British Columbia’s population is getting older. Many older adults are aging with chronic heart conditions. Digital tools, or programs and resources for use with different technologies, can help older adults look after themselves in living with their chronic heart condition(s), but many older adults need training and support to use them. This project will find out what older adults with chronic heart conditions need and prefer in the way of support and training. At the same time, the project will help find out what existing community digital literacy training programs for older adults currently offer, and what they think might be possible and workable for them in adding health technology support to their existing programs. The things we learn will be used to help support older adults with heart conditions to use digital technologies for self-care. Then we will put together all this information and have a meeting to discuss next steps. This project will allow us to build a strong team and gather direction for the best way forward. In particular, by talking directly with older adults with heart conditions and people who support them to use digital technologies, we can come up with ideas that are more likely to be meaningful for them.
Year: 2024
Community-Crafted Priorities for Wildlife Health and Food Sovereignty in Akisq’nuk First Nation
Historically, scientific research has been conducted without legitimate engagement with or, in many cases, at the expense of Indigenous communities. To reconcile research relationships, there is growing recognition of the need to engage with Indigenous nations throughout the research process and to pursue questions that are valued by those who live on and care for the lands where research is occurring. An area of shared interest is the health of wildlife and ecosystems; many communities depend on wildlife for sustenance and livelihoods, and, thus, threats to wildlife health extend to impact food security, culture, and wellbeing. Through two days of relationship-building and dialogue with Akisq’nuk First Nation members who live in and outside of community we plan to 1) identify Nation priorities for wildlife health and Indigenous food sovereignty research, 2) develop an engagement protocol guiding future research, and 3) co-create knowledge products describing these priorities for use by the Nation, the research team, and the Wildlife Health Program (Ministry of Water, Lands and Resource Stewardship). This project will serve as a basis for future community-driven research efforts and inform provincial wildlife health programs.
Generating New Ways to Address Real-World Problems in Seniors Health and Healthcare in British Columbia
Living well as we age is a universal aspiration. It is also a great challenge, particularly for older adults with increasingly complex medical and social care needs. Numerous reports from 6 decades offer evidence of failure of the health and social care systems to respond to population aging in ways that create a sustainable future for healthcare delivery. Despite decades of evidence to inform development of health services and systems to meet the needs of an aging population, action on evidence-informed recommendations or care approaches are negligible. In the last 10+ years, our team and others have produced evidence to inform health system design for aging populations. While some small-scale uptake of research is achieved, broad-based system change which is critical to meet the needs of an aging population has been minimal. The proposed C2 grant is aimed at understanding why that is. Why is this extensive evidence to inform health system change for aging populations seldom used? Our well-positioned team will engage in a series of deliberative dialogues with invited stakeholders to begin laying the foundation for new approaches to both producing and applying research to real-world problems facing senior’s health and healthcare.
Early Intervention for Eating Disorders in British Columbia: Co-Development of a Research Strategy
A surge in eating disorders during the COVID-19 pandemic has contributed to a workforce crisis. Our team’s research shows that one-third of Canadian eating disorder clinicians are considering leaving their job. Currently, eating disorder services are primarily based in limited specialized programs. However, an innovative early intervention model in general mental health settings is being developed for the Canadian context. In this model, integrated youth services play a core role in rapid response. This capacity building model has significant promise, yet it is unknown how to best support clinicians working with this model.
The project will bring together researchers and research users for a full-day interactive event, to co-develop a research strategy for eating disorder early intervention in BC. The research agenda will focus on two key questions: (i) what are the barriers and facilitators to implementation of early intervention across BC service settings; and (ii) how can we best evaluate early intervention outcomes, and the impact of this service model on clinicians who provide care for eating disorders.
The project outcomes will be integrated into a pan-Canadian strategy for eating disorders early intervention research.
Building a practice-based research learning community in British Columbia to strengthen learning health systems and health human resources
Ongoing challenges exist for attracting and keeping healthcare professionals in BC and across Canada due to low job satisfaction and working conditions. Professional development opportunities such as practice-based research (PBR) programs offer a solution to these challenges, as they have been shown to increase job satisfaction and retention of clinicians who work at point-of-care and see opportunities for practice and health system improvement. PBR programs provide training, mentorship, and funding to enable healthcare professionals to conduct small research projects that can lead to better patient experience and outcomes. However, more research is needed on the impact of PBR programs as they are not offered in all BC health authorities and there are continued threats (e.g., fiscal constraints, capacity limits) to sustaining existing PBR programs. Our convening and collaborating activities will bring together leaders, clinicians and people with lived experience in the healthcare system, creating a network that will formulate plans for evaluating, spreading and sustaining PBR programs, for the benefit of patients, clinicians and the healthcare system.
