Catalyzing Capacity Building in Rehabilitation Post-Solid Organ Transplant

Solid organ transplant (SOT) patients have low levels of physical activity before and after transplantation which has a negative impact on their health and survival. Despite this, in Quebec, there is limited availability of rehabilitation and physical activity programming for transplant candidates and recipients. Importantly, many healthcare professionals do not feel confident in counselling SOT recipients about physical activity that is appropriate for them due to lack of specific education about transplantation in their training.

Our objective is to develop a free online continuing education course on exercise prescription in SOT recipients for English-speaking exercise professionals in Quebec that will include interactive lectures, case studies and evaluation materials. This will ultimately improve the confidence of exercise professionals when they deal with SOT recipients and the quality of rehabilitation that they are able to offer.

The development of the course will involve 4 steps:

1. A scientific committee, including both professionals and patient partners, will participate in a video conference call to define the learning objectives and the most relevant content (theory, case studies, evaluations) to be included in the course.

2. The Co-PIs, the coordinator, a trainee, patient partners, Maria Sedeno (RESPIPLUS) and Becky Zucco (Wilkin) will draft the first version of the online course including the learning objectives, content, case studies, evaluation materials as well as visual aspects and interactive components of the module.

3. Feedback from the scientific committee will be sought via email. At least two rounds of revision are planned.

4. Feedback will be integrated into the module. This initiative was made possible through a financial contribution by Health Canada. 7 By providing English-speaking exercise professionals in Quebec with the knowledge and tools to effectively prescribe exercise to SOT recipients, the availability of rehabilitation services and physical activity programming for SOT recipients in Quebec may increase.

Linguistically- and Culturally-Sensitive Psychotherapy: Training and Retaining Migrant & Minority Therapists

Mental health care in multicultural communities is enhanced when local therapists represent the population and when these therapists are trained in linguistically- and culturally-sensitive psychotherapy. Unfortunately, many trainees do not feel well-prepared for diversity and migrants/minorities face barriers to building a career in Québec.

We will: (1) use qualitative inquiry to study perceived training deficits and career barriers in psychologists trained at anglophone institutions; (2) use quantitative techniques to establish a consensus model of the changes needed to retain multicultural expertise in Québec. 

Participants will be 40 clinical psychology trainees and 40 licensed clinical psychologists. This project will use a cultural consensus design, a mixed methods approach with four sequential steps: (1) qualitative interviews (in this case, analysis of previously collected interviews); (2) free listing responses to open-ended questions; (3) sorting the most common responses while thinking aloud; and (4) survey design based on the consensual sorts.

The qualitative interview and think-aloud transcripts will be studied using qualitative inquiry, specifically thematic analysis. The free listing, sorting, and survey components will be studied using quantitative analysis; frequency analysis, multidimensional scaling, and cultural-consensus analysis, respectively.

We anticipate this project will improve training of mental health professionals and will yield steps to boost retention of migrant/minority psychologists in Québec. We will develop recommendations for the two anglophone training programs, and for the professional order. Our results will be relevant to other cultural settings characterized by linguistic and cultural complexity.

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Outputs:

• Zhao, Y., Segalowitz, N., Voloshyn, A., Chamoux, E., & Ryder, A. G. (2021). Language Barriers to Healthcare for Linguistic Minorities: The Case of Second Language-specific Health Communication Anxiety. Health communication, 36(3), 334–346. https://doi.org/10.1080/10410236.2019.1692488

• Ryder, A. G., Doucerain, M. M., Dere, J., Jurick, T., Zhou, B., & Zhou, X. (2021). On dynamic contexts and unstable categories: Steps towards a cultural-clinical psychology. In M. Gelfand, C.-Y. Chiu, & Y.-Y. Hong (Eds), Advances in culture and psychology, volume 8 (pp. 195-245). OUP.

• Voloshyn, A., Dussault, È., Segalowitz, N., Ryder, A. G. (2022, September). A qualitative study of clinical psychologists’ reflections on their work with linguistically- and culturally-diverse clients [Paper session]. Presentation at the 6th World Congress of the World Association of Cultural Psychiatry, Rotterdam, Netherlands.

Thinking social: Examining the efficacy of a social skills training group for young adults on the autism spectrum

Social skills are challenging for individuals on the autism spectrum (AS). Such deficits make everyday living difficult, and can lead to mental health difficulties, most notably anxiety and depression. Social skills training programs have been shown to improve social abilities adolescents and adults on the AS. However, little is known regarding their efficacy to improve mental health issues.

In Québec, few programs aimed at improving social skills in young adults are offered within the public healthcare system, and even fewer are offered to English speakers. Additionally, clinicians rarely receive training to intervene with ASD young adults.

