Join the winners of the National Collaborating Centre for Public Health (NCCPH) Knowledge Translation (KT) Student Awards and get a first-hand look at their crucial work in bridging the gap between research and practice. These students and recent graduates are leading innovative, equity-focused knowledge translation strategies. This session will highlight their academic excellence and feature unique and transferable strategies to address today’s public health priorities.

1. Welcome!
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2. October 26, 2021
Presenters: Erica Phipps
Sujane Kandasamy
Leigh McClarty
Facilitator: Emily Clark
Equity and Knowledge Translation: Insights from the 2021
Knowledge Translation Student Award Recipients

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7. NCCMT Products and Services
Registry of Methods and Tools
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Opportunities
Workshops
Video Series
Public Health+
Networking and
Outreach

8. Presenters
Erica Phipps Sujane Kandasamy Leigh McClarty
Queen’s University McMaster University University of Manitoba
A critical exploration into
Manitoba’s HIV care
cascade
“Culture Eats Strategy for
Breakfast:” An Academic
Journey toward Theory-
informed, Empirically-rooted,
and Co-developed
Knowledge Translation
Interventions for Priority
Populations
Investing in relational
knowledge practices and
‘reversing the gaze’ for
equity-focused intersectoral
action on housing and health
equity: The RentSafe EquIP
research in Owen Sound,
Ontario

9. Investing in relational knowledge
practices and ‘reversing the gaze’ for
equity-focused intersectoral action
on housing and health equity:
The RentSafe EquIP research in
Owen Sound, Ontario
Erica Phipps, MPH, PhD
Vanier Scholar, Centre for Environmental Health Equity, Queen’s University (graduated)
Postdoctoral Fellow, University of Ottawa
Executive Director, Canadian Partnership for Children’s Health & Environment; Director, RentSafe
National Collaborating Centres for Public Health
Webinar, 26 October 2021

10. RentSafe EquIP
Equity-focused Intersectoral Practice
for housing and health equity
in Owen Sound, Ontario
Aim: To catalyze and support interaction among
people from diverse sectors, amidst an
escalating housing crisis, to:
• Better understand the causes and
consequences of housing inadequacy
• Foster new ways of thinking about issues
and solutions

11. Research
overview
§ Community-based Participatory Action
Research (PAR); funded by CIHR Knowledge-
to-Action grant
§ Linked to CPCHE-led RentSafe initiative
§ Catalyzed by work on Equity-focused
Knowledge Translation (EqKT)
§ Explored the role of human relationships and
critical reflexivity in understanding →
deconstructing → transforming knowledge
practices among intersectoral actors
Masuda, Zupancic, Phipps et al (2014). Equity-focused Knowledge Translation: A
framework for ‘reasonable action’ on health inequities. IJPH 59(3).
https://doi.org/10.1007/s00038-013-0520-z
Phipps & Masuda (2018). Towards equity-focused intersectoral practice (EquIP) in
children’s environmental health and housing: the transformational story of RentSafe.
Can J Public Health. 109(379). https://doi.org/10.17269/s41997-018-0094-x
Phipps, & NCCDH (2018). Towards healthy homes for all: What the RentSafe findings
mean for public health in Canada..
http://nccdh.ca/images/uploads/comments/NCCDH_RentSafeSummary_-_EN.pdf

12. Grounded expertise
The knowledge and insights gained and
developed by those who have directly
experienced and lived with(in) a particular
issue, concern or injustice.

13. Research phase 1:
Learning
Exchanges
• 11 sessions
• 45 participants from
16 agencies/sectors
• Convened by co-
researchers with
grounded expertise
• Identifying issues and
gaps
• Reflecting on existing
practices and mindsets
• Creating new
understandings of the
problem and potential
solutions

14. • Four-day immersive ‘experiment’ in
building capacity for equity-focused
intersectoral practice
• ~30 participants from the
community and research team
Research phase 2:
Intersectoral
Retreat

15. Centering of Indigenous ways of
knowing, ceremony and teachings
Solidarity through shared
discomfort and problem-solving

