Projects: Responding to the Pandemic

The impacts of COVID-19 on LGBTQ2S youth at-risk of, and experiencing, homelessness

PI: Alex Abramovich, Co-PI’s: Michael Chaiton, Hayley Hamilton, Sean Kidd, Carmen Logie

The study examines the impacts of COVID-19 on LGBTQ2S youth (aged 14-29) at risk of, and experiencing, homelessness and involves 3 virtual surveys over 6 months and in-depth one-on-one interviews with youth and key informants/service providers. Approximately 95 youth have completed the first of three surveys.

Our preliminary data analysis of the quantitative and qualitative data suggests that youth have been significantly impacted by the COVID-19 pandemic in various ways, including experiencing poor mental health, suicidality, depression, anxiety, and increased substance use, lack of access to health and social support services, and increased rates of youth living in public spaces (vehicle, park, encampments) since the pandemic. 

Alcohol consumption and the COVID-19 pandemic: Synthesizing knowledge for policy action

PI: Kevin Shield, Co-PI’s: Samantha Wells, Shehzad Ali, Jürgen Rehm, Adam Sherk, Tim Stockwell, Matthew Young, Branka Agic

Health researchers are warning that alcohol use and alcohol dependence in many jurisdictions may be increasing due to the COVID-19 pandemic; however, scientific evidence is sparse on the impact of the pandemic on alcohol consumption and alcohol-related harms (including violence against women and children). Thus, a comprehensive understanding of the impact of COVID-19 on short-term and long-term alcohol use and related health harms is urgently needed to inform policy and practice. The proposed project will result in the rapid (within one month of project commencement) production of evidence-informed guidelines for alcohol control policy recommendations. Guidelines will be updated monthly as more information is synthesized by the research team. The results will inform and assist policy makers in determining which alcohol policies should be implemented during the current pandemic and future crises to mitigate alcohol-related harms.

Mental Health Needs of LGBTQ2S Youth and Young Adults during the COVID-19 Pandemic

PI: Michael Chaiton, Co-PI’s: Alex Abramovich, Christine Yager

Youth and young adult serving organizations are facing numerous challenges meeting the needs of youth during the COVID-19 pandemic. Many services typically available to youth in crisis have had to close their doors and are no longer accepting new clients, making it especially difficult for youth to access the services and support they rely on. A recent report focused on the youth-serving sector found that sexual and gender minority youth are experiencing ongoing challenges getting their basic needs met, including food and shelter during the COVID-19 pandemic but little is known about the unmet mental health and substance use needs in these populations. In order to address these gaps, we will leverage an existing cohort of 1500 youth and young adults who identify as LGBTQ2S to understand their specific challenges and unmet mental health and substance use service needs during the COVID-19 pandemic using a longitudinal approach. We will use an innovative machine learning model on our data to identify complex intersectionalities--the way that multiple individual characteristics influence health and behaviour in ways that are difficult to identify with conventional statistics. Finally, in coordination with Rainbow Services at CAMH, our Youth Advisory Board, and our National Community Advisory Board of stakeholders and community organizations, we will use a design-based method called a design charette to allow 40 youth and young adults, who could be potential clients, design adaptations to existing programs and develop new programs that will help meet the needs of sexual and gender minority youth and young adults during the COVID-19 pandemic.

CRISM urgent guideline activities related to COVID-19

PI: Jürgen Rehm

There is urgent need to provide guidance to frontline service providers and decision makers on the best practices for reducing risks (related to COVID-19 and drug-related harms) for people who use drugs. CRISM proposes to rapidly develop a series of guidance documents in six areas. Each document will be developed in a rapid manner with collaboration and review from nationally representative expert committees. The COVID guidance series will be regularly updated based on experiences during implementation, and the evolving literature. Additionally, observational research is urgently required to describe in real-time: (a) challenges faced by people who use drugs in relation to the COVID-19 pandemic, and (b) changes in drug use patterns and impacts during the pandemic and to inform strategies for future pandemics. To address this, we will simultaneously conduct two short-term studies that will be combined to deliver a rapid assessment report produced for decision makers and service providers followed by development of peer-reviewed research publications. Additionally, we propose to synthesize data from these studies along with evaluation activities to determine best practices for health service interventions that were most effective at supporting people who use drugs during the pandemic.

