The Michael Smith Foundation for Health Research (MSFHR) has announced the results of its 2018 Research Trainee competition, naming 33 post-doctoral fellows to be provided salary support through this award.
Among the recipients are WHRI members Drs. Robine Donken and Laura Schummers. Dr. Schummers will be joining the CART-GRAC team to study the effect of mifepristone in primary care on abortion service access, outcomes, and costs. Dr. Donken will be working with Dr. Gina Ogilvie’s team at Global Control of HPV Related Diseases to evaluate the effectiveness of a single HPV vaccine dose.
On July 13-14th, 140 attendants from around the world gathered in Toronto to share their research and insights on the Parental Brain.
There were three keynotes by John Russell (University of Edinburgh), Patrica Tomasi (Huffington Post Canada) and Ruth Feldman (Interdisciplinary Center, Herzlia, Israel). John Russell spoke about pregnancy allostatis and the many physiological challenges for the mother during pregnancy that have repercussions for women’s health. Ruth Feldman took us on a journey of the positive influence of kangaroo care in children up to 21 years later(!), as well as fascinating world of brain synchrony with parenting and the human parental caregiving network. Patrica Tomasi spoke on how researchers can leverage the media to advocate for postpartum depression, her nine points for success are here.
The symposiums centred on: Parental interactions with gut, immune and placenta; treats to mothering; genetics and epigenetics of parenthood; alloparenting; and the neurobiology of nurturing (a tribute to Craig Kinsley who passed away in 2016 at 61 and whose body of research was a stimulus for many at the conference). We also featured a symposium on young investigators sponsored by Wiley. For those interested, abstracts and program can be viewed here or take a look at the hashtag #PB2018. Look out for two special issues to be published on the event one in January 2019 in Elsevier’s Frontiers in Neuroendocrinology (FIN) featuring all the invited speakers and the other in Journal of Neuroendocrinology. The event was co-organized by myself, Frances Champagne(US), Joe Lonstein(US) and Jodi Pawluski (France).
I want to take a moment to acknowledge how truly international the event was as of those 140 attendants we had representation from New Zealand, Israel, Brazil, Netherlands, USA, Germany, Uruguay, Austria, Spain, Hungary, France, Sweden, Belgium, Ireland, Scotland, England, and Mexico! One of the goals of our meeting was to formalize the Parental Brain as a group in an effort to engage our members and hold regular meetings. Towards this end, we have created a closed Facebook group that you can reach here or follow us on Twitter at @ParentalBrain.
Parental Brain originated almost 20 years ago with the first meeting held in Bristol, England in 1999 with organizers Colin Ingram, Michael Meaney, Judith Stern, and John Russell. Many of the meetings have culminated in special issues and/or books, if you have not attended but are interested I highly recommend joining our group to have your say in the next meeting. Parental Brain 2018 would like to acknowledge the support it received from Elsevier, Wiley, Sage Therapeutics and CIHR-IGH.
Dr. Wendy Norman is a recipient of a 2018 CIHR Project Grant for The Canadian Nurse Practitioner medical abortion study! In 2017 Nurse Practitioners (NPs) became the first non-physicians permitted to perform abortion in Canada, although little is known about how to support them to provide medical abortions, or what barriers may exist for implementation of high quality care for this new service.
To address this knowledge gap, Dr. Norman, along with her team – Dr. Ruth Martin Misener (Dalhouse University), Josette Roussel (Canadian Nurses Association), and Dr. Sarah Munro (WHRI member, postdoctoral trainee co-investigator) – will investigate the barriers to and facilitators of accessible provision of medical abortion services by NPs in Canada.
The research will build on the highly successful Mifepristone Implementation Research in Canada study which looked at mifepristone provision by physicians. Findings have already contributed to changes in several mifepristone policies and revisions to the product monograph by Health Canada, and health professional regulator revisions to physician and pharmacist scope of practice in five provinces.
The project grant will provide $481,950 in funding over 3 years.