16. Getting out of our comfort zones
Interacting as people and
neighbours rather than as ‘roles’

17. What we
heard
• Multiple, intersecting drivers of
housing-related inequities
• Some feel excluded from the
‘system,’ others feel trapped within it
• Inadequate knowledge and
understanding create tension and
feed the crisis
• Intersectoral collaboration is
important and can be improved
“...the complex lives of people are not
properly addressed in the support
services that we have...”
“The judgement I was put through.
I was already humiliated enough,
and sick enough.”
”We all run on this hamster wheel sometimes on our own. Until we pick up the phone
and say okay, here’s the real deal, here’s the red tape, how can we work together?”
“...and the guy [prospective tenant] gets
out of the cab and the owner goes ‘Oh,
he’s native. No, sorry. I was wrong. I
don’t have a unit.’”

18. “It is not only okay, it is
imperative to prioritize
relationships.”
“We need to start thinking of
relationships as a resource.”

19. Knowledge
mobilization and
community
momentum
• Report to the community: We are
all Neighbours
• Briefing to high-level intersectoral
table: Healthy Communities
Partnership
• RentSafe EquIP Roundtable
• RentSafe Owen Sound
Collaborative
• Intersectoral video: Housing
Issues? We’re here to help

20. What we
learned
RentSafe EquIP research identified
gaps/barriers and opportunities for
change in...
1. Structures
“It can be very discouraging ...somebody comes in and is
literally sleeping on the streets and they [say]... “I need
help.” And you make the calls and it’s about a 3 year
wait list.”
2. Knowledge, perceptions and beliefs
“.. Attitudes that ...people are poor 'cause they've
messed up their lives, they made bad choices, and they
deserve what they get, which is substandard housing
and no rights.”
3. Practices
“When somebody with mental health issues or is
scared... walks into an office and they say ‘Here, here’s a
phone number, give them a call.’ They’re not gonna
call.”
“[Agency staff] don’t like to be made uncomfortable. It’s
easier to keep the tunnel vision.”
With regard to protocols that screen people out from
receiving services: “Just don’t tick the box.”
Phipps, Butt, Desjardins, Schonauer, Schlonies & Masuda (2021). Lessons from a rural housing crisis: grounded insights for
intersectoral action on health inequities. Social Science & Medicine, https://doi.org/10.1016/j.socscimed.2020.113416

21. What we
learned
EquIP served as a catalyst for...
1. (Re)problematization
• “Housing isn’t just one silo. There are so many aspects...
It’s the determinants of health, it’s the poverty lens... It
is not just bricks and mortar.”
2. Reflexivity
• “What we usually don’t hear is the frustration with our
service and how they [community members] view the
people who are trying to help them. That’s probably
really good to hear.” – senior manager
• “I am now more aware of the boxes [the service
providers] are in, and the limitations they face.” - tenant
3. Rethinking individual and collective agency
• “I feel more empowered and determined to stand up
against barriers within my organization that feel
unethical/unfair.”
• “It is important to build relationships...for those warm
referrals. But it is more than that. It is about
accountability. It is more difficult to turn a blind eye to
someone you know. “
• “People [with grounded expertise] are having a say...
And [people in decision-making roles] are listening.”
Phipps, Bumstead, Butt, Crighton, Desjardins, Hart, Oickle, Sanchéz-Pimienta, Schonauer, Umbach & Masuda (forthcoming).
It doesn’t happen any other way: Relationship-building and critical reflexivity as groundwork for equity-focused intersectoral
practice (EquIP).

22. Equity-
focused
Intersectoral
Practice
(EquIP)
Equity-focused intersectoral practice means:
• Asking upstream ‘why’ questions
• Engaging in intersectoral knowledge practices
in ways that
– Prioritize human relationships
– Create non-hierarchical, safe and inclusive
spaces
– Foster shared understandings, respect and trust
– Prioritize grounded expertise as the lens for
examining systems, policies and practices.
• Shifting the gaze away from perceived deficits
in communities towards blind spots and
barriers in the institutionalized ‘system’ itself.
• Examining one’s own role and possibilities to
act.. And having the courage to do so.

