VEGA Newsletter – February 2018

2017 was an exciting year for the VEGA Project! See what we were up to in our latest blog post featuring our Year in Review.

Update on our progress since the Fall 2017 Newsletter:

Evidence Reviews:

Finalizing the Child Maltreatment Reviews and Guidance – Update from Geneva Meeting: Harriet MacMillan, Chris McKee, and Jill McTavish participated in the December 2017 WHO guideline development meeting for health sector responses to child maltreatment, where Harriet acted as co-chair, and Jill presented some of the findings from the VEGA Evidence Review Group meeting and systematic review. The meeting was a great success, and VEGA staff are working to ensure coordination across WHO and VEGA guidance, where appropriate and meaningful to do so.

December 2017 World Health Organization meeting, Geneva (Photo: C.McKee)

VEGA Handbook & Curriculum Development

  • The VEGA Core Competency Framework has been developed with input from various NGIC partners and other experts in both family violence content, and curriculum development; it is currently being reviewed by the VEGA NGIC Education/Leader Table.

  • Progress has been made on the VEGA Curriculum Game Models, including the development of scripts for one model on IPV, and a second on child maltreatment. This work is still in progress. At least one game scenario will be ready for review at the March NGIC meeting.
  • The first of two VEGA Animated Whiteboards, entitled “Why Vega?”, is in production so that an initial version can be ready for NGIC review at the March meeting. The second whiteboard, “Trauma-and Violence-Informed Care”, is next!
  • Learner & Client Engagement: several activities are underway to ensure meaningful input and integration from end users and those most impacted by the VEGA products. Professionals in various contexts will review draft versions, and student input is being integrated. We are also developing at least one video to capture the patient experience of seeking care, and how VEGA can help. Additional discussion will take place at the March NGIC meeting.
  • Knowledge Mobilization

  • October 2017 WHO Milestones Meeting: A plenary session, “Developing Pan-Canadian Public Health Guidance on Family Violence” was presented by Harriet MacMillan and Nadine Wathen at the 8th Milestones of a Global Campaign for Violence Prevention Meeting hosted by the World Health Organization and the Public Health Agency of Canada in Ottawa, on October 19, 2017. Several NGIC members attended the meeting, including NGIC Co-Chair, Dr. Karima Velji.
  • TVIC Workshop: Nadine Wathen and Marilyn Ford-Gilboe gave a workshop to a group of health and social service providers in Southern Ontario. The focus was trauma-and violence-informed care (TVIC), including an overview of VEGA. A video of the workshop is available by linking from the Resources page on the VEGA website, or directly by clicking here, suitable for sharing with professionals interested in TVIC.

Partner Perspectives

The partner perspectives feature offers insight into various components of the VEGA project, as well as the ways in which different health and service providers approach recognizing and responding to family violence within their own practice areas. The Knowledge Mobilization team would like to thank Darlene Birch for her valuable contribution to this edition.

Darlene Birch (RM), National Aboriginal Council of Midwives (NACM) 

Tell us about yourself and your work. 

Hello, I am an Indigenous midwife of Metis descent from the Winnipeg, Red River area of Manitoba. I began midwifery practice at a time of transition from traditional practice to a legislated profession. I was privileged to receive inspiration and teaching as a young woman from traditional midwives and healers, two of whom were my Maternal grandmother and Great Grandmother, and from the courageous birthing women who reclaimed this essential relationship. I went on to further my education and become a registered midwife in Manitoba. I have actively practised for 35 years. I am honoured to co-represent the National Aboriginal Council of Midwives (NACM) on the VEGA Project, along with my friend and colleague, Carol Couchie.

In my early career, I was instrumental in developing midwifery legislation in Manitoba that was inclusive of Indigenous midwives. I was also a founding member of NACM, and worked in the creation of the Aboriginal Midwifery Baccalaureate Program at the University College of the North where I developed curriculum and instructed in this uniquely community-based program. In the later years of collaborative practice, I mentored midwifery and medical students.

I have worked in Norway House, a First-Nation community in a semi-remote area North of Lake Winnipeg, since 2006. My passion since 2000 has been the repatriation of birth and preservation of midwifery knowledge and practice in Aboriginal communities. I retired from clinical practice in October 2017 to pursue inspiration and further learning, participate in research opportunities, and support the reclamation of Indigenous midwifery practice.

