This Health System Impact Fellowship is co-funded by CIHR, Michael Smith Health Research BC, and the Interior Health Authority (health system partner), to help build BC’s health policy research capacity for the integration of policy research into decision-making.
It has become increasingly common that aging members of our population require healthcare services to support them. Many Canadians spend their final years in long-term care (LTC) facilities as a result. LTC facilities have been under scrutiny in recent years with respect to quality of care and inadequacy of resources, along with concerns about their increased privatization. The COVID-19 pandemic exposed the vulnerabilities of the state of LTC facilities across Canada. There is broad acknowledgement that improvements must be implemented to make the experience and safety of residents of LTC facilities better.
Our intended research is interested in understanding the experiences of harm that residents, family members, and healthcare workers have encountered, particularly those during the COVID-19 pandemic. This proposed project will aim to listen to the stories of patients, families and healthcare workers who have been adversely affected by restricted visitation policies, the loss of residents, and burnout, as a way to better understand the context of LTC, to facilitate a Restorative Community of Care for healing, and to learn from these situations to inform subsequent action.
This initiative will be facilitated using a restorative approach and will be comprised of three phases: listening to understand, planning for future actions, and reporting and evaluating the results of this process. A restorative approach is a principle-based approach that fosters a relational way of thinking and being and is carried out through facilitated dialogue with the intention of speaking openly about the harm experienced and to work together to heal from that harm and to learn from the past to improve the future. This approach supports respect, dignity and mutual care and concern between people, communities, healthcare providers, and the health system.
Source: CIHR Funding Decisions Database
This Health System Impact Fellowship is co-funded by CIHR, Michael Smith Health Research BC, and the BC Ministry of Health (health system partner), to help build BC’s health policy research capacity for the integration of policy research into decision-making.
The early years are a critical time when physical and social development occurs. Children’s experiences during that period shape their behaviors, their learning capacity, and set their health, emotional, socioeconomic trajectories A recent report on the health and well-being of children in BC revealed profound disparities in sex, gender, geography, or data availability. The latter concerns population-level data and linked databases availability. Plus, the absence of a reproducible process to merge databases using a unique common identifier undermines the efforts to analyze and provide evidence for the wellbeing of children in BC.
This proposal seeks to explore a sustainable partnership-based model for connecting health population-level data to health care policymaking and health care delivery decision-making. The specific objectives are:
- Build a co-produced partnership-based process for interconnecting health care policy, decision making, population health monitoring, research, and health care delivery.
- Use a collaborative approach to identify critical questions and analyze relevant health policy, research, and practice priorities.
- Support the development of a monitoring and surveillance system for healthy child development that follows key child development indicators over time.
This research program will formalize a strong partnership and a replicable process on data analysis between the BC Ministry of Health and the Human Early Learning Partnership, a School of Population and Public Health research unit. This process will also enable a monitoring and surveillance system of key indicators of the children’s health and wellbeing. Finally, this work will lay the foundations to create linked health and social databases from other ministries to inform policy and substantially reduce current disparities in BC.
Source: CIHR Funding Decisions Database
This Health System Impact Fellowship is co-funded by CIHR, Michael Smith Health Research BC, and the BC Office of the Provincial Health Officer (health system partner), to help build BC’s health policy research capacity for the integration of policy research into decision-making.
Reporting on the health and wellness of populations is vital to monitor trends, identify priorities, track progress towards targets, and address inequities. All Indigenous peoples — including those who do not have ‘Status’ under Canada’s Indian Act — have the right to be counted. Their perspectives and priorities must guide how data is collected, used, and reported. Yet, at present, First Nations, Metis, and Inuit peoples who do not have ‘Status’ or are not registered with Metis Nation BC are ‘invisible’ and ‘uncounted’ within population health and wellness reporting in British Columbia (BC). Responsibility for reporting on health of BC residents lies with the Office of the Provincial Health Officer (OPHO). Through agreements with federal, provincial, and Indigenous governments, the OPHO’s responsibilities include collaboratively reporting on health and wellness of diverse Indigenous peoples living in the province. Currently, there is no process in place to report on health and wellness of “uncounted” Indigenous peoples. This work must be done in partnership with Indigenous collectives representing this population. Current gaps include:
- No strengths-based, self-determined terminology to refer to diverse Indigenous peoples who are uncounted in population health data.
