Program: Convening and Collaborating Awards

Research co-leads: Robert Woollard University of British Columbia

Research user co-lead: Rahul Gupta Vancouver Coastal Health

Team members: Jane Bishop Sunshine Coast Division of Family Medicine Joerg Jaschinksi Child Youth Mental Health and Substance Use Ray Markham Rural Coordination Centre of BC Marilyn Pederson Emergency Management BC Andrea Stinton  Gibsons Medical Clinic

Chronic illness including multisystem disease, chronic pain, substance use disorders, and mental health challenges are by far the most expensive and frustrating aspects of the health care system. With a deeper understanding of the complexity of health care systems, there is an emerging shift from mechanistic approaches often ineffective to ones that embrace uncertainty, recognize wholeness, and honour individual uniqueness. Understanding relationships, both human and systemic, has become key, to see how different parts are connected to the whole. There are multiple relationships at play: those patients have with their own bodies and biographies, those between patients and their primary healthcare providers, and those between different providers that serve any patient.

Over the last two decades, health coaching and mindfulness arose to offer insights into how best to leverage these relationships. Together they provide guiding principles and practices that orient to complexity and wholeness. This shift in orientation allows access to insights and innate resources that lead to emergent behaviours and health promotion wherein the patient and the team of providers become more than their parts.

On the Sunshine Coast, since 2014, health coaching and mindfulness-based interventions have been integrated into the fabric of medical care. The proposed work at the patient and community level is to better understand how such integration might best be achieved.

This team will first engage stakeholders in dialogue to understand needs, experiences and context specific opportunities. Key stakeholders include patients who experienced these interventions, physicians who referred their patients to these programs, physicians who possess skills and key members of the Sunshine Coast Division of Family Practice. Key members from the Rural Coordination Centre of BC, the Faculty of Medicine and UBC’s Continuing Professional Development will also be invited for input that might be of value for other communities and physician training.

Since their applications are universal, health coaching and mindfulness represent interventions that may support both patients and providers. Wellness of providers themselves is crucial to optimizing patient care so provincial advocates for physician health are invited.

This group will design a research plan to prioritize study elements and support future grant applications. The long-term hope is to further translate knowledge into practice on the Sunshine Coast as a pilot, and provide a template that other rural and remote communities might adopt/adapt to contribute to healing within their own communities.

Research co-leads: Chelsea Pelletier University of Northern British Columbia

Research user co-lead: Sandra Allison Northern Health

Team members: Sabrina Dosanjh-Gantner Northern Health Guy Faulkner University of British Columbia  Gloria Fox Northern Health Robin Keahey University of Northern British Columbia  Anne Pousette Promotion of Wellness in Northern BC Drona Rasali BC Centre for Disease Control

Chronic disease risk factors, such as physical inactivity, are more prevalent in the region served by the Northern Health in BC. This vast geographic region is sparsely populated, culturally diverse, and has high variability in infrastructure and knowledge regarding physical activity. With a passionate team of health service providers, researchers, policy makers, and community leaders, this project will develop a set of actionable research questions, identify research priorities, and create a plan for increasing physical activity, improving chronic disease risk factors, and reducing health inequities in northern BC.

This will be accomplished with a two-day physical activity summit consisting of a higher-level meeting focused on advancing health policy, and a second day that engages people working on the ground in physical activity program delivery. Outcomes of this initiative will include a research agenda rooted in community needs and the creation of a Northern Physical Activity Coalition that includes representation from a broad range of passionate researchers and research users.

 

 

 

 

Research co-leads: Amy Salmon University of British Columbia  Fiona Martin  Dalhousie University Chris Richardson University of British Columbia  Anne Whittaker University of Stirling

Research user co-leads: Otto Lim Otto Lim Counselling Cari St. Pierre From Grief to Action

Tema member: Mai Berger University of British Columbia

A public health emergency has been declared in British Columbia in response to the rising number of fentanyl-related overdose deaths. While numerous efforts are underway to coordinate and improve access to evidence-based addictions treatment and related services, it is crucial these efforts include a comprehensive and nuanced understanding of the impact of substance use problems on parents and families. Stigma, stress, caregiver burden, and current service limitations can affect people’s ability to access services and effective interventions to help them recover from addictions.

