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.
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.
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).
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.
Breast cancer is the most common cancer amongst women in Canada. Breast cancer cells shed tiny pieces of themselves into the blood stream called extracellular vesicles. These tiny pieces, or cell fragments, are different from those of a healthy breast cell and we think they could be used to detect a breast cancer at its earliest stage. Importantly, we can isolate and study these fragments from the blood of healthy females and breast cancer patients. We think that by looking at the sugars and proteins they contain we will find markers that could help in the detection of breast cancer. We are also going to look at tumor cell fragments from patients whose cancer came back years after treatment, a process known as metastasis, and find unique markers that could predict this outcome. By identifying breast cancer early and figuring out whose at risk for a having their cancer come back we can improve how women are treated and reduce the chances of the cancer coming back.
This Pan-Canadian project involves research teams in British Columbia and Alberta. Dr. Williams, lead PI, is an assistant professor at UBC’s Faculty of Pharmaceutical Sciences and her team includes clinical pathologist Dr. Peter Watson (BC Cancer) and Professor of Chemistry Dr. Lara Mahal (University of Alberta).
End of award update: November 2021
Most exciting outputs
Our project successfully isolated small cell fragments, termed extracellular vesicles, from blood plasma of hundreds of breast cancer patients and healthy females. From this, we were able to look at the sugars and proteins on these fragments to identify ones unique to breast cancer patients. This has allowed us to find a couple unique markers that we think can be used to identify breast cancer at its earliest stage of development.
Impact so far
Detecting cancer at the earliest stage will support the best outcome for patients. This is particularly relevant in breast cancer as it is well established that a disease diagnosis at an early stage, Stage I, is associated with the highest rates of patient survival. Our project has identified novel sugar and protein based biomarkers with utility in identifying breast cancer. Validation of newly identified biomarkers could lead to the development of a blood-based test for breast cancer screening.
Potential future influence
Our project aims to reduce the mortality associated with a breast cancer diagnosis. To do this we are aiming to develop a non-invasive test that will support the detection of breast cancer at its earliest stage.
Next steps
We plan to validate our newly discovered breast cancer biomarkers and work towards translating our results into a product that could be used as a simple point-of-care test by a family doctor.
Please visit GlycoNet to learn more about this project.
Health Research BC is providing match funds for this research project, which is funded by the GlycoNet’s Collaborative Team Grant – Cycle II.
Early detection of prostate cancer uses methods that are controversial and lead to uncertainty in care; this leads to a lot of overdiagnosis and overtreatment in men who are healthy or have inactive disease. We recently developed a test using a sugar found on aggressive cancer cells that acts as a biomarker to detect high-risk cancer in patients and support biopsy decision-making. But, for this test to be taken up in Canada to improve patient care, it needs to be evaluated for its potential value for money for the healthcare payer. This pan-Canadian project is the first analysis of the cost-effectiveness of a new sugar-based prostate cancer diagnostic tool. It will tell us whether the maximum possible gains from the new test versus status quo (or other new technologies) are worth their costs, and in which subgroups of patients we see the most positive net benefit.
The leading PI is Dr. Conklin, assistant professor at UBC’s Faculty of Pharmaceutical Sciences and scientist at UBC’s Centre for Health Evaluation and Outcome Sciences (CHEOS). Dr. Conklin’s BC-based team include Drs. Wei Zhang and Larry Lynd (also Scientists at CHEOS) and Dr. Williams (inventor of the new sugar-based test); the team also includes Dr. Liu, a clinician collaborator from Sunnybrook Hospital in Toronto.
This economic evaluation project will address a critical gap in test development early on to avoid the pitfall of creating an economically non-feasible test. The output of this project could contribute to improved patient care and to better decision-making of patients, guideline developers and health ministers.
Please visit GlycoNet to learn more about this project.
End of Award Report – June 2023
Results
In this decision analytical model framework, using real-world whole-population data, a novel rapid assessment and treatment (RAT) (based on an existing new biomarker’s characteristics) was dominant compared to the standard of care. A range of scenarios demonstrates how results were sensitive to the cost and accuracy of the RAT, prostate cancer (PCa) prevalence, the proportion of high-grade PCa, and assumptions about undetected cases. This cost-effectiveness study showed that a new and more accurate biomarker or other RATs to inform biopsy decisions can be a cost-saving or cost-effective strategy, thereby improving PCa diagnosis and treatment.
