Novel STI Care and Prevention for Group Sex Communities

Group sex is an important health phenomenon, with an estimated one-in-ten people engaging in group sex at some point in their life. Group sex can be a source of pleasure and belonging but may increase risk of sexually transmitted infections (STIs). Despite its estimated prevalence, there has been little research on STI prevention and care among people who have group sex. Most group sex research has been done outside Canada and has focused only on men who have sex with men, excluding other sexualities and genders. My goal is to improve the STI outcomes for people who have group sex in Canada and beyond. My research focuses on 1) community-based knowledge around what makes group sex uniquely risky when it comes to STIs, 2) what STI prevention strategies people use during group sex and how effective they are, and 3) the barriers that healthcare providers face in providing STI care to people having group sex. Based on my findings, I will work closely with group sex community members to develop educational materials and support resources to improve STI prevention and care. Ultimately, I hope to reduce STIs and their negative impact on the health of this diverse stigmatized population.

Understanding the health and social harms of drug re-criminalization within the context of homelessness

Drug criminalization is associated with a range of poor health outcomes, such as overdose. Without access to adequate housing, people who use drugs (PWUD) experiencing homelessness are more likely to use drugs in public, and thus are among the most impacted by criminalization. Recent changes to BC’s decriminalization policy re-criminalizing drug use in most public spaces (e.g., parks, sidewalks in front of buildings) will likely have significant implications for the health and wellbeing of unhoused PWUD. This study will examine how emerging re-criminalization impacts health outcomes, including overdose, for unhoused PWUD, and will develop novel approaches to community-based research in rapidly changing policy contexts. Research activities include interviews with unhoused PWUD and outreach service providers, observation in community settings, and analysis of text sources (e.g., policy guidance, press releases) to fully understand topic scope. By understanding the dynamic relationship between drug re-criminalization and overdose vulnerability for people experiencing homelessness, this research will generate ideas to guide future drug policy in BC, and that are scalable and adaptable to other settings pursuing drug policy reform.

Community partnerships to understand and improve movement behaviours

Participation in physical activity provides people with many health benefits. Despite work to improve population physical activity levels, most people do not participate in enough physical activity to get these health benefits. Physical literacy examines the many factors that contribute to physical activity behaviour (motivation, confidence, physical skills, knowledge, and understanding) using an individual lens, and can be captured within the larger contexts that influence movement behaviours. This individual lens is a useful tool to develop and assess strategies to support equitable access to physical activity. I will develop a rich understanding of the interplay between physical literacy and physical activity, using a community-informed approach to improve our understanding of access to and participation in physical activity for equity deserving populations. In partnership with community groups, I will co-develop understanding of the barriers and facilitators to physical activity, and strategies to support increased movement. This research will inform policy change to create physical activity programs that are relevant and engage communities and support population level participation in health promoting movement.

Co-Creating Age and Dementia-Friendly Communities: A Community Engaged Program of Research

Worldwide, there is increased interest in developing age and dementia-friendly communities. This is because communities, organizations, and policy makers recognize the need to make the community setting a place where people can “age in place” and experience quality of life, while living with conditions such as dementia. It is important that older people with dementia have a say in the development of communities meant to support them. As such, this community-engaged research program addresses this need, by engaging directly with people with lived experience. The goal of this research program is to build a Community Action Group (CAG) of people with dementia, and to conduct co-research with the CAG. This means that the CAG will collaborate with the research team to plan and take part in a variety of research activities (such as co-design workshops) that will inform development of age and dementia-friendly communities. This will not only lead to meaningful change in communities, but will empower people living with dementia. Research of this nature will also impact future research by demonstrating the possibilities of collaborating and co-researching with people with lived experience, in order to make meaningful social change happen.

Sharing medicine bundles and pathways to community wellness: articulating nation-specific ceremonial, land-based wellness practices

Prior to the Indian Act and the Potlatch Ban, Indigenous nations in Canada had complex and complete healthcare systems with intrinsic ties to the land and spirit-based understandings of the cosmos. Within these holistic systems, the individual, family, and community were cared for. These systems included medicinal plant use; ceremonial practices across the lifecycle; mentorship; and land-based connections. The purpose of this research program is to: a) enliven the concept of land as healer, b) reclaim ceremonial healthcare practices that were outlawed by the government for several generations, and c) articulate nation specific pathways to community wellness in contemporary contexts. Working with several nations on community identified land-based wellness projects, life-experience and traditional stories will be gathered with knowledge keepers, youth and community to answer the research question: How can we enhance intergenerational knowledge transmission to advance community wellness and the revitalization of traditional health systems? Recommendations will inform the development of nation-specific community wellness frameworks and present ways forward for Canadian healthcare systems that engage the role of traditional healing.

Harnessing the Gut Bacterium Akkermansia muciniphila for Probiotic Innovation and Healthy Aging

The human gut is home to trillions of microbes that play a critical role in health and disease. My laboratory investigates common beneficial bacteria that colonize the intestinal mucus layer. While these bacteria offer benefits including improved metabolic health, they can also weaken the gut’s protective mucus barrier, leading to inflammation. We are using advanced genetic techniques to engineer probiotic strains that maximize health benefits, while maintaining gut safety. A major focus of our work is to engineer these bacteria as probiotics to promote healthy aging and longevity, and as innovative new types of vaccines. We are also working on strategies to modulate mucus degrading bacteria in the gut to combat graft-versus-host disease, a serious post-transplant condition. Using a combination of genetics, animal models, and bacteria isolated from human donors, we aim to contribute to the development of safe and effective microbiome-based therapeutics.

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 CafĂ© 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.