Program: Convening and Collaborating Awards

Research co-lead: Sandra Lauck University of British Columbia

Research user co-lead: Jacqueline Forman St. Paul’s Hospital

Team members: Sandra Carroll McMaster University Dr. Jennifer Baumbusch University of British Columbia Dr. Anita Asgar Transcatheter Valve Therapy Clinic Dr. Leslie Achtem Vancouver Transcatheter Heart Valve Program, St. Paul’s Hospital Amanda Smith McMaster University Dr. Richard Cook Vancouver General Hospital Michelle Tyler University of British Columbia, St. Paul’s Hospital Krystina Lewis University of Ottawa

After the age of 70, about 10% of British Columbians will develop a heart valve disease called aortic (‘a-yor-tic’) stenosis. Over time, the leaflets of the heart valve become harder and blood cannot pass through easily to travel to the rest of the body. This is like having a garden hose with a spout that cannot be loosened. The only treatment is to replace the valve. If this is not done, most people with the worse aortic stenosis will die within a year.

As of recently, this valve replacement can be done in one of two ways: either with open heart surgery (surgical aortic valve replacement) or using a small hollow plastic tube threaded through a leg artery or another way (transcatheter aortic valve replacement). Both ways have different risks and benefits, and many patients can have one way to the other.

The reason our group of clinicians, researchers and patients want to come together is to help patients and their doctors and other health care professionals decide about the way to change the valve together that is the right one for each patient. It is also important that this decision matches the patient’s values and beliefs about their health and their goals. This is called shared decision-making.

Our goals are to look about what we know about the treatment of aortic stenosis and shared decision-making and study how we can use this information to improve the care of older British Columbians and Canadians who need valve surgery.

Research co-lead: Liisa Galea University of British Columbia

Research user co-lead: Shirley Weir Menopause Chicks

Team members: Dr. Elizabeth Rideout University of British Columbia Dr. Lori Brotto  Women’s Health Research Institute Ama Kyeremeh University of British Columbia Wansu Qiu University of British Columbia Kate Wahl University of British Columbia

Women are more susceptible to certain brain disorders, such as depression, anxiety, and Alzheimer’s disease compared to men. Moreover, disease manifestation is different between the sexes. Yet, most research focuses primarily on males, which has contributed to the current knowledge gap and inequities in practice. Although new work has focussed on how biological sex alters disease trajectory and outcome, less is known about how the unique physiological and social challenges experienced by women influence brain health. What we do know is striking. For example, the physiological changes during pregnancy and postpartum alter susceptibility to brain disease, and barriers to access care can significantly affect the timing and accuracy of diagnoses in women.

This highlights the need for a comprehensive understanding of women’s physiological and social challenges that are unique to women to improve health outcomes. Yet, most research has focussed primarily on males which has contributed enormously to the current knowledge gap and inequities in practice.

We will host a one-day Women’s Health Conference to bring together multidisciplinary researchers and stakeholders to:

1. engage in dialogue related to women’s brain health issues,
2. foster new collaborations, and
3. establish a provincial Women’s Brain Health Network that will build new research programs and offer essential student training in order to reduce knowledge gaps and inequities in accessing care.

Research co-lead:  Cheryl Heykoop Royal Roads University

Research user co-lead: Catherine Clelland BC Cancer Agency

Team members:  Jennifer Cartwright BC SUPPORT Unit Karine Chalifour Young Adult Cancer Canada Nicol MacPherson BC Cancer Lisa McCune BC Support Unit Nicolette McGuire Research and Innovation – Ministry of Health Morgan Price University of British Columbia, Innovation Support Unit  Danielle Schroeder Callanish Society Genevieve Stonebridge InspireHealth

In Canada, approximately 8000 young adults (aged 18 to 39) are diagnosed with cancer each year, representing 4% of cancer diagnoses annually. Currently, cancer care systems have limited capacity to meet the complex needs of young adults with cancer and young adult cancer care is generally underrepresented in cancer education and research. However, research indicates that young adults with cancer have a clear understanding of how their care could be improved and want to play an active role in doing so.

This C2 grant would support 20 young adults with cancer and 20 cancer care allies (health care professionals, decision-makers, researchers, and community organizations) in BC to come together for a two-day meeting to share experiences of young adult cancer care and to identify key research and practice priorities to improve young adult cancer care in BC.

Key outcomes include:

1. strengthened relationships and partnerships between young adults and cancer care allies;
2. identification of key research and practice priorities to improve young adult cancer care in BC; and
3. the co-creation of a high-quality report and two knowledge products to share learnings and priorities widely.    

