For those of you who are unfamiliar with the project, Making It Work (MIW) is an Indigenous-focused, community-based research project in British Columbia co-led by PAN and the AHA Centre at the Canadian Aboriginal AIDS Network (CAAN). It’s been several years in development, born out of conversations within the community when looking at the challenges people living with HIV, HCV and all of the other associated—and complex—social and health issues face every day. These discussions led to a realization that we need to understand better whether people facing these challenges experience better outcomes when they access services from organizations that approach care through an Indigenous view of health and wellbeing and also link case management services with community development programs. Successful CIHR Catalyst Grant funding application has supported work that has been done on the project to date.
Over the last year the study team, made up of peers and representatives from various community-based services organizations, has been hard at work building a strong working relationship between the team and each of the community organizations represented. We’ve also been crystalizing the goals of Making It Work and how we will achieve them. The study team met in person in early summer of 2017 and has been meeting monthly via teleconference since then, building upon previous discussions and work each month. It has been a progressive process, figuring out how to “Indigenize” the study’s original theoretical approach of Realist Evaluation. In a very simplified definition, Realist Evaluation is about building knowledge in stages, using what you learned previously to inform the next phase of learning. The team has had many discussions of what this would look like and how it would work, and continue to do so. We realized these discussions will also be an important piece (or deliverable) that will come out of this project in addition to the knowledge we gain around successful outcomes for PLHIV and HCV.
One of the primary goals for MIW is to explore the relationship between improved outcomes and cultural safety, case management and community development by developing an understanding of how service providers adapt case management and programming to “make them work” in ways that are culturally safe for the people they serve. Given the Indigenous focus of the project, exploring what this looks like within services organizations that operate from an Indigenous service delivery model will be a key facet of building our understanding of what works best for service users.
Within this catalyst, or pilot, phase of the project we’ve been working to develop a set of interview questions for a series of pilot interviews with services users and providers at Positive Living North in Prince George and AIDS Vancouver Island in Victoria. We are also building comprehensive descriptions for these two sites and Operation Street Angel in Cranbrook that detail the services these organizations provide, how people access them and what the links are, if any, between case management and community development. As of early March 2018 we are embarking on the pilot data collection phase of the project to finish up our work under the Catalyst Grant.
Another key piece of work the study team achieved in the last year was the submission of a CIHR Operating Grant application in the fall of 2017, before we had even finished the development of our pilot data collection tools or completed any actual data collection at our case study sites! This application required us to think very hard about how we envisioned the project moving forward on a larger scale and what the ultimate outcomes should be – ones that would best meet the needs of the community of people we serve. We approached this future visioning by drawing on Indigenous ways of knowing and doing and Indigenous research methodologies, using that framework to create an adapted approach to Realist Evaluation. We envision our work as a kind of spiral, where everything we learn feeds into the next questions we seek to ask, and the information we glean from those questions then feeds into further questions and so on.
Under this future visioning for Making It Work, the study team landed on three ultimate goals for the project:
- develop and implement an evidence-based evaluation plan for case management and community development programs across BC
- support capacity building in community-based research and evaluation methods for Peer Evaluators, communities, and other stakeholders
- document how Indigenous service delivery models can serve as a helpful tool to inform services for Indigenous and non-Indigenous service users
The best news of all is that we are going to be able to bring these goals to fruition because the CIHR Operating Grant application was successful! Our next steps are to complete the pilot phase of data collection over the next two months and then use the lessons learned from that to further refine our ideas and build additional data collection tools and methodology to help us reach our ultimate goals. The Making It Work study will be ongoing for the next three years and we look forward to doing this important piece of work and the lessons we are all sure to learn together.
To learn more about Making it Work, contact Joanna Mendell, Making It Work Research Coordinator: [email protected]
This piece was written in 2018 by Tabitha Steager, who was coordinating the project at the time.