Background Financial strain is a key social determinant of health. As primary care organizations begin to explore ways to address social determinants, peer-to-peer interventions hold promise. Objective Our objective was to evaluate a peer-to-peer intervention focussed on financial empowerment delivered in primary care, in partnership with a social enterprise. Methods This intervention was hosted by a large primary care organization in Toronto, Canada. Participants were recruited within the organization and from local services. We organized three separate groups who met over 10 weekly in-person, facilitated sessions: millennials (age 19–29) no longer in school, precariously employed adults (age 30–55) and older adults near retirement (age 55–64). We applied principles of adult education and peer-to-peer learning. We administered surveys at intake, at exit and at 3 months after the intervention, and conducted three focus groups. Results Fifty-nine people took part. At 3 months, participants had sustained higher rates of optimism about their financial situation (54% improved from baseline), their degree of control (55% improved) and stress around finances (50% improved). In focus groups, participants reported greater understanding of their finances, that they were not alone in struggling with finances, and that it was useful to meet with others. One group continued to meet for several months after the intervention. Conclusions In this study, a peer-to-peer intervention helped address a key social determinant of health, likely through reducing stigma, providing group support and creating a space to discuss solutions. Primary care can host these interventions and help engage potential participants.

The purpose of this study was to identify the current state of sustainability integration into Canadian government procurement and make recommendations on how to deepen current integration in order to accelerate the advancement of existing sustainability goals. We reviewed 50 publicly available Requests for Proposals (RFPs) issued between 2016 and 2019 and evaluated the significance of sustainability integration and the expanse of considerations using two measurement schemes. Our analysis suggests that sustainability integration into RFPs is currently superficial with limited integration into the evaluation process. We also found that the integration of sustainability was narrow with significant gaps in the breadth of environmental and social impact areas that were considered. As such, we provide insights and recommendations that will enable governments to accelerate the advancement of sustainability through the use of procurement.

No abstract