Developing a roadmap for nurse-assisted injection in BC’s supervised consumption services

Supervised consumption services are an essential part of health care and community services for people who use substances in British Columbia. These services are particularly important for people who inject substances because they offer a safer place to inject and an opportunity to access harm reduction supplies, connect with resources, and receive care if needed. Using in a supervised consumption services can make the difference between life and death in the context of the overdose crisis because staff can quickly detect an overdose, administer naloxone, and call emergency services. Therefore, it is essential to remove any barrier that may prevent people who inject substance from accessing such services. One barrier that is consistently reported is the lack of assistance for people who need help injecting. Nurses are not currently allowed to provide any assistance. This project is designed to explore this issue and find ways to improve access to supervised consumption services for people who need help injecting.


Team members: Tim Gauthier (Nurse Practitioner); Kirstin McLaughlin (University of Victoria); Sandra Ka Hun Chu (HIV Legal Network); Virginie Dalpé (Université de Montréal)

 

Building capacity to reduce overdose among formerly incarcerated people in British Columbia

BC is facing dual public health emergencies of COVID-19 and a public health emergency of overdose, first declared in 2016. New interventions have been introduced to reduce overdose in BC, including efforts to decriminalize drug possession and the introduction of pharmaceutical alternatives to the toxic drug supply, known as “Risk Mitigation Guidance” (RMG) prescribing. RMG allows physicians to prescribe pharmaceutical medications (e.g. opioids, stimulants) to people at risk of overdose. While provincial evaluations of pharmaceutical alternatives are ongoing, little is known about the impact of these interventions on people who have been incarcerated, who face a disproportionate burden of overdose risk and mortality in BC, particularly in the weeks immediately following release from correctional institutions.

We aim to address this knowledge gap by convening a Peer Advisory Group of people with lived and living experience of substance use and incarceration. The group will advise on how data sources created in response to the 2016 public health emergency (BC-ODC) can be used to investigate interventions to reduce overdose, with attention to the unique and context-specific overdose risks faced by people who have been incarcerated.


Team members: Ana Becerra (BC Centre for Disease Control); Helen Brown (UBC); Jane Buxton (BC Centre for Disease Control); Ruth Elwood Martin (UBC); Kurt Lock (BC Centre for Disease Control); Tonia Nicholls (UBC); Erin Wilson (University of Northern British Columbia); Chloe Xavier (BC Centre for Disease Control); Sofia Bartlett (BC Centre for Disease Control); Cameron Geddes (UBC); Heather Palis (BC Centre for Disease Control); Marnie Scow (UBC); Chas Coutlee (Indian Residential School Survivors Society); Nicholas Crier (UBC’s Transformative Health and Justice Cluster); Jade Hoffman (Prince George Urban Aboriginal Justice Society); Patrick Keating (UBC’s Transformative Health and Justice Cluster ); Jenny McDougall (BC Centre for Disease Control); Rick Meier (Coalition of Substance Users of the North); Elder Roberta Price (UBC’s Transformative Health and Justice Cluster); Glenn Young (Unlocking the Gates Services Society); Pam Young (Unlocking the Gates Services Society); Andrew Ivsins (Ministry of Mental Health and Addictions); Carrie McCully (BC Corrections); Angus Monaghan (BC Mental Health and Substance Use Services); Justine Patterson (BC Mental Health and Substance Use Services); Kathryn Proudfoot (BC Mental Health and Substance Use Services); Vijay Seethpathy (BC Mental Health and Substance Use Services)

Enhancing patient self care and management of atrial fibrillation within primary care

Atrial fibrillation (AF) is the most common heart problem causing an irregular pulse. Individuals who poorly managed their AF risk developing serious problems like stroke and heart failure. Self-care, is when individuals actively maintain health through health-promoting practices, health monitoring, and managing illness. Family doctors and nurse practitioners (primary care providers) provide most of the AF care in BC, and yet are often not able to support their patients’ self-care because of limited time and other more urgent problems. They need new ways to address AF self-care. Teaching patients to self-care for their AF can improve their quality of life, reduce their stress, increase their ability to stay on track with their treatment plan (taking mediations), and can prevent serious problems. This research will study ways to improve self-care practices in primary care by bringing together a group of doctors, nurses, patients and researchers to look at what we already know about AF self-care in the literature and what resources exist in BC to support self-care. Second, they will put together all this information and then have a meeting to identify some of the possible solutions to address AF self-care in practice and research.


