#ItsNotInYourHead is a campaign launched by Dr. Lori Brotto and the Women’s Health Research Institute to raise awareness about provoked vestibulodynia (PVD) and evidence-based psychological interventions for improving pain management.

PVD is pain experienced when contact is made with the area near the entrance to the vagina, known as the vulvar vestibule. This pain often occurs during sexual activity, but it can also be triggered by clothing, inserting tampons, pap tests, sitting, or any other touching sensations.  Many women are unable to receive an accurate diagnosis since there are no visible indicators that something is wrong in an exam. This can lead to frustration, hopelessness, and feelings of isolation as patients are led to believe that their pain is “all in their head”.

Dr. Brotto conducted research at the University of British Columbia with two groups of women living with PVD, treating one with mindfulness-based therapy, and the other with cognitive behavioural therapy.  Both groups of women saw improvement in their ability to manage pain.

The #ItsNotInYourHead campaign launched October 6th, 2017 with a short video describing the condition and letting women know that their pain is real.  To follow the campaign, follow @NotInYourHead17 on Twitter and Facebook. You can join the conversation about provoked vestibulodynia using the hashtags #ItsNotInYourHead and #PVD.

CARMA 7: Bone and Renal Outcomes in HIV-Exposed, Uninfected Infants with Perinatal Exposure to Tenofovir

The purpose of CARMA 7 is to investigate how fetal exposure to the anti-HIV medication Tenofovir may affect the bone and kidney health of infants who are born to HIV+ women.

Principle Investigator: Dr. Ariane Alimenti

Primary Contract: Evelyn Maan, Research Manager, 604-875-2000 ext. 2463, emaan@cw.bc.ca

About the Study: Anti-HIV medication has reduced the risk of HIV transmission from mother to child from 25% to less than 1%. However, the effects of some of these anti-HIV medications on the developing fetus have not yet been thoroughly studied. One medication in particular, called “Tenofovir”, can cause some bone and kidney problems for HIV+ adults when taken for a long time, especially with existing bone and kidney diseases. The purpose of CARMA 7 is to investigate how fetal exposure to Tenofovir may affect the bone and kidney health of infants who are born to HIV+ women.

Why is this research important? The use of Tenofovir is becoming far more common in anti-HIV medication regimens because it is so well tolerated. As a result, an increasing number of women are getting pregnant while taking this particular medication (almost 25% of HIV+ pregnancies in BC in 2011). Accordingly, it is very important for the current and future health of infants born to HIV+ women to study the effects of this anti-HIV medication.

Study Status: Recruiting

Who can participate:  Infants who do not have HIV, born at term (>35 weeks +2 days) to an HIV+ mother who took anti-HIV medication during her pregnancy, specifically Tenofovir, Abacavir, or Zidovudine (the last two for the control group).  Infants have visits for the CARMA-7 study at 1 month, 6 months, and 18 months of age.

Co-Investigators: Dr. Helene Cote, Dr. Deborah Money, Dr. Laura Sauve, Dr. Jason Brophy

Funded by: CIHR, Canadian HIV Trials Network

CARMA 7 Participant Consent Form

Personalized Contraception for Canadians – Decision analytic modelling to support women-centered choices

Personalized Contraception for Canadians- Decision analytic modelling to support women-centered choices

Principal Investigator: Dr. Flora Teng

Primary Contact: Weihong Chen, Research Coordinator, 604-875-2424 x 4894, Weihong.chen@ubc.ca

About the study: This study will develop and pilot test a Canadian woman-centered contraception decision-making mobile application. This app will be “effectiveness-based” and will incorporate factors women consider important when choosing a contraceptive. Mixed methods will be used including focus groups and interviews to select design elements and feature priorities and to inform iterative pilot testing and improvement cycles of the application. Operations Research methods will be utilized to design decision pathways, and software engineering will be used to enhance usability and human-computer interaction.

Why is this research important? This study aims to enable women to make contraceptive choices that are highly effective and optimal fit to personal preferences. Therefore, they will be able to continue their chosen method, achieve their reproductive goals, and minimize risk of unintended pregnancy.

Study status: We have conducted several focus groups to understand the most important and relevant decision criteria in choosing contraception from the perspective of Canadian women. This qualitative data is being analyzed and will be used to create a survey that will specifically rank the contraception priorities of women. The survey will be pilot tested with 120-150 women aged 14-49. Results of the survey will be translated into the Decision-Making model to build the electronic application.

Co-Investigators: Wendy Norman, Saied Samiedaluie, Tymarah Colewah

Funded by: Women’s Health Research Institute

MIST (Mindfulness, Incontinence and Sexual function Treatment) Study Research Proposal for a Pilot Study

MIST (Mindfulness, Incontinence and Sexual function Treatment) Study Research Proposal for a Pilot Study

Principal Investigators: Dr. Maryse Larouche/Dr. Geoffrey Cundiff

Primary Contact: Nicole Koenig, Research Coordinator, 604-806-9829, nkoenig@providencehealth.bc.ca

About the study: This study aims to determine if there is an impact on sexual distress using mindfulness-based sex therapy (MBST) in addition to standard urogynecologic care, in women with both urinary incontinence (UI) and sexual dysfunction.

Why is this research important? Urinary Incontinence is prevalent among women and has a significant impact on physical, emotional and mental well-being, including distressing effects on sexual health. Poor sexual health has been associated with lower health related quality of life, and depressed mood. Given the impact that sexual function can have, it is of utmost importance that research in this area is expanded. Mindfulness-based therapy has been used successfully to treat women with sexual dysfunctions. Our pilot study will be the first step in determining its role in women with Urinary incontinence and sexual dysfunction.