23. Concluding thoughts:
Opportunities for
public health practice
• Centering grounded expertise
• Constituting intersectoral work in ways that
advance reconciliation (ex: Giiwe)
• Applying/adapting EquIP methods (e.g.,
Learning Exchanges, creation of relational
spaces)
• ‘Reflexive’ intersectoral projects, e.g., video
• Leveraging research
• Embracing public health’s role as a convenor

24. RentSafe.ca
LogementSain.ca
Thank you!
For more information:
ephipps@uottawa.ca RentSafe.ca/owen-sound
With gratitude for past and current funding support from:
• Canadian Institutes of Health Research KTA grant # RN 27777245
• Vanier Canada Graduate Scholarship
• GESTE -- pour la partage des connaissances fellowship
• CIHR-funded postdoctoral fellowship, uOttawa
• SSHRC-funded U de Montréal REGARD research collaboration
Our team acknowledges the history, spirituality, culture, and stewardship of the Indigenous peoples of the region where this research was carried out:
the Saugeen Ojibway Nation and the Three Fires Confederacy, namely the Odawa, Potawatomi, and Ojibway nations.

25. “CULTURE EATS STRATEGY FOR
BREAKFAST:”
AN EXAMPLE OF A THEORY-INFORMED,
EMPIRICALLY-ROOTED &
CO-DEVELOPED KT INTERVENTION FOR
A PRIORITY POPULATION
Sujane Kandasamy, MSc, PhD
McMaster University

26. KEY TOPICS
Set the stage:
Brief Introduction
Deep Dive:
Key Concepts
Key Lessons:
Learnings
Next Steps:
Future Directions

28. Click here to watch the Documentary-style film shown in this
presentation

29. Evidence
KT Tool
Evaluation
Community-facing
Knowledge Mobilization
Integrated KT
Summary &
Next Steps (Co-design, joint analysis/mobilization,
Iterate/innovate/scale)

30. Thankyou!
kandas3@mcmaster.ca
@NonPlainJane

31. A critical exploration
into Manitoba’s HIV
care cascade
Novel applications of equity-
focused data visualisation to
support knowledge translation
Leigh McClarty, PhD
Postdoctoral Fellow, Institute
for Global Public Health
Rady Faculty of Health
Sciences, University of
Manitoba
2 6 O C T O B E R 2 0 2 1

32. Background
& Context
• Relatively little research focusing on
HIV epidemiology in Manitoba
• In 2013, CIHR-funded program of
research – the LHIV Study – provided
support for the establishment of a
prospective clinical cohort of people
living with HIV in Manitoba
• First comprehensive source of HIV-
specific health data for the province
• Using cohort data, developed the first,
comprehensive HIV care cascade
model for Manitoba
2 6 O C T O B E R 2 0 2 1
26
McClarty LM, Kasper K, Ireland L, et al.
The HIV care cascade in Manitoba,
Canada: Methods, measures, and
estimates to meet local needs. J Clin
Epidemiol 2020; 132: 26-33.
McClarty LM, Cheuk E, Ireland L, et al.
Cohort profile: the LHIV-Manitoba
clinical cohort of people living with HIV
in Manitoba, Canada, BMJ Open 2020;
10(5): e034259.

33. Frameworks & approaches
P R O G R A M S C I E N C E
• A research and program framework for
improving the design and implementation
of public health programs through the
systematic application of theoretical and
empirical scientific knowledge (Blanchard
& Aral, 2011) that is embedded within a
public health program
I N T E G R A T E D K N O W L E D G E
T R A N S L A T I O N
• Active and ongoing partnerships with key
stakeholders in Manitoba
• Inform objectives
• Ensure relevance for policy and programs
6 J A N U A R Y 2 0 2 2
27

34. The HIV care
cascade: What
is it?
• A framework for examining individuals’
progress through the continuum of HIV-related
health services and outcomes
• A tool used for:
• Monitoring performance of HIV care
programs, health systems
• Identifying gaps and bottlenecks
in service provision and uptake
• Tracking progress toward meeting high-
level public health goals (e.g., UNAIDS
90-90-90 Initiative)
28
Gardner EM, et al. Clinical infectious diseases 2011; 52(6): 793-800.

