Community-based Assessment of LGBTQ/2S Education and Research in British Columbia

Research co-leads:

  • Kate Shannon
    University of British Columbia 
  • Tara Lyons
    BC Centre for Excellence in HIV/AIDS

Research user co-lead:

  • Joel Harnest

Team members:

  • Jill Chettiar
    University of British Columbia 
  • Lulu Gurney
    BC Centre for Excellence in HIV/AIDS

This project will bring together a wide range of community members, researchers and stakeholders involved in education and research activities relating to LGBTQ/2S issues. The objective is to compare the content and pedagogical approaches of education sessions carried out by different individuals and organizations, to examine and critically inquire about the ways sharing and building of new knowledge pertaining to LGBTQ/2S communities are approached.

The approach is two-pronged, targeting both education (sharing knowledge) and research (building knowledge).

First is reviewing and auditing the content and pedagogical approaches of education sessions and materials used by different individuals and organizations across BC; to examine and critically inquire about the ways teaching and sharing existing knowledge is approached. There are several organizations and individuals doing education in the areas of queer, trans and two-spirit competency training and with the influx of education needs and trainers, there are several gaps in the collective educational approach at this time. Many educators and trainers are training and developing curriculum ad hoc without the ability to strategically develop educational practices and approaches. Besides providing a comprehensive and cohesive foundation for future LGBTQ/2S education work, this gathering will be an opportunity for peer support amongst educators, and enable the establishment of a province-wide support network.

Second is developing a vision for a new research project focused on trans, two-spirit and gender diverse people in BC. The planned meeting of stakeholders will consult on the priorities and interests of community members and allies regarding a future study. Specific objectives are to establish a provincial research advisory board, identify funding opportunities, and develop research objectives and guiding principles for the theoretical framework and methodologies for the future project. This research will further support the above educational work by providing local data for future materials and interventions.

Physician-led low-carbohydrate therapeutic nutrition for Type 2 diabetes: Building on a grass-roots movement in BC and beyond

Research co-leads:

Research user co-lead:

  • Sean McKelvey
    Institute for Personalized Therapeutic Nutrition

Team members:

  • Barbara Allen Bradshaw
    Low-Carbohydrate Physician Group
  • Cody Durrer
    University of British Columbia
  • Mary Jung
    University of British Columbia Okanagan
  • Karim Khan
    University of British Columbia
  • J. Kler
    Low-Carbohydrate Physician Group
  • J. Kozoriz 
    Low-Carbohydrate Physician Group
  • Carol Loffelman
    University of Toronto
  • Sean Mark
    Approach Analytics
  • Barb Reece
    Institute for Personalized Therapeutic Nutrition
  • Deanna Roberts 
    Low-Carbohydrate Physician Group
  • Laura Saslow
    University of Michigan
  • Adriaan Windt
    University of British Columbia

BC physicians began a low-carbohydrate physician group in 2016, which has grown to over 1,000 members. These physicians have seen tremendous success in stabilizing glucose, improving triglycerides, and reducing or eliminating the need for glucose lowering medications in their patients. No research has been conducted and no formalized data collection has occurred to document this innovative Type 2 diabetes treatment strategy. The goal of this project is to mobilize, coordinate, and expand this group to create a formalized network conducting research. Physicians, researchers, and knowledge users including eHealth technology experts and non-profit foundations will meet to co-create a roadmap for this research. The objectives of this proposed work is to organize a group of identified experts and collaborate on developing:

  • Tools to enhance the delivery of therapeutic nutrition by primary care physicians.
  • An expanded online training program that will promote learning of low-carbohydrate therapeutic nutrition and implementation of a consistent approach by primary care physicians.
  • A roadmap for a research study that will test and evaluate the outcomes of the first two objectives.

The expected outcomes will enhance the effectiveness of primary care in Type 2 diabetes and build the foundation for subsequent research and knowledge translation related to training primary care physicians on how to safely and effectively implement low-carbohydrate therapeutic nutrition.