Thus, this study aims to a) assess the efficacy of a program aimed at improving social skills young adults on the AS, b) examine whether increased social abilities and connection with peers lead to improved mental health in these adults, c) increase the availability of English-language intervention for adults on the AS within the public healthcare system and d) increase clinical capacity of English-speaking clinicians in Québec to deliver social skills interventions.

For this project, 12 young adults on the AS will participate in a 24-week social skills training program. Each participant will be paired with a peer social coach who will be recruited from clinical departments at McGill University (psychology, SCSD, etc.). Participants will undergo testing to assess social skills and mental health at baseline (T0), immediately after completing the program (T1), and six-month post-treatment (T2). ANCOVAs will be used to compare test scores at T0 to those at, T1 and T2.

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Outputs:

• Beauchamp, M. L. H., Amorim, K., Wunderlich, S. N., Lai, J., Scorah, J., & Elsabbagh, M. (2022). Barriers to access and utilization of healthcare services for minority-language speakers with neurodevelopmental disorders: A scoping review. Frontiers in psychiatry, 13, 915999. https://doi.org/10.3389/fpsyt.2022.915999

• Beauchamp, M. L. H., Rezzonico, S., Bennett, T., Duku, E., Georgiades, S., Kerns, C., Mirenda, P., Richard, A., Smith, I. M., Szatmari, P., Vaillancourt, T., Waddell, C., Zaidman-Zait, A., Zwaigenbaum, L., & Elsabbagh, M. (2023). The Influence of Bilingual Language Exposure on the Narrative, Social and Pragmatic Abilities of School-Aged Children on the Autism Spectrum. Journal of autism and developmental disorders, 53(12), 4577–4590. https://doi.org/10.1007/s10803-022-05678-w

• Beauchamp MLH, Rezzonico S, Elsabbagh M, Mirenda P, Bennett T, Duku E, Georgiades S, Kerns CM, Smith IM, Szatmari P, Ungar WJ, Vaillancourt T, Zaidman-Zait A, Zwaigenbaum L. (May 11-14, 2022). Examining the Influence of Bilingualism on the Narrative, Social and Pragmatic Abilities of School-Aged Children on the Autism Spectrum. International Society for Autism Research (INSAR) Conference, Austin, USA, hybrid format,

• Beauchamp MLH, Rezzonico S, Smith I, Duku E, Georgiades S, Kerns C, Mirenda P, Richard A, Szatmari P, Vaillancourt T, Waddell C, Zwaigenbaum L, Zaidman-Zait A, Elsabbagh M. (Nov 17–19, 2022). Narrative, Social and Pragmatic Abilities in Bilingual and Monolingual School-Aged Children on the Autism Spectrum. The American Speech-Language-Hearing Association (ASHA) Convention 2022, New Orleans USA.

• Beauchamp, M. L. H., Blanco Gomez, G., Rezzonico, S.,...Elsabbagh, M (2023). The Validity of the Narrative Scoring Scheme in School-Aged Children on the Autism Spectrum. International Society for Autism Research.

• Scorah, J; Beauchamp, M. L. H.; Amorim, K; Elsabbagh, M. (2022). Examining the Characteristics of Clinicians in an ECHO (Extension for Community Health Outcomes) Autism Program

• Beauchamp, M. L. H., Amorim, K., Wunderlich, S. N., Lai, J., Scorah, J., Elsabbagh, M. (2022, submitted). Identifying Barriers to Healthcare Access and Use for Minority-Language Speakers with Neurodevelopment Disorder

• Beauchamp, M. L. H., Blanco Gomez, G., Rezzonico, S.,...Elsabbagh, M (2023, submitted). The Narrative Scoring Scheme’s Validity with Bilingual and Monolingual Children on the Autism Spectrum

A Synthesis of Evidence of The Unique Psychosocial Challenges Faced By Quebec’s English Speaking Black Communities During the COVID-19 Pandemic

The McGill Human Motivation Lab and the Black Community Resource Center (BCRC) have collaborated on 8 research studies over the last two years to examine the resilience of Quebec English-speaking Black communities in the face of the greatest public health crisis in a century. Our results uncovered numerous important themes, such as how involvement in the BLM movement allowed Black young adults to recover from the social isolation imposed by the pandemic, how it was particularly Black women who assumed leadership roles despite having been especially burdened by the pandemic, and how social support from both family and friends were importantly related to young adults’ psychological adjustment. More recently, with funding provided by the Health Care Access for Linguistic Minorities Network, we conducted studies that compared members of Quebec’s English and French-speaking Black communities and found significant group differences in important real-life outcomes such as experiences of discrimination, barriers to physical and mental health care, and hesitancy regarding vaccination for the COVID-19 virus.