Research co-lead:  Maureen Ashe University of British Columbia

Research user co-lead: Dolores Langford Center for Hip Health and Mobility (CHHM), Vancouver Coastal Health, Vancouver Coastal Health Research Institute

Team members:  Darryl Caves Vancouver Coastal Health Chris Nicol Vancouver Coastal Health Dr. Patro Ariza-Vega University of Granada, Hospital Universitario Virgen de las Nieves Dr. Ken Madden Vancouver General Hospital, University of British Columbia Dr. Morgan Price University of British Columbia Jane Burns Vancouver Coastal Health Dr. Elissa Burton Curtin University Lindy Clemson University of Sydney Lena Fleig Medical School Berlin  Christiane Hoppmann University of British Columbia Paule Bellwood University of British Columbia

Reablement is a short-term intensive interdisciplinary approach to providing health care at home, with a focus on older adults post-hospitalization. Reablement emphasizes a person's autonomy and independence, but the model may pose implementation challenges within a team-based setting. To mitigate these factors requires a consistent training program (for fidelity) to adopt the concept of reablement, and develop skills and knowledge. To create an acceptable, feasible, and effective knowledge strategy requires co-designing the curriculum with the end users.

This study, grounded in behaviour change theory, is designed to work with frontline clinicians and researchers, to create a blended curriculum of online training, video scenarios, and group-based work. We will work within our established clinical academic partnership, to develop the curriculum over 12 months via a series of monthly webinars from experts in the clinical and research fields on topics related to delivering reablement. During the webinars, a facilitator will synthesize information on ways to strengthen team-based practice, maintain fidelity to the model, and support older adults' autonomy and independence.

We anticipate the following outcomes from this collaboration: a co-created curriculum of reablement, a consensus statement on behavior change strategies for reablement, KT capacity building for trainees, peer-reviewed publications, and a research agenda for next steps to advance reablement in BC.   

Research co-lead:  Davina Banner-Lukaris University of Northern British Columbia

Research user co-lead: Marc Bains University of Northern British Columbia Health Research Institute

Team members:  Jennifer Brown Northern Medical Program Stirling Bryan University of British Columbia, BC Support Unit Alison Hoens University of British Columbia Daman Kandola University of Northern British Columbia  Haydn Molcak University of Northern British Columbia  Michelle Mujoomdar Canadian Agency for Drugs and Technology

POR describes the process of involving patients and their caregivers in research, not just as participants but also as collaborators and partners. In response to this, there has been increasing calls for patients to receive compensation for their contributions. However, compensation practices and sources of financial support are varied. Increasing numbers of patients and patient organizations are receiving financial support through industry or pharmaceutical organizations, as well as non-profit advocacy groups.  While this has opened up new opportunities for patients to be involved in research, it is unclear how potential conflicts of interest are understood and managed.

Our project seeks to critically explore the compensation of patients in POR and to gain insights into how conflicts of interest are, and could be, managed. We will first host a facilitated live chat on Twitter to gather a range of perspectives from patients and stakeholders. We will analyze this data and will use this to plan and deliver a one-day consultation meeting. We will invite key stakeholders from across British Columbia, including patients, researchers and others, to share their experiences and identify key research questions, gaps and priorities.

Research co-leads: Mary De Vera  University of British Columbia

Research user co-lead: Dr. Kam Shojania University of British Columbia

Team members: Dr. Nick Bansback University of British Columbia Dr. Hyon Choi Harvard University Kelly English Arthritis Research Canada Patient Advisory Board Russell Friesen St. Paul’s Hospital Alyssa Howren University of British Columbia Dr. Alison Kydd University of British Columbia Dr. Diane Lacaille University of British Columbia Dr. Linda Li University of British Columbia Dr. Nicole Tsao Harvard University Dr. Peter Zed University of British Columbia

Gout is a common and very painful type of joint disease caused by too much uric acid build up in the body. In 2012, our research team showed that gout affects over 171,000 people in BC and that hospital visits from gout has doubled from 2000 to 2011. This is alarming as the cause of gout is known and drugs that lower uric acid are available. Indeed, despite being a curable disease, gout has not been managed well.

In 2019, we completed research that showed that health professionals including rheumatologists, pharmacists, and dietitians remotely working together and sharing electronic medical records (EMR) is a feasible and effective way of caring for gout patients. It is important to continue to work towards implementing this promising approach to gout care. This includes involving family physicians who see the majority of gout patients as well as exploring access for gout patients living in both urban and rural areas.

Our proposed activities involve building partnerships with gout patients, health professionals, researchers, and EMR experts across BC to gather perspectives and expertise needed to inform and design future implementation research of this unique way of caring for gout patients.

Research co-leads:  Katrina Plamondon Interior Health Authority

Research user co-lead: Deanne Taylor Interior Health Authority

Team members:  Dr. Barbara Buckley Thompson Rivers University Dr. Jason Curran Rural Coordination Centre of BC Alex Kent Simon Fraser University Dr. Jude Kornelsen University of British Columbia Dr. Jen Miller Health Systems Brad Anderson Aboriginal Health Kim Peake IH Research Department, BC Support Unit  Sage Runner IH Research Department

Rural communities in British Columbia (BC) face challenges in accessing care and services. Many rural and remote communities are First Nations, for whom geographic and resource inequities are compounded by sociopolitical and historical injustices. Equity considerations are critical to understanding the unique and diverse experiences and needs of rural communities. Research can help generate evidence, equity, and community-informed responses to the needs and priorities of rural communities. It can play a role in co-creating new ways of working together. Yet, BC has no coherent set of guidelines to inform efforts or investments in rural health research.

