Grant: Operating Grant: Population Health Intervention Research

Vancouver's Downtown Eastside (DTES) is a poor neighbourhood. Many of the city's most disadvantaged people, who struggle with addiction, mental illness, and other health issues, find their home here. In the mid-1990s, high rates of drug injection use and HIV/AIDS led to the declaration of a 'public health emergency'. Thanks to programs and services introduced at this time, much progress has been made -- but new challenges have emerged. People are living longer, but living with many chronic diseases such as HIV, Hepatitis C, diabetes etc. They need to access a range of health and social services, many of which are poorly coordinated with each other. To tackle these new challenges, Vancouver Coastal Health (VCH) has developed the Second Generation Strategy (2GS) for the DTES. Our research will evaluate the implementation and outcomes of this strategy. The research will use a Developmental Evaluation approach, which is suited for complex projects implemented into changing environments, where many different stakeholders are involved. We will produce 'real-time' information that allows for on-going program improvement and the continuous refinement of indicators for success. The research includes 3 parts. First, managers and service providers will be asked in interviews about their perceptions of service integration, and how different agencies and programs might best work together. Second, we will draw upon existing data to develop and track measures of integration, service use, and outcomes for disadvantaged groups. The third component will consist of developing a priority setting framework drawing on data inputs from the first and second parts of the research in order for VCH decision makers to determine how best to spend the available resources to achieve a successful full roll-out of the 2GS.