No abstract

Sexual assault against transgender (trans) persons is a complex public health issue requiring the coordinated effort of multiple sectors to address. In response to a global call to improve health equity for persons of diverse gender identities, leaders across health and social service sectors need to enhance collaboration to champion trans-affirming care for sexual assault survivors. In collaboration with Egale Canada Human Rights Trust and the Ontario Network of Sexual Assault/Domestic Violence Treatment Centres, we have undertaken the development of an intersectoral network to connect trans-positive community organizations with hospital-based violence treatment centres to improve support services for trans survivors across Ontario. Guided by the Lifecycle Model for network development outlined by the National Collaborating Centre for Methods and Tools, we describe our approach to planning the intersectoral network, including key insights learned thus far and the potential of the network moving forward.

Objective The objective of this study is to understand the perceptions of new mothers using virtual care via video conferencing to gain insight into the benefits and barriers of virtual care for obstetric patients. Methods Semi-structured interviews were conducted with 15 patients attending the Kingston Health Sciences Centre. The interviews were 20–25 min in length and recorded through an audio recorder. Thematic analysis was conducted in order to derive the major themes explored in this study. Results New mothers must often adopt new routines to balance their needs and their child’s needs. These routines could impact compliance and motivation to attend follow-up care. In our study, participants expressed high satisfaction with virtual care, emphasizing benefits related to comfort, convenience, communication, socioeconomic factors, and the ease of technology use. Participants also perceived that they could receive emotional support and build trust with their health care providers despite the remote nature of their care. Due to its ease of use and increased accessibility, we argue that virtual care shows promise to facilitate long-term compliance to care in obstetric patients. Conclusions Virtual care is a useful modality that could improve compliance to obstetric care. Further research and clinical endeavours should examine how social factors and determinants intersect to determine how they underpin patient perceptions of virtual and in-person care.

Postpartum depression (PPD) refers to a woman's experience with any depressive episode occurring within the first year of the postpartum period (Stewart et al., 2008;53(2):121-4). While PPD is a global phenomenon, the distribution of PPD within populations is not universal. Indeed, evidence from the Canadian literature confirms a significant disparity in PPD outcomes, as the prevalence rate of PPD is markedly increased among immigrant women (Stewart et al., 2008;53(2):121-4), and immigration status emerges as an important risk factor for PPD. However, these two findings alone do not explain the reasons why this particular social patterning emerges. This review essay synthesizes findings on the prevalence and risk of PPD among immigrant women in Canada. It then draws on recent literature to propose three key mechanisms underlying why this social patterning emerges, namely (1) social support, (2) socioeconomic status, and (3) life stressors. These mechanisms are analyzed through the World Health Organization's conceptual framework of the social determinants of health (WHO, 2010; Statistics Canada, 2017). Additionally, this review essay seeks to assess the current state of intervention strategies piloted in Canada for PPD prevention and highlight gaps in the literature on intervention strategies for immigrant women specifically.

Objective: This study aimed to understand the perceptions of new mothers using virtual care in the form of video conferencing to gain insight into the social and environmental determinants that could potentially impact compliance for post-natal follow-up visits.Methods: Semi-structured interviews were conducted with 15 patients of Kingston Health Sciences Centre. The interviews were 20-25 minutes in length and recorded through an audio recorder. Thematic analysis was conducted in order to derive the major themes explored in this study.Results: In general, new mothers reported high satisfaction with virtual care, emphasizing benefits related to comfort, convenience, communication, socioeconomic factors, and the ease of technology use.Conclusions: Not only can virtual care address many of the barriers that new mothers face in accessing in-person healthcare services, but virtual care can also elucidate various social and environmental determinants responsible for facilitating access to postnatal follow-up care. Further research and clinical endeavours should focus on these various determinants (and the ways they intersect) and how they underpin patient perceptions of virtual and in-person care. Such a lens not only addresses the struggle of long-term patient compliance to maternal health care, but will additionally shed light on how to make obstetric care more equitable.

Background: Sexual violence against transgender (trans) persons is a complex public health issue that requires the coordinated effort of multiple sectors to address. A 2017 survey of Sexual Assault Nurse Examiners (SANEs) working within Ontario’s 36 Sexual Assault/Domestic Violence Treatment Centres (SA/DVTCs) revealed a need for training in the provision of trans-affirming care and highlighted a gap in knowledge related to local trans-positive organizations. In response, the successful design, pilot, and evaluation of a curriculum on trans-affirming care for SANEs was completed in 2018. However, there remained a pressing need to connect SANEs with trans-positive service providers across sectors to enhance the provision of care to trans survivors throughout Ontario. Goals and Objectives: To initiate the development a provincial intersectoral network on trans-affirming practice to better support sexual assault survivors by mobilizing knowledge on the new curriculum and connecting SA/DVTCs with local trans-positive community organizations. Approach: Guided by the Lifecycle Model of Network Development, seven regional meetings across the province were facilitated with leaders from SA/DVTCs and local trans-positive organizations. Key insights from meeting activities were transcribed and analyzed. Results: 106 representatives from 96 SA/DVTCs and trans-positive organizations attended a meeting between 7 June and 11 July 2019. 93 organizations expressed interest in being a part of the ongoing development of the network, in addition to 31 organizations unable to attend the meetings. 18 themes related to regional and provincial intersectoral collaboration to address sexual violence against trans communities were identified. Implications: As indicated by high meeting attendance and ongoing interest in developing a network, sexual violence against trans persons is a timely issue relevant to the enhancement of public health policy and practice across sectors. Informed by data gathered across the meetings, we aim to further consolidate the network, including working toward its maturation and sustainability.