First Nations Perspective on Mental Health and Wellness, Culturally Safe and Trauma-Informed Harm Reduction: Collaborative Response to the Impact of the Opioid Crisis on First Nations

Research co-leads:

  • Amanda Ward
    First Nations Health Authority
  • Will Small
    Simon Fraser University

Research user co-leads:

  • Warren Clarmont
    BC Association of Aboriginal Friendship Centres
  • Kora Debeck
    BC Centre on Substance Use
  • Michelle Degroot
    First Nations Health Authority

Team members (FNHA):

  • Harmony Johnson
  • Namaste Marsden
  • Shannon McDonald
  • Jennifer Murray
  • Patricia Vickers

The current opioid crisis in British Columbia (BC) has been devastating to First Nations individuals, families and communities, who continue to be disproportionately affected compared to other BC residents. The First Nations Health Authority (FNHA) provides health programs and services throughout BC to all First Nations and has collaborated with BC’s Ministry of Health, and provincial, regional, and community partners over the past year to develop strategies and solutions toward reducing harm and preventing death due to opioid use. Despite this work, the crisis is showing no signs of slowing without the adoption of multi-faceted and collaborative approaches designed to strengthen community and nation-based responses. A dramatically enhanced collaborative approach for First Nations is needed, grounded in the First Nations Perspective on Health and Wellness, addressing root causes of drug use including intergenerational trauma, and guided by people who use drugs.

FNHA will form a network that includes First Nations people who use drugs, community members, Elders, provincial stakeholders, and service providers from across BC. The proposed “First Nations Mental Health and Wellness Opioid Use Network” will focus on four priority areas grounded in the First Nations Perspective on Health and Wellness, community-informed Mental Health and Wellness Service Model, and the priorities of people who use drugs:

  1. Strengthening service delivery.
  2. Addressing social determinants of health and root causes of opioid use.
  3. Enhancing strategies for culturally safe and trauma-informed engagement, prevention and harm reduction.
  4. Informing and strengthening strategic directions for First Nations.

FNHA will convene a workshop for Network members and invited guests to collaboratively work toward a community-informed approach, implementation plan, and develop research and knowledge exchange activities. We aim to build enduring partnerships between organizations and individuals involved in First Nations health and wellness activities across BC seeking to prevent further death and harm due to opioid use and misuse.

The System Awakens: Building Learning Healthcare Systems in Canada. Centre for Health Services and Policy Research 30th Anniversary Health Policy Conference

Research co-leads:

  • Kimberlyn McGrail
    University of British Columbia 
  • Stirling Bryan
    Vancouver Coastal Health Research Institute

Research user co-lead:

  • Marc Pelletier
    Institute for Health System Transformation & Sustainability

Team member:

  • Shiraz El-Adam
    University of British Columbia 

For three decades, CHSPR’s annual conference has provided a platform for thought-provoking dialogues on emerging research in the health services and policy domain. In 2018, the conference will address the question of how BC can become a learning health system. In a learning health system, every patient interaction is treated as a learning activity, and the ethos of the system overall is improvement. Speakers will share the latest thinking on learning health systems and facilitate conversations on how BC can adopt the principles and actions that define such systems.

The conference will be held March 8-9, 2018 at the Pinnacle Hotel Vancouver Harbourfront, and will be structured around keynote and plenary panel presentations, with ample opportunity for facilitated discussion. Delegates will also present their work and experiences around learning health systems in short oral presentation and poster sessions, and engagement with all speakers and presenters will be encouraged. Web and video based technology will facilitate sharing of new knowledge during and after the conference.

The conference’s key objective is to bring together researchers, policy-makers, decision-makers, clinicians, students, patient partners, and interested public involved in creating, implementing, and being part of a learning health system. Confirmed speakers include Charles Friedman of the University of Michigan, an international leader in learning health systems and our opening keynote; Lucy Savitz of Kaiser Permanente as our closing keynote; and Jean-François Ethier (Université de Sherbrooke), David Ford (College of Medicine in Swansea University, Wales), and Walter Wodchis (University of Toronto) as a panel showcasing learning health system exemplars from outside of BC from which we can learn.

The program will also feature panels taking inventory of nascent learning health systems (and precursors) in BC, and anticipating issues in transforming to learning health systems, such as ethical concerns, policy barriers, informatics challenges, and leadership gaps. Post-conference, meetings of collaborative groups seeded with conference speakers will be organized, intended to help create concrete action plans for moving learning health system ideas into practice in BC. Many conference delegates will probably bring ideas back to their organizations and act as learning health system “champions” to facilitate transformation in BC.

