STRENGTH Pilot Project: a Study of a Women-led, Trauma-informed Model of Outreach to Foster Equity

The Outreach Project: a Study of Women-led, Trauma Informed Outreach to Foster Equity

The goal of this pilot study is to identify the core elements of outreach practice necessary to engage with women experiencing street-involvement who are underserved within health and social care settings. The primary research questions are:

1. How acceptable is the outreach intervention to women experiencing street-involvement?
2. What factors act as barriers or facilitators to acceptability?
3. How feasible is the outreach intervention to enhance women's access to health and social services?

Participants will:

• Meet regularly one-on-one with an outreach worker over an 18-month period
• Co-develop (with the outreach worker) a plan, based on the individuals self-identified needs, for connecting with health and social services
• Be invited to complete surveys at the start of their participation, and again every four months. These surveys ask questions about participants' resiliency, quality of life, independence, safety, and health status
• Be invited to participate in a one-on-one interview with a researcher about their experiences in the study.

Study Overview

• Status: Completed
• Conditions: Safety; Access to Health Care; Outreach Intervention; Gender-Based Violence; Access to Social Services
• Intervention / Treatment: Behavioral: STRENGTH Outreach Intervention

Detailed Description

The STRENGTH Pilot Project is a community-based, participatory action pilot study to design and test the acceptability of a women-led, trauma and violence informed model of outreach situated in the Downtown Eastside Neighbourhood of Vancouver, British Columbia.

Many women are underserved within health and social care due to numerous environmental factors affecting their access and receipt of services appropriate to their needs. These challenges are shaped by siloed service delivery, isolation, knowledge gaps about services, and negative encounters in support service settings. Outreach activities can build lasting relationships between support workers and women in ways that enhance quality of life and overall wellbeing, and are not harmful or re-traumatizing. The overall aim of the project is to develop and test the acceptability of a model of outreach that is women-led, strengths-based and trauma and violence informed.

In collaboration with community service experts and women with lived experience and drawing on existing empirical evidence concerning outreach interventions as a means to engage underserved women with health and social care, a preliminary model of outreach was developed to be tested within a pilot, single case study design focusing on acceptability of the intervention and feasibility of outreach to enhance women's access to health and social care. Within the intervention, outreach teams work with women in identifying their goals and needs and in partnership, support them to engage with services and supports to address their health and social care service needs.

In this pilot study, we will be evaluating (a) the acceptability of the outreach intervention; (b) environmental factors affecting acceptability; and (c) the feasibility of the intervention to increase women's engagement with appropriate health and social care services.

Because this project is a pilot study, the key research questions being addressed are:

1. How acceptable is the outreach intervention to women experiencing street-involvement?
2. What factors act as barriers or facilitators to acceptability?
3. How feasible is the outreach intervention to enhance women's access to health and social services?

Research activities designed to answer the above research questions include

1. Baseline data collection with women and at 4 month intervals to assess resiliency, quality of life, independence (mastery), safety, and health status;
2. Qualitative interviews with women to study acceptability, satisfaction, burden and appropriateness of the intervention;
3. Chart review of the plan of care documentation to study feasibility of increased engagement with services and women's retention in the intervention;
4. Bi-weekly meetings with outreach workers to identify barriers and facilitators to effective engagement.

• Study Type: Interventional
• Enrollment (Actual): 37
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Canada
  • British Columbia
    • Vancouver, British Columbia, Canada, V6T 2B5
      • University of British Columbia

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Self-identify as a woman, therefore the study is trans-inclusive.
• Have some degree of English proficiency in understanding and communication.
• Live or spend most of their time over a 24-hour period in the Downtown Eastside of Vancouver.
• Age 18 or over.

Exclusion Criteria:

• Women without any degree of English speaking or comprehension proficiency.
• People who self-identify as men.
• Youth under the age of 18.
• Women who do not spend time regularly in the Downtown Eastside of Vancouver.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Other
• Allocation: N/A
• Interventional Model: Single Group Assignment
• Masking: None (Open Label)

Number of Arms

1

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: STRENGTH Outreach Intervention; Participants enrolled in STRENGTH intervention elements	Behavioral: STRENGTH Outreach Intervention; The STRENGTH outreach intervention is a community-led, strengths-based, and trauma- and violence-informed program to support self-identifying women who experience interpersonal and structural gender-based violence. The outreach intervention aims to support individuals to achieve self-identified priorities.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Outreach Team Engagement with Individual Participants	Number of times outreach team met with individual participants	From enrollment to end of intervention (up to 18 months)
Participants' Access to Consistent Health Care	Measured in a binary survey item assessing participants' access to a consistent health care provider	From enrollment to end of intervention (up to 18 months)
Participants' Confidence in Engaging with Services	Measured in a survey item (self-rated scale from 0-100%) assessing confidence in accessing services	From enrollment to end of intervention (up to 18 months)

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Acceptability of Outreach Intervention	Measured using a qualitative interview question: "Are you satisfied with what you achieved in this project?"	At 12 to 15 months post-enrollment

Collaborators and Investigators

• Sponsor: University of British Columbia
• Collaborators: Vancouver Foundation; Inner-City Women's Initiatives Society

Publications and helpful links

General Publications

• Bungay V, Dewar L, Schoening M, Guta A, Leiper W, Jiao S. Co-designing an Outreach Intervention for Women Experiencing Street-Involvement and Gender-Based Violence: Community-Academic Partnerships in Action. Violence Against Women. 2024 Jun;30(8):1760-1782. doi: 10.1177/10778012241233004. Epub 2024 Feb 19.

Study record dates

Study Major Dates

• Study Start (Actual): April 15, 2018
• Primary Completion (Actual): January 28, 2020
• Study Completion (Actual): January 28, 2020

Study Registration Dates

• First Submitted: February 14, 2025
• First Submitted That Met QC Criteria: February 25, 2025
• First Posted (Actual): March 25, 2025

Study Record Updates

• Last Update Posted (Actual): March 25, 2025
• Last Update Submitted That Met QC Criteria: February 25, 2025
• Last Verified: February 1, 2025

More Information

Terms related to this study

• Keywords: pilot study; feasibility study; acceptability study
• Other Study ID Numbers: H18-00069 (Other Identifier: UBC Behavioural Research Ethics Board)

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No
• product manufactured in and exported from the U.S.: No