Team members: Louann Janicki (Interior Health); Ryan Wilson (UBC Okanagan); Peter Loewen (UBC); Nelly Oelke (UBC Okanagan); Norma Hilsmann (UBC Okanagan); Jessica Baskerville (South Okanagan Similkameen Division of Family Practice); Kim Orwaard-Wong (Interior Health); Kristi Maltby (Interior Health); Cameron Towle (Interior Health); Robert Janke (UBC Okanagan); Ryan Tooby (Divisions of Family Practice – Bella Coola); Tannis Andersen (Interior Health); Pam Hruska (Interior Health); Kaylee Neill (UBC Okanagan); Denis Decleva (AF Patient); Beth Whalley (Central Okanagan Divisions of Family Practice)

Contraception and abortion in BC meeting: Experience guiding research guiding care

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); 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)

Outdoor early childhood education summit: Pathways to licensing in BC

Research on outdoor early childhood education (ECE) indicates vast benefits to children’s health, development, and learning. Further, outdoor ECE helps solve challenges related to provision of universal childcare and managing COVID-19 transmission. It enables an equitable childcare solution that embraces land-based learning and Indigenous ways of being. Yet BC licenses only indoor facility-based care. We will plan a summit aiming to bring together researchers and research users, including practitioners, licensing officers and policymakers from the BC Government, health authorities, and Indigenous communities to collectively identify priorities to support a pathway to licensing outdoor ECE in BC. Key outcomes will include: 1) To embrace elements of nature-based education — in particular, those having to do with risky play and land-based learning; 2) To identify key research and practice priorities collectively to enable legislative changes for regulating outdoor ECE programs; 3) To co-create products that support KT of summit outcomes for outreach to diverse groups; 4) To strengthen relationships and partnerships among key stakeholders to facilitate collaboration beyond the proposed summit.


Team members: Shelley McClure (Northern Lights College); Rachel Ramsden (UBC); Iris Berger (UBC); Enid Elliot (Camosun College, Early Learning and Care); Glynnis Schwan (Island Health and Community Care Facilities Licensing); Lily Patzer (Aboriginal Head Start Association of BC); Belva Stone (Muddy Boot Prints Outdoor Learning Program); Hartley Banack (UNBC); Kailee Hirsche (UBC)

Co-design of a novel tendinopathy telerehabilitation intervention

Repetitive-use tendinopathy is a major cause of repetitive strain injury (RSI). An estimated one-third of workers’ compensation costs in industry are due to RSI of soft tissues, particularly tendons. In order to establish new treatments for RSI, Dr. Alex Scott established an innovative tendinopathy research program, funded through a MSFHR Scholar award from 2011 to 2019. His lab discovered that injured tendon tissue loses its toughness compared to healthy tendons. The lab then developed a new exercise program which uses real time biofeedback to achieve the key goal of regaining tendon toughness. This project will develop a home-based version of this exercise (see workplan for picture of prototype).

Our goal is to bring this new exercise intervention out of the lab and into the real world. The specific objective of this project is to engage in a collaborative co-design process with clinicians and patients to optimize our working model of the biofeedback exercise system and associated user interface (phone or tablet app). By engaging with patients and clinicians, as well as insurers and regulatory agencies, we believe that the end-product will better suit real-world needs and will be suitable for testing in a future efficacy study.


Team members: Chris Napier (Sports Physiotherapy Canada); Kohle Merry (UBC); Jackie Whittaker (UBC); Rob Morgan (Independent Contractor); Carol Kennedy (Treloar Physiotherapy Clinic); Megan MacPherson (UBC); Bilal Al Momani (Internet of Things Lab, Mohawk College); Brad Wheeler (UBC); Pierre Guy (Vancouver Coastal Health); Dianne Millette (College of Physical Therapists of BC); Maya Butterfield (RA/QA Consulting); Joan Weir (Canadian Life and Health Insurance Association)

Reimagining gynecologic cancer survivorship: Creating a provincial strategy for survivorship research and care in British Columbia

In Canada, two-thirds of people diagnosed with cancer today will be long-term cancer survivors. With advances in early detection and improved treatment, and an ageing population, this number is expected to continue to rise highlighting the urgency for improved strategies to enhance the well-being of individuals, and their families, living with and beyond cancer. In partnership with patients and families, and the clinical and scientific community in BC, we plan to hold a series of stakeholder events and surveys that will address the impact of a gynecologic cancer diagnosis and treatment on the mental health, cognition, financial burden, and sexual health of those affected. We will also examine the impact of hereditary cancers and patient education/navigation to improve upon a patient’s journey through their cancer diagnosis and treatment. Through this work, we will map out the clinical and research resources available across the province to support a long-term research strategy and plan. By putting patient and family voices and experiences at the centre of the strategy, it will enable our research team to develop a provincial strategy that is biologically-relevant and socio-culturally informed.


