Sean Bristowe’s research while affiliated with University of Calgary and other places

The healthcare needs of transgender patients are unique and not accounted for within dominant narratives of medical care. This article explores care challenges faced by two transgender individuals navigating healthcare systems and medical school curriculum in Canada. Medical education has a critical role to play in addressing the invisibility of gender and sexually diverse patients, and the inclusion of diverse patients' stories in medical education can help train emerging medical professionals to apply affirming lenses to their care practices and foster a more inclusive and supportive environment for all.

Background: Canada’s settler history and legacy impacts of colonialization mean that policy is grounded in Eurocentric ideals which exacerbate vulnerabilities for Indigenous families due to gendered and racialized experiences. Objectives: Our purpose was to understand the experiences of Indigenous women as they try and secure safe affordable housing for themselves and their children. Methods: We utilized a community-based approach and interviewed 12 urban Indigenous women with current or recent experiences of homelessness. Results: Structural violence and racism manifested in three ways: trauma leads to homelessness which leads to trauma; families are trapped in dependency; the search for housing leads to fear of violence. Conclusion: The existence of multiple polices and frameworks to prevent human rights and housing violations are inadequate in protecting Indigenous women and children from racism and violence. An anti-colonial approach is necessary to review and align mainstream policy. This work must be led by lived experience experts.

BackgroundA recent quarterly report released by Alberta Health reports that on average 2.5 Albertans die every day from accidental overdose deaths, and that between April 1, 2020, and June 30, 2020, the province lost a total of 301 people. In Canada, between January 2016 and March 2020, a total of 16,364 people died due to opioid-related overdose. The World Health Organization reports that 70% of the 0.5 million deaths worldwide caused by drugs are related to opioid overdose. Although supervised consumption sites or safe injection sites have been shown to be effective in reducing the harms associated with the use of illicit substances and increasing uptake of addiction treatment and other health services, there is still significant stigma associated with them, and it is unlikely that all of the people who would benefit from supervised consumption service will ever access a site. Objective To help prevent deaths in populations that cannot or will not access physical safer consumption services in Alberta, we propose to provide virtual (telephone-based) overdose response services, staffed by people with lived experience.The primary outcome for this study is uptake of the service as measured by the number of calls to the service. Secondary outcomes will include patterns of use of the phone line (days of the week and time of calls) and outcomes from the calls (number of emergency medical services dispatches for overdoses from the service and the results of those dispatches). Methods This phase 1 clinical study is set to officially launch in early May 2020. The service will be available to up to 15 participants who self-disclose as using opioids unobserved and have given informed consent for both data collection and interviews. This group will have access to a toll-free telephone number and be invited to call when they plan to use opioids alone. ResultsThe analysis will include mixed methods. To improve the design of the service and ensure safety of all involved, quantitative data will be collected on phone calls and participant health care usage, while qualitative data will be collected from both participants and virtual overdose response operators Conclusions This clinical trial aims to test the feasibility of a service that provides virtual overdose response in order to help prevent deaths in populations that cannot or will not access physical supervised consumption services in Alberta. Trial RegistrationClinicalTrials.gov NCT04391192; https://www.clinicaltrials.gov/ct2/show/NCT04391192 International Registered Report Identifier (IRRID)DERR1-10.2196/20183

BACKGROUND In 2016, deaths related to fentanyl outnumbered motor vehicle fatalities in Alberta for the first time making opioid misuse one of the most pressing public health problem of our time. Though supervised consumption sites (SCS) or Safe Injection Sites (SIS) have been shown to be effective in reducing the harms associated with the use of illicit substances and increasing uptake of addiction treatment and other health services, there is still significant stigma associated with them and it is unlikely that all of the people who would benefit from SCS will ever access a site. OBJECTIVE To help prevent deaths in populations that cannot or will not access physical safer consumption services in Alberta, we propose to provide virtual (phone-based) overdose response services, staffed by people with lived experience. The primary outcome for this study is uptake of the service as measured by the number of calls to the service. Secondary outcomes will investigate patterns of use of the phone line (days of the week and time of calls) and outcomes from the calls (number of emergency medical services (EMS) dispatches for overdoses from the service and the results of those dispatches). METHODS This phase 1 clinical study is set to officially launch in early May 2020. The service will be available to up to 15 participants who self-disclose as using opioids unobserved and have given informed consent for both data collection and interviews. This group will have access to a toll-free phone number and invited to call when they plan to use alone. RESULTS The analysis will be mixed methods, with quantitative data collected about the phone calls and participant health care usage and qualitative data collected from both participants and Virtual Overdose Response (VOR) operators to improve the design of the service and ensure safety of all involved. CONCLUSIONS This clinical trial aims to test the feasibility of a service that provides virtual overdose response in order to help prevent deaths in populations that cannot or will not access physical safer consumption services in Alberta. CLINICALTRIAL ClinicalTrials.gov – NCT04391192

Although Canada is recognized internationally as a leader in immigration policy, supports are not responsive to the traumatic experiences of many newcomers. Many mothers and children arriving in Canada are at elevated risk of homelessness. Methods: This study utilized a community-engaged design, grounded in a critical analysis of gender and immigration status. We conducted individual and group interviews with a purposive sample of 18 newcomer mothers with current or recent experiences with homelessness and with 16 service providers working in multiple sectors. Results: Three main themes emerged: gendered and racialized pathways into homelessness; system failures, and pre- and post-migration trauma. This study revealed structural barriers rooted in preoccupation with economic success that negate and exacerbate the effects of violence and homelessness. Conclusion: The impacts of structural discrimination and violence are embedded in federal policy. It is critical to posit gender and culturally appropriate alternatives that focus on system issues.