A Framework for Enhancing Access to Equitable Home Care for 2SLGBTQ+ Communities.

Andrea Daley,Shari Brotman,Melissa St Pierre,Judith A Macdonnell

doi:10.3390/ijerph17207533

Abstract

Canadian, US, and UK public health and clinical research has identified barriers to health service access for Two-Spirit, lesbian, gay, bisexual, transgender, queer, non-binary, and intersex (2SLGBTQ+) communities. While offering important insight into the health service experiences of 2SLGBTQ+ communities, this body of research only recently, and still only minimally, reports on home care access experiences. Drawing on key findings from the 2SLGBTQ+ Home Care Access Project, a mixed-methods, Ontario-wide study, this paper animates an Access and Equity Framework, using participant stories and perspectives to underscore the relevance and effectiveness of the Framework as a tool to support systematic organizational assessment, evaluation, and implementation of access and equity strategies. Home care organizations can use this tool to assess their programs and services along a continuum of intentionally inviting, unintentionally inviting, unintentionally disinviting, and intentionally disinviting care for 2SLGBTQ+ people. To support this process, the framework includes six indicators of access to care: community engagement, leadership, environment, policies and processes, education and training, and programs and services.

Highlights

IntroductionEquity and accessibility as important principles of social policy and institutional practice have gained the attention of the federal government in Canada, which has begun to organize and promote criteria to evaluate initiatives funded by them (including, most notably, in the areas of federal employment, research, and post-secondary education) through the lens of equity, diversity, and inclusion (EDI)
Equity and accessibility as important principles of social policy and institutional practice have gained the attention of the federal government in Canada, which has begun to organize and promote criteria to evaluate initiatives funded by them through the lens of equity, diversity, and inclusion (EDI)
We describe the A&E Framework in detail, providing insights into its development and process for implementation as a tool, which may be useful to enacting change within home care settings and in health and social care service organizations generally

Summary

Introduction

Equity and accessibility as important principles of social policy and institutional practice have gained the attention of the federal government in Canada, which has begun to organize and promote criteria to evaluate initiatives funded by them (including, most notably, in the areas of federal employment, research, and post-secondary education) through the lens of equity, diversity, and inclusion (EDI). There is currently a movement across Canada to operationalize EDI and to provide a framework for initiating policy analysis and evaluation [1]. While health and social care policy has not historically been a primary focus of EDI initiatives at the federal level, in part because health and social care policy is a provincial responsibility, it has become increasingly evident over the past several months that the need for attention to access and equity in the design and delivery of health and social care services, and for federal involvement in policy planning, is urgent.

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