A provincial evidence-based approach to better support people experiencing bereavement in British Columbia

The impact of COVID-19 pandemic on the scale of bereavement and those bereaved is becoming apparent, with an estimated 9 people affected by bereavement for each COVID-19 death. Social distancing measures have decreased opportunities for people who are dying to connect with their loved ones, and for bereaved people to access social supports such as traditional rituals and support groups. A potential impact of this is prolonged or complicated grief.

This project aims to help bereaved people access effective supports. We propose hosting a provincial roundtable discussion, where every participant can contribute equally to a structured conversation on how existing bereavement services could be improved. We will invite service providers, bereaved people, policy makers, researchers, and others doing relevant work to participate in the roundtable. The discussion will be guided by recently collected information from bereaved people and service providers in BC about their experiences and views of bereavement care.

After the discussion, the participants will work together to recommend actions to improve the bereavement experience in BC. The recommendations can also be used to inform the development of supportive policies and future research.

Building capacity to reduce overdose among formerly incarcerated people in British Columbia

BC is facing dual public health emergencies of COVID-19 and a public health emergency of overdose, first declared in 2016. New interventions have been introduced to reduce overdose in BC, including efforts to decriminalize drug possession and the introduction of pharmaceutical alternatives to the toxic drug supply, known as “Risk Mitigation Guidance” (RMG) prescribing. RMG allows physicians to prescribe pharmaceutical medications (e.g. opioids, stimulants) to people at risk of overdose. While provincial evaluations of pharmaceutical alternatives are ongoing, little is known about the impact of these interventions on people who have been incarcerated, who face a disproportionate burden of overdose risk and mortality in BC, particularly in the weeks immediately following release from correctional institutions.

We aim to address this knowledge gap by convening a Peer Advisory Group of people with lived and living experience of substance use and incarceration. The group will advise on how data sources created in response to the 2016 public health emergency (BC-ODC) can be used to investigate interventions to reduce overdose, with attention to the unique and context-specific overdose risks faced by people who have been incarcerated.

Enhancing patient self care and management of atrial fibrillation within primary care

Atrial fibrillation (AF) is the most common heart problem causing an irregular pulse. Individuals who poorly managed their AF risk developing serious problems like stroke and heart failure. Self-care, is when individuals actively maintain health through health-promoting practices, health monitoring, and managing illness. Family doctors and nurse practitioners (primary care providers) provide most of the AF care in BC, and yet are often not able to support their patients’ self-care because of limited time and other more urgent problems. They need new ways to address AF self-care. Teaching patients to self-care for their AF can improve their quality of life, reduce their stress, increase their ability to stay on track with their treatment plan (taking mediations), and can prevent serious problems. This research will study ways to improve self-care practices in primary care by bringing together a group of doctors, nurses, patients and researchers to look at what we already know about AF self-care in the literature and what resources exist in BC to support self-care. Second, they will put together all this information and then have a meeting to identify some of the possible solutions to address AF self-care in practice and research.

Contraception and abortion in BC meeting: Experience guiding research guiding care

WHY: Access to abortion and contraception is a challenge in BC, particularly for underserved populations. Innovative models of care developed in response to the COVID-19 pandemic have potential to better meet BC’s needs. We aim to convene key stakeholders to discuss these emerging opportunities, learn best practices, identify policy solutions, and co-create a roadmap for equitable family planning in BC.

WHAT: BC Women’s Hospital and UBC’s Contraception & Abortion Research Team (CART) will convene a hybrid in-person/online one-day event. Top speakers will convey the latest evidence and interactive breakout circles will engage interdisciplinary invitees.

WHO: We will convene patients, Health Authorities, clinical administrators, Public Health and community services, government leaders, and urban and rural clinicians (physicians, NPs, nurses, midwives, pharmacists, social workers).

WHEN: March 4, 2022 from 8 a.m. to 4:30 p.m.

WHERE: Virtually via Robert H. Lee Alumni Centre, UBC

Anticipated outcome: The knowledge exchange and meaningful collaboration supported through this meeting will lead to co-development of new research priorities and policy opportunities that can directly impact equitable access to contraception and abortion care in BC.

Outdoor early childhood education summit: Pathways to licensing in BC

Research on outdoor early childhood education (ECE) indicates vast benefits to children’s health, development, and learning. Further, outdoor ECE helps solve challenges related to provision of universal childcare and managing COVID-19 transmission. It enables an equitable childcare solution that embraces land-based learning and Indigenous ways of being. Yet BC licenses only indoor facility-based care. We will plan a summit aiming to bring together researchers and research users, including practitioners, licensing officers and policymakers from the BC Government, health authorities, and Indigenous communities to collectively identify priorities to support a pathway to licensing outdoor ECE in BC. Key outcomes will include: 1) To embrace elements of nature-based education — in particular, those having to do with risky play and land-based learning; 2) To identify key research and practice priorities collectively to enable legislative changes for regulating outdoor ECE programs; 3) To co-create products that support KT of summit outcomes for outreach to diverse groups; 4) To strengthen relationships and partnerships among key stakeholders to facilitate collaboration beyond the proposed summit.

