Photo caption: The Engaging Diverse Voices in Systems Improvement equity-oriented model was created by a team at Trillium Health Partners' Institute for Better Health.
By: Moonshot Collaborative for Translational Health Equity with Amanda Etty, Senior Communications Advisor, Institute for Better Health, Trillium Health Partners
Better health begins with listening to and meaningfully partnering with those who have been historically excluded from shaping the systems that impact their health and well-being. In Ontario, the time between the first signs of cancer symptoms to receiving a diagnosis and treatment remains excessively long, particularly for individuals from structurally marginalized communities, who often experience worse health outcomes as a result.
To address these inequities, the Moonshot Collaborative for Translational Health Equity at Trillium Health Partners' Institute for Better Health, in partnership with Ontario Health (Cancer Care Ontario), has led a year-long pilot project aimed at centering the voices of individuals from structurally marginalized communities to redesign cancer diagnostic pathways that are more equitable and responsive.
Led by Dr. Ibukun Abejirinde, Scientist at the Institute for Better Health, alongside Research Associates, Nuzha Hafleen and Isabelle Choon, with Research Assistant, Asli Hersi, the project convened three distinct engagement tables comprising of Black, Francophone, and Newcomer patients and care partners across Ontario. Between December 2024 to May 2025, these groups met regularly to share their experiences with the healthcare system, provide recommendations, and identify potential solutions.
“What started as engagement tables have grown into communities of care," adds Dr. Abejirinde. “Participants told us they felt seen, heard, and empowered. Their perspectives are shaping a more equitable cancer diagnosis process and fueling personal healing and system-level change."
While some participants described positive experiences with the cancer diagnosis process, many echoed similar challenges: difficulty navigating the health system due to systemic bias, language and communication barriers, geographic isolation, and limited access to emotional and psychological support. “This project brought forward the voices and lived experiences of people from diverse backgrounds to help shape a cancer diagnosis process that is more responsive, equitable, and inclusive for everyone in Ontario," says Richa Tewari, Newcomer Peer Project Advisor.
Alongside these engagement activities, the team developed and piloted the Engaging Diverse Voices in Systems Improvement (EDVISI) Equity Oriented Model, a first-of-its-kind equity-oriented framework designed to help healthcare and other organizations transform their existing engagement efforts by embedding inclusive, sustained practices into system improvement efforts.
Grounded in the principles of health equity and inclusive co-creation, the EDVISI model offers a guided approach to meaningfully include voices that are too often left out of decision-making. By applying the principles and practices of the EDVISI model, organizations can make progress towards actualizing equity within a learning health system.
Version 1.0 of the model is comprised of three components:
- A Readiness Assessment Tool to evaluate organizational capacity and commitment to equity-oriented engagement
- An Engagement Pathway that outlines key stages and considerations in planning, executing, and sustaining inclusive engagement
- A Toolkit with practical templates, resources, and reflection questions to support implementation and adoption of the EDVISI Equity Oriented model
Together, these tools offer a roadmap for ensuring that meaningful, equity-informed engagement with structurally marginalized groups is not an exception, but a standard. Importantly, the model provides direction in moving the needle forward from what needs to be done to how it can be done.
“We've heard time and again from system leaders, community partners, and patients that a model like this is long overdue. The EDVISI Equity Oriented Model offers a replicable, actionable, and practical pathway for meaningfully engaging structurally marginalized groups, ensuring that the perspectives of those most affected by inequities are at the forefront of shaping change," says Dr. Abejirinde. “How can we hope to truly drive the quintuple aim without these perspectives? Our hope is that the model becomes a transformative tool that organizations can adopt, adapt, and scale to drive equitable and responsive care across our health system." The team is inviting partners across the system – whether in the early stages of considering diversity in patient engagement or already ahead in their journey – to implement the model and join us in advancing health equity through action. If you would like to learn more, request implementation support, or share your feedback, contact info@moonshotcollaborative.ca.