Projects will look at improving N95 masks, mental health and well-being

The BC Ministry of Health is investing in BC Interior research universities to understand the harmful effects of COVID-19 and mitigate its impact on communities across the province.

The province has funded five collaborative research projects through the Interior University Research Coalition (IURC), a partnership between Thompson Rivers University (TRU) in Kamloops, the University of British Columbia, Okanagan (UBCO) in Kelowna and the University of Northern British Columbia (UNBC) in Prince George.

The projects being funded range from identifying the effects of the pandemic on the mental health and well-being of people living in rural communities to developing telehealth programs that will engage older adults outside urban centres. Other projects include a focus on improving the lifespan of N95 masks, as well as building a better understanding of whether new technologies are improving the resiliency of rural health-care practitioners.

“This is a win-win-win situation for the province, for the universities, and for the communities we serve in terms of the impact this research will have on the health and quality of life for the people who live there,” says Will Garrett-Petts, associate vice-president, research and graduate studies at TRU.

He adds that the IURC has developed a model that can ensure responsible and innovative research.

“The work we’re doing is meaningful and is guided by the interests of the local and regional communities,” he says. “This is a wonderful model of collaboration, and one we are collectively celebrating.”

UBC Okanagan’s Vice-Principal and Associate Vice-President for Research and Innovation Phil Barker agrees. He says his campus is especially excited to be working on an initiative that is highly collaborative and that spans campuses and institutions across the BC interior.

“We’re delighted that the BC Ministry of Health is investing in this initiative to help mitigate the effects of COVID-19 throughout our province,” explains Barker. “Our researchers have been able to mobilize quickly through the tri-university partnership and each of the selected projects will leverage our respective strengths to serve communities across BC.”

The BC Ministry of Health has provided the IURC with $150,000 to launch this initiative. The IURC was established in 2017 to advance the research and innovation capacity and commercialization potential of the BC Interior and create new opportunities for economic and social innovation. The inaugural funding is focused largely on COVID-19 issues that affect the BC Interior but the results from these projects will help support regional and provincial health care decision-making and provide real-world opportunities for students to gain experience in the complex, ever-changing realm of health care.

“When researchers from different institutions collaborate across disciplines, the research outcomes benefit from different perspectives and synergies that result from cross-institutional collaboration,” says Kathy Lewis, acting vice-president of research at UNBC. “These projects are fantastic examples of what’s possible when researchers from across the BC Interior come together and seek solutions to pressing public health concerns.”

About the projects

• Shannon Freeman, associate professor in UNBC’s School of Nursing, has partnered with Piper Jackson, assistant professor of computer science at TRU, to develop a COVID-19 risk assessment tool that identifies homecare clients who are at greatest risk of contracting the virus.
• Jian Liu and Abbas Milani of UBCO’s School of Engineering will be working with Hossein Kazemian of UNBC to improve the lifespan of nanofibres and activated carbon mats in N95 masks.
• Brodie Sakakibara, assistant professor in UBCO’s Southern Medical Program and investigator in the Centre for Chronic Disease Prevention and Management, is working with researchers at UBCO, UNBC and Interior Health to create a student-delivered Community Outreach Telehealth Program that will engage older adults from outside urban centres and establish best practices for providing health support during a pandemic.
• TRU’s Bala Nikku has teamed up with Khalad Hasan from UBCO and Rahul Jain from UNBC to better understand whether new technologies are improving the resiliency of rural health care practitioners.
• Nelly Oelke, associate professor in UBCO’s School of Nursing and scientific director of the Rural Coordination Centre of BC, will be collaborating with UBCO’s Donna Kurtz, UNBC’s Davina Banner-Lukaris and TRU’s Bonnie Fournier to expand ongoing research that explores the mental health impacts of climate change events. The new study will identify the effects of the pandemic on the mental health and well-being of people living in rural communities to help foster resilience.

• Interior University Research Coalition
• The University of British Columbia, Okanagan campus
• Thompson Rivers University
• University of Northern British Columbia

About UBC’s Okanagan campus

UBC’s Okanagan campus is an innovative hub for research and learning founded in 2005 in partnership with local Indigenous peoples, the Syilx Okanagan Nation, in whose territory the campus resides. As part of UBC—ranked among the world’s top 20 public universities—the Okanagan campus combines a globally recognized UBC education with a tight-knit and entrepreneurial community that welcomes students and faculty from around the world in British Columbia’s stunning Okanagan Valley.