Across all studies, English-speaking Black communities struggled more than French-speaking Black communities. We propose to synthesize these findings into a single cohesive knowledge translation effort that can be used to prepare workshops, presentations, technical reports, publications, web-based tools, school curricula, and webinars. Our partnership with the BCRC will support the development of these educational and community-building events. Highlighting the unique challenges of English-speaking Black communities is critically important as this community faces a Quebec government that intends to use the not-withstanding clause to pass laws that will restrict English language rights in many spheres of Quebec life. Such language restrictions are likely to have devastating impacts on the health and vitality of English-speaking Black communities. These laws will also weaken the natural alliance that exists between the English and French-speaking Black communities. The purpose of this knowledge translation will be to increase community awareness of unique barriers of accessing health care and social services faced by Quebec’s English-speaking Black communities. It will contribute to improving access to resources and evidence-based information on the status and needs of the English-speaking Black communities.

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Outcomes:

• Lafreniere, B., Audet, É. C., Kachanoff, F., Christophe, N. K., Holding, A. C., Janusauskas, L., & Koestner, R. (2023). Gender differences in perceived racism threat and activism during the Black Lives Matter social justice movement for Black young adults. Journal of community psychology, 51(7), 2741–2757. https://doi.org/10.1002/jcop.23043

• Nweze, N., Davids, J., Fang, X., Holding, A., & Koestner, R. (2023). The Impact of Language on the Mental Health of Black Quebecers. Journal of racial and ethnic health disparities, 10(5), 2327–2337. https://doi.org/10.1007/s40615-022-01412-5

• Audet, É. C., Thai, H., Holding, A. C., Davids, J., Fang, X., & Koestner, R. (2023). The depth of stories: How Black young adults' disclosure of high arousal negative affect in narratives about the COVID-19 pandemic and the BLM protests improved adjustment over the year 2020. Journal of community psychology, 51(4), 1504–1517. https://doi.org/10.1002/jcop.22929

CKOL: Documentation on Health and Social Services in English-Speaking Quebec

The Community Knowledge Open Library (CKOL), created by the Quebec English-Speaking Communities Research Network (QUESCREN), Concordia University, is a growing online repository of documents from groups and stakeholders serving and working with English-speaking communities in Quebec. The objective of the current project for which we are seeking funding is to add material related to health and social services in English-speaking Quebec to the existing CKOL database.

This material will be gathered from existing project partners, and we will establish new partnerships with members of the Community Health and Social Services Network (CHSSN), from whom we will also start obtaining CKOL material. Integrating new documents into this user-friendly one-stop database will increase access to knowledge through an enriched CKOL database. This will make it easier for stakeholders to meet the health care and social service needs of English speakers in Quebec.

Culturally Adapted Education Materials for Families of English-Speaking Minority Patients with Early Psychosis

Psychosis is a serious mental illness that usually begins in adolescence or young adulthood and is characterized by distressing symptoms like hallucinations and paranoia. Psychosis ranks in the top 3 most disabling conditions worldwide. Educating the families of affected individuals is known to make patients feel better, yet many family members of minority patients don’t participate in the education sessions that are offered. Reasons for the lack of participation include not trusting medical authorities and not feeling comfortable to bring up cultural issues like religion, spirituality, and racism. There have been no early psychosis programs that have addressed these problems, so the current study is doing just that.

Over the last two years, researchers have met with leaders and members of English-speaking minority communities, families of English-speaking minority patients with psychosis, patients, and clinicians to understand what changes are needed to make family education about psychosis more acceptable and helpful to people of diverse backgrounds. While it is true that research efforts to date have produced a large and growing body of data, these findings and results need to be prepared for presentation to communities and families. Our knowledge translation activities will include writing plain language summaries of meetings with community and family members to explain what kinds of topics and discussions will facilitate effective care for their loved ones with early psychosis and better collaboration with the clinical team. We will also present statistical findings in a non-threatening and easy-to-access format that will be easy for everyone to understand.

The potential impact of these activities will give community and family members a greater understanding of psychosis, will improve their participation in education seminars, and will contribute to healthier and happier lives of young people with early psychosis.

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Outputs:

• Jarvis, E. G., Desmarais, C., Lang, E., Zimanyi, L., & Leroux-Goyet, S. (March 2023). Family Psychoeducation series [Virtual workshop].

• Khan, S. (March 2023). Looking after our and our Youth's Mental Health. A presentation on caring for our mind, body, and spirit [Presentation]. Amal Center for Women, Montreal, Canada.

• Paquin, V., Pow, R. (March 2023). Training of workers on first episode psychosis L’Annexe is a community organization engaged in the socialization of multicultural young adults with intersectional vulnerabilities [Presentation]. L’Annexe – Ometz Drop-in centre for young adults 16-35, Montreal, Canada.

• Unknown. (Februrary 2023). Exploring the Mental Health Stigma Within the Black Community [Virtual event].

