In Canada, Black communities face a higher burden of chronic illnesses such as diabetes and hypertension, and too often do so without access to equitable or culturally appropriate care.
Over time, that gap takes on a second kind of damage: it wears away trust in the health care system. It's something York University's Michael Kalu has seen play out in his research and heard directly from the communities he works with.
Part of what drives that erosion, he explains, is a feeling voiced by many Black older adults – fatigue from repeatedly raising the same concerns to clinicians and researchers, and seeing little change in return.
"They were exhausted with having to come back every single time to report the same needs over and over again," says Kalu, an assistant professor at York's Faculty of Health.
That collective frustration became a guide for Kalu and helped shape the vision behind the Black-Focused Interactive Repository for Actionable Voices and Engagement (BiRAVE) – a Canadian Institutes of Health Research (CIHR)-funded project in its early stages.
Led by Kalu, the project aims to better understand health care needs of Black older adults – including access, affordability and quality – and will develop a tool to support reporting these health inequities. The CIHR funding supports interviews and the development of an initial prototype, with the team starting in Toronto to collect baseline information that will inform the first version of the platform.
The four-year project will expand to Winnipeg, Halifax and other provinces.
BiRAVE will function as a digital space where users can share experiences with gaps in health care – whether physical, environmental, cognitive or social – by using an AI chatbot.
"The chatbot will either be a part of an app or available on a website – it depends on what the older Black adults decide. It is important that the entire project is co-created with older Black adults," he says.
Kalu adds the team is exploring ways to make the tool accessible through typing or speaking, with offline access also being considered.
"In order to reflect the heterogeneity in the community, BiRAVE will also be culturally aware and include multiple languages," he says, adding the platform is intended to recognize accents and dialects, including Patwa and Pidgin English.
BiRAVE is planned around three connected parts: a space where Black older adults can report unmet needs; a system that suggests real-time solutions based on those reports; and a community forum where members can share experiences to help shape the platform over time. All reporting, he says, will be kept private.
"BiRAVE will work in a continuous loop. Over time, the project aims to build a clearer picture of where gaps in care persist and what solutions could help close them," says Kalu, noting that to his knowledge, BiRAVE would be the first "living" interactive repository of its kind in Canada.
The project brings together a Canada-wide team of about 30 Black researchers and five advisory committee members and partner principal investigators from other Ontario universities: Barbara Hamilton-Hinch, Lydia Kapiriri, Ojembe Blessing, Rita Orji, Salami Oluwabukola and Ingrid Waldron.
In addition to the CIHR project grant, BiRAVE has received funding from York University's Faculty of Health Collaborative/Community Research Seed Grant, the Connected Minds EDI funding and the Canadian Association on Gerontology New Investigator Award.
The research team is also working with 17 community organizations, including Black Creek Community Health Centre, Rexdale Community Health Centre, TAIBU, Sisterhood and Brotherhood Nova Scotia and Afrimama Manitoba.
In the long run, Kalu says BiRAVE's repository will serve as a centralized resource for researchers, clinicians and policy leaders, providing real-time insight into the social and health needs of Black community members.
"Because BiRAVE will be organized by local areas, data from the platform could help health authorities address health inequities in their region," he says, highlighting the project's focus on addressing real-world issues through community-informed and innovative approaches.
With files from Mzwandile Poncana