Community-Engaged Solutions for Recognizing and Responding to Overdose-Induced Brain Injury

Toxic drug poisoning is British Columbia’s longest standing public health emergency. April 2023 marked the 31st consecutive month in which at least 150 lives were lost to unregulated drugs in BC, many of these deaths occurring on Vancouver Island. Research on hypoxic brain injury—a type of brain injury in which the brain does not get enough oxygen—after overdose survival, including work done by our team, raises two pressing questions: How do we recognize brain injury after non-fatal overdose occurs? And how do we best support individuals who experience brain injury after non-fatal overdose? Our proposed work aims to address these critical issues by leveraging the knowledge of researchers, people with lived experience of drug-related brain injuries, and community leaders who support them, to build priorities for future research and produce a community-driven list of recommendations for recognizing and responding to hypoxic brain injury after non-fatal overdose. Through a World Café workshop and follow-up prioritization survey and consensus meeting, our goal is to collaboratively create recommendations for research and practice, ensuring a comprehensive and inclusive approach to service provision on Vancouver Island.

A partnership for PaRX: Developing a road map for evaluating and expanding implementation and sustainability of a national parks prescription program.

There is a growing body of evidence that indicates that time in nature has a wide range of health benefits. Both physical and mental health improve, even just temporarily, after time spent outdoors in a natural environment. This has led to the development of nature-based prescription programs. In Canada, a BC based initiative, PaRX is Canada’s first evidence-based nature prescription program. Licensed healthcare providers in Canada can register with the program and provide evidence-based prescriptions to their patients to spend more time in nature. Despite PaRX’s evidence-based design, the program itself has not yet been evaluated for its reach, usability, or effectiveness. Given the comprehensive health benefits of time spent in nature, we have assembled a team of researchers with a wide range of expertise including physical activity, mental health, neuroscience, and physiology. This team of researchers will partner with the BC Parks Foundation who deliver PaRX, and a licensed family physician to develop an evaluation strategy for the short- and long-term to ensure high-quality nature prescriptions that benefit health are available and accessible to residents of BC and throughout Canada for years to come.

Creating and sharing innovative models for language interpreter services and cultural bridging in health care: A health equity approach

In many areas of healthcare, language interpretation and cultural brokering services either do not exist or are underutilized. As a result, newcomers avoid healthcare, receive less adequate healthcare due to lack of understanding, or experience additional risks due to reliance on family members for interpretation services. As a result, newcomers’ healthcare needs are inadequately addressed across primary care, urgent care, mental health care, and acute care contexts. This can lead to poorer health outcomes and significant costs to newcomer families and to our healthcare and social systems. Our proposal addresses these healthcare inequities for newcomers. Overcoming access barriers remains a human rights issue provincially and across Canada. Building on our teams’ longstanding collaborations across the Capital Region, we will collaboratively identify promising practices related to navigating provincial and local language and cultural resources to assist newcomer communities. This urgent issue will only become more pressing as Victoria continues to increase in ethnic, racial, and linguistic diversity due to the Canadian government’s commitment to increasing rates of immigration and refugee settlement across the country.

Dementia Friendly Communities: Bringing to the Fore the Perspectives and Needs of People with Dementia Who Live Alone

The concept of Dementia Friendly Communities (DFCs) is becoming popular worldwide, as communities, organizations, and policy makers work to make our society a place where people living with dementia can live in comfort, strive for wellbeing, and feel connected to others. However, people with dementia who live alone have not really been included in conversations about and planning for DFCs. This is a significant gap, especially since people with dementia who live alone are a growing group of people. This project aims to address this gap, and to include people with dementia who live alone in co-designing an Action Plan that will lay the groundwork for future planning of DFCs, that takes into account their voices and perspectives. This work will involve an Action Group (AG) of people with dementia who live alone in different communities across BC. 8-10 people will join the AG, and will participate in 5 online co-design workshops to develop an Action Plan. The co-design workshops will be led by a team of designers from the Health Design Lab at Emily Carr University of Art + Design. The Health Design team will work in partnership with the project team and AG to co-design the Action Plan, and plan next steps for ongoing work.

