In Canada, poor mental health among Indigenous youth is an ongoing issue. This leads to high rates of suicide, addiction, violence, chronic diseases and chronic pain. A potential reason for these challenges is historical trauma linked to government policies intended to eliminate Indigenous cultures, including residential schools, the 'sixties scoop' and the child welfare system.
With Indigenous families in the Fraser Valley and Lower Mainland, British Columbia, Dr. Cooper will explore how people understand historical trauma, mental health and abuse. With participants, she will also explore experiences with current mental health programs and interventions. The focus will be on strengths and challenges experienced by First Nations parents and youth aged 11-14.
Indigenous and qualitative arts-based approaches will be used to unpack key themes related to mental health and community wellbeing, and participants will help guide the creation of resources that will aim to improve health within Indigenous families and communities.
Gay, lesbian, and bisexual youth (GLBY) are at increased risk of experiencing substance use disorders (SUD) in comparison to their heterosexual counterparts. The aim of Dr. Ferlatte’s research is to identify the factors associated with SUD experienced by GLBY to inform interventions.
This will include:
- Examining individual, social and structural factors that influence SUD among GLBY through photovoice methods.
- Identifying challenges experienced by GLBY in accessing SUD-related care by gathering experiences through an online survey.
- Identifying how a coordinated set of interventions and policies could best be adapted to address SUD among GLBY through two world cafés, where GLBY and other stakeholders (e.g., intervention decision makers) will be invited to identify solutions to this issue.
The findings of this research will be shared through presentations, articles, and photovoice exhibitions to inform policy and programming decision-making that improves SUD care for GLBY.
Hepatitis C virus is an important public health concern in Canada; however, there is limited information concerning the impact of new direct-acting antiviral therapies on manifestations outside the liver (extrahepatic manifestations, or EHMs), including chronic diseases, cancers, and health-care resource utilization in Canada.
This knowledge is important, as new HCV treatments are generally restricted to those with advanced liver disease and there are no estimates of the reductions in EHMs that can be achieved with expansion of therapy.
Using data from an administrative-linked population-based cohort in BC, Dr. Rossi will assess the impact that HCV treatments have on EHMs and associated health-care utilization.
Results from this study could lead to improved clinical and population health practices in BC by:
- Helping to inform targeted treatment strategies by identifying patients at the greatest risk of developing EHMs associated with HCV.
- Identifying areas where additional allocation of resources will be necessary to manage chronic comorbidities associated with aging.
This study will also provide a better understanding of the challenges and limitations associated with using administrative data for population health research.
Human papillomavirus (HPV) infection is a prerequisite for the development of cervical cancer. Screening for cervical cancer after HPV infection is possible by cervical smear testing, and since 2006 direct prevention of HPV infection has been available in the form of three different vaccines.
These vaccines need two or three doses, and protect against the most common types of cancer-causing HPV. Unfortunately, at this moment globally, women at the highest risk for cervical cancer are not reached by any of these prevention measures. Barriers to vaccine implementation and achieving higher uptake include high costs and lack of the infrastructure required for administering multiple vaccine doses.
Some studies have suggested sufficient and sustained protection against HPV infections occurs after just one dose of the vaccine. Evaluation of one dose of the HPV vaccine is complicated, since it is unknown how and at what level immune responses guarantee protection against infections.
With this study, Dr. Donken aims to measure the effectiveness of single dose vaccination in a real-world setting and to explore whether antibodies are boosted after exposure to HPV in vaccinated women, potentially reducing barriers to vaccine implementation and improving vaccine uptake among those at a high risk for cervical cancer.
While increased access to HIV treatment and other health services has contributed to significant declines in HIV among several key populations in British Columbia (BC), it is estimated that as many as 1 in 6 gay, bisexual, and other men who have sex with men (gbMSM) will be diagnosed with HIV in their lifetime.
To address this health equity concern, BC recently expanded access to a once-a-day pill, called pre-exposure prophylaxis (PrEP), that can prevent HIV acquisition. However, gbMSM who use drugs report reduced adherence to PrEP, as well as to other antiretroviral therapies (ART) that could prevent transmission—thus reducing the overall efficacy of these policy-driven interventions.
Recognizing the diverse experiences of substance-using gbMSM, Dr. Card, along with an interdisciplinary team at the Community Based Research Centre for Gay Men’s Health, will leverage data from the Sex Now Survey to improve our understanding of:
- Which patterns of substance use contribute to poor adherence.
- How we can best address the factors that negatively impact this population.
- What obstacles might limit successful intervention among this population (e.g., feasibility and acceptability).
Working with community members and front-line service providers, Dr. Card will also participate in community consultations to develop an empirically-valid and community-based intervention that will improve adherence among gbMSM who use drugs.
Abortion is a common reproductive health procedure, with nearly one-third of women in Canada having had at least one abortion. However, abortion access is not equitable. Most abortions are surgical, and are provided in a small number of facilities located in BC’s largest cities. Some women, particularly those in rural or remote regions, experience significant wait times and must travel long distances to reach abortion services.
