question(s) being asked. Often, selecting the best approach to a research question means multiple and/or mixed methods, and as indicated in my CV, I have used methods ranging from multi-site experimental trials to qualitative interviews, and believe as well in better utilization of secondary data analysis, including systematic evidence reviews and syntheses.  Recently, I’ve found that the case study approach, utilizing mixed methods to “surround” a question to understand it in depth as well as breadth, is particularly useful for my KMob research, where context plays an extremely important role in knowledge uptake and use.  

Link to CV

Research Productivity Summary

Publications (see CV)

Peer-Reviewed Articles = 121

Non-Refereed Articles in Journals = 9

Books = 3

Book Chapters = 12

Published Abstracts = 16

Peer-Reviewed Presentations = 119

Invited Speaker = 61

Technical Papers & Reports = 21

Grants

as Principal or co-Principal Investigator = ~$14,000,000

as Co-Investigator/Collaborator = ~$19,000,000

Total Funding = ~$33M

 

Google Scholar Metrics (@October 2022) 

  • 9162 Citations

  • h-index = 47

  • i10-index = 89

To view updated metrics, click here

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Current Projects


Trauma- & Violence-Informed Care Education for Health and Social Service Organizations & Providers

Given the demand for strategies to enhance equity in the delivery of various public services, our team at the GTV Incubator (see below) has been working with various partners to develop new online educational modules to support pre- and in-service learners. These build on the TVIC Foundations Curriculum I developed as part of the EQUIP Pathways Project (below), and now includes a module on TVIC in Public Health Nurse Home Visiting and Outreach, partnering with Dr. Susan Jack and the Public Health Nursing Practice, Research & Education Network (PHN-PREP) available here. In development are modules specific to supporting:

1) primary care clinicians in having conversations with people about lung cancer screening - this is a partnered project with Dr. Ambreen Sayani at Women’s College Hospital in Toronto and is guided by a patient advisory panel;

2) primary and secondary school educators to create TVI classrooms - this work is co-led by Dr. Susan Rodger at Western University’s Faculty of Education and build on our previous work with a local school board and in integrating TVIC in course work for teacher candidates (see our publication here);

3) organizations and staff serving survivors of gender-based violence - with our VAW service partners in SW Ontario, we’ve recently applied for SSHRV funding to develop this module as part of an implementation study to integrate TVIC into VAW/GBV and related services in Ontario;

4) family support workers and others providing financial literacy education to women living on low income - partnering with Families Canada, I am giving a series of TVIC webinars in Fall/Winter 2022/3 and consulting on development of new TVIC e-learning for financial literacy educators.

Our related publications on TVIC include:

Wathen, C.N., Varcoe, C.M. (Eds). (in press). Implementing Trauma- and Violence-Informed Care: A Handbook for Diverse Service Contexts. University of Toronto Press.

Wathen, C.N., Schmitt, B., MacGregor, J.C.D. (2021). Measuring Trauma- (and Violence-) Informed Care: A Scoping Review. Trauma, Violence & Abuse. Online first (open access): https://doi.org/10.1177/15248380211029399

Wathen, C.N., MacGregor, J.C.D., Beyrem, S. (2021). Impacts of Trauma- and Violence-Informed Care Education: A Mixed Method Follow-Up Evaluation with Health & Social Service Professionals. Public Health Nursing. Online: https://onlinelibrary.wiley.com/doi/abs/10.1111/phn.12883

Collaborative Development of a Protocol for Trauma- and Violence-Informed Knowledge Mobilization (TVI-KMb)

Led by Professor Glorieuse Uwizeye, I am co-lead on a SSHRC-funded project to bring a TVIC approach to knowledge mobilization (KMb) practices. Dr. Uwizeye’s work explores the impacts of prenatal exposure to genocide or genocidal rape on the well-being of Rwandans conceived during the 1994 Genocide. The desire of many study participants to know the effects of this prenatal adverse experience on their adult health has requires us to consider how best to convey adverse health conditions to the study community in a manner that supports individual and community resilience and promotes community-based interventions. In Fall 2022, we will travel to Rwanda to implement and evaluate our new TVI-KMb protocol with a group of survivors and with a separate group of researchers and professionals who work to support survivors.

We will then bring this protocol to London, Ontario for consultation, via Western’s Centre for Research on Health Equity and Social Inclusion (CRHESI), with community partners and researchers to adapt and evaluate the protocol for local needs, creating a tool and approach that will be useful in any research context where the knowledge to be mobilized has the potential for benefit, but also the potential for harm among traumatized and structurally marginalized individuals and groups. This presents a significant advance in the field of knowledge mobilization.

Shifting Narratives: What Messages about Gender-Based Violence (GBV) in Canada Need to Change?