Disseminate, promote, mobilize: Planning of knowledge transfer activities for English speakers in long-term care facilities.

As part of an action research process initiated with our partner, the CHSLD St Brigid's Home (SBH), a workshop was organized on November 30 and December 1, 2021, and about forty participants from the residential center (i.e., users and their representatives, caregivers, employees, managers) actively participated. This workshop, brought together all stakeholders to reflect on innovative models of long-term care that could promote the sustainable health of workers, residents and their families. This initiative was a great success and laid a solid foundation for the continuation of the research activities planned with our partner. Following this workshop, a written summary (in French) will be made available, as well as the content of the four conferences held during the first half-day (also in French).

As this activity was held in French, through this funding application, we aim to reach the English-speaking population through knowledge transfer and appropriation initiatives. Given the mission and values of Jeffery Hale Saint Brigid's Hospital, we believe it is essential to reach out to English-speaking participants at SBH, as well as to the English-speaking community served in Quebec City and more broadly in Quebec. This will ensure that the language preferences of the end-users are respected, but more importantly, that they are truly involved in the entire process.

More specifically, the funds from this program will be used to translate the workshop summary from French to English, to prepare written summaries of the four conferences presented the first day, and to accommodate a complementary "world café" type of activity in which English-speaking people will be able to participate more actively, thanks to live interpretation services. This will allow, in the end, to enrich the synthesis already written and produce a new version of it. The results thus disseminated in both official languages will facilitate a greater appropriation of knowledge by all stakeholders in this field, regardless of the language in which they express themselves.

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Outputs:

• Feillou, I., Jauvin, N. (January, 2023). Sustainable Health Development in CHSLDs, an action-research initiative in partnership with CHSLD St Brigid's Home and Jefferey Hale Partners [Invited presentation]. CHSSN, Québec, Canada.

• Feillou, I. (December, 2023). CHSLD: milieu de travail, milieu de vie, milieu de soins. Comment favoriser la santé durable des travailleurs, des résidents et de leurs proches? [Webinaire]. ASSTSAS.

• For more information on this project and to view some of its outcomes, please visit: https://centreexpertiseacess.com/en/sustainable-health-project/

Project extension | Assessment and Implementation of the MedComm Online Interpretation Platform into the Clinical Setting

One-year project extension for a previously funded project. See here.

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Outcomes:

• Unknown. (March, 2023). Role of Medical Students as Interpreters in Bridging Language Barriers in Healthcare Centers: A Scoping Review [Poster presentation]. 19th Annual Crossroads Interdisciplinary Health Research Conference.

Project extension | Making the switch to remote interpreting

One-year project extension for a previously funded project.

Project Extension | Language minorities and the risk of depression among individuals suffering from a chronic disease: a retrospective study of the Canadian Longitudinal Study on Aging

One-year project extension for a previously funded project. See here.

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Outcomes:

• Farid, D., Li, P., Dasgupta, K., & Rahme, E. (2022). Determinants of loss to follow-up in the Canadian Longitudinal Study on Aging: a retrospective cohort study. Journal of epidemiology and community health, 76(12), 1011–1018. https://doi.org/10.1136/jech-2022-219307

• Farid, D., Li, P., Dasgupta, K., & Rahme, E. (2022). Determinants of loss to follow-up in the Canadian Longitudinal Study on Aging: a retrospective cohort study. Journal of epidemiology and community health, 76(12), 1011–1018. https://doi.org/10.1136/jech-2022-219307

• Farid, D., Li, P., Da Costa, D., Afif, W., Szabo, J., Dasgupta, K., & Rahme, E. (2020). Undiagnosed depression, persistent depressive symptoms and seeking mental health care: analysis of immigrant and non-immigrant participants of the Canadian Longitudinal Study of Aging. Epidemiology and psychiatric sciences, 29, e158. https://doi.org/10.1017/S2045796020000670

Project Extension | Are language and motivational barriers limiting healthcare access for Black young adults during the COVID-19 pandemic?

One-year extension of a previously funded project. See here.

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Outcomes:

• Lafreniere, B., Audet, É. C., Kachanoff, F., Christophe, N. K., Holding, A. C., Janusauskas, L., & Koestner, R. (2023). Gender differences in perceived racism threat and activism during the Black Lives Matter social justice movement for Black young adults. Journal of community psychology, 51(7), 2741–2757. https://doi.org/10.1002/jcop.23043

• Nweze, N., Davids, J., Fang, X., Holding, A., & Koestner, R. (2023). The Impact of Language on the Mental Health of Black Quebecers. Journal of racial and ethnic health disparities, 10(5), 2327–2337. https://doi.org/10.1007/s40615-022-01412-5