35. Manitoba’s HIV care cascade
2 6 O C T O B E R 2 0 2 1
29
90.8%
86.2%
81.5%
74.4%
0%
20%
40%
60%
80%
100%
Alive and diagnosed In care Retained in care On treatment Virologically
suppressed
Percentage
of
participants
alive
and
diagnosed
n = 703 at alive and diagnosed step
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36. Equity analyses
Rationale & methods
• The Sustainable Development Goals are centred around the notion of leaving no one behind.
• Conventionally, cascades use aggregate data to illustrate population-level engagement in HIV care
• Relying on aggregate data hides underlying heterogeneity among individuals and sub-groups within a population
2 6 O C T O B E R 2 0 2 1
30
Identified relevant “equity variables” available within the cohort
• Age, sex, geography, ethnicity, immigration status, HIV exposure category
Disaggregated each cascade step indicator by each equity variables
Used equiplots to visualize inequalities between participant subgroups in each cascade step
• Exploratory, multivariable logistic regression analyses were then used to quantify inequalities
M
E
T
H
O
D
S
McClarty LM, Blanchard JF, Becker ML.
Leaving no one behind? An equity
analysis of the HIV care cascade among
a cohort of people living with HIV in
Manitoba, Canada. BMC Public Health
2021; 21(1): 281.

37. Inequalities across age groups
CASCADE
STEP
In care Retained in care On treatment
Virologically
suppressed
Total
participants
in cascade
step, N
638 606 573 523
AOR 95%CI AOR 95%CI AOR 95%CI AOR 95%CI
Age range, in years
18-29 Ref. - Ref. - Ref. - Ref. -
30-39 1.62 0.65-4.02 2.39 1.07-5.34 2.01 0.96-4.24 1.57 0.77-3.24
40-49 2.51 1.03-6.11 3.28 1.51-7.13 3.27 1.58-6.77 2.77 1.37-5.59
50-59 4.53 1.73-11.89 3.69 1.67-8.14 4.39 2.08-9.30 3.75 1.83-7.68
60+ 5.04 1.52-16.69 6.37 2.27-17.85 4.99 2.05-12.15 4.53 1.96-10.44
2 6 O C T O B E R 2 0 2 1
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31
n = 703; adjusted for sex and ethnicity

38. Inequalities across geographies
2 6 O C T O B E R 2 0 2 1
32
CASCADE
STEP
In care Retained in care On treatment
Virologically
suppressed
Total
participants
in cascade
step, N
638 606 573 523
AOR 95%CI AOR 95%CI AOR 95%CI AOR 95%CI
Geography, by region
Winnipeg Ref. - Ref. - Ref. - Ref. -
Northern
Manitoba
0.64 0.17-2.35 1.23 0.35-4.41 1.37 0.44-4.26 1.06 0.42-2.70
Western
Manitoba
0.33 0.12-0.90 0.44 0.17-1.11 0.65 0.26-1.66 1.03 0.41-2.61
Eastern
Manitoba
3.04 0.40-23.04 1.91 0.56-6.48 2.27 0.77-6.64 3.82 1.31-11.17
Southern
Manitoba
0.64 0.18-2.35 0.95 0.31-2.95 0.92 0.35-2.45 0.55 0.24-1.27
n = 693; adjusted for age group, sex, and ethnicity
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39. Summary:
Data visualisation as
knowledge translation
2 6 O C T O B E R 2 0 2 1
33
Equiplots are innovative
and critical knowledge
translation tools
Facilitates communication
of evidence with policy
makers, program
implementers, clinicians
Visualisation of data
through equiplots may be
more programmatically
useful than examining
logistic regression models

40. Thank you!
6 J A N U A R Y 2 0 2 2
34
Funding
Study sites &
implementation
support
Questions?
leigh.mcclarty@umanitoba.ca
Committee members
• James Blanchard, Professor & Director,
Institute for Global Public Health, U of
Manitoba
• Marissa Becker, Associate Prof, Institute for
Global Public Health, U of Manitoba
• Carla Loeppky, Director, Epi & Surveillance,
Manitoba Health
• Lawrie Deane, Professor & Senior Scholar,
Faculty of Social Work, U of Manitoba
• Robert Hogg, Distinguished Professor, Simon
Fraser University

41. Q&A

42. Share your story!
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• Email us: nccmt@mcmaster.ca
• We typically respond within 24 business hours
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