Connecting the dots between research and the real world

Annual Report 2024–2025

2024:

Brick by brick: Evidence to overcome barriers to care

We are now a full quarter into the 21st century and health care stands alone as a unique component of modern society: an essential yet imperfect service that we all rely on at some point in our lives. With this ubiquity comes a system rife with obstacles that limit access, quality, and equity—barriers as diverse as the people that face them. These barriers come in many forms, including physical, social, psychological, and practical. Despite the depth and breadth of these issues, many programs and interventions have been implemented to successfully address pieces of this puzzle, fitting them together to make a clearer picture of specific barriers and the paths to clear the way. Behind many of these successes is the requisite evidence to measure, understand, and tackle the problem. At Advancing Health, our scientists are embedded within the health system, supporting policy makers, administrators, and care providers in designing evidence-based solutions, providing the tools necessary to remove barriers to care and improve health equity across the province and country.

About the Centre

What we do

The Centre for Advancing Health Outcomes conducts high-quality research to inform changes to the health care system. As a collaboration between cross-disciplinary scientists, clinicians, and expert research staff, we bridge the gap between data, research, and care to evaluate the effectiveness of health interventions at the population level to improve health outcomes for all.

Established in 1998, the Centre is jointly affiliated with Providence Research and the University of British Columbia (UBC) Faculty of Medicine and is housed in a teaching and research hospital in the heart of Vancouver, Canada. We are committed to creating an inclusive, dynamic and cooperative work environment in which younger researchers are mentored, established researchers are supported, and all participants are encouraged to pursue personal and professional challenges. In addition to providing specialized outcomes and health research services to clinical units, we offer clinical trials support for those currently conducting or seeking to conduct clinical trials.

The researchers and staff at Advancing Health investigate a diverse range of health-related problems, spanning the health care, housing, and education systems, among others. Though each area and approach are unique, our work is united by a common thread: Looking at the big picture from a population-level perspective that aims to provide evidence-based answers to questions with real-world impact.

Who we are

Our Vision

Bridging evidence and care to transform the health system and improve health outcomes for all.

Our Mission

Through interdisciplinary collaboration and mentorship of emerging health researchers, we produce and translate high-quality evidence that informs health care from the individual to the system level.

Our Values

COLLABORATION: We forge meaningful partnerships with researchers, health care professionals, people with lived experience, community-based organizations, and system-level decision-makers.

ORGANIZATIONAL INTEGRITY: We strive to uphold the highest principles for the conduct of research that is designed to improve the well-being of all people.

SCIENTIFIC RIGOR: We identify and address relevant and meaningful research questions from many perspectives through the rigorous application of appropriate and innovative scientific methods at all stages of research.

EQUITY, DIVERSITY, AND INCLUSION: We are dedicated to the promotion and practice of equity, diversity, and inclusion in our workplace and in the research that we conduct.

Advancing Health at a Glance

Services Snapshot

Our expert staff help researchers from around the world turn good ideas into great research.

Proportion of support by service type in 2024/25

120+

personnel

169

new or existing projects supported in 2024/25

Research Snapshot

Our investigators are at the forefront of major areas of health research; many have clinical appointments and include Canada Research Chairs, Health Research BC Scholars, and CIHR Investigators.

$27M+

in total funding held by Advancing Health Scientists through active grants in 2024/25*

*From UBC RiSE, includes only Advancing Health Scientists at UBC, as well as those appointed after March 31, 2024

$2M+

in new CIHR, NIH, and other grant funds awarded to Advancing Health Scientists as lead applicants in 2024/25

78

scientists

12

research programs

Our People

This year, we welcomed several new scientists and numerous staff to diversify our expertise, and celebrated some awards, promotions, and recognitions.

NEW SCIENTIST:

Dr. Alyson Wong

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NEW SCIENTIST:

Dr. Adam Easterbrook

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Scientists awarded by UBC

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Aggie Black Retires from PHC

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Naveed Janjua appointed Director, UBC Centre for Disease Control

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Jason Sutherland appointed Head, Health Services & Policy

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Najib Ayas appointed Associate Head, Research, Division of Critical Care Medicine

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Overcoming barriers

Our scientists are at the forefront of research that tests new paradigms, breaks down barriers, and supports evidence-based care.