Potential Influence
This research may inform decision-makers in BC about the total costs associated with prostate cancer, which we have published. It will also help guide future decision-making on newer biomarkers as we did a cost-effectiveness analysis to show the threshold for acceptable costs of newer technologies to guide biopsy decisions.
Next Steps
Our next steps are to complete the publication process of our second main results paper (just submitted to Cancer Medicine) and to brainstorm with our collaborator about one more paper/study using the same data that our team has now analysed.
This award is being co-funded by Michael Smith Health Research BC, Genome BC, and Genome Canada.
In Canada, more than 1 in 10 people will suffer a major form of depression at some point in their lives. There are many effective treatments for depression, including drug therapy. Finding a medication that both works and does not cause severe side effects is often a matter of trial-and-error. This may contribute to the high non-adherence rates and, subsequently, to poorer health outcomes and increased costs. An individual’s genetic makeup is thought to be partly related to whether particular drugs work and whether there are side effects with the drug. “Pharmacogenomic” testing, that is, using the patient’s genetic information to determine which particular drug might work best, at the right dose, with the fewest side effects, is a new and promising approach.
In this study, we want to know if pharmacogenomic testing for depression treatment should be routinely used in British Columbia. Through a series of research activities, we will evaluate how much improved health patients might see, as well as whether the testing is good value for money for the health system. As a whole, the project will provide tools for evaluating and addressing societal and economic considerations for the implementation of pharmacogenomics tools into clinical practice.
Dr. Stirling Bryan (Principal Investigator) is a health economist, Professor in UBC’s School of Population and Public Health, a Senior Scientist at the Centre for Clinical Epidemiology and Evaluation (Vancouver Coastal Health Research Institute), and President of the BC Academic Health Science Network. Dr. Jehannine Austin (co-Principal Investigator) is a genetic counsellor, Professor in Psychiatry & Medical Genetics at UBC and executive director of the BC Mental Health and Substance Use Services Research Institute. The remaining multi-disciplinary Canadian team has expertise in health policy research, simulation modeling, systematic reviewing, knowledge translation, and includes patient partners.
End of Award Update – November 2023
Results
Key findings: Our research team synthesized multiple types of evidence and developed a sophisticated simulation model to evaluate health outcomes and costs associated with Pharmacogenomics (PGx)-guided care for adults with major depressive disorder (MDD) compared to usual care. Results indicated a compelling case for PGx implementation; $956M in cost-savings to the health system and large population health gains over 20 years.
Successful and meaningful patient engagement: Three patient research partners joined the team as full, active members of this patient-oriented project early on. The depth and extent of their contribution to all of the research activities benefited the research methods, credibility was enhanced, and other team members reported meaningfulness was added from this engagement.
Several publications: Five high-caliber academic journal publications resulted from this work, including the cost-effectiveness modeling results in the Canadian Medical Association Journal (CMAJ). This led to an invited commentary and press releases from CMAJ and UBC, as well as numerous mainstream news articles and radio interviews. We have three additional manuscripts under review.
Extent of knowledge mobilization: Project activity findings were shared at local, national, and international conferences and seminars with both oral and poster presentations and included patient partner presentations. An array of infographics, lay summaries, and policy briefs were developed, many of which are showcased on our UBC-hosted study website. Two whiteboard animated videos were produced, uploaded to YouTube, and have been viewed more than 800 times.
Impact
In our original grant proposal, we stated that “the project will provide tools for evaluating and addressing societal and economic considerations for the implementation of pharmacogenomics tools into clinical practice”. We achieved this goal throughout the entire project by: 1) Asking people what they think (i.e., interviews with people with lived experience (PWLE), healthcare professionals/providers, and decision-makers); 2) Evaluating what is already known; 3) Analyzing what the BC-specific data show to provide estimates of health service use in a cohort of people with major depression; 4) Putting everything together to evaluate costs and benefits of PGx testing; and 5) Holding an event to share the results with a range of interested/affected groups, as well as an opportunity for them to share their reflections and suggestions.
