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:
to identify and prioritize problematic narratives with policy actors and selected GBV stakeholders;
to use data from the Survey of Safety in Public and Private Spaces (SSPPS) to develop evidence-informed messages;
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.