To find out more, visit: ok.ubc.ca

Katrina Plamondon, assistant professor in UBC Okanagan’s School of Nursing.

World trade limitations will impact accessibility of vaccine for millions of people

As the Canadian government plans for a mass inoculation campaign with the soon-to-be available COVID-19 vaccines, a UBC Okanagan researcher, together with more than 100 health researchers across the country, is asking the government to think globally, not locally.

Katrina Plamondon is an assistant professor in UBCO’s School of Nursing. She conducts research on health equity and through her work with the Canadian Coalition for Global Health Research, she joins this collective call for Canada to support a temporary waiver to allow step up of international production of vaccines and other essential health products during the COVID-19 pandemic.

Plamondon explains that intellectual property rights are protected by a World Trade Organization (WTO) agreement. As it stands, she says that the WTO’s Council for Trade-Related Aspects of Intellectual Property Rights (TRIPS) is likely to negatively impact the distribution of vaccines, treatment, equipment, and knowledge to battle the pandemic. There is a global call for a waiver to certain TRIPS rules to ensure developing countries can rapidly scale up access to vaccines, treatments and equipment without fear of a trade dispute.

While the rush to obtain COVID vaccines is important, Plamondon explains how existing trade rules impact the delivery of the vaccine globally.

Why has this become such an important issue? 

News of promising vaccines sparked optimism for light at the end of a pandemic tunnel, with some countries far more optimistic than others. TRIPS protects trade-related aspects of patents and copyrights on things like vaccines, medicines, and medical tests. In this pandemic, public dollars have been poured into research and development for vaccines. The TRIPS waiver is important because access vaccine everywhere is determined by accessibility and affordability. Some countries can afford to purchase, others to manufacture—and many cannot. The TRIPS agreement empowers developing countries’ capacity to get vaccine to people who need it.

The TRIPS waiver would let member states bypass time-consuming procedures for issuing or enforcing patents. That would make COVID-19-related products—including vaccines—global public goods, at least for the acute phase of the pandemic.

Explain why this waiver to TRIPS is vital and why the clock is ticking.

The WTO oversees policy and regulations for trade. Intellectual property, just like natural resources, is considered a trading good. Under ‘normal’ globalization conditions, the agreement works to protect the interests of countries and companies that develop intellectual property. During a pandemic crisis, the goals of this trade agreement clash with those of protecting global public health.

This month, the WTO will meet and member states will vote on the waiver which would allow developing countries to scale-up production of essential pandemic supplies and medicines like vaccines, diagnostic tests or personal protective equipment, without the risk of violating trade agreements. It would enable rapid access to essential medicines and supplies to help the world move through this pandemic as quickly as possible.

My colleagues Ron Labonté, an expert in globalization, global trade and health; and Mira Johri, an expert in vaccinations and public health, have written a compelling piece about this with more to come soon.

Who is supporting this waiver? Who isn’t?

99 developing countries already declare support for the waiver. Along with the World Health Organization’s Director-General, the TRIPS waiver is backed by international leaders, developing countries, dozens of health non-governmental organizations and close to one million public health researchers and 400 civil society groups worldwide. I am among the over 100 Canadian health researchers and professionals endorsing an open letter to the Government of Canada.

The waiver is opposed by a handful of wealthier countries—including Canada—that have strong financial interests in protecting current intellectual property regulations. Others against the waiver are the US, the UK, the EU, Norway, Switzerland, Japan and Brazil.

Canada has committed to the global effort to ensure international and fair access to a COVID-19 vaccine. But you stress that more needs to be done?

Yes, in the fall the Government of Canada announced that it would contribute $243 million help purchase vaccines for low-and middle-income countries. This is an excellent start and a generous contribution from Canada. But we need to keep standing for equity and human rights on the global stage. Canada can do more to leverage its influence as a middle power and our voice matters.

This pandemic will not disappear if countries vaccinate their own population, leaving millions of people around the world isolated and without a vaccine. One thing this pandemic has done, is created an opportunity to build international policies and meaningful programs that will ensure a balanced, fair and healthy future for us all. It’s not always easy to see why we should care so much about how other countries are faring. Today, we can create a better, more equitable shared future. To do so, we need to see ourselves as part of a greater global community. I think that’s a legacy that most, if not all Canadians agree on.