• Audet, É.C., Leboeuf, J., Holding, A.C. et al. Better Together: Family and Peer Support for Black Young Adults During the COVID-19 Pandemic and the Black Lives Matter Movement. Trends in Psychology. 1-18, 688–705 (2022). https://doi.org/10.1007/s43076-022-00157-8

• Audet, É. C., Thai, H., Holding, A. C., Davids, J., Fang, X., & Koestner, R. (2023). The depth of stories: How Black young adults' disclosure of high arousal negative affect in narratives about the COVID-19 pandemic and the BLM protests improved adjustment over the year 2020. Journal of community psychology, 51(4), 1504–1517. https://doi.org/10.1002/jcop.22929

The Law 2 on Palliative and End-of-life Care in Quebec: Getting a Grip on the Challenges associated with Providing Quality of Care to English-speaking Population

Even after the adoption of Bill 2 in Quebec and Bill C-14 in Canada, only very limited efforts were made to adequately educate civil society on these matters. Furthermore, unlike the cannabis law where there was widespread media attention to the multiple issues at stake, the media coverage of Bill 2 has largely focused on medical assistance in dying. This has overshadowed the importance of palliative care. In fact, Bill 2 has led to misrepresentations about the continuum of palliative care services and its access. While Bill 2 in Quebec and Bill C-14 in Canada are available in both official languages and despite selected associated activities to inform civil society in both languages over the past three years, investigator’s field experience and that of expert colleagues reveal that English-speaking health care professionals, caregivers, volunteers, patients, and the population in general do not have ready access to the information.

The present research proposes: 1) Integrative scoping review of best practices related to knowledge translation, literacy and capacity building of frontline health care providers, as well as to reach out to members in reference to chronic and palliative care (year 1); 2) Four focus groups with health care professionals involved in Chronic and Palliative Care and End-of-Life Care at the CIUSSS Centre Sud de l’Île de Montréal and CIUSSS Centre Ouest de l’Île de Montréal. 3a) Five individual interviews with heath care providers involved in Chronic and Palliative Care and End- of-Life Care. Also researchers will develop and pilot-test throughout the focus groups and individual interviews, an easy readily available and accessible training program in English for palliative health care providers, namely physicians, nurses, advanced practice nurses (infirmières de pratique spécialisée (IPS), social workers, field-based nurses and physicians (non-governmental organisations) with adapted support documents in English. 3b) Five individual interviews with experts involved in Chronic and Palliative Care and End-of-Life Care are planned (year 2). Also researchers will develop and validate an interview guide with supporting documents that promote a better understanding of the four components of Bill 2, palliative care resources in English and how to access them; participatory approaches, knowledge exchange and knowledge transfer workshops will be proposed for this purpose.

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Outputs:

1. Vissandjée, B., Fernandez, I., Durivage, P., Freitas, Z., Savignac, P., & Van Pevenage, I. (2021). COVID-19, promotion and provision of palliative care: reaching out, accounting for linguistic diversity. Global health promotion, 28(2), 87–90. https://doi.org/10.1177/1757975921989995

2. Lapierre J, Croteau S, Gagnon M-P, et al. Télésanté en contexte de pandémie et de déconfinement : pratiques infirmières innovantes et partenariats pour des communautés équitables, sécuritaires et durables. Global Health Promotion. 2021;28(1):89-97. doi:10.1177/1757975920980720

3. Unknown. (2020, 6 Februrary). Maîtriser la loi 2 sur les soins palliatifs et de fin de vie au Québec : les défis des proches aidants anglophones avec une littératie de santé faible. 6th International REIACTIS Conference ‘‘Inclusive Society and Aging’’, Metz, France.

4. Fernandez, I. Des soins palliatifs équitables et de qualité : intervenir selon une sensibilité aux diversités linguistiques et aux trajectoires d’immigration. En ligne [Zoom]. Colloque étudiant et jeunes chercheur.es SHERPA/CREDEF. 4 juin 2021.

Language and psychosocial factors associated with post-graduate retention of anglophone health and social services students in Quebec

Language minorities often encounter language barriers when accessing health and social services. Specifically, anglophones in Quebec are a growing population but often report difficulties accessing these services and receiving personalized care due to language barriers. Many studies have explored the retention of healthcare and social service workers capable of delivering services in English. Results have shown that many anglophone students in these sectors choose to leave the province post-graduation. Thus, this study will investigate various key factors that may predict the retention of anglophone health and social service graduating students in Quebec. The results will enhance our understanding of why anglophone students choose to stay or leave the province. This knowledge will help develop programs aimed to incentivise anglophones to remain and work in the health and social services sectors in Quebec.

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Outputs:

• Loiselle, C.G., Durand, A. B., Monarque, M., Brown, T. L.. (manuscript In preparation). Predictive retention factors of English-speaking health and social service students graduating from an Anglophone Québec university.

