Knowledge Translation

Advancing Health Lead: Sarah Munro

Summary: Documentaries are an understudied but potentially powerful strategy to enhance knowledge and behavioural change. However the mechanisms by which health documentaries facilitate audience change has received little study. Dr. Munro’s project involves a realist evaluation of a documentary, “Let Them Eat Dirt,” that aims to reach and inform parents of young children (“the sandwich generation”) about the role of the microbiome in early childhood development. This study is undertaken in partnership with microbiologists in the Finley Lab at UBC and funding for the realist evaluation is provided by a methods grant from BC SUPPORT Unit Methods Cluster for Knowledge Translation and Implementation Science. Through this work we have convened a remarkable Parent Advisory Group comprised of 20 pregnant and parenting adults who are from the greater Vancouver area, many of whom experience challenges and barriers in their lives due to unstable housing or being a recent newcomer to Canada. Through this research we aim to explore:

• What works, for whom, how, and in what circumstances to facilitate uptake of health-related research evidence among “the sandwich generation” in the context of an entertaining documentary on the effect of microbes on child health development?
• What is the feasibility, acceptability, and preliminary effect of the use of a documentary and supporting media to disseminate knowledge related to microbes and early childhood development to parents?

Advancing Health Lead: Sarah Munro, with Vanier Scholar Kate Wahl

Summary: It is vital for the well-being of Canadians that the healthcare system operates using the most up-to-date information. However, it can take years for governments to integrate new discoveries into health policy. One way to solve this problem may be to share research evidence about the healthcare system using real-life stories of Canadians accessing the system. To test this theory, Dr. Munro and trainee Kate Wahl are interviewing provincial and federal policy makers about how stories affect their decision-making on reproductive and sexual health. They will then use the results to help ask Canadians about their experiences accessing reproductive and sexual healthcare, and turn these experiences into stories for policy makers. The last step will be to test the preliminary effect of stories on policy makers’ knowledge, attitudes, and intentions. This study will provide a new set of methods to promote the use of research evidence in government. The methods will be created with and for policy makers and will be evaluated so that other scientists have tools to get research evidence into the hands of people who are responsible for the healthcare system. By closing the gap between science and government, this study will help ensure that the healthcare system provides the best possible care to all Canadians.

Advancing Health Leads: Roxana Geoffrion, Sarah Munro

Summary: Pregnancy, childbirth, and the few months after are times of rapid change for the pelvic floor. Fifty per cent of aging women have pelvic symptoms, which may disappear gradually or last a long time depending on several risk factors. Women often do not talk about pelvic floor problems because of embarrassment. Drs Geoffrion and Munro created animated videos and plan a dedicated website to inform women and maternity providers about how to best care for the pelvic floor in pregnancy. Their team includes patient partners and experienced social media users. They aim to disseminate these videos online, through social media, to raise awareness of pelvic floor health, prevention, and treatment options.

Read more about this project here.

Advancing Health Lead: Sarah Munro, with trainee Zeba Khan and Options for Sexual Health

Summary: Im/migrant populations, particularly youth, experience higher rates of unmet sexual and reproductive health needs. In the absence of culturally appropriate and accessible sexual and reproductive health care, they may face an increased risk of harm when engaging in normal, healthy sexual behaviours for their age. Dr. Munro and trainee Zeba Khan hope to describe and analyze the individual, sociocultural, economic and immigration specific factors that influence the access of sexual and reproductive health among im/migrant youth. The project involves interviews guided by KT and user-centred design principles. Understanding the specific needs of the im/migrant youth will allow them to develop KT strategies to address these gaps, inform policies and optimize programs. This work is funded by a grant from the Vancouver Foundation and is conducted in collaboration with Options for Sexual Health and researchers at the University of Alberta.

PI: A. Salmon (UBC, Advancing Health), Dr. Andrew Larder (Fraser Health Authority)

Summary: In the context of the current public health crisis, the Fraser East region has experienced some of the highest rates of overdose deaths in BC, with the number of deaths increasing more than 700% since 2007. Semi-urban and rural communities such as Fraser East are struggling to identify and implement effective strategies to reduce and prevent overdose-related deaths because most of the interventions in Canada are based on research that has been conducted in urban communities. To address this gap in research and practice, the Overdose Response in Fraser East project is working with peers, families, community members, and organizations in Fraser East to identify practical and supportive interventions to reduce overdose death and increase connectivity to existing services in rural communities. Peer researchers from the Overdose Response team have developed and pilot-tested a demographic survey and detailed interview guide to investigating the perspectives and experiences of people who are currently at the highest risk of overdose death in the Fraser East region: those using drugs alone in a private residence. With funding from CIHR, the KT Program team is extending these peer-led interviews to other more rural and remote communities in the region, which will then be contextualized, validated, and refined with administrative health data from BC’s Provincial Overdose Cohort. These research and community engagement activities represent the first steps needed to develop a practical, evidence-informed, scalable plan (including specific interventions) to reduce fentanyl-related overdose deaths in Fraser East, with significant potential for transferability to other semi-urban and rural communities in Canada. This work has also been supported by the BC SUPPORT Unit, the Vancouver Foundation, and the Chilliwack Research and  Social Planning Council.

