Publications: Policy & Service Improvement

Substance use is a complex issue, with many causes and manifestations. It is a widespread and costly problem to individuals, families, communities, and governments across Canada. Sex and gender are biological and social determinants of health, respectively, that affect everyone’s health. Incorporating sex and gender into our responses to substance use will lead to better practice, and is now expected by funders and the public. This handbook is focused on 10 key questions that illustrate the impact that sex and gender have on substance use, and indicate how this knowledge can inform more tailored responses by service providers and policy makers. View PDF

Because substance use has wide-ranging effects on many different aspects of life, service providers across a range of health care and social service settings can have an important role in addressing the potential harms of substance use and improving overall health. This resource focuses on brief intervention with girls and women in the preconception and perinatal period. Service providers from a range of backgrounds will find it relevant to their practice.

English version  French version

Brief interventions are collaborative conversations between an individual and a health care or social service provider about a health issue. This resource focuses on brief intervention on substance use with girls and women in the preconception and perinatal period in addressing the potential harms of substance use and improving girls’ and women’s overall health.

English version  French version

This toolkit provides information about trauma, gender, and sex informed programs, initiatives and projects to share in staff training, program planning and evaluation, and to assist in supporting these approaches in programs and organizations. It also includes specific tools to support practice and policy change. It is one of many publications created as part of the Trauma/Gender/Substance Use Project.

This resource has been made possible by a financial contribution from Health Canada. The views expressed herein do not necessarily represent the views of Health Canada.

English version  French version

This discussion guide is intended to stimulate further conversation on “becoming trauma-informed” and assist health care and social service providers in considering additional ways of addressing the opioid crisis in their particular context. It is one of many publications created as part of the Trauma/Gender/Substance Use Project.

This resource has been made possible by a financial contribution from Health Canada. The views expressed herein do not necessarily represent the views of Health Canada.

English version  French version

This backgrounder on women and opioids is based on research showing that many women are affected differently from men by the opioid crisis and that prevention and intervention approaches require attention to these differences. Includes suggestions for better reporting on women and opioids along with a brief overview of research and trends in Canada.

This media resource was created by researchers at the Centre of Excellence for Women’s Health as part of the Trauma/Gender/Substance Use Project and in partnership with the Canada FASD Research Network. CEWH is hosted by BC Women’s Hospital + Health Centre, an agency of the Provincial Health Services Authority.

Funding for the creation of this guide was provided by Health Canada. The views herein are not necessarily those of Health Canada.
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A discussion guide for service providers and program planners, this resource offers strategies to support organizational change. It includes reflective questions for examining current approaches to seclusion and restraint, determining current trends and impacts, and developing alternatives that are trauma informed.

It is one of several resources developed as part of the Trauma / Gender / Substance Use (TGS) project made possible by funding from Health Canada. The views in the guide do not necessarily represent the views of Health Canada.

View TGS Trauma-Informed Approaches to Seclusion and Restraint Reduction

Selection of trauma-informed treatment-related resources and curricula. Some focus solely on trauma-informed practices; others incorporate elements of both trauma-informed and trauma-specific approaches.

One of 3 resource lists on trauma, gender, and substance use made possible by funding from Health Canada. Revised May 2019.

View TGS Trauma-Informed Practice Resource list

Overview of gender transformative resources compiled in 2016.

One of 3 resource lists focusing on gender, trauma and substance use. Made possible by funding from Health Canada.

Download TGS Gender Transformative Resource list

An overview of gender-informed resources in the substance use field.

This is one of 3 resource lists focusing on gender, trauma and substance use, and has been made possible by a financial contribution from Health Canada.

Download  TGS Gender Informed Approaches to Substance Use resource list

Repairing the Holes in the Net was a 2 year research and system change initiative to improve policy and practice related to care and support for northern women experiencing homelessness, mental health and substance use concerns.

