This Health System Impact Fellowship is co-funded by CIHR Institute of Population and Public Health (CIHR-IPPH), Michael Smith Health Research BC, and the BC Centre for Disease Control (health system partner), to help build BC’s health policy research capacity for the integration of policy research into decision-making.
The illicit drug overdose crisis in North America has had a profound impact on individuals, families and communities, often leading to premature loss of life and lowering of life expectancy. Since 2016, British Columbia (BC) has been experiencing an epidemic of toxic drug supply leading to a large increase in the number of drug overdose events and related deaths. Coronavirus disease 2019 (COVID-19) and measures taken to limit the transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus that causes COVID-19, have directly and indirectly disrupted access to healthcare and social services worldwide, including harm reduction and social support services. Since the beginning of the COVID-19 pandemic, BC witnessed large increases in drug overdose related deaths, with 2021 being the deadliest year. This requires scaling up of existing interventions and introducing new, targeted interventions to address the overdose crisis. The level and type of response is also affected by the perception of the population towards health issues and debate on intervention options. The information available on social media could help decision makers understand the public discourse about opioid use and intervention options. In this project, the overall aim is to understand public perceptions and discourse related to overdose in social media using Artificial Intelligence (AI) methods and techniques to inform the overdose response.
Source: CIHR Funding Decisions Database
This Health System Impact Fellowship is co-funded by CIHR, Michael Smith Health Research BC, and the BC Centre for Disease Control (health system partner), to help build BC’s health policy research capacity for the integration of policy research into decision-making.
COVID-19 and pandemic response measures implemented to limit its spread have resulted in various indirect health impacts due to the disruption of many preventative, diagnostic, and management services. The extent of their impacts on the diabetes care cascade are not known. South Asians, representing 25 percent of the visible minorities have highest burden of Type 2 diabetes. Higher incidence of COVID-19 was reported in neighborhood areas with higher density of South Asian population in British Columbia (BC) and Ontario. However, it is not known if diabetes care cascade among South Asians was impacted more than other population groups.
We aim to assess: a) The impact of COVID-19 pandemic on the diabetes care cascade, b) Differential impact in South Asians vs other population groups; c) Patient/provider perceptions of disruption of services.
We will use BC COVID-19 Cohort which integrates daily COVID-19 lab tests, case follow-up data, COVID-19 immunizations, hospital and ICU admissions, with demographic, healthcare utilization datasets (medical visits, hospital admissions, emergency room visits, dispensed prescription drugs) Chronic Disease Registry and socioeconomic data and data from BC SPEAK Survey. We will construct care cascade in pre-pandemic years and pandemic/post pandemic years and apply a combination of epidemiological and statistical techniques to investigate the stated aims. We will gather qualitative data based on interviews with diabetes patients and care providers to provide context and inform interventions to prevent further disruptions and optimize care.
This project will characterize the extent of disruption in services across diabetes care cascade and will identify characteristics of population most affected. We will provide evidence on disparities experienced by South Asians and identify strategies to mitigate the impacts of the COVID-19 pandemic or future similar health emergencies for individuals with diabetes.
Source: CIHR Funding Decisions Database
This Health System Impact Fellowship is co-funded by CIHR, Michael Smith Health Research BC, and the BC Ministry of Health (health system partner), to help build BC’s health policy research capacity for the integration of policy research into decision-making.
Lead exposure is an ongoing public health concern due to the association with cognitive deficits and neurodevelopmental disorders, particularly in children and infants. While several vectors of exposure (lead-containing paints and toys) have been reported, the prevalence of elevated blood lead levels has decreased over time with growing awareness. Nevertheless, contaminated drinking water has persisted as an important vector, especially in North America, where the most common source of lead is corrosion of plumbing materials, including lead services lines, brass fixtures and fittings, solders, and galvanized steel pipes. Striving to provide safe drinking water to its residents, British Columbia (BC) adopted Health Canada’s maximum acceptable concentration, 5 ug/L, in 2020. However, longitudinal data on lead exposure in water is limited in time and through consistent sampling approaches. The lack of consistent data represents a critical barrier to understanding the lead burden that is contributed from drinking water, thereby delaying appropriate prioritization of this exposure source for British Columbians, and limiting the implementation of mitigation strategies. The goal of this work is to provide the BC Ministry of Health with a comprehensive report of lead in drinking water in BC. This report will outline the risks associated with exposure and will seek to:
- Identify areas of concern.
- Determine whether concentrations are related to infrastructure (i.e. building specific, distribution materials), or water quality (e.g. pH, alkalinity, NOM) and treatment (e.g. corrosion control, disinfection).
- Use novel analytics to diagnose the source of lead in select water samples.
- Provide recommendation for remediation strategies where appropriate.
The expected deliverable is an extensive report of the above to foster evidence-based decision making.
Source: CIHR Funding Decisions Database
This Health System Impact Fellowship is co-funded by CIHR, Michael Smith Health Research BC, and Blood Services Canada (health system partner), to help build BC’s health policy research capacity for the integration of policy research into decision-making.