About UBC’s Okanagan campus

UBC’s Okanagan campus is an innovative hub for research and learning founded in 2005 in partnership with local Indigenous peoples, the Syilx Okanagan Nation, in whose territory the campus resides. As part of UBC—ranked among the world’s top 20 public universities—the Okanagan campus combines a globally recognized UBC education with a tight-knit and entrepreneurial community that welcomes students and faculty from around the world in British Columbia’s stunning Okanagan Valley.

To find out more, visit: ok.ubc.ca

Health inequity and vaccine nationalism undermines health for all

With governments around the world seeking to develop and distribute a COVID-19 vaccine and put a stop to the spread of the virus, one UBC Okanagan researcher says we should resist the urge to engage in nationalist policies for global health issues.

Katrina Plamondon is an assistant professor in UBCO’s School of Nursing and through her work with the Canadian Coalition for Global Health Research (CCGHR) and Canadian Society for International Health, recently collected over 100 signatures of health and policy experts from across Canada calling on governments to engage in an equitable approach to vaccine development.

She explains how health equity is important in battling current and future pandemics and health crises.

What do you mean when you talk about health equity?

Health equity is an aspiration! It’s about striving for a world where, regardless of nationality, social class, education or other social and economic factors, people can live to their full potential, with access to things like quality health care, clean and safe drinking water, access to education and freedom from violence. It is closely tied to the ideals described in the UN’s Universal Declaration of Human Rights and core values that most Canadians subscribe to, and are central to what our government argues for on the international stage.

How has COVID-19 affected equity around the world?

Before exploring the pandemic’s impact on health equity, I think it’s important to understand that systemic and pervasive health inequities were present long before COVID-19 entered our lives. The pandemic simply exposed them. We’re seeing today that navigating life during a pandemic is far more complex for people who were already in a position of social disadvantage.

And of course, the virus itself doesn’t discriminate. Though race-based data is limited in Canada, we know that Indigenous, Asian and other visible minorities are suffering disproportionately greater burdens of both this disease and social and economic impacts of policies related to it. There is no biological reason why Black Americans are hospitalized and dying at disproportionately alarming rates in the US, or why migrant agricultural workers in Canada are over-represented in COVID-19 outbreaks. Issues of equity are systemic and deeply rooted issues around things like systemic racism and how it differentially shapes housing, social mobility, economic opportunities and access to basic services.

How can you wash your hands, for example, if you have no home, or live in a refugee camp with no reliable access to clean water? How can you stay home from work when you’re sick, if staying home means you could lose your job?

You’ve spoken of ‘vaccine nationalism.’ What does that mean?

Governments around the world are under enormous political pressure to develop, manufacture and distribute a COVID-19 vaccine as quickly as possible. Some wealthy countries, including Canada, have signed contracts with vaccine manufacturers to secure doses for exclusive use within their borders. That, in turn, has put further pressure on other countries to do the same. We are all served best when the vaccine is distributed equitably and universally, with science and respect for our shared humanity, rather than nationalism, dictating who gets the first doses and when.

I can’t help but draw a parallel between this national vaccine ‘hoarding’ and the panic to buy toilet paper in the early days of the pandemic. Though often described as irrational and unhelpful, many of us got caught up in the scramble. We couldn’t see that there was more than enough to go around, provided we all took only what we needed when we needed it. Likewise, if we work together to leverage the resources we share globally, aiming to protect our collective global health, everyone could have access to what is needed when it is needed.

What can we do to ensure equitable access to a COVID-19 vaccine?

Before we can consider what to do, we should think about why we should do it. Canada, and all of its citizens, have moral obligations to improve the health of humanity as a whole. There are issues that are inherently global, that affect the health of all people, everywhere. COVID-19 is not the only issue like this, and future pandemics are entirely possible.

Our collective futures depend on our capacity to respond as a global community. What we do today matters now, and long into the future. We need to ensure that health equity is a key component of local, national and global health policies. And Canada has an important role to play. While we aren’t a global superpower, we are an influential middle power and I think we can take global health policy positions, especially around a COVID-19 vaccine, that shows the world how to make sure health of all of humanity isn’t sacrificed for national interests.