This C2 grant will bring people together to share their perspectives about the pressing research priorities for rural communities. Together, people who live and work in (or with) rural communities will articulate priorities for rural health research in BC. This early set of priorities will inform broader online dialogue, where people will collectively shape a vision for rural health research. The outcome will be an evidence and community-informed agenda for rural health research that can guide future directions for funders, researchers, health systems, and community partners.

Research co-leads:  Caroline Sanders University of Northern British Columbia

Research user co-lead: Lauren Irving Northern Health Authority

Team members:  Sandra Allison Northern Health Jennifer Begg Northern Health Chris Bone City of Prince George Matthew Burkey Cariboo Chilcotin Child Development Centre Stacy Cabage HOY Medical Clinic, Foundry Youth Centre Kim Chernenkoff The Native Friendship Centre  Darcy Dennis Ministry of Children and Families Jenessa Ellis Carney Hill Neighbourhood Centre Society, Hadih House Erica Koopmans University of Northern British Columbia Christy Kubert Child Development Centre of Prince George and District Andrea Maurice School District 57 Lisa Provencher School District 57 Rhoda Viray Northern Health

Fifty years of infant and early childhood universal health care program evaluation has repeatedly demonstrated that effective early childhood services make a difference to secure more positive long-term health and wellbeing outcomes for children and their families. The early years are a critical period of transitions with fluctuating family needs. An array of services, each with its own structure and process exist. Children whose life circumstances are more complex will need additional support to help them to navigate what is already a challenging developmental journey. Such enhanced services should leverage connectivity by creating and enhancing opportunities for engagement and access despite contextual factors (i.e. rurality).

In addition, we are faced with a shift in the ways we have to work, financial and cost-saving plans, organisational restructuring and nuances linked to rural geography. What our team has come to learn is that in applying services from urban centres there is a lack in understanding the unique environmental factors, fiscal vulnerability, and cultural complexities in the north. Using our completed rapid realist review, as a starting point, we want to engage with a broader community to understand enhanced service needs for the north. Using a systems and compassionate leadership stakeholder approach, we wish to join enhanced service work streams across health, municipalities, social care and not-for-profit organisations.

Research co-leads:  Dr. Skye Barbic University of British Columbia

Research user co-lead: Dr. Frank Scheuermeyer Providence Health Care

Team members:  Dr. David Barbic University of British Columbia, BC Emergency Network, Centre for Health Evaluation & Outcome Sciences  Dr. Steve Mathias Inner City Youth Program, St. Paul's Hospital, University of British Columbia, Infant, Child, and Youth Mental Health and Addictions Regional Program, Vancouver Coastal Health, Centre for Health Evaluation & Outcome Sciences  Pam Liversidge Foundry Tara Beaulieu University of British Columbia, British Columbia Centre on Substance Use

In Canada, there has been a profound disconnect between emergency services and mental health services for youth and young adults. Recent evidence suggests that more than half of Canadian youth and young adults presenting to an Emergency Department (ED) with mental health and substance use (MHSU) needs have not had any previous mental health-related contact with the health care system.

In BC, the opioid epidemic has compounded this crisis, with youth and young adults accounting for 20-25% of all opioid-related overdoses and deaths. From coast to coast, there is an immediate need to improve referral to integrated youth and young adult services to limit repeated ED visits and hospitalization for MHSU disorders and to promote the health and well-being of this population. The goal of our work is to build a partnership in BC between a network of EDs and an integrated youth and young adult health services network called Foundry.

Specifically, we propose to coalesce a group of patients and their family, service providers, clinicians, and physicians for a one-day workshop to inform the development of an intervention (ED2Foundry) designed to improve the linkages between EDs and community health services for youth and young adults with MHSU concerns.  

Research co-leads:  Tami Howe University of British Columbia

Research user co-lead: Katharine Davies Providence Health Care, University of British Columbia – Vancouver

Team members:  Indershini Pillay Providence Health Care Tara Chen Providence Health Care Dr. Jeff Small University of British Columbia

Communication is central to everyday life. It is essential for maintaining relationships with family and friends and for participating in community, social, and leisure activities. In older adults, communication is particularly important because of the increased risk for social isolation and depression. A major contributor to communication disorders in BC is dementia, which has an estimated prevalence of 62,000. Most people with dementia (PWD) experience communication difficulties early on, making it a high priority for intervention.  

Speech-language pathologists (SLPs) are the health professionals with specialist knowledge in managing communication disorders. There is a strong evidence base for the provision of nonpharmacological interventions to address the communication needs of PWD and their families. However, SLPs report many barriers to implementing these interventions and PWD seldom have access to evidence-based communication care. There is a need to narrow this evidence-to-practice gap. We plan to create a collaboration between clinical research users and researchers to identify the barriers and facilitators to implementing evidence-based communication care in BC and to develop a set of research priorities for this area.