Abstract: Examining a Peer Counselling Ehealth Intervention for Racialized LGBTQ+ Participants: #Safehandssafehearts (Society for Social Work and Research 29th Annual Conference)

Schedule:

Saturday, January 18, 2025

Redwood B, Level 2 (Sheraton Grand Seattle)

* noted as presenting author

Tolulola Taiwo-Hanna, MSW, PhD Student, University of Toronto, ON, Canada

Peter Newman, PhD, Professor, University of Toronto, ON, Canada

Charmaine C. Williams, PhD, Dean, University of Toronto, Toronto, ON, Canada

Wangari Tharao, Director of Research and Programs, Women's Health in Women's Hands Community Health Centre, Toronto, ON, Canada

Joelleann Forbes, MSW, Social Worker and Research Associate, University of Toronto, Toronto, ON, Canada

Muna Aden, MPH, Program Manager, Research, Women's Health in Women's Hands, Toronto, ON, Canada

Phylicia Crichlow, MSW, Program and Project Coordinator, The Black Health Equity Lab, Toronto, ON, Canada

Shainah Adolphe, MSW, Researcher, The Black Health Equity Lab, Toronto, ON, Canada

Ewura-Ama Ackon, MSW, Researcher, The Black Health Equity Lab, Toronto, ON, Canada

Gregory Serieaux-Halls, MSW, Researcher, The Black Health Equity Lab, Toronto, ON, Canada

Notisha Massaquoi, PhD, Assistant Professor, University of Toronto Scarborough, Toronto, ON, Canada

Ali Pearson, MSW, Student, University of Toronto, Toronto, ON, Canada

Background and Purpose: Racialized populations bore a disproportionate burden of COVID-19 morbidity and mortality in Canada; in Toronto, 83% of all COVID-19 cases were attributed to racialized populations. This coupled with pervasive health disparities among LGBTQ+ populations who experience adverse social determinants of health and lack access to healthcare services, exposed the absence of coordinated community-engaged responses that were racially and culturally competent to address the excess burden of COVID-19 on racialized members of LGBTQ+ communities. #SafeHandsSafeHearts was developed and implemented in collaboration with a local Community Health Centre (CHC) to test the effectiveness of a brief peer-counselling eHealth intervention in increasing COVID-19 knowledge and protective behaviors and reducing psychological distress of racialized LGBTQ+ participants. Following the effectiveness of the intervention, we aimed to gain insights into the roles and perspectives of peer counsellors who delivered and supported the success of the intervention, and to inform the CHC which aims to adopt the eHealth modality to expand its services. The purpose of this community-based, collaborative qualitative study was to examine the perspectives and experiences of peer counsellors, clinical staff, and coordinators of the #SafeHandsSafeHearts study.

Methods: We used a multi-method qualitative approach. Semi-structured interviews were conducted with peer counsellors, clinical supervisors, project [research] coordinators, and CHC staff, to identify their perspectives on elements of the effectiveness of the #SafeHandsSafeHearts intervention in reducing psychological distress and increasing protective behaviors, challenges in implementing the eHealth intervention, and recommendations to improve intervention delivery and acceptability. We also reviewed anonymized counselling notes collected from peer counsellors during the intervention. Using ATLAS.ti software, a team-based inductive analytical approach was used to code and to thematically analyze the data.

Results: Nine participants were recruited from the #SafeHandsSafeHearts team and 263 counselling notes reviewed. Findings showed that the evidence-based counselling model requires careful planning, adequate resources, and ongoing evaluation and assessment. Motivational interviewing, psychoeducation, and crisis intervention which undergirded the intervention were all found to be highly beneficial in helping counsellors to support their clients amid a public health emergency. Participants reported that the sense of belonging within the implementation team; attending biweekly online group supervision where critical reflexivity was emphasized; and being able to access timely and responsive technological supports from research coordinators in implementing the online peer-counselling sessions for racialized LGBTQ+ participants, were all imperative to the success of this eHealth intervention.

Conclusions and Implications: This study was an important step in the collaborative development of clear guidelines for the effective involvement and supervision of peer counsellors to increase counselling services for marginalized populations within community-based settings. Using findings from this study, we have created a replicable and effective e-counselling model for racialized LGBTQ+ communities based on the following core elements: a) cultural responsiveness; b) trust, rapport-building and connection; c) stigma reduction; d) reducing loneliness; e) ensuring accessibility and affordability; f) tailored psychosocial support; g) customized peer counsellor training and supervision; and, h) strategic diversity within peer counselling groups.