Matters of Engagement

mattersofengagement

Matters of Engagement examines issues at the intersection of health, health care and society. Including: how people in Canada access and experience health care service delivery and distribution; how those experiences impact both individual and community health; and the multitude of environmental, systemic, and political factors that favour some and disadvantage many. Jennifer Johannesen and Emily Nicholas Angl produce each episode with the aim of illuminating difficult or confounding issues, to provoke much-needed critical dialogue among all stakeholders.

  1. Mar 31

    Optics over Impact: Patient Engagement at the Provincial Level

    Sangeeta Chopra-Charron came to Ontario Health's Patient and Family Advisory Council (PFAC) with a background in transformational change and a genuine belief that Ontario Health was sincere about partnering with patients and families in system transformation. Four years later, she resigned from the co-Chair role, publicly, with a letter that resonated across the health care sector. Emily sat down with Sangeeta to talk about what she found, what she tried, and why she eventually concluded the council was implemented more for optics than for impact. It seems Ontario Health had built its PFAC around the language of patient-centred design and genuine partnership, and had provided just enough structure to signal commitment... without the governance, accountability, or shared decision-making to back it up. Her experience isn't unique to Ontario Health. It's a pattern that shows up at every level of the health care system. [download transcript] Links: Sangeeta Chopra-Charron on LinkedIn Ontario Health Ontario Health Patient and Family Engagement ---------------------- We reference Sangeeta's resignation letter in this episode, here's the full reprint: "November 14, 2025 Hello Matt, I am writing to resign as Co-Chair and member of the CEO Patient and Family Advisory Council (PFAC), effective December 31, 2025. By providing this notice well in advance, I hope to support a smooth transition and allow time to identify a suitable successor. This decision follows careful reflection on PFAC’s purpose and its alignment with Ontario Health’s mandate to deliver connected, patient/person-centred care. It has been a privilege to serve alongside individuals dedicated to improving patient and family experiences. As both a patient and caregiver, I have been committed to advancing genuine partnership in care and contributing my professional expertise in transformational change. However, it has become clear that the current PFAC structure does not support authentic collaboration. Despite consistent advocacy for shared decision-making, the Council’s influence, even in basic areas such as agenda setting, remains limited. As a result, the CoChair role is largely symbolic, making it difficult to fulfil with integrity. Without meaningful structural and procedural change, PFACs risk functioning as token bodies rather than true drivers of improvement, a concern shared by many members. My experiences within PFAC also reflect broader systemic challenges at Ontario Health. After six years, the system remains fragmented, with weak accountability, limited digital integration, and inconsistent performance reporting. These issues continue to undermine confidence in Ontario Health’s ability to deliver on its transformation mandate. This is a difficult but necessary decision. I remain hopeful that Ontario Health will renew its commitment to transparency, accountability, and genuine patient partnership, not only in rhetoric, but in practice. As I step back, I do so with the same conviction that first drew me to this work: meaningful change is both possible and necessary. I trust that you and your colleagues will confront the hard truths and take the steps needed to build a truly patient/person-centred, integrated, and outcome-driven system. Thank you for the opportunity to serve. Thanks  Sangeeta"

    19 min
  2. Mar 12

    Zooming Out: Research, Implementation, and the Road Ahead (BETTER Women 5/5)

    In this fifth and final episode of the BETTER Women series, Jennifer and Emily zoom out from the study itself to explore what the results actually mean — and why mixed findings are far from failure. Dr. Ruth Heisey reflects on what the project got right, why peer health coaching remains full of promise, and what the healthcare system stands to lose if prevention keeps taking a back seat. Implementation scientist Laura Desveaux then offers a reframe: effectiveness research tells us if something works, but implementation science tells us how to make it work in the real world — with real people, real constraints, and real complexity. Jennifer and Emily close the series by reflecting on what it means to produce a podcast in real time, as a research story unfolds. [download transcript] More episodes in this series: Trailer Episode 1: Going “Upstream” to Prevent Chronic Disease Episode 2: The Science behind Peer Health Support Episode 3: Voices from the Heart of the Project: Peer Health Coaches Episode 4: Learning From Unexpected Results: What the Numbers Didn’t Capture Related research: Assessing the effectiveness of “BETTER Women”, a community-based, primary care-linked peer health coaching programme for chronic disease prevention: protocol for a pragmatic, wait-list controlled, type 1 hybrid effectiveness-implementation trial Improving chronic disease prevention and screening in primary care: results of the BETTER pragmatic cluster randomized controlled trial. Results from the BETTER WISE trial: a pragmatic cluster two arm parallel randomized controlled trial for primary prevention and screening in primary care during the COVID-19 pandemic Links: The BETTER Women project Canadian Cancer Society Women's College Hospital

