People living in rural, remote, and Indigenous (RRI) communities face a disproportionate burden of chronic diseases yet have limited access to healthcare services. Often, this is due to shortages of healthcare workers in such areas. A rapid shift towards virtual care is markedly influencing how people access healthcare. However, adoption of digital technologies without consideration for health equity risks creating further disparities in health outcomes. Two novel virtual health programs have deployed âhybridâ approaches to health service delivery by blending in-person and team-based virtual care. These services honour relational virtual support built on collaboration, empathy, and cultural safety. A group of researchers, and research-users have formed the Hybrid Care Research Collaborative with the goal of integrating research within âhybrid careâ programs to understand the needs of healthcare providers and community members in RRI areas. This data-driven approach will enable the development of interventions and policies incorporating local knowledge and cultural perspectives. Our proposed planning activities will advance interprofessional rural health research and inform a long-term research agenda with community partners.
Award Partner: Pacific Public Health Foundation
Identifying research priorities to support the evaluation of âupstreamâ health promotion initiatives in British Columbia
Public health interventions that aim to reduce adverse health outcomes and promote population health are more likely to be effective when they address the social conditions in which people are born, live, and age. Increasingly more public health initiatives in BC are intervening at this âupstreamâ level, targeting public policies, systems, and structures that perpetuate health inequities. Evaluating the impacts of these initiatives introduces unique challenges, such as uncertain timing and multiple actors, that cannot be addressed with traditional evaluation tools. Yet, policy makers and health practitioners need evidence to determine whether they are doing the right things â and whether they are doing them right. Through a series of online consultations and an in-person Thought Exchange event, we will bring together researchers who evaluate upstream health promotion initiatives, and public health research users who use evaluation evidence to guide decision-making. Together we will investigate how upstream evaluation is currently being conducted in BC, where efforts can be coordinated to improve innovation and capacity, and what are the research priorities âmoving upstreamâ in the area of health promotion evaluation.
Co-developing research priorities to address digital determinants of health among historically marginalized populations disproportionately affected by sexually transmitted and blood-borne infections
As society becomes increasingly digital, some people are getting left behind because they may lack access or skills to use the internet or may not trust it. The effects of these âdigital determinantsâ of health (DDoH) may be particularly hard for communities that are already historically marginalized in British Columbia, including those with higher rates of sexually-transmitted and blood-borne infections (STBBI). This topic has not received a lot of attention in STBBI related research, even as related health services are increasingly âdigital-first,â and has only in the past year become a topic important to public health leaders in BC. Through this project we hope to understand this issue better. We will start by holding focus groups with people from these communities (e.g., people with lived experience of incarceration, people living with HIV) and representatives from the community organizations that serve them. From these discussions, we hope to better understand how DDoH affect their lives and how services are provided. We will then review these findings with peers, community organizations, and researchers in a two-day workshop to identify important research questions that will be the focus of future grant applications.
Enhancing Well-Being in the North: Co-Developing a Community-Based Participatory Action Research Strategy to support mental health & redress health inequities with precariously housed people in BC
This grant will support research planning with community health and social service providers and men, women and gender diverse people living at the margins of poverty, precarious housing and poor mental health in rural and remote northern BC. We will build relationships with both provider and people with lived experience (Research Users) through World Cafés, and the inclusion of Research Users in all activities. Guided by community-based, participatory approaches, we will: (i) conduct a literature synthesis on mental health promotion and housing strategies with a focus on remote communities; (ii) conduct a synthesis of recent community-led consultations with Research Users on the strengths and challenges of mental health care and housing support in their region; (iii) undertake 2 inclusive World Cafés with Research Users to share outcomes of the literature synthesis and consultations and generate key research priorities necessary to support optimal mental health and housing security. Collaboratively, we will plan and develop a CIHR grant application to support subsequent research to co-develop an intervention that simultaneously enhances mental health care and housing security for people precariously housed in rural and remote BC.
Cannabis Substitution of Alcohol as a Component of Managed Alcohol Programs: Co-Developing and Disseminating Research Evidence from a Recent Pilot Project.
We propose to come together with MAP site partners and people with lived and living experience of substance use to discuss findings from a recent pilot evaluation of cannabis substitution in MAPs, with the aim of contributing evidence to the well-established knowledge base for MAP. During this gathering, attendees will co-develop a KT strategy to package evidence for different audiences and plan to disseminate this evidence. Developing a KT strategy, including opportunities for knowledge mobilization, will support partners to review robust data related to cannabis as a harm reduction alternative to alcohol and other drugs, improve and sustain their current programs, and create evidence-based recommendations for other harm reduction organizations that want to implement cannabis substitution.
Our ultimate goal is to contribute to the development, implementation, and improvement of cannabis programs in harm reduction organizations, providing a safer alternative to alcohol and positively influencing the health of people with alcohol disorders. Dissemination of evidence will also grow the body of knowledge around cannabis substitution for other drugs, including opioids, to influence advocacy efforts and policy change.
