Exploring associations between social determinants of health and patient-reported outcome measures in oncology: Elucidating the disparities to be addressed

Social determinants of health, including income, education, and language, play an important role in cancer outcomes and survival. In Quebec, where nearly one in five residents speaks a first language other than French, language can be a particularly important barrier to accessing healthcare services and communicating effectively with care teams. These barriers may influence patients’ ability to advocate for themselves, ask questions, and engage in shared decision-making—factors that are linked to improved health outcomes.

Patient-reported outcome measures (PROMs) are standardized tools that allow patients to report symptoms and health status directly, and are increasingly used to improve communication, symptom monitoring, and clinical care. However, their effectiveness may vary depending on social factors such as education and language. This PhD project begins by examining how PROM data differ across key social determinants of health. Future phases will explore patients’ lived experiences completing PROMs and assess whether generative AI tools can help reduce barriers—particularly language-related barriers—to improve equitable use of PROMs in cancer care.

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Empowering Communication: An Exploratory Qualitative Study of the Perception of Voice Cloning in Persons with Amyotrophic Lateral Sclerosis

Amyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative disease that often leads to severe speech impairment and, in most cases, the loss of functional speech within a short period after symptom onset. To maintain communication, individuals with ALS rely on augmentative and alternative communication (AAC) tools, including emerging technologies such as AI-based voice cloning. Unlike traditional voice banking methods, voice cloning can offer faster setup, greater flexibility, and potentially more natural-sounding synthetic voices, but its acceptability and perceived value among users remain poorly understood.

This study explores how English-speaking persons living with ALS in Quebec perceive voice cloning technology, particularly in terms of ethics, usability, emotional resonance, and identity preservation. It also examines whether perceptions of naturalness, expressiveness, and identity differ according to the severity of speech impairment. The goal is to better understand user perspectives to support the ethical and patient-centred integration of voice cloning technologies in ALS care.

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Advancing equitable health and primary health care access for English-speaking Black communities in Quebec

Language is increasingly recognized as a key determinant of health, particularly in contexts where linguistic and racial identities intersect. In Quebec, the English-speaking Black community (ESBC) occupies a unique position at the intersection of racialized minority status and official language minority status. Despite this, there is limited disaggregated data on how these intersecting identities shape access to primary healthcare and health outcomes. This gap reflects broader systemic challenges in Canadian health research, including a lack of representation of racialized populations in available data and a relative scarcity of Canadian studies compared to other countries.

Since the COVID-19 pandemic, our research team, in partnership with the Black Community Resource Centre (BCRC), has investigated health inequities affecting Black communities in Quebec. Our previous work has identified racial and linguistic disparities in healthcare experiences, including lower vaccination uptake, higher distrust in the healthcare system, reduced access to regular healthcare providers, and less access to COVID-19–related information among English-speaking Black communities compared to other groups. We also found that perceived discrimination is linked to poorer health outcomes and lower satisfaction with care. Building on these findings, this study uses Self-Determination Theory to examine how perceptions of restricted collective autonomy and language barriers shape healthcare access and dissatisfaction among ESBC populations in Quebec. The goal is to better understand the mechanisms driving inequities in healthcare experiences and outcomes, and to inform more equitable health system responses.

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Linguistic minority status and Psychosis trajectories in Québec: A study of Pathways to care and Outcomes

Psychotic disorders are among the most severe mental health conditions and often emerge during early adulthood, a critical period for education, employment, and social development. Immigrant populations and their children are disproportionately affected, yet they frequently encounter barriers to timely and appropriate mental health care. These barriers include delayed access to services, higher rates of police involvement or compulsory treatment, and increased likelihood of disengagement from care. Emerging evidence suggests that language proficiency may play an important but understudied role in shaping both access to care and long-term outcomes in psychosis.

This project examines how linguistic minority status influences pathways to care and clinical outcomes in individuals with first-episode psychosis in Montréal, particularly in a predominantly French-language treatment context. It will assess whether prior findings on treatment disengagement can be replicated in a new cohort, and explore how language background relates to key indicators such as mode of entry into care, duration of untreated psychosis, symptom progression, and vocational recovery. The goal is to better understand how language barriers shape mental health trajectories and to inform more equitable, accessible psychosis care for linguistic minority communities.

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Exploring Healthcare Equity: How to Increase Satisfaction for Non-Francophone Immigrants Using Telemedicine Services

The COVID-19 pandemic accelerated the rapid adoption of digital health tools, particularly telemedicine, which has transformed how healthcare is delivered in Canada. Telemedicine improves access to care and supports national goals of health equity, especially for populations facing geographic or systemic barriers. However, Canada’s linguistic diversity also raises important questions about whether digital health services are equally accessible across language groups.

In Quebec, where French-first policies shape many aspects of healthcare delivery, telemedicine services may not consistently address the linguistic and cultural needs of non-francophone patients. This can create barriers for immigrant and minority-language communities seeking care through virtual platforms. This study explores how telemedicine experiences can be improved for non-francophone immigrant patients in Quebec by identifying and addressing linguistic and cultural barriers that impact user satisfaction and access to care.

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Evaluation of the use and impact of English on access to mental health care among the Spanish-speaking Latinx minority group in Montreal

This study is about illness stories from Spanish-speaking Latinos/Latin Americans in Montreal with schizophrenia. These participants speak English, French, or Spanish. This study suggests mental health services should be provided in English and other languages. We want to show how English was used by Spanish-speaking Latinos/Latin Americans in Montreal with schizophrenia. Most people in our study used English and Spanish services. This shows there is a need for mental health services for minorities. Many of these services could reach to wider cultural populations if they were provided in English. For our participants experiencing problems, mental health services for language minorities were important. In our study, we used a questionnaire and an interview to find out more about this group. We learned that English was important for using mental health care for several participants. This study will help us understand the need for English services for this language minority group. This research supports more specific mental health care for language minorities in Montreal, including English mental health services.

Access and Equity: Evaluating Linguistic Disproportionality in Child Protection Services

In Quebec, access to social services can vary significantly for linguistic minority communities, with evidence suggesting that public policy and system organization can shape service equity. Following the 2016 merger of health and social services into the Centres intégrés universitaires de santé et de services sociaux (CIUSSS), and ongoing reforms toward Santé Québec, these large-scale restructuring efforts have been criticized for potential unintended impacts on service accessibility, particularly for minority populations. Concerns have been raised that such system changes may have contributed to disparities between communities, including those based on language.

This project investigates whether differences exist between English- and French-speaking child welfare services in Quebec. Using provincial administrative data (AS480), we will compare key indicators such as child protection signalments, time to investigation, placement availability, clinical decision-making outcomes, and adoption rates across Montreal-based agencies and other regions over the past five years, including both pre- and post-pandemic periods. The goal is to identify potential service gaps linked to linguistic context and regional variation. Ultimately, this research aims to support more equitable, timely, and consistent child welfare service delivery across Quebec’s English- and French-speaking communities.

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