This summer there are four students working on projects with Dr. Gina Ogilvie’s team! Sandy Zhang, Catherine Sanders, and Kara Plotnikoff are SFU Master of Public Health students completing their practicums over the summer, and Christine Lukac is an epidemiologist and UBC Medical student researching the impact of the school-based HPV immunization program.
Sandy is currently working on CervixCheck, a web-based application which utilizes HPV self-collection kits to improve cervical cancer screening in BC. Sandy is involved with community engagement to help guide and inform CervixCheck’s online platform. Her role focuses on engaging with patients and clinicians in four family practices through administering a cross-sectional survey to assess the feasibility and acceptability of the program. Her work will provide knowledge and insight into the acceptability of CervixCheck in preparation for its launch.
Sandy’s favorite part of her practicum thus far has been the opportunity to connect with women in the community and work with frontline health care teams to better understand and address the existing barriers to cervical screening through a unique program like CervixCheck.
Catherine is excited to be completing her practicum with the Advances in Screening and Prevention in Reproductive Cancers (ASPIRE) project. The most recent ASPIRE initiative is a pragmatic, randomized control trial in rural Uganda which compares 3 different approaches to cervical cancer screening. Her role has been to assist with the design and implementation of the study, primarily through the development of standard operating procedures, training materials, and data collection forms. The most valuable aspect of her practicum has been gaining knowledge and experience in Implementation Science as an ideal approach to conducting research and improving health care and health service delivery in low- and middle-income countries.
Kara shares her time between the BC Centre for Disease Control and the Women’s Health Research Institute. Kara has been involved in the development, implementation, and analysis of a survey for BCCDC STI clinic clients exploring their perceptions about STI vaccines as an emerging form of prevention and treatment. Kara is also working with STRIVE-BC to plan a pre-conference symposium dedicated to the research and development of STI vaccines at a global scale, to be held preceding the STI & HIV World Congress in July 2019. Kara enjoys her time at the WHRI because of the ample opportunities to learn about the important and ground-breaking work in the field of women’s health research while being immersed in a dynamic and forward-thinking environment. She can often be found attending rounds or listening to webinars and live-streams trying to learn as much as she can about research and research methods.
As part of Dr. Ogilvie’s team, I am studying the impact of the school based Human papillomavirus (HPV) immunization program on the rates of genital warts (GW) in BC. HPV is a common sexually transmitted infection, and GARDASIL®4 is a highly efficacious vaccine that protects against four HPV serotypes, including 6 and 11 which are associated with 90% of GWs. In 2008, the first cohorts of girls were immunized in grades 6 and 9, and by 2017 they reached the age of sexual maturity. Among the first immunized cohort, some women are now sexually active and may have been exposed to HPV. This work is timely and the results are highly anticipated by public health stakeholders in BC to monitor attainment of population health targets and optimize the HPV immunization program.
This project has afforded an opportunity to practice research skills during all stages of the study: literature review, project planning, data access, data management and analysis, communicating results, writing a manuscript, and submission for publication. I am grateful to be working with Dr. Ogilvie as she creates learning opportunities, promotes the strengths of her team members, and builds collaboration between her networks. For example, Dr. Ogilvie connected me with Dr. Robine Donken, a postdoctoral research fellow at the Vaccine Evaluation Center and Women’s Health Research Institute. One of my favourite and enjoyable parts of working on this project has been meeting with Dr. Donken on a weekly basis to discuss progress and next steps in data management and analysis.
We would like to invite you to participate in WHRI’s annual event to celebrate World Sexual Health Day taking place on Wednesday September 5th, 2018 from 12 – 1:30 in D308.
World Sexual Health Day is an awareness day managed by the World Association for Sexual Health (WAS), a global advocacy organization committed to promoting best practices in sexual health. It is celebrated annually on September 4th and attempts to break down social and cultural taboos associated with sexuality and to promote positive sexual health around the world.
The focus this year will be on trainees, students, fellows, and other researchers in training to present on their completed research or research in progress or any planned research. Talks will be rapid-fire – (approximately 5 minutes each).
