Research Spotlight: Kingston Health Sciences Centre

Kingston Health Sciences researchers tackling health equity issues world-wide

Four Kingston Health Sciences Centre researchers are combining their experience with disadvantaged populations, their relationships with institutions on three continents, and a novel approach to evidence-gathering to tackle health equity issues world-wide.

ARCH, a research collaborative for global health equity, grew out of the diverse yet complementary research interests of Kingston General Health Research Institute and Queen’s University researchers Drs. Heather Aldersey (Rehabilitation Therapy), Susan Bartels (Emergency Medicine), Colleen Davison (Public Health Sciences) and Eva Purkey (Family Medicine).

“Global health isn’t just international,” explains Dr. Davison, “it’s about advantage and disadvantage, and unequal access, and working at the structural and community level on things that can benefit the vulnerable in Canada, and around the world.”

In March, the ARCH group was awarded $449,000 from the Queen Elizabeth II Scholars Program (QES) to establish The Queen Elizabeth Scholars Network for Equity in Maternal and Child Health.

“The most vulnerable mothers and children are rarely prioritized in health research or health policy, especially outside the immediate delivery and neonatal period,” Dr. Purkey says. The network aims to address the inequities in access to health services in low- and middle-income countries, where six million children die before the age of five, and where maternal death rates are still 14 times higher than in developed regions.

To do this, the project will support the research, learning and advocacy skills of 17 PhD, postdoctoral and early career researchers from the University of Kinshasa (Democratic Republic of Congo), Institute of Social work and Social Science (Haiti), the Mongolian National University of Medical Sciences (Ulaanbaatar, Mongolia), and Queen’s University (Kingston). The trainees will take part in international exchanges to conduct research and community outreach aimed at understanding and reducing disparities in maternal and child health.

“We want to develop engaged, ethical and innovative global health researchers who can advocate for these vulnerable populations, and address these real-world issues,” says Dr. Aldersey.

To build their collective experience, the group will also contribute to a common, multi-country study looking at the factors that contribute to maternal and child health inequities. This research has the potential to be boundary-breaking through its use of SenseMaker®, an innovative data-collection tool for mobile phones and tablets.

“It’s an efficient tool that enables us to get a quick picture of people’s experiences and perceptions,” says Bartels, who recently led a team using the tool to study child marriage in Syrian refugee camps across Lebanon. “It allows people to tell their stories without feeling judged or guilty, and then use the tool to interpret their stories for us without the filter of our own biases.” (Using SenseMaker, the researchers captured 1400 stories from Syrian refugees in hard-to-reach places in just eight weeks.)

Algorithms within the tool enable both qualitative and quantitative analysis of these anonymous stories, providing researchers with data patterns and contextual factors to capture common themes and identify inequities, quickly, so that researchers can go back to the communities within weeks or a few months to gain further information and begin to find solutions to these problems.

“QES is just the beginning for ARCH,” say the four researchers. “We’ll be seeking other funding opportunities to continue this kind of research.”

 

Related Stories:

 

Kingston Health Sciences Centre is one of Ontario’s 23 research hospitals that contribute to a healthier, wealthier, smarter province. Read more Research Spotlight posts on our Healthier, Wealthier, Smarter blog or join the conversation about why health research matters for Ontario on Twitter, using the hashtag #onHWS.

HWS Field Trips: Holland Bloorview Kids Rehabilitation Hospital

Research hospitals play a leading role in making Ontario healthier, wealthier, and smarter. To demonstrate the world-class hospital-based research happening across our province, we took a field trip to Holland Bloorview’s research institute, where researchers are creating a world of possibility for kids and youth with disability and their families.

This blog post highlights only a fraction of the research we learned about on our field trip – but we also live tweeted every minute! To take the full live-tweeted tour, scroll through our Storify story here.

Patient Engaged Research

We kicked off our tour by meeting with Suzanne Jorisch, a family leader on the hospital’s Research Family Engagement Committee (RFEC) who is also a long-time health research champion. Suzanne’s son Wesley first came to Holland Bloorview in 2010 with a brain injury. It wasn’t long before Suzanne and Wesley started getting involved in research projects underway at Holland Bloorview. “They started performing miracles,” said Suzanne, “and their research has given me tremendous hope that my son will have new opportunities for his future.”

Since then, Suzanne has become a strong voice for the value of paediatric research at Holland Bloorview’s research institute – and a champion for partnership with patients, families and caregivers. Together with hospital leaders like Lori Beesley, a family-centred care specialist, she is working to support standards and processes for meaningful family-researcher partnerships.

