Healthy Cities Research Initiative: Research profiles
Notice
The information is provided in the language in which it was submitted by the respondent.
| Funding Opportunity |
Funding Start Year |
Profile |
|---|---|---|
| Applied Public Health Chair - Sex, Gender and Healthy Cities | 2022 | Project title: REsearch and ACtion for Healthy Cities (REACH-Cities) Abstract/SummaryThe REsearch and ACtion for Healthy Cities (REACH-Cities) program is focused on how cities can welcome and support people of all genders -especially those of age, racial, income, or ability groups who have historically been overlooked within city planning. The research spans the implementation and impacts of population health interventions (e.g., municipal transportation and community planning policies, to on-the-ground changes to the built environment such as new rapid transit and bicycle facilities, to programs to support social connections and physical activity) and focuses on the health-related outcomes that pattern by gender and other intersectional identities. There are three connected themes of work: A.Generate new knowledge on the implementation and impacts of healthy cities interventions, using a gender-based intersectional lens (Population Health Intervention Research) B.Develop and apply novel approaches for integrating gender equity into decision-making in local, national, and international settings (Methods and Tools for Intersectoral Action) C.Foster a generation of changemakers, equipped with the expertise to catalyze action toward cities that promote health and health equity for all people. (Training for Healthy Cities) REACH-Cities is designed as a responsive program, adopting community-engaged research methods to ensure it reflects both urgent needs and timely opportunities. My primary partners are local government decision-makers: those responsible for designing and building healthy cities. Outputs will empower partners with relevant evidence on their pressing needs around gender equity; embed change in how equity is considered within city planning processes and actions; and train the next generation of healthy cities researchers and practitioners to advance action on gender equity. Collectively, these impacts will shape a host of future interventions that serve to improve urban environments for all genders. |
| Building Healthy Cities | 2018 |
Dr. Steven C. Brooks, Associate Professor, Queen's University Department of Emergency Medicine Project title: Rethinking Public Access Defibrillation to Build Healthier Cities - A Planning Meeting to Build Partnerships, Identify Novel Strategies and Plan for a Large-Scale Community Intervention Abstract/Summary"Sudden cardiac arrest" occurs when the heart stops beating unexpectedly. Each year, more than 40,000 Canadians have a cardiac arrest. Less than 10% percent of those who have a cardiac arrest outside of hospital survive. A bystander who sees the event can drastically improve survival by starting chest compressions (CPR) and applying a defibrillator (AED). A defibrillator is a machine that can automatically apply an electric shock to restart the heart. When someone is suffering cardiac arrest, it is very important to restart the heart quickly. Waiting for paramedics to do this is not optimal. Delays of even a few minutes can result in death. As a result, cities around the world have placed defibrillators in public places and encouraged members of the public to use them in an emergency. Unfortunately, less than 3% of cardiac arrest victims outside of a hospital have a public access defibrillator used. This is a missed opportunity to save lives. We plan to gather a group of experts in emergency medicine, defibrillators, engineering, psychology, urban design and policy to rethink our approach to public access defibrillation. We will be discussing barriers to public access defibrillation and brainstorming new ideas to fix the problem. Specifically, we will be thinking about defibrillators in cities to make them safer and healthier places. By gathering people with expertise in a broad range of areas, we hope to generate practical ideas that are worthy of a large study. We are planning to gather for 1.5 days in Edinburgh to share ideas and make plans for a community-level intervention. We will spend time creating what we think would be a good way to increase the chances of defibrillation for victims of cardiac arrest in cities. We will then apply to the CIHR with our plans for funds to support a trial. We hope to use this meeting to develop an ongoing working group of experts which aims to study the problem in depth. |
| Building Healthy Cities | 2018 | Project title: Community Based Health Data Cooperative in an Urban Immigrant Community Abstract/SummaryCanada, well known for its friendly immigration and refugee policy, attracts a significant number of immigrants every year from all around the globe. Most of these newcomers settle in the cities across Canada and contributes to the urban human dynamics immensely. Canadian immigrant populations come from diverse ethno-geographical backgrounds and exhibit differences in their cultural and understanding of health and wellness. To achieve the goal of building healthy cities, it is imperative to empower these diverse communities for enabling them to be their own champions for improvement of health and wellness. Enabling the immigrant communities to build their health data cooperatives has the potential to promote health equity by empowering community members. Health data cooperative is an emerging concept that provides a digital platform to gather individual health data in one secure place under the ownership of the data-providers. Health data platforms, if organized as cooperatives, will be solely owned and controlled by their respective members to safely store, manage, and share their health-related data with other stakeholders (e.g. research communities, commercial entities, government bodies), and can be more effective in the active participation of the community members. We propose to explore applied approaches to pilot the development and implementation of a health data cooperative in a local setting among an immigrant community in Calgary. |
