Program: Match Funding

Canadian Primary Care Research Network – Phase 2

Health Research BC is providing match funds for the BC Primary Health Care Research Network (BC-PHCRN) Phase 2, the BC node of the Canadian Primary Care Research Network (CPCRN), which is funded by the Canadian Institutes of Health Research’s (CIHR) Strategy for Patient-Oriented Research (SPOR) Primary Care Network. 

 

The goal of the BC-PHCRN is to encourage, facilitate, and support collaborations between government, health authorities, health professionals, patients and researchers. The CPCRN and BC-PHCRN objectives include:

  • Expand PBRLNs by recruiting new primary care practices and providers  to include more electronic medical record data for research purposes,
  • Participate in CPCRN research and quality improvement projects and other projects as well,
  • Support development of a pan-Canadian primary health care information system that integrates electronic medical records with Patient Reported Experience Measures (PREMs) and Patient Reported Outcome Measures (PROMs),
  • build a network of primary care researchers, patient partners, clinicians, decision-makers and trainees to facilitate communications and knowledge mobilization, and
  • build capacity in patient-oriented primary care research in BC and beyond.

In British Columbia, the network is participating in both funded and non-funded research projects. Funded projects include:

  • OECD PaRIS to measure the outcomes and experiences of health care that matter most to people,
  • SPIDER to deprescribe potentially inappropriate prescriptions among elderly living with chronic conditions, and
  • Choosing Wisely antibiotic prescribing to provide CPCSSN providers with portrait detailing their antibiotic prescribing for respiratory tract infections.

Non-funded projects include:

  • Evaluation of ICD-11 and ICPC-3 codes to build evidence for updating Canada’s Disease Classification Systems in primary care, and
  • Team-based care to understand functioning of teams in primary care.

The Nominated Principal Investigator of BC-PHCRN is Dr. Rubee Dev. Dr. Dev is an Assistant Professor in the UBC School of Nursing & Associate Faculty in the Centre for Health Services and Policy Research, University of British Columbia, with research foci in global health and primary health care nursing. Dr. Dev leads the BC PHCRN along with Dr. Nathaniel Hawkins who is also Director of Research and Associate Professor at the UBC Division of Cardiology.

Canadians Seeking Solutions and Innovations to Overcome Chronic Kidney Disease (Can-SOLVE CKD) Network – Phase 2

Health Research BC is providing match funds for Phase 2 of the Network, which is funded by the Canadian Institutes of Health Research’s (CIHR) Strategy for Patient-Oriented Research (SPOR) Networks in Chronic Disease. 

 

The Can-SOLVE CKD Network is Canada’s largest-ever kidney research initiative. This national partnership of patients, researchers, health care providers, and policy-makers is working to transform treatment and care for Canadians affected by chronic kidney disease.

The network coordinates and conducts innovative research using a patient-oriented approach. During Phase 1 (2016-2023), 18 research teams developed projects seeking to diagnose kidney disease earlier, discover better treatments, and deliver innovative patient-centred care. These projects took many forms: treatment and education interventions, e-health decision aids, and clinical trials testing new therapies.

 

For Phase 2 (2022-2027), the focus shifts to mobilizing these innovations and implementing them into health care policy and practice on a national scale. The goal is to apply this knowledge to clinical practice in order to improve patient care. Can-SOLVE CKD Phase 2 also aims to change the culture of kidney research by strengthening Indigenous cultural competency and equity, diversity, and inclusion (EDI) in health research.

 

Patients have been central to these accomplishments. The network’s Patient Governance Circle has enabled a system in which all research activities are developed collaboratively by patient partners, researchers, and other key stakeholders.

 

In British Columbia, the network is delivering the Kidney Check program. This initiative brings point-of-care screening for chronic kidney disease and its risk factors to rural and remote First Nations communities. Mobile screening technology, including a custom-built iPad app, enables real-time result sharing and the creation of personalized treatment plans. The goal is to support early detection of kidney problems and ensure timely follow-up care. With appropriate treatment, fewer individuals will suffer from kidney failure requiring dialysis, resulting in better health for communities and lower costs for our health care system.

 

The Named Principal Investigator of Can-SOLVE CKD is Dr. Adeera Levin. Dr. Levin is the former president of the International Society of Nephrology and was awarded the Order of Canada in 2015 for her work’s impact on those living with chronic kidney disease. As Senior Medical Lead, Integration Clinical and Academic Networks at Providence Health Care, Dr. Levin has played an important role in facilitating implementation and impacting policy in British Columbia.

