The avian influenza virus H5N1 is shed in infected birds’ saliva, mucous, and feces. Still, other infected animals may shed bird flu viruses in respiratory secretions and other body fluids (e.g., cow milk). The virus can spread rapidly through poultry flocks and among wild birds. Thus, developing diagnostic tests to identify the virus at early stages before dissemination is crucial to contain a pandemic at early stages.
Detecting pathogens during a pandemic has mainly been based on PCR amplification. Although PCR is relatively fast, samples must undergo a lengthy extraction process, especially for environmental samples. Sequential sequencing also requires highly trained personnel, expensive equipment, and specialized facilities. Thus, the current project will develop a rapid test for the surveillance of H5N1 in human communities, point-of-care settings, animal farms, water supply, sediments of wetlands, farming- and human-derived sewages, animal processing plant sewage, and personnel working in animal husbandry.
The project will take place in BC. The project will develop engineered antibodies against the virus H5N1. These antibodies will be used to generate a rapid test. Samples from different environments, such as water supply, sediments of wetlands, farming- and human-derived sewages, animal processing plant sewage, etc., will be sampled, analyzed, and validated by the BCCDC using PCR techniques. The impact of the rapid test will be a fast delivery across the province for the early detection of the H5N1 virus to contain the dissemination and allow better management of the disease.
Since 2021, North America has experienced devastating outbreaks of Highly Pathogenic Avian Influenza virus (HPAIV) driven by HPAIV H5N1 clade 2.3.4.4b. Recently, it has spilled over into dairy cattle in the USA, raising concerns about its adaptation to mammals and potential human spread. Wild birds are the natural carriers of avian influenza viruses (AIV), but H5N1 can also infect wild mammals. Current HPAIV surveillance programs sample dead wildlife and use molecular methods that only detect active infection, underestimating the true number and distribution of infected animals. Serological tools measure antibodies from previous exposure and not active infection. However, current serology assays are not specific for HPAIV H5N1, can only be used in a limited number of species, and/or are too complex for large-scale implementation. To address this challenge, the BC based leadership team (Dr. Agatha Jassem at UBC/BC Centre for Disease Control and Dr. Chelsea Himsworth at BC Ministry of Agriculture) will design a new assay to detect antibodies specific for AIV. The test will detect multiple subtypes in one sample and can be used on different animal species with confirmatory testing done at the Canadian Food Inspection Agency (Dr. Yohannes Berhane) and cross-validation at Public Health Ontario (Drs. Maan Hasso and Vanessa Tran). This research will generate a standardized test crucial for nationwide comparative analyses. Its species independent nature allows for easy use in domestic animals and humans as needed, providing crucial insights into antibody reactivity, cross-reactivity, and infection reservoirs.
GetCheckedOnline is a digital service in British Columbia that allows people to get tested for sexually transmitted infections (STIs) without visiting a clinic. It has been successful in reaching people who face challenges accessing traditional healthcare. As the program continues to grow, it is important to find ways to keep its benefits accessible to everyone while managing resources effectively. This project will examine evidence from similar programs elsewhere, analyze GetCheckedOnline’s existing data, and conduct interviews with those involved in running the program. Our goal is to develop a plan to ensure GetCheckedOnline remains sustainable and well-integrated within the broader health system, continuing to serve all residents of British Columbia effectively.
Big data science is becoming more prominent in many fields, including HIV. Data science utilizes electronic data already collected from multiple health sources, including administrative health data, i.e. data produced at each encounter with the healthcare system for administrative or billing purposes. Historically, active participation by People Living with HIV (PLHIV) has been pivotal to HIV research. However, data science has largely excluded PLHIV participation. It is established that community engagement is a matter of ethics and improved science, and it is problematic that this practice is underdeveloped in data science. Knowledge creation through data science brings two important shifts from traditional community-engaged research: data are typically not collected for research purposes, and opportunity for research collaboration comes after data collection. There is a need to develop new ways to engage people with lived/living experience in this form of research. This project brings together a team of older adults living with HIV, data scientists, clinicians and social scientists. We will examine how to authentically engage community members in data science while piloting community-led administrative data research. Our research investigates rates of survival from, and recurrence of, cardiovascular events among PLHIV compared to people without HIV in BC. Research about recurrence of cardiovascular events for PLHIV, particularly in Canada, is lacking.
The goal is to build a framework for researchers to engage community in data science for improved health outcomes among PLHIV in BC and British Columbians generally. We also hope to help reframe big data science research from an extractive to a collaborative process for more impactful research elsewhere.
This Health System Impact Fellowship is co-funded by the Canadian Institutes of Health Research, Michael Smith Health Research BC, and the BC Ministry of Health (health system partner), to help build BC’s health policy research capacity for the integration of policy research into decision-making. Gender-affirming care is a fundamental right supported by the Canadian Charter of Rights and Freedoms. In this project, the BC Ministry of Health will collaborate with a research team at Simon Fraser University and Two-Spirit, Transgender, Non-binary, and Gender Diverse (2STNBGD) community members to explore what it means for 2STNBGD people to feel safe in reproductive health care spaces and use these insights to collaboratively create resources designed to promote safety.