• Brown, T. L., Durand, A., Monarque, M., & Loiselle, C. G. (2022, May). Language and psychosocial factors associated with post-graduate retention of anglophone health and social services students in Quebec [Poster Presentation]. Poster presented at the World Conference on Health Promotion, Montreal, Quebec.

• Brown, T. L., Monarque, M., Durand, A., & Loiselle, C. G. (2021, December). Key psychosocial predictors of students' retention. In C. G. Loiselle (Chair), Language matters: Dialogue McGill’s supported initiatives [Symposium]. Dialogue McGill Conference, virtual.

Innovative Practices in Service Provision with Interpreters in Times of Health Crisis: A Qualitative Study of Clinicians, Interpreters, and Service Users’ Perspectives

Language barriers hinder access and quality in health and social services. Attention to cultural and social norms is also key to the provision of good care, especially with migrants and refugees. The benefits of working through interpreters have been documented, yet not in the context of health crises nor from the perspective of service users. Our study explores how practitioners, interpreters, and service users in Quebec provide/receive health and social services during the COVID-19 crisis. Individual semi-structured interviews (n=60) will be conducted with public and community-based health and social service providers, interpreters, and non-francophone users in Montreal and Quebec. Interviews will explore (a) innovative practices in service provision with interpreters used during the COVID-19 crisis and (b) barriers and enablers to the success of these practices. Interviews will be conducted by phone, skype, or in-person following Public Health guidelines, with assistance of an interpreter when necessary. Interviews will be audio recorded with permission of participants, transcribed verbatim, and translated into English or French. Interview transcriptions and interviewers’ fieldnotes will be analyzed thematically using NVivo 12. The perspectives of clinicians, interpreters, and users will be contrasted within and across practices and socio-demographic groups. Innovative practices will be classified using the Innovative Practices Evaluation Framework. Special attention will be paid to ensuring voluntary and respectful participation and confidentiality. Ethics approval will be sought from the CIUSSS West Centre Montreal and researchers’ universities. This study will identify innovative strategies for service provision through interpreters in times of health crisis, including digital innovations.

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Outputs:

• Ruiz-Casares, M. & Bentayeb, N. (March, 2022). Intervenir avec interprètes durant la COVID-19 : le point de vue des intervenant.e.s, des interprètes et des usager.ère.s [webinar]. Sherpa University Institute.

Does language ecology in Québec modulate COVID-19 health access or outcomes?

The COVID19 pandemic suggests that language barriers impact access to health-related information and medical outcomes in Québec at societal and individual levels. The Association for Canadian Studies recently reported that English minority speakers in Québec have greater COVID19-linked anxieties and distrust of Québec Provincial pandemic governmental policies, compared to French majority speakers. Currently unclear is what gives rise to these differences, and how language barriers impact both personal attitudes and societal public health outcomes regarding the pandemic. Guided by sociolinguistic and psychological theory, reseachers will investigate several factors including people’s language experience, interpersonal networks, community contexts, and society-level constraints. We will use cutting edge social network analyses and statistical modelling approaches to analyze large-N, language-tagged, COVID19 questionnaire data from Anglophone and Francophone respondents across Quebec, particularly in Montreal. The team, comprised of language scientists, social psychologists, and big data scientists, is uniquely qualified to address these urgent questions. This work will generate important, timely knowledge and student training opportunities about language barriers faced by English minority speakers that are relevant to COVID19 health access and public health outcomes in Quebec.

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Outputs:

• Hernández-Rivera, E., Gullifer, J. W., & Titone, D. (2022). Socioecological and psycholinguistic approaches to multilingual health literacy. Translational Issues in Psychological Science. https://doi.org/10.1037/tps0000325

• Hernández-Rivera, E., Gullifer, J. W., & Titone, D. (2022). Socioecological and psycholinguistic approaches to multilingual health literacy.Translational Issues in Psychological Science, 8(2), 197–209. https://doi.org/10.1037/tps0000325

• Hernández-Rivera, E., Marco S. G., Ahia, M., Tiv, M., Knäuper, B., Johns, B. T., Doucerain, M., & Titone, D. (In prep). Does language ecology in Québec modulate COVID19 health access or outcomes?

• Ahia, M., Hernandez-Rivera, E., Titone, D. (2021). Do Language Use Affiliations Predict Health Outcomes? COVID-19 Publich Health Outcomes in Linguistic Majority and Minority Populations in Montreal. [poster presentation]. Department of Psychology, McGill University, Montreal, Quebec.

• Hernández-Rivera, E., Marco S. G., Ahia, M., Tiv, M., Knäuper, B., Johns, B. T., Doucerain, M., & Titone, D. (2021). Language-Use and COVID-19 Outcomes: Exploring Population Data Across Two Canadian Cities. Presentation at the Dialogue McGill Annual Conference of 2021. Montreal, Canada.

