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.

Co-creating Fraser Health’s partner-centred long-term care and assisted living research priorities

The COVID-19 pandemic has shown failings in the care provided to older adults in care homes and a clear need for the voices of residents and their family to inform positive change. A group of residents, their family and friend carers, staff, physicians, nurses, leaders and researchers in care homes at Fraser Health will work together to agree on the most important research questions for people that live and work in care homes to improve the care that is given. Priority setting activities will be held with the goal to discuss key research topics and decide together the most important research questions in care homes at Fraser Health. Undertaking these activities also will build strong relationships between the different partners. The activities will be conducted so that the different partners in care homes, such as residents, their family and friend carers and staff, can contribute to the talks about research that is most important to them. The different research partners will also talk about plans for ongoing research projects to answer the top research questions together in the care homes at Fraser Health.

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.

Developing a roadmap for nurse-assisted injection in BC’s supervised consumption services

Supervised consumption services are an essential part of health care and community services for people who use substances in British Columbia. These services are particularly important for people who inject substances because they offer a safer place to inject and an opportunity to access harm reduction supplies, connect with resources, and receive care if needed. Using in a supervised consumption services can make the difference between life and death in the context of the overdose crisis because staff can quickly detect an overdose, administer naloxone, and call emergency services. Therefore, it is essential to remove any barrier that may prevent people who inject substance from accessing such services. One barrier that is consistently reported is the lack of assistance for people who need help injecting. Nurses are not currently allowed to provide any assistance. This project is designed to explore this issue and find ways to improve access to supervised consumption services for people who need help injecting.

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.