A Chemogenomic Platform for Identifying Orphan Glyco-immune Checkpoints

Health Research BC is providing match funds for this research project, which is funded by GlycoNet’s Collaborative Team Grant.

 

This Canada-wide project is a collaboration between Prof. Landon Edgar (University of Toronto, lead PI) and Prof. Simon Wisnovsky (UBC). Both PIs research the ways in which cellular sugar molecules control the activity of immune cells. All of the cells in our body are coated with different types of sugar molecules. Cells in our immune system have ways of “tasting” these sugars. Some types of sugars taste good to our immune system, signaling that our cells are healthy and that everything is normal. Other sugars (like those attached to invading bacteria, viruses or cancer cells) taste bad to our immune cells, triggering them to activate and try to protect us from disease. Sometimes our cells can become altered in ways that lead them to produce different or abnormal types of sugar molecules on their surface. When this happens, it can lead our immune cells to either overlook unhealthy cells (in the case of cancer) or inappropriately attack healthy cells (in the case of autoimmune diseases). Understanding the details of how this happens can help us develop new drugs to treat such diseases. We face the problem, however, that these cellular sugar molecules are not like the sugar that we eat. Cellular sugars are notoriously chemically complex, making it difficult to predict exactly how specific types of sugar molecules will affect our immune system. This proposal attempts to solve this problem by using advanced genetic techniques to better understand the ways in which immune cells interact with cell-surface sugars. The goal of the project is to identify specific proteins that bind to cancer-associated sugars whose activity can then be blocked for therapeutic purposes.

Dissecting regulation of the CD44-hyaluronan axis in cancer metastasis

Health Research BC is providing match funds for this research project, which is funded by GlycoNet’s Collaborative Team Grant. Additional funding is provided by the Cancer Research Society. 

 

This BC-based research project is a collaboration between UBC cancer researchers Prof. Simon Wisnovsky (lead-PI), Prof. Pauline Johnson and Prof. Cal Roskelley. The research of all three Principal Investigators focuses on defining ways that cellular carbohydrates can act as drivers of cancer progression. The majority of deaths due to cancer occur as a result of cancer spread (called metastasis). Thus, it is important to identify molecules that drive metastasis, in order to develop targeted therapies to limit cancer spread. Here, we will determine how one widely expressed cell surface molecule, CD44, drives metastasis and we will identify novel cellular factors that regulate this process. To do this, we will use mouse models of melanoma and breast cancer metastasis, where cancer cells spread to the lung. We will use cancer cells expressing particular forms of CD44, or mutated forms of CD44, and test whether the interaction of CD44 with a long sugar molecule (called hyaluronan or HA) promotes metastasis. We will also determine if one variant of CD44, CD44v6, drives melanoma metastasis. We will then use these mouse models to determine at which stage CD44-HA interactions and CD44v6 affect the metastatic process: migration, survival, or growth in the lung. Next, we will use two innovative high throughput screening approaches (siRNA and Crispr-Cas9) to identify genes that regulate CD44 binding to HA and CD44v6 expression in cancer cells. Putative regulatory genes will be validated, then cancer cells with these genes deleted will be tested in our mouse models of metastasis. Our goal is to identify new proteins that regulate CD44 functions and reduce metastasis. These proteins will provide new targets for intervention and the development of novel anti-metastatic therapies to help cancer patients both in BC and internationally.

Clinical Trial for Montbretin A (MbA) in Diabetics

Health Research BC is providing match funds for this research project, which is funded by GlycoNet’s Translational Grant. 

 

This fully B.C.-based project will undertake a Phase 1 human clinical trial of a promising natural product from plants, Montbretin A (MbA), for control of blood glucose levels in diabetics. The team comprises a chemist (Stephen Withers), a clinician (Robert Petrella), a plant biochemist (Joerg Bohlmann) and a biochemist/coordinator (J.P. Heale). Earlier B.C. work identified MbA as a potent inhibitor of amylase, the principal human enzyme that degrades starch in our guts leading to glucose release into the bloodstream. Subsequent studies in diabetic rats confirmed that orally administered MbA lowers blood glucose levels and is safe, even at very high dosages. On this basis Health Canada approved a Phase 1 clinical trial to evaluate the safety of MbA in humans. This funding will allow us to carry out that trial in a side-by-side evaluation with the drug acarbose that is currently used but causes unpleasant side effects. Due to its different mode of action of MbA should be better tolerated yet highly active.

