SHIFT - PrEP / SYSTEM NAVIGATION Discussion Group by Terence Lowe https://padlet.com/terencelowe/prepsystem IN WHAT WAYS CAN TASK-SHIFTING SUPPORT ACCESS TO PrEP & NAVIGATING THE SYSTEM? WHAT DOES IT LOOK LIKE? en-us 2021-01-27 16:11:05 UTC 2021-01-29 03:02:44 UTC hello@padlet.com https://padlet.net/icons/png/1f4a1.png "IF THERE WAS AN IDEAL TASK-SHIFTING INITIATIVE RE: PrEP AND/OR SYSTEM NAVIGATION, WHAT WOULD IT BE?" terencelowe https://padlet.com/terencelowe/prepsystem/wish/1132361161 What are some ideas for task-shifting mental health services? How can supervision/training support this? 
Some findings from the SHIFT study have been pre-prepared below. New ideas can be generated by taking an "IDEA" card (below), writing on it, and including it with others.
Add any concerns/solutions/opportunities/challenges associated with each idea by taking a corresponding card (below) and adding it to the idea(s) as you see fit. 
Keep in mind: feasibility, cost, resources, barriers, attitudes, and anything else you find important in consideration of each idea.
Once all ideas are posted, begin the process of identifying one specific idea you think is most implementable, given the above criteria, as a group.  
Remember, anything goes! Feel free to be creative with how these ideas are represented, expressed, and shown below.]]> 2021-01-27 16:11:05 UTC https://padlet.com/terencelowe/prepsystem/wish/1132361161 IDEA : PrEP Follow-Up terencelowe https://padlet.com/terencelowe/prepsystem/wish/1132361293 2021-01-27 16:11:05 UTC https://padlet.com/terencelowe/prepsystem/wish/1132361293 RECOMMENDATION FOR TOMORROW: terencelowe https://padlet.com/terencelowe/prepsystem/wish/1132361313 2021-01-27 16:11:05 UTC https://padlet.com/terencelowe/prepsystem/wish/1132361313 CONCERN terencelowe https://padlet.com/terencelowe/prepsystem/wish/1132361393 Difficulty with follow-up and readiness for PrEP

How do we link people between for example TPH and CWs, or other clinicians and CWs]]> 2021-01-27 16:11:05 UTC https://padlet.com/terencelowe/prepsystem/wish/1132361393 CONCERN terencelowe https://padlet.com/terencelowe/prepsystem/wish/1132361411 Lots of training already happening (from GMSH for example) but there is a lot of turnover in the field and trainings not ongoing

Various levels of understanding ]]> 2021-01-27 16:11:05 UTC https://padlet.com/terencelowe/prepsystem/wish/1132361411 CONCERN terencelowe https://padlet.com/terencelowe/prepsystem/wish/1132361414 How do you identify and make people realize that they might be at risk? 

