Year: 2022

The 2S/LGBTQ ‘therapeutic spectrum’: Establishing a BC team and research strategy to connect 2S/LGBTQ people with affirming mental health practitioners

Finding affordable and accessible professional mental health support in BC is difficult. It can be even more difficult for Two-Spirit, lesbian, gay, bisexual, transgender, and queer (2S/LGBTQ) people, who must navigate mental healthcare with uncertainty about professionals’ attitudes toward 2S/LGBTQ identities and expressions. In this project, we will bring together a team of researchers, students, health professionals, and service users to start BC-based research on the spectrum of approaches adopted by mental health professionals in BC to affirm 2S/LGBTQ people. The project is based on our team’s experience with MindMapBC.ca, a mental health service finder that prioritizes 2S/LGBTQ-affirming services. Using MindMapBC, we will invite professionals at various places on this spectrum (e.g. those already adopting affirming practices, and those who wish to adopt affirming practices but do not know how) to tell us what is needed to create more mental health services that meet the needs of 2S/LGBTQ people. We will take what we learn to launch research that further builds our ability to encourage professionals to develop 2S/LGBTQ-affirming practices and communicate these practices to the service users who seek them.

Team members: Meera Dhebar: she/her (Eagle Wellness); A.J. Lowik: they/them (Centre for Gender and Sexual Health Equity); Anita David: she/her; Jessy Dame: he/him (Community-Based Research Centre); Kinnon MacKinnon: he/they (York University); Milo Applejohn: he/they (Simon Fraser University); Miranda Tymoschuk: she/her (Simon Fraser University); Sarah Watt: she/her (Simon Fraser University); Travis Salway: he/him (Simon Fraser University).

Developing a collaborative research agenda to improve the care of patients living with metastatic breast cancer in British Columbia

Metastatic breast cancer (MBC) affects up to 30 percent of women with early breast cancer and represents up to 10 percent of new breast cancer diagnoses. It is one of the most common causes of death from cancer amongst females. The availability of new treatments has improved survival; however, the treatments are very toxic. There is a trade-off between managing treatment toxicity for these patients, in terms of extending survival and maintaining a decent quality of life. Constant treatment and monitoring are required; this results in a burden at the patient and at the health systems levels. Through a series of virtual meetings, we will bring together front-line cancer care providers, academic researchers, and patients and families to reflect and share their experiences about the MBC care in BC. The meetings will aim to discuss the facilitators and barriers to accessing specialized MBC care. Our goal is to establish partnerships, encourage knowledge exchange, and develop a collaborative research agenda to ensure quality care for individuals living with MBC in BC.

Team members: Stephen Chia (BC Cancer); Leah Lambert (BC Cancer); A. Fuchsia Howard (UBC – School of Nursing); Robert Olson (BC Cancer); Fiona Mitchell (BC Cancer); Scott Beck (BC Cancer); Jagbir Kaur (BC Cancer); Sara Izadi-Najabadi (BC Cancer); Nathalie LeVasseur (BC Cancer).

Navigating Long COVID: Co-creating research priorities to understand and address the information needs of unpaid care providers in British Columbia

The pandemic has posed significant challenges to people globally. These dynamics have been complicated and prolonged by “Long COVID”, where those previously infected with the SARS-CoV-2 virus continue to experience symptoms for weeks to months after infection. Long COVID also affects unpaid care providers, including family and friends, who care for those with Long COVID. Beyond the many challenges that unpaid care providers face — such as lack of time and resources — the heightened uncertainty around Long COVID poses additional barriers to accessing information and supporting care providers and recipients. Our goal is to begin to address this important issue by convening a group of unpaid care providers, health care professionals (e.g. doctors, nurses), and research scientists in BC. Through knowledge synthesis and convening activities, we will identify priority research areas that will serve as the basis for co-created, collaborative research programs to bridge the gap in care provider access to information and Long COVID resources in the province. With an emphasis on relationship-building and strengthening, we will promote opportunities for continued collaboration among stakeholder groups beyond this proposal.

Team members: Stacey Dawes (Family Caregivers of British Columbia); Julia Smith (Simon Fraser University); Kiffer Card (Simon Fraser University); Anne-Marie Nicol (Simon Fraser University); Gina Ogilvie (UBC); Esther Khor (Provincial Health Service Authority); Niloufar Aran (Simon Fraser University); Alice Murage (Simon Fraser University).

