Offering Hyper-Local Community Health and Information Fairs through an Ontario Health Team to Provide Low-Barrier Access to Sexual Health Services

Through Community Health and Information Fairs (CHIFs) held in equity-deserving neighbourhoods in North York, Canada, health and social care partners provide low-barrier access to services and information, including for those who do not have health insurance or a primary care provider.

Certain neighbourhoods disproportionately experience health inequities due to challenges such as low health system literacy, transportation difficulties, limited resources, and gaps in health and community support services including for sexual health.  North York Toronto Health Partners (NYTHP) Ontario Health Team has worked to address these gaps through an innovative model of integrated care—CHIFs in high-needs neighbourhoods.  NYTHP is a coordinated network of over 50 organizations including a primary care clinic, community hospital, newcomer settlement agency, and mental health organizations.  Co-designed with our Patient and Caregiver Health Council members and community ambassadors, CHIFs provide hyper-local, low-barrier access to services and information, even to individuals without health insurance or a primary care provider.  To select neighbourhoods and tailor the themed services, we consider local health data and community ambassador input.  Community ambassadors are essential team members for designing, implementing, and monitoring CHIFs: they advise on CHIF locations, provide community knowledge, promote CHIFs in-person and online, and participate in meetings.  As trusted community members working within a peer education framework, our trained ambassadors provide system navigation support, trauma-informed peer engagement, and primary care connection in a culturally sensitive manner.

We have held 40 CHIFs since May 2022.  In April 2024, we began providing sexual health services at the CHIF through a newly established partnership with the Immigrant Women’s Health Centre.  This CHIF also welcomed individuals without health insurance who would not be able to access the services otherwise.  Over the course of one afternoon, we provided 33 tests for sexually transmitted infections, 32 cervical cancer screenings, and 13 requisitions for additional tests including pelvic exams and intrauterine device follow-up.  Attendees reported a 27% increase in their understanding of local community health information and services.  Other survey results were that attendees were female (100%), aged 25-39 (65%), preferred speaking a non-English language (93%), and did not have a consistent primary care provider (96%).  Community ambassadors were key to this successful CHIF by providing the initial community feedback that sexual health services are a gap in that neighbourhood; they also advised on a suitable location near a transit hub, outreach strategy, and timing in consideration of cultural holidays. 

CHIFs are an example of co-designing care approaches and leveraging partnerships to improve community well-being with a hyper-local focus.  The CHIF perspective acknowledges the social determinants of health and seeks to address the needs of individuals that are not met by traditional service models.  We illustrate how community ambassadors are crucial to the success of CHIFs and how this integrated care model can be improved to reduce inequities in high-needs neighbourhoods.  Next steps are to expand CHIFs to more equity-deserving neighbourhoods, forge new and strengthen existing local partnerships, and continue collaborating with community ambassadors to identify and address service gaps in a culturally informed manner.