 

Key words: diabetes, obesity, blood glucose, amylase, inhibitor

Breaking Barriers: Empowering Primary Care Providers to be Instigators of Change in Hearing Health Care Practice

Health Research BC is providing match funds for this research project, which is funded by the Vancouver Foundation’s Participatory Action Research Investigate Grant. 

 

Up to 65% of adults in British Columbia (BC) aged 60+ will develop hearing loss. Fewer than one-quarter of these adults use hearing health care, with most delaying treatment 7 to 10 years on average. Untreated hearing loss affects health-related quality of life with links to social isolation, depression, greater risk of falls, and reduced financial security. For adults with concerns about their hearing, primary care providers (PCPs) are often a first point of contact for help seeking, and yet for reasons that remain unclear, PCP referrals to hearing health care are inconsistently and infrequently practiced. This problem was identified as a top priority through focus groups conducted in 2020. These graphics illustrate the focus group discussions that led to the development of this research question.

 

We will use a community-based approach to identify reasons for lack of referral and develop strategies that empower primary care providers to be key instigators for increased, timely uptake of hearing health care by individuals with hearing concerns.

 

The research team, all based in BC, is led by Lorienne Jenstad, PhD, an audiologist and associate professor at the University of British Columbia; Brenda Poon, PhD, the research program lead at the Wavefront Centre for Communication Accessibility; and Ruth Warick, PhD, president of the Canadian Hard of Hearing Association, Vancouver Branch. The team works closely with other individuals who have lived experience of hearing loss, physicians, nurses, clinical audiologists, and community organizations.

 

Ultimately we hope that primary care providers and the general public will have better recognition of the importance of hearing health and better understanding of the process to receive hearing health services, leading to timely uptake of hearing health care by individuals with hearing concerns and the potential to improve long-term health outcomes.

Mental health needs and technological interventions for social connectedness amongst older adults

Health Research BC is providing match funds for this research project, which is funded by a Social Sciences and Humanities Research Council (SSHRC) Connection Grant. 

 

Older adults are one of the most at-risk groups in the COVID-19 pandemic, both to the negative effects of the virus and on their social connections. In order to stop the spread of COVID-19, social distancing and stay-at-home orders have been put in place. As a result of these steps, places that older adults go to socialize, for example seniors’ community centres, have been forced to close. The aim of this project is to work with a not-for-profit community centre, the West End Seniors Network (WESN), to disseminate the finding from a project where we examined the social connectedness of seniors during the COVID-19 pandemic. The mission of WESN is to enhance the quality of life of older adults by providing social, recreational, educational and supportive programs and services that foster connection and inclusion in the broader community. WESN is the second-largest independent seniors’ centre in Vancouver with over 900 active members; however, due to COVID-19 WESN was forced to close its doors. Through this project we will work with WESN staff and community members to disseminate ways that we can develop stronger social connections. Through interviews with staff, community members, and older adults, we identified what worked, and what did not work to better seniors COVID-19 experience. We will use this information to inform policy-makers, other community centres, and older adults of the ways that we can improve social connections during the pandemic. Through this project we can use the lessons learned and relationships built in this project in larger programs and with more partners.

Digital interventions to improve social connectedness and mental wellbeing of vulnerable older adults during COVID-19 and beyond

Indira Riadi, as a PhD candidate and student lead under the supervision of Dr. Theodore Cosco, is being co-funded by Health Research BC and Mitacs as part of a studentship program led by Mental Health Research Canada in partnership with the Mitacs Accelerate program, designed to develop the brightest Master’s students conducting research in mental health.

 

During her internship, Indira will work with the West End Seniors Network, Vancouver’s second largest not-for-profit seniors centre, to identify ways to improve the social lives and mental wellbeing of ethnic and gender/sexual minority seniors during COVID-19 and beyond. This project hopes to explore the mental health priorities of these populations, investigate what has been done (with specific emphasis on digital interventions), and identify successful and unsuccessful interventions to help raise social connectedness and alleviate mental distress among marginalized older adults in Vancouver.

Adapting breath/air communications to rural, remote and Indigenous ways of living

Health Research BC is providing match funds for this research project, which is funded by a Social Sciences and Humanities Research Council (SSHRC) Connection Grant. 

