Starting this fall, eight registered nurses from the Middlesex-London Health Unit (MLHU) and Southwestern Public Health (SWPH) will be equipped to offer the iHEAL program, which was developed by researchers at Western in partnership with the University of British Columbia and University of New Brunswick.
A free program for women who have experienced or are experiencing intimate partner violence, iHEAL connects them with a nurse who can help manage common issues to improve their health, safety, relationships, connections, personal growth or access to basic resources.
"iHEAL is an evidence-based program that is grounded in more than 20 years of research, including feedback from women themselves," said Marilyn Ford-Gilboe, iHEAL project lead and professor at Western's Arthur Labatt Family School of Nursing in the Faculty of Health Sciences. "The implementation of this program in two public health units will help bridge important gaps in supports for women's longer-term healing and recovery, including in rural areas."
The Ontario Ministry of Children, Community and Social Services recently granted $2.4 million in funding for iHEAL as part of the National Action Plan to End Gender-based Violence. The investment will help launch the program for the first time at SWPH, which serves residents in Elgin County, Oxford County and the City of St. Thomas, and increase capacity at MLHU, where it has been running since 2021, supported by the Public Health Agency of Canada.
"This research project has the potential to be transformative for women in our region," said David Smith, healthy foundations program director at SWPH. "We know intimate partner violence has long-term effects on a woman's health, safety and overall well-being. Through iHEAL, women who need support will receive personalized, one-on-one public health nursing support to help begin to rebuild their lives."
The launch and the expansion provide a chance to learn how a complex program, such as iHEAL, can be effectively embedded into a service organization, said Nadine Wathen, professor at the Arthur Labatt Family School of Nursing. It also allows researchers to better understand the scale of the program's impact in the community. The ultimate goal is to find ways to expand iHEAL so it can be offered to women in communities across Canada.
Participant-led, flexible, health-focused care
For one participant, Gwen (a pseudonym has been used to protect her privacy), the program was a turning point.
"iHEAL is so critical for somebody in my situation. I think without this program it would have been a much longer recovery, healing and growth process," she said. "It enhances existing supports and services rather than duplicating them and it offers tools beyond counselling or therapy. The program really amplifies the entire healing process in a positive direction."
She also appreciated the ease of accessing iHEAL. Knowing the program was developed through robust evidence helped her trust the process as she progressed, too.
"What makes iHEAL unique is the focus on health and the impacts that it has on women who experience intimate partner violence," said Jody Shepherd, associate manager of the nurse-family partnership and early years group programs team at MLHU. "We address health outcomes - including physical and mental well-being - and the fact it's delivered by registered nurses makes it truly distinctive."
iHEAL-educated registered nurses meet with participants weekly or biweekly for approximately six months. The meetings are tailored to each woman's priorities and situation, and are held in-person at a safe, convenient location or virtually. Additionally, nurses often introduce women to the iHEAL app, a resource available to the general public in English and French, which provides resources and ongoing support between sessions, and after the completion of the program. They also incorporated a community of practice where the nurses meet together monthly to share new approaches to care and best practices.
The registered nurses work with women to build their capacity to manage issues that affect their health - concerns that are identified by the participants themselves - including:
- improving physical, emotional and psychological safety
- managing basic resources such as housing, childcare, access to health care
- economic stability such as building a resume or going back to school or work
- managing health symptoms that are often the effects of trauma, violence and toxic stress
- building a positive social support network, including connections with services
- caring for themselves - and their hopes and dreams for the future
Leanne Field, a public health nurse with MLHU, has witnessed similar beneficial outcomes in other participants.
"I have seen improvements in women's safety, their health and well-being, their sense of self, their self-confidence and control. In collaborating with their health-care provider to address health concerns, I've seen women build positive coping skills, improve sleep practices and healthy eating habits," said Field. "The expansion of the program will allow us to offer even more support in a timely manner and reach more women in our community who would benefit from this program."
The innovative program is one of only a few in existence to show sustained, long-term benefits for both women's health and their safety, said Ford-Gilboe, Women's Health Research Chair in Rural Health. The tools and resources participants gain from the program are intended to last beyond its completion. iHEAL nurses also link women to community support and services if they wish to enhance wrap-around support.
"They gave me the skills and knowledge and everything I needed to be able to get back on my feet," said Gwen. "Even half a year later, I'm still using the resources, the knowledge and expertise that my nurse gave me."
If you are experiencing violence in a relationship or feel you are at risk of violence
- In an emergency, call 9-1-1.
- In London, Ont., Anova offers counselling and various other support such as emergency shelter and second-stage housing. Atlohsa Family Support Centre provides support for Indigenous women and families. The London Abused Women's Centre provides community-based programming and counselling.
- In Elgin County, Valora Place offers community-based counselling, support and housing help.
- In Oxford County, Domestic Abuse Services Oxford provides services for women and children who have been impacted by gender-based violence in Oxford County.
- In the City of St. Thomas, St. Thomas-Elgin Second Stage Housing provides transitional supports and safe housing to women with or without children, who are leaving abusive relationships.
- Nationally, Canadians can find a suite of family-violence resources and services at this link.
- To access the free and bilingual iHEAL app: https://ihealapp.ca/
- For more information about the iHEAL program and research: contact Marilyn Ford-Gilboe at mfordg@uwo.ca.
- For more information about the iHEAL program at MLHU: https://www.healthunit.com/iheal
- For more information about the iHEAL program at SWPHU: https://www.swpublichealth.ca/iheal
