Harm Reduction and Healthcare Delivery to Vulnerable Women (title)

• This research is supported by the New Brunswick Health Research Foundation (NBHRF), New Brunswick (NB), Canada.

This research investigates harms and risks faced by vulnerable women populations in Saint John (SJ), NB, Canada, and examines their needs for health, treatments, and other care services.

This study focuses on two segments of at-risk women groups:

(i) women with substance or alcohol use disorder, and,

(ii) women survivors of intimate partner violence (IPV).

A social determinants of health approach (examining cultural, social, and environmental variables that affect population health) is utilized in this study; along with and, a patient-oriented research framework (study design is shaped by the perspective of the patient/study informant), in conjunction with SPOR of CIHR. The methodology of this study comprises of a mixed-method design. Both qualitative and quantitative data will be collected, using focus groups, case study, interview – methods. Furthermore, metadata & data from NB-IRDT database will also be analysed.

The participants of this study are: women (with substance or alcohol use disorders, & victims of IPV); women’s families, immediate social circle and informal caregivers; service providers (social workers, counsellors, doctors, nurses, mental health specialists, teachers, community outreach professionals, legal personnel, etc.); and, service organisations (de-addiction centres, emergency shelters, clinics, hospitals, employment & educational institutions, etc.).

Women with substance or alcohol use disorder

This research collaborates with the Parent Child Assistance Program – Saint John (PCAP-SJ) for the research segment regarding women with substance or alcohol use disorder.

Analysis of existing literature and data, pregnant women and new mothers affected by substance or alcohol use disorder have complex and multidimensional needs, and there is necessity for more information within the localized context of Saint John (NB). Therefore, this study will comprehensively assess the needs of the clients of PCAP-SJ. It is also crucial to document PCAP-SJ’s services from the client’s perspective, in order to examine the women-focused structure of the program. Hence, this research will evaluate the PCAP-SJ as regards the goals of the program, as well as, appraise it in terms of reducing stigma faced by clients, decreasing clients’ mistrust for support institutions (especially governmental), and lessening the disconnection amid services and providers.

This study will also address the question of adequacy of services for clients in SJ, and identify gaps (if any), along with investigating the barriers to access and utilization of services. Additionally, there is lack of information as regards SJ concerning prejudice or discrimination within institutions, as is reported by clients at other Canadian communities. Moreover, lack of coordination exists among services and institutions in SJ. Therefore, this research will conduct a methodical analysis of the systemic problems within the services and institutions in SJ, which attend women suffering addiction.

The objective of this study is providing systematic data to the PCAP-SJ regarding the gaps in services available for the clients in SJ. This information will assist the NB-PCAP in providing services that address these gaps. Furthermore, outcomes of the need-assessment of clients as well as evaluation of the NB-PCAP will facilitate tailored and effective services for the clients and their children.

Women suffering Intimate Partner Violence (IPV)

This research will analyse existing data about IPV among women (causes, consequences, immediate and enduring health-related impacts, and rehabilitation practices) – within New Brunswick. Next, data will be collected concerning IPV among women in Saint John (physical and mental health impacts of IPV, and about experiences of obtaining, and providing, healthcare services for IPV in NB) – with a specific focus on visible minority & newcomer women (in partnership with women’s and multicultural organisations in SJ).

Furthermore, need for services, institutions, policies, protocols, and barriers in availing services, will be evaluated, from both IPV victims’ and service providers’ perspectives. The objective is to construct a knowledge framework for patient-centric medical care services (physical and mental), aimed at sustainable well-being of women victims of IPV. Also, examining the efficacy of a comprehensive single-source service provision model for immediate and long-term medical care of IPV victims – from survivor’s/family’s perspective; and, investigate viability from the providers’/institution’s point of view.

–Dr. Baba Das (Sept. 2018)

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