Provincial Dissemination of Lower Risk Cannabis Use Guidelines for Youth, by Youth

The Low-Risk Cannabis Use Guidelines for Youth, By Youth (the Guidelines) are a novel public health resource that reflect day-to-day realities of youth’s lives and provide practical and feasible strategies to help mitigate the harms of cannabis use. The Guidelines were developed for and by youth, responding to calls by the Lancet Commission and BC’s Representative for Children and Youth for the greater inclusion of youth voices in policies and guidelines that support their health and wellbeing.

While Phase 1 of the Guidelines project focused on developing the youth-oriented guidelines, the objective of Phase 2 is to develop and implement a youth-led knowledge translation (KT) strategy, designed for broad dissemination of the Guidelines. To meet this objective, we will (1) establish a KT Youth Working Group (KT-WG) comprised of youth across BC with lived experience of cannabis use, and (2) co-create and implement a KT plan with the KT-WG, Canadian Institute for Substance Use Research, and Foundry Central Office to mobilize the Guidelines at provincial, national, and international levels. In doing so, we aim to promote youth-oriented harm reduction guidelines and contribute to the health and wellness of youth in Canada.

Disseminating a Multilingual Virtual Family-Based Childhood Obesity Management Program

The COVID-19 pandemic lockdown has further exacerbated unhealthy lifestyle behaviors, increasing the risk of childhood obesity, particularly among certain minority population groups. Our team is working with the Childhood Obesity Foundation (a knowledge user) to design, evaluate and scale up a “made in B.C.” 10-week healthy lifestyle program called Generation Health for families with children aged 8-12 years who want to be on a healthier lifestyle path. However, a key challenge facing program dissemination is accommodating those at-risk families who have trouble understanding English. This has significantly influenced program uptake and effectiveness for those families. To address this, the aim of this project is to 1) leverage artificial language translation tools to make our virtual program accessible in the three most spoken non-English languages (Punjabi, Chinese, Spanish ) in Canada; 2) collaborate with our knowledge user to disseminate the program across B.C. We have amassed a multi-disciplinary team with extensive experience in delivering and disseminating virtual family-based interventions. This project has the potential to be incredibly impactful to families for whom English is a barrier.

A Hot Topic Podcast: Amplifying the Voices of those Directly Affected by Extreme Heat

The 2021 heat dome in BC resulted in 619 heat-related deaths and as well as a range of suffering from slight discomfort to emergency room visits. The way the heat dome impacted people was not uniform. Some people experienced significant discomfort while others ended up hospitalized. Despite this lack of uniformity in experience, many governments and agencies responded with one size fits all solutions. To better understand the diversity of experience related to extreme heat, we have embarked on a robust research project collecting survey responses and sharing circle engagement from hundreds of people across the Capital Regional District in BC. This has helped us highlight stories of suffering and recommendations for responses. To ensure this research drives appropriate equity-informed policy creation and government action, we are entering the next step of our project by amplifying the voices and stories we have heard through a podcast. It is our aim that this podcast series will highlight the voices of those most impacted by extreme heat and allow them to speak directly to governments and other organizations that will take their recommendations forward in order to prepare for the next extreme heat event.

