Can mHealth help save lives? Dr. Beth Payne’s research is exploring the use of mobile devices to aid decision in high-risk situations.
Over the past several years, Dr. Payne’s work has centred on finding a way to reduce the risk of adverse maternal and neonatal outcomes from hypertensive disorders in low and middle income countries.
The only way to start resolving pre-eclampsia, Dr. Payne explains, is to deliver the baby and the placenta. However, while delivery might save mum, it might not always be the right choice for baby. The PIERS models, which were the foundation of her PhD work, are a set of clinical risk prediction models to help identify women with a hypertensive disorder (like pre-eclampsia) at risk of severe complications in the next 48 hours.
Dr. Mark Ansermino, a BCCHRI investigator, who was also working in South Africa using mobile technology to deliver health services. His project inspired Dr. Payne’s team to consider the possibility of converting the PIERS models into a simple mHealth app that nurses and community healthcare workers could use to assess women’s risk, and then determine whether the necessity of delivery to save mum outweighed the potential for adverse outcomes for baby. This work resulted in PIERS on the Move, an app-based decision making tool for community-based healthcare workers, which was put to the test through the CLIP Cluster randomized control trials.
Ultimately, the use of the PIERS on the Move app did not make a difference in mortality and morbidity for women and babies. However, Dr. Payne explains that despite their null finding, the app played an important role in the community.
Through mixed method evaluation with community-based healthcare workers and supervisors in the healthcare system, she learned that the use of the app led to community-based healthcare workers feeling more respected by formal healthcare workers and the community, and more confident in communicating with medical language. They also said the app was easy to use.
“mHealth or eHealth interventions by nature are complex,” Dr. Payne explains. “They’re working on the individual level because they’re changing behaviour, health-seekng behaviour, and care pathways – but they’re also working at the systemic level. So, you can design and evaluate at both of those stages, and really have the opportunity to create some really unique knowledge and change.”
Dr. Payne’s new project is also in collaboration with Dr. Ansermino and Dr. Matt Wiens. Together they are building off the PIERS on the Move experience to develop “Smart Discharges for Mom and Baby.” This project, based in Uganda, will look at the risk for women and their babies after delivery. The team hopes to take lessons from PIERS on the Move to develop technology that is not only successful, but that is also successful in saving lives.
You can learn more about Dr. Payne here. Results from PIERS on the Move will be submitted for publication in the coming months.
Dr. Caroline Sanders and her team are in the midst of undertaking their second digital health project, DSDTransitions.ca. In the lead-up to Digital Health Week we spoke to them about their experiences in the digital health space, and their ideas about harnessing technology to empower patients.
Dr. Caroline Sanders, Associate Professor and Coordinator of Graduate Programs in the School of Nursing at UNBC, has completed her first phase of research leading an international team which sought to address the needs of women with congenital adrenal hyperplasia (CAH). Drawing on existing literature and information available through hospital sites, her team began developing a list of key issues for women living with CAH, which was then expanded upon and validated by women living with the condition. These findings were used to create an infographic, website, and eventually a video funded by the Michael Smith Foundation for Health Research.
Her new research seeks to better understand experiences within the healthcare system from the perspectives of people living with Differences in Sex Development (DSD, or intersex variations), as well as healthcare providers. This project, funded by the Canadian Institutes of Health Research, has just begun, but the team is already thinking big about how digital health can play a part in reaching, learning from, and informing key stakeholders.
The process of creating a web-enabled tool for disseminating information has been filled with learning opportunities – beginning with how to decide what medium is most appropriate for a given project. When thinking digital dissemination, social media probably comes to mind. But, for a population that regularly faces discrimination, it wasn’t a natural fit.
“It is nice to have a non-Facebook platform for some people that want information but don’t want to be accessing it through something with their name on it,” explains Leigh Crawford, a Canadian policy analyst and UNBC Research Assistant. Websites are also more easily updated than traditional print materials, like informational booklets, adds Dr. Nina Callens, a collaborating Psychologist and researcher from Belgium.
Further to these issues, privacy and data security are increasingly common concerns.
“People are concerned about the security of their data. By developing a website, we can host [their data], we can own it,” explains Dr. Sanders. This also means that the website is not subject to commodification or commercialization, which could compromise patients’ consent, explains Dr. Tiffany Jones, an Australian collaborator and Associate Professor at Macquarie University.
