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)

Co-developing a digital health systems research program to support cultural safety and health equity for Two-Spirit, transgender and nonbinary patients in British Columbia

Better and more inclusive care is dependent on including patient perspectives or “voice.” Yet, patient voice is rarely included in the design, modification or implementation of digital health systems (DHS) such as patient portals or electronic health records. As a result, DHS are rarely embraced by patient populations who could have the greatest benefit.

For Two-Spirit, transgender, nonbinary and other gender-diverse people (Trans+), this lack of voice is made worse by inaccurate DHS representations of gender identities. Negative healthcare experiences can discourage Trans+ patients from attending or returning for future visits.

Our collaboration includes Trans+ people, Trans Care BC, and other researchers. We will co-develop a program of research that brings patient voices into the design, modification, and implementation of DHS. The project extends our ongoing work to improve representation in DHS. This project is timely given the provincial government’s recent implementation of Health Gateway, a patient-accessed DHS allowing patients access to their health records.


Team members: Lorraine Grieves (Provincial Health Services Authority); Marcy Antonio (University of Victoria); Francis Lau (University of Victoria); Lindsay MacNeil (Trans Care BC); Quinn Bennett (Trans Care BC); Kelly Davison (University of Victoria); Roz Queen (University of Victoria); Aaron Devor (University of Victoria); Patient Partner TBA (Community Member)

Cancer and aging research engagement: Identifying priorities to enhance research and care of older adults with cancer and their caregivers

Cancer is most common amongst older adults. Older adults with cancer have distinct needs due to underlying health conditions and social situations, which may include a lack of social and financial supports. These factors often affect their ability to manage treatments, cope with treatment side effects, and make health care decisions. For older adults who do not speak English, have limited knowledge about the health care system, or have poor understanding of health or illness; navigating the cancer system is even harder. Older adults are often cared for by informal caregivers, such as family members, due to limited resources or services available to support older adults with cancer in the community. Caregivers face challenges trying to balance their caregiver role, not only for the older adult, but also for their younger dependents; work; and their own health needs.

Through virtual meetings and priority setting work, we will achieve the following goals: establish partnerships between older adults, caregivers, and diverse seniors’ groups; identify key research priorities to improve cancer care for older adults and their caregivers in BC; and develop a five-year research agenda to improve care for older adults with cancer.


Team members: Caroline Mariano (BC Cancer); Bonnie Leung (BC Cancer); Lorelei Newton (University of Victoria, and Canadian Association of Nurses in Oncology); Daniel Renouf (BC Cancer); Sabrina Wong (UBC); Lisa Quay (Jewish Community Centre); Keiko Funahashi (Tonari Gumi); Anthony Kuperschmidt (West End Seniors Network)

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.


Team members: Siv Klausen (UBC); Nancy Cleveland (Gynecologic Cancer Initiative); Nicole Keay (Gynecologic Cancer Initiative); Stephanie Lam (UBC); Jocelle Refol (Simon Fraser University); Gavin Stuart (UBC); Michelle Woo (UBC); Nicole Prestley (Women’s Health Research Institute); Lori Brotto (Women’s Health Research Institute); Janice Kwon (UBC)