The Department of Research and Evaluation at Fife House is engaged in community-based research and evaluation studies that impact the programs and services for people living with HIV/AIDS.
Internal evaluations provide feedback that informs decisions on the delivery and expansion of services.
Building a Community of Practice of ASOs Implementing Peer Engagement: Learning Together & Leading Together: Midterm Report
In June 2020, the Department of Research and Evaluation completed a Midterm Report for the project “Building a Community of Practice of ASOs Implementing Peer Engagement: Learning Together & Leading Together”. Funded by Public Health Agency of Canada, this is a five-year project developed and implemented by an alliance of six agencies: Elevate NWO, AIDS Committee of Windsor, Fife House Foundation, Toronto People with AIDS Foundation, Réseau ACCESS Network and AIDS Bereavement and Resiliency Program of Ontario (ABRPO). Through educational activities, this project aims to increase the capacity to use harm reduction practices, increase adherence to treatment or care behaviours and build capacity and skills of peers to prevent transmission of HIV/Hep C/STBBIs among people living with HIV/Hep C/STBBIs (Sexually Transmitted Blood Borne Infections), Indigenous peoples and people who use drugs.
- A significant increase of 23.2% in 2018-2019 and 33.5% in 2019-2020 in practicing harm reduction behavior was reported by participants.
- A moderate increase in practicing harm/risk reduction behavior among Indigenous people was observed (increased by 7.3% and 5.7% during 2018-2019 and 2019-2020 respectively).
- The average capacity of practicing harm/risk reduction behavior among substance users improved by 21.6% in 2018-2019 and 13.8% 2019-2020.
- In 2018-2019, the most significant changes appeared in the participants knowledge of program and services (30%), treatment options (29%) and harm/risk reduction practices (23%).
- During 2019-2020 participants showed higher improvement rates in their knowledge of program and services (35%), disclosure strategies (30%) and harm/risk reduction practice (29%) .
- The capacity of peer coordinators and peer leaders improved during the project period and majority of peer coordinators reported having applied new skills in supporting people at risk or living with HIV/Hep C/STBBIs in 2019-2020. Almost one third of them had applied new skills more than 10 times.
- Transition of Peers into paid work
- Increase in capacity and confidence of Peers
- Increase in practice of harm reduction behaviors
- Greater engagement of Peers and Peers with a range of experiences engaged
- Resources building and sharing
- Create an alternating/shared leadership plan for the Alliance agencies: Sense of leadership and more personal accountability can be enhanced in alliances and partnerships through shared/alternating leadership plans;
- Developing focus on behavioural change: While participation in single events is impactful, behaviour change requires multiple contacts. It is recommended to include behavioural change communication strategies and models for sustainable behaviour change;
- Target area expansion: Since the efficacy of the initiative among the most vulnerable groups has been substantiated, expanding the project to rural and remote areas, in future projects is recommended;
- Finding alternate ways to enhance data collection: A considerable number of event participants from the priority population live in poverty and often experience homelessness. They change their contact information often but rarely update the information with agencies and are thus often lost to follow-up.
Trillium Project Evaluation: The Peer Engagement Project
The PHA Peer Engagement Project was a four-year project funded by the Ontario Trillium Foundation, aimed at developing training, structured mentorship support and experiential learning opportunities for people living with HIV/AIDS. This evaluation was collaboratively conducted by the departments of research and community programs.
The objectives of this evaluation were:
- To assess peer involvement with Fife House Peer Engagement Project;
- To identify the challenges and successes of the project;
- To identify areas of growth and improvement of peer engagement;
- To identify future areas for peer engagement at Fife House.
Summary of findings:
- Peer engagement is invaluable in creating an ‘inclusive’ and ‘trusted’ environment.
- Engagement with the peer engagement project facilitates integration into the workplace.
- Mentorship (or lack of it) is critical in peer engagement and retention.
- A sense of belonging within the workplace impacts sense of self.
- The Fife House environment is conducive for peer engagement work.
- Peer engagement increases a sense of community.
- Learning opportunities in boundaries and multiple roles also creates challenges.
- Confidence in agency as a ‘service user’ determines engagement as ‘peers’.
- Engagement as a peer positively impacts future aspirations.
- Meaningful placement of volunteers is key to the success of the program.
- Developing a strong core training and role-specific training strengthens peer engagement.
- A holistic support system important for peer engagement.
- Navigation between multiple identities can pose challenges.
Complete final report available.
