Developing a research agenda to support northern internationally educated nurses return to the healthcare workforce

The nursing workforce is in crisis. The BC government’s commitment to health workforce strategy highlights that a systemic approach supporting nurses with international education (IENs) living in British Columbia returning to the workforce needs to be updated and strengthened. The proposed activities are based on this need and call for a learning system approach to workforce planning, including building capacity for IEN networking, education, recruitment, and retention. Applying learning systems principles to co-create a nimble northern post-secondary-health authority partnership will require effective teamwork to develop a research agenda on IEN access to education to support workforce sustainability. To use evidence to guide IEN programming in northern BC, we intend to invite provincial partners and stakeholders and facilitate a face-to-face meeting, followed by four online group meetings. Participatory techniques will be used in these sessions to explore the practicality of original and creative solutions for IEN nurse assessment, education, and employment in the north. Finally, we will focus on determining ways to improve IEN systems in practice, research, and policy across BC.

Rising Up: Collaborating with Chinese Families and Communities to Promote Mental Health Literacy

Many Chinese families living in BC struggle in silence to support their child’s mental health. Most resources are available only in English and were developed without cultural knowledge about mental health or related considerations of stigma. In this project, we begin to address this gap by partnering with Chinese families and community agencies to co-design resources that are culturally-meaningful, engaging, and effective. To start, we will work with a committee of Chinese caregivers and community providers of children aged 3-13y to promote mental health awareness early on in childhood.

We will co-host workshops with 2 activities to gain information and feedback about (i) existing resources, and (ii) what mental health information is needed and how they wish to receive it. The workshops will be offered both in-person and online, across daytime, evening and weekend hours, so people from different locations and schedules can attend. We will make special efforts to include a balance of mothers, fathers and grandparents. We will identify key themes and top priorities from the discussions to guide future steps towards co-developing culturally appropriate mental health resources for Chinese families.

Partnering to improve early identification and early intervention for children with developmental coordination disorder

Developmental Coordination Disorder (DCD) is a common condition that significantly interferes with a child’s ability to learn motor skills. Without treatment, these motor challenges can persist into adulthood and limit job opportunities, affect physical and mental health, and impact quality of life. Early identification and intervention are crucial to change this negative trajectory.

More than 50,000 children in BC may have DCD, but most of these children are unlikely to have a diagnosis or receive therapy. Our survey of BC parents of children with DCD showed that they first identified concerns about their child’s motor skills at age 3 years, but did not receive a diagnosis until age 8, missing a critical window for early intervention. Parents also identified significant barriers to accessing therapy for their child.

In this project, we will bring together a diverse group of parents, researchers, health organizations, and clinicians to determine how to streamline early identification and improve access to early intervention. We will hold a series of meetings with these key partners to identify research objectives and co-develop a grant application to implement and evaluate early interventions for children with DCD.

Community-Engaged Solutions for Recognizing and Responding to Overdose-Induced Brain Injury

Toxic drug poisoning is British Columbia’s longest standing public health emergency. April 2023 marked the 31st consecutive month in which at least 150 lives were lost to unregulated drugs in BC, many of these deaths occurring on Vancouver Island. Research on hypoxic brain injury—a type of brain injury in which the brain does not get enough oxygen—after overdose survival, including work done by our team, raises two pressing questions: How do we recognize brain injury after non-fatal overdose occurs? And how do we best support individuals who experience brain injury after non-fatal overdose? Our proposed work aims to address these critical issues by leveraging the knowledge of researchers, people with lived experience of drug-related brain injuries, and community leaders who support them, to build priorities for future research and produce a community-driven list of recommendations for recognizing and responding to hypoxic brain injury after non-fatal overdose. Through a World Café workshop and follow-up prioritization survey and consensus meeting, our goal is to collaboratively create recommendations for research and practice, ensuring a comprehensive and inclusive approach to service provision on Vancouver Island.

Centring the margins: forging an equitable path for early childhood well-being in Canada emerging from the Covid era

It is well known that the period starting at pregnancy and ending with the start of kindergarten sets the stage for how children learn, experience the world, and grow into adults. In our current society, there are many people whose children have unfair disadvantages in their opportunities in these first years, for reasons parents can’t control. These reasons can include things like living in poverty, experiencing racism having a disability, or using drugs.

It can be hard for researchers and people that make government decisions to hear what is really important to people that have these unfair disadvantages. This means that they can’t solve problems or create programs that are helpful to these families.

This project will bring together researchers, people that make decisions in government, community program workers, and community members to work together to identify:

1) What are the most important topics to research to help all kids be healthy, especially those with less advantages
2) How should these research projects receive input from communities during the process

The team hopes that this will help all kids, especially those that already have unfair disadvantages, to lead happy and fulfilling lives.

