'About time!' Insights from Research with Pride: a community-student collaboration.

Research with Pride (RwP) was a community-student collaborative initiative to promote and build capacity for community-based research exploring health and wellness in lesbian, bisexual, trans and queer (LGBTQ) communities. The event took place at University of Toronto's Dalla Lana School of Public Health (DLSPH) in September 2009, and engaged over 100 students, community members and academic researchers in a full day of discussion, learning and networking. RwP was initiated by a group of graduate students in Health Promotion who identified a gap in resources addressing LGBTQ health, facilitating their further learning and work in this area. By engaging in a partnership with a community service organization serving LGBTQ communities in downtown Toronto, RwP emerges as a key example of the role of community-student partnerships in the pursuit of LGBTQ health promotion. This paper will describe the nature of this partnership, outline its strengths and challenges and emphasize the integral role of community-student partnerships in health promotion initiatives.

Barriers to primary care responsiveness to poverty as a risk factor for health.

BACKGROUND: Poverty is widely recognized as a major determinant of poor health, and this link has been extensively studied and verified. Despite the strong evidentiary link, little work has been done to determine what primary care health providers can do to address their patients' income as a risk to their health. This qualitative study explores the barriers to primary care responsiveness to poverty as a health issue in a well-resourced jurisdiction with near-universal health care insurance coverage. METHODS: One to one interviews were conducted with twelve experts on poverty and health in primary care in Ontario, Canada. Participants included family physicians, specialist physicians, nurse practitioners, community workers, advocates, policy experts and researchers. The interviews were analysed for anticipated and emergent themes. RESULTS: This study reveals provider- and patient-centred structural, attitudinal, and knowledge-based barriers to addressing poverty as a risk to health. While many of its findings reinforce previous work in this area, this study's findings point to a number of areas front line primary care providers could target to address their patients' poverty. These include a lack of provider understanding of the lived reality of poverty, leading to a failure to collect adequate data about patients' social circumstances, and to the development of inappropriate care plans. Participants also pointed to prejudicial attitudes among providers, a failure of primary care disciplines to incorporate approaches to poverty as a standard of care, and a lack of knowledge of concrete steps providers can take to address patients' poverty. CONCLUSIONS: While this study reinforces, in a well-resourced jurisdiction such as Ontario, the previously reported existence of significant barriers to addressing income as a health issue within primary care, the findings point to the possibility of front line primary care providers taking direct steps to address the health risks posed by poverty. The consistent direction and replicability of these findings point to a refocusing of the research agenda toward an examination of interventions to decrease the health impacts of poverty.