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Though there is no standard model or practice for what decolonizing research methodology looks like, there are ongoing scholarly conversations about theoretical foundations, principal components, and practical applications. However, as qualitative researchers, we think it is important to provide tangible ways to incorporate decolonial learning into our research methodology and overall practice. In this paper, we draw on theories of decolonization and exemplars from the literature to propose four practices that can be used by qualitative researchers: (1) exercising critical reflexivity, (2) reciprocity and respect for self-determination, (3) embracing “Other(ed)” ways of knowing, and (4) embodying a transformative praxis. At this moment of our historical trajectory, it is a moral imperative to embrace decolonizing approaches when working with populations oppressed by colonial legacies.

This research article seeks to introduce readers to my dissertation’s methodology, where I conceptualize and apply methodology as a form of repatriation in my research project. I do this by first setting the stage of my dissertation, explaining my influences for this methodology of repatriation, breaking down key components of this methodology in relation to my work, and lastly, demonstrating the intent and importance of methodology of repatriation throughout this critically reflexive note. The purpose of this piece is to expand our methodological imaginations as qualitative researchers and to showcase the beginnings of how our personal and political positionalities, theories, and ethics can be beautifully weaved to create research methodologies for healing – and even repatriation. Besides, being able to reimagine academic research methodology – with its roots in harmful Eurocentric, colonial institutions – is itself a form of repatriation.

Background Individuals experiencing homelessness face unique physical and mental health challenges, increased morbidity, and premature mortality. COVID -19 creates a significant heightened risk for those living in congregate sheltering spaces. In March 2020, the COVID-19 Community Response Team formed at Women’s College Hospital, to support Toronto shelters and congregate living sites to manage and prevent outbreaks of SARS-CoV-2 using a collaborative model of onsite mobile testing and infection prevention. From this, the Women’s College COVID-19 vaccine program emerged, where 14 shelters were identified to co-design and support the administration of vaccine clinics within each shelter. This research seeks to evaluate the impact of this partnership model and its future potential in community-centered integrated care through three areas of inquiry: (1) vaccine program evaluation and lessons learned; (2) perceptions on hospital/community partnership; (3) opportunities to advance hospital-community partnerships. Methods Constructivist grounded theory was used to explore perceptions and experiences of this partnership from the voices of shelter administrators. Semi-structured interviews were conducted with administrators from 10 shelters using maximum variation purposive sampling. A constructivist-interpretive paradigm was used to determine coding and formation of themes: initial, focused, and theoretical. Results Data analysis revealed five main categories, 16 subcategories, and one core category. The core category “access to healthcare is a human right; understand our communities” emphasizes access to healthcare is a consistent barrier for the homeless population. The main categories revealed during a time of confusion, the hospital was seen as credible and trustworthy. However, the primary focus of many shelters lies in housing, and attention is often not placed on health resourcing, solidifying partnerships, accountability, and governance structures therein. Health advocacy, information sharing tables, formalized partnerships and educating health professionals were identified by shelter administrators as avenues to advance intersectoral relationship building. Conclusion Hospital-community programs can alleviate some of the ongoing health concerns faced by shelters – during a time of COVID-19 or not. In preparation for future pandemics, access to care and cohesion within the health system requires the continuous engagement in relationship-building between hospitals and communities to support co-creation of innovative models of care, to promote health for all.

Background Suicide and risk management protocols in mental health research aim to ensure patient safety, provide vital information on how to assess suicidal ideation, manage risk, and respond to unexpected and expected situations. However, there is a lack of literature that identifies specific components and strategies to include in suicide and risk management protocols (SRMPs) for mental health research. The goal of this scoping review was to review academic and grey literature to determine core components and associated strategies, which can be used to inform SRMPs in mental health research. Methods and analysis The methodological framework outlined by Arksey and O’Malley was used for this scoping review. The search strategy, conducted by a medical librarian, was multidisciplinary and included seven databases. Two reviewers independently assessed eligibility criteria in each document and used a standardized charting form to extract relevant data. The extracted data were then examined using qualitative content analysis. Specifically, summative content analysis was used to identify the core components and strategies used in SRMPs. The data synthesis process was iterative. Results This review included 36 documents, specifically 22 peer-reviewed articles and 14 documents from the grey literature. Five core components of SRMPs emerged from the reviewed literature including: training; educational resources for research staff; educational resources for research participants; risk assessment and management strategies; and clinical and research oversight. Potentials strategies for risk mitigation within each of the core components are outlined. Conclusions The five core components and associated strategies for inclusion in SRMPs will assist mental health researchers in conducting research safely and rigorously. Findings can inform the development of SRMPs and how to tailor them across various research contexts.

