Understanding and mitigating the impact of COVID-19 on the mental health of parents and caregivers of children and youth with support needs in British Columbia

This Child, Youth & Family Mental Health Impact Grant is co-funded through a partnership between Mental Health Research Canada, Michael Smith Health Research BC, and the BC Ministry of Children and Family Development.

While COVID-19 has affected the mental health of all Canadians, those with complex family needs have struggled even more. The strain is especially great on parents and caregivers of children and youth with support needs experiencing (or at risk of) developmental delay or disability.

Research studies about the impact of the pandemic on parental mental health tend to view parents of children with support needs as a homogenous group, or they tend to explore separate diagnostic categories (such as Autism Spectrum Disorder and medical complexity).

Lead investigators Dr. Jennifer Baumbusch and Angela Clancy will not replicate existing studies but will extend what is currently known, particularly in the context of British Columbia.

The investigators and their team will compare mental health impacts with a larger pan-Canadian sample. They will also compare mental health impacts within the sample of parents of children with support needs based on diagnostic categories, individual factors of parent and child (such as gender, age, race, ethnicity, education, family structure and household income), and community factors (such as geographic location and size of community) — and compare between these categories.

The goal is to identify specific strengths and vulnerabilities of different sub-groups that can be used to customize supports.

The BC research team will also explore existing knowledge about programs (such as peer-to-peer and one-on-one counselling) and promising practices (such as virtual/tele-health and enhanced respite) that help mitigate mental health impacts and foster family resilience.

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 friends 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.


Team members: Adriaan Windt (Fraser Health); Laura Kadowaki (Simon Fraser University); Lucy Kervin (Simon Fraser University); Emma Leong (Kwantlen Polytechnic University); Annette Berndt (Fraser Health); Catherine Youngren (Fraser Health); Akber Mithani (Fraser Health); Suzanne Fox (Fraser Health); Clayon Hamilton (Fraser Health and Simon Fraser University); Valorie Crooks (Simon Fraser University); Nick Petropolis (Fraser Health); Amber Jarvie (Fraser Health); Gita Rafiee (Fraser Health); Anita Wahl (Fraser Health); Dan Levitt (Tabor Home Society)

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.


Team members: Marney Thompson (Victoria Hospice Society); Kathleen Yue (BC Centre for Palliative Care); Rachel Carter (BC Centre for Palliative Care); Nicolas Starkes (UBC Okanagan); Heather Mohan (Camp Kerry Society); Jessica Lowe (BC Bereavement Helpline); Shelly Cory (Canadian Virtual Hospice); D’Arcy Wingrove; Annette Berndt

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.


Team members: Tim Gauthier (Nurse Practitioner); Kirstin McLaughlin (University of Victoria); Sandra Ka Hun Chu (HIV Legal Network); Virginie Dalpé (Université de Montréal)

 

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.


Team members: Ana Becerra (BC Centre for Disease Control); Helen Brown (UBC); Jane Buxton (BC Centre for Disease Control); Ruth Elwood Martin (UBC); Kurt Lock (BC Centre for Disease Control); Tonia Nicholls (UBC); Erin Wilson (University of Northern British Columbia); Chloe Xavier (BC Centre for Disease Control); Sofia Bartlett (BC Centre for Disease Control); Cameron Geddes (UBC); Heather Palis (BC Centre for Disease Control); Marnie Scow (UBC); Chas Coutlee (Indian Residential School Survivors Society); Nicholas Crier (UBC’s Transformative Health and Justice Cluster); Jade Hoffman (Prince George Urban Aboriginal Justice Society); Patrick Keating (UBC’s Transformative Health and Justice Cluster ); Jenny McDougall (BC Centre for Disease Control); Rick Meier (Coalition of Substance Users of the North); Elder Roberta Price (UBC’s Transformative Health and Justice Cluster); Glenn Young (Unlocking the Gates Services Society); Pam Young (Unlocking the Gates Services Society); Andrew Ivsins (Ministry of Mental Health and Addictions); Carrie McCully (BC Corrections); Angus Monaghan (BC Mental Health and Substance Use Services); Justine Patterson (BC Mental Health and Substance Use Services); Kathryn Proudfoot (BC Mental Health and Substance Use Services); Vijay Seethpathy (BC Mental Health and Substance Use Services)

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.


