Access to the most effective contraceptive methods (intrauterine devices or subdermal implants) is inequitable in BC. Many people are unable to reach a health professional able to insert them. Regulatory changes allowing BC pharmacists to prescribe contraception presents an opportunity to expand the role pharmacists could play to better meet BC’s needs.
BC Women’s Hospital and Health Centre and our research team will host a one-day meeting of BC stakeholders and leaders to discuss any potential to expand the role of pharmacists to insert subdermal contraceptive implants. Participants will identify perspectives and provide insights on both the opportunities and facilitators as well as anticipated barriers and challenges associated with this potential expansion of pharmacy practice. A pre-meeting survey and series of stakeholder interviews (separately funded) will provide information to guide our discussion during the meeting.
Key sessions during the meeting will include interactive discussions and panels involving a diverse range of stakeholders, including health policy, regulatory and care leaders, patient groups, and health professionals. Conclusions from this meeting will inform potential next-steps to expand service access.
UBC researchers, Ribbon Community, and local service organizations, such as Central Interior Native Health Society, will harness our collective experiences in supporting WLWH to host five women-centred knowledge mobilization (KM) events. Ribbon Community has supported the HIV community since 1983, with services including peer-to-peer programming, case management, and grocery support. Researchers at UBC are investigating healthy aging in women living with HIV, from cell-to-society, in the community-based British Columbia CARMA-CHIWOS Collaboration (BCC3) study. We aim to host a series of “mini-retreats” – or full-day KM events that will be held in natural settings (e.g. Loon Lake). Here, WLWH and organizers will share nourishing food and discuss research findings through interactive activities surrounding the theme “What is healthy aging.” Events will take place in the five geographical regions visited by the research team during prior study enrollment. KM topics will focus on women’s sexual and reproductive health as they age, with specific topics chosen in consultation with WLWH. Participants will leave each event with a lay-language KM summary and an appreciation bag of health-promoting items.
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.
Endometriosis is a common condition, affecting 1 in 10 women of reproductive age, or approximately one million women in Canada. Endometriosis occurs when tissue from inside the womb grows outside of the womb, such as in different areas of the pelvis. Half of women with endometriosis experience sexual pain, which is felt as pelvic pain with deep penetration during sexual activity.
Sexual pain in endometriosis can occur when the endometriosis cells show invasive qualities. We recently identified non-inherited gene mutations in this type of invasive endometriosis.
Our team has established a registry of endometriosis patients along with surgical samples from these patients. I will validate the role of gene mutations in endometriosis sexual pain, in particular whether these mutations are associated with invasion of endometriosis, and also with increased nerve growth around endometriosis.
In the future, gene mutation testing could be incorporated into clinical care for endometriosis to identify subgroups and promote more individualized care. These mutations could also be potential novel treatment targets for this common condition in women.
Today the greatest barrier to optimal health among persons living with HIV (PLWH) is antiretroviral (ART) adherence. The WelTel program uses weekly text-messages to improve ART adherence and HIV viral suppression among PLWH, but does not work for everyone. The literature states that personality traits and sense of purpose (dispositional traits) play a role in HIV-related outcomes. Measuring disposition is simple and rapid, and could be used to personalize adherence supports for clients with relative ease.
We will enrol 300 PLWH from three Vancouver HIV clinics into the WelTel program. Participants will receive a basic cell phone and phone plan if they do not have one, and receive a weekly (two-way) text message for 12 months asking 'How are you?'. Problem responses will be triaged by a nurse.
We will use existing validated tools to measure disposition at baseline/over time to determine whether we can predict who is most likely to benefit from the WelTel program, and how WelTel works to enact behaviour change. In this way we hope to provide a means by which limited resources could be triaged in vulnerable populations struggling with adherence to provide well-suited programs to the greatest number of individuals possible.