Dr. Sanders and her team are collaborating with a company in Northern BC, called DUC Design, to design the site. Collaborating with a local development company has meant that they are able to work closely with the developers to iron out details that might not be at top of mind for those new to digital platforms, like domain names, site maintenance, copyright and ownership, and how to ensure that content is mobile-friendly and downloadable.
CONSIDERING THE LIMITATIONS
“[A] digital health platform is useful, but there [are] still areas we need to be really mindful of,” explains Dr. Sanders. “If you think about the Rural North, you know digital health won’t work great if they don’t have the internet.”
Further, the team explains how issues with access extend beyond geographic location. They describe how a patient in the Rural North might rely on a shared resource – for instance, a public library computer – to access a digital health tool. Dr. Sanders wonders whether people have been provided with the digital literacy required to know that they may want to delete their browser’s cookies, or other sensitive information that may have been logged on a public computer.
“We take for granted that we have our own [technology] and [that] no one else will be looking at our search history. If [people are] using communal spaces to access the internet and digital stories we need to think about that, too.”
THINKING BIG ABOUT DIGITAL OPPORTUNITIES
Beyond the scope of their current project, the team is thinking about other ways they can harness digital technologies to address patients’ needs. One area they’re particularly interested in relates to patients’ access to their own healthcare narrative. Women with DSD might not know their complete medical history and resulting healthcare needs.
“Which is complex,” Dr. Jones explains, “because our data so far is suggesting that very young people or parents — who are not yet sure how they feel about these conditions or variations — are becoming the knowledge holders and the knowledge providers to their future healthcare providers, without the knowledge of basic anatomical features they have or don’t have, or what surgeries were actually performed or not. There’s all sorts of astounding gaps in what is provided to them, and yet astounding expectations of what they’re supposed to be able to tell their next healthcare provider.”
“I’ve heard conversations with healthcare providers before about [how] ‘it’s [the patient’s] responsibility to come and teach me because [they] may be my only patient in my cohort that I know who has this condition,’” adds Dr. Sanders. “But, if we’ve not given people access to their health [records] then I don’t know how that’s even possible…I’ve met people who’ve said ‘I’ve gone [into] the healthcare profession with this condition because I wanted access to information I couldn’t get… so I can access [medical papers] in my education so that I can learn about me.’”
For many people, the experience of retelling past medical history can be a traumatizing experience. Dr. Sanders describes developing a way to share digital narratives about patients’ health in order to relieve patients and their families of that burden.
“I think about all the children that I’ve had the privilege of knowing, and their families all say ‘I get so fed up of giving you the same story’…Those people are telling and telling and telling [their story] because they may meet a new junior doctor, they may meet a specialist, they may meet a new nurse… Whoever they meet is new, and they have to recount it.”
Further, Drs. Sanders and Jones explain that for those with disabilities or with mental health concerns, the added pressure to recount the right details at the right time for each provider may not be possible. This type of work – though still just an idea they are grappling with – could have applications beyond the scope of DSD.
Whether considering their future research ideas, or their projects at hand, the team is driven by the needs of people living with DSD. They admit that an online presence has definitely opened them up to criticism and feedback from the community – but that they welcome it.
“We know [that with] this topic area there’s so much to learn, and we know there are so many contentious issues…so it’s also about accepting criticism and being prepared to take it humbly,” Leigh says. “You should expect criticism, because if [you don’t receive it], how are you learning?”
Dr. Sanders explains that this criticism might be upsetting, especially when you as a researcher are trying to come from a place of understanding and compassion. She suggests identifying supports you can turn to, as opening yourself up online can be a vulnerable process.
FINAL WORDS OF WISDOM
Ultimately, the team’s advice on undertaking a digital health project is to have fun and be creative. Other advice includes:
Knowing who will take care of technical work, and for how long
Always get a cost quote – and add 10-15% for unexpected costs
Social media is inescapable. If you have capacity to extend your work to multiple platforms, consider engaging your audience there as well
Understand your contracts, especially when it comes to data ownership, hosting, and what will happen if your hosting provider changes
Companies you work with will likely have a grasp on things like copyright – but you may want to brush up, too
Further, Dr. Gordon is the author of multiple letters calling for updates to guidelines and screening practices in publications like the Canadian Medical Association Journal (February 2019, May 2019), Canadian Family Physician (July 2019), and JAMA Oncology (August 2019).
In honour of Breast Cancer Awareness Month, help continue to raise awareness about breast density, breast health, and breast cancer screening. Check out some of these pieces and share them with your network.