The medical abortion drug mifepristone became available in BC in 2017. Mifepristone can be provided in primary care and is a safe and effective alternative to travelling to large centres for surgical abortion, enabling abortion to occur at earlier (and therefore safer) gestations. Mifepristone medical abortion delivered in primary care has the potential to improve equity for abortion access and outcomes in BC, while reducing pressure on surgical services.
Dr. Schummers’ research will centre on a population-based cohort study using BC linked health administrative data to understand abortion access, outcomes, and costs before and after mifepristone became available.
The results of this study will inform knowledge users and health policy-makers about the effect of mifepristone medical abortion delivered in primary care on abortion service access, outcomes, distribution, and costs.
Human papillomaviruses (HPV) can lead to cervical cancer and other anogenital, head, and neck cancers in both women and men. A safe and effective vaccine against the most common types of HPV associated with cancer was introduced in 2008 into BC’s exemplary school immunization program. However, rates of HPV vaccine uptake have remained low, with less than 70% of eligible students receiving the vaccine each year.
Evidence suggests parents are more likely to consent to an HPV vaccine for their child if they engage in a conversation with a trusted health care provider. Suggesting that simply leveraging existing public health infrastructure could improve HPV vaccine uptake to reduce the future burden of HPV related diseases.
Dr. Racey’s research will evaluate the implementation and impact of a tailored messaging intervention, delivered by public health nurses , to improve HPV vaccine uptake for grade 6 girls and boys in a rural community in BC. BC’s robust immunization registry and monitoring will allow the measurement of HPV vaccine uptake across comparable communities to assess the impact of the intervention.
The results of this research will be directly relevant to school-based immunization programs across BC and Canada, and could lead to or help inform future expansion of the intervention.
Many seniors aged 65 or older experience “age-associated memory impairment,” a normal aging process. However, Alzheimer’s disease is different, and not a normal part of aging. Alzheimer’s is a progressive brain disease with gradual loss of nerve cells and resulting problems with thinking, memory, and movement. Changes in the brain can start to happen 20 years before any memory problems appear.
Currently, no treatments are available to cure Alzheimer’s disease; however, if the disease is diagnosed and treated at an early stage, patients have a greatly improved quality of life.
Measurement of some proteins in a body fluid found in the brain and spinal cord has been used to aid in diagnosis. The sample collection is performed by inserting a needle into the spinal canal. People are usually reluctant to take the test, which causes a delay in diagnosis.
Dr. Shi’s research aims to develop a new test that could help doctors diagnose Alzheimer’s disease at an early stage. This new test is different from the current tests in two ways in that it uses blood instead of spinal fluid, which is much easier to get through venipuncture; and uses a new technique that is more sensitive and specific.
The resulting blood test could be a convenient and accurate way of diagnosing Alzheimer’s disease at an early stage.
Interstitial lung disease (ILD) is a group of disorders characterized by fibrosis and inflammation of the lungs. Dyspnea (i.e., breathlessness) is the most common symptom in ILD. To minimize dyspnea, ILD patients commonly avoid physical activity, leading to a progressive decline in exercise capacity, and eventually the inability to perform daily activities. Maintaining exercise capacity is important, given that ILD patients with the lowest physical activity levels have the lowest quality of life and the highest mortality.
Unfortunately, treatment options for improving dyspnea and exercise tolerance in ILD patients are limited. It is thought that skeletal muscle dysfunction, which appears to be common in ILD patients, may contribute to dyspnea and exercise intolerance. However, few studies have adequately investigated skeletal muscle dysfunction in patients with ILD.
Relative to the inexorable damage to the lungs, the skeletal muscles could be an important site by which to therapeutically reduce dyspnea and improve exercise tolerance. Dr. Molgat-Seon’s research aims to determine the role of skeletal muscle dysfunction on dyspnea and exercise intolerance in ILD. The results of this research could lead to improved functional capacity and quality of life in ILD patients.
Bioprosthetic heart valves (BPHVs), valves made of biologic tissues rather than synthetic materials, have revolutionized the treatment of heart valve disease, which constitutes a significant health and economic burden in BC, Canada and around the world. BPHVs serve as an alternative to mechanical valves, which require lifelong treatment to prevent clotting and therefore lead to an increased risk of bleeding.
With the development of new transcatheter methods for delivery of BPHVs, they now represent the overwhelming majority of valves. Despite these successes, the long-term durability of BPHVs is not well established and remains a concerning potential limitation.
Dr. Sellers’ research will look to determine how BPHVs degenerate and potential strategies to assess this in patients. This will include using a combination of analysis of dysfunctional valves and novel imaging approaches using computed tomography (CT) imaging.
The results of this research will help determine the long-term durability of BPHVs and improve decision-making for patients with heart valve disease.