Undertaking the co-design of climate distress services for young people in British Columbia

This proposal aims to facilitate a new partnership between the Green Technology Education Centre (GTEC), the Mental Health and Climate Change Alliance (MHCCA/SFU), and youth and young adults, aged 16-24. Leveraging this partnership, we will convene and collaborate with youth to inform the development of potential GTEC campus- and digitally-based interventions for climate-related distress. The convening and collaboration activities will include two multi-stage focus groups and ongoing meetings between GTEC and MHCCA researchers. Each focus group cohort will consist of 6-12 young people, recruited through the MHCCA and GTEC professional networks and advertisements on Twitter and Facebook. Each focus group will be interviewed twice to: 1) Explore current reactions to climate change and 2) Develop ideas about educational and support services that GTEC can offer to support young people. These focus group interviews and ongoing meetings between GTEC and MHCCA team members will be leveraged to develop a CIHR project grant proposal that will aim to develop, pilot, and evaluate an intervention for climate change related distress among young people, aged 16-24.

Team members: Arden Henley (Green Technology Education Centre); Linda Thyer (Green Technology Education Centre); Andreea Bratu (UBC – School of Population and Public Health).

End of Award Update – November 2024

 

Results

The project’s findings vividly highlighted the emotional toll of climate change on young people, including heightened anxiety, feelings of uncertainty about the future, and a sense of betrayal by societal leaders. These insights provide a clear picture of the mental health challenges faced by young individuals in the context of climate change, informing the development of targeted support services. 

The project underscored the need for enhanced education on climate change and its impacts, as well as the importance of community-based programs. By advocating for the integration of climate education into school curricula and the establishment of supportive community initiatives, the project paves the way for more informed and resilient young populations. 

The project’s collaborative approach has set a precedent for future community-academic partnerships aimed at addressing complex societal issues like climate change. This model of cooperation ensures that interventions are both evidence-based and closely aligned with community needs and perspectives. 

The project’s work in designing and planning specific interventions, such as professional development courses for service providers and peer-to-peer support networks, offers a blueprint for practical strategies to combat climate distress. These planned interventions, once implemented, could serve as models for similar initiatives worldwide. 

 

Impact

The “Repairing the Social Contract” project has made significant strides in integrating the mental health impacts of climate change into the broader conversation on health care in British Columbia, catalyzing a shift towards recognizing and addressing climate distress among young people. By uncovering the profound emotional and psychological effects of climate change on youth and advocating for targeted educational and support services, the project has laid the groundwork for more informed, compassionate, and effective health care responses.  

 

Potential Influence

The “Repairing the Social Contract” project is poised to influence human health and health care significantly in British Columbia, and potentially on a national and international scale, by pioneering a holistic approach to integrating climate change into mental health care strategies. As the project develops targeted interventions and disseminates its findings, it is likely to inspire health care policies and practices that acknowledge and address the psychological impacts of climate change, encouraging a shift towards more resilient public health systems. Additionally, by serving as a model for collaborative, community-engaged research, the project could influence global health care paradigms, promoting the incorporation of environmental factors into mental health considerations and treatment protocols. 

 

Next Steps

We are launching an intervention series provincially to help communities act on these findings, supported by a $1.8 million dollar investment.  

Mind the gap: Hormonal contraceptives and the brain

Hormonal contraceptives (HC) are used by 850 million girls, women and people with uteri — all reflected in the term women+ — , and 16 percent of people (5-49Y) in Canada. In addition to being contraceptives, HCs are prescribed off-label to treat many other conditions. Few studies have examined effects of these hormones on the brain; however, recent work suggests they can increase risk for mood disorders during adolescence and alter brain activation patterns. Yet, how HC use may influence long-term brain health is not known. Understanding brain health, especially through an equity lens, is critical. Women+ experience different brain health symptoms as a result of their unique experience of stress, which is impacted by age, gender, and race/ethnicity. Stress outcomes affect disease risk, which is also influenced by HCs. Collaborations between academics and research users are vital to understanding the unique ways that women+’s lives impact their brain health. This conference will explore how HCs influence women+’s brain health by bringing together researchers, clinicians, community partners, trainees, and policymakers to exchange knowledge and identify new research priorities that fill knowledge gaps and address patient experiences.

Team members: Katherine Moore (Women’s Health Research Cluster); Jesse Lacasse (Concordia University); Bonnie Lee (UBC); Jennifer Williams (McMaster University); Maureen MacDonald (McMaster University); Nafissa Ismail (University of Ottawa); Elizabeth Hampson (University of Western Ontario); Gillian Einstein (University of Toronto); Frances Chen (UBC); Sofia Ahmed (University of Calgary).