“Researchers should work on research not administration”: Erin Cherban named N2 Chair

Erin Cherban has begun her term as Chair of the Network of Networks, a not-for-profit organization with the goal of enhancing national clinical research capability and capacity.

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Patient patience: The long wait for elective surgery in Canada

With many people across Canada struggling to access timely health care, Dr. Jason Sutherland discusses his work on understanding and solving wait times for elective surgery.

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We need to reconsider precisely how we organize waitlists and triage patients.

To monitor or not to monitor? Understanding barriers and facilitators to effective mental and substance use disorder treatment

To help understand patterns of care and treatment for those living with mental and substance use disorders Dr. Daniel Vigo led a study conducting and examining World Mental Health surveys.

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Announcing the Conconi Family Foundation Distinguished Scholar in Seniors Care

Dr. Salmon has been named the inaugural Conconi Family Foundation Distinguished Scholar in Seniors Care in support of her work on principles-focused evaluation within the seniors’ care system.

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Physician burnout across the health care system

To better understand burnout among medical professionals and how it impacts health care systems, Dr. Nadia Khan surveyed physicians across several different specialties in Vancouver.  

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Site Budgeting 101

With calculating expenses being one of the most daunting tasks undertaken by clinical research staff, Senior Project Manager Leslie Love discusses how to budget as a site for a clinical trial.

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Like, share, heal: Leveraging social media in youth mental health research

Social media has become an integral part of modern society, and now researchers are turning to these platforms to explore how social media can be used to share health information with the public.

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Methadone much more effective than buprenorphine/naloxone, with no difference in mortality risk

Dr. Bohdan Nosyk: People with opioid use disorder in BC who received methadone had a 37–40% lower rate of treatment discontinuation compared with those who received buprenorphine/naloxone.

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Is the path to better outcomes paved in gold? Physician incentives and hospital readmissions

One in 11 Canadians admitted to hospital are readmitted within 30 days of discharge and are 3 times more likely to die within a year. Can physician incentives improve readmission risk?

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Physician incentives are intuitively appealing because everybody can understand how if you offer a little bit more money, people’s behaviour might change.

Shaping skilled surgeons: How research supports training, feedback, and lifelong learning

To meet the needs of the next generation and their patients, Advancing Health surgeon–scientists Drs. Roxana Geoffrion and Jane Lea are leading their surgical specialties in developing new training paradigms.

Read more >

In the news

Lack of treatment, housing options exacerbating substance abuse crisis in Abbotsford: study

How can wait times at hospitals be reduced?

Women with little to no migraine disability had a lower quality of life than men

Cost is a reason many Canadians don’t take prescriptions

B.C. doctors urged to talk to chronic disease patients about substance

Walking pneumonia infections are on the move among kids

If you use stimulants, talk to your doctor about heart health

Recent ICD implant not a risk for car crashes, but there are caveats

UBC/Harvard Study on mental health and substance use disorders

Arthritis sufferers don’t get the mental health support they need, study says

Jason Sutherland: Trump’s tariffs would upend Canadian health care

Research Highlights

Each year, our scientists publish over 500 peer-reviewed papers. Below is a small selection from The Evidence Speaks, a monthly series that summarizes some of the latest in Advancing Health research.

Naik H, Zhu B, Er L, Sbihi H, Janjua NZ, Smith PM, Tran K, Levin A, Zhang W. Health-related adverse work outcomes associated with post COVID-19 condition: a cross-sectional study. BMJ Public Health. 2025;3(1):e001801.