A hot topic: Defining vulnerability, capturing resilience and learning lessons to support vulnerable groups adapt and respond to extreme weather in Victoria’s capital regional district

The summer 2021 heat wave caught British Columbians and many policy-makers by surprise. This project seeks to develop a research agenda and build community-engaged research partnerships to identify ways in which service providers, private businesses, governments and individuals can support vulnerable communities to avoid negative health outcomes associated with future heat events that occur in the Capital Regional District (CRD). Guiding questions include: Who in the CRD is most vulnerable to negative health impacts related to extreme heat events? What does the experience of extreme heat look like for these vulnerable groups? What recommendations do they have for supporting other members of their group during extreme heat events? These questions will be answered through secondary and primary research. Following a community-engaged research approach, the most appropriate methodology will be determined in collaboration with service providers and individuals with lived experiences to ensure we are accounting for diverse experiences of trauma and resilience. Project outcomes will include policy recommendations, data and stories for decision-makers to craft messages and communicate with the public to avoid heat-related harm.

Team members: Kirsten Mah (Capital Regional District; Summer Goulden; City of Victoria); Kristie Signer (City of Victoria); research trainee (University of Victoria).

A multi sector World Cafe to promote mental health of refugees in BC: A participatory realist evaluation project

The purpose of our project is to convene and collaborate with service users, health practitioners, settlement service providers, and policy makers in a series of deliberative dialogues and a multi-sector World Cafe to co-develop a program theory about integrated mental healthcare services for refugees. The global humanitarian refugee crisis has highlighted refugees as one of the most vulnerable population groups requiring integrated mental health services and supports. However, the COVID-19 pandemic has stressed healthcare systems in providing equitable, gender sensitive, language appropriate and trauma and violence informed care to diverse refugees resettled in Canada. Integrated care can improve clinical and organizational outcomes for more effective health services but limited knowledge exists on what promotes integrated mental health care for refugees, how it works, for whom and in what contexts. Convening multidisciplinary stakeholders is an important step to building a program theory and how it works. Our approach will develop an evidence informed model that will later be used and tested across multiple primary health care and social service settings to improve mental health service and promote refugee mental health.

Team members: Simon Carroll (University of Victoria); Suzanne Huot (UBC – Faculty of Medicine); Anita David (patient partner); Cindy Quan (University of Victoria); Eliseo Verdugo (University of Victoria); Maura Macphee (UBC); Sara Hosseina (New Canadian Primary Care Clinics); Karen Davison (Kwantlen Polytechnic University – Health Sciences); Vidhi Thakkar (University of Victoria; Victoria Hospice Society); Mikhail Torban (Ministry of Mental Health and Addictions); Brandon Hey (Mental Health Commission of Canada); Niels Agger-Gupta (Royal Roads University); Frank Cohn (VAST Refugee Mental Health Services Vancouver); Pamela Toor (REACH Community Health Centre).

Building Roads Together in BC

Building Roads Together (BRT) is an intergenerational trauma-informed peer-led walking/rolling group program implemented in public urban greenspace, that trains and mentors migrants living in low-income urban neighbourhoods to promote social inclusion, equitable healthy aging, and mental health in their communities. Our Building Roads Together-Global (BRT-G) Solutions Network is adapting, scaling, evaluating, and sustaining BRT in three cities (Surrey, BC; Toronto, ON; Bogota, Colombia). This C2 award is to establish a Victoria site team for our Building Roads Together-Global Solutions Network to adapt, scale, evaluate, and sustain Building Roads Together in low-income, migrant-receiving neighbourhoods in Victoria. We will: 1) Build a new community-university-health system partnership in Victoria; 2) Develop a research agenda to integrate Victoria community partner priorities into BRT-G Solutions Network research objectives; 3) Begin the installation phase of implementing BRT in a low-income, migrant-receiving neighbourhood in Victoria; 4) Co-develop a training strategy for career development in inclusive implementation science; and 5) Build inclusive implementation science capacity among trainees.

Team members: Paola Ardiles (Bridge for Health); Nancy Clark (University of Victoria – School of Nursing, Faculty of Human and Social Development); Fiona Stevenson (DIVERSEcity Community Resources Society); Florentien Verhage (Inter-Cultural Association of Greater Victoria); Sureya Ibrahim (Centre of Learning & Development); Adriana Diaz del Castillo H. (Ensamble Investigaciones).