| Building Healthy Cities | 2018 | Project title: Towards healthy mid-sized cities: Assessing the potential for electric-bicycles to facilitate sustainable transportation reform using big-data Abstract/SummaryPrivate automobile use in North America is associated with a wide range of negative environmental and health outcomes. Electric bicycles offer a more sustainable, healthy, and cost-effective mode of transportation compared to automobiles. While e-bike ownership is rapidly rising elsewhere in the world, in Canada this is still an emerging technology with great potential to positively influence health behaviour, improve health equity, mitigate unhealthy built environments and facilitate sustainable transportation reform. This grant will assess the viability of a large scale e-bike and sensor deployment in Canadian mid-size cities that generates big-data relevant for assessing the impact of e-bike adoption on public health. Further, the grant will shed light on the importance of local context, policy and processes in municipal decision-making and implementation related to sustainable and active transportation. |
| Building Healthy Cities | 2018 | Project title: Creating the conditions for outdoor free-play to emerge in cities Abstract/SummaryChildren have been called an indicator species for cities. The visible presence of children and youth of different ages and backgrounds, with and without their parents, outside in city streets, sidewalks, yards, and open spaces is a sign of the health of human habitats. Indeed, the extent to which a neighbourhood supports children's outdoor play - i.e., its "playability" - can be directly linked not only to children's health, levels of obesity and psychological well-being, but also to the population's well-being as a whole. Recent concerns about stranger-danger, traffic accidents and a general lack of safe, enticing places for children to play outdoors, however, have been partially held responsible for children becoming more sedentary and remaining indoors to play. Concomitantly, there has been an increasing interest in promoting children's outdoor play due to the myriad of benefits it is shown to provide, particularly increasing physical activity, since children are more physically active during outdoor free play than any other activity, including organised sports activities. This grant takes children's outdoor play as a critical public health issue that can help municipal policy makers, public health practitioners, active transport advocates, urban designers, child advocates and society in general join the dots between complex issues like pollution and global warming, active transport planning and community cohesion on the one hand, and concerns regarding the physical and mental health of both children and adults on the other. |
| Building Healthy Cities | 2018 | Project title: Transportation and Health Impact Modelling for Healthy Cities Abstract/SummaryThis project will help researchers and policy makers better understand the potential health impacts of large transportation interventions happening in Canada. There are a number of large scale transportation interventions happening right now, including the Jacques Cartier Bridge in Montreal and the Calgary light rail system. Better understanding the potential health impacts of these transportation interventions is important consider that transportation interventions have significant costs to construct and maintain, and overall, may be good or bad for our health. |
| Building Healthy Cities | 2018 | Project title: makeCalgary: Planning Grant Abstract/SummaryThe makeCalgary initiative is an interdisciplinary collaborative platform initiative that connects stakeholders at the University of Calgary with counterparts at the City of Calgary. The initiative aims to produce research partnerships and new knowledge that will inform municipal policies for health and well-being. This planning grant application will catalyze the initiative's research activities, and enhance national and international connections. |
| Building Healthy Cities | 2018 | Project title: Developing an Age-Friendly Approach for Promoting Health and Wellbeing in Vulnerable Older Adults Living in the City of Toronto Abstract/SummaryOlder adults are a significant and growing part of the population in the City of Toronto, and currently represent about one quarter of the city's population. Recent reports show that a large proportion of older adults living in the City of Toronto struggle with disability and/or poor health, which contributes to poor physical and mental health outcomes (e.g., social isolation). Unfortunately, the delivery of services to meet the health and social care needs of vulnerable older adults (i.e., those living with a disability and/or chronic health condition) is fragmented, which makes navigating the healthcare and social systems challenging. As a result, vulnerable older adults and their families are not always receiving the care or support needed to optimize their health and wellbeing. We are proposing to form a multi-disciplinary team comprised of health care system professionals, representatives from community-based organizations, City of Toronto staff, researchers and other key stakeholders to plan a large-scale approach to make the City of Toronto more age-friendly for vulnerable older adults. This will involve conducting an environmental scan of existing programs, services and policies in place to support the health and social care needs of vulnerable older adults and their families. Doing so will help to identify areas that can be prioritized for research approaches that will provide the necessary knowledge to streamline available resources to improve outcomes for older vulnerable adults and their families living in the City of Toronto. |
