Being pregnant can bring extra challenges, especially for people who are struggling financially and socially. It can make them feel stressed and less able to respond to catastrophic events such as pandemics, family illness and climate change.
Caring for this population is especially challenging now with fewer maternity providers in the province. There is currently no specifically designed program for socially vulnerable pregnant people. Around the world, programs supported by Community Health Workers (CHWs) have made it easier for people to get healthcare, help them stay healthy, and improve their social situations, but less is known about how they could be used in BC.
This project unites researchers, providers, CHWs and pregnant individuals with diverse identities, especially multiethnic and low-income, including new immigrants and refugees in Vancouver.
Together, we will explore:
What are the most important areas to include in a CHW-supported prenatal and postnatal program?
What could improve the delivery and satisfaction of the program?
How could success be measured?
We wish to hear what is important to people to create programs that can elevate the experience of pregnancy for those facing challenging social situations.
We will bring together people who research, provide, and receive menopause care. They will create a complete list of research ideas to support healthy aging in British Columbia. The process will include healthcare providers from nursing, medicine, and psychology. It will also include researchers from basic, health, and social sciences. Individuals with lived experience of midlife and menopause will also take part. Power dynamics within and throughout groups will be accounted for with trauma-informed and patient-centered approaches. Together, we will create a âResearch Agenda for Menopause and Midlife Womenâs Health.â It will show ways to improve care for menopause and midlife womenâs health. The project activities will lead to new and stronger partnerships among researchers, clinicians, and people with lived experience. The Agenda will be hosted by the Womenâs Health Research Institute and will set up the new Menopause and Midlife Health Program at BC Womenâs Hospital to be a Centre of Excellence in both research and clinical care.
The âHER-BCâ study explored transitions throughout menopause for mid-life women in BC. The next step is to share the knowledge gained during this study, and promote awareness and use of this new knowledge amongst the public and healthcare providers. To reach as diverse an audience as possible, we will undertake a series of knowledge sharing activities with researchers and research users, including people with lived;living experience (PWLE) of perimenopause and menopause. Together, we will plan and put in place a series of knowledge translation (KT) activities that are widespread and varied in format. We aim to reach two target audiences: 1) PWLE and the public, and 2) health care practitioners. Planned KT activities include Facebook Live events, online webinars, podcasts, video interviews, and in-person presentations. We will also create a communications toolkit to share with community organizations, professional associations and the public. They will distribute findings of HER-BC to their networks, including on social media. The proposed KT activities aim to empower women to make informed decisions about menopause care, and to support health care practitioners to provide responsive and appropriate menopause care and services.
This project will bring together women living with HIV, HIV community organizations/allies, and researchers to establish a community advisory committee for the NOVA-HIV clinical trial. This committee will co-lead the clinical trial by reviewing study materials to ensure they are safe and appropriate, holding regular meetings to review study progress, and providing ongoing feedback on topics such as recruitment. A critical component of this community advisory committee will be capacity building among trainees through immersion in community engagement work and women living with HIV through pairing community members with less experience interfacing with research with a mentor community member to learn and develop their ability to contribute to additional research in the future.
Antenatal corticosteroids are a medication given to women who are at risk of an early delivery to reduce the chance of breathing problems for their baby after birth. Current guidelines recommend giving antenatal corticosteroids to pregnant women who might have their baby before 34 weeks of pregnancy. This medication may also help those at risk of an early delivery at 34-36 weeks of pregnancy but the balance between the benefits and harms of this treatment is less clear at these ages. Guidelines for giving this medication at 34-36 weeks of pregnancy are also unclear, making it difficult for doctors and patients to decide whether to use it. We will find out if including a decision support tool in clinical guidelines will improve how doctors discuss antenatal corticosteroids with patients at 34-36 weeks of pregnancy. We will ask patients whether they had better discussions with their doctor about this treatment after their doctor had access to the decision support tool within the clinical guideline, and we will ask doctors how this decision support tool impacted their counselling. This project could improve communication between doctors and patients, especially when it is unclear whether a treatment’s benefits outweigh its harms.
Anxiety disorders are the most common of all mental health conditions. They affect 20 percent of pregnant and postpartum people, and are associated with significant distress and life interference for sufferers, as well as negative consequences for the fetus and infant.
Little, if any, routine screening for these disorders is conducted. This is mostly because accurate screening tools have yet to be identified. The majority of screening studies have used poor quality research methodology or have assessed measures which appeared to perform too poorly to be recommended for widespread use. The result of this is that perinatal anxiety disorders often go unidentified, resulting in continued suffering and life impairment.
The purpose of this research is to identify one or more accurate and reliable perinatal anxiety disorder screening tool(s). To do this, we will conduct a large scale study of pregnant and postpartum people in which we assess the accuracy of the most promising perinatal anxiety disorder screening tools.
This research will provide important information to inform healthcare providers, policymakers and scientists, about the most effective approach to screening for anxiety disorders during pregnancy and the postpartum period.
Why: Access to abortion and contraception is a challenge in BC, particularly for underserved populations. Innovative models of care developed in response to the COVID-19 pandemic have potential to better meet BC’s needs. We aim to convene key stakeholders to discuss these emerging opportunities, learn best practices, identify policy solutions, and co-create a roadmap for equitable family planning in BC.