Please share with us the impact of your work. 

I believe that the overall health and wellbeing of an Indigenous community begins with the reintegration of values and teachings that reflect the cultural identity of the people, and give hope and self-respect. The core values of NACM honour these traditional approaches to care. They are: healing, respect, autonomy, compassion, bonding, breastfeeding, cultural safety, clinical excellence, education, and responsibility.

Midwifery care encompasses the childbearing year but as an Indigenous woman, I place the event of birth in the context of the woman’s life, the life of her family and community, and the history of her people. It is about ceremony, healing, growth, and relational ties. Just as childbearing is seen in the Indigenous view as a sacred responsibility, midwifery is understood to carry a similar responsibility.

Midwives, as many other professionals represented within VEGA’s work, work in a relationship-based model of care. Women and families arrive daily with complex lives that are ripe for change. They are often enmeshed in generational patterns of abuse. The way that Indigenous midwifery serves a community is a catalyst for a positive change at a susceptible time, a guardian of sorts, and a witness to creation. In many ways, the care midwives provide is the opposite of institutionalization, which has been the demise of culture.

Much of my work involves advocacy for clients who live in poverty and substandard conditions. The communities are underserved and under-resourced. One result of successful advocacy was the announcement in 2017 by then-Health Minister Philpott that women travelling away from home to give birth can now have a funded escort.

What are three practical tips that you would give to people in your field regarding care of adults and/or children who have experienced family violence and its impact?

  • I would encourage caregivers to seek education about the prevalence of family violence and the generational roots of systemic trauma and addiction. It is critical to understand that the history Indigenous people experienced, lives on. It is not something individuals or communities can “get over”.
  • Work to reduce the institutionalization of people and life events as solutions. Instead, look to communities for answers and direction in how help can be offered. No one else knows the lived reality. This includes minimizing the burden of travel to access services. People should not be required to leave their traditional lands or home to access essential services.
  • Never forget the wisdom, hope, and even humour that exists just below the surface of trauma.

VEGA appreciates the dedication of our partners in bringing their unique practice and lived experiences to our collective work. Thank you for these insights, Darlene.

Family Violence Champions

This new section of our newsletter highlights some of the important work that VEGA NGIC partners are undertaking to both bring the issue of family violence to the attention of their stakeholders, as well as feature VEGA’s work. We invite all NGIC partners to share the work they or their organizations are doing in this area and talk to Harriet or Nadine about opportunities for collaboration to share VEGA’s work.

Child Welfare League of Canada
The Child Welfare League of Canada (CWLC) has held two events providing important opportunities to both showcase VEGA work, and address the links between various forms of family violence. In October 2016, Harriet and Nadine gave a joint keynote presentation to more than 400 attendees at the Domestic Violence & Child Welfare: Collaborating Across Provinces and Territories conference co-hosted by CWLC and the British Columbia government. In October 2017, Harriet was an invited Plenary Speaker at the National Forum on Innovations in Infant, Child, & Youth Mental Health in Calgary, AB. The VEGA Project was presented to health and social service providers and policy actors from across Canada, with particular attention to linking practice and policy with evidence around children’s exposure to intimate partner violence. Innovations in child maltreatment curriculum delivery were also discussed.

Canadian Psychological Association
In February 2017, representative of the Canadian Psychological Association and VEGA NGIC member, Dr. Kerry Mothersill, both showcased the VEGA Project, and presented briefs on PreVAiL IPV and CE-IPV, at Calgary’s 5th Annual Psychology Day. Sponsored by the psychologists of the Calgary Zone of Alberta Health Services, the event was an important opportunity to introduce this work to attendees spanning a range of disciplines, including psychologists, social workers, occupational therapists, psychiatrists, and nurses.

