Michael Smith Health Research BC announced funding for 15 projects through its Health Professional-Investigator Program.
The Health Professional-Investigator Program helps close the gap between health research and its implementation. HP-I awards are dedicated to support health professionals who are actively involved in patient care to conduct and apply research relevant to health and/or the health system to ultimately improve health outcomes in BC and beyond.
The 2021 award competition invited a broad range of health professionals, and this year recipients included psychologists, psychiatric nurses, physicians and dieticians.
Thirteen researchers at UBC and affiliated health research institutions received funding through the program.
UBC Recipients
Paxton Bach
Physician (Department of Medicine)
Evaluating the use of prescription psychostimulants for the treatment of methamphetamine use disorder
Crystal meth is a powerful stimulant that is increasingly implicated in the ongoing overdose crisis in BC. Despite steadily increasing rates of crystal meth detection in overdose deaths, little is understood about the specific role that it may be playing in the overdose crisis, and treatment options for those suffering from crystal meth use disorder (MUD) are limited.
One class of medications that has previously shown some promise in the treatment of MUD are prescription stimulants such as those used to treat ADHD. While research in this area remains inconclusive, there is some suggestion that these medications may play a helpful role in the treatment of MUD, especially among patients with an overlapping diagnosis of opioid use disorder.
This proposal will employ a variety of research methodologies to explore two related questions: (1) Can we identify patients who use crystal meth and opioids that are at particularly high risk of overdose, and (2) Are prescription stimulants a helpful tool in the treatment of MUD in a population of patients who use opioids? These results will have significant implications for both healthcare providers and those suffering from MUD, at a time where new tools are sorely needed.
Host Institution: UBC
Research Location: BCCSU
Nichole Fairbrother
Registered Psychologist (Department of Psychiatry)
Perinatal Anxiety Screening Study
Anxiety disorders are the most common of all mental health conditions. They affect 20% of pregnant and postpartum people, and are associated with significant distress and life interference for sufferers, as well as negative consequences for the fetus and infant.
Little, if any, routine screening for these disorders is conducted. This is mostly because accurate screening tools have yet to be identified. The majority of screening studies have used poor quality research methodology or have assessed measures which appeared to perform too poorly to be recommended for widespread use. The result of this is that perinatal anxiety disorders often go unidentified, resulting in continued suffering and life impairment.
The purpose of this research is to identify one or more accurate and reliable perinatal anxiety disorder screening tool(s). To do this, we will conduct a large scale study of pregnant and postpartum people in which we assess the accuracy of the most promising perinatal anxiety disorder screening tools.
This research will provide important information to inform healthcare providers, policymakers and scientists, about the most effective approach to screening for anxiety disorders during pregnancy and the postpartum period.
Host Institution: UBC
Research Location: VIHA, WHRI
Ryan Flannigan
Physician (Department of Urologic Sciences)
Leveraging Computational Modelling and 3-D Bioprinting in Pursuit of a Regenerative Therapeutic Approach for Male Infertility
A desperate need exists to develop technology to regenerate sperm that can be used for in vitro fertilization (IVF) among men who lack sperm production, such as pediatric cancer survivors. In Canada, approximately 2440 boys aged less than 15 will be diagnosed with cancer each year. Fortunately, the field of oncology has made significant improvements in survival rates, which are estimated to be 83%. However, treatments will render up to 97% of paediatric cancer survivors infertile with no sperm production, despite over 75% eventually desiring to have biological children. While stem cells (sperm precursors) can be retrieved prior to cancer therapies, no technology currently exists to regenerate sperm, which is required to achieve a pregnancy. This project proposes to utilize single cell sequencing and along with state-of-the-art computational modelling to reveal molecules and pathways that are key regulators of developing sperm from stem cells. These findings will be screened and tested to identify critical molecules that help generate sperm in 3D bioprinted structures. Results from this study will contribute to developing the understanding and technology to regenerate sperm for men lacking any ability to father biological children.
Host Institution: UBC
Research Location: VPC, VCHRI
Alana Flexman
Physician (Department of Anesthesiology, Pharmacology and Therapeutics)
Perioperative Stroke Screening and Outcomes in High-Risk Surgical Patients
Up to 2% of patients will experience a stroke during or after surgery and these patients have a high chance of disability and death. Currently, we don’t understand clearly how to prevent, detect, and treat stroke after surgery. Although risk factors have been identified including older age and cardiac surgery, high risk surgical patients are not usually identified and strokes can be missed, leading to fewer treatment options and more complications. My previous pilot study showed that anesthesia and surgery can limit the accuracy of standard screening tools for stroke. We urgently needed a screening tool and protocol specifically for surgical patients. We also don’t understand well how patients recover after perioperative stroke, such as which patients survive, and whether they can stay in their homes. Building on our prior research, this multiphase study aims to: (1)Understanding which patients do poorly after perioperative stroke and whether those factors can be changed; (2)Compare mortality and other complications after stroke between those who had recent surgery and those who did not; and (3)Identify a useful perioperative stroke screening tool to quickly and accurately detect stroke after surgery.