| Building Healthy Cities | 2018 | Project title: A system sciences approach to building healthy, equitable, and smart cities: a citizen science-driven population health intervention Abstract/SummaryThis year is the 10th anniversary of the infamous Maclean's article that earned the city of Regina's North-Central area the title of the worst neighbourhood in Canada. North-Central neighbourhood's problems are apparent from the Maclean's article. Out of the 9,980 people living in the North-Central neighbourhood of Regina, 44% identify as having Indigenous ancestry. Overall, in Canada, Indigenous peoples experience a significantly lower life expectancy than other residents in Canada due to historical injustices. More importantly, whether the health inequalities are among Indigenous, or non-Indigenous populations, the inequities that drive them are unfair, unjust and avoidable. Based on this principle of equity, we would like to develop an innovative, and citizen science-driven initiative that would lay the foundation for revitalization, rather than gentrification of North-Central. A city is a living, breathing, system, and any intervention or efforts to improve health or wellbeing of its citizens needs to recognize the various drivers of health, interconnectedness between actors (i.e., sectors: education, transportation, healthcare). We intend to take this inter-connected approach to develop a scalable systems map for the North-Central neighbourhood that would inform ways to improve the health of people in this neighbourhood. Principal applicant Katapally, and co-applicants Osgood, and Rainham, are currently conducting a citizen science investigation called the SMART Study (www.smartstudysask.com) in the cities of Regina and Saskatoon using smartphones. As we are already using SMART Study platform has to take an inter-connected approach, we would be an advantage to scale up our existing infrastructure for a large-scale population health intervention. This planning grant serves to bring together key stakeholders (City of Regina, Ministry of Health, Regina Schools, YMCA Regina), to build a large-scale proposal based on their interconnectedness. |
| Building Healthy Cities | 2018 | Project title: INTervention Research Across Cities Team Abstract/SummaryThe INTervention Research Across Cities Team (INTERACT) was funded by CIHR in 2016, (1) to assess the impact of urban change on population level physical activity, social participation and well-being; and (2) to create and share methods that support urban health research, working with a multidisciplinary network of academics and knowledge users to guide future interventions for healthier and more equitable Canadian cities. This grant will help us plan the extension of the INTERACT framework towards a comprehensive National Healthy Cities Intervention Research Program. This extension will include concepts, tools and methods related to additional important environmental dimensions of healthy cities that are not yet part of the current INTERACT framework; for example, the impact of urban change on air quality, noise, and food environments, and on related health outcomes and health inequalities. We will also develop an online platform to deploy tools and methods within the 25 most populated cities in Canada. The built environment has been associated with various health behaviour including physical activity, social participation, and well-being. It is also related to air quality, noise and local food environments, which have been linked to various non-communicable diseases. The massive investments planned by the federal and provincial government in infrastructure and urban change projects, give us a unique opportunity to conduct natural experiments and generate robust new evidence that can guide future decisions to create healthy equitable cities. We plan to revise the INTERACT conceptual framework, reach out to key academic experts and knowledge users covering additional areas of expertise and consult with the larger Canadian community of researchers working on healthy cities, their network of knowledge users, and citizens to develop a comprehensive conceptual representation supporting a shared vision of a pan-Canadian healthy cities intervention research program. |
| Building Healthy Cities | 2018 | Project title: Understanding the Population Health Impacts of a City-Wide Initiative to End Poverty Abstract/SummarySocioeconomic status has been linked to health across a wide variety of populations, with a clear and consistent finding that "the poor die first" (Glymour, Avendano, & Kawachi, 2014, p 17). In 2016, the City of Edmonton initiated a bold and comprehensive approach to ending poverty within a generation called EndPovertyEdmonton. Many other Canadian municipalities are developing poverty alleviation, reduction, or elimination plans; provinces are following, and the federal government is currently developing a national poverty reduction strategy. The success of these efforts depends on large, multisectoral collaboration and leadership, and ongoing and intentional learning and evaluation processes. However, the latter rarely occurs (Cabaj, 2011; Lowen, 2009); measurement of these efforts are prohibitive as they require significant coordination, expertise, and cost. Through this IPPH opportunity, we will be able to study population level impacts of a comprehensive and bold poverty elimination plan that will inform efforts on what other Canadian cities can do to address poverty and ultimately have healthier cities. |
