Program: Reach Awards

Co-leads: Suzanne Lewis Pacific Autism Family Network / University of British Columbia Dawn McKenna Pacific Autism Family Network

Team member: Caylee Raber Emily Carr University

Trainee: TBC

The objective is to support research dissemination and knowledge translation in the autism spectrum disorders (ASD) community by co-designing a web-platform that will facilitate the uptake of research evidence by families and individuals with ASD. This platform will link research users to credible sources of information, research, and services by acting as a knowledge broker and research wayfinding system.

ASD is a growing condition impacting society in profound ways; it is the most common neurological disorder in children, affecting approximately 60,000 people in BC. There is an urgent need for a more fulsome approach to the dissemination of knowledge to families about best practices, new research, evidence-based treatments and support. Families are essentially left to their own devices to make critical decisions about what services are most beneficial for their child and hence where best to direct their funding. This is critical because the earlier treatment is started, the better the outcome.

The Pacific Autism Family Network’s (PAFN) mandate is to be a Knowledge Centre of Excellence: bringing together state of the art resources for research, information, learning, assessment, treatment and support across BC. Since 2015, PAFN has collaborated with the Health Design Lab (HDL) at Emily Carr University to better understand the communication challenges and needs of researchers and families in the ASD community. Through this collaboration in 2016/17, it was found that access to reliable and credible research for families is a significant challenge due to barriers including time, money, location, language and format. To improve knowledge exchange, researchers and families identified the need for a web-platform that will curate credible ASD research for families and disseminate it through more diversified and accessible communication modes.

To meet this challenge of co-designing the web-platform, workshops with the ASD community will be held. Based on input from researchers and research-users, the HDL will design and prototype a web-platform. This will facilitate knowledge exchange and support research users (families and self-advocates) in making informed decisions based on best-practice research. It will also enable researchers to connect with families to support their research endeavors creating direct linkages and ongoing connectivity with the ASD community.

Co-leads: Lori Brotto  Women's Health Research Institute / Provincial Health Services Authority Lana Barry Self Management BC / University of Victoria

Team members: Christine Clark  Thinking Box Carolin Klein Vancouver General Hospital Nicole Prestley Women's Health Research Institute

Trainee: TBC

Chronic genital pain affects up to 12 percent of women and is characterized by painful, distressing, and anxiety-evoking intense sensations when the vulva/vagina is touched. The multidisciplinary team at the University of British Columbia completed a grant-funded trial of group psychological skills training for women with this condition and found both experimental treatments to lead to statistically and clinically meaningful improvements for women. A 90-second infographic video (#ItsNotInYourHead) was then developed with the help of a media design partner and engaged patients. The video conveys two compelling messages:

1. Chronic genital pain is common and you are not alone.
2. There is evidence that psychological treatments can be very effective in managing symptoms.

The intention is to develop a targeted plan for widespread dissemination of the video to the target audience — primarily women (patients) who may experience chronic genital pain. This video will also be disseminated to other audiences who may benefit from the information, including women’s partners, health care providers, hospital policy makers, and the general public. The project goals are to:

1. Develop a social media outreach campaign.
2. Capture metrics associated with various forms of social media used to distribute the video.

The evaluation plan ensures that KT goals have been achieved. The overarching goal is to facilitate the update of scientific evidence from the grant-funded trial by women (and other key stakeholders) who can directly use this new knowledge.

Co-leads: Kimberly Miller Simon Fraser University Vanessa Bland  Vancouver Coastal Health

Team members: Sandra Dawson  Patient partner Laura Johnston Community Legal Assistance Society Erin Michalak University of British Columbia Jessica Wang  Patient partner

Trainee: Iva Cheung  PhD student

Under the provincial Mental Health Act, patients involuntarily hospitalized for a mental disorder must be informed of their rights upon admission. But in a 2011 survey of short-stay mental health patients, 43 percent of respondents said they were not explained their rights in an understandable way. Qualitative research by Iva Cheung suggests this gap may be due to inconsistent rights-advice practices and an ineffective communication tool.

Clinicians use a statutory form to give rights advice to involuntary patients, but user testing of this form with people with lived experience has uncovered weaknesses in the document, from the patient’s perspective, as a communication tool.

