Closing the equity deficit: Sustainability justice in municipal climate action planning in Waterloo region.

There is growing recognition that often well-intended climate action solutions perpetuate and exacerbate manifestations of colonialism and racism due to the lack of equity and justice considerations in designing and implementing these solutions. There is limited research exploring why the integration of these considerations are lacking in municipal climate action planning. This exploratory descriptive qualitative study explored how municipal actors perceive and understand equity and justice in municipal climate action planning as a step toward addressing this issue. Semistructured interviews were conducted with seven members of the core management group from ClimateAction Waterloo region, and a template analysis of the interview data resulted in six themes. Findings suggested that those involved in municipal climate action planning understand and perceive justice and equity considerations as important to their work, however, translating this understanding to practice is a challenge due to structural (governmental and societal) and capacity (limited time, funding, resources, and knowledge) barriers. By better understanding how key actors consider justice and equity, we identify shifting colonial mental models as a potential pathway for transformative change given the central role of these actors.

Reducing the risks of extreme heat for seniors: communicating risks and building resilience. / Réduire les risques de chaleur extrême pour les personnes âgées : communiquer les risques et renforcer la résilience.

INTRODUCTION: As the global climate changes, heat waves are having a disproportionate impact on seniors and other socially vulnerable groups. In order to mitigate the threats of extreme heat, it is critical to develop and promote resources for coping during these events. A better understanding of the role of risk perceptions and the factors that influence them is needed in order to improve public responses to threatening events, particularly among seniors. METHODS: This mixed-methods study examined risk perceptions and coping practices in seniors using qualitative interviews (n = 15) and a survey (n = 244) of seniors across Waterloo Region, Ontario. RESULTS: Seniors showed relatively accurate risk tracking as indicated by the link between measures of actual risk and perception of personal risk. While vulnerability to heat is often believed to be associated with inaccurate perceptions of risk, within our sample, vulnerability appears more strongly related to social location and access to resources. Participants described social connections as important resources for resilience, but the stigma surrounding vulnerability, and other social norms, as barriers to seeking support. CONCLUSION: The positive relationship between participants' risk perceptions and actual risk for negative consequences of extreme heat was an important finding, given that problems of emergency preparedness and risk reduction are often framed as issues of awareness of risk, rather than social location and inequality. Along with increased public resources for coping with extreme heat, communicating about resources, fostering social connections and reducing stigma may be important leverage points for increasing the resiliency of seniors to heat waves.

Cost-effectiveness analysis of single-session walk-in counselling.

BACKGROUND: An increasing number of family service agencies and community-based mental health service providers are implementing a single-session walk-in counselling (SSWIC) as an alternative to traditional counselling. However, few economic evaluations have been undertaken. AIMS: To conduct a cost-effectiveness analysis of two models of service delivery, SSWIC compared to being waitlisted for traditional counselling. METHODS: A quasi-experimental design was employed. Data were collected from two community-based Family Service Agencies, one using SSWIC and one using traditional counselling. Participants were assessed at baseline and four weeks after the baseline. Cost-effectiveness was estimated from the societal and payer's perspective. RESULTS: The societal and payer's costs for SSWIC were higher than for those waiting for traditional counselling, and health outcomes were better. SSWIC is not cost-effective compared to being on the waitlist for traditional counselling (or, for a few patients, having received counselling, but after a wait of several weeks). CONCLUSIONS: SSWIC has the potential to reduce the pressure on the mental health care system by reducing emergency visits and wait lists for ongoing mental health services and eliminating costly-no shows at counselling appointments. Long-term studies involving multiple walk-in counselling services and comparison services are needed to support the findings of this study.

A comparison of walk-in counselling and the wait list model for delivering counselling services.

BACKGROUND: Walk-in counselling has been used to reduce wait times but there are few controlled studies to compare outcomes between walk-in and the traditional model of service delivery. AIMS: To compare change in psychological distress by clients receiving services from two models of service delivery, a walk-in counselling model and a traditional counselling model involving a wait list. METHOD: Mixed-methods sequential explanatory design including quantitative comparison of groups with one pre-test and two follow-ups, and qualitative analysis of interviews with a sub-sample. Five-hundred and twenty-four participants ≥16 years were recruited from two Family Counselling Agencies; the General Health Questionnaire-12 assessed change in psychological distress. RESULTS: Hierarchical linear modelling revealed clients of the walk-in model improved faster and were less distressed at the four-week follow-up compared to the traditional service delivery model. Ten weeks later, both groups had improved and were similar. Participants receiving instrumental services prior to baseline improved more slowly. The qualitative data confirmed participants highly valued the accessibility of the walk-in model, and were frustrated by the lengthy waits associated with the traditional model. CONCLUSIONS: This study improves methodologically on previous studies of walk-in counselling, an approach to service delivery not conducive to randomized controlled trials.