This World Contraception Day we’re putting the spotlight on Dr. Dineley, whose research focuses on improving contraceptive counselling practices for patients with complex medical needs.
Dr. Dineley believes that it’s important for patients to have the right choice for their unique needs, at the right time.
Inspired by the intersection between contraception, medicine, and patient-driven resources, Dr. Dineley wanted to look at the experiences of patients who had chosen to undergo bariatric surgery. Her research relies on qualitative research methods, which she explains give voices to patients to help shape a program that fits their needs – something that is especially important to her, given Canada’s long history of reproductive coercion.
Designing resources based on this lived experience is important for improving contraceptive counselling, as it helps to ensure that decision making isn’t dictated purely on the basis of ‘best’ practices. She hopes that this work will help produce resources for contraceptive counselling that can help guide both healthcare providers and patients through the decision making process.
Dr. Dineley has finished qualitative interviews, and her next steps include developing a resource and pilot testing it with individuals from BC and Ontario who had bariatric surgery.
Dr. Dineley is also involved in a qualitative study looking at decisions around language used by abortion providers to better understand why they use specific language and how it might impact patient care. She is also investigating women’s experiences with contraceptive care in the Ontario prison system.
Dr. Brigid Dineley completed her Bachelors of Science in Mathematics and medical school at Queen’s University. She graduated from the McMaster OBGYN Residency Program, and recently completed the UBC Family Planning Fellowship.
This August, Dr. Deborah Money was presented with a Lifetime Achievement Award by the Infectious Diseases Society of Obstetricians and Gynaecologists (IDSOG). This award highlights a career spent changing the landscape of women’s reproductive health research both in Canada and the United States, and her determination to better the lives of women not just here in North America, but around the globe.
Dr. Money’s journey with IDSOG began in 1993, as she finished her residency in obstetrics and gynaecology. At her first IDSOG meeting, she was struck by the work being conducted by leading researchers in the United States to advance women’s health, primarily in the area of preventing reproductive infections. Inspired, she subsequently entered a fellowship program in reproductive infectious diseases at the University of Washington under the supervision of Dr. David Eschenbach.
Upon completing her fellowship, Dr. Money returned to Vancouver as the first Canadian with this combined training, where she was met with uncertainty from her colleagues.
“I came back to Canada to work in the fall of ’94, and people went ‘What? OB/GYN infectious diseases? Really?’” she describes. “There was a lot of curiosity about this unusual area, but we finally managed to convince people that it was important – that infections in obstetrics were important, that infections in gynaecology were important, that infections in women through a public health perspective were important.”
Fast forward to 2006, and Dr. Money had established a reproductive infectious disease subspecialty fellowship at the University of British Columbia, and was settling into her role as Executive Director of the newly formed Women’s Health Research Institute. A few years later in 2010, she was invited to serve as President for IDSOG.
Historically, for this two year term, the President of IDSOG was expected to plan the annual scientific meetings, communicate with members, and act as the ‘face’ of the society. Dr. Money’s term would mark the first time a Canadian held the position.
Her excitement to hold this position, however, was quickly met with a series of obstacles, the first of which was the American economic crash.
“The large organization that had been managing the society, and staff there, had been taking care of the business side of the society,” she explains. Due to the impact of the crash, the organization announced with very little notice that they would no longer support IDSOG.
“Suddenly I was president of a society with no management, and found out that we were in financial crisis. So, I called on the support of the society’s executive, discussing via conference calls what we could do to solve a myriad of problems.” From her office in Vancouver, she was tasked with finding a way to manage and preserve a society on the brink of collapse.
“It was kind of one of those things where I said ‘Not on my watch!’” she recalls. “So, they literally mailed the boxes of all the documents for this society to the WHRI. We put them in one of the rooms, stacked high, and I seconded staff from the WHRI to rescue the society.”
With support from WHRI, a colleague at the University of British Columbia, an American tax lawyer, and determination to preserve IDSOG’s 43 year legacy, Dr. Money managed to turn the society’s fate around.
“We managed to hold the next meeting in Chicago as planned. It was a scientific and financial success, and then we held the 2012 meeting in Whistler. It was unbelievable. We had the society back in financial order, we had all of the management sorted, and I was able to hand off to the President Elect an intact, functioning society.”
This incredible feat may have been spearheaded by Dr. Money, but she’s quick to stress that WHRI played a pivotal role in saving IDSOG.
“It felt like WHRI was like the little engine that could,” she says. “Everybody just felt that it was important…it’s the only society dedicated to infectious diseases in women in North America, and so we all decided that it was worthwhile to resurrect it.”