Co-design of a novel tendinopathy telerehabilitation intervention

Repetitive-use tendinopathy is a major cause of repetitive strain injury (RSI). An estimated one-third of workers’ compensation costs in industry are due to RSI of soft tissues, particularly tendons. In order to establish new treatments for RSI, Dr. Alex Scott established an innovative tendinopathy research program, funded through a MSFHR Scholar award from 2011 to 2019. His lab discovered that injured tendon tissue loses its toughness compared to healthy tendons. The lab then developed a new exercise program which uses real time biofeedback to achieve the key goal of regaining tendon toughness. This project will develop a home-based version of this exercise (see workplan for picture of prototype).

Our goal is to bring this new exercise intervention out of the lab and into the real world. The specific objective of this project is to engage in a collaborative co-design process with clinicians and patients to optimize our working model of the biofeedback exercise system and associated user interface (phone or tablet app). By engaging with patients and clinicians, as well as insurers and regulatory agencies, we believe that the end-product will better suit real-world needs and will be suitable for testing in a future efficacy study.

Reimagining gynecologic cancer survivorship: Creating a provincial strategy for survivorship research and care in British Columbia

In Canada, two-thirds of people diagnosed with cancer today will be long-term cancer survivors. With advances in early detection and improved treatment, and an ageing population, this number is expected to continue to rise highlighting the urgency for improved strategies to enhance the well-being of individuals, and their families, living with and beyond cancer. In partnership with patients and families, and the clinical and scientific community in BC, we plan to hold a series of stakeholder events and surveys that will address the impact of a gynecologic cancer diagnosis and treatment on the mental health, cognition, financial burden, and sexual health of those affected. We will also examine the impact of hereditary cancers and patient education/navigation to improve upon a patient’s journey through their cancer diagnosis and treatment. Through this work, we will map out the clinical and research resources available across the province to support a long-term research strategy and plan. By putting patient and family voices and experiences at the centre of the strategy, it will enable our research team to develop a provincial strategy that is biologically-relevant and socio-culturally informed.

Kitchen table justice: Co-developing Indigenous-informed food justice participatory action research strategy to support holistic health and redress health inequities with paroled women in BC

This grant will support research planning with women who have been recently incarcerated and will directly support future research guided by Indigenous approaches to holistic health and health equity through food-based program development. We will build relationships with paroled Research Users through the making and sharing of food, and the inclusion of Research Users, stakeholders and Indigenous Elders in all activities. Specifically, we will: (i) conduct a literature synthesis on the potentials of food justice to support holistic health equity for women on parole, and; (ii) meet bi-weekly to: (a) collaboratively develop a Terms of Reference and Governance Structure that outlines team roles and responsibilities and decision-making processes; (b) engage in co-learning about food-related health and social inequities to develop a shared understanding of the potentials of food to support health; and (c) explore potential solutions and actions to redress overlapping health, prison and food inequities. Additionally, we will: (d) collaboratively plan and develop a grant application to support subsequent research to co-develop a food justice health intervention with and for women leaving prison in BC.

Exploring Indigenous community access to airway health prevention and care: Towards the development of community-driven interventions

Indigenous peoples across Canada continue to be disproportionately impacted by respiratory diseases (RD) (i.e. asthma, COPD, long COVID); however, there is limited evidence describing their Indigenous peoples respiratory healthcare needs and ways in which respiratory healthcare services can be improved. Given this knowledge gap, this project seeks to engage Indigenous peoples with RD to understand their experiences living with RD; to explore Indigenous peoples’ healthcare experiences; and to identify promising practices that can improve the treatment experiences and outcomes among Indigenous peoples with RD. In order to accomplish this, we plan to hold a minimum of five talking circles with Indigenous peoples with RD across urban and rural areas of the Vancouver Coastal Health (VCH) region. A graphic facilitator will guide a journey mapping exercise with community members in order to understand community members’ experiences when attempting to access services, while also elucidating promising practices in the treatment of RD. In addition to the benefits that this project may have for the health of Indigenous peoples in the VCH region, findings also have implications for Indigenous peoples living in other parts of British Columbia.

Digital health to guide the transition to menopause: Recognizing normal and abnormal changes during reproductive aging

During the years leading up to menopause, women often experience menstrual cycle and flow changes. This is usually part of normal aging, but can also be the first symptom of endometrial cancer, the most common gynecological cancer in Canada. Few women are aware of the risk factors for endometrial cancer, can recognize abnormal bleeding, and/or seek medical help. Predicting cancer risk and determining which abnormal bleeding is associated with endometrial cancer is a top priority for clinicians and women alike, because if detected early, this cancer is curable and has exceptional outcomes. Digital health technology (e.g. mobile phones apps) and analytics can help women track and monitor risk factors and symptoms and be alerted when suspicious patterns arise. In this project, we will collaborate with women in the community, patients, clinicians, and women’s health researchers to co-design digital health tools that can help women learn about and assess their risk factors for endometrial cancer, discern symptoms of cancer from those of normal aging, and provide opportunities for education, prevention, and early detection, especially among women at high-risk for cancer.