From monkeypox to measles, vaccination is essential to controlling infectious disease. COVID vaccines alone saved approximately 20 million lives in the first year. However, barriers to vaccination—including inaccessibility, lack of confidence in vaccine safety or effectiveness, and distrust in those providing vaccination—threaten our ability to stop epidemics.
My program of research applies unique interdisciplinary expertise in information science and population health to investigate how we can use information to reduce vaccination barriers. Over the next 5 years I will conduct a suite of studies aiming to improve population health interventions focused on vaccine communication and surveillance.
Studying how people use information and how vaccine communication and surveillance affects people in real-life contexts will help us meet needs of co-parents who disagree about child vaccination, people deciding whether to get new vaccines, and members of marginalized groups targeted by vaccination campaigns. It will generate evidence on how technologies can best be used for identifying and sharing information with vaccine hesitant people. Ultimately, this knowledge will improve vaccine uptake and reduce disease burden and inequity.
The flood, fire and heat events of 2021 brought the health impacts of climate change into focus for British Columbians. New public health interventions are required to support effective adaptation, but especially for the most impacted population groups. The BC-REACH (BC Research for Equitable Adaptation to Climate and Health) project is a mixed-methods research platform to build evidence on effective and equitable public health adaptation to climate change. The project’s goal is to equip public health practitioners and residents of British Columbia (and beyond) with new evidence and interventions to enhance their preparedness to a variety of climate change-related health risks. Working in partnership with applied health system partners, this research will ultimately lead to the co-development and evaluation of novel programs and policies that have multiple co-benefits for populations that may be more exposed or physiologically sensitive, or lack the capacity to adapt to a changing climate. By centring equity in this analysis, this research will build knowledge and capacity to reduce population-level health inequities by ‘climate proofing’ the future of the health system’s responses to a wide variety of climate and health risks.
Health is connected and collective. Connections across species and geographies promote the spread of infectious diseases. Collectively, humans, animals, and environments face shared health threats like climate change. This concept of ‘One Health’ is a valuable lens through which to identify actions that support a healthy world. Yet, One Health’s major strength is also its largest challenge as it relies on bridging disciplinary silos — veterinarians and doctors, policy makers and public health practitioners, scientists, and the public. My community-engaged research explores a framework for mobilizing information at this nexus of health. Working with policy makers, health practitioners, and communities, I will identify communication structures that can be deployed at regional scales and across sectors. By understanding community knowledge and perceptions of three One Health issues (chronic wasting disease, avian influenza virus, and rat-associated diseases), I will resolve how health messages can be strengthened to promote public participation in disease surveillance programs. Engaging with knowledge users at all levels will help to improve data collection, monitoring, and inform government decision making and timely action.
Most parents struggle with their baby’s sleep in the first year. Severe and persistent sleep difficulties can harm parent-child relationships and infant and parental mental health. Parental education, individual consultations, and/or group sessions can help parents improve their baby’s sleep but parents are often overwhelmed with rigid or conflicting advice. Canadian families are diverse, and what works for one may not work for others. For example, a family may be impacted by depression, poverty, or both, and these intersecting factors will affect what educational content and delivery will work best. The SLeep solUtions to proMote Better Early childhood Relationships (SLUMBER) program will give families options to meet their specific needs to get everyone sleeping better. Each part of the program will be designed in partnership with parents. We will develop groups of program options (portfolios) and test them to see who, how, and why they help. This personalized approach will prevent and/or lessen sleep problems with the added benefit of supporting parent-infant relationships and infant mental health. Having a baby is stressful, and this research will support sleep as a foundational pillar of family mental health and well-being.
Stressors encountered in daily life such as family conflicts contribute to the risk of experiencing mental health issues such as anxiety. Conflicts between parents and their children increase in adolescence, but research has focused primarily on its mental health implications for adolescents and not also parents. Parents of adolescents go through their own developmental transitions (e.g., midlife) that bring significant stressors with them. Therefore, both parental and adolescent developmental status and mental health need to be understood to help families develop healthy communication and conflict skills, which may benefit the mental health of both individuals. We need to identify which types of emotion patterns are associated with increased risks, or protection from, the development of mental health issues in response to stressors. We aim to identify parent-adolescent emotion dynamics in the context of stress that are associated with both parents’ and adolescents’ anxiety. The primary impact will be to refine an existing community-based intervention for parents of anxious adolescents and to promote its accessibility by involving families and counsellors in the redevelopment process.
