Grant: Catalyst Gr.: Quadruple Aim and Equity-National Mental Health Service Standards

Background Multiple sclerosis (MS) affects >90000 Canadians and is very expensive from the Canadian health and social care perspective; 1/3 costs derive from 'hidden' symptoms such as stress. Access to clinical care is challenging, especially for those more disabled or with mental health impairment. People with MS (PwMS) frequently describe the condition as stressful, that stress is overlooked by healthcare providers, who prioritize drug treatments. Stress is toxic for PwMS, linked with increased disease activity, greater anxiety and depression, lower disease modifying treatment adherence, and reduced quality of life. The COVID-19 pandemic has exacerbated this issue enormously. Acceptable and effective online stress management interventions for PwMS are urgently needed. Our previous research suggests online Mindfulness-based interventions (MBIs) are acceptable and effective, but application in the Canadian healthcare system has not been rigorously researched Methods A panel of PwMS, MS clinicians, MBI instructors and researchers will oversee study relevance and quality throughout. In phase 1 we will conduct 40 qualitative interviews with PwMS, MS clinicians, MBI instructors, health service policy-makers to explore stakeholder priorities for the implementation of online MBIs for PwMS in Ontario. Qualitative findings will be used to design a quantitative survey which we will then administer to the same stakeholder groups across Ontario to gauge priorities at a provincial level Deliverables The main deliverable is an implementation toolkit to address barriers to use of MBIs for PwMS, outlining a business plan, intake processes for the MBI, delivery strategies, and what we should use to measure success. Findings will be translated directly into existing MS clinical services in Ontario and written into best practices modules for MS clinicians (MSBEST) Impact Delineating how MBIs should be delivered for PwMS across Ontario will address key knowledge and treatment gaps