Medical-dental integration (MDI) is regarded as a crucial strategy for achieving improved health outcomes, patient and provider experience, and cost savings. Despite its potential benefits, there is currently limited practical guidance available for implementing MDI effectively, and key stakeholders’ (patients;healthcare providers) perspectives of such integration are not well understood. Our project aims to support meaningful collaboration and knowledge exchange between health researchers, research users, and key stakeholders to co-develop a person-centred approach to MDI within an interdisciplinary community health centre (CHC). We will bring together a diverse group of stakeholders to identify the vision of medical and dental integration at the CHC, the activities needed to achieve this vision, and indicators to evaluate success. The convening and collaborating activities will include the formation of a Stakeholder Implementation Advisory Group (SIAG), ongoing meetings between researchers and SIAG participants, and interviews with key stakeholders at the CHC. Our goal is to elevate community voices and knowledge to inform the development of person-centred MDI at the EFry CHC that meets the needs of clients.
Program: Convening and Collaborating Awards
Empowering Integrated Care for Healthy Aging: Co-developing a Collaborative Plan with South Asian and Chinese Communities for Inclusion and Equity
In 2021, 20.3% of BC’s population was 65 and older. Our older population is expected to grow to 25% in 2041 – a super-aged society. An integrated and inclusive care approach is needed for diverse and complex needs of older people to promote healthy aging for all. Fraser Health has implemented two regional initiatives to support healthy aging: social prescribing and the frailty pathway. Meanwhile, half of the population in the Fraser Health region are visible minorities, and 60% of the population are South Asian and Chinese. To ensure a culturally inclusive integrated care model, this project will bring health practitioners, community partners, policymakers, South Asian and Chinese older adults, and families together to discuss research priorities that can empower communities and increase health system capacity. Utilizing Appreciative Inquiry and WHO’s Integrated Care for Older People (ICOPE) methodology, we will co-plan two citizen workshops to build shared visions and collaborations across sectors. Collectively, all partners will identify strengths, potentials, and actionable strategies to enable research collaborations for an inclusive integrated model of senior care.
Co-creating a Community of Practice around Substance Use and Employment to Address the Social Determinants of Drug Toxicity and Overdose in British Columbia
The proposed project establishes a provincial community of practice (CoP) in substance use, employment, and economic engagement that will advance the expansion of supported employment programming in British Columbia (BC). Despite evidence of work and employment as critical social determinants of health, existing programming that addresses equitable engagement for multiply barriered populations such as people with lived and living experience of substance use (PWLLES), has been fragmented and limited in scale and scope. The proposed initiative will bring together key informants from existing employment and economic engagement programs, PWLLES, Indigenous advisors, and subject matter experts from across BC to facilitate knowledge sharing, project development, and collaboration. Through the development of a core working group and sub-groups, this initiative: (1) facilitates capacity for best practices in knowledge generation, mobilization, and implementation of low-barrier employment programming for PWLLES; (2) expands a health and economic monitoring system that supports sustainable low-barrier employment programming; and (3) develops the capacity for a CoP to advocate for policy environments supportive of socio-economic integration.
Co-Creating Collaborative Pathways: Advancing Indigenous Clinical Nurse Specialist Roles
Health organizations in BC are creating Clinical Nurse Specialist, Indigenous Health and Cultural Safety (CNS IH;ICS) roles. This collaborative partnership intends to convene expert knowledge holders to ensure the CNS IH;ICS leaders are leading an impactful, nurtured, and sustainable workforce. The BC Indigenous Health Nursing Research Chair has generated knowledge into the practice of Indigenous health nursing and the Providence Health Care and BC Cancer research team conducted a study examining the CNS roles. Our research activities include hosting a two-day Symposium to bridge these two parallel pathways of knowledge to generate share and mobilize research findings that will inform, nurture, and sustain the CNS IH;ICS roles in BC. Formalizing this partnership and collaboration will address the health human resources crisis by identifying pathways for a collaborative research inquiry to increase structural frameworks that inform Indigenous health policy and program development. Indigenous health systems require a distinct approach that recognizes the authentic voices and experiences of Indigenous nurses in health leadership and provides opportunities for intergenerational research mentorship and training.
Better Aging in BC: Mapping Menopause Research Priorities
We will bring together people who research, provide, and receive menopause care. They will create a complete list of research ideas to support healthy aging in British Columbia. The process will include healthcare providers from nursing, medicine, and psychology. It will also include researchers from basic, health, and social sciences. Individuals with lived experience of midlife and menopause will also take part. Power dynamics within and throughout groups will be accounted for with trauma-informed and patient-centered approaches. Together, we will create a “Research Agenda for Menopause and Midlife Women’s Health.” It will show ways to improve care for menopause and midlife women’s health. The project activities will lead to new and stronger partnerships among researchers, clinicians, and people with lived experience. The Agenda will be hosted by the Women’s Health Research Institute and will set up the new Menopause and Midlife Health Program at BC Women’s Hospital to be a Centre of Excellence in both research and clinical care.