With this award, the research team aims to apply evidence from that user testing to create a new suite of rights-advice communication tools and a training program for clinicians to implement these tools. Two patient partners on the team will co-create the communications, which will be user tested with people with lived experience, to make them as clear and useful to patients as possible. The team’s research user co-lead, an experienced resource nurse with a mentorship role and access to 11 psychiatric units, will contribute her knowledge of rights-advice practices and clinical workflows to ensure that the tools will be practical to use in hospital settings. The legal expert on the team will review the tools for legal accuracy.

The research user co-lead will champion this research in her workplace and help develop an interactive training program for clinicians who give rights advice. This training will

• Introduce the new communication tools.
• Emphasize the importance and potential therapeutic benefits of rights advice.
• Refresh clinicians’ knowledge of salient parts of the Mental Health Act.
• Support clinicians in establishing strategies for implementing rights advice in practice.

Expected outcomes:

• Patients will know they have Mental Health Act rights.
• Patients will better understand their rights and how to exercise them.
• Clinicians will improve their knowledge about the Mental Health Act.
• Clinicians will gain strategies for implementing rights advice in their workflow.

The activities of this team, with a balance of researcher, clinician, and patient representation, align well with integrated knowledge translation best practices and with the health authority’s priority of providing patient-centred care.

Co-leads: Lise Olsen  University of British Columbia – Okanagan Rachelle Hole Centre for Inclusion and Citizenship / University of British Columbia Vicki Cairns Autism Okanagan Kelowna

Team member: Alison McManus University of British Columbia – Okanagan

Trainee: Matthew Ferrier Undergraduate student Zarka Kiktavy MSW student Crystal Shannon MSN student

This project aims to communicate and stimulate stakeholder interest in developing strategies to better support Okanagan families with autism spectrum disorder children, thus enabling them opportunities to pursue safe and active recreation.

The activity will be a one-day symposium at the Okanagan campus with a proposed date of March 2018. The short term goals are to share research findings and build a stronger network and researcher/practice connections. The long term goals are to build a community of interest, identify and agree on key areas of needed practice and policy change in the Okanagan, and develop a strategy through a funding proposal to enact such changes. Specific objectives of this activity include:

1. For a symposium planning group to oversee the development of the symposium activities and strategies.
2. Raising awareness among stakeholders about research in this area.
3. Providing a forum for interaction between attendees and researchers on this topic.
4. Providing an opportunity for stakeholders in the Okanagan communities to become involved in developing an ongoing plan based on current research evidence for furthering research and intervention development.

Co-leads: Heather McKay University of British Columbia Joanie Sims-Gould University of British Columbia Callista Ottoni CHHM / Vancouver Coastal Health Research Institute Kahir Lalji United Way of the Lower Mainland Rebecca Tunnacliffe BC Recreation and Parks Association Marcy Cohen BC Raising the Profile Project

Trainee: Samantha Gray University of British Columbia

In Canada, and elsewhere, there is a continual battle to find effective ways to engage older citizens in physical activity programs. Despite the known benefits of physical activity to counter the risks of a host of chronic diseases, only 13 percent of Canadian seniors meet recommended physical activity guidelines. For over three years, the BC Recreation and Parks Association (BCRPA) and the United Way of the Lower Mainland (UWLM) have been collaborating to address these issues.

Most recently, under the auspices of the Active Aging BC (ABC) program, these organizations came together to co-create, deliver, adapt and evaluate a physical activity intervention (Choose to Move) and disseminate Active Aging grants. ABC (funded by BC Ministry of Health) enhances the health, mobility and social connectedness of low active older adults. The partners are experts in implementation and dissemination of community-based programs. There is also a partnership with the Raise the Profile Project (Cohen) and participation in the Executive Organizing Committee for the Provincial Seniors Summit (November 2017).

As researchers, there is a reliant on data, graphs and figures to convince communities and policy makers at local, provincial and national levels to take action toward improving health. However, the voices of those most affected by inaction speak much louder than researchers can.

The objectives of this award are to:

• Create a short documentary video telling the stories of older adults, their activity coaches and community stakeholders involved in Choose to Move across BC.
• Launch this KT product at the Raising the Profile Project Seniors Summit (November 2017) and the BCRPA annual meet up (April 2018).
• Disseminate this KT product through the research users’ extensive distribution channels.