Mental Health Commission of Canada
In November 2017, Harriet presented Addressing Trauma: The Violence Evidence Guidance Action (VEGA) Project at Mental Health Innovations in Canada in Washington, DC. VEGA’s participation was arranged by both the Mental Health Commission of Canada (MHCC) (a VEGA NGIC member) and VEGA’s funder, the Public Health Agency of Canada. The event was hosted by the International Initiative for Mental Health Leadership (IIMHL) and The Embassy of Canada, in partnership with MHCC. Harriet’s keynote highlighted the relationship between family violence and mental health; international representatives included those from the United Kingdom, United States, Australia, New Zealand, the Netherlands and Sweden.

Partner Links

We are very excited to be working with two of our NGIC organization partners on upcoming knowledge mobilization activities.

April 19, 2018 – Canadian Dental Association Canadian Oral health Roundtable (COHR)
This annual forum brings together leaders from over 20 dental, medical, and allied health organizations with an interest in oral health. We are very excited that this year’s Roundtable will focus entirely on family violence, and feature VEGA. Nadine Wathen, Harriet MacMillan, and our Canadian Paediatrics Association partner, Michelle Ward, will participate throughout the three-hour session, which will include interactive scenarios and group work, as well as previewing VEGA resources. Thank you to CDA Knowledge Mobilization lead, John O’Keefe, and NGIC representative, Kevin Desjardins, for inviting VEGA to this important event.

May 28-30, 2018 – Canadian Public Health Association Conference

VEGA and our Canadian Public Health Association (CPHA) partners will be presenting a workshop at the 2018 CPHA Conference in Montreal, titled “Reducing Stigma through Trauma-and Violence-Informed Care (TVIC): Practical Applications in Family Violence, Sexual Health and Harm Reduction”. Vega team members Nadine Wathen, Marilyn Ford-Gilboe, and Colleen Varcoe will present the VEGA approach to integrating TVIC and other equity-oriented care principles into our family violence guidance and curriculum, while our CPHA partner, Rachel McLean, will discuss its application to sexual health. Thanks to Rachel and NGIC Representative, Greg Penney, for inviting VEGA to partner with them at this key national event.

Featured Resources

McTavish JR, Kimber M, Devries K, et al. Mandated reporters’ experiences with reporting child maltreatment: a meta-synthesis of qualitative studies. BMJ Open 2017. Doi:10.1134/bmjopen-2016-01394. Published in BMJ Open, available here.

  • Based on feedback from some NGIC members – who indicated that mandatory reporting presented a barrier when responding to children experiencing maltreatment – members of the VEGA team conducted a systematic review to evaluate the effectiveness of this process;
  • No evidence of effectiveness was found. Instead, the review team decided to synthesize qualitative research about mandatory reporting from the perspective of mandated reporters, in order to summarize mandated reporters’ solutions to potential harms associated with reporting;
  • Mandated reporters have indicated that discussing the limitations of confidentiality at the beginning of a relationship with a patient/client (especially when the relationship is continuous), can help minimize feelings of betrayal that can arise if a report needs to be filed at a later date.
  • Upcoming Events

  • March 20-23, 2018: Canadian Domestic Violence Conference, Halifax, Nova Scotia. Information available here.

  • May 28-31, 2018: Canadian Public Health Association: Public Health 2018, Montreal, QC. Registration launches February 21, 2018. Information available here.

  • June 13-15, 2018:Shelters of the Future: A National Conversation hosted by Women’s Shelter Canada in Ottawa, Ontario. Call for abstracts, panels, and workshops and moderated debates open until February 15, 2018. Information available here.

  • July 15-17, 2018: International Family Violence and Child Victimization Research Conference, Portsmouth, New Hampshire, US. Abstract submission deadline is March 12, 2018. Information available here.
  • September 2-5, 2018: International Society for Prevention of Child Abuse and Neglect (ISPCAN) XXII International Congress on Child Abuse and Neglect, Prague, Czech Republic.  Abstract submission deadline is February 14, 2018.  Information available here
  • September 26-28, 2018: Transforming Health Services, Policies and Systems through Research, Education, Innovation, and Partnerships. Conference hosted by the Nursing Network on Violence Against Women International (NNVAWI), Niagara-on-the-Lake, Ontario. Abstract submission deadline is January 19, 2018. Information available here
  • November 21-22, 2018: International Domestic Violence & Health Conference, Melbourne, Australia. Abstract submission deadline is March 6, 2018. Information available here