In each of the capital cities of Canada’s three northern territories − Whitehorse, Yellowknife, and Iqaluit − a group of researchers, health care and social service providers, community advocates, and policy makers met monthly to share, learn and collaborate.

This booklet describes how the project participants (who came from diverse government departments and service agencies and included sectors such as addictions, mental health, primary health care, justice, housing, police, income support, child protection, shelters and women’s advocacy) worked to find ways to understand the complexity of homelessness and make shifts in whole systems of service delivery.

View pdf  RTN Summary_August 9 2015

 This poster is designed for use by services involved in prevention of alcohol, tobacco and other substance use in pregnancy.  On the front it is a poster, and on the back is information for service providers on supporting women, families and communities from a harm reduction stance.  This resource was developed with the support of the Education and Training Council, Alberta FASD Cross Ministry Committee and was reviewed by members of the CanFASD Research Network with prevention expertise.

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Canada FASD Research Network’s Action Team on Prevention from A Women’s Health Determinants Perspective

Legislation, social policy and health care and child welfare practices can contribute significantly to effective care and support for women who use substances during pregnancy. This backgrounder provides a brief overview of several important areas of policy-making and discusses how policy can contribute to developing supportive health and social services to effectively address substance use during pregnancy.

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Gerald Thomas, Ph.D, Okanagan Research
Nancy Poole, BC Centre of Excellence for Women’s Health, 2013

This resource includes a discussion of the form and types of messages that can be provided via FASD prevention signs including examples of recommended messages designed to help prevent drinking in pregnancy and promote health among women of childbearing ages.

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These maps are intended to help program staff, planners and funders to more easily identify the aspects of programs that contribute to positive client and community outcomes and the range of outcomes that can result from or be associated with certain approaches and program activities. They also give us a common framework for thinking about how to conduct evaluations across programs or across communities.

Mapping Evaluation of FASD Support Programs

Deborah Rutman, Carol Hubbertstey, Nancy Poole, Sharon Hume and Marilyn Van Bibber, 2012.

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Mapping Evaluation of FASD Prevention Programs

Deborah Rutman, Carol Hubbertstey, Nancy Poole, Sharon Hume and Marilyn Van Bibber, 2012.

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Mapping Evaluation of FASD Programs in Aboriginal Communities

Marilyn Van Bibber, Sharon Hume, Carol Hubbertstey, Deborah Rutman and Nancy Poole, 2012.

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British Columbia Centre of Excellence for Women’s Health, 2014.

This guide is a companion resource to the fasd-evaluation.ca website. The website includes evaluation frameworks, methods, tools, and indicators of success to support the work of community-based FASD prevention programs for women who are pregnant and parenting, supportive intervention programs for adults and older youth with FASD, and FASD programs in Aboriginal communities. The guide provides an introduction to the program philosophies and theoretical frameworks discussed on the website. It also includes discussion questions for groups beginning or renewing evaluation and suggestions on how to make use of the variety of resources available on-line.

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BCCEWH, Prairie Women’s Health Centre of Excellence, and Atlantic Centre of Excellence for Women’s Health Editors: A. Pederson, M.J. Haworth-Brockman, B. Clow, H. Isfeld and A. Liwander, 2013

The BCCEWH, the Atlantic Centre of Excellence for Women’s Health and the Prairie Women’s Health Centre of Excellence have released a new women’s health resource entitled Rethinking Women and Healthy Living in Canada. The report, funded by Health Canada, is intended to generate an understanding of women and healthy living and to contribute to the development of evidence-informed responses to addressing challenges related to healthy living for women in Canada.

