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MAP Centre for Urban Health Solutions names new chair in early life interventions

Dr. Katerina Maximova has been named the inaugural Murphy Family Foundation Chair in Early Life Interventions at MAP Centre for Urban Health Solutions, St. Michael’s Hospital, and the University of Toronto.

Dr. Maximova’s research and policy work focuses on children and youth, including social dimensions of health, behaviours that increase future risk of chronic disease risk, misperception of risk, and the effectiveness of early life interventions.

At MAP, Dr. Maximova will focus on solutions-oriented research to improve the early life experiences, development, and well-being of children and youth experiencing poverty.

“I am so pleased to be joining MAP and St. Michael’s,” said Dr. Maximova, “I’m also very grateful to the Murphy Family Foundation for their commitment to addressing upstream determinants of health for children and youth.”

Dr. Maximova received her PhD in epidemiology and biostatistics from McGill University. She is currently an associate professor in the School of Public Health at the University of Alberta, where she is a member of the Population Health Intervention Research Unit. She has played a major role in evaluating the impact of the APPLE Schools (A Project Promoting healthy Living for Everyone in Schools) intervention program targeting physical activity, healthy eating, and mental health of children and youth experiencing marginalization. APPLE Schools reaches more than 21,000 students annually in 75 schools across northern Alberta, British Columbia, Northwest Territories, and Manitoba. Prior to academia, Dr. Maximova spent several years with the Government of Canada working on policy issues focused on poverty in early life, ‘working poor’ families, income support for low-income families, family-friendly policies, affordable housing and homelessness.

Dr. Maximova has received several awards including a Career Development Award in Prevention Research from the Canadian Cancer Society Research Institute. She recently received a CIHR COVID-19 Rapid Research Grant to study the impact of prolonged school closure and social isolation on the mental health and lifestyle behaviours of elementary school children experiencing disadvantage.

About MAP Centre for Urban Health Solutions

MAP is a world-leading research centre dedicated to creating a healthier future for all. Through big-picture research and street-level solutions, our scientists tackle complex urban health issues — many at the intersection of health and inequality. Internationally recognized for groundbreaking science and innovation, MAP is changing the way the world understands the health consequences of social inequality in cities. Together with our community and policy partners, we are charting the way to the world’s healthiest cities: places where people, communities, and the political, economic, social, environmental, and health infrastructures come together so that everyone can thrive. MAP is part of the Li Ka Shing Knowledge Institute of St. Michael’s Hospital and is fully affiliated with the University of Toronto. St. Michael’s is a site of Unity Health Toronto, which also includes Providence Healthcare and St. Joseph’s Health Centre.

New research shares safety strategies for women experiencing domestic violence during the COVID-19 pandemic

Featured in Hospital News

As a researcher who has studied intimate partner violence for 25 years, Dr. Patricia O’ Campo knows that women experience higher rates of increased violence during epidemics — a troubling and well documented pattern. However, Dr. O’Campo discovered a puzzling gap in academic literature when the COVID-19 pandemic hit: there are no verified strategies women can utilize to promote safety and protect themselves during public health emergencies.

“There’s a lot of opinions about what women might do, but nobody has verified those strategies,” said Dr. O’Campo, Interim Executive Director of the Li Ka Shing Knowledge Institute and scientist at MAP Centre for Urban Health Solutions.

Once the COVID-19 pandemic was declared, Dr. O’Campo and her co-principal investigator, Dr. Nicholas Metheny, a Post-Doctoral Research Fellow at St. Michael’s, began exploring how to redesign the Pathways app — an earlier project which provides women in abusive partnerships with a personalized safety plan.

In a pandemic, women and children living with violence may be forced to shelter with violent partners, unable to access resources outside of the home, while dealing with a reduction in services available to them. Due to public health measures to prevent the spread of COVID-19, service agencies aren’t always able to support women face-to-face, so women experiencing violence may need to consider additional safety strategies.

To fill this gap in research, Dr. O’Campo and her team put together a list of around 35 suggested strategies and asked over 100 service providers and women with lived experience of domestic violence to rate whether the suggestions are “recommended” or “not recommended.” Some of the suggestions were rated by survey responders as having the potential to make violence worse.

“For example, we know that alcohol and substances can make an episode of violence more likely, and one of the recommendations was to hide alcohol or other substances that may make abuse worse,” she continued. “That one was rated by many women with lived experience as being something that would make violence worse.”