Plasma is the liquid component of blood and is collected from donors. It is used for transfusions in hospitals, and for the manufacture of treatments that are used for patients with various chronic and life-threatening conditions. But we currently do not receive enough plasma from donors in Canada, and this will only get worse as the demand for plasma is increasing.
The Canadian Blood Service is considering how to best invest in new donor centres that will increase plasma donations. There are a number of different options to consider — from where to geographically place the centres, to what hours the centres should be open, to what incentives to provide such as free meals. All these options have different costs — from rents and material costs to staff salaries, and it can be hard to predict how impactful these different options will be on overall volume of plasma donated.
This project will survey existing blood donors and non donors to understand the impact of these different options on their willingness to donate. This will enable us to predict what locations, and features will result in the most plasma being donated. We expect people will say they will donate more than they actually do, but because people tend to do this in a predictable way, we will be able to adjust for this. The results of the surveys will be combined with costs in a model. For example, one option (e.g. a centre in a downtown) might be expected to obtain a 20 percent higher volume of donated plasma, but if this comes at an additional 50 percent cost, it might not be the best investment. The model will inform which options and locations are expected to provide the most plasma donation for the CBS investment budget.
Source: CIHR Funding Decisions Database
This Health System Impact Fellowship is co-funded by CIHR, Michael Smith Health Research BC, and the BC Centre for Disease Control (health system partner), to help build BC’s health policy research capacity for the integration of policy research into decision-making.
Multimorbidity is when an individual has two or more chronic diseases. But, behind this simple definition lies a complex phenomenon. Chronic diseases interact, and their combined health impacts can be greater than predicted by their individual impacts. Multimorbidity accumulates with age and affects the majority of senior citizens in Canada. For these seniors, multimorbidity increases health complications; including dementia, severe complications from COVID-19, and susceptibility to heat and climate events.
The BC Centre for Disease Control’s mandate is to provide accurate, timely and actionable health intelligence about population well-being and its determinants to decision makers in BC. This project follows this mandate, to improve knowledge of multimorbidity across BC. Multimorbidity is a huge challenge for our health care system because of its complexity. There are countless possible disease combinations, each with unique interactive effects on health. For this reason, most previous research has indexed multimorbidity by a simple count of the number of co-occurring diseases. But this approach loses granularity in understanding the nature of disease combinations.
Our goal is to use data clustering analyses to identify patterns of co-occurring diseases across the BC population and create a multimorbidity disease cluster index. We will apply this cluster index to measure how common different clustered disease combinations are across BC, and how different disease clusters relate to negative health outcomes. Finally, we will measure how disease clusters vary by sociodemographic variables like age, sex and gender, and socioeconomic status.
This project will enhance the ability of BC health authorities to identify opportunities for public health planning around multimorbidity, with knowledge of specific disease combinations and their sociodemographic context. Our project output will lay the foundation for enhanced population health surveillance and monitoring in BC.
Source: CIHR Funding Decisions Database
This Health System Impact Fellowship is co-funded by CIHR, Michael Smith Health Research BC, and the BC Ministry of Health (health system partner), to help build BC’s health policy research capacity for the integration of policy research into decision-making.
Many types of healthcare professionals are legally regulated, meaning there are specific legal rules about the types of healthcare activities that they can do. This is to protect patients and the public from harm and to have a way to hold healthcare professionals accountable if they are practicing irresponsibly or inappropriately. Genetic counsellors are specialized healthcare providers who help patients and their families understand and adapt to the medical and psychological impacts of genetic conditions. Genetic counselling is a relatively new area of healthcare and there are not very many genetic counsellors in British Columbia. Because of this, genetic counsellors are not legally regulated at this time. To be able to explore the options for legal regulation of genetic counsellors in British Columbia, we need to better understand exactly what types of healthcare activities genetic counsellors do. To get this information, we plan to survey genetic counsellors to ask them which healthcare tasks are part of their jobs and if they expect that this will change in the future. We hope that this information can be used to decide when and how to legally regulate genetic counsellors in British Columbia to improve the safety of and access to clinical genetic services in the province.
Source: CIHR Funding Decisions Database
This Health System Impact Fellowship is co-funded by CIHR, Michael Smith Health Research BC, and the Interior Health Authority (health system partner), to help build BC’s health policy research capacity for the integration of policy research into decision-making.
It has become increasingly common that aging members of our population require healthcare services to support them. Many Canadians spend their final years in long-term care (LTC) facilities as a result. LTC facilities have been under scrutiny in recent years with respect to quality of care and inadequacy of resources, along with concerns about their increased privatization. The COVID-19 pandemic exposed the vulnerabilities of the state of LTC facilities across Canada. There is broad acknowledgement that improvements must be implemented to make the experience and safety of residents of LTC facilities better.
Our intended research is interested in understanding the experiences of harm that residents, family members, and healthcare workers have encountered, particularly those during the COVID-19 pandemic. This proposed project will aim to listen to the stories of patients, families and healthcare workers who have been adversely affected by restricted visitation policies, the loss of residents, and burnout, as a way to better understand the context of LTC, to facilitate a Restorative Community of Care for healing, and to learn from these situations to inform subsequent action.
