Substance use disorder is a growing chronic disease in Canada, with increasing harms. Racialized South Asian (SA) men living in the Lower Mainland have been shown to be particularly vulnerable to the harms of alcohol and opioid use, with many struggling to access support due to a variety of systemic and intrinsic barriers. Ensuring that research users are engaged as equal partners alongside researchers, the team will have shared leadership between SA men who use substances, health service providers, community organization representatives, and researchers. The goal of the project is to design an evidence-informed, culturally resonant intervention to support SA men who use substances, as well as identify next steps for further research and study of culturally resonant interventions. This will be completed during 5 collaborative meetings between the team and various stakeholders, guided by an experienced facilitator who will use an anti-racist approach to facilitation. Overall, this initiative will produce a culturally resonant intervention designed by researchers and research users and an agenda for future research that embodies anti-racist ideas and centres the experiences and ideas of SA men who use(d) substances.
Program: Convening and Collaborating Awards
Health Equity in the Digital Age: Enhancing Virtual Care for South Asians in British Columbia
Three in four South Asians in British Columbia live within the Fraser Health (FH) region. South Asians in Canada experience higher rates of chronic disease compared to the general Canadian population. These health disparities may be due, in part, to the ways in which social and environmental factors impact health and contribute to health inequities.
Virtual care services involve the delivery of health services through remote technologies (e.g., telephone, video calls, internet). Virtual care has the potential to improve healthcare access for marginalized populations; yet, South Asians in Canada are less likely to use virtual care services. They also face significant barriers in accessing culturally appropriate services. There is a need to develop and implement more equitable policies and virtual care services to improve access and reduce disparities.
This study aims to understand the barriers to, and facilitators of, virtual care services faced by South Asians in the FH region to help inform the development of more equitable and accessible virtual care solutions within FH.
Defining research priorities for trauma-informed design of digital health interventions in sexual health
There has been an increase in the adoption of digital health interventions, especially among people with sensitive and potentially stigmatizing sexual health challenges. While digital health technologies can be convenient and cost-effective, there are concerns that negative online activities could inadvertently trigger emotional trauma among end-user patients. Trauma-informed design has emerged in response to the threats of technology-mediated trauma. Yet, this important field is lacking clear research direction on the best and meaningful ways to conduct research that satisfies the collective interest of all the stakeholders that are typically involved in the design and deployment of digital health interventions. This proposed interdisciplinary stakeholder engagement brings together experts in digital health, trauma-informed care, and patient partners in sexual health to explore research priorities on trauma-informed design of digital technologies. This project will identify key research priorities on trauma-informed design that reflect the collective interest and priorities of the stakeholders.
A multisectoral physical activity engagement strategy for youth living in Northern British Columbia
Inequities in opportunities to participate in regular physical activity (PA), and the health risks associated with insufficient PA, including low self esteem, increased adiposity, low academic performance and the early onset of non-communicable diseases among youth, requires urgent attention. Insufficient PA is higher among rural youth, who are typically excluded in PA related research. Our recent review shows that overall, successful PA interventions for rural youth involve intersectoral collaboration. We propose a series of multisectoral youth engagement workshops to identify and address PA barriers for youth living in northern BC.
This is a community-based project involving 4 collaborative engagement workshops to identify and address barriers to youth PA in northern, rural, and remote BC communities. This strategy will bring together youth, community-based organizations, decision makers and researchers. The project will consist of brainstorming workshops conducted over 12 months aimed at centering youth voices. We will provide opportunities for youth to take leadership roles in developing and promoting PA programs, as well as advocating for policies and initiatives that support their regular PA participation in the community.
Exploring Health Professional Attitudes towards Parent-of-Origin-Aware Genomic Analysis: Hereditary Cancer and Beyond
Genetic changes can cause hereditary syndromes, and genetic testing can detect these changes. Parents may pass genetic changes to their children, and these changes can run in families. Unfortunately, if a parent cannot be tested, it is harder to understand test results, counsel patients, and test other family members.
Parent of Origin Aware Genomic Analysis (POAga) is brand new test which may predict which parent has passed down a genetic change. This prediction may work even when the parent cannot be tested. Vancouver researchers reported on POAga earlier this year, and we hope that it will lead to faster testing and better counselling. POAga should still be discussed with the health professionals who order genetic testing. This includes geneticists, genetic counsellors, and medical oncologists.
This project will help bring this brand-new research from the laboratory to the genetics clinic. After watching a short video about POAga, participants will be able to ask questions. Then, we will lead focus groups gathering their own questions, concerns, and opinions. The information we learn will help us develop future educational resources for these professionals.
A Patient-Oriented Research Approach to Improve Access to and Experiences with Medical Assistance in Dying for Persons Whose Death is not Reasonably Foreseeable
In 2021, the Canadian Government expanded access to medical assistance in dying (MAiD) to persons whose death is not reasonably foreseeable (Track-2 MAiD) with the introduction of Bill C-7. Island Health has consistently had the highest yearly provisions of MAiD in Canada since its legalization in 2016. However, the number of Island Health physicians and nurse practitioners willing to assess and provide Track-2 MAiD is low. Recent media reports and public discussions about Track-2 MAiD have increased the spread of misinformation and mistrust. Our overall goal is to improve experiences with and access to Track-2 MAiD for patients and their families, and to support clinicians assessing and providing this service. To achieve this goal, we will establish a network that consists of patient-partners, multidisciplinary clinicians, researchers, and trainees. Using a transparent, collaborative approach to share knowledge and identify gaps, we will seek to minimize mistrust towards Track-2 MAiD and inform meaningful developments and safeguards in clinical practice. The activities proposed will also help build a research program and the capacity for further meaningful changes that support safe access to and experiences with Track-2 MAiD.
Early identification of bipolar disorder in adolescents and young adults: Establishing a collaborative research agenda.
Bipolar disorder (BD) is a psychiatric condition that affects about 2 percent of Canadians. Individuals with BD experience extreme changes in their mood, as well as their energy and ability to function. Research from our group and others has shown that BD often goes unrecognized for years, making it hard for affected individuals to receive the care they need. This can result in negative consequences including inappropriate treatment, more hospitalizations, and an increased risk of suicide. Factors that may play a role in this delay are complex and include, among others, the presence of co-occurring conditions, inadequate use of screening tools, and limited access to specialized mental health services. Therefore, finding the best strategies to address this challenge requires collaboration among multiple individuals and institutions. Our project will establish a collaborative network of healthcare leaders, clinicians, researchers, and international experts, as well as those with lived experiences of BD and their families. By organizing a series of workshops and meetings, we will co-create a research agenda aimed at finding ways to reduce the delay in the diagnosis and treatment of BD among youth and young adults in BC and beyond.
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).
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).
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 MindMapBC.ca, 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).