Supported by my Canada Research Chair, this is a multi-stage project in partnership with the Federal Department of Women and Gender Equality (WAGE), The overarching goal is threefold:

  1. to identify and prioritize problematic narratives with policy actors and selected GBV stakeholders;

  2. to use data from the Survey of Safety in Public and Private Spaces (SSPPS) to develop evidence-informed messages;

  3. and to work with partners to communicate these new messages in ways that will start shifting public narratives about GBV.

The initial focus is on intimate partner violence (IPV). The project has multiple integrated stages that began in Fall 2019 with a media analysis, featured a Deliberative Dialogue with federal policy partners in March 2020, and continued through 2021 as we analysed IPV data from the SSPPS to better understand Canadians’ experiences of IPV and how they related to other aspects of their lives. As part of this, and related, work we developed a scoring approach to the Composite Abuse Scale-revised Short Form (CASr-SF) that differentiates more severe, patterned forms of violence, from bi-directional aggressive behaviours in relationships. A full report of those analyses, including Canadian prevalence data and the scoring algorithm is available here. A brief summary of findings can be found here.

Next steps, working with WAGE, will be to develop strategies to mobilize these new, evidence-informed narratives, to key stakeholders and the public.

The Gender, Trauma & Violence Knowledge Incubator @ Western

GTVIncubator.uwo.ca :: @GTVIncubator

The GTV Incubator, a core innovation space supported by my Canada Research Chair, is a collective of researchers, community service leaders, educators and trainees committed to gender, trauma and violence research, policy and practice. We develop, evaluate and mobilize knowledge to transform systems to trauma- and violence-informed care (TVIC) approaches to policy and practice. Our work has been cross-sectoral, including public health, primary health care, domestic violence services, social services, policing, education, and beyond. With Colleen Varcoe, I am currently editing a book, forthcoming in late 2022 or early 2023 from University of Toronto Press, with contributions from Incubator members. Titled Implementing Trauma- and Violence-Informed Care: A Handbook for Diverse Service Contexts it is intended for those who want to integrate TVIC into their organizational and/or individual practice.

I am also working with the Public Health Agency of Canada and Women & Gender Equality Canada to embed TVIC thinking into policy and program development, and mobilizing knowledge on gender-based violence.

EQUIP: Research to Equip Health & Social Services for Equity

www.equiphealthcare.ca :: @EQUIPHealthcare

Pathways to Care for People Who Use Drugs: Equipping Health Care to Tackle Stigma, Discrimination and Inequity, [Public Health Agency of Canada, $795K, 2020-2022] [Wathen, co-PI & KMob Lead; C. Varcoe (NPI), A. Browne & V. Bungay, Co-PIs]. Summary.

Promoting Health Equity for Indigenous and non-Indigenous People in Emergency Rooms. [CIHR, $2.175M, 2016-2021] [Wathen, co-I & KMob Lead; C. Varcoe (NPI), A. Browne & V. Bungay, Co-PIs]

Equity-Oriented Primary Healthcare Interventions for Marginalized Populations: Addressing Structural Inequities and Structural Violence [CIHR, $1.975M, 2011-2018] [Wathen, co-PI & KMob Lead, with A. Browne (NPI), C. Varcoe & M. Ford-Gilboe]

EQUIP-Primary Health Care (EQUIP-PHC) was a CIHR-funded interdisciplinary research program designed to promote health equity for marginalized populations through innovative equity-oriented interventions.  The research questions were: Can providing training to health care providers about the impacts of violence, discrimination, and poverty, and support to their organizations, improve primary health care services, and make patients happier with their care, and healthier? Does this type of training and organizational support make health care providers more satisfied with their own practice, and the impact they are having on patients’ health and quality of life? What policies, practices and other aspects of clinic context influence the uptake of equity-oriented health care? Can equity-oriented primary health care indicators be identified and integrated into systems? Five primary health care clinics in Ontario and BC participated.

The EQUIP intervention was adapted and tested (2017-2022) in Emergency Department settings in BC (EQUIP-ED), with key findings indicating that the site with the most robust implementation of EQUIP showed significant improvement in a key equity-sensitive administrative metric, specifically that people at this site were less likely, after the EQUIP intervention, to leave before their care was completed. Additionally, using latent class analysis, we identified groups that were more likely to face discrimination and poor care in EDs.