Inappropriate use of antipsychotic medication has been recognized as a concern in long-term care (LTC) in Canada. VCH is committed to reducing inappropriate antipsychotic medication use in LTC through implementing a strategic plan developed by the BC Ministry of Health. VCH leadership identified understanding the barriers and facilitators of implementing the strategies as their priority to spread the learnings to LTC across VCH and other parts of BC. The research aims to examine the facilitators and barriers to implementing the strategies for reducing antipsychotic medication use in LTC. It will adopt a mixed-method design, including rapid review, semi-structured interviews, and pharmacy data analysis. The anticipated findings will help to identify facilitators and barriers to implementing the strategies for reducing antipsychotic medication use in LTC. The potential impacts will include: 1) support and enhance the implementation of the antipsychotic medication use strategy in LTC, 2) reduce the inappropriate antipsychotic use in LTC and enhance the safety and quality of care to residents, and 3) promote learning for sustainable and continuous quality improvement for LTC patient care, and 4) ensure the efficient and effective use of resources by investing in strategies that work.
This research proposal aims to enhance the assessment and monitoring of water distribution systems in British Columbia (BC). Water distribution systems (WDS) are crucial for public health, delivering drinking water from treatment plants to consumers. However, these systems often face challenges such as microbial contamination, cross-connection, corrosion, disinfectant byproducts, and physical integrity issues that can degrade water quality.
BC faces unique challenges, including microbiological quality issues, infrastructure complexities, drought, and climate change effects on infrastructure. These challenges can lead to WDS breaches impacting potable water quality, pathogen regrowth, biofilm formation, and external contamination. Heavy metal and chemical contamination due to pipe corrosion or accumulation from source water also poses a risk.
Existing provincial drinking water guidelines do not provide consistent advice to BC health authorities for assessing and monitoring WDS, as highlighted in the 2024 Provincial Health Officer’s Drinking Water report. This project aims to fill this gap by developing evidence-based best practices for the BC Ministry of Health to develop adequate guidelines. The project is funded by the Canadian Institutes of Health Research Health System Impact program with the contribution from Health Research BC and Michael Smith Institute. In this research, the project benefits from the collaboration of the BC Ministry of Health and the University of British Columbia to develop evidence-based best practices for the management of BC WDS.
Heart failure is a complicated medical condition that decreases patients’ quality of life and life expectancy. It is recommended that patients with heart failure receive care, and have their medications managed, by specialized heart failure clinics. However, heart failure clinic teams are different across the province (for example, only some teams have a pharmacist) and not every patient with heart failure has access to one of these clinics. This research will determine if there is a better way to manage heart failure medications in British Columbia. This could mean creating a standard team of healthcare providers for these clinics or better promoting heart failure care outside of these clinics (such as by family doctors). The results of this research will be used by Cardiac Services BC to decide how to best improve heart failure medication management across British Columbia.
This research has been generously funded by Health Research BC, Canadian Institutes of Health Research, and Cardiac Services BC through a Health System Impact Fellowship. Dr. Ricky Turgeon (Assistant Professor at the University of British Columbia’s Faculty of Pharmaceutical Sciences), Kelly Mackay (Senior Director Provincial Quality with Cardiac Services BC), and Dr. Nathaniel Hawkins (clinician-scientist cardiologist and Associate Professor at the Unive
Family physicians (FPs) are the first point of contact in the community, providing comprehensive care as an integral part of the healthcare system. However, twenty percent of Canadians cannot access a regular FP, which does not meet the population’s needs and is an unfair service distribution. FPs are being challenged by the growing demand on their time for administrative tasks, which impacts their well-being. Third-party forms such as sick notes and disability forms place an unnecessary burden on the health care system, particularly with staff shortages, and they take away from the time FPs spend with patients. This research project will evaluate strategies to reduce FPs’ administrative burden, potentially increasing patient appointments and improving FPs’ workflow and work-life balance. The economic evidence generated from this research will strengthen policy arguments and guide decisions on reducing administrative burden.
This project was funded by the Health System Impact Fellowship from CIHR and is being conducted in partnership with Health Research BC. The doctoral student leading this project is Hayley Lawrence from the School of Population and Public Health at UBC. She will work with Dr. Craig Mitton, whose research focuses on applying health economics to impact health policy, and Christina Krause from Health Quality BC.
Cystic fibrosis (CF) is a leading genetic disease in Canada, particularly prevalent in British Columbia. The treatment of CF is complex, requiring multiple medications and therapies. The recent introduction of Elexacaftor/Tezacaftor/Ivacaftor (ETI), marketed as Trikafta®, has shown significant potential in improving lung function and quality of life for People with CF (PwCF). However, as PwCF experience symptom relief from ETI, many reduce or discontinue traditional inhaled therapies. The potential risks associated with stopping these established treatments are not well understood.
This study will evaluate the impact of ETI therapy on medication use, lung function, and healthcare costs among PwCF in British Columbia. By analyzing connected health data, the study will compare outcomes for PwCF before and after starting ETI, as well as against non-eligible CF patients and healthy individuals. This research addresses a critical knowledge gap regarding the safety and implications of reducing or discontinuing older therapies in favor of ETI, with a focus on the long-term effects on health outcomes and healthcare costs.