Has COVID-19 created an opportunity to rethink public health policy?

There’s no doubt that talking about health equity during a global health crisis can be extremely challenging! I have also never before been so hopeful for the future of humanity. The entire world is singularly focused on solving this emergency with some of the greatest minds working around the clock.

We are at an inflection point where existing systems and structures are primed to be reinvented and improved. That’s something we haven’t seen since the end of World War II. This pandemic offers a real opportunity to create new equity-centred policies and programs that prioritize creating a more balanced, equitable future for humanity.

About UBC’s Okanagan campus

UBC’s Okanagan campus is an innovative hub for research and learning founded in 2005 in partnership with local Indigenous peoples, the Syilx Okanagan Nation, in whose territory the campus resides. As part of UBC—ranked among the world’s top 20 public universities—the Okanagan campus combines a globally recognized UBC education with a tight-knit and entrepreneurial community that welcomes students and faculty from around the world in British Columbia’s stunning Okanagan Valley.

To find out more, visit: ok.ubc.ca

A young person vaping an e-cigarette.

E-cigarette companies know how to target their products

UBC researchers are raising the alarm about the increase of vaping among teenagers and how e-cigarette marketing strategies target youth.

Assistant Professor Laura Struik, who teaches in UBC Okanagan’s School of Nursing, recently published a paper examining why teens take up vaping and whether advertising capitalizes on those reasons.

“This is the first study of its kind that makes direct links between reasons for youth uptake and the marketing strategies of e-cigarette companies,” says Struik. “The public needs to know how the next generation is being targeted to take up and ultimately become addicted to these nicotine products.”

Struik conducted the study with Assistant Professor Sarah Dow-Fleisner, who conducts research in the UBCO School of Social Work on development trajectories and resilient functioning of children and families in high-risk contexts.

The researchers say there are a variety of reasons teens take up vaping—ranging anywhere from managing stress or anxiety, curiosity, taste, peer pressure, easy access and even factors like it’s easy to hide from parents and is perceived to be less harmful than cigarettes.

When e-cigarettes first entered the North American market in 2008, they were hailed as a smoking cessation tool. However, Dow-Fleisner says when they take a closer look at who uses them, it’s clear teens do not use the products to quit smoking.

“According to recent statistics, only three per cent of Canadian youth in grades 7 to 12 are current smokers—while 20 per cent use e-cigarettes,” she says. “This suggests that upwards of 17 per cent of e-cigarette users were originally non-smokers. In addition, among youth who do smoke combustible cigarettes, fewer than eight per cent of those report using e-cigarettes to quit smoking.”

Recent polls found that 95 per cent of teens said they were curious about vaping so they wanted to try it, while 81 per cent tried an e-cigarette because a friend vaped, and 80 per cent reported continued e-cigarette use because they enjoyed the good flavours. More than 70 per cent of the teens agreed e-cigarettes were “cool and fun.”

Despite emerging evidence of both short- and long-term health risks associated with vaping, Struik says the evidence is clear the other reasons teens take up vaping override the health risks.

“Youth don’t make the decision to vape because they don’t understand the risks or don’t care about the risks,” she says. “Young people are taking up vaping for a variety of reasons and e-cigarette companies are leveraging those diverse reasons to recruit teens into using their products. And it’s working.”

Struik and Dow-Fleisner, with their research assistants and UBCO’s Associate Chief Librarian Robert Janke, reviewed more than 800 studies and viewed numerous e-cigarettes TV commercials.

“The TV advertisements we reviewed were found to tap into almost all of the reasons youth cite for taking up e-cigarettes,” says Dow-Fleisner. “The most highly-cited reasons were most prominently presented in the ads, including a focus on relational aspects of vaping and product-related benefits, such as a positive sensory experience.”

A noteworthy finding is that vaping advertisements do promote e-cigarettes as a way to enhance your social life, says Struik.

“This is particularly concerning because teens are at a developmental stage when establishing a social identity is of utmost importance to them,” she says. “It has been found in previous research that forming an identity around other forms of tobacco use, like smoking, results in resistance to health promotion efforts. So, we may have a more challenging context to work with than originally thought when it comes to intervening.”

Youth vaping is a concern, she adds, and there is a growing need for comprehensive strategic plans to curtail their use of e-cigarettes.