- Lack of formal relationships with Indigenous collectives representing uncounted Indigenous peoples.
- No way of identifying this population in existing BC population health data.
- Absence of research frameworks that reflect uncounted Indigenous peoples’ perspectives of health and wellness.
- No implementation plan for province-wide population health reporting led by uncounted Indigenous peoples, on their terms .
The goal of this project is to support the health and wellness of uncounted Indigenous peoples living in BC by addressing current gaps in population health reporting, through partnerships that uphold Indigenous self-determination, decision-making, and perspectives of health and wellness.
Source: CIHR Funding Decisions Database
This Health System Impact Fellowship is co-funded by CIHR, Michael Smith Health Research BC, and BC Ministry of Health (health system partner), to help build BC’s health policy research capacity for the integration of policy research into decision-making.
In late 2020, the Government of British Columbia committed to a policy of free contraception for all. This first-in-Canada policy presents an opportunity to address the cost barrier that limits access to contraception, and to understand and address how other identity factors like race, ethnicity, religion, age, and ability intersect with gender to affect the experience of contraceptive access. The goal of this project is therefore to use a gender and diversity lens called Gender-Based Analysis Plus (GBA+) to support the planning, implementation and evaluation of free contraception policy and programs in BC. Specifically, a family planning researcher will work with the BC Ministry of Health to engage with stakeholders about the impact of free contraception on communities known to face various barriers to safe and appropriate contraception care. Stakeholder engagement will be complemented by reviews of the relevant scientific evidence as well as invited presentations from researchers doing work connected to gender, diversity, and contraception. In alignment with the Ministry mandate to provide free contraception for all and addressing systemic discrimination, the results will be shared with policy makers to inform decisions about free contraception policies and programs and will be used to inform templates and guidelines for future GBA+.
Source: CIHR Funding Decisions Database
This Health System Impact Fellowship is co-funded by CIHR, Michael Smith Health Research BC, and the First Nations Health Authority (health system partner), to help build BC’s health policy research capacity for the integration of policy research into decision-making.
Healing Indicators is a research project that aims to improve health assessment policy. It addresses the need to create tools that centre communities and Indigenous knowledge in the assessment of the health impacts of resource development. The project is grounded in community-based Indigenous methods, with the purpose of developing land-based wellness indicators. The work draws on self-determination, culture, kinship, community, and land to inform and define health and wellness in a First Nations context. As a research program, Healing Indicators is committed to engaging land-based healing and health justice and features a decolonial ‘two-eyed seeing’ approach, with one eye informed by Indigenous ways of knowing, and the other western science. Progressing land-based indicator research is important within the context of the First Nations Health Authority’s “Public Health and Wellness Agenda.” Land-based health indicator development requires emergent community-based methods and design that is inclusive of leadership from Indigenous peoples. The impact of this collaboration is the promotion of critical Indigenous health research, with opportunities to expand on policy gaps in relation to land-based wellness and Indigenous health assessment. Asset-based work, such as this, is relevant within the context of provincially acknowledged widespread racism within the health care system in British Columbia. This work is also significant to the provincial commitment to implement the Declaration of the Rights of Indigenous Peoples (DRIPA 2019). Healing Indicators is a collaborative research project designed to promote community-led health through land-based indicator development to inform self-determination and wellness in collaboration with the First Nations Health Authority.
Source: CIHR Funding Decisions Database
This Health System Impact Fellowship is co-funded by CIHR, Michael Smith Health Research BC, and the BC Centre for Disease Control (health system partner), to help build BC’s health policy research capacity for the integration of policy research into decision-making.
Health promotion (HP) enables people to increase control over health and reduce health inequities through action on the determinants of health. HP actions include developing personal skills, creating supportive environments, strengthening community action, building healthy public policy, and reorienting health services to improve population health and wellness.The COVID-19 pandemic has emphasized the need for more coordinated, integrated and intersectoral HP action. The focus and value-add of the project is the development of co-created (with research, policy, and practice stakeholders) recommendations for enhanced HP and the innovative application of a complex systems approach to support this work. Using physical activity as a starting point, this project will to map (inventory) HP initiatives targeting physical activity at the provincial, regional, and local levels and identify areas to enhance coordination and integration to build healthier communities. The anticipated impacts and value of achieving this goal include:
- Shared leadership, governance, and accountability for HP.
- Increased collaborative capacity to align HP.
- Enhanced focus among stakeholders on reducing health equities.