Team members: Louann Janicki (Interior Health); Ryan Wilson (UBC Okanagan); Peter Loewen (UBC); Nelly Oelke (UBC Okanagan); Norma Hilsmann (UBC Okanagan); Jessica Baskerville (South Okanagan Similkameen Division of Family Practice); Kim Orwaard-Wong (Interior Health); Kristi Maltby (Interior Health); Cameron Towle (Interior Health); Robert Janke (UBC Okanagan); Ryan Tooby (Divisions of Family Practice – Bella Coola); Tannis Andersen (Interior Health); Pam Hruska (Interior Health); Kaylee Neill (UBC Okanagan); Denis Decleva (AF Patient); Beth Whalley (Central Okanagan Divisions of Family Practice)

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.


Team members: Cheryl Davies (BC Women’s Hospital and Health Centre, and Provincial Health Services Authority); Wendy Norman (UBC); Regina Renner (UBC); Natasha Prodan-Bhalla (Chief Nurse and Professional Practice Officer); Glenys Webster (Women’s, Maternal and Early Childhood Health); Ann Pederson (Interim Executive Director); Michelle Fortin (Options for Sexual Health); Unjali Malhotra (First Nations Health Authority); Madeleine Ennis (UBC); Ali Fuchshuber (UBC); Laura Schummers (UBC); Kate Wahl (UBC); Zeba Khan (UBC and Options for Sexual Health); Carly Rivers (Contraception and Abortion Research Team); Ama Kyeremeh (Contraception and Abortion Research Team)

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.


Team members: Shelley McClure (Northern Lights College); Rachel Ramsden (UBC); Iris Berger (UBC); Enid Elliot (Camosun College, Early Learning and Care); Glynnis Schwan (Island Health and Community Care Facilities Licensing); Lily Patzer (Aboriginal Head Start Association of BC); Belva Stone (Muddy Boot Prints Outdoor Learning Program); Hartley Banack (UNBC); Kailee Hirsche (UBC)

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.


Team members: Chris Napier (Sports Physiotherapy Canada); Kohle Merry (UBC); Jackie Whittaker (UBC); Rob Morgan (Independent Contractor); Carol Kennedy (Treloar Physiotherapy Clinic); Megan MacPherson (UBC); Bilal Al Momani (Internet of Things Lab, Mohawk College); Brad Wheeler (UBC); Pierre Guy (Vancouver Coastal Health); Dianne Millette (College of Physical Therapists of BC); Maya Butterfield (RA/QA Consulting); Joan Weir (Canadian Life and Health Insurance Association)

Sharing the podium: Identifying solutions to meaningfully collaborate with youth in mental health and substance use research

Mental health and substance use (MHSU) are key health concerns for youth in British Columbia. Involving youth in research for these topics improves the development of MHSU interventions and solutions. However, youth may not want to engage in MHSU research due to concerns about confidentiality, stigma, and other barriers. Researchers may also perceive barriers in finding and working with youth researchers.

Our project goal is to identify barriers for youth engagement in MHSU research and recommend solutions for these issues. Two key activities will be used to bring together youths and researchers to identify the perceived barriers for each group and how these barriers can be overcome. These activities include a small-group discussion (utilizing nominal group technique) and a World Cafe. Our team will synthesize these results and outline a list of recommendations for youth engagement in MHSU research. We also plan to use this output to pursue additional funding for a pilot study using these recommendations. The pilot study would measure changes in youth research engagement and research outcomes due to the recommendations.


Team members: Dan Nixon (Providence Health Care and Foundry); Krista Glowacki (UBC); Kirsten Marchand (Providence Health Care and Foundry); Nikki Ow (UBC); Travis Salway (SFU); Hasina Samji (SFU); Steve Mathias (Providence Health Care and Foundry); Renee Cormier (Providence Health Care and Foundry); Anne Gadermann (UBC); Sarah Munro (UBC); Amanda Butler (Providence Health Care and Foundry); Chloe Gao (UBC)