• Hernández-Rivera, E. (2021) Invited Speaker: Experiencias en el uso de datos censales para estudiar de la distribución de COVID-19 en Canadá. Segundo Encuentro de Egresados de la Facultad de Medicina y Psicología. Department of Medicine and Psychology, Autonomous University of Baja California, Baja California, México.

Language minorities and the risk of depression among individuals suffering from a chronic disease: a retrospective study of the Canadian Longitudinal Study on Aging

The risk of depression in individuals with diabetes has not been evaluated in relation to language. Communication barriers may lead to isolation and impaired access to health care. This may affect the mental well-being of individuals specially those also suffering from a chronic disease such as diabetes. Researchers will use baseline and 3-year follow-up data of the Canadian Longitudinal Study on Aging Comprehensive cohort (CLSA; 2012-2015 and 2015-2018; ages 45-85 years, N=21,000) to determine, among those with and those without diabetes, the effect of maternal language (French, English or Other) on the risk of depression at three years and on the rate of seeking mental health care for depression.

The cohort will include CLSA participants without baseline depression (Center for Epidemiological Studies Depression-10 score<10 and no depression treatment). These will be separated by baseline diabetes status (HbA1c ≥7% and/or self-reported diabetes). Maternal language will be the ‘language first learnt at home and still understood’ (French, English or Other). English (French) speaking minorities will be those with ‘Other’ native language and English (French) as the language most spoken at home. The associations between maternal language and language minorities and the outcomes of interests will be examined overall and by diabetes status using multivariate logistic regression models.

Findings will help health care providers and program developers tailor their services toward reducing language barriers for minorities to help curb their risk of depression and appropriately manage their diabetes and mental health disorders.

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Outputs:

• Farid, D., Li, P., Dasgupta, K., & Rahme, E. (2022). Determinants of loss to follow-up in the Canadian Longitudinal Study on Aging: a retrospective cohort study. Journal of epidemiology and community health, 76(12), 1011–1018. https://doi.org/10.1136/jech-2022-219307

• Farid, D., Li, P., Dasgupta, K., & Rahme, E. (2022). Determinants of loss to follow-up in the Canadian Longitudinal Study on Aging: a retrospective cohort study. Journal of epidemiology and community health, 76(12), 1011–1018. https://doi.org/10.1136/jech-2022-219307

• Farid, D., Li, P., Da Costa, D., Afif, W., Szabo, J., Dasgupta, K., & Rahme, E. (2020). Undiagnosed depression, persistent depressive symptoms and seeking mental health care: analysis of immigrant and non-immigrant participants of the Canadian Longitudinal Study of Aging. Epidemiology and psychiatric sciences, 29, e158. https://doi.org/10.1017/S2045796020000670

English official language minorities in Quebec who have autism: Healthcare access and developmental outcomes

This project extends research on the healthcare access of official language minorities in Canada to a new population: individuals with Autism Spectrum Disorder (ASD) and their families. Individuals with ASD face significant communication challenges (APA, 2013). There are consequential delays in the access to ASD services in Quebec, to both obtain a diagnosis (Zwaigenbaum et al., 2019), and then wait for provincial services (Rivard et al., 2014). We expect that English speakers in Quebec with ASD will face compounded challenges in access to services due to communication difficulties, delays in ASD services, and minority language status. Official language minorities in Canada (English-speaking people in Quebec, and French-speaking people in other provinces) face multiple barriers to healthcare access, and negative disparities in health outcomes (Bouchard & Desmeules, 2013; de Moissac & Bowen, 2019; Falconer & Quesnel-Vallée, 2014). In the US, language barriers had negative impacts on service access for families with a child with ASD (St. Amant et al., 2018). Researchers aim to 1) evaluate the accessibility of health and social services to English-speaking families with a child with ASD in Quebec, relative to French-speaking families and 2) obtain detailed information from a subset of families with adolescents with ASD, via focus groups, including richer quantitative survey data on the question of service access and language and cognitive measures that serve as indicators of developmental health outcomes. By identifying potential disparities in access, as well as their implications for outcomes, this project furthers the goal of optimal outcomes for English speakers in Quebec.

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Outputs:

• Amantayev, N. & Nadig, A. (2022, May). Healthcare Access of Language Minorities with Autism: The Case of English Official Language Minorities in Quebec, Canada. Poster to be presented at the annual meeting of the International Society for Autism Research, Austin, Texas, USA.