We produced numerous and widely varied project outputs, which we successfully shared with a range of audiences. This raises awareness of major depression, what kinds of treatments are available, and demonstrates the potential benefit that could be realized by pharmacogenomic testing – a tool that could help practitioners find an effective medication for major depression in a shorter number of medication trials and one that is less likely to cause intolerable or serious side effects. From the patient perspective, this could lead to major improvements in their health and quality of life, without having to undergo what can be a painful, long, and challenging treatment journey to find an effective medication to relieve symptoms of depression. From the healthcare system perspective, this would result in fewer healthcare appointments, hospitalizations, and decrease the use of much more intensive treatments that are also expensive to the healthcare system. Our results provide hope to patients and healthcare providers to guide better medication prescribing for a condition that is extremely common, and yet would benefit from improved treatments.
Potential Influence
The concluding recommendation of the project was to move forward with implementing pharmacogenomic testing for major depression in BC, and we have strong and ongoing policy engagement from the Ministries of Health and Mental Health & Addictions in BC. While our results indicated a compelling case for such implementation (major cost-savings, large population health gains), exploration of implementation strategies, such as which healthcare professionals are best-suited to deliver PGx, is the natural next step and remains unexplored in Canada. We have developed a project proposal for this follow-on phase of work and hope to answer some key questions that remain around implementation.
There has been widespread interest in our cost-effectiveness analysis results, which were published in the Canadian Medical Association Journal. We have had requests to adapt the microsimulation model to other health jurisdictions, so that they are able to establish context-relevant economic evidence for policymakers in those jurisdictions. We very much hope to be able to collaborate with other jurisdictions and remain open to considerations to adapt the model for other interventions for major depression or even for other health conditions.
Next Steps
Our next steps include publishing three further manuscripts (all currently under review), collaborating with other Canadian provinces and other countries to adapt the economic model for those jurisdictions, and to secure funding for the follow-on project around how best to implement pharmacogenomic testing for major depression in BC.
Pharmacogenomic Testing for Major Depression: A Simulation Model
To provide your thoughts on the model described in the video, please contact:
Louisa Edwards, PhD
Research Program Manager
School of Population & Public Health
University of British Columbia
Email: louisa.edwards@ubc.ca
Here is the link to our UBC-hosted project website, which does list publications and some other project outputs (animated videos, conference presentations, infographics): https://spph.ubc.ca/pgx4depression/
Health Research BC is providing match funds for this research project, which is funded by CIHR’s Strategy for Patient Oriented Research (SPOR) Primary and Integrated Health Care Innovations (PIHCI) Network – Knowledge Synthesis Grants.
Jason Sutherland is Professor in UBC’s Centre for Health Services and Policy Research in the School of Population and Public Health. He is also a Scholar of the Michael Smith Foundation for Health Research.
This is a two-province research team, though the scope of the project is examining integrated funding models across the globe. Little is known regarding how other countries have developed and implemented policies for supporting integrated healthcare. This study will conduct an extensive review of the literature and synthesize the evidence regarding the scope and breadth of policies and their effectiveness to improve integration of healthcare across sectors of the delivery system.
Knowledge translation activities:
Policy roundtable to disseminate findings to knowledge users in Calgary, Alberta
Policy roundtable to disseminate findings to knowledge users in Vancouver, British Columbia
Patient Groups Compensation (honorarium, travel cost, parking) in Calgary, Alberta
Patient Groups Compensation (honorarium, travel cost, parking) in Vancouver, British Columbia
Open Access Publication jointly by University of Calgary and University of British Columbia
Webinar and YouTube video preparation by the University of British Columbia
The team expects to share findings of the project with key public stakeholders regarding attributes of policy and delivery systems that integrate sectors of the healthcare delivery system to improve care and outcomes.
End of Award Update – April 2022
Most exciting outputs
In my opinion, the most exciting outputs from this project include the development of a multi-institution collaborative to collect surgical patients’ health and health outcome information. The information that this project has generated has led to innovative insights into the value of operative treatment for the patient, health system and government. This information has led to creative ways of re-configuring access to elective surgery, improving mental health in addition to physical health, and training students on the importance of patients’ perceptions of their health.
Impact so far
The impact of this project is local, national and international. Locally, operative patients, the health system and the province are benefiting from understanding the gain in health attributable to surgery. Nationally, this work is garnering significant attention from outcomes researchers and health systems seeking to understand variability in health and healthcare outcomes from surgical care. Internationally, this work is attracting interest from countries with public health systems with similar problems in accessing surgical care and cost-efficiency of healthcare delivery, international agencies, such as the International Consortium for Health Outcomes Measurement (ICHOM), and academic institutions.