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Emily Arthur, Amanda Seymour, Michelle Dartnall, Paula Beltgens, Nancy Poole, Diane Smylie, Naomi North, and Rose Schmidt. Initial draft authors: Cristine Urquhart and Fran Jasiura of Change Talk Associates. British Columbia Centre of Excellence for Women’s Health; BC Ministry of Health, Mental Health and Substance Use Branch; and Vancouver Island Health Authority, Youth and Family Substance Use Services, 2013

The Trauma-Informed Practice (TIP) Guide was developed collaboratively to support the application of trauma-informed principles into practice and policy, by clinics, agencies and groups assisting clients with mental health and substance use concerns in British                                             Columbia. View PDF

Canada FASD Research Network’s Action Team on Prevention from A Women’s Health Determinants Perspective, 2012

In this document, we profile the development of single-access programs in four different communities and talk about why this type of program works.

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British Columbia Centre of Excellence for Women’s Health (BCCEWH) in partnership with the Canadian Centre on Substance Abuse (CCSA) and the Universities of Saskatchewan and South Australia, 2010

This discussion guide explores bringing a gender-based analysis to harm reduction strategies. It 1) introduce some of the intersecting components of harm reduction and health determinants, such as violence and trauma and pregnancy and mothering, 2) highlights the key ways that these elements interact to influence women’s substance use experiences, 3) provides examples of Canadian women-centred harm reduction programs.

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Olena Hankivsky and Renée Cormier with Diego de Merich, 2009

The purpose of this primer is to explore the following question: How can health researchers, policy analysts, program and service managers, decision makers, and academics effectively apply an intersectional perspective to their day-to-day work? While it is important to highlight that an intersectional framework can be applied to all populations this primer specifically focuses on its applicability in the context of women’s health.

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The VANDU Women CARE Team, 2009

This report is a summary of the most relevant findings of this community-driven research project for health care providers treating women who use drugs in the DTES.

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Prepared by Tessa Parkes, Nancy Poole, Amy Salmon, Lorraine Greaves, and Cristine Urquhart, 2008.

This report is a review of evidence from peer-reviewed literature on the topic of interventions aimed at supporting women to reduce their use of alcohol in the childbearing years. The phrase, “Double Exposure” in the title reflects our concern with the effects of alcohol on both the woman and the fetus and underlines the importance of addressing women’s health and women’s circumstances during pregnancy to optimize health.                                                            View PDF

British Columbia Centre of Excellence for Women’s Health, BC Women’s Hospital & Health Centre, 2008

In 2004, a provincial women’s health strategy was realeased. Advancing the Health of Girls and Women: A Women’s Health Strategy for British Columbia provided a coordi¬nated blueprint for future change and helped define a province-wide perspective on women’s health. This report continues that legacy by analyzing the its contribution to activities aimed at advancing the health of girls and women in British Columbia in the past four years.

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Jo-Anne Fiske and Annette J.Browne, 2008

This report constitutes the second of two phases of research conducted in collaboration with a First Nation community in north central British Columbia. The research considers health care policy within the context of government-sponsored policy “reform” consultations with citizens and within everyday encounters in health services where policy is implemented.

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Lorraine Greaves, Natasha Jategaonkar and Sara Sanchez, 2006

El presente informe, Pasando página: Mujeres, tabaco y el futuro, facilita una perspectiva muy necesaria del consumo de tabaco entre mujeres de distintos contextos sociales, identifica los efectos para la salud que tiene el tabaco y describe el papel de la mujer en su producción y comercialización. También proporciona una directriz para evaluar y afrontar las cuestiones de género del control del tabaquismo en las políticas, programas e investigaciones y reducir los devastadores efectos que tiene el tabaco sobre las mujeres.

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Lorraine Greaves, Natasha Jategaonkar and Sara Sanchez, 2006

Le présent rapport, Pour tourner la page – Les femmes, le tabac et l’avenir, brosse un portrait de l’utilisation du tabac par les femmes dans différents contextes sociaux, détermine les effets du tabac sur la santé et décrit le rôle des femmes dans la production et la mise en marché du tabac. En outre, il trace des lignes directrices pour évaluer et résoudre les questions spécifiques au sexe liées à la lutte contre le tabagisme dans les politiques, les programmes et la recherche.

