Weight stigma includes the negative attitudes, stereotypes, and discriminatory behaviours towards people with higher weights. Weight stigma is both common and socially acceptable in Canada and contributes to inequity across the lifespan. These inequities negatively impact the health of higher-weight people, who experience poorer physical and psychological health due to weight stigma. It also impacts the quality and quantity of healthcare that higher-weight people receive, via dehumanizing language and stereotyped assumptions. The impact of weight stigma on health and healthcare is further compounded by the health consequences associated with other forms of stigma. The objective of this research is to better understand the impact of weight stigma on the health and healthcare of diverse people in Canada. This aim will be achieved by surveying and interviewing diverse people with higher weights about their experiences with weight stigma at any point in their lives. Additionally, existing health data will be examined to better understand real-life impacts of weight stigma in primary healthcare. This research will contribute to changes in healthcare services and policy, leading to greater health equity in Canada.
Program: Scholar
Developing a culturally responsive strategy to advance child health equity
There are unfair differences in healthcare for children and families. Specifically, children from racialized and underserved communities are likely to face more roadblocks when trying to get the care they need. This can be particularly challenging for children with serious and life-threatening illnesses that require specialty care. Culture, including what children and their families believe, their languages, and how they adjust to new places, can affect how they understand their diagnoses and communicate with their healthcare teams. The goal of this project is to create and test culturally informed approaches that can improve the healthcare and related experiences for racialized children and families, including those with cancer, eating disorders, and serious neurological conditions. This research will be conducted in partnership with children and families, healthcare providers, and community organizations. Results will be shared in a way that is understandable and usable. A major outcome of this work is to build long-term working relationships with children and families, healthcare providers, and local communities. Ultimately, this research will find more ways to support children and families that come from diverse backgrounds.
Enhancing nursing capacity to promote equity: Remediating healthcare inequities through collaborative research partnerships
The Canadian health system aims to provide excellent healthcare for all. Yet, unfortunately there remain considerable inequities in healthcare, and as a result, people who experience such inequities face poorer health outcomes. There is dire need for research that identifies new strategies and approaches to achieve this aim – particularly within nursing, as the largest group of healthcare providers in Canada. This program of research centres on enhancing nursing capacity to promote equity, towards remediating these inequities that lead to poor health outcomes. In particular, this program of research focuses on addressing healthcare inequities faced by people who experience mental health challenges, and the Two-Spirit, lesbian, gay, bisexual, transgender, queer, intersex, and asexual (2S/LGBTQIA+) community. Working in collaboration with health system leaders and providers, as well as people with lived experience of inequities, the ultimate vision of this program of research is to support more equitable health systems. By doing so, people who currently face inequities will experience safe and inclusive healthcare encounters, and as a result, enjoy improved health outcomes.
Collaborative Governance for Ethical and Trustworthy AI in Healthcare: A Lifecycle Perspective
Artificial intelligence (AI) is reshaping healthcare worldwide, offering opportunities to improve efficiency, reduce costs, and deliver more personalized care. These advances could greatly benefit British Columbia (BC) by enhancing healthcare access, particularly in remote or underserved areas. However, without strong safeguards, AI systems may fall short in reliability, fairness, and accountability, resulting in uneven outcomes and inadequate oversight. My research focuses on building ethical and governance frameworks to guide the use of AI in healthcare. I am committed to developing tools that are inclusive, ethically designed, and equitable. By working closely with researchers, policymakers, and communities, I aim to create ethical guidelines and public policies that uphold transparency, fairness, and public trust. This mission is even more urgent as global calls for AI deregulation grow, risking weakened safeguards and accountability. My work addresses these challenges by ensuring that AI innovations align with global ethical standards while advancing BC’s healthcare system. Together, we can shape a future where AI is not only effective but also trustworthy, fair, and beneficial for everyone.
Addressing the structural and social determinants of young people’s health
Although young people’s mental health remains a public health priority, there continue to be knowledge gaps in what diverse youth identify as facilitators and barriers to accessible, safe, and inclusive mental health services and systems. To date, there is limited information about the broader social factors and forces that shape youth mental health. This research program will study the relationship between social factors and patterns of health service use for youth mental health; the role of racial discrimination in mental health and mental health care, including youth perspectives on their experiences; and ways to improve knowledge mobilization and the implementation of mental health equity interventions. Planned KT activities include in-person and online discussions, community reports, webinars, infographics, social media posts, presentations, and academic publications. This research will generate needed information about youth mental health, racial discrimination, and other social factors that can inform changes in practice, policy, and future research to address health system barriers and improve mental health outcomes for diverse youth.
