1.1 Introduction
The Office of Drug Research and Surveillance (ODRS), Health Canada is launching a sentinel site survey entitled the People with Lived and Living Experience Survey (PWLLES) to examine or determine the prevalence of alcohol and drug use among at-risk populations. At this time, Health Canada is focused on conducting a sentinel-site survey, which will measure the prevalence of alcohol and drug use among street-involved youth (17 to 24 years of age), in urban centres across Canada.
Objectives:
The overall objective of this project will be to help address data gaps pertaining to the at-risk population of street-involved youth. Results from this survey will help Health Canada better address the needs of people with lived and living experience, as well as to expand current surveillance practices in order to better understand both current and emerging drug situations that at-risk populations are faced with across the country. This project will also enhance our understanding of barriers, such as stigma, linked to substance use and to seeking and accessing treatment.
The primary outcomes that will be measured by the PWLLES will be to better understand:
drug use patterns including prevalence, frequency and volume of consumption;
drug market activity including price, purity, and availability indicators for specific drugs of interest; and,
harms and risks related to drug consumption including primary health indicators, drug dependency indicators and social and financial problems.
1.2 Background
In recent years, problematic substance use has had a devastating and profound impact across Canada, especially given the opioid crisis. Health Canada sponsors the following five major health surveys to measure prevalence and harms associated with problematic substance use in the Canadian general population: the Canadian Alcohol and Drugs Survey (CADS, formerly the CTADS), the Canadian Student Tobacco, Alcohol and Drugs Survey (CSTADS), and the Canadian Cannabis Survey (CCS), and more recently the Canadian Post-secondary education Alcohol and Drugs Survey (CPADS) and the Online New Psychoactive Substances (NPS) Survey.
Historically, drug surveillance efforts have been limited to general population surveys for alcohol and drug use and are not designed to capture data from at-risk populations. Consequently, at-risk populations of people with lived and living experience with drugs remain under-represented in Health Canada’s surveillance efforts, resulting in data gaps.
In 2012, Health Canada conducted a two-year pilot project, entitled the High-Risk Population Study (HRPS), to examine current and emerging substance use trends and related consequences within three at-risk populations of people who use drugs: a) adults who use drugs and are street-entrenched, b) youth who use drugs and are street-involved, and c) people who use drugs for recreational purposes at club, rave, and bar scenes.
Adapted for use at a sentinel sites across Canada, the objective of the 2012-2013 Health Canada pilot survey was to assist in developing a comprehensive epidemiological monitoring system for Canada. In this survey, respondents were recruited from each of the three (3) respective at-risk populations to complete face-to-face interviews from sentinel sites located in seven (7) urban cities across Canada. This survey was successful in gathering both qualitative and quantitative data on patterns of substance use, risk behaviours, market activity, prices, and experienced harms.
In 2018, in light of the opioid crisis and emerging drug issues in Canada, the Government of Canada brought back to the fore, the importance of addressing the needs of at-risk populations, including for its surveillance purposes, as part of its consultation on Strengthening Canada’s Approach to Substance Use Issues. Following this consultation, Health Canada has built off of the work completed in 2012-2013 and is launching a revised epidemiological monitoring project, which will help understand the situation of at-risk populations in urban centres across the country.
1.3 Scope of the Work
The Contractor is required for implementing sentinel site data collection for the PWLLES in fall 2020, with cities where sentinel sites should be based, as predetermined by the Project Authority. The Contractor will develop a similar methodology to that used by Health Canada in the 2012-2013 HRPS, including ensuring that sentinel site approvals are in place, and that protocol has been adapted uniformly across sentinel sites.
The Contractor will be responsible for undertaking the following:
Reviewing initial documentation and coordinating an initial meeting with the Project Authority (Section 2.1);
Reviewing all current survey materials and providing recommendations for improvement (Section 2.2);
Developing a sentinel site-based sampling strategy for recruitment of street-involved youth who use drugs, from sentinel sites in urban centres across Canada, including producing a comprehensive, written sampling plan, developing the questionnaire for interview format, and developing other supplementary interviewing materials (Section 2.3);
Securing research ethics board approvals at Health Canada and anywhere else that it may be required (Section 2.4);
Networking and collaboration with sentinel sites located in urban centres across Canada, as well as the selection, and providing training and ongoing support to interviewers and/or relevant staff within the sentinel sites. (Section 2.5);
Ongoing recruitment and reporting, management of data collection, analysis, and development of reporting and supplementary documentation (Section 3.0);
Delivering a final dataset with all supporting documentation (including a user guide and codebook) to Health Canada (Section 3.5).Some of the above tasks will need to be conducted simultaneously in order to meet the project timelines.
