The 2S/LGBTQ ‘therapeutic spectrum’: Establishing a BC team and research strategy to connect 2S/LGBTQ people with affirming mental health practitioners

Finding affordable and accessible professional mental health support in BC is difficult. It can be even more difficult for Two-Spirit, lesbian, gay, bisexual, transgender, and queer (2S/LGBTQ) people, who must navigate mental healthcare with uncertainty about professionals’ attitudes toward 2S/LGBTQ identities and expressions. In this project, we will bring together a team of researchers, students, health professionals, and service users to start BC-based research on the spectrum of approaches adopted by mental health professionals in BC to affirm 2S/LGBTQ people. The project is based on our team’s experience with, a mental health service finder that prioritizes 2S/LGBTQ-affirming services. Using MindMapBC, we will invite professionals at various places on this spectrum (e.g. those already adopting affirming practices, and those who wish to adopt affirming practices but do not know how) to tell us what is needed to create more mental health services that meet the needs of 2S/LGBTQ people. We will take what we learn to launch research that further builds our ability to encourage professionals to develop 2S/LGBTQ-affirming practices and communicate these practices to the service users who seek them.

Team members: Meera Dhebar: she/her (Eagle Wellness); A.J. Lowik: they/them (Centre for Gender and Sexual Health Equity); Anita David: she/her; Jessy Dame: he/him (Community-Based Research Centre); Kinnon MacKinnon: he/they (York University); Milo Applejohn: he/they (Simon Fraser University); Miranda Tymoschuk: she/her (Simon Fraser University); Sarah Watt: she/her (Simon Fraser University); Travis Salway: he/him (Simon Fraser University).

Toward inclusive and meaningful partnership of South Asian communities in Fraser Health Long-Term Care and Assisted Living Research

Fraser Health (FH) serves an aging and ethnoculturally diverse population. In 2021, our Long-Term Care and Assisted Living (LTCAL) Research Team, embedded in FH, set up the LTCAL Research Partners Group to help guide research priorities for LTCAL and facilitate patient partnerships in research. However, we have had challenges recruiting members from ethnocultural communities to be involved in the Partners Group. This is problematic because ethnocultural groups are often left out of the foundational stages of research, which can result in studies that do not meet their needs. To address this gap, we want to identify barriers ethnoculturally diverse people may perceive or experience to meaningfully participating and ways they can be addressed. Our ultimate goal is to recruit two to three ethnoculturally diverse new members for the existing LTCAL Research Partners Group. To facilitate this, we will hold consultation dialogues with three different South Asian groups, the fastest growing ethnic community in the region, to obtain their insights about research, challenges to participation and what may help. These consultative activities will also help make inroads with these communities and build relationships with researchers and patient partners.

Team members: Karim Chagani (Long-Term Care and Assisted Living; Fraser Health); Leah Coppella (Simon Fraser University – Department of Geography); Tyler Cole (Simon Fraser University – Department of Geography); Akber Mithani (Long-Term Care and Assisted Living; Fraser Health); Suzanne Fox (Integrated Long Term Care and Assisted Living Services; Fraser Health); Susan Brown (Integrated Long Term Care and Assisted Living Services; Fraser Health); Ian Cameron (Long-Term Care and Assisted Living; Fraser Health); Janice Sorensen (Long-Term Care and Assisted Living; Fraser Health); Valorie Crooks (Simon Fraser University – Department of Geography); Emily Carpenter (Diversity and Language Services; Fraser Health); Alia Januwalla (BC SUPPORT Unit, Fraser Centre); Arun Garg (community-based physician); Rajeev Mohindru (Progressive Intercultural Community Services Society); Sherman Chan (Multilingual Orientation Service Association for Immigrant Communities).

A hot topic: Defining vulnerability, capturing resilience and learning lessons to support vulnerable groups adapt and respond to extreme weather in Victoria’s capital regional district

The summer 2021 heat wave caught British Columbians and many policy-makers by surprise. This project seeks to develop a research agenda and build community-engaged research partnerships to identify ways in which service providers, private businesses, governments and individuals can support vulnerable communities to avoid negative health outcomes associated with future heat events that occur in the Capital Regional District (CRD). Guiding questions include: Who in the CRD is most vulnerable to negative health impacts related to extreme heat events? What does the experience of extreme heat look like for these vulnerable groups? What recommendations do they have for supporting other members of their group during extreme heat events? These questions will be answered through secondary and primary research. Following a community-engaged research approach, the most appropriate methodology will be determined in collaboration with service providers and individuals with lived experiences to ensure we are accounting for diverse experiences of trauma and resilience. Project outcomes will include policy recommendations, data and stories for decision-makers to craft messages and communicate with the public to avoid heat-related harm.

Team members: Kirsten Mah (Capital Regional District; Summer Goulden; City of Victoria); Kristie Signer (City of Victoria); research trainee (University of Victoria).