Engagement with Physicians to Enhance Cultural Safety in Primary Care for People who Use Substances

Research co-leads:

Research user co-leads:

  • Alisa Harrison
    (Victoria Division of Family Practice)

Team members:

  • William Cunningham
    (Island Health)
  • Bryn Meadows
  • Cindy Trytten 
    (Island Health)

The proposed activity is to develop, host and facilitate a two-day workshop with key system partners, and physicians, to identify practice and policy priorities, and strategize next steps. Physician engagement represents the next step in the broader research agenda — to support implementation and practice change. The expected outputs of the workshop include:

  1. The development of a plan to implement the research evidence through transforming how primary care is delivered to people who use substances.
  2. A strategy for collaborating with primary care physicians, with a long-term goal of improving access to and quality of primary care for people who use substances.

This workshop will be co-facilitated with peer research associates who are trained in recovery and have lived experience with substance use. It will focus on looking at how the evidence from the concept mapping (currently underway) with people who use substances can enhance primary care services for people who use substances. This will be integrated with substantial data from the Victoria Division of Family Practice on what physicians need to support this population. One output is developing guidelines for physicians who work with substance users across the full spectrum, from youngsters experimenting with substance use, to recreational drinkers and drug users, to those using illicit substances and experiencing serious health and social impacts.

The content produced as part of the workshop will leverage evidence from an ongoing patient-oriented research project that this team is conducting, funded by a Strategy for Patient Oriented Research Collaboration grant, led by team members at the Centre for Addictions Research of BC at the University of Victoria, the Centre for Health Leadership and Research at Royal Roads University, and patient partners from two non-profit peer support organizations, the Society of Living Illicit Drug Users and the Umbrella Society (which support people who use substances). In both projects, the team will collaborate with people who use substances to better understand how to reduce stigma and increase accessible, appropriate primary care services for them.

InNovATE: Innovation in the Northwest to Advance Assistive Technology Excellence

Research co-leads:

  • William Miller
    University of British Columbia 

Research user co-leads:

  • Ian Denison
    Vancouver Coastal Health
  • Ruby Ng
    Sam Sullivan Disability Foundation

Team members:

  • Mark Harniss
    University of Washington
  • Richard Robinson
    AbleTech Assistive Technologies
  • Emma Smith
    University of British Columbia 

British Columbia can be a global leader in assistive technology (AT) research, education, and health service, as one of the first World Health Organization (WHO) affiliated Regional AT Hubs. InNovATE (Innovation in the Northwest to Advance Assistive Technology Excellence), a two-day meeting of AT leaders from Western Canada and the Pacific Northwest USA, is the first step in achieving that goal.

Addressing health care needs is challenging, especially with the aging population, many of whom have complex conditions and/or experience mental health issues. Health care costs are growing and leading to centralized services, affecting those in rural/remote communities. There is a rapid pace of technological change. ATs are applications of new and existing technological innovation, which assist individuals to maintain health and well-being. They are mediators for independence for those with functional limitations and can help to reduce health related costs. The WHO Global Cooperation on Assistive Technology (GATE) initiative was formed to address challenges in access to AT globally. They have issued a call to action to form regional AT hubs to collaboratively advance the GATE agenda in each region and contribute to a global network to promote access to AT. An AT regional hub in Western Canada and the Pacific Northwest USA would bring together experts in AT research, provision, education, policy, and use, and provide leadership at a local, regional, and global level to promote access to AT.

The team will hold two days of stakeholder meetings with leaders in AT research, education, and health service in Western Canada and the Pacific Northwest USA to increase awareness of innovations and initiatives in AT in this region, develop networks focused on collaboration and funding opportunities, and establish next steps for a WHO-affiliated AT Regional Hub.

Post-meeting, a publicly available InNovATE report will bring awareness to innovations and opportunities in the field. Cooperative initiatives, including a collaboration and funding database and network listserv will promote ongoing communication. Finally, a public lecture (recorded and available freely online) will help increase awareness of AT initiatives in the region, and scholarly research through a delegate survey will demonstrate the impact of this two-day meeting on awareness and collaboration among meeting delegates.