| Building Healthy Cities | 2018 | Project title: Creating Connections: Innovative transportation solutions for older adults Abstract/SummaryCanadian census data released in 2016 reported that for the first time in our history there are more older adults (>=65 y) than children (<=14 y) in the general population. The proportion of seniors is projected to exceed 30% by the year 2050. Older adult independence is limited by physical and mobility challenges. Mobility is "the best guarantee of retaining independence ..." and limited mobility predicts disease, disability and mortality. The transportation needs of older adults will shift with this aging and increasingly low-activity demographic. In 2009, 200,000 Canadians aged >85 held a driving license. Transportation immobility contributes to a cascade of negative effects, as increased reliance on others for transportation and inadequate transportation services (e.g. HandyDart) limits access of older adults to family, friends and community based and health care services. This in turn may negatively impact their physical, emotional and mental health -- including their ability to stay socially connected. Given the importance of improving seniors' health in Canada, there is a desperate need for blue sky intervention strategies that offer Canada's oldest citizens accessible, affordable transportation alternatives. Ideally, these alternatives would integrate mobility, physical activity and social connectedness with safe, transportation services while considering new and renewable sources of energy. We propose to convene a group of experts and stakeholders to enhance the health of older adults at the population level by cultivating innovative scalable 'rideshare' transportation strategies. We will synthesize and evaluate existing evidence on transportation and health for older adults and host a catalytic think tank event. By providing a conduit for discussion, ideas, synthesis and action we ultimately aim to create and implement a sustainable, environmentally friendly transportation solution that promotes the health and social connectedness of older adults. |
| Building Healthy Cities | 2018 | Project title: SMART PREVENTION: Developing smart city enabled precision public health research infrastructure for disease and injury prevention Abstract/SummaryCity infrastructure - roads, energy systems, sewers, transit, parks, communication technology - are important factors in human health outcomes. Cities are increasingly investing in information and communication technology infrastructure to improve economic productivity, efficiency and sustainability. These "smart cities" are a new frontier in urban decision making. To date, very little research has examined the health and health equity impacts of smart city infrastructure. Despite lofty claims about the benefits to be reaped through smart city technology, significant questions remain about the actual health impact of these advances, and how these impacts are distributed within the Canadian population. Smart Prevention is our new term to describe how smart city approaches can be applied to chronic disease and injury prevention in cities, and promote health equity. Our project aims to: 1) build on our team's smartphone health intervention work to examine how different local neighbourhood area environmental exposures are linked with health outcomes within diverse populations living in 4 Canadian cities; 2) document and analyze the process of how smart prevention projects engage different stakeholders - industry, municipalities, researchers, community groups, and the broader public - and how smart prevention projects are implemented in different cities; and, 3) to scale up lessons from 1 and 2 to create a web-based dashboard system for city leaders, supporting their real-time operational decisions and strategic planning to improve health outcomes and health equity in Canadian cities. We will do this by assembling our multi-sector, interdisciplinary team of experts to: identify research sites; make context-specific adaptations of our existing smartphone data collection app, and; develop specific research protocol and collaborative research program teams for each city. |
| Building Healthy Cities | 2018 | Project title: Healthier Cities, Sustainable Futures: Leveraging Municipal Smart City Data and Technological Innovation to Improve Population Health and Health Equity Abstract/SummaryHealthy Cities initiatives worldwide have demonstrated that health is closely tied to where people live, including local social issues, policies and the economy. The City of Edmonton is a leader in linking healthy city principles with city building. They include healthy cities principles in strategic visions and in planning and development policies. Edmonton is also a leader in traffic safety: it was the first major Canadian city to adopt Vision Zero (zero traffic fatalities and serious injuries). Edmonton is also working with its municipal partners in the Edmonton Metropolitan Region to implement coordinated, growth-oriented sustainable planning and development. Blue-Sky Idea: We will develop an Edmonton Metropolitan Region healthy city Living Lab to systematically study how municipal initiatives impact health and health equity. The Living Lab will include 4 inter-related Activity Nodes: 1) Health & Social Impact: quality of life, physical health, mental wellbeing, social inclusion and urban indigenous health; 2) Accessible & Safe Environment: accessibility, transportation and traffic safety; 3) Innovation & Evaluation: impact of building and community design on health; and 4) Sustainability: environmental issues. Plan/Impact: The Living Lab will use rigorous scientific methods, theory, and scientific and practice-based data. We will develop leading-edge data collection strategies that build on technological advances. We want to understand the health consequences of community design. The Living Lab will build on a rich partnership between researchers and cross-sectoral practitioners from the City of Edmonton and other key organizations and municipalities in the Edmonton Metropolitan Region. We will continue to build the Living Lab initiative through two planning meetings and current state of science assessment through rapid reviews (academic sources) and environmental scans (grey sources) related to the Activity Nodes. |
