Rural Site Visits Project

Although COVID-19 caused disruption to the Rural Site Visits Project by necessitating the postponement of most community site visits scheduled for the year, the team pivoted and successfully pursued several related activities.

The Rural Site Visits team developed the new Rural Site Visits and Health Innovations website, which features reports and over 150 “rural health innovations”—models, programs, initiatives, approaches, and work-arounds—that rural communities have designed and implemented to improve citizens’ health. By showcasing and sharing these innovations with people in other communities, the website has potential to spark action, ideas, and collaborations between citizens in all parts of BC to overcome shared challenges. The response from communities has been highly supportive; one contributor said, “I took a look at the innovations site last night and it is very inspiring. I wanted to read each and every post on there!”

Research was also an important focus for the Rural Site Visits Project this year. The team submitted its first manuscript in BMJ Open about the process for site visits and overarching themes of relationships, autonomy, and change over time. It also began writing its second manuscript on racism and cultural safety in healthcare in BC, and working with a First Nations Elder to help amplify Indigenous voices. The team also developed two specialized reports on Youth Mental Health and Addictions Services, and Indigenous Need for Culturally Safe Maternity.

Before the pandemic struck, Rural Site Visits was able to complete five in-person site visits to rural and remote BC communities, bringing the total number of visited RSA communities to 107 and the number of meetings to 382. Given that in-person site visits to rural and remote communities were not possible after COVID-19, the Site Visits team trialed “virtual visits” with three communities. These were not as positively received because the in-person aspect of engagement and relationship building was not as present. It was decided to wait for in-person visits to resume when safe.

The team embarked on providing educational opportunities for the broader Site Visits team, comprised of rural health practitioners and RCCbc staff. It hosted a four-session workshop on racism and cultural safety with Cultural Safety Facilitator, Harley Eagle, to help the Site Visits team learn more about systemic racism and how to call others in if they witness any harm during site visits. The impact of the workshop on participants was profound, as evidenced in evaluative feedback:

“I think knowing that all members of the Site Visits team have had this opportunity helps me feel more comfortable—knowing that, as a team, we are coming at difficult conversations and situations with the same goal: To help First Nation peoples and upend racism.”

 “I feel more confident in speaking up and advocating for Indigenous people when I witness racism, discrimination, and inequity. Not using my voice makes me complicit in that behaviour. As a physician, I feel more confident in treating Indigenous patients, families, and communities. I see how racism creates culturally unsafe practices, leading to sub-standard care and poor health outcomes. And I can see that, as an individual, I have the capacity to influence change at many levels.”

The Rural Site Visits Project experienced some staffing transitions throughout the year. Erika Belanger, Research Coordinator and Data Analyst, Anne Lesack, Research Assistant, and Bree Loeffler, Project Administration Lead, left the Site Visits team to pursue new opportunities. The team therefore began scoping to find a Research Assistant at the new RCCbc Island Node and a Research Associate with an Indigenous research background. The team also welcomed Dr. Danette Dawkin as its new Physician Lead, while Dr. Stuart Johnston began transitioning into a second (and hopefully final) retirement. The team also worked closely with RCCbc’s new communications team to develop a comprehensive communications plan for the Rural Health Innovations portion of its website.

The Rural Site Visits Project has completed visits to about half of all RSA communities in the province. The team is hopeful that, in coming year, they will be able to resume site visits to the remaining RSA communities. In addition, the various changes to the Project over the past year resulted in the opportunity to re-examine its research methodology to incorporate a western appreciative inquiry approach and Indigenous relational ways of thinking, knowing and being (i.e., a two-eyed seeing approach). The team anticipates adding a team member with an Indigenous research background to help shape an adapted research framework in the coming year. It will also continue implementing its newly-developed communications plan to expand and promote the website.