This project will support an emerging team of investigators, clinicians, and advocates passionate about reducing health and social inequities for and improving the care of families affected by substance use problems. Under a participatory research agenda, families, researchers, clinicians, service planners, and policy makers will be brought together for a three-day workshop to support the development of a pragmatic, rigorous evidence-base needed to enable this work. The main deliverable will be a sustainable “Learning Alliance”, made up of researchers and research users who will address challenges around effective policy and practice related to supporting families affected by substance use problems and develop momentum for subsequent activities. The knowledge this team’s research and learning alliance will generate would inform provincial efforts to improve the delivery of services to individuals struggling with addictions and the family members who support them.

The breadth and scope of this collaboration will be increased through synergy with an emerging five country collaboration focused on examining policy and practice on substance use and parenting in Canada, the UK, US, Ireland and Australia. This perspective, also supported through a learning alliance, will allow for knowledge exchange, provide a more nuanced understanding of the core governing principles and ethics of care in different contexts, and will catalyze efforts to generate the evidence-base needed to enable this work.

Research co-leads: Joyce O'Mahony Thompson Rivers University Nancy Clark University of Victoria

Research user co-leads: Shahin Kassam University of Victoria Khim Tran Options Community Service

Team member: Jessie Bauer Thompson Rivers University

This project’s purpose is to hold a symposium followed by several advisory board meetings. The key objective is to bring health researchers and research users together to share ideas and plan for activities regarding Syrian mothers support and access to health care. This first step connects to a larger proposed longitudinal study application (MSFHR Health Professional-Investigator Program 2018) in planning research and building a strong foundation of trust and relationships within the community. The research team has been established and will complement the two funding opportunities. The proposed activities align with British Columbia’s health system priority areas of i) enhanced access to effective primary health care and; ii) mental health care.

Activities will focus on community engagement, a symposium (face to face event), and development of an advisory board consisting of key stakeholders and gatekeepers of the Syrian community. The advisory board promotes knowledge exchange about the aims of this research and to build dialogue about how the community might benefit from the research findings. Advisory board members will include Syrian mothers and members of the Syrian community, settlement workers, health care professionals, non-government organizations, and immigrant service representatives. As a point of entry, this research team has existing relationships with key stakeholders working at Bridge Clinic, Options Community Services and other immigration service centers already working with Syrian mothers and their families.

Anticipated outcomes are:

1. Develop a comprehensive community engagement plan.
2. Form an advisory board.
3. Provide important and foundational knowledge for future research opportunities with the Syrian population.
4. Give graduate research trainees invaluable experience in community development and engagement processes.

Research co-leads: Brianna Turner University of Victoria Skye Barbic University of British Columbia

Research user co-leads: Deborah McKnight Borderline Personality Disorder Society of BC Baylie McKnight Borderline Personality Disorder Society of BC Wendy Young Island Health

Team members: Jenny Cartwright BC SUPPORT Unit Elizabeth Hallam Island Health Hazel Meredith BC Schizophrenia Society Wendy Mishkin  BC Schizophrenia Society Susan Rich Island Health Liz Wigfull Island Health

Borderline Personality Disorder (BPD) is a complex mental health condition associated with high rates of self-injury and suicidal behaviours. BPD is estimated to affect over 200,000 adults in BC. People with BPD experience challenges in accessing and engaging with mental health services due to high levels of stigma among mental health clinicians, frequent misunderstanding or misinformation about their diagnosis, inadequate access to evidence-based outpatient programs, and perceptions by clinicians and people with BPD that psychiatric care will not be effective. Together, these experiences often result in feelings of demoralization, hopelessness, and reluctance to engage with mental health services.

Peer support for people with mental health issues can improve their healthcare experiences and quality of life. However, a recent systematic review concludes that further research is needed to evaluate the effectiveness of peer support interventions. This project’s purpose is to bring together people with lived experience of BPD, mental health clinicians and decision-makers, and health researchers to lay the groundwork for a pilot trial to evaluate a peer support intervention for adults with BPD.

The activities will have three phases.

• Phase 1 will consist of reviewing and summarizing evidence for peer support interventions.
• Phase 2 will be gathering input on the needs and priorities of stakeholders to inform the peer support intervention.
• Phase 3 will be developing a research plan to assess the feasibility and effectiveness of the peer support intervention.

These activities will achieve four outcomes. They will:

1. Build research capacity in our team through training, co-development of the research plan, and collaborative grant writing.
2. Increase knowledge of community priorities and needs of people with BPD.
3. Create and summarize knowledge to guide decision-making around peer support interventions for people with BPD.
4. Instill hope in people with BPD that community input will guide care improvements.

Significant commitments from each of the stakeholder groups support the feasibility of this work. The patient-led approach ensures activities will reflect the priorities of people with BPD and their families. This work strongly aligns with the BC Health System Priority of improving care for people living with mental illness.