Brain fog, fatigue, and cognitive difficulties are a few of symptoms of post–COVID-19 condition (PCC), however there is little research on how these symptoms can impact work outcomes. In this recent study, Advancing Health’s Drs. Wei Zhang, Adeera Levin, Karen Tran, and Naveed Janjua examined the impact of PCC on work-related outcomes among adults in BC. Among 1,106 participants, 87% contracted COVID-19 while employed. This study found that 47% of these participants reported having post–COVID-19 condition, and these individuals were significantly more likely to experience health-related work problems compared to those without it. People with PCC were 2.6 times more likely to face adverse work outcomes, such as changing jobs, reducing workload, or taking early retirement. They also took an average of 43 more sick days in the two years following their COVID-19 infection. Certain PCC symptoms, including fatigue, fever, weakness, heart palpitations, and brain fog, were strongly associated with these work-related issues. The researchers concluded that PCC has a substantial impact on people’s ability to work.

Advancing Health Scientists: Naveed Janjua, Karen Tran, Adeera Levin, Wei Zhang

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Scime NV, Grandi SM, De Vera MA, Dennis C-L, Boblitz A, Brown HK. Primary Cesarean delivery and future risk of maternal autoimmune disease: A population-based cohort study. J Autoimmun. 2025;151:103370.

Caesarean section has been hypothesized to increase a women’s risk of autoimmune disease later in life, but existing evidence is unclear. A team of researchers from BC and Ontario, including Advancing Health’s Dr. Mary De Vera, recently published research on this possible association. Of 253,901 women in Ontario who gave birth to their first child between 2012 and 2017, 28.2 per cent gave birth through Caesarean delivery, while 71.8% gave birth vaginally. At up to 9 years following childbirth, the data indicated that Caesarean delivery was associated with an increased risk of multiple sclerosis (MS; occurring in 0.28% of women who gave birth via Caesarean delivery), but not rheumatoid arthritis (RA), systemic autoimmune rheumatic disease (SARD), or celiac disease. In comparison, 0.21% of women who gave birth vaginally developed MS. Furthermore, the association with MS was strongest in the first three years after birth. The researchers concluded that, while Caesarean delivery is possibly linked with the development of MS, further studies are warranted.

Advancing Health Scientist: Mary de Vera

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Kwon J-Y, Johnson KL, Haase KR, Newton L, Fitch M, Sawatzky R. Patterns of social support among older adults with cancer and associations with patient-reported outcomes: A latent class analysis. J Geriatr Oncol. 2024;16(1):102157.

Advancing Health Program Head – Patient-Reported Outcomes Dr. Rick Sawatzky and colleagues explored patterns of social support and patient-reported outcomes among 7,097 older adults with cancer. Three levels of social support were identified: low, moderate, and high emotional support. While 96 per cent of the participants were among moderate or high social support groups, the availability of other types of support were not always equal. Participants in the high social support group reported easier access to emotional support compared with those among the moderate and low groups, giving them more opportunities to share concerns and build trusting relationships. Participants in the high and moderate social support groups were more likely to have access to informational support than those in the low social support group, improving their ability to navigate their cancer journey. Participants across all social support groups reported instrumental support, which is vital for performing daily activities. Meanwhile, participants in the low social support group were most likely to be providers of support to others. Understanding social support patterns among older adults with cancer could help understand and address their psychological and emotional wellbeing.

Advancing Health Scientist: Rick Sawatzky

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Barrett KA, Sheikh F, Chechulina V, Chung H, Dodek P, Rosella L, Thavorn K, Scales DC, Canada S. High-cost users after sepsis: a population-based observational cohort study. Crit Care. 2024;28(1):338.

High-cost users (HCUs) in health care are a small population of individuals who account for a disproportionately large proportion of health spending. Advancing Health Scientist Emeritus Dr. Peter Dodek and colleagues investigated whether experiencing sepsis during hospitalization increased the risk of the patient becoming a HCU. Using linked health-administrative databases, the research team identified 927,057 hospitalized individuals in Ontario, 79,065 of whom had sepsis over a two-year period. Analyses revealed that individuals who had sepsis while hospitalized were more likely to be a top five per cent HCU for 90 consecutive days at any time after discharge and be a HCU for a longer period of time after discharge, compared with individuals who did not have sepsis. Furthermore, the likelihood of becoming a HCU after sepsis was higher among patients who didn’t have high health care costs previously, accentuating the impact of sepsis on someone’s health care usage. The results of this study highlight the economic impacts of sepsis and emphasize the need to implement interventions that aim to prevent sepsis, reduce the clinical burden of sepsis, and improve outcomes after sepsis.