Ethicolegal implications of screening for intimate partner violence-caused brain injury: Co-creating research priorities and practice recommendations

Brain injury (BI) is known as an invisible injury. Intimate partner violence (IPV) is equally invisible, often happening behind closed doors with no witnesses. Almost half of women in Canada report experiencing at least one incident of physical or sexual violence at the hands of a partner in their lifetime, and as many as 92% of women who seek help from abuse at a hospital emergency room or a women’s shelter may have experienced a BI. IPV-caused BI is a public health emergency, overdue for research and attention.

BI can have chronic and devastating health implications. Our research indicates it may also be weaponized against a survivor in family court where custody of, or access, to children is contested, based on assertions the injury makes a mother unfit to parent.

In this project we will bring together experts from legal, community, and health care-focused agencies, to review the research findings, and analyze and prioritize their attendant recommendations. In response, our team will conceive, draft, and disseminate an action plan and position paper designed to inform future research and practice, and spark system change with the hope that this will result in better outcomes for survivors.

A partnership for PaRX: Developing a road map for evaluating and expanding implementation and sustainability of a national parks prescription program.

There is a growing body of evidence that indicates that time in nature has a wide range of health benefits. Both physical and mental health improve, even just temporarily, after time spent outdoors in a natural environment. This has led to the development of nature-based prescription programs. In Canada, a BC based initiative, PaRX is Canada’s first evidence-based nature prescription program. Licensed healthcare providers in Canada can register with the program and provide evidence-based prescriptions to their patients to spend more time in nature. Despite PaRX’s evidence-based design, the program itself has not yet been evaluated for its reach, usability, or effectiveness. Given the comprehensive health benefits of time spent in nature, we have assembled a team of researchers with a wide range of expertise including physical activity, mental health, neuroscience, and physiology. This team of researchers will partner with the BC Parks Foundation who deliver PaRX, and a licensed family physician to develop an evaluation strategy for the short- and long-term to ensure high-quality nature prescriptions that benefit health are available and accessible to residents of BC and throughout Canada for years to come.

Creating and sharing innovative models for language interpreter services and cultural bridging in health care: A health equity approach

In many areas of healthcare, language interpretation and cultural brokering services either do not exist or are underutilized. As a result, newcomers avoid healthcare, receive less adequate healthcare due to lack of understanding, or experience additional risks due to reliance on family members for interpretation services. As a result, newcomers’ healthcare needs are inadequately addressed across primary care, urgent care, mental health care, and acute care contexts. This can lead to poorer health outcomes and significant costs to newcomer families and to our healthcare and social systems. Our proposal addresses these healthcare inequities for newcomers. Overcoming access barriers remains a human rights issue provincially and across Canada. Building on our teams’ longstanding collaborations across the Capital Region, we will collaboratively identify promising practices related to navigating provincial and local language and cultural resources to assist newcomer communities. This urgent issue will only become more pressing as Victoria continues to increase in ethnic, racial, and linguistic diversity due to the Canadian government’s commitment to increasing rates of immigration and refugee settlement across the country.

Convening Health and Community Service Providers and Patients to Support the Co-design of A Digital Social Prescribing Platform

This project aims to support meaningful collaboration with Island Health and the Nanaimo Division of Family Practice in order to co-develop a social prescribing program. Social prescribing is a model of patient-centered, team-based care that aims to link individuals with community services to address their non-clinical health needs.[1] By leveraging social prescribing, Island Health and the Nanaimo Division of Family Practice aim to address social and material determinants of health by building low-barrier referral pathways for “social prescriptions” within the Nanaimo region. Examples of social prescriptions include Parks and Recreation passes, referrals to job programs, and other types of social and material support. In order to implement social prescribing in the Nanaimo region, we propose the co-design of Connect Rx, an online platform that will facilitate social prescribing (See prototype at www.casch.org/connect-rx). To accomplish this, we will (1) identify community assets and social prescriptions in Nanaimo, (2) convene health and community service providers to participate in the co-design of Connect Rx, and (3) co-develop an evaluation that can be used to assess the acceptability, feasibility, and efficacy of Connect Rx.

Co-developing research priorities for improving palliative care for patients with advanced disease who also experience structural inequities.

Despite experiencing much higher death rates, people living with structural inequities are not adequately served by the current healthcare system, including by palliative care services. As a key provider of healthcare to people living in Vancouver’s Downtown Eastside (DTES), Providence Healthcare’s (PHC) Division of Palliative Care is establishing a research program for equity informed palliative care. The knowledge gained by this program will allow PHC to improve access to and quality of palliative care for patients with advanced disease who also experience structural inequities.

To allow this research program to be truly patient centred, and ensure the experiences and perspectives of all relevant patient populations are prioritised, we will co-develop the research priorities with:
– people with lived experience of palliative care for people experiencing structural inequities (such as family/friend caregivers),
– people experiencing structural inequities who may need palliative care in the future,
– representatives from community-based organisations serving this population, and
– members of the healthcare system.