“Patient engagement isn’t something that can be done off the side of your desk,” said Lori. “We need to embed it into our research culture and process.” In her over 20 years of navigating the Canadian developmental and disability health sector, Lori has fostered numerous partnerships between clients, families, and staff, using the principles of client and family-centred care. She also cared for her son Mitchell who has Fragile X Syndrome. At Holland Bloorview, Lori leads both the Family Leadership Program and RFEC. “The Research Family Engagement Committee is not only leading patient and family engagement in research at Holland Bloorview, but it’s creating best practices for organizations around the world.”

Research Family Engagement Committee Holland Bloorview
 “At Holland Bloorview, they don’t look through you, they look with you,” said Suzanne Jorisch of her experience being involved in research at Holland Bloorview. L-R: Karen Michell, Executive Director, CAHO, Suzanne Jorisch, Family Leader, Lori Beesley, Family-Centred Care Specialist.

STOP 1: PEARL and PROPEL labs

Making therapy fun: Our next stop focused on innovative solutions that improve mobility for kids with disabilities. We met Ajmal Khan and Alexander Hodge, two members of the PEARL (Possibility Engineering and Research lab) team who work with Dr. Elaine Biddiss to develop mixed reality therapy games and interactive play spaces that are accessible to young people of all abilities. Immersive and interactive mixed reality games like Botley’s Bootle Blast help to make reaching rehabilitation therapy goals fun. For example, one game might help to strengthen shoulder mobility, while another might focus on strengthening fine motor skills. And as a bonus, the games can be played at home with friends!

Botley's Bootle Blast at Holland Bloorview
L-R: Ajmal Khan, Research Manager, and Alexander Hodge, Game Developer, introduce Botley’s Bootle Blast, a mixed reality therapy game.

Ontario-grown innovation: Dr. Jan Andrysek and his team at the PROPEL lab (Paediatrics, Rehabilitation, Orthotics, Prosthetics, Engineering, Locomotion) developed and commercialized the All-Terrain Knee (AT-Knee). It’s a low-cost, high-functioning mechanical knee that’s already being sold in 21 countries by social enterprise, LegWorks. Post-doctoral student, Matt Leineweber explained that, compared to standard prosthetics, patients using the AT-Knee expend 40% less energy and have reported a reduced number of falls. The AT-Knee is a great example of how health research helps fuel our innovation economy and improve quality of life for patients in Ontario and beyond.

LegWorks AT-Knee demo at PROPEL lab at Holland Bloorview
L-R: Sam Shi, Masters Student, and Matt Leineweber, Postdoctoral Fellow, demo some of the innovations from the PROPEL lab

 STOP 2: ProFILE lab

Addressing weighty topics: Weight-related issues can be challenging for people to discuss openly with their doctors. It can be uncomfortable and emotional – especially when you’re managing other conditions. For children with disabilities, conversations about nutrition, physical activity and weight are important for maintaining a high quality of life. Interim vice president of research and scientist, Dr. Amy McPherson, and her team at the ProFILE lab (Promoting Fitness and Healthy Lifestyles for Everyone) are looking at how to better approach these tough conversations, so that kids, families and care providers can comfortably discuss how to best manage a healthy lifestyle.

Some evidence-based lessons gathered from the team’s research:

  • Start conversations early and discuss regularly
  • Include the right people in the conversation – kids, families or caregivers, care providers and others who may be relevant
  • Communicate trust and respect with active listening, open questions and a collaborative attitude

 Weight research at Holland BloorviewWeight research at Holland Bloorview 
L-R: Laura Hartman, Postdoctoral Fellow and Christine Provvidenza, Knowledge Translation Specialist, highlight their findings on fostering positive weight-related conversations between kids, families and care providers.

Read more from Dr. McPherson on healthy choices for kids with disabilities in Canadian Living.

STOP 3:  PRISM lab

A philosophy of strengths-based innovation: Researchers at the PRISM (Paediatric Rehabilitation Intelligent Systems Multidisciplinary) lab discover and evaluate innovative technology solutions that help kids with severe disabilities communicate and interact with the world around them. A guiding principle of their research is to let innovation start from a child’s strengths and asking how those strengths can be augmented to give the child a voice.

Fanny Hotze, Paediatric Assistive Technology Specialist, shows us how the Hummer works Alborz Rezazadeh and Rozhin Yousefi demonstrate EEG-based brain-computer interface technology.
L-R: Fanny Hotze, Paediatric Assistive Technology Specialist, shows us how the Hummer works /// PhD students Alborz Rezazadeh and Rozhin Yousefi demonstrate EEG-based brain-computer interface technology. 

The vocal cord vibration switch, also known as the Hummer, is a great example of this principle. It harnesses a non-verbal child’s ability to hum by translating vocal cord vibrations into binary control signals for computer-supported communication.

