Thank you so much for your interest in the Wellness Hub research and support program. We are working with long-term care homes (LTCH) and retirement homes (RH) to learn more about COVID-19 prevention and management in LTCH/RHs.
Some of our study objectives include trying to understand the factors that cause higher rates of COVID-19 infection, as well as how we can support LTCH/RHs with implementing wellness, infection prevention and control (IPAC) best practices, and increasing vaccine confidence, and the uptake of other wraparound care resources to mitigate the spread and impact of COVID-19 and improve well-being. As a part of this research program, we are inviting the staff and residents at the LTCH/RH (as well as staffs' household members and residents' caregivers) to participate in multiple research activities. What does this mean for you? Participating in our study would involve a few different components that would provide us with valuable information towards better understanding COVID-19 infection in LTCH/RH, as well as how to prevent these infections. Participation is completely voluntary and would not impact your/your family/the resident you are an SDM for/your household members' employment or relationship with Unity Health Toronto or the LTCH/RH, as well as the medical care received in these settings.
Depending on your eligibility, you have the option to participate in any or all of the following study activities:
We are also interested in how some of this information changes over time during the pandemic, and we invite you to complete follow-up demographic questionnaires and samples. Participation in these additional activities is completely voluntary and you can remain in the study if you do not agree to participate in the follow-ups.
Please identify if you are a:
must provide value Staff Member Staff's Household Member Resident's Family Member/Caregiver/Essential Care Partner Resident (or substitute decision maker)
Have you participated in the study before?
must provide value Yes No I don't know/I don't remember
How many times have you participated so far in the study?
must provide value Once Twice I don't know/ I don't remember
Please identify the long-term care or retirement home that you are associated with in Ontario:
must provide value
Please note that if you are filling out this form on behalf of both yourself and another individual, you will need to submit one form per person.
Are you eligible to participate?
You are unfortunately not eligible to participate if you: Are under the age of 18 Do not speak English Self-identify as Indigenous Rationale: Conducting research with Indigenous communities must involve partnerships with Indigenous Peoples from developing the research question through to research completion and dissemination to ensure the research is done in a culturally appropriate way and to avoid tokenism. This project has not engaged Indigenous partners from project onset and as such, in keeping with these principles, individuals who self-identify as Indigenous will not be eligible to participate in this study. Guidance from the Indigenous community has stated that engaging Indigenous populations without use of these thoughtful and resourced approaches can be damaging for the Indigenous communities and Indigenous Peoples. There are additional studies COVID-19 studies occurring designed specifically for Indigenous populations which you may be interested in. For more information, please contact our study team, or Olivia Oxlade, Associate Scientific Director at CITF (the study funder) https://www.covid19immunitytaskforce.ca/contact-us/).
I do not fall into any of the above categories, and am eligible to participate:
must provide value Yes, I am eligible to participate in this study No, I am not eligible to participate in this study Unfortunately, you are not eligible to participate in the Wellness Hub research study. Please contact the Wellness Hub Team by email at email@example.com if you have any further questions.
How can you participate?
To participate in this study you can choose to complete the information and consent form online (through a link sent to your email address), over the phone with a study research staff, or in-person at your long-term care or retirement home.
Please select your preferred method of reviewing the consent form and providing your consent to participate in this study:
Online survey sent to my email Phone call from study research staff In-person at my long-term care or retirement home Any of the above would be fine Please note that email is not a guaranteed private and secure form of communication (e.g., emails can be shared and modified without knowledge of the sender or recipient, emails may contain viruses, and emails may be inspected for legal reasons).
Participant's First Name:
must provide value
Participant's Last Name:
must provide value
What is your preferred method of contact?
must provide value
Please select at least one
must provide value
Does this participant need a substitute decision maker?
Substitute Decision Maker First Name:
Substitute Decision Maker's Last Name:
Substitute Decision Maker's Relationship to Participant:
Please fill out the following information for the participant's substitute decision maker Please note that email is not a guaranteed private and secure form of communication (For e.g., Emails can be shared and modified without knowledge of the sender or recipient, emails may contain viruses, and emails may be inspected for legal reasons). Entering your email address means you consent to be contact by email for this research study.
What time of day would you prefer to receive a phone call?
As mentioned, we are interested in enrolling the household members of staff and the family members/caregivers/essential care partners of LTCH/RH residents in this study.
If you are comfortable, please indicate if you would like to share the names and contact information of others in your family or household that would be eligible so that we can reach out to them. Note: If you choose to share anyone’s contact information, please inform them that their contact information has been shared with the Wellness Hub study team.
I have consulted one or more of my household members, and they have agreed to let me share their contact information:
I have consulted additional family members/ caregivers/ essential care partners of the resident, and they have agreed to let me share their contact information:
I have consulted one or more of my family members/ caregivers/ essential care partners (or have consulted these individuals on behalf of my loved one), and they have agreed to let me share their contact information:
A study coordinator will be in contact with you at the phone number listed above. We will try our best to accommodate your time-of-day preference. If you have any questions or concerns, please reach out by email to WellnessHub@unityhealth.to
A study coordinator will be in contact with you to arrange a time to provide you with the information and study consent form at your long-term care home or retirement home. If you have any questions or concerns, please reach out by email to WellnessHub@unityhealth.to
You will receive an online survey with instructions to the email address listed above. If you have any questions or concerns, please reach out by email to WellnessHub@unityhealth.to