Community partnerships to understand and improve movement behaviours
Participation in physical activity provides people with many health benefits. Despite work to improve population physical activity levels, most people do not participate in enough physical activity to get these health benefits. Physical literacy examines the many factors that contribute to physical activity behaviour (motivation, confidence, physical skills, knowledge, and understanding) using an individual lens, and can be captured within the larger contexts that influence movement behaviours. This individual lens is a useful tool to develop and assess strategies to support equitable access to physical activity. I will develop a rich understanding of the interplay between physical literacy and physical activity, using a community-informed approach to improve our understanding of access to and participation in physical activity for equity deserving populations. In partnership with community groups, I will co-develop understanding of the barriers and facilitators to physical activity, and strategies to support increased movement. This research will inform policy change to create physical activity programs that are relevant and engage communities and support population level participation in health promoting movement.
Exploring the shifting landscape of medication-based drug treatment and safer supply in the fentanyl era: a research program to address the evolving overdose crisis in BC
Canada continues to grapple with an overdose crisis driven by illicitly manufactured fentanyl and novel psychoactive substances (e.g., etizolam, xylazine). The drug treatment landscape is rapidly evolving in response, and includes the implementation and expansion of a number of medication-based drug treatments (e.g., oral and injectable hydromorphone) and prescribed safer supply programs (SSP) that provide pharmaceutical alternatives to the toxic drug supply. However, socio-structural factors have impeded broader expansion and support, and SSP remain controversial with many healthcare providers expressing concern. This ethno-epidemiological research program will gather the views of people who use drugs, policymakers, and health system actors across BC to explore how individual, social, structural and environmental factors shape access to and outcomes from existing and emerging medication-based drug treatment programs and SSP. This is a critical opportunity examine the rapidly shifting drug treatment and overdose response landscape to better inform public health approaches to the ongoing overdose crisis. Knowledge gained will inform and guide future policy and public health developments to improve the lives of people who use drugs.
Evaluating the impact of cannabis exposure and access on substance use trajectories among people who use unregulated drugs during the fentanyl era
The impact of cannabis access and use on the development of high-risk substance use behaviours remains controversial during the opioid overdose crisis. To address this knowledge gap, I plan to:
1. Identify how cannabis access and use impact early substance use careers, including the use of opioids, stimulants and injection drug use among at-risk youth;
2. Analyze how cannabis access and use impact overdose, as well as risk factors for overdose (e.g., binge opioid use) among high-risk subgroups of people who use drugs (e.g., people with chronic pain, HIV);
3. Characterize how cannabis use impacts engagement and effectiveness of addiction treatments. We will also investigate how cannabis use intentions (e.g., recreational vs. therapeutic use) shape addiction treatment outcomes.
This project will analyze data from three studies (N=3,375) of people who use drugs (PWUD). Established partnerships with the BC Ministry of Health and community groups of people with living experience of substance use will support the production of scientific evidence, policy briefings and community resources that will be important to inform clinical and public health practice, as well as policy responses to the overdose crisis during the fentanyl era.
Tailoring health services by contextualizing the person behind patient-reported data
There is growing interest in using patient-reported data collection to improve patient outcomes. The data collected via patients’ reports are generated from the patient’s perspective, which can provide important information about aspects of their health status particularly relevant to their quality of life, including symptoms, functionality, and physical, mental and social health. However, the data collected are merely numbers that do not provide a holistic assessment of a patient’s health. To achieve the full potential of patient-reported data, clinicians would benefit from learning how to translate these data into a patient’s “health story.” My research program is pioneering a new approach for contextualizing patient-reported data with patient stories to optimize their use in practice. The results have the potential to support clinicians in better identifying and addressing evolving needs and enhance person-centred care by facilitating patient-clinician dialogue and adopting education and intervention strategies attuned to the needs of individual patients.
Co-Creating Age and Dementia-Friendly Communities: A Community Engaged Program of Research
Worldwide, there is increased interest in developing age and dementia-friendly communities. This is because communities, organizations, and policy makers recognize the need to make the community setting a place where people can “age in place” and experience quality of life, while living with conditions such as dementia. It is important that older people with dementia have a say in the development of communities meant to support them. As such, this community-engaged research program addresses this need, by engaging directly with people with lived experience. The goal of this research program is to build a Community Action Group (CAG) of people with dementia, and to conduct co-research with the CAG. This means that the CAG will collaborate with the research team to plan and take part in a variety of research activities (such as co-design workshops) that will inform development of age and dementia-friendly communities. This will not only lead to meaningful change in communities, but will empower people living with dementia. Research of this nature will also impact future research by demonstrating the possibilities of collaborating and co-researching with people with lived experience, in order to make meaningful social change happen.