 

Breathing is living. In recent years, policies that impact lung health and air quality have led people to change how they go about daily life. Traditionally, these policies are crafted by experts and specialists, with little input from the public. More effective policies could be developed by enhancing public participation and collaboration in the policy process. The overarching goal of our work is to improve the sharing and exchange of information about lung health policies with people living in rural, remote, and Indigenous communities.

 

This study uses design methods to adapt lung health policy communications for rural, remote, and Indigenous communities. The connections we create will be facilitated by two streams of outreach activities:

 

Stream 1 — AIRWISE-CONNECT — creates a community advisory group with Indigenous and non-Indigenous community members in northern British Columbia. This group will meet four times over a year to participate in a human-centred design process and interactive group meetings. During these meetings, we will adapt a previously developed website: www.airwisebc.ca.

 

Stream 2 — AIRWISE-VISION — develops a working relationship with the Witset First Nation Band Council and community members to better inform policies and practice. We will draw on the Design Justice method to create new breath/air policy communications that honour the traditional knowledge and practices in Witset.

 

The principal investigator, Sonya Cressman, a health economist at Simon Fraser University and the Centre for Clinical Epidemiology and Evaluation, will lead the study with co-Investigators: Brian Fisher and Dawn Hoogeveen at SFU and collaborators: Renelle Myers (BC Cancer), Anthony Noonan (Executive Director, Witset First Nation), Anne- Marie Nicol (SFU), and Chris Carlsten (Legacy for Airway Health).

General and inexpensive saliva-based viral RNA testing by direct imaging

This award is co-funded by Health Research BC, through CIHR’s Operating Grant: COVID-19 Rapid Research Funding Opportunity – Diagnostics. 

 

In the absence of a vaccine and/or effective treatment, rapid and robust testing is vital not only to reduce the transmission and spread of SARS-CoV-2, but also for paving the way to safely reopen borders and reinstating the world economy. Most Covid-19 tests are performed using nasopharyngeal swabs that are sent to a hospital or public health laboratory to be processed for RT-PCR analysis using expensive equipment by technically trained staff. The specificity of such amplification-based tests makes them superior to many other detection tests. However, the occurrence of false-negative results due to the low levels of viral RNA found in such samples, as exemplified by recent problems with Spartan Cube1, suggests that avoiding nucleic acid amplification entirely and switching to the direct detection of viral RNA could be highly advantageous for SARS-CoV-2 detection.

 

Dr. Peter Unrau is leading a team of researchers to develop a new saliva-based viral testing strategy for use in the current Covid-19 pandemic. Dr. Unrau (professor in RNA biochemistry) and co-investigator Dr. Forde (professor in biological physics) will coordinate a research team at Simon Fraser University. They will work in collaboration with David Rueda, a professor in single-molecule imaging at Imperial College London.

 

This COVID-19 research will allow the development of a fast, inexpensive and sensitive viral RNA test that, in principle, could be used for point of care testing at home. The proposed SARS-CoV-2 RNA single-molecule imaging test will be highly specific, will rely on simple well-understood chemistry, and will include an inexpensive imaging device that connects to a cell phone. An additional benefit of this device is that test procedures can easily be adapted for the screening of other RNA pathogens in the future.

End of award update – January 2022

Most exciting outputs

We have developed a prototype device able to test for viral pathogens in spit. This device can report results easily over the internet and has many potential rapid testing applications.

 

Impact so far

Reliable and inexpensive point of care diagnostic technology is extremely important during a pandemic for both primary and community health care. As can be seen with the explosive spread of the Omicron coronavirus variant, RT-PCR test centers are overwhelmed and there is no coherent way to report point of care test results to centralized government agencies. We have developed an inexpensive (< $100 if mass produced) point of care instrument that via the internet can simply and reliably report test results to centralized data centers. This device accepts modular test cartridges, which could, with further development, offer a broad range of test services at low cost. Such a device has many uses, but could easily be imagined to play an important role in rural and remove health care locations in the future. While now only a proof of principle prototype, future investment should result in a device able to provide a health benefit to BC citizens.

 

Potential future influence

Inexpensive point of care tests are difficult to develop and implement. Our device offers a potential solution to this global problem.

 

Next steps

We are seeking further investments by third parties to commercialize our prototype technology.

 

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