Recipients of NL SUPPORT’s Spring 2022 Graduate Student Fellowships

As part of a mandate to foster an atmosphere of learning, capacity development and sustainability within patient-oriented research (POR), NL SUPPORT/Quality of Care NL aims to provide funding to Master’s and PhD students conducting POR on a biannual basis.

In Spring 2022, a new funding round was launched for graduate students. A review committee comprised of our staff, faculty and patient partners reviewed each application to determine their value within POR, including level of patient engagement.

In this round, graduate students from varying disciplines, including science and medicine, were awarded funding. Read more about their projects below! And, check out the program for SHARE Summit 2022 where these students will be presenting their research during the lunchtime poster session!

Applications are currently open for the next round of graduate student funding (deadline: October 28, 2022)! Visit https://nlsupport.ca/funding-opportunities/.

Photo by Green Chameleon on Unsplash

Creating a Body Dissatisfaction Measure for Transgender Populations

Noah Pevie, Faculty of Science-Psychology (Supervisor — Dr. Christopher Quinn-Nilas)

The purpose of this study is to develop and validate a Gender Dysphoria Body Dissatisfaction Scale (GDBDS) designed for use with transgender populations. Transgender people often struggle with body image dissatisfaction which can lead to disordered eating however, minimal research exists to address the unique body image concerns transgender populations face. Using purposive sampling, transgender people will be recruited to participate in focus groups or one-on-one qualitative interviews to help identify concerns in existing eating disorder and body dissatisfaction measures. Development of the GDBDS will begin before conducting the interviews, and each item on the scale will be continually assessed throughout the interview process with the focus group participants. Once the GDBDS is finalized, a large-scale field test of the items will be conducted by recruiting approximately 300 transgender and cisgender participants across Canada to aid in scale refinement.

The development of the GDBDS will help clinicians to distinguish between gender dysphoria fueled body dissatisfaction from body dissatisfaction concerns typical of patients with eating disorders. Additionally, providing the patient with an inclusive measure that accurately recognizes their unique concerns may increase retention rates among transgender patients in eating disorder programs.

Directed Education on Cannabis for Youth Decision Empowerment (DECYDE): A New Tool for Evaluating Cannabis Health Literacy in Grades 4–6

Emily Rowe, Faculty of Science-Psychology (Supervisor — Dr. Nicholas Harris)

This study is a sub-part of an initiative led by Cannabis Health Evaluation & Research Partnership (CHERP) team to design and evaluate a cannabis education strategy for school-age youth titled DECYDE. The objective of this project is to address what tools are available to measure harm reduction programs directed for youth (grades 4–6) and what we know about their intended use, scope and theoretical foundation. Through a patient engagement approach, this project aims to: 1) conduct a scoping review to inform the development of a tool for grades 4–6; 2) develop and validate a cannabis health literacy tool to evaluate the pilot of the grades 4–6 curriculum.

Patients in this study include educators and students between grades 4–12. Patients will be engaged in all stages of the project and they will be a member of the study team. Students will participate as members on a youth advisory panel and work alongside the team. This panel will offer support by piloting materials, sharing insights and perspectives. The patient and stakeholder engagement activities will inform the development and validation of the tool that will be used to evaluate the grades 4–6 DECYDE curriculum.

Variables Associated with Time to Treatment in Youth with Psychotic Disorders

Zachary Giovannini-Green, Faculty of Medicine-Clinical Epidemiology (Supervisor — Dr. Gerry Mugford)

This research will impact the lives of patients by identifying ways to decrease time from diagnosis of a psychotic disorder to treatment, a factor that the literature indicates greatly affects health outcomes. Patients with the diagnostic criteria, as well as their caregivers, will be recruited to the patient advisory committee to give input on all stages of the research. Using a mixed-methods approach of in-depth interviews and focus groups, this study will address the following question: what potential variables associated with time to treatment can be identified which improve health outcomes in youth with psychotic disorders?

Secondary analysis using administrative databases from the Canadian provinces of Newfoundland and Labrador and New Brunswick will address the following questions:

1. What differences in these potential variables exist in urban and rural areas of both Newfoundland and Labrador and New Brunswick?
2. What differences in these potential variables exist between the provinces of Newfoundland and Labrador and New Brunswick?
3. What differences appear in variables across the duration of the study? Is there a discernible and significant pattern? Is there a significant difference in data since the COVID-19 pandemic?

After research completion, the multidisciplinary group within Memorial, in combination with the patient advisory committee, will create a knowledge translation plan that will reach diverse groups and organizations.

Lived Experiences of Older Adults Living with Type II Diabetes Mellitus: An Exploration Using a Digital Storytelling Approach

Abdullah Omar Saif, Faculty of Medicine (Supervisor — Dr. Natalie Beausoleil)

Using a digital storytelling approach and focus group discussions, this research aims to critically explore the lived experiences of older adults living with type II diabetes mellitus. The objectives of the study are:

1. What are the narratives of older adults in relation to their experiences with T2DM?
2. What meanings do they ascribe to their narratives?
3. How do these meanings shape their identities and worldviews?
4. What impact do the broader discourses have on their narratives?

Patient partners will be recruited through different support groups located in Newfoundland & Labrador (NL) and will include people 65 years of age or older, English speaking and living with T2 diabetes. Patient partners will assist in the understanding of participants’ stories and will also help as contributors in reviewing research questions, study designs and patients’ stories to identify common threads/relevant themes. The use of digital storytelling as a methodology allows people to be experts in their narratives and establish them as partners rather than subjects in research.

Physician-Reported Barriers to Using Evidence-Based Antibiotic Prescription Guidelines in Primary Care: A Systematic Review and Synthesis of Qualitative Studies Using the Theoretical Domains Framework

Krystal Bursey, Faculty of Medicine — Clinical Epidemiology (Supervisor — Dr. Amanda Hall)

Overprescription of antibiotics poses a significant threat to health care globally as it contributes to the issue of antibiotic resistance. While antibiotics should be predominately prescribed for bacterial infections, they are often inappropriately given for uncomplicated upper respiratory tract infections (or the common cold, URTIs) and related conditions. Using theoretically designed resources based on behaviour change theory, the Theoretical Domains Framework (TDF) and the Behaviour Change Techniques (BCT) Taxonomy, an intervention can be built to target antibiotic prescribing behaviours. The main objectives of this thesis are:

1. To conduct a qualitative systematic review of physician-reported barriers to using evidence-based antibiotic prescription guidelines in primary care settings.
2. To analyze the data collected from the systematic review using the TDF.
3. To propose an intervention to support family physicians’ adoption of antibiotic prescribing guidelines that include specific strategies from the BCT taxonomy that are most likely to be effective for overcoming the TDF-based barriers identified in objective 2.

An experienced patient engagement team has been established and meets monthly to assist in the development of an infographic regarding the problem of antibiotic prescribing and why a theory-informed intervention is needed. Furthermore, a patient engagement plan has been developed that outlines key research activities where patient input is needed. It includes activities such as the interpretation of findings and assisting all post-publication knowledge translation projects (e.g., infographics, plain language summaries). The patient partners will be surveyed allowing them to choose how they wish to be involved with these activities. As part of engaging knowledge users, a family physician will also be included in the research team to provide the clinician perspective.

The results of this study will hopefully lead to the development of evidence-based interventions to address the over prescription of antibiotics for URTIs. These interventions would improve patient care by reducing antibiotic prescriptions, increasing the delivery of appropriate care for URTIs to patients, and hopefully benefit the overarching issue of antibiotic resistance.

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