Creating Safe Connections: A Co-Designed E-Learning Module to Advance Equity and Social Accountability in Preventative Primary Care

Ambreen Sayani,1,2 Zeenat Ladak,1,3 Jackie Manthorne,4 Erika Nicholson,5 Gary C Bloch,6,7 Janet Parsons,2 Stephen W Hwang,6 Bikila Amenu,8 Howard Freedman,8 Tara Jeji,8 Angus Pratt,8 Vinesha Ramasamy,8 Jean-Claude Camus,8 C Nadine Wathen,9 Jennifer CD MacGregor,9 Danielle Dilkes,10,11 Aisha Lofters1,12,13 1Women’s College Hospital Research & Innovation Institute, Women’s College Hospital, Toronto, Ontario, Canada; 2Institute of Health Policy, Management & Evaluation, University of Toronto, Toronto, Ontario, Canada; 3Applied Psychology & Human Development, University of Toronto, Toronto, Ontario, Canada; 4Board of Directors, Canadian Cancer Survivor Network, Ottawa, Ontario, Canada; 5Executive Team, Canadian Partnership Against Cancer, Toronto, Ontario, Canada; 6Family and Community Medicine, St. Michael’s Hospital, Toronto, Ontario, Canada; 7Board of Directors, Inner City Health Associates & Health Providers Against Poverty, Toronto, Ontario, Canada; 8Patient Partner, Women’s College Hospital, Toronto, Ontario, Canada; 9Arthur Labatt Family School of Nursing, University of Western Ontario, London, Ontario, Canada; 10Centre for Teaching & Learning, University of Western Ontario, London, Ontario, Canada; 11Curriculum, Teaching, & Learning, University of Toronto, Toronto, Ontario, Canada; 12Department of Family & Community Medicine, University of Toronto, Toronto, Ontario, Canada; 13Peter Gilgan Centre for Women’s Cancers, Women’s College Hospital, Toronto, Ontario, CanadaCorrespondence: Ambreen Sayani, Women’s College Hospital Research & Innovation Institute, Women’s College Hospital, 76 Grenville St, Toronto, Ontario, M5S 1B2, Canada, Tel +1 416 323 6400 ext 3772, Email [email protected]: Lung cancer is the leading cause of cancer-related deaths worldwide and in Canada. Primary care providers (PCPs) play a vital role in incorporating lung cancer prevention and early detection into routine practice. This study outlines the co-design of Creating Safe Connections, an e-learning module developed to build PCPs’ capacity to deliver equity-oriented preventative care.Methods: This manuscript describes the pre-design and co-design phases of the innovation process, guided by the Generative Co-Design Framework for Healthcare Innovation. The pre-design phase established a governance structure comprising patient partners with lived/living experience and interest-holders including PCPs. During the co-design phase, key module priorities and research goals were identified, including barriers to access, stigma and trauma, and operationalizing equity-oriented care. All aspects of the module—its name, logo, content, and knowledge mobilization strategies—were co-developed with the patient partners and health system partners. To inform the e-learning module content, interviews were conducted with community-based PCPs in Ontario, Canada to explore how they apply equity-oriented skills in practice. Interviews were analyzed using deductive content analysis.Results: PCPs’ (five family physicians, two nurse practitioners) interview analysis was informed by the four pillars of Trauma- and Violence-Informed Care: recognizing the impact of trauma and violence; creating emotionally, culturally, and physically safe environments; promoting choice, collaboration, and connection; and adopting a strengths-based, capacity-building approach. These themes shaped the co-design of a Continuing Medical Education-accredited module, which includes video narratives, case studies, a learner’s notebook, and interactive assessments.Conclusion: This work offers a model for the participatory co-design of equity-focused educational interventions that bridge gaps in provider training while aligning with the care needs and priorities identified by structurally underserved populations. The module uses lung cancer screening as a case example to illustrate approaches to addressing inequities in preventative care.Keywords: patient-partnered, accessibility, asynchronous learning, patient-centered care, lung cancer screening, smoking cessation, trauma- and violence-informed care, co-design, lived experience expertis

Priorities for research in child maltreatment, intimate partner violence and resilience to violence exposures: results of an international Delphi consensus development process

BACKGROUND: Intimate partner violence (IPV) and child maltreatment (CM) are major global public health problems. The Preventing Violence Across the Lifespan (PreVAiL) Research Network, an international group of over 60 researchers and national and international knowledge-user partners in CM and IPV, sought to identify evidence-based research priorities in IPV and CM, with a focus on resilience, using a modified Delphi consensus development process. METHODS: Review of existing empirical evidence, PreVAiL documents and team discussion identified a starting list of 20 priorities in the following categories: resilience to violence exposure (RES), CM, and IPV, as well as priorities that cross-cut the content areas (CC), and others specific to research methodologies (RM) in violence research. PreVAiL members (N = 47) completed two online survey rounds, and one round of discussions via three teleconference calls to rate, rank and refine research priorities. RESULTS: Research priorities were: to examine key elements of promising or successful programmes in RES/CM/IPV to build intervention pilot work; CC: to integrate violence questions into national and international surveys, and RM: to investigate methods for collecting and collating datasets to link data and to conduct pooled, meta and sub-group analyses to identify promising interventions for particular groups. CONCLUSIONS: These evidence-based research priorities, developed by an international team of violence, gender and mental health researchers and knowledge-user partners, are of relevance for prevention and resilience-oriented research in the areas of IPV and CM