Host Institution: UBC
Research Location: PHC
Jonathan Troy Grennan
Physician (Department of Medicine)
The DISCO Study: Rethinking STI Prevention
Syphilis, chlamydia and gonorrhea are three of the most common sexually transmitted infections (STI). Over the last decade, these STIs have seen a resurgence in many parts of Canada, with most infections seen in major urban centres. These infections have primarily affected gay, bisexual, and other men who have sex with men (gbMSM). Recently, a small pilot study found that doxycycline – an inexpensive, well-tolerated antibiotic – given daily may prevent new STIs in gbMSM. Another study looked at the use of doxycycline given after a sexual encounter for prevention of STIs, and the results of this study showed protection against STIs as well. Based on these promising data, along with the concerning increases in STIs seen in Canada, the current study will examine the use of doxycycline as either a daily prevention therapy (preexposure prophylaxis, or PrEP) or an 'after sex' prevention tool (postexposure prophylaxis, or PEP) for STIs in gbMSM. While examining for efficacy as its primary goal, this study will also do an examination of some of the potential challenges and concerns associated with the use of a daily antibiotic: drug resistance, tolerability and side effects, and how acceptable this drug is for people to take regularly.
Host Institution: UBC
Research Location: UBC
Maria Hubinette
Physician (Department of Family Practice)
Exploring the experiences of racialized learners to understand and dismantle racist structures in our healthcare system
Racism is experienced by learners, professionals, and patients in our healthcare system and contributes to well-documented health inequities. However, patient care and health outcomes are improved through a diverse physician workforce. Medical schools have attempted to support diversity through the admissions process, including increased racial diversity in their programs. Yet we know little about the experiences of racialized learners once admitted. This study will explore the impact of existing policies, processes and practices on learners' sense of agency, attending to their perspectives on how their experiences of racism impact patient care.
This study focuses on racialized learners’ experiences in their clinical education over time through the use of diaries and interviews. Engaging with learners across four medical schools, we will attend to the impact of important differences in their identities such as race, gender, and sexual orientation.
Through this study, we will identify concrete ways in which our healthcare (and clinical education) systems perpetuate racism. From this, I will work with clinicians, educators and policy makers to enact systems changes that will ultimately reduce health inequities.
Host Institution: UBC
Research Location: UBC Vancouver
Matthew Kadatz
Physician (Division of Nephrology)
Economic evaluation of the use of expanded criteria donor kidneys pre-emptively to improve the critical organ shortage
Kidney transplantation can be life saving for people with end-stage kidney disease at a lower cost than the only other alternative which is dialysis treatments. Unfortunately, there are not enough kidneys available for transplant. This means that until we can improve the kidney supply, patients will continue to have to wait on a waiting list and may die in the process.
Kidneys from older donors have been successfully used for transplant, but at a higher risk. This higher risk discourages some patients and physicians from accepting these kidneys for transplant. This results in kidneys being discarded that could otherwise have saved lives.
However, these kidneys will have better outcomes if they are given to patients before they ever need to start dialysis, instead of our current practice which is to wait until someone is at the top of the waitlist after years of dialysis. This research project will use economic models to study how allocating kidneys from older donors to some patients before they ever need dialysis might impact the overall kidney supply and patient outcomes. This research will help inform future health care policy which may improve organ supply for patients waiting for a life-saving transplant.
Host Institution: UBC
Research Location: VCH
Florian Kuchenbauer
Physician (Division of Hematology)
Exploring oxidative phosphorylation as therapeutic vulnerability in high risk acute myeloid leukemia
The standard of care for AML patients was introduced in the 1970s and has not significantly changed since then. Patients suffering from acute myeloid leukemia (AML) with unfavourable genetics are characterized by dismal overall survival due to poor treatment response to standard chemotherapy. In this research proposal, I aim to better understand the energy metabolism of high-risk AML cells and explore this as a novel treatment avenue. My research will create a rational for future clinical trials to improve patient care and develop novel treatment perspectives for a patient collective with a bleak prognosis.
Host institution: BC Cancer - Vancouver
Research location: BC Cancer - Vancouver
Jessica Liauw
Physician (Department of Obstetrics & Gynaecology)
Improving clinical practice guidelines for antenatal corticosteroids: Incorporating a decision support tool to impact clinical counselling
Antenatal corticosteroids are a medication given to women who are at risk of an early delivery to reduce the chance of breathing problems for their baby after birth. Current guidelines recommend giving antenatal corticosteroids to pregnant women who might have their baby before 34 weeks of pregnancy. This medication may also help those at risk of an early delivery at 34-36 weeks of pregnancy but the balance between the benefits and harms of this treatment is less clear at these ages. Guidelines for giving this medication at 34-36 weeks of pregnancy are also unclear, making it difficult for doctors and patients to decide whether to use it. We will find out if including a decision support tool in clinical guidelines will improve how doctors discuss antenatal corticosteroids with patients at 34-36 weeks of pregnancy. We will ask patients whether they had better discussions with their doctor about this treatment after their doctor had access to the decision support tool within the clinical guideline, and we will ask doctors how this decision support tool impacted their counselling. This project could improve communication between doctors and patients, especially when it is unclear whether a treatment’s benefits outweigh its harms.