Ultimately, through life-changing stories, the aim is to raise and change the profile of older British Columbians. With evidence from the Choose to Move impact evaluation, stories will be integrated to illustrate that there are effective, evidence-based solutions to older adult physical inactivity. Practitioners and organizations who serve the needs of the older population will also be made aware of Choose to Move. Finally, through BCRPA, UWLM and RPP channels, this KT product will be disseminated and used to recruit older adult participants into the Choose to Move programs.

Co-leads: Quynh Doan BC Children’s Hospital Research Institute / Provincial Health Services Authority Garth Meckler BC Children’s Hospital Research Institute / Provincial Health Services Authority Christy Hay University of British Columbia

Trainee: Benetta Chin MD, FRCPC [pediatric], sub-speciality resident

This award will help establish a standardized approach to acute care for mental health crises at BC Children’s Hospital’s Emergency Department (BCCH ED). BCCH is the only quaternary level PED in BC and receives over 46,000 annual visits, of which almost 1,000 are mental health related. Over an 11-year period, the annual number of mental health visits at BCCH increased by 86 percent, from 529 visits in 2002 to 983 in 2012. Youth with mental health concerns are among the fastest growing segment of the ED population and this is true across North America. Data further shows that repeat visits account for almost one-third of all mental health visits, suggesting a need for improvement in the discharge and follow up processes.

This project will implement a child and youth specific ED protocol for the clinical assessment, management and discharge of patients with mental health concerns at BCCH ED. Supported by a partnership between the Doctors of BC and the BC Ministry of Health (Shared Care), the Child & Youth Mental Health & Substance Use Emergency Department Protocol (CYMHSU ED protocol), which includes HEARTSMAP, a validated clinical assessment tool, is already being implemented in community EDs across BC. Unfortunately, the BCCH ED was not included in the provincial plans and has not benefited from this initiative. This omission may cause non-uniform use of the HEARTSMAP tool and discrepancies in care, discharge planning, and referral/follow up plans for youth seen at BCCH ED compared to the rest of BC.

Scientific evidence will be used to:

1. Improve youth and family care by orienting them to the BC mental healthcare system, including information about the role of the emergency department and access to community mental health resources after discharge.
2. Help PED clinicians conduct efficient and effective emergency psychosocial assessments with proper documentation, and guide them in choosing the right mental health service at the right time to optimize patient care.
3. Evaluate the effectiveness of this implementation program.

To reach these aims, three activities are proposed:

1. Customize the CYMHSU ED protocol components for use at BCCH ED.
2. Implement the protocol through workshops for clinical end-users.
3. Evaluate the effectiveness of the implementation program.

Co-leads: Noeman Mirza Thompson Rivers University Wendy Hulko  Thompson Rivers University Lori Seeley  Interior Health

Trainee: Emma Schultz  Undergraduate student

By 2019, the senior population will increase by 20 percent in Kamloops; this outpaces the expected general population increase of 4.8 percent (Interior Health, 2014). This change has forced a need to re-examine the structure and delivery of healthcare services in BC’s central interior. In response, Interior Health (IH) is undergoing a system change to enhance the delivery of primary and community care for frail older adults and those with complex chronic conditions. This “repositioning” or restructuring of healthcare services is anticipated to provide comprehensive and effective community based care for clients.

Since evidence-informed practice in healthcare must include client preferences (DiCenso, Guyatt & Ciliska, 2005), there is an urgent need to consult service users to guide the direction of IH’s decisions on the repositioning of older adults within BC’s central interior. Supported by an IH Evidence-Informed Practice Challenge grant (2016 – 2017), this ROAR (Researching Older Adults Repositioning) study engaged older adults (from Kamloops and nine surrounding rural and remote communities) in research and enabled them to share views on primary and community care in BC’s interior and the repositioning work undertaken by IH.

Taking place over the next year, the TRiP (Translating ROAR into Practice) project is an integrated knowledge translation (iKT) process that will enable the engagement of IH staff (as decision-makers and knowledge users) and older adults (as service users and research participants) in interpreting research findings from the ROAR study. One of the iKT strategies for this project is to hold a summit where study participants and knowledge users, along with representatives from key seniors and/or patient advocacy groups, will work together to develop a plan to ensure findings from the ROAR study effectively make their way into practice at IH.

This award will go towards a dissemination scheme to complement the TRiP project. As part of the proposed scheme, dissemination tools will be developed to make research users aware of the ROAR study findings within IH, BC and beyond. ROAR findings will be shared through publication in an open-access journal and presentations at local venues, and one regional or national aging-related conference.