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 email@example.com 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.
The Faculty of Medicine, UBC, is very pleased to recognize the Women’s Health Research Institute (WHRI) as a Faculty of Medicine Research Centre in recognition of its scientific contributions and its significance to the Faculty of Medicine’s mission and the public’s health. By coming within the Faculty’s organizational structure as the Women’s Health Research Centre, WHRI will now have a voice in strategic discussions about research at UBC.
As one of only two research centres in Canada dedicated to advancing women’s health research, and led by Executive Director Dr. Lori Brotto, the WHRI proudly serves as the research arm of BC Women’s Hospital + Health Centre, and as the face of women’s health research for the Provincial Health Services Authority (PHSA). Borne of the need to catalyze B.C. research in women’s health and champion the need for sex disaggregated methods of analysis, the WHRI enhances and galvanizes the impact of research conducted at BC Women’s Hospital and by women’s health researchers across the province.
As a Faculty of Medicine Women’s Health Research Centre, the WHRI recently published “women’s health research agenda” aligns very well with the Faculty of Medicine’s strategic plan, “Building the Future,” by emphasizing the generation of new knowledge in response to urgent health issues related to women.
WHRI’s membership has steadily grown over the past few years, and now has over 220 members whose research spans various UBC departments and faculties, as well as other institutions. WHRI also works collaboratively alongside BC Children’s Hospital Research Institute, BC Cancer, the B.C. Mental Health and Addictions Research Institute, the B.C. Centre for Disease Control Research, and the PHSA Research Leadership Council, which advises PHSA on strategic research priorities.
The WHRI is able to offer its members exceptional biostatistical support and a research program facilitator who provides targeted support in concept development, study design, and grant facilitation. The WHRI also provides research support infrastructure through access to lab facilities, space for trainees, bookable interview rooms, assistance with ethics and regulatory requirements, and database management.
The WHRI is currently undertaking a strategic planning process, aiming to release its plan in January 2019.
Ciana Maher, Research Coordinator at WHRI, journeyed home last month to vote in Ireland’s historic referendum on abortion. Read
By Ciana Maher, Research Coordinator
A few weeks ago I, like thousands of other Irish citizens living abroad, was privileged to fly home to vote in Ireland’s historic referendum on abortion. The referendum was held to repeal the Eighth Amendment which was written into the Irish constitution in 1983, and gave “the unborn” the equal right to life as the mother carrying it. This rendered abortion effectively illegal in all cases – including those of rape, maternal illness and fatal fetal abnormalities. On May 25th 2018 the Republic of Ireland overwhelmingly voted ‘Yes’ to end the country’s ban on abortion.
For many centuries state and church have been intertwined in Ireland. Historically the Catholic Church provided all formal education in the country, and as a result it was seen as people’s moral compass. Abortion had been banned since 1861 but the beginnings of the Eighth Amendment can be traced back to the late sixties and early seventies, when abortion became legalized in both the UK and the United States. The Irish government, heavily influenced by the Church, decided this was a worrying trend which needed to be stopped before it got to Irish shores. In 1983 a referendum was proposed to make abortion illegal, and after heavy campaigning from the church, it was voted in by a majority 66.9%.
Since its controversial enshrinement in the constitution The Eighth has naturally come up against legal difficulties causing further amendments to be added. In 1992 a 14-year-old girl who became pregnant after she was raped was stopped by the government when attempting to travel to the UK for a termination. This prompted two additions to The Eighth to be put to public referendum both of which passed.
The first allowed women to travel abroad to seek an abortion, and the second granted freedom to obtain or provide information on access to abortion services. In 2013, The Protection of Life During Pregnancy Act was passed to allow abortion in cases where the mother’s life is at risk following the tragic death of Savita Halappanavar.
Savita’s story galvanized the call to repeal The Eighth. She was a 31-year-old Indian dentist living in Ireland, and was admitted to hospital while having a miscarriage at 17 weeks. Knowing the inevitable outcome of her pregnancy she requested a termination to accelerate the miscarriage, but she was told that since Ireland is a “Catholic country” and the fetus still had a heartbeat this option was not available. Savita died 7 days later in intensive care from cardiac arrest caused by severe sepsis from her miscarriage.
Since Savita’s death a growing number of Irish citizens have been campaigning for a referendum to change the constitution. Very shortly after becoming prime minister of Ireland in 2017, Leo Varadkar (a 39 year old Medical Doctor), announced the referendum on repealing the Eighth Amendment.
As a woman working in an institute dedicated to enhancing women’s health — specifically on projects to provide better abortion services for women and their partners — this referendum was deeply personal. Knowing that this essential medical care was not even a possibility in my own country – that every day nine Irish women were being forced to travel to the UK for an abortion and a further three were taking abortion pills illegally – filled me with indignation on a daily basis.
Following the campaign from afar made me restless, especially when I would come across the false information and scaremongering claims and imagery being promoted by the “Save the Eighth” campaign. I have spent the past 12 months being intimately involved with women receiving abortion services in Canada, and while compassionate, safe, legal and free care is available to them, stigma around abortion is still pervasive. My decision to travel home was not only to make my vote count, but to make the journey in solidarity for all the women who make these emotional and isolating journeys for abortions every day facing stigma and shame.
In the space of 35 years Irish citizens opinion on abortion has done a U-turn and now the vast majority have decided it is no longer acceptable to export our women in need. The same number of people (66.4%) who originally voted to instate the ban on abortion voted to repeal it on May 25th 2018. During the campaign people from every corner of the country came forward to share their heartbreaking experiences of seeking a termination abroad highlighting that this issue affected the entire Nation. The final referendum results showed that both women and men of all social classes, from both rural and urban areas, and almost all age groups were in the majority for a ‘Yes’ vote.
I am honoured to have been a part of a moment in history that has made my country a more compassionate place that values women’s health, safety and dignity. This referendum result has paved the way for new abortion legislation to be drawn up which will allow terminations within the first 12 weeks of pregnancy with no restrictions, and up to 24 weeks in exceptional circumstances. It is expected to be introduced by the end of 2018.
“Under the Eighth the only thing we could say to women was take a boat or a flight, Today we are saying take our hand” – Irish Minister for Health Simon Harris
This month Dr. Joelle LeMoult was awarded a Michael Smith Foundation for Health Research (MSFHR) Scholar Award for her project Predicting Depressive Symptoms During the Transition to High School.
Existing research on adolescent depression typically studies risk factors in isolation, which Dr. LeMoult proposes may be the reason that only 20% of individuals with major depressive disorder (MDD) receive adequate treatment. To address this gap, she will take an integrative approach to research, considering multiple cognitive, emotional, and biological variables that might predict depression in adolescents transitioning into high school.
Dr. LeMoult will mobilize the results of her work through a variety of Knowledge Translation (KT) activities, including a website disseminating study findings created in collaboration with primary research users. This KT work is intended to reach youth at risk for MDD and their families, as well as clinicians and policy-makers to provide better support through this transition period, identify risk factors of MDD, and mitigate those risks.