Figure 1
Youth Wellness Hubs Ontario sites.
Table 1
Youth Wellness Hubs Ontario core components and descriptions.
| CORE COMPONENTS | DESCRIPTION |
|---|---|
| Youth and Family Engagement | Empowers youth and families to make decisions about their care by embedding their voice at all levels |
| Integrated Governance | Strategic collaboration between youth and service provider network to manage resources and organize service delivery |
| Accessibility | A comprehensive array of services that reflect the diversity of youth’s goals and needs |
| Culturally Diverse | Services that respond to the health beliefs, practices, cultural, and linguistic needs of diverse youth |
| Integrated Service Delivery | Integration of community-based service through a single, youth-friendly access point |
| Measurement-based Care | Use of standardized measures and outcome evaluation to enhance services to individual youth and to improve care |
Table 2
Most common themes and sample quotations related to the facilitators of the implementation of YWHO.
| FACILITATOR THEME | SAMPLE QUOTATIONS FROM NETWORK LEADS |
|---|---|
| 1. Diversified funding model | “We didn’t have infrastructure at the lead agency so [philanthropic funding] helped out with renovation dollars.” “At the beginning of COVID-19, the YWHO backbone gave us emergency funding to get the equipment we needed to provide services virtually. We got laptops, cameras for virtual groups, this was very helpful for us to move forward.” |
| 2. YWHO Provincial Office supports | “The backbone team has been super helpful – without our backbone – I wouldn’t have even thought of it [implementation considerations].” “When we look for supports and need help, the response is do what works for you. The flexibility to contextualize is helpful, to do what works for our program, this has been helpful as well.” |
| 3. Strong community partnerships | “Strong core partnerships – we got everyone to the table and identify what processes we can put in place quickly to reduce gaps in service offerings – did that quickly – like a week turnover.” “Representation on governance table from all sectors like [provincial enforcement agency] and child services – helped bring the conversation forward.” |
| 4. Organizational support and dedicated staff | “Our operations table has really bought into the project – they are committed to making sure the project is successful, so we can give community and youth the best service. We brainstorm together, they enjoy trainings and they volunteer for working groups. Great buy-in from the frontline staff.” “Great leadership at core team and within partners and other agencies.” “Openness to adapt from the whole team, they accept that we need to do things differently and not everything will work the first time.” |
| 5. Clear hub processes | “Core components laid out like that as a model for what we are trying to do – gave universal vision for us to focus on.” “There was an ongoing network leads meeting – direct communication with [leadership] and help understand the vision/thinking of the model. Hear what other sites are doing and how they are tackling issues.” |
Table 3
Most common themes and sample quotations related to the barriers of the implementation of YWHO during the demonstration phase.
| BARRIER THEME | SAMPLE QUOTATIONS FROM NETWORK LEADS |
|---|---|
| 1. Staffing and financial resources | “Availability of service providers/clinicians is difficult in rural/remote contexts.” “Role of primary care isn’t as fulsome as it could be because for nurse practitioner they need a clinic room, neither of our sites have that. No [access to] full water or full bed, we say it’s primary care but it is quite limited.” “We don’t have funds for power buttons on bathrooms and elevator. It was hard to find commercial space, spent a year and a half trying to find physical space. Three year funding model was a barrier because we couldn’t sign a 10 year lease.” |
| 2. Implementation challenges of the shared data collection platform and measurement-based care | “[Data collection platform] doesn’t allow for fulsome shared documentation, this prevents full integration, leads to double documentation, double consents, double registration.” “Speaking on the data piece, collecting the data virtually has been a challenge, so emailing forms ahead of time |
| 3. Partnership challenges | “Partnerships are wonderful but partnerships should change as needs of communities change and that’s hard… resources are required to evaluate partnerships” “Joint training is difficult, all providers are in-kind, and each one has multiple service providers that circle through – no core team [during demonstration phase]. This makes it difficult to get them all there in one place, this takes away from service delivery. Ten hours of training for those with 3 hours at the hub doesn’t make sense.” |
| 4. Difficulties with integrated service delivery | “At systems level each of our agencies need certain things. [Other service provider] only serves 16–20 year olds, it didn’t even cross our minds, so we serve 12–25 and now we have a list of different age ranges and who we can send all the different intake processes and different questions. How do I count numbers? This gets in the way of delivering.” “Need for monthly getting together of setting goals and benchmarks for clinical goals and making sure all sites are doing it. For example standardized information on harm reduction for youth, otherwise hamburgers taste different at each [restaurant].” |
| 5. Branding and communications challenges | “The fact that we weren’t already there for them to know our services, getting the word out and services known is one of the biggest challenges.” “Not having a communications specialist helping us with social media… this promotion needs to be constantly there, youth awareness of our services need to be better.” |
Table 4
COVID-19 Pandemic and modifications to service delivery.
| COVID-19 THEME | SAMPLE QUOTATIONS FROM NETWORK LEADS |
|---|---|
| 1. Building online presence (social media for marketing and program delivery) | “Increased social media presence. Communication and marketing became really important because no physical access point, we put time and funds into that– silver lining.” “Then how to be innovative in reaching youth virtually – this is challenging, not being in person and promote something virtually that was originally supposed to be in person” |
| 2. Pivot to virtual service delivery | “Had to get a platform – we have [videoconferencing platform] and had to figure out which platform to use for service. Using a phone-line, a number that youth can be familiar with, kind of like a helpline.” “Virtual counselling, we moved in three days when our original plan was to implement in 2022. Thinking about phone counselling was way ahead in the future but we did it so quickly.” “Some youth couldn’t leave home due to depression and other things, but now we can bring programming to them, which we couldn’t do before, COVID has changed the way we think and how we do social work.” |
| 3. Increased community outreach and advocacy | “Trying to address the Social Determinants of Health. Other folks in community are raising awareness of the internet issue, as a basic human right and youth have been engaged to speak to that by attending council meetings and speaking to press.” “Outreach, we picked places in the community. We offer gift cards, masks, snacks and see youth that can’t travel. Have some sort of connection and just reinforce the services. We let them know about what’s happening virtually, trying to get them to come back to us. We give them phone number and stuff and get relationship that way.” |
| CORE COMPONENTS | LESSONS LEARNED |
|---|---|
| 1. Integrated Service Delivery | Optimize integrated service delivery by:
|
| 2. Measurement-based Care | Success with implementing MBC can be achieved by:
|