Beyond these roles, Dr. Money has been a passionate leader for women’s health research across Canada. Since establishing the reproductive infectious disease fellowship, she has trained seven more fellows who are helping to pave the way for this important work throughout the provinces.
“We’ve been able to build, I think, a very successful and quite large research program, primarily in HIV and pregnancy and studying the different ways to safely prevent vertical transmission,” she says. The team also has “an entire body of work on the HPV vaccine and the elimination of cervical cancer,” which now also includes a series of projects led by Dr. Gina Ogilvie, Assistant Director of the WHRI.
“We’ve been working on the vaginal microbiome with other colleagues across the country, and that’s gone beyond OB/GYN infectious diseases to microbiologists and bioinformatics experts and social scientists, to create this huge multidisciplinary network across the country studying the vaginal microbiome.”
Throughout a career spent originating this body of research in the Canadian landscape, Dr. Money has received approximately $24M in peer-reviewed research awards to date. When asked what advice she would give to new and future researchers, she says that there are two important things that have contributed to her success.
“You ideally want to be working in an area you’re really passionate about, and that you think is really important. I fell in love with this area, and so even though it’s been hard work, it’s always been a passion of mine.
“The second piece is team. We have succeeded doing an extraordinary amount of work because of the kind of people I’ve been able to work with — lovely, wonderful people. My mentors in the United States…have continued to provide long-distance psychological support, and I launched a lot of our research with collaborative grants with them originally… Essentially everything has been about creating the right team. It’s been partly about people with the right expertise, but also partly people with the right compatibility.”
Dr. Money’s research and practice has had a tremendous impact on the lives of women in Canada, and contributes to a greater understanding of women’s reproductive health. She urges other researchers to continue in this field, and emphasizes that work in this area holds great relevance for the health of women around the world.
“Globally, the problems related to infectious diseases in women continue to be a significant cause of death and morbidity, and they’re old, old problems — they’re cancer, they’re peripartum infections – and we can solve them. But, it requires a concerted effort, and certainly here in BC we have an opportunity to demonstrate, in this sort of small living laboratory way, that we can do things like eliminate cervical cancer and then roll it out globally.”
The WHRI is proud to share a small part of Dr. Money’s legacy as IDSOG’s saviour and as a fierce women’s health champion, and would like to extend a very warm congratulations for this well-deserved award.
Jessica Liauw is a fellow in the Clinician Investigator Program at UBC, and an Obstetrician and Maternal Medicine specialist. Her clinical practice is focused on high-risk pregnancy, and her research interests are preterm birth, fetal growth, and clinical decision making.
She is currently working the #NavigatingTheGreyZone project, which aims to find ways to help pregnant women decide if they should take steroids to help their babies’ lungs when faced with the possibility of an early delivery.
Keep reading to learn more about Jessica and her work!
Briefly, can you describe your research project?
We are trying to find out what pregnant women and clinicians want to know when deciding whether or not antenatal corticosteroid medication should be used if she is at risk for delivering 4 to 6 weeks preterm. Our overall goal is to create a decision aid to help patients and clinicians make this treatment decision. In Phase 1 of the study, we will interview pregnant women, obstetricians, and pediatricians, to find out what to include in the decision aid. In Phase 2 of the study, we will draft the decision aid, and then ask pregnant women and clinicians to provide feedback on it.
What inspired this research?
Along with some members of the research team, I helped to update a recent clinical practice guideline on the topic of antenatal corticosteroids for preterm birth. From this experience, I became fascinated by the “grey zones” and controversies surrounding this treatment decision, especially for women who are at risk for delivering from 34 to 36 weeks of gestation. I realized that we need to find a way to help pregnant women and clinicians navigate the risks and benefits of this treatment to help patients make the decision that is right for them.
What impact do you hope this research will have on women’s health?
We hope this research will help us understand what pregnant women and their doctors need to help them improve decision making. Research in women’s health is always expanding, which is exciting but can also be overwhelming when trying to make the best decisions at the bedside. From this research, we hope to create an effective decision making tool that patients and clinicians can use together.
Anything else we should know?
We are looking for pregnant women, obstetricians, and pediatricians to interview for Phase 1 of this study. We need your opinions on what to include in a decision aid about antenatal corticosteroids after 34 weeks’ gestation – we just need 15 minutes of your time. If you are interested in participating please email us at firstname.lastname@example.org. Thank you!