Please submit your abstract and abstract title, no more than 300 words to firstname.lastname@example.org and include “World Sexual Health Day abstract” in the email subject line.
As part of the #ItsNotInYourHead awareness campaign wrap-up, Melissa Nelson, Communications Assistant, and Ciana Maher, Research Coordinator, sat down with patient partner Lana Barry to discuss why involving a patient partner in KT work is important, and to explore how this collaboration between researchers and patient partners can catalyze a social media campaign.
On October 6th, 2017 Dr. Lori Brotto and the Women’s Health Research Institute (WHRI) launched the #ItsNotInYourHead (INIYH) campaign which shared the results of the five year clinical trial Cognitive behaviour therapy Or Mindfulness FOR Treating PVD (COMFORT) which taught women with provoked vestibulodynia (PVD) mindfulness meditation or cognitive behavioural therapy (CBT) as a means of coping with the pain and distress of PVD.
To share this message, Dr. Brotto enlisted the help of Lana Barry, a participant in COMFORT, to be involved in an end-of-grant Knowledge Translation (KT) project funded by the Michael Smith Foundation for Health Research (MSFHR), to share results of the study and raise awareness about PVD.
Lana had faced a long and painful journey to diagnosis. As a single woman participating in the COMFORT study, she quickly developed a passion for self-advocacy and a desire to let women know that their own sexuality and health was a vital part of their identity, regardless of whether they were in a relationship or not. So, when Dr. Brotto decided to enlist the help of ThinkingBox.com to develop an educational video sharing the findings of COMFORT, Lana was the perfect voice to narrate the video.
The COMFORT study team approached Lana to assist with developing the storyboards leading to the video creation, and together they embarked on a co-creation process to translate the study findings. The video would begin with Lana sharing her own story, urging women to speak to a healthcare provider and to know that their pain is real, even if it is not evident to a doctor on an exam.
“I wanted to be the voice,” Lana explains. “I was feeling a lot of sadness that these women were going through such private matters, and were not able to say the word[s provoked vestibulodynia] out loud….I thought, ‘this has to change.’”
With the completed video, Dr. Brotto successfully applied for a MSFHR Reach Award to support a social media knowledge dissemination campaign. Lana was identified as the Research User Co-lead, and with a team of staff skilled in social media and KT at the WHRI, the INIYH campaign was launched.
Prior to participating in the COMFORT study Lana says that finding any information on PVD was difficult, and some of the most valuable information she found came from personal blogs written by other women with PVD. With the knowledge she gained about social media through INIYH, she was able to amplify this information with the hope to help bridge the knowledge gap for others. Her voice added another layer of credibility to the campaign, and allowed her to share her lived experiences with PVD.
Incorporating a patient’s experience and unique perspective into KT work is not only beneficial for researchers – it can profoundly impact a patient’s life. While Lana’s voice added value to INIYH activities, it also encouraged her to be vulnerable with others, and for Lana, this was a very good thing. She explained that prior to diagnosis she felt so much shame from being told the pain was ‘all in her head’ that she hid it from those closest to her.
“At that time [when I was asked to record the voiceover] I said yes because I knew my future self would be able to handle it,” Lana says, “but that person in the moment had a lot of work to do to get there.”
What we learned
INIYH was a novel partnership between a graphic design team, researchers, clinicians, and a patient partner. The team not only faced the steep learning curve of designing a social media campaign from scratch, but also facilitating a patient partner relationship that was respectful and safe.
One important lesson we took from the experience is that providing training is an essential step in building a relationship with your patient partner. WHRI provided training on Twitter and Facebook, which Lana found invaluable, and urges other researchers to offer the same to their patient partners. We helped amplify her profiles by tagging and retweeting her, and offered guidance for content creation and other activities. She credits this experience for the creation of a virtual toolbox which will help her continue her advocacy work.