EQUIP for Pain: Enhancing the capacity of primary health care providers in BC in the provision of equitable health services for people living in pain in marginalized conditions in BC

Research co-leads:

  • Kenneth Craig
    University of British Columbia 
  • Francine Darroch
    University of British Columbia 
  • Cindy Holmes
    University of Victoria
  • Colleen Varcoe
    University of British Columbia 

Research user co-leads:

  • Maria Hudspith
    Pain BC
  • Niknaz Kahnamoui
    Pain BC

Team member:

  • Sharalyn Jordan
    Simon Fraser University

Marginalized people typically experience higher prevalence of painful medical conditions compared to non-marginalized people, but access and use pain management services less frequently. This project will work towards solutions by bringing together people in marginalized conditions living with chronic pain, primary care providers, community health care centres, non-profit organizations and pain researchers along with scholars who specialize in trauma and violence informed care (TVIC) for a one-day knowledge translation gathering.

To prepare for this event, the team will engage with people in marginalized conditions and focusing on three groups: Indigenous peoples, newcomers and refugees, and the Lesbian, Gay, Bisexual, Trans, Queer, and Two-Spirit (LGBTQ2S) communities living with chronic pain in three small group dialogue sessions to explore their unique perspectives and lived experiences. In parallel, the team will also conduct outreach to identify health care providers throughout the province committed to making their practices more culturally accessible and safe. The purpose of the final gathering is to:

  1. Center the voice of people living in marginalized conditions and with chronic pain, to inform research, practice, and policy to create more equitable structures and programs for pain care.
  2. Support individuals and organizations to identify the gaps in their provision of pain care service and program delivery that contribute to inequitable access and to develop plans for applying the theory and evidence behind cultural safety and TVIC, as developed by the CIHR funded EQUIP research project.
  3. Enhance pain researchers’ awareness of the body of knowledge regarding TVIC to help inform their research priorities and questions.

Approximately 1 million British Columbians live with chronic pain. A substantial proportion of these people also have a history of trauma, suffer discrimination, experience emotional stress and depression, and might also struggle with substance use. The BC Centre for Disease Control recently identified support for pain management therapies as one of its top three priorities to help prevent illegal drug overdose. This project tackles health service delivery at the intersection of chronic pain, trauma and systematic discrimination. The overdose crisis provides an urgent backdrop for the work. While resources are most needed to directly address the impacts of the overdose crisis, i.e. harm reduction, interventions at an earlier stage will help prevent the further escalation of the problem and help reduce and better manage people’s suffering.

Contraception & Abortion in BC: Experience guiding research guiding care

Research co-leads:

Research user co-lead:

  • Cheryl Davis
    BC Women's Hospital & Health Centre

Team members (UBC):

  • Julianne Burke
  • Julianne Busby
  • Brigid Delany
  • Courtney Devane
  • Roopan Gill
  • Genevieve Leduc-Robert
  • Sarah Munro
  • Nevena Rebic
  • Emma Rossnagal

WHY: Equitable access to abortion care is a problem in BC, particularly for disadvantaged and rural populations. Rapid changes in regulations on the provision of medical abortion and the recent roll out of a program improving access to contraception present important and timely opportunities to better meet BC’s needs. At this exciting juncture, BC Women’s, in partnership with UBC’s Contraception & Abortion Research Team (CART), and a range of collaborators, invite health professionals, health administrators and system leaders to prepare for key opportunities and to identify challenges and solution strategies in primary care and rural and remote family planning health services.

This meeting will build on four successful BCW-CART meetings (2009, 2011, 2014 & 2016) convening a wide range of provincial collaborators. The many changes in regulations and stakeholder experiences with programs introduced since the 2016 meeting indicate that now is an ideal time to reconvene. Understanding stakeholder perspectives on what is needed, what is working, what is not, and where research is needed, is key to improving access. The aim is to examine BC-specific opportunities for provision of medical abortion and post-abortion contraception, to improve equitable access to primary care provision of primary care family planning health services in BC, particularly throughout rural and remote areas.

WHAT: A one-day meeting held at BC Women’s Hospital and Health Centre

Top speakers will share the latest evidence, and BC-specific health system and health service changes, related to medical abortion and to the new SMART post-abortion contraception program. Sessions will engage participant input to emphasize the opportunities and processes specific to BC and to understand a range of perspectives and the challenges each stakeholder faces in their role.

Interactive audience-panel discussions will engage interdisciplinary invitees including key knowledge users, patient groups and health system leaders, administrators and a range of health professionals. Facilitated discussion will explore health system improvement options to ensure women in BC have equitable access to high quality family planning services.

