Research

Diseases such as HIV/AIDS and Hepatitis-C (HCV) thrive in conditions of poverty and marginalization. Research on the quality of life of people living with HIV/AIDS reveals that unemployed individuals report more depression, anxiety, social isolation, and low self-esteem than employed individuals. Moreover, unemployment is a key factor in the contemplation of suicide among people with HIV/AIDS. Alternatively, employment among people living with HIV/AIDS is a strong indicator of improved quality of life. A finding we confirmed in our research study (PROMPT) supporting 80 members of Ottawa’s low-income homeless (or at-risk for homelessness) people Who Use Drugs reduce (and in some cases quit) smoking. 

Many PROMPT participants repeatedly stated that boredom and a lack of meaningful social connections and employment were major hindrances in their reduction and overall recovery from smoking and drug use.  We propose a community-based participatory action study that builds the social capital of 80 participants that identify as members of Ottawa and Toronto’s low-income People Who Use drugs living with or are at-risk for HIV/AIDS/HCV. The proposed multi-site study will include life-skills training, counseling, health services access, and education on HIV/AIDS/HCV. Most importantly the study will include a poverty reduction intervention that connects participants with short-term work and volunteer opportunities that are made possible with the support of local business owners and networks. The aim of study will be to demonstrate the feasibility of holistic healthcare that encourage a state of complete physical, mental, and social well-being. 

At the Bridge, we work closely with people who self-identify as homeless, at risk for homelessness, low-income racialized including Indigenous populations. These same people also suffer from poor mental health, addictions to tobacco, alcohol and drugs. We experienced that the student volunteers or trainees at the Bridge also hold similar stigma, stereotype and racism against the Bridge populations. Hence, the Bridge has developed a Bridge Inclusivity Training (BIT) in partnership with community peer researchers with lived experience. Over the past several years, we have thus far administered BIT to multiple students (medical and non-medical) with great success. It is an in-person training provided in partnership with community peer researchers over 3-4 hours where multiple case scenarios are discussed in a non-judgmental, open discussion format. Students get to ask questions and seek input from people with lived experience of poverty, marginalization, especially racism, in the healthcare settings.   

Currently, we are evaluating the adaptation and Effectiveness of the Bridge Inclusivity Training (BIT) for medical trainees. This pilot evaluation process of BIT aims to provide suitable training for medical trainees to improve their awareness and responsibilities to society’s most marginalized people and the Canadian healthcare. It will also allow us to understand how to best evaluate the effectiveness of such activities as BIT.  BIT aims to produce adapted inclusivity training and standardized patient assessment for future medical graduates. BIT seeks to help these students get the concrete skills they need to provide culturally competent and compassionate care as students and as future doctors. 

This project is ongoing

Tobacco health inequities disproportionately impact people who suffer from poor mental health, inject or use drugs, identify as 2SLGBTQ+, who experienced childhood traumas, immigrants, individuals who identify as Indigenous people, and those who begin smoking before the age of 18 years.   

Conventional smoking cessation programs remain ineffective and have shown low quit rates among marginalized urban populations. The MIST study is a Community-Based Participatory Action feasibility study that will use Nicotine Mouth Spray for tobacco dependence management and treatment in t marginalized populations. The study participants will be randomly assigned to one of the two groups, Nicotine mouth spray /counselling group or the PROMPT group (see PROMPT study). The primary objective of the MIST study is to compare the effectiveness of nicotine mouth spray and counselling with a peer-led Management and Point-of-Care for Tobacco Dependence (PROMPT) strategy. The PROMPT group will access community-building activities and counselling designed for marginalized populations.  The feasibility study will build a foundation to guide the future of tobacco dependence management strategies and community programs in the marginalized populations who disproportionately  suffer the socio-economic and health consequences of tobacco use. 

 This project is ongoing 

Evidence shows, compared to the general population, mental illness disproportionately affects people who inject or use drugs, smoke, 2SLGBTQ+, those who experienced childhood traumas, immigrants, people who identify as Indigenous, and homeless populations & those at risk for homelessness. Even though recreational marijuana is legal in Canada, it might not be accessible or affordable for the vulnerable populations. Thus, they might resort to unsafe means to obtain it, which may provide them with marijuana that is contaminated with other fatal illicit drugs.  

Moreover, research has shown that there is an association between marijuana use and mental illnesses.  But it is unknown if marijuana is what is likely triggering the mental illness or if people with mental illness happen to use marijuana to self-medicate their mental illness symptoms (i.e., what came first, chicken or the egg situation).  

To understand the relationship between the use of marijuana and mental illness. We will interview people from those marginalized populations living with mental illness and who have presently or in the past used marijuana.   

The study will collaborate with the Bridge Engagement Centre (The BRIDGE). Marginalized populations who are the at core of the Bridge Research center will be invited to take part in this study. These individuals may be part of the street-involved (people who use drugs, sex workers and people who sell and buy street level drugs and involved in the justice system), homeless or at-risk for homelessness, and racialized communities. The study will only include those (1) currently living with a mental illness (including: post-traumatic stress, anxiety, depression, or experiencing more the one mental health condition including schizophrenia and bipolar disorder), and those with (2) current or past history of marijuana use; and they must have the (3) ability to read and speak English. 

Members of the Bridge will be engaged in all parts of this research project. From this study, we hope to understand why marginalized populations use or avoid marijuana, which help us increase our understanding into the patterns of marijuana use and its effects on the mental health of Ottawa’s marginalized populations. 

 This project is ongoing