Other strategies that were rated as “not recommended” include trying to “keep the peace” and switching to texting or emailing instead of phone calls.

Based on the results of the rapid survey, Dr. O’Campo and her team created factsheets listing verified recommendations for women living in situations of intimate partner violence. The factsheets include tips for online and physical safety planning during public health emergencies. They are being disseminated to women and service providers to help them navigate issues that COVID-19 has exacerbated.

“There are risk factors for violence that are increasing as a result of the pandemic, and the economic pandemic that’s accompanying the infectious pandemic,” Dr. O’Campo said. “For example, an episode of unemployment highly increases household stress and therefore the risk of violence.”

The takeaway from this work, she says, is that there are strategies women can implement — that are recommended by women with lived experience and experienced service providers — to promote safety when they’re sheltering at home. These strategies, however, are not a “one-size fits all.”

“Everything should be tailored to the context in which you’re residing, but you can continue to promote safety even in this very difficult time.”

New CIHR funding to study impact of COVID-19 on mental health and substance use services

How has the COVID-19 pandemic impacted people who were released from prisons and require mental health services? What about people who rely on in-person addiction treatment to stop using opioids?

Two MAP scientists have been awarded new funding through the Canadian Institutes of Health Research (CIHR) Operating Grants: COVID-19 Mental Health & Substance Use Service Needs and Delivery to tackle their research questions.

The research and knowledge mobilization supported through these grants will help inform policy and practice in near real-time to respond to crisis-based needs. Congratulations to our researchers and their teams, whose projects are outlined below, for receiving this support.

Assessing mental health and substance use needs and service disruptions for people released from custody during the COVID-19 pandemic

In Canada, there are approximately 40,000 people in custody in correctional facilities on an average day and more than 250,000 people experience custody annually. A number of public health and correctional policy experts called for widespread release of people from custody during the pandemic to protect their health. In response, more than 2,300 people were released from jails in Ontario between March 16 and April 9, 2020.

MAP scientist Dr. Flora Matheson is interested in finding out how people released from correctional facilities during the pandemic have received mental health and substance use services, and whether they have experienced any disruptions or adaptations to the services they need. Dr. Matheson’s work will provide real-time, evidence-based agency and system-level recommendations to support the needs of this population as the pandemic continues.

Alterations in Prescribing of Opioid Agonist Therapy due to the Pandemic (ALT-POP) Study

A key treatment to help people who use illicit opioids is a medication that reduces cravings and prevents overdose. These medications, referred to as opioid agonist therapy, often require clients to frequently visit the pharmacy and their clinic. To ensure the safety of these clients during the pandemic, which has required physical distancing, several changes were made to how doctors and nurses provide these life-saving medications. These changes included less frequent visits to the pharmacy and reduced monitoring such as urine drug tests.

Dr. Ahmed Bayoumi and Dr. Samantha Young, a PhD student in Dr. Bayoumi’s research group, will evaluate how the changes in prescribing of medications for opioid use disorder as a result of COVID-19 impacted the clients who take them. This study will help inform how to best provide these medications going forward in order to reduce overdose death and treat opioid use disorder during the pandemic and beyond.

Opinion: Racism in the medical system goes far beyond a few bad apples

By Janet Smylie, Diane Smylie & Lisa Richardson

THE GLOBE AND MAIL

Over recent years we have seen an alarming increase in media reports of striking events of negligence and anti-Indigenous racism in Canadian hospitals. The emerging pattern is one of public outrage and a linked public policy debate in which Indigenous leaders advocate for tangible systemic change while non-Indigenous hospital and governmental leaders resist the premise or don’t see that anti-Indigenous racism in Canadian hospitals is common, pervasive and systemic.

For example, during the inquest into the death of Brian Sinclair, a 45-year-old First Nations man who died from treatable causes after waiting 34 hours in a Winnipeg emergency department, Dr. Thambirajah Balachandra, the province’s chief medical examiner, stated: “Even if Snow White had gone there, she would have got the same treatment under the same circumstances.”

While most incidents of anti-Indigenous racism in hospitals go unreported, at times evidence and public outrage are sufficient to result in public investigations or inquests with subsequent recommendations. Sadly, the latter are commonly diluted and only partially implemented. Efforts are typically superficial and performative, involving, for example, ineffective “cultural sensitivity” trainings.

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