Bridging the knowledge-to-practice gap: Co-developing a Design Jam for building a Learning Health System at Vancouver Coastal Health

Vancouver Coastal Health (VCH) delivers over 150 programs and services in community settings across the region. Organizational learning to continuously improve health care is limited by the complexity of this delivery model, current policies and processes, barriers to coordinating data systems, and insufficient capacity for data analysis, and evidence mobilization to inform decisions. VCH is exploring the Learning Health System (LHS) framework to bridge the knowledge-to-action gap and our team aims to facilitate that effort. This proposed stakeholder engagement project — bringing together teams of researchers, VCH care providers and decision makers, patients, and community members — will explore practical strategies for co-creating a systemwide LHS for community health at VCH. Our objectives are to: 1) Organize a Design Jam to collectively identify stakeholder needs and priorities, system gaps, and actionable strategies for co-creating a Community LHS; and 2) Form a LHS Community of Practice to support long-term knowledge exchange and research collaboration. Through meeting these goals, our project will produce a shared vision, an action plan, and a Community of Practice to support the long-term co-development of a Community LHS at VCH.

Team members: Margaret Chen Mei Lin (UBC); David Hall (Providence Health Care); Brittany Bingham (Vancouver Coastal Health); Andreas Pilarinos (Vancouver Coastal Health); Shannon Field (Vancouver Coastal Health); Tracy Windsor (Canadian Mental Health Association); Elaina Moss (Canadian Mental Health Association); Steven Barnes (UBC); Sue MacDonald (VCH); Regina Casey (UBC); John Higenbottam (UBC); Andrew Day (Vancouver Coastal Health); Alexander Rutherford (Simon Fraser University); Stephania Manusha (Vancouver Coastal Health); Joleen Wright (Vancouver Coastal Health); Jae-Yung Kwon (University of Victoria); Ben Fair (UBC); Jas Dhahan (Simon Fraser University).

Improving access to breastfeeding support in interior British Columbia: A collaborative planning project

While breastfeeding has many health benefits for both infant and mother, many women and birthing people experience breastfeeding challenges. Insufficient supply, poor latch, and pain, as well as stigma and lack of support can impact breastfeeding goals. These challenges can be heavily influenced by social inequities, parental leave, and societal pressures, particularly among disadvantaged populations in Canada. It is important for postpartum people to receive breastfeeding support from healthcare professionals, especially during public health emergencies like the COVID-19 pandemic, where in-person contact is limited. Therefore, this C2 project will establish key networks and resources around optimal breastfeeding support in interior BC. Specific objectives are to build partnerships, conduct a needs assessment, and co-create a research agenda to develop and evaluate a virtual breastfeeding intervention study in this region. We expect to identify key aspects of virtual support that will create a thorough and meaningfully designed breastfeeding intervention study, which will ultimately lead to higher rates of breastfeeding rates, as well as improved user satisfaction and self-efficacy among parents and families in BC.

Team members: Elizabeth Keys (UBC – Okanagan); Rishma Chooniedass (UBC – Okanagan); Michele Hopkins (The Bridge Youth & Family Services); Ellen Boelcke (KCR Community Resources); Olivia Andrews (UBC – Okanagan).

A multi sector World Cafe to promote mental health of refugees in BC: A participatory realist evaluation project

The purpose of our project is to convene and collaborate with service users, health practitioners, settlement service providers, and policy makers in a series of deliberative dialogues and a multi-sector World Cafe to co-develop a program theory about integrated mental healthcare services for refugees. The global humanitarian refugee crisis has highlighted refugees as one of the most vulnerable population groups requiring integrated mental health services and supports. However, the COVID-19 pandemic has stressed healthcare systems in providing equitable, gender sensitive, language appropriate and trauma and violence informed care to diverse refugees resettled in Canada. Integrated care can improve clinical and organizational outcomes for more effective health services but limited knowledge exists on what promotes integrated mental health care for refugees, how it works, for whom and in what contexts. Convening multidisciplinary stakeholders is an important step to building a program theory and how it works. Our approach will develop an evidence informed model that will later be used and tested across multiple primary health care and social service settings to improve mental health service and promote refugee mental health.

