behind the study

The Middlesex-London Health Unit (MLHU) and the Centre for Research on Health Equity and Social Inclusion (CRHESI) from Western University Health Sciences engaged in a research partnership to understand how a temporary overdose prevention site in southwestern Ontario has influenced the lives of people who use drugs (PWUD).

Funding for this study was provided by MLHU. Additional in-kind contributions from both MLHU and CHRESI.

Research Question

Our research question: How has the temporary overdose prevention site changed the lives of those who have accessed the site?

We were interested in finding out about the following types of changes in site users lives, including:

  • Behaviours
  • Relationships
  • Interactions with others
  • Feelings and
  • Perceptions of self and others


  • Our research design included a Photo Narrative Method which involved recruiting people who use drugs (PWUD) at the overdose prevention site to participate in semi structured interviews and were provided with a camera to take photos that represented the influence of the site on their lives.
  • Semi-structured interviews took place between May-September 2019.
  • The transcribed interviews were analyzed using a critical narrative analysis approach.
  • The analysis was conducted by the research team members in a multi-phased process involving individual and group analysis with the overall goal being to generate a core narrative supported by key themes.


Site staff assisted with:

  • Pre-screening
  • Introducing potential participants to researchers, and
  • Achieving maximum-variation sample.

Research staff were responsible for:

  • Explaining the study purpose and process,
  • Obtaining consent, and Conducting the interviews.

Data Collection Process

First interview:

  • Semi-structured interviews were conducted to gather information of their experiences on how the site had
    influenced their day-to-day lives.
  • Participants were then provided with a disposable camera to take photos that represent the influence of the site.

Camera Return and Photo Development:

  • Participants were asked to return the cameras to the site, where the researchers then retrieved the cameras and arranged photo development.

Second Interview:

  • In the follow-up interviews, the photographs were used to facilitate story-telling.
  • Participants were asked to share the meaning of the photos they chose.

Changes to Data Collection Protocol:

  • Due to a low rate of camera return (8/27 participants), a new protocol was implemented utilizing a Peer Support Worker employed by the Regional HIV/AIDS Connection (RHAC) to accompany participants in a digital photo taking process.
  • Second Interviews were conducted with participants immediately following photo taking process with the research team. 

Participatory Approaches

We used participatory approaches throughout the study including:

  • Study Design – We engaged site users and site staff in discussions on the study design.
  • Formation of an Advisory Team – We formed an Advisory Team which included four community stakeholders (i.e. site staff, staff providing services in the Aftercare Room) and three site users.
  • Member-checking – Member checking was an important part of the café event that gathered feedback on the preliminary findings with participants, site staff and community stakeholders.

Café Event to Share Preliminary Findings (Fall 2019)

  • The research team presented the proposed core narrative with four chapters and themes to the Community Advisory Team, research participants, and site staff in an afternoon café event at RHAC.
  • Feedback was overwhelmingly positive regarding both the structure and the content of the proposed findings.
  • This café event helped us to refine the terminology of the chapters and themes.


The Project Team:
Our Project Team included the following individuals which also aligns with the authors of our reports:

Michelle Sangster Bouck, MA
Program Evaluator
Middlesex-London Health Unit,

Abe Oudshoorn, RN, PhD
Western University,

Melissa McCann,
MSW Middlesex-London Health Unit, melissa.

Shamiram Zendo, PhD Western University,

Helene Berman, RN, PhD
Distinguished University Professor Emerita, Western University
Academic Director, Centre for Research on Health Equity and Social Inclusion

Jordan Banninga, MSc
Middlesex-London Health Unit,

Marlene Janzen Le Ber, PhD
Brescia Excellence in Research Professor,
Chair School of Leadership & Social Change, Brescia University College

Zayya Zendo, BSc
Western University,