Host institution: Provincial Health Services Authority
Research location: BC Children's Hospital Research Institute
Nitasha Puri
Physician (Department of Family Practice)
Design and pilot of a culturally resonant intervention to treat substance use disorder among South Asian men
Substance use disorder is a growing problem affecting racialized men in Canada. There is increased awareness and understanding about why and how racialized men use substances, yet little is known about effective treatments and interventions. The project will use anti-racist research methods to design and study an intervention to support a racialized group, South Asian men who use substances. The team will consist of Punjabi men who use substances, community organization members, health care providers, and researchers. Using a rigorous facilitated approach that highlights evidence from literature and draws upon members’ life experiences, the team will design an intervention to support South Asian men who use substances in the Lower Mainland. Once the design is complete, the intervention will be studied in a feasibility study and pilot randomized controlled trial (RCT) in preparation and justification for a full scale RCT.
Host institution: Fraser Health
Research location: Fraser Health
Jonathan Rayment
Physician (Department of Pediatrics)
Advanced pulmonary diagnostics in paediatric respiratory medicine: from technical development to clinical implementation
Chronic lung diseases present a serious health challenge for Canadian children and youth. For example, cystic fibrosis (CF) shortens life expectancy and carries an enormous treatment cost (>$250,000 per person per year). Another example is asthma, which affects nearly 1 in 7 Canadians under age 20. Improving the lives of people with these conditions is possible but requires accurate detection and close monitoring of their lung disease.
Unfortunately, the tests available to paediatric respiratory physicians are often difficult for children to perform and not sensitive enough to detect or subtle disease. This significantly limits physicians’ ability to detect, treat and monitor lung disease in children and must change.
My research program focuses on the development of easy-to-perform and sensitive tools to help physicians diagnose and monitor lung disease in children. Specifically, I am an expert in techniques known as hyperpolarised xenon lung MRI (XeMRI) and multiple breath washout testing (MBW).
During tenure of this MSFHR Health Professional-Investigator award, I will lead research focused on improving the XeMRI and MBW techniques and using these new tools clinically to improve the health of children with lung diseases.
Host Institution: UBC
Research Location: BCCHRI
Tricia Tang
Registered Psychologist (Division of Endocrinology)
Evaluating a virtual care platform (REACHOUT) that delivers peer-led mental health support to adults with type 1 diabetes in rural and remote communities in British Columbia.
Mental health is often overlooked in diabetes care. In fact, BC’s provincial health plan does not cover psychological services for patients with chronic illness. Studies have found that, of psychological stressors, diabetes distress (DD) is the most closely associated with poor blood sugar control and worse health consequences. DD refers to the unique and often hidden emotional burdens, and relentless frustrations and worries that patients experience when trying to manage this condition. In 2027, almost 35,000 British Columbians diagnosed with type 1 diabetes (T1D) will report clinically significant levels of DD. Unfortunately, T1D adults living in rural and remote regions will have the least access to mental health services. I seek to address three major gaps in BC’s diabetes care: the availability, affordability, and accessibility of mental health support for T1D patients living in settings with limited resources. In collaboration with T1D patients, clinical psychologists, digital health specialists, and biomedical engineers, I will use digital health strategies to “drive” a peer-led mental health support intervention (REACHOUT) to adults with T1D living in geographically isolated communities.
Host Institution: UBC
Research Location: UBC Division of Endocrinology
Ivan Torres
Registered Psychologist (Department of Psychiatry)
Neuropsychological Functioning in Treatment Resistant Schizophrenia
Schizophrenia is a severe and disabling psychiatric illness involving primary symptoms of psychosis (hallucinations, delusions, disordered thinking and behavior). Unfortunately, as many as 30% of patients respond poorly to standard antipsychotic medications and are considered to have treatment resistant schizophrenia (TRS). Neuropsychological impairment is an important clinical feature of schizophrenia, as cognitive deficits predict poor treatment response, daily functioning, and disability. However, very little is known about cognitive functioning in the clinically complex subset of patients with TRS. The aims of this project are therefore to investigate the severity, pattern, and variation in cognitive functioning among individuals with TRS, and to determine whether cognitive difficulties predict treatment response and functioning. This will be achieved by analyzing clinical and neuropsychological data that has been collected on TRS patients who have been treated within the BC Psychosis Program since 2012. Findings using this unique dataset will have a direct impact on shaping assessment and treatment strategies, improving prognosis and ability to predict functioning, and improving clinical decision-making and planning.
Host Institution: UBC
Research Location: UBC