In light of extensive research linking stress and disease, and the high rates of reported stress in Canadians, there is a need to identify what people can do to protect their health from the ill effects of stress.
My work to date demonstrates that highly stressed and active individuals have significantly healthier biological and psychological stress responses than those who are highly stressed and inactive. This model suggests that physical activity could be helping to protect active individuals against the disease-promoting influences of stress.
This program seeks to clarify whether this is a cause-and-effect relationship. Is the better health of active individuals merely a result of traits that also cause them to remain active when under stress? Or can highly stressed, inactive people also gain these health advantages through interventions that increase their physical activity levels?
Goals of this program include:
- Discovering whether increasing habitual physical activity levels in highly stressed and inactive adults reduces the impact of stress on pathways to physical disease.
- Developing novel targets for evidence-based intervention programs tailored to individuals with high levels of life stress
Collaboration with researchers, stakeholders in high-risk populations, and policy makers will support the design of interventions that target biological and psychological stress-reactive pathways years before disease appears.
By focusing on health promotion in high-adversity communities, the ultimate goal is to improve quality of life and to reduce the economic burden on our health care system.
This project seeks to improve our means of developing social, economic, and workplace policies that improve worker health and reduce worker health inequalities. It builds on existing stakeholder collaborations and is structured around a series of comparative and cross-jurisdictional studies on occupational health and safety and workers’ compensation.
The broad aim of this research program is to expand current comparative research in order to develop an enduring policy and practice network that creates research and data infrastructure and a knowledge exchange and mobilization node that will support improved practices.
This program builds and extends data and research partnerships among researchers, compensation boards, and insurers from Canadian provinces, Australian states and New Zealand.
It has five objectives:
- Build and expand the network of compensation boards, researchers and other stakeholders to create a forum and group that can identify, guide and inform the focus of the cross jurisdictional policy comparisons.
- Expand the current comparative cross-provincial dataset on workers’ compensation to include all Canadian compensation boards’ data and a broader set of comparable variables.
- Work with international partners to create a more limited set of comparable data that would permit comparisons between different countries.
- Conduct policy-relevant, hypothesis-driven research with the comparative data to examine differences in and the effectiveness of different approaches to improving work disability outcomes.
- Utilize the policy and researcher network to effectively translate the results into policy and practice.
The vision of this research program is to advance our understanding of work-related disability and facilitate the translation of results into policy and practice.
The neighbourhood environment has been found to affect the levels of physical activity among children. We are investigating the mediating effect of parenting practices on this relationship.
For example, some studies have found that children living in neighbourhoods that are more walkable or have more green space were more likely to be physically active. This may be related to parenting practices. For example, parents may restrict their children from playing outdoors if they feel that their neighbourhood is unsafe but may encourage outdoor play if they live near a park.
This study will address this gap by using survey data collected from two sample populations. First, data collected from a web-based survey of 500 parents across Canada and the USA will be used to describe the relationship between the neighbourhood environment (e.g. safety, crime, walkability) and physical activity parenting practices.
Second, one child from each of 88 living in Metro Vancouver will be provided with an accelerometer to record their physical activity patterns. Their parents will complete a questionnaire measuring their perception of the environment and the parenting practices they employ.
The goal of the project is to better understand how the environment can influence parenting practices, enabling recommendations on designing neighbourhoods to allow children to be more physically active.
Co-infections with sexually transmitted infections and blood borne infections (STIBBI) are common among people living with HIV. They occur because of shared risk behaviours and common social conditions. It is a significant public health issue because groups of people at high risk of acquiring and transmitting infections can spread them more readily to the broader population.
This study proposes to examine neighbourhood-level characteristics (e.g. socio-behavioural groupings, geographic areas) to describe how contextual variables and socioeconomic status contribute to STIBBI co-infection trends. We will use provincial surveillance, laboratory, and healthcare utilization data linkages.
Our goal is to shed light on whether real-time data linkage could improve delivery of health services to core groups of people living with HIV. Ultimately, this work could inform health service policies and procedures that improve quality of life and reduce the spread of STIBBI among the general population.
Women living with HIV/AIDS (WLWH) have been identified as a key population of interest by the Federal Initiative to address HIV/AIDS in Canada. An October 2012 ruling of the Supreme Court of Canada upheld the criminalization of HIV nondisclosure except where both a condom is used and the person has a 'low' HIV viral load. The decision has drawn criticism as being 'gender-blind' for failing to consider the gender imbalance in negotiation of male condom use and in associated risks for violence and livelihood.