In honour of International Midwives Day we’re shining the spotlight on Zoe Hodgson, PhD and Registered Midwife.
What are your research interests?
All families face many choices during their pregnancy, birth and postpartum period. Midwives recognise the childbearing client as the primary decision maker and help them make decisions within a context of informed choice. To enable this, a midwife will review the options with a client and discuss the evidence for and against a given procedure, treatment or course of action. However, the current problem faced by midwives is that there is often a dearth of literature on many of the choices available to clients today, meaning such informed choice discussions are based on anecdotal reports alone. This is especially the case when these options are alternatives to the standard practice. The overall aim of my research program is to build research capacity and create a culture of research among midwives in BC particularly in relation to the study of midwifery outcomes.
What inspired you to transition from your career as the Director of Women’s Research to catching babies as a midwife?
I always knew I wanted to be a careprovider. My role at the WHRI enabled me to become familiar with the maternity scene in BC. I was very fortunate to work with midwives, family doctors, nurses and obstetricians. Midwives have only been regulated and legally recognized as autonomous health care practitioners in BC since 1998. As such, midwifery in BC is still relatively new and has so much potential to grow! I saw midwifery as a career where I could both work as a clinician and academic and conduct research that really mattered to families. Not only this, but I was excited by the potential to narrow the gap between the acquisition of evidence and uptake into clinical practice. As a midwife, I can readily share new evidence with the families I care for.
What has been the most interesting part of your journey to midwifery?
What hasn’t?! I am constantly blown away by this profession, the care providers, the families, and how much midwives truly embrace informed choice and support their clients to have their best possible birth experience. When it comes to baby catching, there is never a dull moment! I truly believe I have the best job in the world.
How does your experience as a researcher influence your clinical work (and vice versa)?
Evidence-based practice is a key component of midwifery care. As midwives, we endeavour to provide our clients with the update to date evidence to allow them to make informed decisions. I feel very fortunate to be in the position to be able to use evidence in my daily practice and also be aware of the knowledge gaps and use these to fuel my program of research.
What’s a fun fact about you?
I am one of a team of midwives who is currently training for Tough Mudder in Whistler in June. I am yet to master the monkey bars!
Meet Dr. Vilte Barakauskas, BCCHRI/WHRI joint-researcher and clinical biochemist working at BC Children’s Hospital, who is part of a team working to establish reference intervals for pregnant women to better interpret lab test results.
Dr. Barakauskas works alongside a large team of people who obtain, process, and analyze specimens – like blood or tissue samples – in the department of Pathology and Laboratory Medicine at the BC Children’s and Women’s Hospitals campus. As a clinical biochemist she works closely with medical lab technologists, medical lab assistants (MLAs), and clinicians in a role focused on interpreting lab test results, to aid in accurate diagnoses and management of disorders and diseases.
In her day-to-day work, she is also involved with quality oversight in the lab to help ensure that they are producing reliable, accurate, and timely results, as well as providing consultation for healthcare providers and physicians. This might include assisting with test result interpretation by reviewing records, producing interpretive reports, evaluating test performance, or helping to find, select, or order and utilize appropriate tests. She is also involved with decisions around implementing new types of tests or developing tests when a need is identified.
In addition to her role in the lab, Dr. Barakauskas is helping to establish reference intervals for pregnant women around the time of labour through the Pregnancy Reference Intervals for Safe Medicine (PRISM) study. For the average person, lab results are interpreted by comparing against a set of reference intervals. These are a range of data compiled from ‘healthy individuals’ (commonly adults), which can help determine whether or not a patient’s test results are within a normal range, or if there might be a need for further investigation and testing.
However, for patients who belong to a population outside of the ‘average, healthy adult’, it becomes difficult to determine when there is a cause for concern. Dr. Barakauskas offers the example of pediatric medicine, where babies and kids are developing so quickly that it becomes harder to pinpoint what ‘normal’ should look like in test results.
Similarly, pregnancy is a time period during which physiology changes and test results might appear abnormal when compared with non-pregnant adults. Currently, there is little available information about reference intervals for this population, and less data directly applicable to our diverse population of women in British Columbia. Access to representative reference intervals is important because they help reduce the risk of under or over diagnoses and support appropriate patient care.
Creating reference intervals is a daunting task, Dr. Barakauskas explains, as it requires a lot of blood sampling and a lot of data. Further, she emphasizes the added difficulty of collecting specimens from ‘healthy’ populations, who are less likely to require bloodwork as part of their routine care, and thus volunteers for research participation and blood collection are required.