For other children, researchers are developing brain-computer interfaces that identify and communicate thoughts and intentions. PhD students Alborz Rezazadeh and Rozhin Yousef gave a live demonstration of how one such brain-computer interface can allow child with complex disabilities to interact with the world around them. By focusing his attention on a series of images on the computer screen, he gave commands that turned on lights, fans, music and more.

ScreenPlay Pit Stop!

In general, hospital waiting rooms can be a stressful experience for children and their families. Holland Bloorview has created the ScreenPlay – an interactive waiting room that is proven to reduce waiting room anxiety. Developed by scientist Dr. Elaine Biddiss and the PEARL lab team, ScreenPlay heralds the high-tech waiting room of the future.


Holland Bloorview’s President and CEO, Julia Hanigsberg, shows us how kids can generate, grow and shift colourful images on-screen when they step or wheel across the pressure-sensitive tiles.

STOP 4: Autism Research Centre

Self-managing anxiety: The Autism Research Centre (ARC) conducts research aimed at improving outcomes and quality of life for children with autism spectrum disorders (ASD) and their families. A highly diverse team (its expertise spans neurology, developmental pediatrics, psychology, psychometry, engineering, occupational therapy, speech and language pathology, and nursing) focuses on understanding the biology and symptoms of autism, developing novel interventions and investigating service delivery models.

Now in early commercialization stages, the Anxiety Meter is one such intervention, developed by scientists Drs. Azadeh Kushki and Evdokia Anagnostou. The app is designed to help kids with ASD better manage their anxiety by measuring their heart rate and converting it into a visual representation on a tablet and/or watch through the Anxiety Meter app.

Dr. Kushki and Stephanie Chow, Research Assistant at Holland Bloorview Autism Research Centre
“Kids with autism often don’t realize that they’re anxious,” explains Dr. Azadeh Kushki, scientist at the Autism Research Centre. “By helping them identify their anxiety, we can help them manage it.” (L-R, Dr. Kushki and Stephanie Chow, Research Assistant)

The Holli glasses are another example of cutting-edge innovation. They glasses interact with Google Glass technology to provide prompts and cues during social interaction, like ordering food in a restaurant. It holds the potential to complement traditional therapy and provide coaching over the long term.

Holli Glasses at Holland Bloorview Autism Research CentreHolli Glasses at Holland Bloorview Autism Research Centre
Harnessing Google Glass technology, the wearer sees prompts and responses on a tiny screen in the right corner of the glasses that aim to reduce anxiety and provide coaching during social interactions.

Read more about the Anxiety Meter, Holli and autism research at the Bloorview Research Institute in Today’s Parent.

STOP 5: Evidence to Care

Putting knowledge into practice: Using evidence-informed care is an expectation of all health care professionals in leading academic health sciences centers around the world, but it isn’t always easy to ensure that knowledge translation happens consistently.

The Evidence to Care team at Holland Bloorview, led by Dr. Shauna Kingsnorth, promotes knowledge translation by identifying the best available research evidence and developing strategies to influence care.

“We don’t want to reinvent the wheel,” said Dr. Shauna Kingsnorth, Manager, Evidence to Care. Holland Bloorview
“We don’t want to reinvent the wheel,” said Dr. Shauna Kingsnorth, Manager, Evidence to Care. “We want to package the existing evidence in a way that makes it accessible for clinicians and families.”

Case Study: 1 in 4 children with cerebral palsy experience chronic pain. The Chronic Pain Toolbox, developed by the Evidence to Care team, is an evidence-based best practice product to assist clinicians in their efforts to accurately assess chronic pain in children with disabilities, especially those with cerebral palsy.

At Holland Bloorview, we translate research into real life impact for kids and their families
HWS Field Trippers end their tour inspired by the health research underway at Holland Bloorview’s research institute and the impact it will have on kids and families today and tomorrow; locally and globally.

“At Holland Bloorview, we translate research into real life impact for kids and their families,” said President and CEO, Julia Hanigsberg.

After a morning of meaningful research and imaginative, boundary-pushing innovation, it’s clear that Holland Bloorview is serious about its mission to create a world of possibility. We want to extend our sincere thanks to our hosts at Holland Bloorview’s research institute and Holland Bloorview Kids Rehabilitation Hospital.

 

Why does health research matter to us? We know that it generates new discoveries, better care, and greater efficiency all while contributing to our knowledge-based economy. That’s how it makes Ontario healthier, wealthier, and smarter today. Investing in research hospitals will help us continue to build a healthier, wealthier, smarter Ontario tomorrow. Discover more health research and patient stories by signing up for our monthly newsletter or joining the #onHWS conversation on Twitter.

Read our other HWS Field Trips here.