The colon is teeming with life, not just due to our own cells, but also due to a rich and diverse community of microbes. Remarkably, this community is a virtual organ, helping to digest food and fight inflammation. Unfortunately, this “organ” can malfunction and cause chronic diseases like inflammatory bowel disease (IBD), which affects thousands of Canadians. How to promote the benefits and prevent the harmful activities of our microbiota is a central question. One major factor is gut mucus, a sugar-rich gel-like layer that surrounds the microbiota to act as a barrier to prevent their invasion. This mucus layer is defective in IBD. The objective of my research is to develop new ways to capture the protective power of human mucus to prevent and cure IBD. To do this I will use a new approach my lab developed to extract and purify human mucus to test its protective abilities in mouse models of IBD. We will also learn how microbes control mucus production so we can target these pathways in patients. Last we will use human colon cells to generate a “mucus factory” that can produce mucus with enhanced protective properties. The results of this research will illuminate new paths to restore healthy host-bacteria relationships in IBD.
Walk With Me was developed by Dr. Karsten and her research team throughout the past four years with intent to combat stigma and create systems change in relation to the toxic drug poisoning crisis – a public health emergency that has enacted more deaths in BC than suicides, car accidents and homicides combined. This team has been working in Vancouver Island communities of various sizes, and within Island Health acute care facilities, to better understand the ways in which the drug poisoning crisis is impacting communities and systems. Through deep listening, peer engagement and leadership, and collaborative design, the team has developed recommendations designed to close service gaps and reduce stigma. In the summer of 2022, Island Health released its first Harm Reduction Policy. Stemming from this release is an opportunity to deepen this existing partnership, through the co-creation of a Harm Reduction Learning Health System. This system, developed through patient/peer insights and leadership, and alongside clinicians, management and staff, will enable Island Health to respond effectively to a rapidly-evolving public health crisis.
All of the cells in our body are coated with a dense layer of sugar molecules. Cells in our immune system constantly “taste” these sugars. Some types of sugar taste good to our immune system, signaling that our cells are healthy. 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 own cells can become altered in ways that lead them to produce abnormal types of sugar molecules on their surface. When this happens, it can allow cancer cells to evade detection and destruction by the immune system. Our group applies powerful genomics technologies to better understand how human cells generate these immune-regulatory carbohydrates. This information allows us to predict when cell-surface sugars may become chemically altered and identify specific molecules that can be targeted for manipulating immune activity. The insights generated from our research directly impact the design of new immune-targeted cancer therapies.
Traumatic brain injury affects approximately 450 people every day in Canada and is a leading cause of disability nationally and globally. These injuries can lead to life-long disability and health problems, and people who sustain them often experience decreased quality of life, poor mental health, and long-term unemployment.
There is a critical gap in the development and delivery of programs and services that help people with traumatic brain injury to improve their health. Current health services focus on areas of impairment rather than personally-important priorities for rehabilitation. In addition, participatory research, which engages people with traumatic brain injury and community organizations as active partners, is underused in the development of rehabilitation programs.
My goal is to implement a peer support program for people with traumatic brain injury. I will use a partnered approach, in which people with traumatic brain injury and members of their community are leaders in the project. This will ensure that the research answers to their needs and values. Ultimately, this research will improve the access to services, health, and quality of life of people with traumatic brain injury in Canada.
Spinal cord injury leads to permanent and severe paralysis and loss of sensation. The principal reason for this is that nerve cells connecting the brain with the rest of the body lose the capacity to regenerate their processes (axons) as they mature during development. Despite decades of progress, no regenerative therapy for the injured spinal cord is available today, making a regenerative treatment for spinal cord injury a major unmet need of the British Columbia healthcare system. In this project, we will focus on the fundamental processes through which maturation suppresses axon regeneration. We have discovered a molecular switch that is turned off in mature neurons and that we hypothesize is critical for nerve cells to regrow axons. We will study how this molecular switch is turned off during maturation, the processes that it controls to enable growth and test whether re-activating it in mature neurons can promote regeneration and functional improvements following spinal cord injury. Collectively, this work will provide critical insight into why mature nerve cells fail to regenerate. We anticipate that this work will be a major steppingstone towards the development of a treatment that regenerates the injured human spinal cord.