    23 min
  3. 12/02/2025

    Learning From Unexpected Results: What the Numbers Didn't Capture (BETTER Women 4/5)

    The BETTER Women research team gathered to review their findings, hoping to see clear evidence that peer health coaching improved women's preventative health behaviours. But the results told suggested a more complex story. While the quantitative data showed no statistically significant benefit from adding peer health coaches to the program, the qualitative interviews revealed a different picture: participants and coaches described meaningful relationships, increased confidence, and genuine support that simply weren't captured in the measured outcomes. In this episode, we sit in on the research team's candid debrief as they work through disappointing numbers, examine what might have gone wrong, and discover valuable insights about the gap between what researchers measure and what participants actually value. From volunteer bias to pandemic pivots to goals that don't fit neatly into outcome frameworks, this is an honest look at what happens when research doesn't go as planned—and why mixed or disappointing results are just as important as clear successes. [download transcript] More episodes in this series: Trailer Episode 1: Going “Upstream” to Prevent Chronic Disease Episode 2: The Science behind Peer Health Support Episode 3: Voices from the Heart of the Project: Peer Health Coaches Related research: Assessing the effectiveness of “BETTER Women”, a community-based, primary care-linked peer health coaching programme for chronic disease prevention: protocol for a pragmatic, wait-list controlled, type 1 hybrid effectiveness-implementation trial Improving chronic disease prevention and screening in primary care: results of the BETTER pragmatic cluster randomized controlled trial. Results from the BETTER WISE trial: a pragmatic cluster two arm parallel randomized controlled trial for primary prevention and screening in primary care during the COVID-19 pandemic Links: The BETTER Women project Canadian Cancer Society Women's College Hospital

    30 min
  4. 10/01/2025

    Voices from the Heart of the Project: Peer Health Coaches (BETTER Women 3/5)

    Meet the peer health coaches - the volunteers at the heart of the BETTER Women project. Through candid conversations, we hear from women who underwent extensive training in motivational interviewing and health coaching to support others on their wellness journeys. From international physicians to cancer survivors to newcomers seeking community connection, these coaches share what drew them to the program, how the training changed their own relationships, and the profound impact of walking alongside someone through health behaviour change. This is healthcare powered by human connection. [download transcript] More episodes in this series: Trailer Episode 1: Going “Upstream” to Prevent Chronic Disease Episode 2: The Science behind Peer Health Support Related research: Assessing the effectiveness of “BETTER Women”, a community-based, primary care-linked peer health coaching programme for chronic disease prevention: protocol for a pragmatic, wait-list controlled, type 1 hybrid effectiveness-implementation trial Improving chronic disease prevention and screening in primary care: results of the BETTER pragmatic cluster randomized controlled trial. Results from the BETTER WISE trial: a pragmatic cluster two arm parallel randomized controlled trial for primary prevention and screening in primary care during the COVID-19 pandemic Links: The BETTER Women project Canadian Cancer Society Women's College Hospital

    40 min

About

Matters of Engagement examines issues at the intersection of health, health care and society. Including: how people in Canada access and experience health care service delivery and distribution; how those experiences impact both individual and community health; and the multitude of environmental, systemic, and political factors that favour some and disadvantage many. Jennifer Johannesen and Emily Nicholas Angl produce each episode with the aim of illuminating difficult or confounding issues, to provoke much-needed critical dialogue among all stakeholders.