As a result, her team is conducting this research both through a recruitment process, where they seek out ‘healthy’ pregnant women to collect blood from, and through retrospective data analysis, where existing data is sorted using mathematical methods. While the study’s primary goal is to produce reference intervals and improve test interpretation, it will also allow the team to compare these two research methods for future development of reference intervals for other populations.
Dr. Barakauskas and her team have finished recruitment for the initial PRISM study of women around the time of labour, throughout which they had great collaboration across lab staff, nurses, and healthcare providers. They are currently starting sample and data analysis. She would like to acknowledge the mothers who participated, along with all the MLAs, lab technologists, nurses, students, BCCH Biobank and others who invested their time and hard work in the PRISM study and is grateful for the mentorship of co-investigators Dr. Wee-Shian Chan, Head of the Department of Medicine at BC Women’s Hospital, and Dr. Benjamin Jung, Clinical Biochemist, currently at SickKids. Together with Dr. Kate Chipperfield, Hematopathologist in the department of Pathology and Laboratory Medicine, Dr. Chan and an expanded team of clinician and patient collaborators, they will work to begin recruitment for the next iteration of PRISM which will look at blood from healthy mothers postpartum, as well as blood from their infants.
Members of the PRISM research team, and BC Children’s laboratory staff.
To learn more about PRISM click here. To read more about Dr. Barakauskas, click here.
Dr. Côté received the award for her project “The BCC3 cohort: Cellular aging in women living with HIV”.
In a few sentences, what is your research about?
My research focuses on the health of women living with HIV and their children. We are studying how the virus and the medications used to treat the infection affect cellular aging processes and their health over time. We are also asking how exposure to HIV and medications during pregnancy may affect mother and child in the short and long term.
What impact do you hope your research will have?
By understanding and teasing apart the effects of chronic viral infection(s), of various HIV medications, and other sources of stress on cellular aging, we hope to gain important knowledge on which medication may be safer for women, both before and during pregnancy, as well as later in life. We also want to identify the modifiable factors we should work on to promote healthy aging.
Are you using any innovative approaches in your research?
We seek to have a holistic approach to research. We consider not only the clinical and demographic factors that may affect markers of cellular aging but this recent grant, through a collaboration between two ongoing cohorts in BC (CARMA and CHIWOS), will also consider how other common chronic or latent viral infections (herpes virus, cytomegalovirus, etc.) and how psycho-social factors (mental health, stigma, etc.) may also affect cellular aging and comorbid diseases.
Dr. Renner received the grant for “The Canadian Surgical and Medical Abortion Provider Survey (CAPS)” project.
In a few sentences, what is your research about?
Our research is about exploring abortion provider characteristics and clinical practice in regards to first and second trimester medical and surgical abortion. This is a national survey, and we’re hoping to capture potential changes to the results of a similar survey conducted in 2012, since Mifepristone was introduced in Canada in 2015.
What impact do you hope your research will have?
This work will provide crucial evidence to inform health policy, system and service leaders and regulators charged with providing equitable, free-of-harassment, and high-quality nation-wide access to abortion services. These high impact decisions may result in: expansion of access to abortion care, in particular to women residing in rural and remote areas, credentialing of multidisciplinary providers, organization of services, update of guidelines, and creation of educational opportunities.
Are you using any innovative approaches in your research?
We aim to expand our sample framework compared to the previous 2012 survey in order to capture changes in abortion care workforce since the implementation of Mifepristone in 2015. That will probably be the biggest challenge – to have a very broad sampling framework to capture abortion providers that work in bigger clinics, solo providers, rural or urban providers – people who might not necessarily identify as an ‘abortion provider’, but provide services as part of their other clinical work.
In order to conduct the best possible survey with the most optimal sample framework we have built a large multidisciplinary research team including family planning experts from across the country. Our repeatedly CIHR funded Canadian family planning network (Contraception & Abortion Research Team, CART-GRAC) engages with the national health professional organizations for nurses (CNA), gynecologists (SOGC), and family physicians (CFPC), in addition to government leaders. Additionally, we paired more junior researchers, like me, with senior researchers, like Dr. Wendy Norman. This is a fantastic career development opportunity for me.
Dr. Regina Renner is a family planning specialist and Clinical Associate Professor in the UBC Department of Medicine, Division of Obstetrics and Gynecology. She has been a CART member since 2011 and is also the Co-director of the Family Planning Fellowship at UBC.