Evaluating systems-level interventions to reduce overdose during dual public health emergencies

Over the past two years, the COVID-19 pandemic has exacerbated the ongoing overdose public health emergency in British Columbia (BC). Over 3,700 persons have died from illicit drug-related overdose since April 2020. In the context of the sixth year of the ongoing overdose provincial public health emergency and unprecedented COVID-19 pandemic, there is urgent need to evaluate how changes to the correctional health system and prescribed safer supply interventions have effected overdose. The overarching objective of my research program is to conduct timely and policy-relevant research on overdose that informs response activities throughout the province. This will be achieved by using novel linked health data to identify trends in overdose since the original public health emergency declaration. I will also evaluate provincial interventions introduced to reduce overdose such as prescribed safer supply and systems-level changes to the delivery of health care in correctional settings. This project will directly inform provincial and regional overdose response activities through collaborations with persons with lived experience and knowledge users from the BC Overdose Emergency Response Centre.

Co-developing a digital health systems research program to support cultural safety and health equity for Two-Spirit, transgender and nonbinary patients in British Columbia

Better and more inclusive care is dependent on including patient perspectives or “voice.” Yet, patient voice is rarely included in the design, modification or implementation of digital health systems (DHS) such as patient portals or electronic health records. As a result, DHS are rarely embraced by patient populations who could have the greatest benefit.

For Two-Spirit, transgender, nonbinary and other gender-diverse people (Trans+), this lack of voice is made worse by inaccurate DHS representations of gender identities. Negative healthcare experiences can discourage Trans+ patients from attending or returning for future visits.

Our collaboration includes Trans+ people, Trans Care BC, and other researchers. We will co-develop a program of research that brings patient voices into the design, modification, and implementation of DHS. The project extends our ongoing work to improve representation in DHS. This project is timely given the provincial government’s recent implementation of Health Gateway, a patient-accessed DHS allowing patients access to their health records.

Team members: Lorraine Grieves (Provincial Health Services Authority); Marcy Antonio (University of Victoria); Francis Lau (University of Victoria); Lindsay MacNeil (Trans Care BC); Quinn Bennett (Trans Care BC); Kelly Davison (University of Victoria); Roz Queen (University of Victoria); Aaron Devor (University of Victoria); Patient Partner TBA (Community Member)

Building a provincial public health agenda for addressing geographic contributors to overdose

Research co-leads: 

  • Amanda Slaunwhite
    Provincial Health Services Authority 

Research user co-lead:

  • Gillian McLeod
    City of Delta

Team members:

  • Dr. Aamir Bharmal
    Fraser Health Authority
  • Jennifer Hawkins 
    Fraser Health Authority
  • Dr. Michael Schwandt
    British Columbia Centre for Disease Control, University of British Columbia
  • Amy Salmon
    Centre for Health Evaluation and Outcomes Sciences
  • Marinel Kniseley
    Centre for Health Evaluation and Outcomes Sciences
  • Dr. Alexis Crabtree
    University of British Columbia
  • Dr. Jesse Kancir
    University of British Columbia

Illicit drug overdose is the central provincial public health challenge in British Columbia (BC). All communities in BC have been affected by the overdose crisis, however little is known about how harm reduction and addictions treatment interventions can be adapted to rural and remote places that do not have supervised consumption/overdose prevention sites or addiction medicine providers.

We aim to address this significant gap in knowledge by convening a diverse group of persons with lived experience, policy makers, clinicians, and researchers from across BC to develop a public health action and research agenda for addressing geographic and place-based contributors to overdose that leverages existing data sources such as the Provincial Overdose Cohort. The objectives of this project are to:  

  1. Determine knowledge gaps and identify opportunities to collaborate across organizations and regions to better understand (a) geographic variations in overdose and (b) access to harm reduction, addictions treatment and acute care services outside of urban centers;  
  2. Identify immediate (6 month), short-term (1 year) and medium term (2 year) priorities for action in addressing overdose deaths in sparsely populated places with an emphasis on scaling up existing networks, programs and services;  
  3. Develop an interactive concept map and lay language publication that synthesizes the results of (1) and (2) for public release.   


Increasing consumer access to cognitive behaviour therapy (CBT) in British Columbia

The Provincial Health Services Authority and the BC Ministry of Health are jointly sponsoring a clinical practice initiative to improve the quality and availability of Cognitive Behaviour Therapy (CBT) for mental health and addictions in BC. While CBT has been established as an empirically supported treatment for many disorders, there has been a lack of availability of CBT in the community. Research is needed on issues related to dissemination and adoption/uptake of CBT. Another priority is evaluating the success of the joint CBT initiative by examining aspects such as changes in client care outcomes and cost-effectiveness. This award supports the creation of a team that will focus on developing a better, more integrated understanding of the most effective CBT dissemination methods. The team aims for its research effort to lead to increased access to CBT mental health services for British Columbians.