“It is clear that we need to bring youth to the table to understand how we can generate relevant information and interventions to support their decision to not vape,” says Struik. “Our health promotion efforts need to keep up by accommodating the various reasons youth report vaping, and youth need to be meaningfully included to navigate this issue.”

The research was published in the Journal of Medical Internet Research.

About UBC’s Okanagan campus

UBC’s Okanagan campus is an innovative hub for research and learning founded in 2005 in partnership with local Indigenous peoples, the Syilx Okanagan Nation, in whose territory the campus resides. As part of UBC—ranked among the world’s top 20 public universities—the Okanagan campus combines a globally recognized UBC education with a tight-knit and entrepreneurial community that welcomes students and faculty from around the world in British Columbia’s stunning Okanagan Valley.

To find out more, visit: ok.ubc.ca

UBCO associate professor Nelly Oelke is one of the researchers receiving funding from the interior university research coalition for her work in mental health resilience in rural communities

Interior university research coalition funds research to improve the lives of those living outside large urban centres

The challenges facing rural and remote communities do not always make front-page news, but this lack of attention does not make them less important, especially for those who live there.

Supported by the Interior University Research Coalition’s (IURC) Regional/Rural/Remote Communities (R3C) Collaborative Research Grant, three Interior university research teams will address the complex problems faced by British Columbians who live outside large metropolitan areas. The funded projects grapple with disparate topics such as aging, water treatment and mental-health resiliency in the face of climate change.

“Rural and remote communities in non-metropolitan areas are experiencing economic, social and environmental changes that are profound and complex,” says Janice Larsen, IURC director.

“It is vital to understand and support the healthy and stable development of our society, our economy and our environment,” she adds.

Each of these three research teams receives $40,000 to complete their projects.

TRU associate professor Wendy Hulko, joined by UBCO’s Kathy Rush and UNBC’s Sarah De Leeuw, leads a project investigating the results of the Interior Health’s repositioning of health-care services for seniors. The intent of repositioning services was to enable older adults to live at home longer, reduce hospital admissions and delay residential care.

One of the outcomes of Interior Health’s service restructure was the creation of health and wellness centres in Kamloops and Kelowna. The centres provide primary health care for older adults and were designed to create better access to health services for vulnerable populations. The impact of the COVID-19 pandemic will certainly play a role in the study, says Hulko.

“One of the goals of these wellness centres was to get people connected to care, but we will have to find out how those services have been impacted by the pandemic and how the pandemic is impacting the ability of older adults to age in place,” she explains.

UNBC Environmental Engineering professor Jianbing Li leads research to develop an effective, low-cost, portable water-treatment system for remote and rural communities. Due to a lack of resources, rural communities have long faced challenges in accessing potable water, and consumption of untreated water poses health risks. Joined by Rehan Sadiq and Kasun Hewage, professors in UBCO’s School of Engineering, the research team aims to develop a household water-treatment system that would remove common contaminants from rural water sources. By the project’s end, a prototype of the water treatment system would be demonstrated in the community.

“Having reliable access to a safe drinking water supply is essential for the healthy development of rural, regional and remote communities,” says Li. “Our interdisciplinary research team is working toward discovering a water treatment solution, training graduate students and developing meaningful partnerships with relevant communities in British Columbia.”

UBCO associate professor Nelly Oelke leads a project that aims to foster resilience in rural and remote communities by developing a greater understanding of the mental-health impacts of climate-change events.

“Climate-change events can result in extreme physical and psychological trauma for vulnerable populations living in rural and remote communities,” says Oelke. “PTSD, depression, anxiety, increased substance use and suicidality are all found to increase during and after problematic flooding, wildfires and drought, which are becoming more and more common in BC and around the world.”

She adds that many of the approaches used to address mental health relating to natural disasters are also used in pandemics and the evidence-based solutions they develop will provide increased support to Indigenous peoples, people living in poverty, children and first responders.

The research takes place in the Similkameen region of BC’s Southern Interior, including Keremeos, Hedley and Princeton, in addition to Ashcroft in the Thompson-Okanagan region and Burns Lake in Northern BC. Collaborators on this project include Sue Pollock (interim chief medical health officer at Interior Health), UNBC’s Davina Banner, TRU’s Bonnie Fournier and UBCO’s Lauren Airth and Carolyn Szostak. One outcome of this project is the development of community-based action plans for mental-health support, as research shows rural communities are disproportionately impacted by climate change.