Publications from the Primary Care and ED studies are available at https://equiphealthcare.ca/publications/

Funding from the Public Health Agency of Canada (2020-2022) supported updating all EQUIP resources, developing new online learning strategies, and tailoring content to better serve people who face substance use stigma. The primary suite of implementation support resources, including Discussion, Action and Educational tools, is found in the EQUIP Equity Action Kit:

https://equiphealthcare.ca/equity-action-kit/

The media stories on the launch of the Action Kit include:

Tools aim to improve care for people experiencing substance use stigma: Team from Western and UBC launch the EQUIP Equity Action Kit - https://news.westernu.ca/2022/09/tools-aim-to-improve-care-for-people-experiencing-substance-use-stigma/

Western University and UBC launch ‘action kit’ to fight substance use stigma - https://globalnews.ca/news/9148873/equip-equity-action-kit-western-university-ubc/

Related projects:

Oudshoorn, A., Smye, V. (co-PIs), EQUIP Housing: Enacting Culturally Safe Housing Stability for Indigenous Youth Finding Home. Making the Shift – Networks of Centres of Excellence (Canada). $235,902 (03/2021-02/2024). [Wathen, co-investigator] - see the media stories on the launch here and here.

Wylie, L., Ray, L. (co-PIs). Educating for Equity: Building Culturally Safe Care through Indigenous Narratives. Canadian Institutes for Health Research: Project. 2019-2024. ($460,050). [Wathen, co-investigator] - see the announcement here.

Past Research

Research in a Pandemic: Our Work on Violence and COVID-19

The COVID-19 pandemic, and our response to it, laid bare social and health inequities, especially as they affect women and children experiencing violence in the home. Our research team helped address these issues by working with local violence against women services in SW Ontario, and across the province, to understand the impact of “stay at home” orders, and physical distancing mandates on women’s experiences of safety, and on how services deliver care.

A team from our Gender, Trauma & Violence Knowledge Incubator @ Western received a Western Catalyst Grant to study the effects of pandemic-related changes in service experiences on those using and delivering anti-violence services. I’m honoured to co-lead this inter-related set of studies with Jessie Rodger, Executive Director of Anova, London’s women’s shelter and sexual assault service. We’re also partnering with violence against women services in Strathroy, Stratford, Sarnia and Thunder Bay. The Western research team included Tara Mantler (Health Studies), Susan Rodger (Education), and Marilyn Ford-Gilboe & Vicki Smye (Nursing), and staff and trainees Jen MacGregor, Eugenia Canas, Jill Veenendaal and Caitlin Burd (all from FIMS) and Isobel McLean (University of British Columbia). A study summary is available here.

In October 2020 our team was awarded a SSHRC Connections Grant to hold two events to develop and share knowledge within and beyond the VAW sector. A study summary is available here.

Key outputs, including open access journal articles, graphic research briefs, video summaries and our Space Planning Handbook are available at: https://gtvincubator.uwo.ca/vawservicespandemic/

Preventing Violence Across the Lifespan (PreVAiL)

Preventing Violence Across the Lifespan (PreVAiL) Research Network [Canadian Institutes of Health Research (CIHR)  Institute for Gender and Health; $2M; 2009-17 and Public Health Agency of Canada, $445K; 2017-2019] [Wathen, Co-Principal Investigator (PI)] http://www.prevailresearch.ca/ :: @PreVAiLResearch


PreVAiL, which wound down in 2019, was an international research collaboration of over 60 researchers and partners from Canada, the US, the UK, Asia, Europe and Australia whose goal was to bring together researchers and decision-maker partners to produce and share knowledge to help children, women and men exposed to child maltreatment and intimate partner violence (IPV). PreVAiL had three main objectives: 1) to increase knowledge about the links between mental health impairment, gender and exposure to child maltreatment and IPV, both in Canada and internationally; 2) to develop interventions to prevent or reduce child maltreatment, IPV and related mental health problems; and 3) to develop and use proven methods of knowledge translation and exchange to ensure that our research findings reach those who make decisions in these areas. In PreVAiL's initial iteration, funded by CIHR, I led the knowledge mobilization (KMob) Theme area, which brought together researchers and knowledge-user partners to develop and evaluate KMob strategies in the area of violence, gender and mental health. In PreVAiL's second iteration, funded by the Public Health Agency of Canada, our focus was on positioning PreVAiL as a KMob "hub" for family violence research, with a specific focus on Canadian public policy.

DV@WorkNet

The Impact of Domestic Violence on Workers and Workplaces [Social Sciences & Humanities Research Council of Canada (SSHRC), $198K, 2014-2016] [Wathen, co-PI]

www.dvatworknet.org

DV@WorkNet began as a SSHRC-funded international network of researchers, advocates, labour organizations and other partners interested in collaborating to generate knowledge on the impacts of domestic violence (DV) in the workplace. Its first project was a pan-Canadian survey, partnering with the Canadian Labour Congress, on the impact of DV on workers and workplaces.
Survey report: http://www.canadianlabour.ca/sites/default/files/dvwork_survey_report_2014_en.pdf

We created a series of infographics highlighting key findings from this work:

http://dvatworknet.org/content/infographics

You can hear me discuss the impact of some of our research here.