Open

An evaluation of the effectiveness of remedial interventions for impaired drivers provided using videoconferencing technologies

PI’s: Christine Wickens, Robert Mann

In Ontario and every other province, remedial programs form an integral component of countermeasures developed to address and prevent impaired driving. The remedial program in Ontario is titled Back on Track (BOT) and is managed by the Centre for Addiction and Mental Health (CAMH). All offenders convicted of a Criminal Code (CC) impaired driving offence are required to complete BOT before they are eligible for full relicensing. The COVID-19 pandemic and physical distancing requirements have created a crisis in the provision of in-person remedial, educational and related services traditionally offered face-to-face, and many service providers have responded by adopting videoconferencing technologies to offer individual and group interventions. Nevertheless, little is known about the comparative effectiveness of provision of individual and group services by videoconferencing, and service providers have substantial reservations about the effectiveness and appropriateness of services offered by videoconference. In BOT, about 75% of all CC impaired driving offenders complete an 8-hour brief intervention designed to help them deal with alcohol and other substance use problems. This intervention was mandated to be provided on an in-person basis, but the onset of the pandemic required service providers to deliver the intervention by videoconferencing, as well as in-person, in order to meet mandatory service provision standards that clients be able to complete program requirements within certain time limits. This has created the opportunity for a scientifically rigorous comparison of the effectiveness of a remedial intervention for impaired drivers provided in-person versus by videoconferencing modalities. A total of 136 participants assigned to the 8-hour intervention in the BOT program will be randomly assigned to the in-person or videoconferencing modalities. The immediate impact of the two interventions on measures of client satisfaction, knowledge, attitudes, program engagement, and behavioural intentions will be compared. Subsequently, 6-month and 12-month outcomes on substance use, self-reported impaired driving and other problems related to substance use will be examined.

Impact of COVID-19 on road safety: A population-based survey of Canadian drivers

PI’s: Christine Wickens, Robert Mann

Preliminary data from jurisdictions around the world have demonstrated reductions in traffic volumes during the COVID‐19 pandemic, which in turn, should correspond with similarly sized reductions in number of motor vehicle collisions. However, many jurisdictions are reporting that the reduction in number of collisions has not been as significant as the reduction in traffic volumes, and in fact, some jurisdictions have reported that the road fatality rate during the pandemic has increased. The COVID‐19 pandemic may be associated with changes in attitudes and behaviours of some subgroups of drivers that may be having important road safety effects. For example, there is preliminary evidence of increased aggressive driving incidents (speeding, street racing, stunt driving, etc.), alcohol- and drug-impaired driving, and cell phone use while driving during the pandemic. Although speed enforcement and crash‐related data provide some evidence, it is likely that these data sources do not capture all instances of risky roadway behaviour, particularly given that enforcement resources may have been stretched or diverted elsewhere during the pandemic due to low traffic volumes. An online survey will be conducted of 6,500 drivers aged 18 years and older drawn from a general web-based panel of residents from six regions across Canada (i.e., British Columbia, Alberta, the Prairies, Ontario, Quebec, and the Atlantic provinces). The proposed survey will identify changes in drivers’ behaviours associated with the COVID‐19 pandemic, identify subgroups (based on age, sex/gender, attitudes, etc.) who are most likely to engage in unsafe driver behaviours during the pandemic, and explore their potential influence on motor vehicle collision risk. This information will inform strategies for both policy and practice (e.g., enforcement, education and health promotion, legislation) in addressing this and future public health crises.

The First Nations Wellness Initiative: A Community-Driven Approach to Promoting Mental Wellness in the Context of the COVID-19 Pandemic

The FNWI Team: Samantha Wells, Renee Linklater, Branka Agic, Kathryn Graham, Sean Hillier, Melody Morton Ninomiya, Lisa George, Lee Ann Hampton, Sheena Kewageshig, Lori Kewaquom, Sonya Roote

Despite high rates of mental health and substance use (MHS) challenges in many First Nations due to the effects of colonialism, many existing programs designed to address these challenges are not culturally safe, wholistic or responsive to community-specific needs. The COVID-19 pandemic is exacerbating these MHS challenges, and First Nations communities are disproportionately affected, largely due to health and socio-economic disparities stemming from the enduring effects of colonialism. The First Nations Wellness Initiative is a collaborative model for developing community-driven, evidence-informed and community-based wellness strategies addressing age- and gender-specific MHS challenges in First Nations communities. Building on strong research partnerships with two First Nations, we will develop sustainable mental wellness strategies in both communities and disseminate knowledge to promote successful wellness strategies in other First Nations. Participatory Action Research will be used. The team will evaluate the strategies and their outcomes, and disseminate best practice knowledge from the strategies regionally, provincially and nationally.