Research Report Released: caat.link/news/bbd-research-report-released/
Our Research Study (2019-2023)
Beyond Blue Door: A research study to reduce knowledge and service gaps for people living with HIV (PLHIV) with precarious or no health insurance coverage
People living with HIV with precarious / no health care experience major barriers in accessing HIV care. This affects both people’s individual health as well as the overall public health response in curbing the HIV epidemic. In response to these needs, a coalition of health and community service agencies came together and developed the Blue Door Clinic, which has provided HIV treatment, community support and assistance, and links to ongoing services for people living with HIV with limited/ no health care coverage since September 2019.
Along with the Committee for Accessible AIDS Treatment (CAAT) as well as our collaborative partners we realize that we need to continue our work to build our knowledge evidence-based interventions to reduce health inequities and promote equitable access to our communities. The Beyond Blue Door Research Study was set up to address these objectives.
The study will engage PLHIV with precarious and no health insurance coverage and service providers working with them to learn about their experiences, evaluate the effectiveness and impact of the Blue Door Clinic, and identify long term strategies to improve the care and well-being of our communities. The project is supported by the Endgame Research Funding from the Ontario HIV Treatment Network.
Purpose and Objectives
The Beyond Blue Door Research Project aims to:
- Generate knowledge on the determinants of HIV related health disparities experienced by PLHIV with precarious or no health insurance coverage
- Evaluate the effectiveness and sustainability of the Blue Door Clinic initiative in supporting the linkage to stable, long-term primary care; and
- Identify evidence-based strategies to advance policy and service access for precariously/ non-insured PLHIV who experience marginalization.
Are you a person living with HIV (PLHIV) who faces barriers in getting health care or treatment due to lack of health insurance? We want to hear from you!
To participate in the Beyond Blue Door Study you must meet the following criteria:
People Living with HIV
You must be:
- Living with HIV
- Over the age of 16
- Able to read and communicate in English, and do not hold status that entitles you to public health care coverage in Canada (i.e., Canadian Citizenship, Permanent Residence, etc.)
You must be a service provider who has experience working with precariously insured/uninsured clients who are 16 years or older and who are HIV positive
If you are interested in getting involved with this study, please self select either PLHIV or Service Provider to learn more about the participating. All participation is completely voluntary and you can withdraw at any time without repercussions.
To address our objectives, we have designed four components of the Beyond Blue Door Study using different methods. Our methods include individual interviews, focus groups, questionnaires, community consultations, and strategic planning sessions. Our research components will engage PLHIV with precarious or no health coverage, as well as the service providers who work with them.
Component 1: Understanding the experiences of non-insured people living with HIV through focus groups and interviews.
Component 2: Service evaluation of Blue Door Clinic (Focus group and surveys)
To evaluate the effectiveness and sustainability of the Blue Door Clinic intervention, we will adopt the RE-AIM framework to track the Reach, Effectiveness, Adoption, Implementation, and Maintenance/Sustainability of the clinic. Data will be collected through focus groups and surveys with PLHIV and the service providers who work with them, as well as community advisors. Guided by the RE-AIM framework, we will apply descriptive statistics to analyze the data and assess the level of effective implementation of the Blue Door initiative.
Component 3: Supporting the Ontario Cohort Study
This component of our research involves working with the OHTN OHTN Cohort Study (OCS) to develop a data collection system that will enable us to document and understand the long-term health needs and outcomes of our target populations. We will do so by recruiting approximately 50 PLHIV with little to no health care coverage to participate in baseline health data collection. The same tool will be used to conduct follow- up questionnaires on the health statuses of survey participants annually after completion of their baseline. This phase also includes ongoing capacity building training of six Peer Researchers who will assist in OCS data collection.
Component 4: Knowledge Translation Activities
Based on our research study’s findings, this component of the study will engage project collaborators and community members in knowledge translation activities. Some of these activities will include: a long term sector wide working group on non-insured PLHIV health; publications and presentations; community policy and practice think tanks; and advocacy to advance systemic changes
The Committee for Accessible AIDS Treatment (CAAT) is a network of service providers and immigrant/refugee PLHIV working together to improve access and quality of care for marginalized PLHIV. It has an extensive history of community based research and capacity building collaboration with marginalized PLHIV. For more information, please visit https://www.caat.link
About Blue Door Clinic
The Blue Door Clinic is a walk-in clinic for people who do not have health insurance or immigration status in Canada. It provides short-term medical care focusing on HIV treatment, community support and assistance, and links to ongoing services. For more information, please visit https://www.bluedoorclinic.org/
Dr. Alan Li (Principal Investigator)
Alan is a primary care physician at Regent Park Community Health Centre with over 30 years of experience working with diverse and marginalized communities to advance health equity and social justice. As the past president of the Chinese Canadian National Council, founding president of Asian Community AIDS Services and the Committee for Accessible AIDS Treatment, Dr. Li has worked closely with community stakeholders on many research projects that directly resulted in the creation of innovative services and informed policy changes. These include: the establishment of a compassionate medication program at the Toronto People with AIDS Foundation, immigration legal services at the HIV Legal Clinic of Ontario, multiple health literacy and community mentorship training programs, as well as policy change in health cost threshold for immigration economic exclusion eligibility.
Dr. Josephine Pui-Hing Wong (Co-Principal Investigator)
Josephine is a professor at the Daphne Cockwell School of Nursing at Toronto Metropolitan University (TMU). She has extensive experience in critical public health. She specializes in community-based action research, stigma reduction interventions, and implementation science to promote health equity among racialized and marginalized communities.
Dr. Mandana Vahabi (Co-Principal Investigator)
Mandana is a Professor at the Daphne Cockwell School of Nursing at Toronto Metropolitan University (TMU). Dr. Vahabi is a social epidemiologist with expertise in population-based assessment, planning and evaluation in population health programs, and infectious disease surveillance and outbreak management. She held the position of senior epidemiologist and policy consultant at the Toronto District Health Council (TDHC), and Ministry of Health Long Term Care (MOHLTC) for over a decade.
Alessandro Bisignano, Co-Applicant
Formerly PLHIV mentorship program coordinator at Committee for Accessible AIDS Treatment. Areas of expertise: community capacity building, mental health and addiction, immigration and refugee issues, community based research. Currently, Alessandro works as Client Engagement Evaluation Specialist, Casey House.
Eugene Nam, Co-Applicant
Master of Social Work (with collaborative study in Public Policy) Community based researcher, research on health system access issues & international students living with HIV. Currently, Eugene works as Community Manager, Medical Affairs, HIV, Gilead Sciences Canada.
Rene Lopez, Co-applicant
Formerly Gay men outreach & strategy worker at Centre for Spanish speaking people’s HIV program. HIV prevention, stigma reduction and service access navigation. Currently, Rene works as the Sexual Health and Volunteer Coordinator at the Hassle Free Clinic.
Jeffrey Reinhart RN,BScN, BA
Primary care nurse and LGBTQ Program Manager at Sherbourne Health Centre.
Executive Director at Toronto People with AIDS Foundation.
Senior Coordinator, Policy and Research, at the Ontario Council of Agencies Serving Immigrants.
Former Director of Clinical Services, Regent Park Community Health Centre.
Ontario Aboriginal HIV/AIDS Strategy.
Manager of the Health Analytics team, Toronto Central LHIN.
Ilyess El. Karouni
Associate professor of Health Economics, University Paris 8.
Executive Director, Black Coalition for AIDS Prevention.
Research Project Coordinator
Ower Alexander Oberto