What: BC Women’s Hospital and UBC’s Contraception & Abortion Research Team (CART) will convene a hybrid in-person/online one-day event. Top speakers will convey the latest evidence and interactive breakout circles will engage interdisciplinary invitees.
Who: We will convene patients, health authorities, clinical administrators, public health and community services, government leaders, and urban and rural clinicians (physicians, NPs, nurses, midwives, pharmacists, social workers).
When: March 4, 2022 from 8 a.m. to 4:30 p.m.
Where: Virtually via Robert H. Lee Alumni Centre, UBC
Anticipated outcome: The knowledge exchange and meaningful collaboration supported through this meeting will lead to co-development of new research priorities and policy opportunities that can directly impact equitable access to contraception and abortion care in BC.
Team members: Cheryl Davies (BC Women’s Hospital and Health Centre, and Provincial Health Services Authority);Â Wendy Norman (UBC); Regina Renner (UBC); Natasha Prodan-Bhalla (Chief Nurse and Professional Practice Officer); Glenys Webster (Women’s, Maternal and Early Childhood Health); Ann Pederson (Interim Executive Director); Michelle Fortin (Options for Sexual Health); Unjali Malhotra (First Nations Health Authority); Madeleine Ennis (UBC); Ali Fuchshuber (UBC); Laura Schummers (UBC); Kate Wahl (UBC); Zeba Khan (UBC and Options for Sexual Health); Carly Rivers (Contraception and Abortion Research Team); Ama Kyeremeh (Contraception and Abortion Research Team)
Dedicated women’s health research is a relatively recent milestone. Available guidance for including trans and intersex people in this work has not acknowledged the social, historical and political contexts that led to naming cisgender women (women whose gender aligns with their sex assigned at birth) in research, and tends to be focused either on clinical work (e.g. how to refer to patients and their anatomy) or on data collection (e.g. how to ask about sex and gender).
“Beyond the Binary” will include a survey to assess current gender-equity initiatives in BC, two educational workshops, and two knowledge exchange events to inform guidance for gender-equitable practice within BC’s women’s health research community. To co-create safe, trauma-informed, and patient-oriented guidance, trans and intersex people will be invited to participate in these activities and to participate on a Community Steering Committee. Through collaboration with people from trans, intersex, research, health, ethics, and academic communities, we aim to develop context-specific guidance, resources, and recommendations for researchers and health decision-makers to bridge this knowledge gap.
Team members: Beverley Pomeroy (Fraser Health); Laurel Evans (UBC); Caroline Sanders (University of Northern British Columbia); Ann Pederson (BC Women’s Hospital + Health Centre); Michelle Chan (UBC); Tamara Baldwin (UBC); Lindsay Carpenter (University of Northern British Columbia); Faith Jabs (UBC); Skye Barbic (UBC); Julia Santana Parrila (Women’s Health Research Institute); Nicole Prestley-Stuart (Women’s Health Research Institute); Lorraine Greaves (Centre of Excellence for Womenâs Health); Lori Brotto (UBC); Wendy Robinson (BC Children’s Hospital Research Institute); Melissa Nelson (Women’s Health Research Institute); AJ Murray (BC Women’s Hospital + Health Centre)
Evidence of disrespect and abuse during pregnancy and birth is increasing globally; however, little is known about the experiences of childbearing people in BC and high-quality data is needed, to address this serious issue. While it is essential to ensure a positive birthing experience regardless of the person’s background, research suggests that racialized and minority groups are more likely to report disrespectful treatment by care providers and are less likely to access high-quality care during pregnancy and birth.
In my study, I plan to analyze the pregnancy and birth stories from childbearing people, using several data sources and analysis approaches. Body mapping is a participatory method of data collection that will help to depict experiences of respect, disrespect and abuse. My goal is to create a Continuum of Respectful Experiences (CORE) model to describe complex, multi-layered experiences each birthing person may encounter during perinatal care. This model can be used as a tool to change patterns in care provision. It can teach care providers ways to reduce disrespect and abuse; enable person-centered decision making and understand the needs of people with different identities.
Cervical cancer remains a significant women’s health issue in Canada even after the introduction of cytology screens (i.e. Pap smears) in 1949, which resulted in a reduction of cases. It is frequently diagnosed in young women, who are embedded in careers, raising families, or still planning to conceive. Treatment can affect women’s ability to work, care for families and cause infertility, and survival rate is often low. It is thus vital to improve preventative screening programs using recent testing innovations. Testing for human papillomavirus (HPV) is more effective than cytology, but it is not yet used in BC. HPV FOr CerviCAL Cancer (FOCAL) was a trial investigating HPV testing. Participants were followed for ten years post-trial through linkage to the BC Cervix Screening Program to create the FOCAL-DECADE cohort. We will use data from this cohort to compare long-term rates of cervical precancer between those who received cytology or HPV testing, expecting significantly reduced rates in the HPV group. These results will inform decision-makers, like the provincial screening program, of best screening practices (e.g. screen interval), aiding transition to HPV-based testing programs, thus helping reduce cervical cancer across BC.