Beyond Pills: Exploring Pharmacists’ Role in Long-Acting Reversible Contraception Services
Access to the most effective contraceptive methods (intrauterine devices or subdermal implants) is inequitable in BC. Many people are unable to reach a health professional able to insert them. Regulatory changes allowing BC pharmacists to prescribe contraception presents an opportunity to expand the role pharmacists could play to better meet BC’s needs.
BC Womenâs Hospital and Health Centre and our research team will host a one-day meeting of BC stakeholders and leaders to discuss any potential to expand the role of pharmacists to insert subdermal contraceptive implants. Participants will identify perspectives and provide insights on both the opportunities and facilitators as well as anticipated barriers and challenges associated with this potential expansion of pharmacy practice. A pre-meeting survey and series of stakeholder interviews (separately funded) will provide information to guide our discussion during the meeting.
Key sessions during the meeting will include interactive discussions and panels involving a diverse range of stakeholders, including health policy, regulatory and care leaders, patient groups, and health professionals. Conclusions from this meeting will inform potential next-steps to expand service access.
From Social Media Advertisement to Type 2 Diabetes Remission: Harnessing Innovative Social Media Strategies to Make Remission Possible in British Columbia
Type 2 diabetes (T2D) remission, which means that blood sugar levels return to sub-diabetes levels without taking any glucose-lowering medications, is achievable for many people living with T2D through changes to diet;lifestyle. T2D remission offers new hope to those living with diabetes and empowers them to make positive lifestyle changes. Despite this potential, many individuals living with T2D remain unaware that remission is possible. Our mission is to raise awareness and provide support for people living with T2D to help make Remission Possible across British Columbia.
The “Remission Possible” team includes researchers, doctors, people living with T2D, and social media experts to help share the inspiring stories of persons with lived experience of T2D remission through Facebook advertisements. Once people view one of our advertisements, they are directed to our website, www.DiabetesRemission.ca, where they find credible information on remission and can sign up for doctor-led programs designed to support them in their remission journey. Given the popularity of social media, this strategy can directly connect thousands of people who might benefit from T2D remission and guide them to programs that can help improve their health.
Art for connection and wellbeing: Integrated Knowledge Translation to support health literacy with and for men in prison in BC.
Our team, co-led by incarcerated Research Users, will strengthen, expand and finalize arts-based and trauma-informed health literacy content, in partnership with BC Researchers working to address overlapping public health emergencies that disproportionately impact people in prison and parole. Building on previously created digital literacy and art creation and inspiration content, our team will host two Health Fairs â an initial event in the community will welcome BC Health Researchers and trainees, and criminalized Researcher User-artists who will provide feedback and expert guidance on the accessibility and acceptability of presented public health information. Resulting knowledge will be captured using arts-based methods, and outputs will be uploaded onto Tablets and shared in a prison. A final Health Fair will be hosted in the prison, providing opportunities for health Researchers, Trainees and Research Users to strengthen shared understandings of prison health and public health emergency priorities, and empower health advocacy with and for people in prison. The Tablets will be left in the prison, and feedback mechanisms built into the software will support ongoing learning, reciprocal benefit and public health advocacy.
âA Day in the Life of a Longhaulerâ: Using Photography as a Tool for Long COVID Awareness
3.5 million Canadians (9% of the population) experience Long COVID symptoms. Every Canadian knows someone affected, whether it is a mild or disabling case, impacting family, friends, and communities. Many patients and the people who provide care for them have identified the need to increase awareness and recognition of Long COVID in Canada. Our project addresses this community-identified priority by using photography to showcase the visible realities of this âinvisible illnessâ in British Columbia.
“A Day in the Life of a Longhauler” is a photography exhibition co-produced and presented at the Museum of Vancouver that will display photos taken by Longhaulers (people with Long COVID) to highlight their daily lived experiences. To guide visitors through the exhibition, accompanying text integrated throughout the photo collection will provide information and resources about Long COVID. Opportunities for museum visitors to document their own experiences and feedback on the event and in the exhibition space will also be provided.
By using a community participatory arts-based approach we will promote education and informed discourse surrounding Long COVID to reduce shame and stigma, empower patient voices, and advocate for support.
Building an anti-oppressive gerontological social work community of practice in Canada in collaboration with researchers, practitioners, and older adults
To ensure social workers are adequately prepared to work in the context of the aging and increasing diversification of the Canadian population, we propose to host a symposium that brings together established researchers, emerging scholars, practitioners;educators, and older adults. The impetus for this gathering is the preparation of a second edition of Hulko, Brotman, Stern and Ferrer’s popular and nationally adopted 2020 Routledge Press text on anti-oppressive social work (AOP) practice with older adults, their families, and communities. Our book filled a gap as it was the first Canadian text on aging to use a critical AOP lens, focus on direct and indirect practice, and showcase the voices and experiences of older adults from equity-denied groups. While creating and marketing the first edition, we identified the need for a community of practice (CoP) as those working in this field are widely dispersed and have limited access to research and education on aging and older adults. Our intention is to grow a CoP like those that are emerging in other countries, and in doing so amplify the work of Black, Indigenous, racialized, and queer scholars whose work often gets overlooked and encourage them onwards as the next generation.