Team members: Simon Carroll (University of Victoria); Suzanne Huot (UBC – Faculty of Medicine); Anita David (patient partner); Cindy Quan (University of Victoria); Eliseo Verdugo (University of Victoria); Maura Macphee (UBC); Sara Hosseina (New Canadian Primary Care Clinics); Karen Davison (Kwantlen Polytechnic University – Health Sciences); Vidhi Thakkar (University of Victoria; Victoria Hospice Society); Mikhail Torban (Ministry of Mental Health and Addictions); Brandon Hey (Mental Health Commission of Canada); Niels Agger-Gupta (Royal Roads University); Frank Cohn (VAST Refugee Mental Health Services Vancouver); Pamela Toor (REACH Community Health Centre).

A translational research network to study and improve the clinical care of brain injury in intimate partner violence (IPV) on Vancouver Island

IPV is a serious societal and medical challenge worldwide that has severe impacts on the lives of survivors. In Canada, >40 percent of women over the age of 15 who have been in an intimate partner relationship (~6.2 million women) have experienced IPV. The prevalence of IPV is particularly high in the Nanaimo and Duncan regions of Vancouver Island. Among many challenges faced by IPV survivors, the physical assaults often result in brain injuries that have short- and long-term consequences. Brain injury occurs in the vast majority of IPV survivors, yet the nature, identification, and treatment of this brain damage has been remarkably understudied. Consequently, care pathways to improve patient outcomes are extremely limited. To address this issue, the proposed activities will bring together a diverse and balanced group of scientists, clinical practitioners, trainees, patients, and community leaders on Vancouver Island, as well as other national and international experts on the topic. Specifically, the primary goal of this application is to apply a patient-oriented approach to identify key knowledge gaps and establish a research network capable of investigating these issues and translating the findings into meaningful clinical outcomes.

Team members: Aimee Falkenberg (Island Health); Kix Citton (Nanaimo Brain Injury Association); Uta Sbotofrankenstein (BC SUPPORT); Jodie Gawryluk (University of Victoria); Paul Van Donkelaar (UBC – Okanagan); Karen Mason (Supporting Survivors of Abuse and Brain Injury through Research); Taylor Snowden (University of Victoria); Justin Brand (Vancouver Island University); Naz Saadat (University of Victoria); Jackie Demmy (Island Health; nursing students; Vancouver Island University); Janet Hildebrand (Island Health); Sasha Dallaire (Island Health); Coral Taylor (Island Health); Janet Calnan (Island Health); Charlotte Breakey (Island Health); Carrie Esopenko (Icahn School of Medicine Mount Sinai); Cheryl Wellington (UBC); Stuart McDonald (Monash University); Josh Allen (Vancouver Island University).

Peer supports for Indigenous clients initiating opioid agonist therapy (OAT): Early concept and proposal for an experimental study

In order to foster collaboration and co-development of research by researchers and research users throughout the research cycle, we plan to address one of BC’s health system priorities — the evaluation of the impact of peer support programs in BC — by engaging people with lived experience, opioid agonist therapy (OAT) providers and policymakers in workshops, focus groups, and key informant interviews to define feasible peer support models. Recruitment for these workshops will be facilitated by engagement with drug user advocacy groups such as the Vancouver Area Network of Drug Users (VANDU), the Peer Engagement and Evaluation Project (PEEP), and the BC/Yukon Association of Drug War Survivors (BCYADWS). Workshops will be co-led by researchers and research users, to collaboratively define the ‘active ingredients’ of the proposed intervention, considering elements of cultural safety and the extent of adaption necessary to suit client needs across the province.

Team members: Brittany Barker (First Nations Health Authority; BC Centre on Substance Use); Kirsten Ellingson (First Nations Health Authority); Keshia Cleaver (First Nations Health Authority); Nikhil Gandhi (First Nations Health Authority); Jolene Pagurut (First Nations Health Authority); Cheryl Tress (First Nations Health Authority); Alexa Norton (UBC); Kate Hodgson (First Nations Health Authority); Sue MacDonald (Vancouver Coastal Health); Jane Buxton (BC Centres for Disease Control; University of British Columbia); Laura Dale (Centre for Health Outcomes and Evaluation Sciences); Mo Korchinsky (First Nations Health Authority); Micah Piske (Centre for Health Outcomes and Evaluation Sciences); Reija Roberts (BC Association of People on Methadone); Amy Salmon (Centre for Health Evaluation and Outcome Sciences); Amanda Slaunwhite (BC Centres for Disease Control; School of Population and Public Health; UBC).