Team members: Siv Klausen (UBC); Nancy Cleveland (Gynecologic Cancer Initiative); Nicole Keay (Gynecologic Cancer Initiative); Stephanie Lam (UBC); Jocelle Refol (Simon Fraser University); Gavin Stuart (UBC); Michelle Woo (UBC); Nicole Prestley (Women’s Health Research Institute); Lori Brotto (Women’s Health Research Institute); Janice Kwon (UBC)

Kitchen table justice: Co-developing Indigenous-informed food justice participatory action research strategy to support holistic health and redress health inequities with paroled women in BC

This grant will support research planning with women who have been recently incarcerated and will directly support future research guided by Indigenous approaches to holistic health and health equity through food-based program development. We will build relationships with paroled research users through the making and sharing of food, and the inclusion of research users, stakeholders and Indigenous Elders in all activities. Specifically, we will: (i) conduct a literature synthesis on the potentials of food justice to support holistic health equity for women on parole, and (ii) meet bi-weekly to: (a) collaboratively develop a terms of reference and governance structure that outlines team roles and responsibilities and decision-making processes; (b) engage in co-learning about food-related health and social inequities to develop a shared understanding of the potentials of food to support health; and (c) explore potential solutions and actions to redress overlapping health, prison and food inequities. Additionally, we will: (d) collaboratively plan and develop a grant application to support subsequent research to co-develop a food justice health intervention with and for women leaving prison in BC.


Team members: Angel Willard (Elizabeth Fry Society of Greater Vancouver); Kelsey Timler (UBC); Lisa Bowden (Elizabeth Fry Society of Greater Vancouver); Nyki Kish-Field (University of Fraser Valley); Lyana Patrick (Simon Fraser University); Valerie Napoleon (University of Victoria)

Exploring Indigenous community access to airway health prevention and care: Towards the development of community-driven interventions

Indigenous peoples across Canada continue to be disproportionately impacted by respiratory diseases (RD) (i.e. asthma, COPD, long COVID); however, there is limited evidence describing their Indigenous peoples respiratory healthcare needs and ways in which respiratory healthcare services can be improved. Given this knowledge gap, this project seeks to engage Indigenous peoples with RD to understand their experiences living with RD; to explore Indigenous peoples’ healthcare experiences; and to identify promising practices that can improve the treatment experiences and outcomes among Indigenous peoples with RD. In order to accomplish this, we plan to hold a minimum of five talking circles with Indigenous peoples with RD across urban and rural areas of the Vancouver Coastal Health (VCH) region. A graphic facilitator will guide a journey mapping exercise with community members in order to understand community members’ experiences when attempting to access services, while also elucidating promising practices in the treatment of RD. In addition to the benefits that this project may have for the health of Indigenous peoples in the VCH region, findings also have implications for Indigenous peoples living in other parts of British Columbia.


Team members: Christopher Carlsten (UBC and Vancouver Coastal Health Research Institute); Andreas Pilarinos (Vancouver Coastal Health and UBC); Shannon Field (Vancouver Coastal Health and UBC); Karen Rideout (Vancouver Coastal Health Research Institute); Pat Camp (UBC); Phalgun Joshi (Vancouver Coastal Health Research Institute); Shiloh Joe (Sechelt First Nation); Coreen Paul (Musqueam First Nation); Michael Dumont (Lu’ma Medical Centre); Krisztina Vasarhelyi (Vancouver Coastal Health Research Institute and Simon Fraser University); Roberta Price (Snuneymuxw and Cowichan First Nations); Leslie Bonshor (Vancouver Coastal Health Research Institute and Simon Fraser University;)

Digital health to guide the transition to menopause: Recognizing normal and abnormal changes during reproductive aging

During the years leading up to menopause, women often experience menstrual cycle and flow changes. This is usually part of normal aging, but can also be the first symptom of endometrial cancer, the most common gynecological cancer in Canada. Few women are aware of the risk factors for endometrial cancer, can recognize abnormal bleeding, and/or seek medical help. Predicting cancer risk and determining which abnormal bleeding is associated with endometrial cancer is a top priority for clinicians and women alike, because if detected early, this cancer is curable and has exceptional outcomes. Digital health technology (e.g. mobile phones apps) and analytics can help women track and monitor risk factors and symptoms and be alerted when suspicious patterns arise. In this project, we will collaborate with women in the community, patients, clinicians, and women’s health researchers to co-design digital health tools that can help women learn about and assess their risk factors for endometrial cancer, discern symptoms of cancer from those of normal aging, and provide opportunities for education, prevention, and early detection, especially among women at high-risk for cancer.


Team members: Jerilynn Prior (UBC); Lauren Tindale (UBC); Malak Ibrahim (UBC); Lori Brotto (UBC); Gurm Dhugga (UBC); Shirley Weir (Community Partner); Ali Zentner (Revolution Medical Clinic); Elise Abi Khalil (UBC); Shanzhao Wang (OVCARE, BC Cancer Agency); Sabrina Wong (UBC); Candice Taguibao (Women’s Health Research Institute); Nicole Prestley (Women’s Health Research Institute)