One in three Canadians are affected by diabetes. Diabetes prevention programs can help people considerably lower their risk for Type 2 diabetes. Yet, research understanding how to put programs in place (implement) in community settings is low. Site-specific context is often ignored, limiting program success. This means very few Canadians have access to effective diabetes prevention programs. Small Steps for Big Changes (SSBC) is a program for individuals at risk of developing Type 2 diabetes. This effective program was successfully implemented within two community sites. The program is ready to be implemented across Canada. This project will examine the implementation of SSBC in 10 unique community sites. Each site will be a case study to discover factors that affect implementation. A matrix will organize all the cases to compare results within and between sites. This method will reveal how context impacts implementation (what works, where and why). Results will offer lessons learned on how to successfully implement diabetes prevention programs across different contexts. Ultimately, this project will increase access to an effective diabetes prevention program across Canada.
Research Pillar: Population Health
Envisioning urban Indigenous-led pathways to mental wellness through community-based research in the interior of British Columbia and new partner engagement in the north
Colonialism, racism, and a lack of culturally safe care result in poorer mental health outcomes for Indigenous peoples in Canada. Indigenous-led services grounded in local values and priorities improve culturally safe care and wholistic health for Indigenous peoples. Urban (off-reserve) Indigenous peoples are, however, often excluded from mental health planning that affects them. This is especially felt by urban Indigenous peoples residing in rural and northern areas. Building on established partnerships with five British Columbia (BC) Interior Friendship/Métis Centres, and Interior Health, this research aims to change this. Together we will: 1) renew/strengthen existing relationships; 2) explore local mental wellness needs and priorities; 3) develop community-led pathways for promoting mental wellness; and 4) engage new community and health system partners in Northern BC. Local Elders, community research liaisons, and advisory teams will direct and facilitate information gathering and sharing. This may include surveys, talking circles, and community gatherings. Results will be community-owned, and shared with directions from communities.
Unravelling the complexity of familial influences that shape children’s obesity-related behaviors over time
The transition from elementary to secondary school is a challenging time for children as many obesity-related behaviors tend to worsen in this period. My research will examine how the familial environment can support a healthy transition; specifically, how parenting practices influence children’s choices with respect to diet, physical activity and sedentary time. I will first synthesize the published literature about how mothers’ and fathers’ parenting practices relate to children’s obesity-related behaviors. To gather real-world data, I will then use a combination of interviews, surveys, and wearable tech (accelerometers) with 150 British Columbian families to assess their parenting practices and children’s obesity-related behaviors daily for 14 consecutive days during elementary school, and again in secondary school. These data will be analyzed to identify how variations in parenting practices affect children’s behaviors day-to-day before and after the school transition, and the interviews will help understand more deeply how familial factors influence children’s behaviors. Together, my findings will guide the development of parenting interventions to help children maintain healthy behaviors during adolescence.
Buddy Up for men’s mental health: Engaging men through mutual help and social connection
Approximately one in five men struggle with mental health challenges each year; however, men often experience unique barriers that prevent them from seeking help or accessing treatment. The COVID-19 pandemic has placed additional pressure on many men and efforts are urgently needed to tailor services and norm men’s mental health help-seeking. While asking for help may be viewed by some men as a sign of weakness, helping others is often perceived as a strength that aligns with masculine ideals. By emphasizing the benefits of mutual help, it may be possible to equip men with the skills and confidence to support other men’s mental health challenges, as well as their own. The aims of this research are to explore men’s mutual help for mental health challenges and develop an online intervention to promote mental health and social connection through shared activities (e.g. physical activity). We will conduct interviews with Canadian men and use the findings to inform the development of the e-intervention. Men will be recruited to test the intervention and provide feedback. Findings will provide important information about men’s mutual help for mental health challenges and opportunities to norm mental health promotion.
Defining optimal pregnancy weight gain ranges for Canadian women
Maternal weight gain is closely monitored during pregnancy because as weight gain increases, so does the risk of excess postpartum weight retention, diabetes, and high blood pressure. While lower weight gain may prevent these complications, it also increases the risk of poor fetal growth and stillbirth. Pregnancy weight gain recommendations that balance these risks are important. The goal of this project is to establish the optimal range of pregnancy weight gain for Canadian women. We will use existing medical records from approximately 560,000 women who delivered in BC between 2004 and 2018. We will obtain information on pregnancy weight gain, and link this with short- and longer-term health complications for mother and newborn, such as excess postpartum weight retention, maternal diabetes and heart disease, poor fetal growth, and stillbirth. We will use statistical models that enable us to consider all health complications at the same time, while accounting for the fact that some complications are more serious than others. Our findings could provide the basis for new public health recommendations on pregnancy weight gain, which could help to reduce overweight and obesity in Canadian mothers and their children.