| Building Healthy Cities | 2018 | Project title: A Nature-based Solutions Research Incubator (NBSRI) for Healthy Cities Abstract/SummaryOur research team seeks funding to support planning activities focused on the development of a nature-based solutions approach to assess health benefits from urban infrastructure development and renewal. Nature-based solutions are actions to protect, manage and restore urban ecosystems as a part of urban planning while also providing benefits to human health. More than 82% of Canadians live in cities and there is increasing evidence that natural features are an important feature of built environments that mitigate stressors on health. Grant funds will be used to identify urban challenges where health benefits can be found from implementing nature-based solutions. Funds will also be used to plan for the creation of a nature-based solutions research incubator to evaluate health impacts or benefits from urban development projects, assess health outcomes associated with existing programs and interventions and implement innovative data collection and sharing processes using citizen science and integrated school-based curriculum opportunities. |
| Building Healthy Cities | 2018 | Project title: Building Healthy and Resilient Cities: Identifying and Creating Enablers for Effective Governance Processes Abstract/SummaryCity governments are investing to create places where people can work, live, and play in a healthy way according to their life goals. Even though city governments aim to improve citizen well-being, they are also faced with stresses and shocks such as extreme weather events, air pollution, and aging populations which create challenges to building healthy cities. Improving the city's resilience or its capacity to adapt to stresses has been identified as a strategy for creating and maintaining healthy cities. Unfortunately, there is only limited knowledge about the best type of city governance to achieve these goals. We propose to develop the blueprint for large-scale investigation about how to increase resilience through city actions in 5 Canadian cities and 5 European cities. We propose to conduct a 2-day workshop during which researchers and knowledge-users involved in two major Canadian initiatives will be gathered together to design the large-scale investigation. The first initiative is called The LivingLab on Urban Resilience Governance and is a collaborative space that brings together Canadian city managers, private organizations, citizens, and university researchers. The LivingLab is an incubator for developing new approaches for increasing resilience and is funded by the Fonds de recherche du Québec. The second initiative is called MUSE (Multisectoral Urban Systems for health and Equity in Canadian Cities) and is a 5-year research program funded by the CIHR. The program of research is aimed at understanding how partnerships can help build healthy cities to improve physical activity, healthy eating, and safe/affordable housing. Specific topics to be addressed during the workshop include identifying research questions, choosing the design, developing measures, describing data analysis approaches, and developing the best ways to share the new knowledge gained through the projects. |
| Building Healthy Cities | 2018 | Project title: Creating a Healthier Community through Indigenous Approaches to Health and Wellness Abstract/SummaryHealth and wellness promotion within Indigenous peoples is an important line of research directly meeting the research priorities and mandate of the CIHR Institute of Population and Public Health. New and culturally relevant methods of improving the health and wellbeing of Indigenous communities need to be addressed that leave sustainable effects upon the community. Our proposed planning grant will engage key stakeholders at all levels including Indigenous scholars, Elders, and community leaders, and organizations (non-profit, provincial, and federal) and decision makers dedicated to improving the health and wellbeing of Indigenous communities. We envision the creation of various new inter- and multi-disciplinary collaborations amongst our research team and key knowledge users ultimately improving the health and wellness of Lytton First Nation. We will capitalize on the best aspects of existing models in health and wellness promotion incorporating Indigenous knowledges and traditions to allow for the development of a viable program that improves the health and wellness of Lytton First Nation. |