This initiative will be facilitated using a restorative approach and will be comprised of three phases: listening to understand, planning for future actions, and reporting and evaluating the results of this process. A restorative approach is a principle-based approach that fosters a relational way of thinking and being and is carried out through facilitated dialogue with the intention of speaking openly about the harm experienced and to work together to heal from that harm and to learn from the past to improve the future. This approach supports respect, dignity and mutual care and concern between people, communities, healthcare providers, and the health system.
Source: CIHR Funding Decisions Database
This Health System Impact Fellowship is co-funded by CIHR, Michael Smith Health Research BC, and the BC Ministry of Health (health system partner), to help build BC’s health policy research capacity for the integration of policy research into decision-making.
The early years are a critical time when physical and social development occurs. Children’s experiences during that period shape their behaviors, their learning capacity, and set their health, emotional, socioeconomic trajectories A recent report on the health and well-being of children in BC revealed profound disparities in sex, gender, geography, or data availability. The latter concerns population-level data and linked databases availability. Plus, the absence of a reproducible process to merge databases using a unique common identifier undermines the efforts to analyze and provide evidence for the wellbeing of children in BC.
This proposal seeks to explore a sustainable partnership-based model for connecting health population-level data to health care policymaking and health care delivery decision-making. The specific objectives are:
- Build a co-produced partnership-based process for interconnecting health care policy, decision making, population health monitoring, research, and health care delivery.
- Use a collaborative approach to identify critical questions and analyze relevant health policy, research, and practice priorities.
- Support the development of a monitoring and surveillance system for healthy child development that follows key child development indicators over time.
This research program will formalize a strong partnership and a replicable process on data analysis between the BC Ministry of Health and the Human Early Learning Partnership, a School of Population and Public Health research unit. This process will also enable a monitoring and surveillance system of key indicators of the children’s health and wellbeing. Finally, this work will lay the foundations to create linked health and social databases from other ministries to inform policy and substantially reduce current disparities in BC.
Source: CIHR Funding Decisions Database
The summer 2021 heat wave caught British Columbians and many policy-makers by surprise. This project seeks to develop a research agenda and build community-engaged research partnerships to identify ways in which service providers, private businesses, governments and individuals can support vulnerable communities to avoid negative health outcomes associated with future heat events that occur in the Capital Regional District (CRD). Guiding questions include: Who in the CRD is most vulnerable to negative health impacts related to extreme heat events? What does the experience of extreme heat look like for these vulnerable groups? What recommendations do they have for supporting other members of their group during extreme heat events? These questions will be answered through secondary and primary research. Following a community-engaged research approach, the most appropriate methodology will be determined in collaboration with service providers and individuals with lived experiences to ensure we are accounting for diverse experiences of trauma and resilience. Project outcomes will include policy recommendations, data and stories for decision-makers to craft messages and communicate with the public to avoid heat-related harm.
Team members: Kirsten Mah (Capital Regional District; Summer Goulden; City of Victoria); Kristie Signer (City of Victoria); research trainee (University of Victoria).
Fraser Health (FH) serves an aging and ethnoculturally diverse population. In 2021, our Long-Term Care and Assisted Living (LTCAL) Research Team, embedded in FH, set up the LTCAL Research Partners Group to help guide research priorities for LTCAL and facilitate patient partnerships in research. However, we have had challenges recruiting members from ethnocultural communities to be involved in the Partners Group. This is problematic because ethnocultural groups are often left out of the foundational stages of research, which can result in studies that do not meet their needs. To address this gap, we want to identify barriers ethnoculturally diverse people may perceive or experience to meaningfully participating and ways they can be addressed. Our ultimate goal is to recruit two to three ethnoculturally diverse new members for the existing LTCAL Research Partners Group. To facilitate this, we will hold consultation dialogues with three different South Asian groups, the fastest growing ethnic community in the region, to obtain their insights about research, challenges to participation and what may help. These consultative activities will also help make inroads with these communities and build relationships with researchers and patient partners.
Team members: Karim Chagani (Long-Term Care and Assisted Living; Fraser Health); Leah Coppella (Simon Fraser University – Department of Geography); Tyler Cole (Simon Fraser University – Department of Geography); Akber Mithani (Long-Term Care and Assisted Living; Fraser Health); Suzanne Fox (Integrated Long Term Care and Assisted Living Services; Fraser Health); Susan Brown (Integrated Long Term Care and Assisted Living Services; Fraser Health); Ian Cameron (Long-Term Care and Assisted Living; Fraser Health); Janice Sorensen (Long-Term Care and Assisted Living; Fraser Health); Valorie Crooks (Simon Fraser University – Department of Geography); Emily Carpenter (Diversity and Language Services; Fraser Health); Alia Januwalla (BC SUPPORT Unit, Fraser Centre); Arun Garg (community-based physician); Rajeev Mohindru (Progressive Intercultural Community Services Society); Sherman Chan (Multilingual Orientation Service Association for Immigrant Communities).