“This is a very exciting project and allows me to build upon the relationships I have already developed in Ashcroft, while also allowing me to work alongside two really fantastic researchers,” says Fournier. “The R3C program is innovative and unique, and I haven’t seen anything like it across Canada.”

About UBC’s Okanagan campus

UBC’s Okanagan campus is an innovative hub for research and learning founded in 2005 in partnership with local Indigenous peoples, the Syilx Okanagan Nation, in whose territory the campus resides. As part of UBC—ranked among the world’s top 20 public universities—the Okanagan campus combines a globally recognized UBC education with a tight-knit and entrepreneurial community that welcomes students and faculty from around the world in British Columbia’s stunning Okanagan Valley.

To find out more, visit: ok.ubc.ca

Study concludes Crush the Crave has potential, but needs tweaking

With the trend of an app for just about everything these days, a team of researchers from several universities, examined the success of a mobile app designed to help young adults quit smoking.

UBC Professor Joan Bottorff, director of UBC Okanagan’s Institute for Healthy Living and Chronic Disease Prevention, says while there are more than 500 mobile-based programs to help people quit smoking, little is known about the role these apps play in the overall smoking cessation picture.

Crush the Crave is an evidence-based app that has quitting strategies built into it to help avoid succumbing to smoke cravings, explains Bruce Baskerville, one of the app’s developers and a senior research associate with the University of Waterloo.

An earlier study of its effectiveness, led by Baskerville and funded by the Canadian Institutes of Health Research, involved a randomized controlled trial to determine whether it helped young adults, aged 19 to 29, quit smoking.

Bottorff, a professor in UBC Okanagan’s School of Nursing, says while the app worked for some study participants, it didn’t have the results the researchers were hoping for.

“At the end of the day, results showed that the app was feasible for delivering cessation support but was no better than the paper-based self-help guide that participants in the control group were given,” says Bottorff. “It still helped and it’s another alternative method to support smoking cessation. We need different ways to reach people and this is another tool in the toolbox.”

PhD student Laura Struik is a lead author on the study.

Under the supervision of Bottorff, PhD student Laura Struik completed a qualitative study, investigating young adults’ experiences with using Crush the Crave.

Young adults make up the largest number of people who smoke in Canada. While the national average is 14.6 per cent, Struik says that 19 per cent of people aged 20 to 35 smoke.

“One of the greatest benefits of this app is the great reach potential it has,” says Struik. “The target audience is young adults, and that age group’s use of smartphones is ubiquitous, giving this specific app huge potential. So it is important to understand what worked and didn’t from the perspective of users, to guide future improvements.”

For example, Struik notes that one of the main criticisms was that the social media space in the app led users to protect their identity, largely due to its public status.

“While support for connections with other users was wanted, the way it was offered in the app did not align with young adults’ desire to avoid stigmatization and judgement related to their smoking.”

On a positive note, Struik found that the tracking features in the app proved to be one of the strongest aspects. She also says users appreciated the way the app displayed the health benefits of quitting on the body.

“These benefits were tailored to each individual and displayed via statistics, such as percentage of lung health improved,” Struik says. “Because the impacts of smoking are otherwise invisible, users valued this feature, saying it helped them better understand the connection between smoking and health at their age.”

The innovative approach Struik used in this study provides a new way to share understanding and capitalize on effective platforms that support smoking cessation. The qualitative study was published recently in JMIR mHealth uHealth.

“Regardless of whether these apps remain or not, the effective mechanisms in the app, such as documentation and visibility of quitting benefits, will likely hold their value for this population,” Struik says. “This study contributes to understanding what features have the most promising potential for mobilizing quitting smoking and then helping developers scale up these interventions.”

About UBC’s Okanagan campus

UBC’s Okanagan campus is an innovative hub for research and learning in the heart of British Columbia’s stunning Okanagan Valley. Ranked among the top 20 public universities in the world, UBC is home to bold thinking and discoveries that make a difference. Established in 2005, the Okanagan campus combines a globally recognized UBC education with a tight-knit and entrepreneurial community that welcomes students and faculty from around the world. For more visit ok.ubc.ca.