Since 2020, brought to the forefront by movements such as Black Lives Matter and Idle No More, it has been widely acknowledged that systemic racism contributes to racially differentiated health outcomes. Health professional educators have been called to address such disparities within healthcare, policy, and practice. To tackle structural racism within healthcare, one avenue that has emerged is the creation of medical education interventions within postgraduate residency medical programming. The objective of this scoping review is to examine the current literature on anti-racist educational interventions, that integrate a systemic or structural view of racism, within postgraduate medical education. Through the identification and analysis of 23 papers, this review identified three major components of interest across medical interventions, including (a) conceptualization, (b) pedagogical issues, and (c) outcomes & evaluation. There were overlapping points of discussion and analysis within each of these components. Conceptualization addressed how researchers conceptualized racism in different ways, the range of curricular content educators chose to challenge racism, and the absence of community’s role in curricular development. Pedagogical issues addressed knowledge vs. skills-based teaching, and tensions between one-time workshops and integrative curriculum. Outcomes and evaluation highlighted self-reported Likert scales as dominant types of evaluation, self-evaluation in educational interventions, and misalignments between intervention outcomes and learning objectives. The findings are unique in their in-depth exploration of anti-racist medical interventions within postgraduate medical education programming, specifically in relation to efforts to address systemic and structural racism. The findings contribute a meaningful review of the current state of the field of medical education and generate new conversations about future possibilities for a broader anti-racist health professions curriculum.

Individuals experiencing homelessness face unique physical and mental health challenges, increased morbidity and premature mortality. In Canada, it is estimated that 235,000 individuals experience homelessness annually, and 180,000 use emergency shelters each night. (1) COVID -19 creates a significant heightened risk for those living in congregate sheltering spaces. Individuals with a recent history of homelessness and diagnosed with COVID-19, are at significantly higher risk of hospitalization and death than those housed in Ontario communities (2). Women’s College Hospital (WCH) is an ambulatory hospital situated in downtown Toronto. In March 2020, WCH set up one of Toronto’s 14 COVID-19 assessment centres to facilitate free testing for SARS-CoV-2. Formed by a group of health care providers at WCH, the goal of the COVID-19 Community Response Team (CRT) was to support Toronto shelters and congregate living sites to manage and prevent outbreaks of SARS-CoV-2 using a collaborative model through onsite mobile testing; supporting the management and prevention of outbreaks; and providing infection prevention and control training and guidance. (3) In total, CRT leveraged this model of care with 49 shelter and congregate living sites from April 2020 to April 2021. From this, the WCH COVID-19 vaccine program emerged, where 14 shelters were regionally identified to co-design and support the administration of vaccine clinics within each sheltering site. This research seeks to evaluate the impact and importance of this partnership model and its future potential in community-centered integrated care. In this study, three areas of inquiry are addressed: (1) Vaccine program evaluation and lessons learned (e.g., What were barriers, facilitators, and lessons throughout the process? How were shelter staff and clients impacted?); (2) Perceptions on hospital/community partnership (e.g., What were overall perceptions of this partnership and strategy?); (3) Opportunities forward (e.g., How can this partnership between hospitals and shelters be sustained in the future to fulfill needs beyond COVID-19). Constructivist grounded theory (CGT) is used in this project to explore perceptions and experiences of this partnership. (4) CGT data analysis revealed five main categories, 16 subcategories, and one core category. The core category is “access to healthcare is a human right; understand our communities”. The main categories are COVID-19 response capacity, outbreak identification and management, barriers to the vaccine program, community-centred immediate shelter needs, and avenues for intersectoral relationship strengthening. In conclusion, three key takeaways emerged for health(care) policy and practice: 1.‘Health as a human right’ framework is an organizing principle in shelters but not necessarily in hospitals. How can hospitals adopt and integrate this framework at the policy level to operationalize an equity-based approach to care? 2.For hospitals, there are gaps in knowledge about community and shelter realities. Ongoing formal partnering between hospitals and communities is one way to bridge this gap. 3.Empowering shelter staff is crucial to the success of hospital-partnered programs and clinical interventions. Finally, this project calls attention to the urgent context-specific exploration needed to advance official hospital-community partnerships, where there is an everlasting commitment and accountability.  

The science of learning health systems (LHSs) has expanded to include equity aims. However, efforts toward this end are nascent. The purpose of this study was to critically examine how equity has been discussed in LHS literature. We conducted a critical scoping review informed by the bounded justice concept. Using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, Pubmed, Embase, Scopus, and CINAHL Complete (Ebsco) databases were searched to identify relevant literature from inception to June 2024. We used qualitative descriptive analysis for detailed extraction and to identify patterns across equity conceptions in the literature. The search strategy generated 420 articles. Forty articles met the selection criteria. Our analysis generated four interrelated themes: (1) , (2) , (3) , and (4) . Most articles fell into the theme. Notably, 35 (87.5%) articles were published between 2020 and 2024. We also identified five emerging equity-centered LHS approaches. LHS equity science is emerging, though it still privileges narrow, Westernized approaches. It is imperative that future work more deeply engages health justice traditions to inform LHS theory, research, and practice.