How do you have that conversation without making people feel bad? ]]> 2021-01-27 16:11:05 UTC https://padlet.com/terencelowe/prepsystem/wish/1132361414 CONCERN terencelowe https://padlet.com/terencelowe/prepsystem/wish/1132361424 Similar service might require some subsidization]]> 2021-01-27 16:11:05 UTC https://padlet.com/terencelowe/prepsystem/wish/1132361424 SOLUTION terencelowe https://padlet.com/terencelowe/prepsystem/wish/1132361431 2021-01-27 16:11:05 UTC https://padlet.com/terencelowe/prepsystem/wish/1132361431 SOLUTION terencelowe https://padlet.com/terencelowe/prepsystem/wish/1132361435 2021-01-27 16:11:05 UTC https://padlet.com/terencelowe/prepsystem/wish/1132361435 IDEA : Phone line for service referrals davidbrennan2 https://padlet.com/terencelowe/prepsystem/wish/1133769261 2021-01-27 20:43:02 UTC https://padlet.com/terencelowe/prepsystem/wish/1133769261 IDEA : Directory of services davidbrennan2 https://padlet.com/terencelowe/prepsystem/wish/1133769272 2021-01-27 20:43:02 UTC https://padlet.com/terencelowe/prepsystem/wish/1133769272 IDEA : Pre-Counselling for PrEP/Assessing readiness/Referrals davidbrennan2 https://padlet.com/terencelowe/prepsystem/wish/1133769493 What is the definition of pre-counselling? Clarity around whose turf is that?]]> 2021-01-27 20:43:06 UTC https://padlet.com/terencelowe/prepsystem/wish/1133769493 davidbrennan2 https://padlet.com/terencelowe/prepsystem/wish/1133829830 2021-01-27 21:01:20 UTC https://padlet.com/terencelowe/prepsystem/wish/1133829830 davidbrennan2 https://padlet.com/terencelowe/prepsystem/wish/1133835753 2021-01-27 21:03:13 UTC https://padlet.com/terencelowe/prepsystem/wish/1133835753 davidbrennan2 https://padlet.com/terencelowe/prepsystem/wish/1133836446 2021-01-27 21:03:27 UTC https://padlet.com/terencelowe/prepsystem/wish/1133836446 CONCERN davidbrennan2 https://padlet.com/terencelowe/prepsystem/wish/1134189710 Whose turf is this? Discussion around side effects, for example. Could CWs take on that role?]]> 2021-01-27 23:47:24 UTC https://padlet.com/terencelowe/prepsystem/wish/1134189710 CONCERN davidbrennan2 https://padlet.com/terencelowe/prepsystem/wish/1134190375 Uptake of PrEP in Ontario is still low. Many do not perceive themselves to be at risk even if "objectively" at risk. Lots that happens before we get to doctor's door. ]]> 2021-01-27 23:47:53 UTC https://padlet.com/terencelowe/prepsystem/wish/1134190375 CONCERN davidbrennan2 https://padlet.com/terencelowe/prepsystem/wish/1134190522 Kidney tests, HIV tests, there is an irreducibly medical moment. Where would CWs fit along that cascade? ]]> 2021-01-27 23:47:59 UTC https://padlet.com/terencelowe/prepsystem/wish/1134190522 IDEA : Freddie or other online service (through HQ) maxcharest https://padlet.com/terencelowe/prepsystem/wish/1134193696 Online access and reduced rates
Potential partnerships with  pharmacies
Freddie provides lots of funding for PrEP to decrease price
People are aware of PrEP but have not accessed it (do not think they are at risk)]]> 2021-01-27 23:50:14 UTC https://padlet.com/terencelowe/prepsystem/wish/1134193696 IDEA : CWs Performing Case Management maxcharest https://padlet.com/terencelowe/prepsystem/wish/1134204218 2021-01-27 23:57:26 UTC https://padlet.com/terencelowe/prepsystem/wish/1134204218 "PADLET LOT" : SOMETHING TO BE DISCUSSED FURTHER davidbrennan2 https://padlet.com/terencelowe/prepsystem/wish/1134208794 2021-01-28 00:00:24 UTC https://padlet.com/terencelowe/prepsystem/wish/1134208794 SOLUTION maxcharest https://padlet.com/terencelowe/prepsystem/wish/1137498991 2021-01-28 17:15:38 UTC https://padlet.com/terencelowe/prepsystem/wish/1137498991 SOLUTION maxcharest https://padlet.com/terencelowe/prepsystem/wish/1137499619 2021-01-28 17:15:45 UTC https://padlet.com/terencelowe/prepsystem/wish/1137499619 SOLUTION maxcharest https://padlet.com/terencelowe/prepsystem/wish/1137500083 Don't want to duplicate already existing services (Maple Leaf, the PrEP Clinic) but might want to increase connections]]> 2021-01-28 17:15:50 UTC https://padlet.com/terencelowe/prepsystem/wish/1137500083 SOLUTION maxcharest https://padlet.com/terencelowe/prepsystem/wish/1137500586 Work with HQ to implement these solutions/promote PrEP/perform follow-ups]]> 2021-01-28 17:15:55 UTC https://padlet.com/terencelowe/prepsystem/wish/1137500586 SOLUTION maxcharest https://padlet.com/terencelowe/prepsystem/wish/1137501088 Community workers doing follow-up with clients around PrEP

