Theme: Epidemiology & Public Health Research Year: 2022
Background:
Residents of Winnipeg, Manitoba’s Downtown and Point Douglas areas are struggling with racism,
poverty, housing instability, substance use and Sexually Transmitted and Blood-Borne Infections
(STBBI’s). They experience barriers to accessing care and are often unable to attend a health care
setting for an appointment. Barriers include mental health, addiction, trauma and discrimination.
The priority population of MTM are people who use drugs (PWUD), or experience housing instability
or social exclusion, in Winnipeg’s core.
Description of model of care/intervention:
MTM partners with community organizations to pilot and evaluate low threshold multidisciplinary
services in community settings (ex. Community centers, emergency adult/youth shelters) to reduce
barriers to accessing care, and meet people where they are. MTM combines street outreach, harm
reduction, primary care and addictions medicine, and cultural and social services. MTM meaningfully
engages peers (members of the priority population) in all aspects of the project including design,
promotion, implementation, and evaluation.
Effectiveness:
MTM has been highly successful in connecting and providing care to the priority population. 684 clients were seen in year 1, and there are many requests from the community for increased services. Service Coordination and Traditional Medicine were the most accessed services for Social Work and Cultural Support Work respectively. Education and STBBI care was the most accessed service by the Nurse Practitioner (NP). Targeted outreach by NP located 13 HIV clients who had not accessed care, and re-connected 9 to care.
Conclusion and next steps:
Providing access to a multidisciplinary team that includes prescribers, peers, nursing, social work and
cultural supports are valued by clients. Peer engagement informs practice and builds trust within the
community. Offering services outside traditional health settings that are flexible and responsive to
the needs of the community shows promise for increased access and reduced barriers to care. The
project aims to continue piloting and evaluating interventions, and using data to support sustainable
community-based care.
Disclosure of Interest Statement:
There are no conflicts of interest to disclose.