Given the prevalence of gender-based violence and ongoing HIV-related stigma, there is a need to better understand how the criminalization of HIV non-disclosure uniquely affects WLWH.
The central objectives of the proposed study are to investigate how the criminalization of HIV non-disclosure shapes:
- The gendered power dynamics of negotiating HIV disclosure, safer sex practices, and violence among WLWH
- HIV-related stigma and access to HIV treatment and care among WLWH
To do this, we will observe participants (e.g. in health care settings) and conduct in-depth individual interviews with WLWH, legal advisors, and health and social service providers.
There is potential to translate the findings of this research into evidence-based HIV policy that better considers gendered power dynamics and HIV-related stigma.
In 2010, BC launched the Seek and Treat for Optimal Prevention of HIV/AIDS (STOP HIV) program, which implements antiretroviral Treatment as Prevention (TasP) through enhanced HIV testing and universal treatment for HIV-positive individuals. The success of TasP at the population level will be challenging. The needs for enhanced case-finding efforts, early treatment following HIV diagnoses, and consistent adherence to treatment regimes are among the top concerns, particularly with regard to a key target population for TasP: people who inject drugs (PWID).
This project will examine key implementation challenges and opportunities regarding PWID’s experiences with the testing, treatment and prevention imperatives of TasP policy and program delivery practices. The objectives are to:
- Collect and analyze interview accounts from PWID regarding their experiences with TasP
- Collect and analyze interview accounts of decision makers in order to characterize how various ethical and implementation considerations related to PWID are taken up or rejected
- Use the new information gathered to develop recommendations for tailoring TasP policies and program delivery practices to advance the effective and ethical scale-up of TasP among PWID
Vaccination has been proven to be an effective tool to combat the spread of many communicable diseases. However, recent outbreaks of vaccine-preventable diseases such as measles have heightened concern regarding parents who are vaccine hesitant (i.e. who exhibit delayed acceptance or refusal of some or all vaccines).
Understanding what types of information most influence parents is key to producing effective public health messages that will improve vaccination rates.
Working in collaboration with the Canadian Immunization Research Network (CIRN), this project will examine the relationships among health information, social context, and parental decision-making around routine early childhood vaccinations.
To understand how information interventions interact with social context to influence parental decisions about routine childhood vaccinations, we will conduct:
- critical discourse analysis of vaccine discussions on social media
- a study of vaccine-hesitant new parents, following their information use and vaccination decisions over the course of a year
- a population survey module on health information seeking and use
This work will complement studies by CIRN and contribute to CIRN recommendations for Canadian immunization policy and practice.
Amyotrophic lateral sclerosis (ALS) is a devastating disease with fatal outcomes usually within a few years following diagnosis. The progressive degeneration of the nerve cells responsible for muscle movement leads to muscle wasting and paralysis, and eventually restricts breathing. The cause of ALS is unknown and probably includes a number of external factors.
There is a relative lack of very large-scale studies with data on potential risk factors collected before ALS occurs. This project aims to assess data from the entire population of Canada to examine the effect of external factors such as military service, trauma, and medication use on the risk of:
- developing ALS
- progression of ALS
Ultimately, this research could aid in designing effective disease prevention efforts and treatment strategies.
Non-communicable diseases cause 63 percent of all deaths, with cardiovascular and respiratory diseases (CVD/RD) accounting for most of these. Outdoor and household air pollution (OAP/HAP) contribute greatly to this global burden: they are responsible for seven million deaths and 10.3 percent of disability-adjusted life-years annually worldwide, largely due to CVD/RD. Our aim is to conduct the first worldwide health study of air pollution impacts on CVD/RD, using an existing large international cohort: the Prospective Urban and Rural Epidemiological Study.
We will use novel satellite-based approaches and targeted air pollution monitoring to estimate OAP levels. Household air pollution will be estimated using detailed information already collected on heating/cooking methods, fuel types and ventilation practices within study participants' homes. We will then determine the associations of pollution exposures with measures of CVD/RD as well as key relevant risk factors such as blood pressure and lung function. This study will provide a worldwide analysis to allow us to make inferences about air pollution and related diseases in the context of a large number of other risk factors.
