Five projects awarded CIHR funding for primary care research at McMaster

Researchers at the Department of Family Medicine at McMaster University have seen great success in recent grants from the Canadian Institutes of Health Research (CIHR), Canada’s federal funding agency for health research.

Almost $1.3 million has been awarded to five projects led by faculty members in the Department of Family Medicine.

Three of the projects are from a funding stream to assess the wider health impacts of COVID-19. This funding will support the health care system with research that responds to the current and next phase of the COVID-19 pandemic. Researchers at McMaster will examine how the COVID-19 pandemic has impacted health care for people who are pregnant or have with chronic conditions, and the rise in moral distress among health care providers.

One project was funded through the CIHR Project Grant program, which supports research projects with the greatest potential for important advances in all areas of health. This project will examine continuity of care at the end of life.

A fifth project was a part of the Healthy Cities Implementation Science Team Grant program. This program supports projects to design and implement evidence-based interventions in urban contexts to improve population health and health equity. This project was successful based on their letter of intent (LOI) and have been awarded a grant to develop a full application.

These projects will be supported by facilities and resources of the David Braley Primary Care Research Collaborative and the Department of Family Medicine.

Pregnancy health decision-making during COVID-19

Principal Investigator: Meredith Vanstone, Devon Greyson (University of British Colombia)
Co-Investigators: Hamideh Bayrampour, Elizabeth Darling, Amie Davis, Michelle Howard, Sujane Kandasamy, Jessica Liauw, Sarah McDonald, Monica Molinaro, Manisha Pahwa, Tejal Patel

Why it matters: Pregnant people have been vulnerable to both direct and indirect impacts of COVID-19, but we don’t know how their perceptions of COVID-19 risk impacted the health decisions they made in pregnancy about vaccination, prenatal care, and social supports for mental health. We also don’t know how these decisions may differ across groups of pregnant people.

Research methods: This study will analyze administrative data from Ontario and British Columbia on key outcomes related to vaccination, perinatal care, social supports, and mental health at different stages of the pandemic. We will also conduct interviews with people who gave birth between May 1, 2020 and Dec 1, 2021, to understand how their perceptions of COVID-19 risk and pandemic circumstances influenced their decision-making.

Impact: The results of this study will contribute to understanding how individuals perceive risk and how it influences their decision-making, which is important for future health promotion initiatives in a variety of settings.

This project is funded for $381,645 and will take place over 2 years.

Primary care impacts of COVID-19 on chronic conditions

Principal Investigators: Michelle Howard, Dee Mangin
Co-Investigators: Kris Aubrey-Bassler, Neil Drummond, Sheri Hosseini, Kathryn Nicholson, John Queenan, Marie-Thérèse Lussier, Amanda Ramdyal, Meredith Vanstone

Why it matters: People with chronic health conditions rely on regular contact with their primary care team to manage their symptoms, pre-empt future problems and improve their quality of life. However, the COVID-19 pandemic disrupted access to primary care as the focus was placed on assisting the pandemic response and infection control with a shift to virtual visits.

Research methods: This study will use Canadian Primary Care Sentinel Surveillance Network (CPCSSN) data, which DFM contributes data to though the local McMaster University Sentinel and information collaboration (MUSIC) practice-based research network. The study will describe how COVID-19 did and did not impact the management of chronic conditions in different patient groups. Researchers will also interview patients with chronic conditions to understand how they perceived their health care and made decisions to balance the pandemic circumstances with managing their illness.

Impact: The results of this study will be used to inform primary care strategies for sustained chronic condition management, as well as inform policies and prioritisation of resource allocation as the health care system focuses on pandemic recovery.

This project is funded for $284,570 and will take place over 2 years.

Moral distress in critical care and family medicine during the COVID-19 pandemic

Principal Investigators: Lawrence Grierson, Monica Molinaro
Co-Investigators: Gina Agarwal, Deborah Cook, Kirsten Fiest, Gabrielle Inglis, Myles Leslie, Daniel Niven, Tejal Patel, Elizabeth Peter, Meredith Vanstone

Why it matters: There has been an increase in reports of hospital-based clinicians, including physicians, nurses, and social workers leaving their professions, catalyzed by COVID-19 circumstances. This attrition may in part be due to moral distress and moral injury. This study will explore how context and policies have affected the experiences of healthcare providers (HCPs) working in critical care and family medicine in Ontario and Alberta.

Research methods: Administrative and qualitative data will be used to identify how policies have affected HCP experiences along with potentially impacting how care has been provided during the COVID-19 pandemic.

Impact: The results of this study will enhance understanding of what factors contribute to moral distress and injury, how they present in different contexts, and how they can be prevented and mitigated. This knowledge will help the health care system respond to the current conditions and help plan for future events.

This project is funded for $248,374 and will take place over 2 years.

Continuity of care at the end of life

Principal Investigators: Michelle Howard, Sarina Isenberg (Bruyère Research Institute, University of Ottawa)
Co-Investigators: Peter Tanuseputro, Doug Manuel, Colleen Webber, Amy Hsu, Aaron Jones, Erin Gallagher, James Downar
Collaborators: Wilkes K, Oikonen K, Cheung M, Mattsson W, Wheway C
Knowledge Users: Blacker S, Redwood E, Bryant D, Walton T (Ontario Palliative Care Network)

Why it matters: Patients at the end-of-life often experience health care from different teams and in different settings as their illness progresses, making continuity of care (CoC) important. However, the current measures of CoC are not ideal indicators of quality end-of-life care. Therefore, this study will aim to understand how to best define and capture CoC and help to ensure patient-centered care near the end-of-life.

Research methods: This study will use health administrative databases in Ontario, along with creating two installations that will act as public consultation through participatory art. Finally, qualitative data will be collected from bereaved caregivers of patients who received palliative care in Hamilton and Ottawa.

Impact: The results of this study will contribute to our understanding of health service delivery, health systems planning, and health services research related to continuity of care at the end of life.

This project is funded for $336,600 and will take place over 4 years.

Interventions to improve healthy aging and quality of life in Canadian cities

Principal Investigators: Gina Agarwal, Amy Poll (BC Emergency Health Services), James Dunn (Department of Health, Aging & Society, McMaster University), Catherine Wyndham-West (Ontario College of Art & Design University)
Co-investigators: Iwona Bielska, Lauren Griffith, Sharon Kaasalainen, Melissa Pirrie, Lehana Thabane

This research project proposes to implement the Community Paramedicine at Clinic (CP@clinic) and At Home/Chez Soi programs in new municipalities (Surrey and Victoria, British Columbia; Hamilton, Ontario) and evaluate the process to find out how the program works best, for whom, and in what settings.

The results will help guide future expansions of the CP@clinic and At Home/Chez Soi programs to other municipalities across Canada. This will improve the delivery of healthcare for many populations that cannot access it and will ultimately improve population health in Canada.

This project received $25,000 to develop a full application.