Help BC Hear Better: Identifying gaps in knowledge and setting our research agenda
Approximately 1 in 5 Canadians aged 20 to 79 has hearing loss that affects their ability to hear speech. Left unmanaged, hearing loss can contribute to social withdrawal, loneliness, decreased mental and physical health, and increased risk of hospital readmission. The burden of hearing loss increases with age, rising to 65% in adults over 70 years old. Despite how common hearing loss is, there are many barriers to accessing hearing healthcare. Barriers at the individual level (e.g., hearing aid appearance, minimal perceived benefit) have been well researched, while social and systemic barriers (e.g., policy gaps in hearing aid funding; inequitable access) have received relatively less attention. This project will explore the feasibility of funding hearing healthcare for seniors aged 60+ in BC. This grant will fund two activities: a data scan and a workshop. The data scan will identify existing published and unpublished data on hearing loss prevalence, individual and societal impacts of unmanaged hearing loss, and economic models of hearing health funding programs. The workshop will bring together stakeholders to discuss the existing data, plan for how to fill in gaps, and start a conversation about advocacy messaging.
Creating a research agenda to improve treatment for patients with epilepsy in BC
Epilepsy affects millions globally, including 50,000 in BC. Of this population, about 1;3 have drug-resistant epilepsy. Seizures can be unpredictable and often dangerous, leading to injury, hospitalization, and mortality. In addition, they often negatively impact mental health and daily functioning. Epilepsy surgery is the only curative therapy for patients with drug-resistant epilepsy. It can improve patients’ lives and reduce the risk of sudden unexpected death. Magnetoencephalography (MEG) is a non-invasive neuroimaging tool that aids in presurgical planning, proven effective in a multitude of studies and used continent-wide. Despite this, BC lacks a comprehensive epilepsy program supporting MEG for presurgical planning, lagging behind other Canadian regions in funding and treatment availability for its epilepsy population. Addressing this gap necessitates collaboration among the community, healthcare providers, researchers, and policymakers to co-create a research agenda. Our outcomes will include identifying and learning from successful models outside of our region, identifying the specific needs in our current model, and creating a research agenda aimed at addressing these needs.
Indigenous, community and research partnership to collaboratively explore environmental justice, unconventional gas development (UGD), wildfires, and health in Northeast British Columbia
UGD is taking place in Northeast BC, close to traditional territories of First Nations who rely on the land for food, water, ceremonial practices and cultural identity. People living in the region have also faced unprecedented wildfires. Health concerns about UGD include carcinogenic and endocrine-disrupting chemicals, and asthma triggers while the negative health impacts of wildfires are only beginning to be understood. To our knowledge, there is almost no research into the combined effects of both UGD and wildfire exposures. Furthermore, neither UGD nor wildfires are distributed or experienced equally across Indigenous and non-Indigenous populations. Indigenous communities in Canada are more likely to be evacuated due to wildfires and face disproportionately greater negative health impacts from UGD. Applying a lens of environmental justice and Indigenous Ecological Knowledge, our goal is to partner with the Saulteau First Nation and local health providers to review the current research on the health impacts of UGD while understanding the lived experiences and priorities of research users. We will work together to review and co-design the best approaches to studying the dual health impacts of UGD and wildfires in Northeastern BC.
Making moves towards active living after hip and knee replacement surgery: A consensus meeting of healthcare providers, fitness leaders and people with lived experience
More than 18,000 people in BC will have a hip or knee replacement this year to treat severe pain and reduced mobility from arthritis. After surgery, most patients will have a short course of physiotherapy and be encouraged to engage in regular physical activity such as walking and cycling. However, our research shows that patients receive inconsistent advice and few supports to help them become more active. In fact, they are less active than guidelines recommend to promote health and less active than their healthy peers. There are community-based programs available to help people be active after surgery but we do not know where they are located or how well they are designed and delivered. Most importantly, we want to learn if these programs are safe and help people to become active after joint replacement surgery. To answer these questions, we propose to search websites and query providers to find programs available in BC and describe program features. We will then bring together researchers, healthcare providers, fitness leaders, and patients for a 1½-day meeting to decide what makes a community-based exercise program safe, easy to access, open to everyone, and helpful for people with a hip or knee replacement.
Co-developing research priorities to address digital determinants of health among historically marginalized populations disproportionately affected by sexually transmitted and blood-borne infections
As society becomes increasingly digital, some people are getting left behind because they may lack access or skills to use the internet or may not trust it. The effects of these “digital determinants” of health (DDoH) may be particularly hard for communities that are already historically marginalized in British Columbia, including those with higher rates of sexually-transmitted and blood-borne infections (STBBI). This topic has not received a lot of attention in STBBI related research, even as related health services are increasingly “digital-first,” and has only in the past year become a topic important to public health leaders in BC. Through this project we hope to understand this issue better. We will start by holding focus groups with people from these communities (e.g., people with lived experience of incarceration, people living with HIV) and representatives from the community organizations that serve them. From these discussions, we hope to better understand how DDoH affect their lives and how services are provided. We will then review these findings with peers, community organizations, and researchers in a two-day workshop to identify important research questions that will be the focus of future grant applications.