Lana suggests one way to improve the patient partner experience is to allow patients “greater involvement in the process.” She emphasizes that time spent in-person with the campaign team helped to expedite the learning curve and provide a greater understanding of her role as well as bolster team cohesion. Further, ask your patient partner what you can do for them. For us, this included: accommodating Lana’s schedule for meetings, providing regular campaign updates, and assisting with any personal story writing.
We also took guidance from a variety of useful sources, including the Strategy for Patient-Oriented Research, Knowledge Translation Canada, and this podcast with the champion of the It Doesn’t Have to Hurt campaign, Dr. Christine Chambers. Creating a thorough job description for patient partners so that they have clear expectations for their role and involvement; making room in the budget to adequately compensate them for their time and efforts; and creating time for face-to-face communication are all ways that researchers can better facilitate patient partner relationships.
Beyond the campaign
We are grateful for Lana’s bravery and willingness to share her story. Throughout the process people have reached out to Lana to share their own stories, inspired by her vulnerability. And, for Lana, she credits INIYH for giving her confidence and helping her to take a step forward to deal with difficult emotions.
“Through this process I have found my voice,” she says. When asked if she would recommend becoming a patient partner to other patients she does not hesitate to say yes, “it will change their lives for the better.”
Now that the campaign has officially ended Lana will be the champion of a private Facebook group where she can continue her advocacy work. The group – which was one of the campaign initiatives – is designed for people with PVD to connect and find solidarity with others. With Lana’s help, INIYH will continue to let women know that their pain is real, and treatment is available.
This foundational research at the time of introduction for an innovative practice in Canada, will support advances for training programs and will inform health policy, system and service improvements to facilitate equitable access to medication abortion options for women throughout Canada.
Principal Investigator: Dr. Wendy Norman
Primary Contact: Sarah Munro, Post-doctoral Fellow, 604-875-2424 ext 4990, Sarah.Munro@ubc.ca
About the study: Mifepristone, approved by Health Canada, will be introduced in 2017. Currently 96% of Canadian abortions are surgical, largely concentrated in the largest cities close to the southern border. Overcoming barriers for provision of mifepristone abortion by current and new abortion providers could help to address this disparity. We are undertaking this national study to measure, and concurrently address, the facilitators and barriers for successful initiation and ongoing provision of medical abortion, and to measure changes to abortion access throughout Canada.
Why is this research important? This foundational research at the time of introduction for an innovative practice in Canada, will support advances for training programs and will inform health policy, system and service improvements to facilitate equitable access to medication abortion options for women throughout Canada.
What impact has this research had on policy? This study has involved close partnership with decision makers responsible for mifepristone policy in Canada. During the study period, our research-policy collaboration accelerated health system change through concurrent identification and mitigation of barriers to implementation of mifepristone. The research evidence contributed to removal of the federal requirements for observed dosing, practitioner training, practitioner registration, and physician-only prescribing and dispensing.
Study status: In the process of data collection and has begun preliminary analysis.
Who can participate? This study has three groups of participants: (1) physicians and pharmacists completing mifepristone training certification; (2) physicians and pharmacists who were eligible to provide mifepristone abortion services but did not complete certification; and (3) health service stakeholders who have an influential role in the health policy, system, and/or services that contribute to adoption and diffusion of abortion practice in Canada.
Co-Investigators: Drs. Tamil Kendall, Jan Christilaw, Edith Guilbert, Jennifer Blake, James Meuser, Philip Emberley, Rollin Brant, Melissa Brooks, Stirling Bryan, Dustin Costescu, Sheila Dunn, Angel Foster, Janusz Kaczorowski, Sarah Munro, Regina Renner, Judith Soon, Eleni Stroulia, Flora Teng, Ashley Waddington, Marie-Soleil Wagner.
Funded by: CIHR, MSFHR, BC Women’s Hospital + Health Centre
Dr. Gina Ogilvie and team have been featured by multiple news outlets for their new publication in JAMA, Effect of Screening With Primary Cervical HPV Testing vs Cytology Testing on High-grade Cervical Intraepithelial Neoplasia at 48 Months: The HPV FOCAL Randomized Clinical Trial.