The impact of olfactory dysfunction on social and mental health
Our sense of smell enriches our lives—from enhancing pleasures (e.g. aroma of coffee) to signalling danger (e.g. smoke). Loss of smell is related to a range of social and emotional impairments, including elevated rates of depression, social isolation, and relationship difficulties. The COVID-19 pandemic causes transient smell loss, providing a novel opportunity to study one of our least understood senses. My first aim is to examine pathways linking olfactory loss to social and emotional impairments. I will recruit a prospective cohort of adults with recent onset of olfactory dysfunction and no flu-like symptoms (N=300) as well as a control cohort (N=100). Participants will be assessed over eight weeks, covering the typical period for olfactory recovery in COVID-19 patients. This data will provide a first-ever look at how within-person changes in olfaction relate to changes in social and emotional wellbeing. My second aim is to develop a brief, behavioral intervention by conducting a randomized trial focused on the benefit to participants from an online intervention. After refinement, this intervention will be offered freely, and findings will inform efforts to improve mental health for people with olfactory dysfunctions.
Pain and healthcare experiences of sex and gender minority citizens living with chronic pain in Canada
One in four people in Canada live with chronic pain. These individuals experience poorer health outcomes, higher healthcare services use, and lower quality of life. Studies show males and females experience pain differently, for example differences in pain sensitivity and pain control. But little is known about pain experiences in people who identify as a sex and gender minority, meaning a person’s sexual orientation or gender identity differs from traditional societal views. Sex and gender minority persons report higher pain and experience unique life stressors (e.g. discrimination), which may lead to worsening of their pain. We aim to study 1) pain experiences and 2) strategies to improve healthcare experiences for individuals who identify as sex and gender minority living with chronic pain by collaborating with patient and public stakeholders to answer these questions. Involving persons who identify as sex and gender minority with chronic pain in research studies is important because it provides them with a voice to offer personal stories and perspectives. Community engagement will help researchers ask the “right questions” and guide research priorities to improve the lives of people who face similar health challenges.
Generating, co-creating, and implementing solutions and supports for older adults with cancer and their caregivers
The number of adults over age 65 in Canada is growing as baby boomers age. Older adults are the most likely to be diagnosed with cancer and likely to have other chronic health conditions. These health conditions may mean increased medications, medical appointments, and/or difficulties getting around, which combine to make the cancer experience more challenging. Older adults may also require help from family or friends to attend their many cancer and other health appointments (family doctor, geriatrics, and other specialists). COVID-19 has created additional challenges for older adults with reports of reduced or limited treatment offerings, and a sudden shift to virtual appointments.
My research responds to ongoing calls to rethink how we provide care for older adults with cancer. Specifically, we will partner with patients, community groups, health system leaders, and clinicians to co-create and implement tools to make cancer management easier for older adults. This work focuses on improving the processes rather than merely supporting individuals to navigate complex systems. This research will have important implications for health systems, clinicians, and researchers, but most significantly for older adults with cancer.
Indigenous community-based health research in British Columbia’s interior
Indigenous health injustices and inequities are formed by colonial structures that are paralleled within health research itself. Therefore, Indigenous health research must re-center Indigenous Peoples approaches, or it risks re-colonization.
Thus, I aim to reframe Indigenous Peoples, cultures, knowledges, and capacities as central to a promising health future. My program of research focuses on three primary community-based health projects, which are guided by Indigenous approaches to health and research with community-partnerships as the foundation. First, in partnership with the Okanagan Nation Alliance, we are working together to frame community data within Sylix Okanagan approaches to health and data. The second project partners with Indigenous Programs and Services at the UBCO campus, to offer a healthy masculinities program for students. The third project brings together a cluster of experts to support urban Indigenous health in collaboration with Metis Centres and Friendship Centers in the Okanagan region.
My research program seeks to promote Indigenous health, health knowledges, capacities, and outcomes in ways that community understand as meaningful, and thereby support Indigenous control of Indigenous health.
Drawing on decolonizing and intersectional research approaches to inform action for health equity and reproductive justice among Indigenous women, Two-Spirit and gender diverse people
Health and social inequities faced by Indigenous women continue be shaped by ongoing systemic colonialism. My research program draws upon Indigenous and decolonizing methods to establish an empirical evidence base to inform interventions and action. Specific objectives include: 1) To draw upon Indigenous methodologies, community and arts-based approaches to understand Indigenous reproductive and maternal health experiences, identifying factors that influence access culturally-safe and trauma informed care; 2)Through intersectional, feminist and decolonial lenses understand how socio-structural factors facilitate or mitigate access to responsive justice systems, identifying community-led and strengths-based responses for Indigenous women who have experienced violence; 3) Examine and evaluate policies and initiatives aimed at addressing the MMIWG calls to justice for marginalized Indigenous women (including women living with HIV and in sex work). Map and innovative strategies and inform evidence-based actions for the development of structural, community-based and Indigenous-led responses; 4)Explore and map marginalized Indigenous women’s primary care experiences using cultural and arts-based methods to inform innovative interventions.