Making the switch to remote Interpreting

For the past six months, the COVID-19 pandemic has prompted the use of remote public service interpreting (R-PSI), a form of interpreting that was gradually being put into practice in Quebec’s health and social services network. R-PSI refers not only to the use of telecommunication technologies (such as videoconferencing, telephony, and web conferencing) that allow interpreters to deliver their services remotely but also to the specific communication strategies that require proper training. The goal of this study is twofold: 1) to develop two training programs (one for interpreters and one for service providers) as per recent R-PSI management and practice guidelines, and 2) to measure their impact on the satisfaction and collaboration of the professionals involved. The study will primarily ensure quality services for a clientele that is especially at risk, i.e., immigrants and refugees, during the COVID-19 crisis. It will also help ensure that Quebec’s health system makes the transition to R-PSI.

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Outputs:

• Unknown (2021). Travailler avex des interprètes à distance : les bonnes pratiques [webinar]. Québec, Québec, Canada.

• Unknown (2021). Interpréter à distance au temps de la COVID-19 [webinar]. Québec, Québec, Canada.

• Unknown (June 2022). Unknown [Oral communication]. 1er congrès international de l’EDIQ.

Examining language and social development in bilingual children with ASD and identifying the barriers to bilingualism for these children

Given Canada’s officially bilingual status and its multicultural profile, many children with autism spectrum disorder (ASD) are brought-up in minority-language or bilingual households. Although language is intimately linked to cultural identity, many families of children with ASD face barriers to raising their child bilingually, which can have important repercussions, both for the child and their family. However, there is evidence that bilingualism may not be detrimental to these children’s language development, and that bilingual children with ASD may present better social abilities when compared to their monolingual peers, which has been found in monolingual children with ASD, to predict future language development.

Thus, the current study aims to better understand bilingual language development in children with ASD by examining the trajectories of language and social development in bilingual and monolingual children with ASD from early childhood to middle school, and the relationship between these two variables. To do so, longitudinal data will be analyzed using growth curve and pathway analyses. In addition, using a thematic analysis, we aim to identify barriers to bilingualism across Canada and specifically in the province of Québec, with a focus on barriers within the healthcare system.

Results from this study will serve to better inform clinicians about the language and social development of bilingual children with ASD, and to inform the development of evidence-based recommendations and interventions geared towards these children. Additionally, by identifying barriers to bilingualism, we aim to pinpoint areas where knowledge mobilization is required, thus diminishing, and even eliminating these barriers.

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Outputs:

• Unknown. (May 2022). Examining the Influence of Bilingualism on the Narrative, Social and Pragmatic Abilities of School-Aged Children on the Autism Spectrum [Poster presentation]. International Society for Autism Research, virtual conference.

• Unknown. (April 2022). Bilingualism, narrative, social and pragmatic skills in children on the autism spectrum [Oral presentation]. Speech-Language Pathology and Audiology Canada-Virtual Convention.

• Unknown. (August 2021). Examining the barriers and facilitators to bilingual language development in children with neurodevelopmental disorders [Symposium]. COUHR National Symposium. Virtual conference

• Unknown. (August 2021). Examining the barriers and facilitators to accessing healthcare and to receiving equitable health services: a literature review [Symposium]. COUHR National Symposium. Virtual conference

• Unknown. (April 2021). Does bilingualism influence the narrative, social and pragmatic skills of children on the autism spectrum [oral presentation]. Transforming Autism Care Consortium Pre-INSAR Blitz. Virtual presentation.

Linguistically- and Culturally-Sensitive Psychotherapy: Evaluating an Approach to Assessment and Treatment

The Centre for Clinical Research in Health (CCRH) successfully established a university- funded state-of-the-art research clinic at Concordia University (of which the principal investigator is co-founding member). The clinic is launching an evidence-based, culturally-sensitive psychotherapy program for migrants with anxiety and/or depression. This larger project provides investigators with a valuable opportunity to evaluate the effectiveness of language-sensitive mental health interventions in a real-life clinical setting.

It is therefore proposed to: (1) Integrate research tools (developed with previous Dialogue McGill funding) into the assessment battery completed by all clients completing the treatment protocol used with migrant clients at CCRH. (2) Use qualitative techniques to study video-recordings and transcripts of actual clinical sessions to study the consequences of language discordance on effective communication and treatment. (3) Use quantitative analysis techniques to test whether potential problems identified by the assessment battery are linked to problematic features of actual clinical interactions. Hypotheses are: H1: Indices related to better functioning in a given language will predict fewer in-session communication difficulties when the treatment is conducted in that language. H2: Fewer in-session communication difficulties will predict more rapid symptom improvement.

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Outputs:

1. Unknown. (2020, May). Cultural scripts for normalcy and deviancy: A mixed-methods approach to understanding mental illness in new contexts [Presentation]. Interacting Minds Center, Aarhus, Denmark

2. Unknown. (2019, November). Linguistically- and Culturally-Sensitive Psychotherapy: A Proposal [Presentation]. Centre for Clinical Research in Health, Montreal, Quebec.