Navigating Long COVID: Co-creating research priorities to understand and address the information needs of unpaid care providers in British Columbia

The pandemic has posed significant challenges to people globally. These dynamics have been complicated and prolonged by “Long COVID”, where those previously infected with the SARS-CoV-2 virus continue to experience symptoms for weeks to months after infection. Long COVID also affects unpaid care providers, including family and friends, who care for those with Long COVID. Beyond the many challenges that unpaid care providers face — such as lack of time and resources — the heightened uncertainty around Long COVID poses additional barriers to accessing information and supporting care providers and recipients. Our goal is to begin to address this important issue by convening a group of unpaid care providers, health care professionals (e.g. doctors, nurses), and research scientists in BC. Through knowledge synthesis and convening activities, we will identify priority research areas that will serve as the basis for co-created, collaborative research programs to bridge the gap in care provider access to information and Long COVID resources in the province. With an emphasis on relationship-building and strengthening, we will promote opportunities for continued collaboration among stakeholder groups beyond this proposal.

Team members: Stacey Dawes (Family Caregivers of British Columbia); Julia Smith (Simon Fraser University); Kiffer Card (Simon Fraser University); Anne-Marie Nicol (Simon Fraser University); Gina Ogilvie (UBC); Esther Khor (Provincial Health Service Authority); Niloufar Aran (Simon Fraser University); Alice Murage (Simon Fraser University).

Developing a collaborative research agenda to improve the care of patients living with metastatic breast cancer in British Columbia

Metastatic breast cancer (MBC) affects up to 30 percent of women with early breast cancer and represents up to 10 percent of new breast cancer diagnoses. It is one of the most common causes of death from cancer amongst females. The availability of new treatments has improved survival; however, the treatments are very toxic. There is a trade-off between managing treatment toxicity for these patients, in terms of extending survival and maintaining a decent quality of life. Constant treatment and monitoring are required; this results in a burden at the patient and at the health systems levels. Through a series of virtual meetings, we will bring together front-line cancer care providers, academic researchers, and patients and families to reflect and share their experiences about the MBC care in BC. The meetings will aim to discuss the facilitators and barriers to accessing specialized MBC care. Our goal is to establish partnerships, encourage knowledge exchange, and develop a collaborative research agenda to ensure quality care for individuals living with MBC in BC.

Team members: Stephen Chia (BC Cancer); Leah Lambert (BC Cancer); A. Fuchsia Howard (UBC – School of Nursing); Robert Olson (BC Cancer); Fiona Mitchell (BC Cancer); Scott Beck (BC Cancer); Jagbir Kaur (BC Cancer); Sara Izadi-Najabadi (BC Cancer); Nathalie LeVasseur (BC Cancer).

Undertaking the co-design of climate distress services for young people in British Columbia

This proposal aims to facilitate a new partnership between the Green Technology Education Centre (GTEC), the Mental Health and Climate Change Alliance (MHCCA/SFU), and youth and young adults, aged 16-24. Leveraging this partnership, we will convene and collaborate with youth to inform the development of potential GTEC campus- and digitally-based interventions for climate-related distress. The convening and collaboration activities will include two multi-stage focus groups and ongoing meetings between GTEC and MHCCA researchers. Each focus group cohort will consist of 6-12 young people, recruited through the MHCCA and GTEC professional networks and advertisements on Twitter and Facebook. Each focus group will be interviewed twice to: 1) Explore current reactions to climate change and 2) Develop ideas about educational and support services that GTEC can offer to support young people. These focus group interviews and ongoing meetings between GTEC and MHCCA team members will be leveraged to develop a CIHR project grant proposal that will aim to develop, pilot, and evaluate an intervention for climate change related distress among young people, aged 16-24.

Team members: Arden Henley (Green Technology Education Centre); Linda Thyer (Green Technology Education Centre); Andreea Bratu (UBC – School of Population and Public Health).

Mind the gap: Hormonal contraceptives and the brain

Hormonal contraceptives (HC) are used by 850 million girls, women and people with uteri — all reflected in the term women+ — , and 16 percent of people (5-49Y) in Canada. In addition to being contraceptives, HCs are prescribed off-label to treat many other conditions. Few studies have examined effects of these hormones on the brain; however, recent work suggests they can increase risk for mood disorders during adolescence and alter brain activation patterns. Yet, how HC use may influence long-term brain health is not known. Understanding brain health, especially through an equity lens, is critical. Women+ experience different brain health symptoms as a result of their unique experience of stress, which is impacted by age, gender, and race/ethnicity. Stress outcomes affect disease risk, which is also influenced by HCs. Collaborations between academics and research users are vital to understanding the unique ways that women+’s lives impact their brain health. This conference will explore how HCs influence women+’s brain health by bringing together researchers, clinicians, community partners, trainees, and policymakers to exchange knowledge and identify new research priorities that fill knowledge gaps and address patient experiences.

Team members: Katherine Moore (Women’s Health Research Cluster); Jesse Lacasse (Concordia University); Bonnie Lee (UBC); Jennifer Williams (McMaster University); Maureen MacDonald (McMaster University); Nafissa Ismail (University of Ottawa); Elizabeth Hampson (University of Western Ontario); Gillian Einstein (University of Toronto); Frances Chen (UBC); Sofia Ahmed (University of Calgary).