Sustaining Health Sustaining Housing is an evaluation study of our Jarvis Program investigating how people living with HIV/AIDS, who have accessed support services view the impact of these services on their housing experiences and their overall health. Thirty five residents (43%) were recruited and interviewed by the peer research assistants for the quantitative study; fifteen went on to participate in focus groups.
The study reveals that supportive services at Jarvis have a positive impact on the lives of people living with HIV/AIDS. Eighty-nine percent (89%) indicated that it is important to have support services within the building. The majority of participants (66%) reported that they were satisfied with Fife House services and knowing that they are available enhanced a sense of security and reduced isolation.
“…you know with this disease you’re going to have a turn… And anyone who I know who’s…had a real hard time and struggling has felt very supported and very cared for by Fife.”
Although participants had competing concepts of community, the majority (98%) felt that their home provides them with a good location to live their lives. Fifty-four percent (54%) of the participants had been residing at Jarvis for six years or more and 20% had been there for more than 12 years. The need for open and regular communication was an important theme throughout the study.
Homeless Outreach Program (HOP) Evaluation: The purpose was to uncover elements of the HOP operating effectively and those that need further development. Thirteen service users of the program were recruited for participation in three focus groups. Participants consisted of seven males (53%) and six females (46%) with 85% having been in an unstable housing situation for one to two years.
Discrimination on the basis of race and employment status were identified by participants as significant barriers to accessing housing, while issues of disclosure and stigma presented barriers in maintaining housing. A significant difference was observed between the experiences of women with children and male participants. Abusive relationships and drug use were some of the factors leading to unstable housing situations.
Housing workers’ support was reported to be helpful in diffusing issues of discrimination. While the program provides service users with learning opportunities, information, support and skills, those facing housing issues became anxious when staff was unable to return calls rapidly. Recommendations focused on 24-hour on-call support, more staff, and a website and/or monthly workshop encouraging social networking. The latter indicates a willingness to learn new skills and navigate and address housing issues independently.
Improving the Housing Environment for People Living with HIV/AIDS
Fife House is involved in provincial and regional research projects that aim to address the gaps in information to influence policy decisions that will improve housing for people living with HIV/AIDS.
Women, HIV & Aging Study
This community-based research study was developed by Fife House, in collaboration with Wilfrid Laurier University, Toronto People with AIDS Foundation, Two-Spirited People of First Nations, and Loft Community Housing, further supported by AIDS Committee of Durham Region, Alliance for South Asian AIDS Prevention, and Older Women’s Network. The issues of women aging with HIV continue to be marginalized and subordinated within HIV research, policy, service provision, and program development. Their under-representation within HIV/AIDS research perpetuates the absence of their experiences, which can inform programming, policy and decision making. Grounded in the principles of greater involvement of people with AIDS (GIPA) and meaningful involvement of people with AIDS (MIPA), this study ensured greater and meaningful involvement of people living with HIV/AIDS at all levels in the research process. Peer research associates received training and were engaged in qualitative interviewing, data collection, and data analysis, and will be engaged in dissemination of study findings.
- To identify the individual and structural barriers to social support and health care services that women aging with HIV/AIDS experience.
- To understand the intersection of sexuality and socially constructed gender roles and responsibilities and decision making for women aging with HIV/AIDS.
- To explore the issues of stigma as experienced by women aging with HIV/AIDS.
- To document the variation in experiences of aging aboriginal, visible minority and other women living with HIV.
Summary of Findings and Recommendations of the Study
Transitional Housing Study
This community-based research study was a Fife House collaboration with Bruce House, John Gordon Home, Loft Community Services, people living with HIV, and university researchers, and was funded by Canadian Institutes of Health Research.
- Transitional housing programs provide foundational skills in managing daily living (with HIV and other health concerns).
- Transitional housing provides a safe space for residents to stabilize and manage fundamental HIV and non-HIV health care needs.
“The moment I came here, I, I had peace of mind which I believe is my priority, like, if I’m based on any other thing, you can survive any other thing.”
- Support from transitional housing promotes better utilization and greater access to health and social services.
- Benefits that accrue from transitional housing supports lay the groundwork for transformative changes in the lives of residents, upon which other core competencies can be developed for residents to live independently in permanent housing.
“All of my morning appointments, I kept missing all of them, until I sat down one day and figured out that this is a problem… so, it was when I came out and let Fife House know, that morning appointments won’t work… so they actually helped me … getting my doctor to give me a continuous afternoon or evening appointments, instead of early hour appointments. ”
For a more comprehensive look at the study and the findings click on the links below: