Grant: Catalyst Grant: SPOR Innovative Clinical Trials (iCT)

Canadians face a serious crisis in access to primary care, with 1 in 5 lacking a primary care provider. Governments have announced billions in new funding, however, without planning and the engagement of vulnerable patients these investments may actually widen inequities in access. Our work will establish a foundation for a national adaptive platform trial (APT) to continuously and efficiently evaluate approaches to engage and support vulnerable patients in accessing primary care. Objective 1: We will assess current approaches and resources to engage vulnerable patients in primary care across Canada, and conduct in-depth interviews with policymakers in four provinces. Simultaneously we will build the ENGAGE team and seek input from vulnerable patients and frontline health providers. Objective 2: To inform the design of our APT, we will conduct a pilot cluster randomized controlled trial (cRCT) in the Toronto region in collaboration with the Office of Health System Partnership (U of T) and Ontario Health. This will examine feasibility, data collection, and support sample size calculations. ENGAGE will catalyze collaboration among researchers, patient partners, health providers, and system leaders to identify the best approaches to address the crisis in access to primary care.