E.g., TPH asking clients if they want to be contacted by CWs]]> 2021-01-28 17:16:01 UTC https://padlet.com/terencelowe/prepsystem/wish/1137501088 SOLUTION maxcharest https://padlet.com/terencelowe/prepsystem/wish/1137501975 Have an online, ongoing webinar so that people could continuously be trained? ]]> 2021-01-28 17:16:09 UTC https://padlet.com/terencelowe/prepsystem/wish/1137501975 SOLUTION maxcharest https://padlet.com/terencelowe/prepsystem/wish/1137502568 Training/"certification" for people to learn how to have those conversations around risk? 

More widespread campaigns about PrEP]]> 2021-01-28 17:16:16 UTC https://padlet.com/terencelowe/prepsystem/wish/1137502568 IDEA : PrEP vending machine/Safer sex/use supplies maxcharest https://padlet.com/terencelowe/prepsystem/wish/1137548830 2021-01-28 17:23:27 UTC https://padlet.com/terencelowe/prepsystem/wish/1137548830 IDEA : PrEP System Navigation (Referrals, Financing) maxcharest https://padlet.com/terencelowe/prepsystem/wish/1137549696 2021-01-28 17:23:32 UTC https://padlet.com/terencelowe/prepsystem/wish/1137549696 INSTRUCTIONS davidbrennan2 https://padlet.com/terencelowe/prepsystem/wish/1137562913 1. BRAINSTORM TASK-SHIFTING IDEAS. EACH "IDEA" GETS ONE CARD.

2. WRITE COMMENTS IN THE COMMENT SECTION OF EACH IDEA.

3. EACH "CONCERN" GETS A CARD.

4. EACH "SOLUTION" GETS A CARD.

5. ARRANGE THE CARDS TO CREATE A SUMMARY OF YOUR GROUP DISCUSSION.

6. DECIDE WHICH IDEA(S) ARE GOING TO BE PRESENTED ON FRIDAY TO THE REST OF THE GROUP. ]]> 2021-01-28 17:25:30 UTC https://padlet.com/terencelowe/prepsystem/wish/1137562913 Importance of linking PrEP quickly and with least barriers maxcharest https://padlet.com/terencelowe/prepsystem/wish/1138208884 2021-01-28 19:20:53 UTC https://padlet.com/terencelowe/prepsystem/wish/1138208884 How are clinicians connected to case workers and people who receive PrEP? What are those connections and how can we amplify them? maxcharest https://padlet.com/terencelowe/prepsystem/wish/1138216480 2021-01-28 19:22:21 UTC https://padlet.com/terencelowe/prepsystem/wish/1138216480 Some barriers: financial (not one of 5 provinces that covers PrEP), finding clinicians, potential side effects/misinformation or concerns about getting on the medication maxcharest https://padlet.com/terencelowe/prepsystem/wish/1138297774 2021-01-28 19:38:37 UTC https://padlet.com/terencelowe/prepsystem/wish/1138297774 Keep in mind: Injectable PrEP maxcharest https://padlet.com/terencelowe/prepsystem/wish/1138356373 2021-01-28 19:51:22 UTC https://padlet.com/terencelowe/prepsystem/wish/1138356373 FINANCIAL BARRIERS maxcharest https://padlet.com/terencelowe/prepsystem/wish/1138475682 2021-01-28 20:20:02 UTC https://padlet.com/terencelowe/prepsystem/wish/1138475682