Publications:

Substance Use and Overdose Risk: Documenting the Perspectives of Formerly Incarcerated Persons in the Fraser East Region of BC (Link)

PIs: A. Salmon and Jill Cory

Summary: Nearly a decade ago, the Building Bridges initiative responded to emerging evidence that women experiencing violence are under-served by services when they have overlapping mental health and/or substance use concerns. This community-based participatory action research project facilitated consultations with 470 anti-violence, mental health, and substance use service providers and policy leaders, and conducted focus groups with 102 women with these overlapping experiences. The project documented what other research findings confirm: that there are complex connections between gender-based violence, mental health, and substance use and that gender-based violence often precedes the development of mental health and substance use. The study also documented how the dynamics of abuse can be echoed in services and systems. The service landscape that once viewed women as resilient survivors and the system as flawed now has a tendency to frame individual women as flawed and in need of treatment and social control. From this perspective, services can further entrap women by holding them responsible for circumstances that they did not choose and cannot control or prevent. This results in “help” that increases women’s vulnerability: the harms of help.

Funded by the Vancouver Foundation, this project is building on the findings of the Building Bridges study with a focus on knowledge mobilization. It brings together a diverse group of researchers, front-line service providers, community leaders, policymakers, and advocates to generate policy-relevant, evidence-based resources supporting the anti-violence sector in meeting the safety and health needs of women with overlapping experiences of violence, mental health, and substance use.

PI: A. Salmon

Summary: Stepped Care Models (SCMs) are an increasingly favoured approach to mental health services planning, particularly in services for youth and young adults. SCMs hold promise for optimizing the access and efficiency of mental health services for young people, by ensuring that system resources are allocated to respond appropriately and cost-effectively to clients’ varying needs. The implementation of SCMs has been seen to hold promise for enhancing early access to youth mental health services as well as improving mental health system coordination and performance. However, there are substantial gaps in knowledge surrounding the formation, implementation, operation, and outcomes expected of SCMs. Specifically, there is limited data on the optimal number of steps and the range of treatments delivered within each step; the proportion of patients who require higher intensity treatments while skipping lower intensity treatments; the process of decision-making to “step-up” or “step-down” to a higher or lower intensity of care; a range of other client and system-level factors. This scoping review assessed the available peer-reviewed and grey literature to provide a descriptive summary of the models of and outcomes associated with SCMs in mental health services for youth and young adults. This review was commissioned by Frayme, a Network of Centres of Excellence that supports international collaborations between researchers, knowledge users, and their partners, to accelerate knowledge translation in mental health service delivery for young people. Financial support was provided by the Cundhill Foundation.

Publications:
Fernando, S., Berger, M., and Salmon, A. (under review). Stepped Care Interventions for Mental Health and Substance Use Service Delivery for Youth and Young Adults: A Scoping Review. Early Intervention in Psychiatry.

Berger, M., Fernando, S., and Salmon, A. (under review). Stepped Care Models for Youth Mental Health Service Delivery: What Does the Evidence Say? Early Intervention in Psychiatry.

PI: A. Salmon

Summary: This project is supporting an emerging team of investigators, clinicians, and advocates passionate about reducing health and social inequities for and improving the care of families affected by substance use problems. Under a participatory research agenda, families, researchers, clinicians, service planners, and policymakers will be brought together for a series of workshops to support the development of a pragmatic, rigorous evidence base needed to enable this work. The main deliverable is a sustainable “Learning Alliance”, made up of researchers and research users who will address challenges around effective policy and practice related to supporting families affected by substance use problems and develop momentum for subsequent activities. The knowledge this team’s research and learning alliance will generate will inform provincial efforts to improve the delivery of services to individuals struggling with addictions and the family members who support them. The breadth and scope of this collaboration will be increased through synergy with an emerging five-country collaboration focused on examining policy and practice on substance use and parenting in Canada, the UK, the US, Ireland, and Australia. This perspective, also supported through a learning alliance, will allow for knowledge exchange, provide a more nuanced understanding of the core governing principles and ethics of care in different contexts, and will catalyze efforts to generate the evidence base needed to enable this work.

Policy Briefs

Salmon, A., Richardson, C., Barbic, S., Sutherland, J., Puyat, J., Mathias, S., Tee, K., Liversidge, P., and Anis, A. (2017). Measuring Accessibility, Quality of Care and Outcomes: Key Considerations for Children, Youth, and Young Adults. Prepared for the Canadian Federal Minister of Health. Vancouver: Centre for Health Evaluation and Outcome Sciences. 10 pgs.

Learning Modules

Heard and Valued: Patient Engagement with Marginalized Populations

Heard and Valued is an online learning module that translates the findings of a research project on engaging marginalized populations in health services planning. This module is available for free to anyone interested in conducting inclusive engagement activities that support diverse populations to participate in health services planning in a meaningful way.

Access the Learning Module

Video Productions

Salmon, A., Wright, L., Langdale, K. (2013). Finding Voices. Produced by Amy Salmon and Lonnie Wright, Seen and Heard Productions. Funded by the Canadian Institutes of Health Research (CIHR) as part of Your Rights in Research: A Resource Kit on Ethical Research Practice with Women who use Drugs.

See at: https://vimeo.com/73620090

Smye, V., Parkes, T., Salmon, A., Lipsky, N., Gloyn, S.& the BCAPOM Board. (2014). We are the Warriors – The Methadone Warriors. Produced by Lonnie Wright, Three Bridges Films. Funded by the Canadian Institutes of Health Research (CIHR) as part of The Methadone Mess Workshop.

See at: https://vimeo.com/94816611