Study status: Currently the research study is obtaining ethics approval with recruitment starting upon research ethics approval.

Who can participate: Patients (Women 19 years of age and older) who attend the Centre for Pelvic Floor at St. Paul’s Hospital and present with both urinary incontinence and sexual dysfunction.

Co-Investigators: Dr. Lori Brotto, Dr. Roxana Geoffrion

Funded by: Sexual Medicine Society of North America

Mifepristone Implementation Research in Canada

Mifepristone implementation research in Canada – The CART-Mife Study

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.

Study status: In preparation for participant recruitment and data collection.

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

Canadian Sexual Health Survey Study

Canadian Sexual Health Survey Study

Principal Investigators: Dr. Wendy Norman, Dr. Stirling Bryan

Primary Contact: Eva McMillan, Research Coordinator, 604-875-2424 x 4871, eva.mcmillan@ubc.ca

About the study: This study developed and validated the Canadian Sexual Health Survey (CSHS) that aimed to collect data on sexual and reproductive health among women aged 14-49 years throughout BC. The survey was then administered door-to door by trained health professional surveyors, who finished 1677 surveys in total, within 21 Local Health Authorities, across all five Regional Health Authorities.

Why is this research important? Data collected through the Canadian Sexual Health Survey will be used to develop Canada’s first contraception Cost-effectiveness Model.  This model will be used to create decision-making tools capable of supporting evidence-informed policies for optimal health system strategies, such as the potential for universal subsidy of contraception, in BC and for adaptation to other Canadian provinces, territories and federal health jurisdictions.

Study status: Survey administration and data collection were completed in Fall 2015. The research team is cleaning the survey data and will conduct data analysis to help build the cost-effectiveness model and answer research questions.

Co-Investigators: Drs. Perry Kendall, Rollin Brant, Janusz Kaczorowski, Steven Shechter, Saied Samiedaluie, Gina Ogilvie, Jean Shoveller, and Sheila Dunn.

Funded by: Canadian Institutes of Health Research

Partners: Michael Smith Foundation for Health Research; BC Women’s Hospital.

Better Contraceptive Choices: Insertion timing and effectiveness of intrauterine and other contraceptive methods post-abortion

Better Contraceptive Choices: Insertion timing and effectiveness of intrauterine and other contraceptive methods post-abortion

Principal Investigator: Dr. Wendy Norman

Primary Contact: Weihong Chen, Research Coordinator, 604-875-2424 x 4894, Weihong.chen@ubc.ca

About the study: This project includes two randomized controlled trials:  1) Immediate vs. delayed insertion of intrauterine contraception after second trimester abortion; and, 2) Is FlexiT non-inferior to NovaT when inserted immediately after first-trimester abortion?  Comparing the effectiveness of copper intrauterine devices available in Canada. BC has a higher rate of abortion per thousand women of reproductive age than any Canadian province other than Quebec. We seek to find the most effective method to prevent unintended pregnancies among women seeking abortion in British Columbia. We hope to see that the interventions investigated in the project, such as inserting the IUC immediately after the second trimester abortion compared to the standard practice that delays the insertion to 4-6 weeks post abortion, will result in fewer unintended pregnancies.

Why is this research important? This research should produce compelling evidence of the highest scientific quality, permitting a change to the current device indication for world-wide use. We aim for international improvement in the delivery of highly effective long lasting contraception following both first and second trimester abortion.

Study Status: The uniqueness of this research project is that we have obtained consent from the participants to link the study data to the provincial health administrative data. This allows the team to have a close to 100% follow-up rate of the study outcomes for almost all the participants. The team has been busy analyzing the data and writing the manuscripts for publication.

Co-Investigators: Study 1: Janusz Kaczorowski, Judith Soon, Stirling Bryan, Rollin Brant, Lyda Dicus, Konia Trouton; Study 2: Jessica Chiles , Caroline Turner.

Funded by: Study 1: Canadian Institutes of Health Research; Study 2: Society of Family Planning.

Partners: BC Women’s Hospital + Health Centre

Study Documents:

Published Study 1 Protocol: http://www.ncbi.nlm.nih.gov/pubmed/21672213

Published Study 2 Protocol: http://www.ncbi.nlm.nih.gov/pubmed/22920273

Attitudes and intentions to receive medical and surgical abortions among women seeking pregnancy termination

Principal Investigator: Dr. Brian Fitzsimmons

Primary Contact: Nicole Prestley, Research Manager, 604-875-2424 ext 4956, Nicole.Prestley@cw.bc.ca 

About the study: Health Canada has recently approved Mifegymiso, a medication which is used around the world for medical termination of pregnancy. In order to understand how the use of this medication will impact Canadian women, WHRI is leading a study to learn how women feel about this method and whether or not they are interested in its use.

Why is this research important? Medical abortion has the potential to increase access to abortion services for women who live in rural and remote locations across the province. Additionally, as the CARE program is one of the first sites in Canada to offer this option, this research will help inform other Canadian sites that may also choose to provide this method.

Study status: Recruiting

Who can participated? Women who are seeking pregnancy termination at the CARE program are invited to participate.

Co-Investigators: Dr. Gina Ogilvie, Dr. Heather Armstrong, Caitlin Johnston, Nicole Prestley