Advancing Health Scientist: Peter Dodek

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Villain C, Ebert N, Glassock RJ, Mielke N, Bothe T, Barghouth MH, Pöhlmann A, Fietz A-K, Gill JS, Schaeffner E. Medical suitability and willingness for living kidney donation among older adults. Am J Kidney Dis. 10.1053/j.ajkd.2024.07.010

Researchers, including Advancing Health’s Dr. John Gill, analyzed data from 2,069 adults aged 70 years and over to determine the suitability and willingness of living kidney donation among older adults. Of the participants, 93% had at least one medical contraindication for living donation, plus 38–54% kidney-related issues. In all, 5–6% of the study population had neither medical nor kidney-related exclusions and were therefore eligible for living donation. Of these, only 11–12% were still eligible for living donation eight years later. While the suitability for living kidney donation was not overly high, willingness to donate was: 73% of participants would consider living kidney donation, while 60% would consider deceased kidney donation. Because of the mismatch between eligibility and willingness to donate, the team concluded that additional research is required to expand living donation among older adults and meet kidney transplantation needs.

Advancing Health Scientist: John Gill

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Metcalfe RK, Dobischok S, Bansback N, MacDonald S, Byres D, Lajeunesse J, Harrison S, Koch B, Topping B, Brock T, Foreman J, Schechter M, Oviedo-Joekes E. Client preferences for the design and delivery of injectable opioid agonist treatment services: Results from a best–worst scaling task. Addiction. doi:10.1111/add.16620.

Despite recommendations and evidence indicating that individualized care improves engagement, retention, and outcomes for people with opioid use disorder (OUD), system-level requirements often dictate how injectable opioid agonist treatment (iOAT) can be delivered, preventing iOAT programs from effectively providing person-centered care. A study led by Advancing Health’s Dr. Rebecca Metcalfe, with Drs. Nick Bansback, Martin Schechter, and Eugenia Oviedo-Joekes, explored the preferences of people receiving iOAT in Vancouver, Canada. There were 124 participants surveyed, most of whom were current iOAT clients. By analyzing responses using the best-worst scaling survey method, the researchers identified two main groups of clients with different preferences: 1) autonomous decision-makers and 2) shared decision-makers. Autonomous decision-makers preferred to have more control over their treatment decisions and shared decision-makers were more open to collaborating with health care providers on treatment decisions. Despite these differences, both groups shared several common preferences including access to take-home medication, ability to set their own treatment schedule, receiving treatment in a space they like, and having access to other services, such as primary care and counselling, at the iOAT clinic. The study found that, overall, iOAT clients in Vancouver desire more autonomy in their treatment, most notably their medication type and dosage, as well as their treatment schedule. These findings highlight the importance of considering client preferences in designing and delivering iOAT services with the goal of improving client engagement, retention, and outcomes for people with OUD.

Advancing Health Scientists: Nick Bansback, Martin Schechter, Eugenia Oviedo-Joekes

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Oppliger K, Blair S, Price R, Nahanee M (Latash), Nahanee D, Duncan R (Tsitsáyx̱emaat), Lamont E, Beverly A, Dawson A (Spelexilh), Conklin AI. Promoting Slhánay̓ Sḵwálwen (Indigenous Women’s Heart Health): Findings from sharing circles with Squamish Nation. J Nutr Educ Behav. doi:10.1016/j.jneb.2024.04.003.