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Lorraine Greaves, Joy Johnson, Joan Bottorff, Susan Kirkland, Natasha Jategaonkar, Melissa McGowan, Lucy McCullogh and Lupin Battersby, 2006

This report reviews evidence of the effectiveness of three aspects of tobacco control policy on diverse groups of males and females particularly vulnerable to smoking: Aboriginal and individuals from low socioeconomic backgrounds.

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Lorraine Greaves, Natasha Jategaonkar and Sara Sanchez, 2006

This report provides a much-needed picture of women’s tobacco use in different social contexts, identifies the health effects of tobacco, and describes women’s role in tobacco production and marketing. It also provides direction on assessing and addressing the gendered issues of tobacco control in policy, programming, and research in order to reduce the devastating effects of tobacco on women.

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BC Women’s Hospital & Health Centre and British Columbia Centre of Excellence for Women’s Health, 2004

The aim of the Provincial Women’s Health Strategy is to improve the health of girls and women throughout BC. This document describes an approach to understanding girls’ and women’s health and provides background information to promote the development of initiatives to integrate girls’ and women’s health into research, policy and clinical care.

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Lorraine Greaves
British Columbia Centre of Excellence for Women’s Health, 2003

The number of people who need palliative care in Canada is rising, yet we have no national policy and no national regulations to ensure consistency and quality of care. This paper seeks to make recommendations regarding palliative care and the ability to achieve consistent, high-quality palliative care across all sites and caregivers.

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Aleina Tweed
British Columbia Centre of Excellence for Women’s Health, 2003

Although breast implant surgery is most often privately-funded surgery, the publicly-funded healthcare system may bear the burden of increased use due to resulting complications. But do women who undergo breast implant surgery use the public system more than women who have never had this surgery? This report addresses this question, with implications for women and for policy-makers.

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Marina Morrow
British Columbia Centre of Excellence for Women’s Health, 2003

Evidence shows that certain mental illnesses are more prevalent in women, that women utilize mental health services more frequently than men do, and that women would like a wider range of treatment and support options than is currently available. This report outlines the need for both provincial and national health strategies to address the issues distinct to women’s mental health.

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Janet C. Currie
British Columbia Centre of Excellence for Women’s Health, 2003

This report describes benzodiazepines, prescribing rates and practices, and their effect on women in Canada. Based on this information, recommendations are made regarding policy and intervention strategies to address the effects of benzodiazepines and sleeping pills on women, families and society in Canada.

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Jude Kornelsen, 2003

This report captures presentations and debates about new and innovative ways midwives can use their skills and expertise to meet the needs of Canadian women, including plans for alternative models of care, collaborative practice with other health care professionals and an expanded scope of practice.

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Jude Kornelsen, 2003

This report discusses the need for new policies at the provincial and federal levels to enhance the capacity of midwifery to make a greater contribution to maternity care and to help solve the health care practitioner crisis.

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Lenore Riddell, Kathy Greenberg, Joan Meister and Jude Kornelson, 2003

This research study addresses to what extent women with disabilities regularly receive screening for breast and cervical cancer, what barriers prevent them from receiving this care and how the information collected can improve screening. The report also describes the innovative Access Clinic at BC Women’s Hospital designed to provide gynecologic and breast health care for women with disabilities.

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British Columbia Centre of Excellence for Women’s Health, 2003

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Jude Kornelsen
British Columbia Centre of Excellence for Women’s Health, 2002

This report reflects the focus of the “Midwifery in Canada: Directions for Research” workshop, moving forward with a national midwifery research agenda.

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Colleen Reid
British Columbia Centre of Excellence for Women’s Health, 2002

This report discusses the definitions of women’s health, how it is and could be measured, and the implications of these topics for research, action and policy in women’s health.

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Marina Morrow, 2002

This paper documents practice in five mental health care settings with respect to the provision of services to women diagnosed with mental illnesses who are survivors of trauma.