WHO: This meeting will be convene perinatal service leads from all health authorities, hospital and clinic women’s health service administrators, public health and community services related to family planning, government leaders in public health, and urban and rural health professionals (physicians, NPs, nurses, midwives) working with those seeking abortion.

WHEN: Friday March 9, 2018  |  8:00 a.m. – 4:30 p.m.

WHERE: Shaughnessy Auditorium, BC Women’s Hospital and Health Centre, Vancouver

Stakeholder engagement to study and optimize the translation of knowledge by the integration of health coaching and mindfulness into medical care on the Sunshine Coast

Research co-leads:

  • Robert Woollard
    University of British Columbia 

Research user co-lead:

  • Rahul Gupta
    Vancouver Coastal Health

Team members:

  • Jane Bishop
    Sunshine Coast Division of Family Medicine
  • Joerg Jaschinksi
    Child Youth Mental Health and Substance Use
  • Ray Markham
    Rural Coordination Centre of BC
  • Marilyn Pederson
    Emergency Management BC
  • Andrea Stinton 
    Gibsons Medical Clinic

Chronic illness including multisystem disease, chronic pain, substance use disorders, and mental health challenges are by far the most expensive and frustrating aspects of the health care system. With a deeper understanding of the complexity of health care systems, there is an emerging shift from mechanistic approaches often ineffective to ones that embrace uncertainty, recognize wholeness, and honour individual uniqueness. Understanding relationships, both human and systemic, has become key, to see how different parts are connected to the whole. There are multiple relationships at play: those patients have with their own bodies and biographies, those between patients and their primary healthcare providers, and those between different providers that serve any patient.

Over the last two decades, health coaching and mindfulness arose to offer insights into how best to leverage these relationships. Together they provide guiding principles and practices that orient to complexity and wholeness. This shift in orientation allows access to insights and innate resources that lead to emergent behaviours and health promotion wherein the patient and the team of providers become more than their parts.

On the Sunshine Coast, since 2014, health coaching and mindfulness-based interventions have been integrated into the fabric of medical care. The proposed work at the patient and community level is to better understand how such integration might best be achieved.

This team will first engage stakeholders in dialogue to understand needs, experiences and context specific opportunities. Key stakeholders include patients who experienced these interventions, physicians who referred their patients to these programs, physicians who possess skills and key members of the Sunshine Coast Division of Family Practice. Key members from the Rural Coordination Centre of BC, the Faculty of Medicine and UBC’s Continuing Professional Development will also be invited for input that might be of value for other communities and physician training.

Since their applications are universal, health coaching and mindfulness represent interventions that may support both patients and providers. Wellness of providers themselves is crucial to optimizing patient care so provincial advocates for physician health are invited.

This group will design a research plan to prioritize study elements and support future grant applications. The long-term hope is to further translate knowledge into practice on the Sunshine Coast as a pilot, and provide a template that other rural and remote communities might adopt/adapt to contribute to healing within their own communities.

Move the north: Development of a research agenda and action plan for physical activity in northern BC

Research co-leads:

  • Chelsea Pelletier
    University of Northern British Columbia 

Research user co-lead:

  • Sandra Allison
    Northern Health

Team members:

  • Sabrina Dosanjh-Gantner
    Northern Health
  • Guy Faulkner
    University of British Columbia 
  • Gloria Fox
    Northern Health
  • Robin Keahey
    University of Northern British Columbia 
  • Anne Pousette
    Promotion of Wellness in Northern BC
  • Drona Rasali
    BC Centre for Disease Control

Chronic disease risk factors, such as physical inactivity, are more prevalent in the region served by the Northern Health in BC. This vast geographic region is sparsely populated, culturally diverse, and has high variability in infrastructure and knowledge regarding physical activity. With a passionate team of health service providers, researchers, policy makers, and community leaders, this project will develop a set of actionable research questions, identify research priorities, and create a plan for increasing physical activity, improving chronic disease risk factors, and reducing health inequities in northern BC.

This will be accomplished with a two-day physical activity summit consisting of a higher-level meeting focused on advancing health policy, and a second day that engages people working on the ground in physical activity program delivery. Outcomes of this initiative will include a research agenda rooted in community needs and the creation of a Northern Physical Activity Coalition that includes representation from a broad range of passionate researchers and research users.