Bridging the knowledge-to-practice gap: Co-developing a Design Jam for building a Learning Health System at Vancouver Coastal Health

Vancouver Coastal Health (VCH) delivers over 150 programs and services in community settings across the region. Organizational learning to continuously improve health care is limited by the complexity of this delivery model, current policies and processes, barriers to coordinating data systems, and insufficient capacity for data analysis, and evidence mobilization to inform decisions. VCH is exploring the Learning Health System (LHS) framework to bridge the knowledge-to-action gap and our team aims to facilitate that effort. This proposed stakeholder engagement project — bringing together teams of researchers, VCH care providers and decision makers, patients, and community members — will explore practical strategies for co-creating a systemwide LHS for community health at VCH. Our objectives are to: 1) Organize a Design Jam to collectively identify stakeholder needs and priorities, system gaps, and actionable strategies for co-creating a Community LHS; and 2) Form a LHS Community of Practice to support long-term knowledge exchange and research collaboration. Through meeting these goals, our project will produce a shared vision, an action plan, and a Community of Practice to support the long-term co-development of a Community LHS at VCH.

Team members: Margaret Chen Mei Lin (UBC); David Hall (Providence Health Care); Brittany Bingham (Vancouver Coastal Health); Andreas Pilarinos (Vancouver Coastal Health); Shannon Field (Vancouver Coastal Health); Tracy Windsor (Canadian Mental Health Association); Elaina Moss (Canadian Mental Health Association); Steven Barnes (UBC); Sue MacDonald (VCH); Regina Casey (UBC); John Higenbottam (UBC); Andrew Day (Vancouver Coastal Health); Alexander Rutherford (Simon Fraser University); Stephania Manusha (Vancouver Coastal Health); Joleen Wright (Vancouver Coastal Health); Jae-Yung Kwon (University of Victoria); Ben Fair (UBC); Jas Dhahan (Simon Fraser University).

Improving access to breastfeeding support in interior British Columbia: A collaborative planning project

While breastfeeding has many health benefits for both infant and mother, many women and birthing people experience breastfeeding challenges. Insufficient supply, poor latch, and pain, as well as stigma and lack of support can impact breastfeeding goals. These challenges can be heavily influenced by social inequities, parental leave, and societal pressures, particularly among disadvantaged populations in Canada. It is important for postpartum people to receive breastfeeding support from healthcare professionals, especially during public health emergencies like the COVID-19 pandemic, where in-person contact is limited. Therefore, this C2 project will establish key networks and resources around optimal breastfeeding support in interior BC. Specific objectives are to build partnerships, conduct a needs assessment, and co-create a research agenda to develop and evaluate a virtual breastfeeding intervention study in this region. We expect to identify key aspects of virtual support that will create a thorough and meaningfully designed breastfeeding intervention study, which will ultimately lead to higher rates of breastfeeding rates, as well as improved user satisfaction and self-efficacy among parents and families in BC.

Team members: Elizabeth Keys (UBC – Okanagan); Rishma Chooniedass (UBC – Okanagan); Michele Hopkins (The Bridge Youth & Family Services); Ellen Boelcke (KCR Community Resources); Olivia Andrews (UBC – Okanagan).

A multi sector World Cafe to promote mental health of refugees in BC: A participatory realist evaluation project

The purpose of our project is to convene and collaborate with service users, health practitioners, settlement service providers, and policy makers in a series of deliberative dialogues and a multi-sector World Cafe to co-develop a program theory about integrated mental healthcare services for refugees. The global humanitarian refugee crisis has highlighted refugees as one of the most vulnerable population groups requiring integrated mental health services and supports. However, the COVID-19 pandemic has stressed healthcare systems in providing equitable, gender sensitive, language appropriate and trauma and violence informed care to diverse refugees resettled in Canada. Integrated care can improve clinical and organizational outcomes for more effective health services but limited knowledge exists on what promotes integrated mental health care for refugees, how it works, for whom and in what contexts. Convening multidisciplinary stakeholders is an important step to building a program theory and how it works. Our approach will develop an evidence informed model that will later be used and tested across multiple primary health care and social service settings to improve mental health service and promote refugee mental health.

Team members: Simon Carroll (University of Victoria); Suzanne Huot (UBC – Faculty of Medicine); Anita David (patient partner); Cindy Quan (University of Victoria); Eliseo Verdugo (University of Victoria); Maura Macphee (UBC); Sara Hosseina (New Canadian Primary Care Clinics); Karen Davison (Kwantlen Polytechnic University – Health Sciences); Vidhi Thakkar (University of Victoria; Victoria Hospice Society); Mikhail Torban (Ministry of Mental Health and Addictions); Brandon Hey (Mental Health Commission of Canada); Niels Agger-Gupta (Royal Roads University); Frank Cohn (VAST Refugee Mental Health Services Vancouver); Pamela Toor (REACH Community Health Centre).