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Patricia Lee
British Columbia Centre of Excellence for Women’s Health, 2001

This background report serves to assist sexual assault services in British Columbia in developing informed and thoughtful policy on the complex issue of consent to collect forensic evidence from an unconscious patient/victim who has been sexually assaulted.

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Wendy Frisby, Fearon Blair, Therese Dorer, Larena Hill, Jennifer Fenton and Bryna Kopelow, 2001

This study documents the factors that influence whether or not action is taken in communities to increase the access of women on low incomes to community recreation. A resource to support service providers in their work with women.

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Marina Morrow with the Midlife Health Needs of Women with Disabilities Advisory Committee
British Columbia Centre of Excellence for Women’s Health, 2000

This study highlights the interconnections between menopause, midlife, disability and aging, and through interviews with women with different disabilities, makes clear that further research, education of health care professionals, and information for women with disabilities is needed.

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Marie L. Hoskins with Kristy Dellebuur
British Columbia Centre of Excellence for Women’s Health, 2000

This survey of contemporary research on adolescent girls, eating disorders and prevention looks at self and self-identity and the influence of media on how identities are formed in relation to the phenomenon of eating disorders and body image disturbances.

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Joan L. Bottorff, Lynda G. Balneaves, Lorna Sent, Suki Grewal and Annette J. Browne, 2000

Underutilization of mainstream health services has led to the development of specialized health services for women from different ethnocultural groups. These services provide an important focus for the study of women-centred care. The purpose of this study was to identify and describe critical elements of women-centred care within the context of three cervical cancer screening clinics in Vancouver serving Asian, South Asian and First Nations women. A further aim of the study was to determine factors that influenced full implementation of women-centred care within these clinics.

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Lorraine Greaves, Victoria J. Barr, with the collaboration of the Women and Tobacco Working Group, 2000

This paper develops a gendered analysis of tobacco policy, contextualized in the national and international tobacco control and reduction movement, and identifies women-centred policy directions to reduce women’s tobacco use.

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Jude Kornelsen, V. Susan Dahinten and Elaine Carty
British Columbia Centre of Excellence for Women’s Health, 2000

This report describes the results of a survey of nurses on the topic of midwifery, which was conducted shortly after the introduction of midwives as a regulated and funded part of the British Columbia health care system.

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Lorraine Greaves et Victoria J. Barr; en collaboration avec le Groupe de travail sur les femmes et le tabagisme, 2000

Le présent document décrit ces questions et ces tendances et définit les éléments propres au sexe biologique et au sexe social qui, au Canada, ont des incidences sur le tabagisme chez les femmes. Il est essentiel, en particulier, d’analyser le niveau de revenu, les responsabilités concernant les soins à prodiguer aux enfants et la nature du travail des femmes pour comprendre les effets selon le sexe des politiques de lutte contre le tabagisme. Nous examinons les mesures de réglementation du tabac et nous appliquons une « analyse comparative entre les sexes » à plusieurs d’entre elles, dont l’emballage des produits du tabac et la restriction de l’usage du tabac.

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Jude Kornelson, 2000

This report considers the current relationship between midwives, physicians and nurses from both a professional and interpersonal perspective, looks at objections put forward by the medical and nursing communities and considers the way objections have affected client care.

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Jeanne Lyons and Elaine Carty, 2000

Documenting the observations of a researcher in the midwifery field, this report observes and comments on province-wide presentations and discussions on midwifery and its integration into BC’s health care system.

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Marina Morrow with Monika Chappell
The British Columbia Centre of Excellence for Women’s Health, 1999

This multi-level study into the experience of mental health care for women in BC ranges in scope from the voices of consumers to policy makers and includes recommendations for change throughout the system.

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Colleen Fuller, 1999

This paper places BC’s health system reform in a national context and points out the information gaps and inadequacies concerning issues affecting women users and workers in the system.

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Shirley Masuda, 1999

This report details the results of a study about how women with disabilities experience being healthy and the structural barriers they face in achieving health.

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