Potential future influence
The project is continuing to expand with financial and in-kind support from new organizations. In 2021, PHSA and the Heart and Stroke Foundation (B.C.) began funding the expansion of the project.
Next steps
Continued expansion with existing and new collaborators.
Renewed knowledge translation with government and healthcare organizations.
Attract new funding from national and provincial research organizations.
Health Research BC is providing match funds for this research project, which is funded by a Social Science and Humanities Research Council of Canada (SSHRC) Partnership Grant. Additional support is provided by UBC (Vancouver and Okanagan) and an anonymous donor.
Through community-based research design and implementation we aim to address an urgent priority of providing access and receipt of services among women and youth affected by violence who experience the worst severity in terms of types, duration, frequency and impact of violence for their lives. This pan-Canadian team includes 31 co-investigators and 14 partner organizations, across academic, public service, not for profit and private organizations.
Together, this team will implement an innovative, trauma and violence informed approach to outreach and community service integration in 4 Canadian cities including two in BC, testing the efficacy of this model to positively impact women’s engagement with an array of health and social services that can help women recover from and prevent ongoing violence in women’s lives. Study outcomes will provide essential information about the current primary care services in the BC Sites, and offer evidence informed strategies with transferability within these and other BC locations to enhance primary care for vulnerable women.
Additionally, because our model includes an integrated service approach we will be investigating how not-for-profit service organizations navigate and collaborate with primary care services to support appropriate referral for the women to whom they provide services. This information can also support more effective collaborations between these two service provider sectors.
The principal investigator is Victoria Bungay, Associate Professor, School of Nursing, UBC-Vancouver and Canada Research Chair in Gender, Equity and Community Engagement. Other BC team members are:
Jennifer Baumbusch, School of Nursing, UBC-Vancouver
Aggie Black, Providence Health Care
Linda Dewar, Inner City Women’s Initiatives Society
Kasari Govender West Coast Legal Education and Action Fund (West Coast LEAF)
Kim Hawkins, Rise Women’s Legal Centre
Angie Lohr, H.O.P.E. Outreach in Kelowna
Karen Mason, Kelowna Women’s Shelter
Michelle Novakowski, Central Okanagan Elizabeth Fry Society (COEFS)
Will Panenka, Department of Psychiatry, UBC-Vancouver
Eli Puterman, School of Kinesiology, UBC-Vancouver
Paul Van Donkelaar, School of Health & Exercise Sciences, UBC-Okanagan
The team also includes an incredible advisory of women with expert knowledge in accessing supports and services within their respective communities.
Health Research BC is providing match funds for this research project, which is funded by CIHR’s Strategy for Patient Oriented Research (SPOR) Primary and Integrated Health Care Innovations (PIHCI) Network – Comparative Program and Policy Analysis Grant.
Dr. Kelli Stajduhar is working with a team of researchers across Canada including PI R. Urquart (NS), and Co-Is K. Pfaff (ON), G. Johnston (NS), B. Lawson (NS), C. Tschupruk (NS), and G. Warner (NS). Using a realist evaluation, survey questionnaires, and in-depth interviews with program personnel, programs users and family members, this study will focus on gaining an improved understanding of innovative community-based navigation programs across Canada with a focus on end-of-life care and support.
Of particular interest are those programs that have been developed and successfully put into place across various health jurisdictions and which help educate patients and families, link them to critical health system and community services and supports, and facilitate coordination of services and supports across healthcare settings. Generally speaking, the programs of interest will help patients access the services and resources they need, though it’s expected the way in which they do so will vary from program to program.
It will be examined 1) whether and how these navigation programs work across different community and health system contexts; and 2) what is needed to integrate successful community-based navigation programs into currently existing primary healthcare services and systems of care so they are sustainable, and can improve patient and family outcomes across Canadian jurisdictions and healthcare settings at the end-of-life.
End of Award Update – August 2023
Most significant outputs
Navigation programs tend to be cancer-centric, and this pan-Canadian research project looked at programs for those with other chronic life limiting illnesses. A program theory was developed that sets out the conditions for successful programming.
Impacts
This program theory has the potential to impact the development, evaluation, and sustainability of future programs.
Potential Influence
We hope that navigation programs are recognized as a part of the health care continuum of care. This recognition will allow programs to receive sustainable funding and build much needed infrastructure that is responsive to the needs of people living with life-limiting chronic illness in our communities.
Next Steps
As time allows, the research team will continue to publish data and meet with community members who are interested in the research results.