Identifying research priorities to support the evaluation of “upstream” health promotion initiatives in British Columbia
Public health interventions that aim to reduce adverse health outcomes and promote population health are more likely to be effective when they address the social conditions in which people are born, live, and age. Increasingly more public health initiatives in BC are intervening at this “upstream” level, targeting public policies, systems, and structures that perpetuate health inequities. Evaluating the impacts of these initiatives introduces unique challenges, such as uncertain timing and multiple actors, that cannot be addressed with traditional evaluation tools. Yet, policy makers and health practitioners need evidence to determine whether they are doing the right things – and whether they are doing them right. Through a series of online consultations and an in-person Thought Exchange event, we will bring together researchers who evaluate upstream health promotion initiatives, and public health research users who use evaluation evidence to guide decision-making. Together we will investigate how upstream evaluation is currently being conducted in BC, where efforts can be coordinated to improve innovation and capacity, and what are the research priorities ‘moving upstream’ in the area of health promotion evaluation.
Working Together: Co-development of a person-centred approach to medical-dental integration in a Community Health Center serving structurally vulnerable women and children
Medical-dental integration (MDI) is regarded as a crucial strategy for achieving improved health outcomes, patient and provider experience, and cost savings. Despite its potential benefits, there is currently limited practical guidance available for implementing MDI effectively, and key stakeholders’ (patients;healthcare providers) perspectives of such integration are not well understood. Our project aims to support meaningful collaboration and knowledge exchange between health researchers, research users, and key stakeholders to co-develop a person-centred approach to MDI within an interdisciplinary community health centre (CHC). We will bring together a diverse group of stakeholders to identify the vision of medical and dental integration at the CHC, the activities needed to achieve this vision, and indicators to evaluate success. The convening and collaborating activities will include the formation of a Stakeholder Implementation Advisory Group (SIAG), ongoing meetings between researchers and SIAG participants, and interviews with key stakeholders at the CHC. Our goal is to elevate community voices and knowledge to inform the development of person-centred MDI at the EFry CHC that meets the needs of clients.
Empowering Integrated Care for Healthy Aging: Co-developing a Collaborative Plan with South Asian and Chinese Communities for Inclusion and Equity
In 2021, 20.3% of BC’s population was 65 and older. Our older population is expected to grow to 25% in 2041 – a super-aged society. An integrated and inclusive care approach is needed for diverse and complex needs of older people to promote healthy aging for all. Fraser Health has implemented two regional initiatives to support healthy aging: social prescribing and the frailty pathway. Meanwhile, half of the population in the Fraser Health region are visible minorities, and 60% of the population are South Asian and Chinese. To ensure a culturally inclusive integrated care model, this project will bring health practitioners, community partners, policymakers, South Asian and Chinese older adults, and families together to discuss research priorities that can empower communities and increase health system capacity. Utilizing Appreciative Inquiry and WHO’s Integrated Care for Older People (ICOPE) methodology, we will co-plan two citizen workshops to build shared visions and collaborations across sectors. Collectively, all partners will identify strengths, potentials, and actionable strategies to enable research collaborations for an inclusive integrated model of senior care.
Co-creating a Community of Practice around Substance Use and Employment to Address the Social Determinants of Drug Toxicity and Overdose in British Columbia
The proposed project establishes a provincial community of practice (CoP) in substance use, employment, and economic engagement that will advance the expansion of supported employment programming in British Columbia (BC). Despite evidence of work and employment as critical social determinants of health, existing programming that addresses equitable engagement for multiply barriered populations such as people with lived and living experience of substance use (PWLLES), has been fragmented and limited in scale and scope. The proposed initiative will bring together key informants from existing employment and economic engagement programs, PWLLES, Indigenous advisors, and subject matter experts from across BC to facilitate knowledge sharing, project development, and collaboration. Through the development of a core working group and sub-groups, this initiative: (1) facilitates capacity for best practices in knowledge generation, mobilization, and implementation of low-barrier employment programming for PWLLES; (2) expands a health and economic monitoring system that supports sustainable low-barrier employment programming; and (3) develops the capacity for a CoP to advocate for policy environments supportive of socio-economic integration.
Co-Creating Collaborative Pathways: Advancing Indigenous Clinical Nurse Specialist Roles
Health organizations in BC are creating Clinical Nurse Specialist, Indigenous Health and Cultural Safety (CNS IH;ICS) roles. This collaborative partnership intends to convene expert knowledge holders to ensure the CNS IH;ICS leaders are leading an impactful, nurtured, and sustainable workforce. The BC Indigenous Health Nursing Research Chair has generated knowledge into the practice of Indigenous health nursing and the Providence Health Care and BC Cancer research team conducted a study examining the CNS roles. Our research activities include hosting a two-day Symposium to bridge these two parallel pathways of knowledge to generate share and mobilize research findings that will inform, nurture, and sustain the CNS IH;ICS roles in BC. Formalizing this partnership and collaboration will address the health human resources crisis by identifying pathways for a collaborative research inquiry to increase structural frameworks that inform Indigenous health policy and program development. Indigenous health systems require a distinct approach that recognizes the authentic voices and experiences of Indigenous nurses in health leadership and provides opportunities for intergenerational research mentorship and training.