There is limited knowledge evaluating culturally safe and environmental approaches to nutrition education and cardiovascular health awareness in Indigenous communities. Advancing Health Scientist Dr. Annalijn Conklin, with input and leadership from members of the Squamish Nation, aimed to develop a model to improve the understanding of heart health and increasing heart health awareness by integrating this knowledge with land-based practices. These community-led foraging walks serve as a culturally safe way to educate participants about nutrition, as they reported previous mistreatment and judgement by health professionals. Participants, who mostly had limited foraging experience, expressed a strong desire to learn about traditional foods and noted a lack of heart health-related nutrition education. They highlighted key elements for future programs, including involvement, implementation, and ideal settings. All agreed that foraging walks help promote five dimensions of heart health — physical, emotional, spiritual, mental, and social — through physical activity, purposeful nutrition, and connection to community and culture. The findings informed a template for future sessions and plant identification cards for the community. This study suggests the need for pilot programs and further research on heart health and land-based practices tailored to different Indigenous groups nationally.

Advancing Health Scientist: Annalijn Conklin

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Hayashi K, Rabu G, Cui Z, Klaire S, Homayra F, Milloy MJ, Nosyk B. Characterizing the use of healthcare access supports among people who use drugs in Vancouver, Canada, 2017 to 2020: A Cohort Study. Subst & Addict J. 2024:29767342241249870. doi:10.1177/29767342241249870.  

For people who use drugs (PWUD), ensuring fair access to health care can be achieved through various support systems. Formal supports include outreach workers and healthcare professionals and informal supports include friends and family. Few studies have looked at how often PWUD use formal and informal supports. Led by Dr. Bohdan Nosyk and supported by Advancing Health’s Fahmida Homayra, researchers evaluated what factors were linked to the use of formal and informal supports among PWUD. Data was analyzed from two studies of PWUD collected from 2017 to 2020. Statistical models were used to identify factors associated with using each type of support compared to no support. Out of 996 participants, 350 (35.1%) reported accessing supports in the past 6 months: 6.2% accessed informal supports, 14.1% accessed outreach workers, and 20.9% accessed health care professionals. Living with HIV, chronic pain, and avoiding health care due to past mistreatment were linked to increased engagement with health care professionals and outreach workers. It should be noted that those who were avoiding access to care due to mistreatment were more likely to receive support from outreach workers and peer navigators rather than healthcare professionals. Overall, the rate of accessing formal health care supports was relatively low among the participants. However, formal supports were more often accessed by PWUD with more health issues and those who faced discrimination in health care, highlighting the need to diversify care supports to help alleviate unmet healthcare needs.

Advancing Health Scientist: Bohdan Nosyk 

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Wahl KJ, Brooks M, Trenaman L, Desjardins-Lorimer K, Bell CM, Chokmorova N, Segall R, Syring J, Williams A, Li LC, Norman WV,  Munro S. User-centered development of a Patient Decision Aid for choice of early abortion method: Multi-cycle mixed methods study. J Med Internet Res. 2024;26:e48793. doi:10.2196/48793.

People seeking abortion in early pregnancy have the choice between medication and procedural options for care. The choice is preference-sensitive as there is no clinically superior option. This provides an opportunity to use patient decision aids (PtDAs), which are tools that help patients make informed decisions that align with their values. Led by Advancing Health PhD student Kate Wahl, and supported by Advancing Health Scientists Drs. Linda Li and Logan Trenaman, published a study on the development and usability of It’s My Choice, a PtDA for individuals considering abortion in Canada. To create the PtDA, researchers used a systematic approach, considering evidence on abortion decision-making and the risks and benefits of each option. They then refined the tool through interviews. A survey involving patients and health care professionals showed that the revised PtDA was user-friendly and provided the necessary information for patients to make an informed decision on their care. This study addressed the need for a tool to help people make informed decisions about abortion methods and is currently available for public use.

Advancing Health Scientists: Linda Li, Logan Trenaman

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Publications

Advancing Health research is found in some of the world’s top journals and covers a wide breadth of specialties, areas, and populations.

372

original research publications

79

reviews

62

editorials & commentaries

Top 10 areas of publication in 2024/25