- Shared resources (human, financial, infrastructure) to implement HP.
- Improved information (knowledge exchange, research and evaluation, monitoring and surveillance).
- Shared learning and understanding among stakeholders of new approaches to HP identified through the lens of a complex systems paradigm.
There are three objectives:
- Describe and map existing physical activity HP initiatives and systems in BC.
- Assess systems to identify facilitating and hindering factors and key feedback mechanisms that influence implementation, coordination and integration.
- Strengthen systems through identification of priority leverage points and recommendations for more synergistic implementation of coordinated intersectoral HP in BC.
Source: CIHR Funding Decisions Database
The number of Canadians diagnosed with cancer is rising with a growing and aging population and we need to ensure our healthcare system is equipped to meet this growing demand. As the most common female cancer worldwide, breast cancer is the second leading cause of cancer deaths in Canadian women. In recent decades, advancements in breast cancer screening and treatments have resulted in approximately 87% of Canadian women diagnosed with breast cancer surviving 5 years after diagnosis. Increased survival rates are due in part to adjuvant endocrine therapy (AET) (e.g., tamoxifen), which is used to treat early-stage, hormone receptor-positive breast cancer, representing the large majority of breast cancer diagnoses. Women prescribed AET are recommended to take this medication everyday for 5-10 years depending on their diagnosis, which results in the need for increased follow-up care over a long period of time. Previous research, however, has shown there are many issues associated with transitions in care, particularly as breast cancer survivors move from receiving care from their oncologist back to seeing their family physician or nurse practitioner in the community. The objective of this project is to improve transitions in care to better support women diagnosed with breast cancer and also the healthcare providers that deliver care to these women. The goal is to meet the supportive care needs of breast cancer survivors as they transition through the healthcare system to support them in living well beyond their breast cancer diagnosis.
This Health System Impact Fellowship is co-funded by CIHR, Michael Smith Health Research BC, and the BC Ministry of Health (health system partner), to help build BC’s health policy research capacity for the integration of policy research into decision-making.
Substance use costs British Columbia $4.9 billion in 2014, of which 70% was due to alcohol and tobacco. These estimates include costs related to the use of health care resources, productivity losses, criminal justice, and other direct costs such as accidents, research and prevention. Broader societal costs not included in these estimates relate to inequities, marginalization and hindered social development. This project aims to develop a model to evaluate the economic and social impact of legal substance use harm prevention in British Columbia. Evidence on economic consequences and how public health programs can minimize costs and harms from substance use is important for policy makers, who need to consider the health system priorities against efficiency, scalability and sustainability of interventions. The challenges to developing comprehensive economic evaluations in public health are well known. In the area of substance use, these pertain to the multitude of the socioeconomic determinants that influence use – such as employment, income, social exclusion, and hopelessness – and the difficulty of measuring broader benefits including family wellbeing, community development and equity gains. This fellowship will facilitate collaboration between knowledge users and academics with the aim of optimizing investment in the area of alcohol, tobacco and cannabis harm prevention in BC. It will provide the Ministry of Health with tools to implement efficient priority setting that aligns with the institution’s values and development goals. This will be achieved through important methodological advances to allow evaluations to account for the broader societal impact of preventing harm from legal substance use in BC. As a result, this fellowship will sustain future research in health economics with an increased ability to respond to policy makers’ needs when it comes to priority setting.
In Northern British Columbia, a region rich in natural resources, there has been a rapid expansion of resource extraction projects across the region in recent years. While generating economic growth for local communities, this has also led to concerns among health practitioners and community members about the potential health risks associated with declining air quality due to increased industrial emissions. In the BC Northwest, in particular, projections indicate that sulphur dioxide emissions will likely increase in the Kitimat airshed due to multiple new industrial projects and expansion of existing projects.Timely information about air quality and associated health risks is important for developing public health policies, to prevent potential negative health impacts, and for planning at both local and regional levels. The objectives of this project are to 1) conduct a health impact assessment of impacts of SO2 emissions on human health in the Kitimat region; 2) make recommendations for development of effective surveillance tools to assess air quality health impacts in the region; and 3) review how local and regional policy makers use environmental health impact information for decision-making.This project will directly support Northern Health's organizational impact goal of healthy people in healthy communities, through promoting and protecting healthy environments, and through helping to build regional capacity for conducting health impact assessments and surveillance.