| Building Healthy Cities | 2018 | Project title: Policy Action for Healthy Cities Abstract/SummaryUrban change is typically driven by intersectoral policy action at local and regional levels, driven by agendas outside of the realm of health (e.g. sustainability, housing, transportation). Yet there is no tracking of these intersectoral policy actions across the country, limiting the ability to determine which policies carry the greatest potential for creating healthy cities. Our vision is a collaborative research initiative to specify policies that have the greatest potential for the healthy cities agenda, and track their impacts on health behaviours and outcomes. In this planning grant (year 1) we will scope policies that may impact health, and inventory the extent of policy action in cities across the country. In the following 5-7 years, we will refine the inventory, collaborate with stakeholders to: identify and model health impacts of select policy scenarios; and to design and conduct studies to assess the health impacts of policy actions. This specific 1 year planning grant includes two main activities: A. Think Tanks, which will assess the scope of policies currently developed and under consideration in 5 realms: sustainability, active living, housing and urban planning, age-friendly cities, and road safety. B. Incubator Session. The team will convene to synthesize the findings of the think tanks and cement the plan for the multi-stage research program. As outputs, in the planning stage we will develop a national policy inventory which we envision as an open resource. The overall research program will result in a toolbox of best practices in healthy public policy targeted to stakeholders. In addition, we will use health impact modeling tools and make these available for cities. Through this work we aim to catalyze new interdisciplinary collaborations (planning, geography, engineering, data science, health, and political science) and of primary importance, engaged work with intersectoral stakeholders to advance knowledge on policy action for health. |
| CIHR-NSERC-SSHRC Healthy Cities Research Training Platform (HCRTP) - Full application | 2021 | Project title: Implementing Smart Cities Interventions to Build Healthy Cities (SMART) Training Platform Abstract/SummaryThe Implementing Smart Cities Interventions to Build Healthy Cities (SMART) training platform addresses an urgent need to build capacity in implementation science to develop, evaluate and promote the uptake of interventions, with the aim of improving population health. A central driver of population health is access to healthy food, with food insecurity linked to a number of poor physical and mental health outcomes. In Canada, there are large differences in food insecurity across urban areas, accompanied by mounting evidence that the built environment and food systems can influence access to affordable and healthy food. Food security and resilient food systems are thus critical to building healthy cities. We propose a national implementation science training program whose hallmarks include (1) a thematic focus on the central place of food in healthy cities; (2) the use of 'big data' to create smart solutions for urban environments, and (3) bringing together the best knowledge, practices and tools from different fields of study to find solutions to complex problems. Focusing on food as a theme in the proposed training platform will equip trainees with transferable knowledge and skills to tackle many Healthy City challenges. They will learn, for example, that food security is a complex, multidimensional and multisectoral issue that requires collaboration and a systems-thinking approach. Specifically, the SMART training platform will deliver new curriculum, experiential learning, a portfolio of courses across 9 academic institutions, an annual conference, a summer institute and a virtual hub of resources. In addition to training a critical mass of future implementers to support the growth of Healthy Cities, SMART will strengthen implementation science practice and research in Canada, intensify research and generate innovation, create new research-practice partnerships and improve health outcomes related to food in Canada and globally. |
| CIHR-NSERC-SSHRC Healthy Cities Research Training Platform (HCRTP) - Letter of Intent | 2020 | Project title: Healthy Cities of Tomorrow Research and Training Platform Abstract/SummaryThis project aims to train a generation of researchers and professionals who will help Canadian cities foster human health, reduce social inequity, and protect the environment. We will develop a training platform that reinforces urban planning and public health as interdependent disciplines, like they used to be more than a century ago. The platform will unite professors, health professionals, urban planning organizations, and other partners to develop a research training platform that will: 1) train students in a new interdisciplinary field that integrates urban planning, geography, engineering, public health, and environmental sciences; 2) produce a systematic framework that details best practices for urban projects like light rail, which are associated with better health and environmental outcomes; and 3) generate and maintain an accredited, freely accessible online course on healthy cities. The unifying hallmark of these activities will be the investigation of the environmental, health-related behavioural, and social impacts of large urban infrastructure projects across Canada. The 'low carbon transport' theme will examine best practices for implementing transport projects that balance environmental sustainability and promote human health. The 'healthy neighbourhoods' theme will focus on the interplay between social and built environments and cardio-metabolic health. The 'sustainable urban natural environments' theme will consider the multi-level impacts of urban environmental exposures in a changing climate. The platform's training program will include opportunities for students to study within the key theme areas, pursue internships with project partners, participate in an annual 'Building Healthy Cities' workshop with peers and mentors, and collaboratively build an online 'super-course,' which will eventually serve as a repository of knowledge, freely accessible to all. |
| CIHR-NSERC-SSHRC Healthy Cities Research Training Platform (HCRTP) - Letter of Intent | 2020 | Project title: Implementing Smart Cities Interventions to Build Healthy Cities Abstract/SummaryThe Implementing Smart Cities Interventions to Build Healthy Cities training platform will leverage the multidisciplinary and multisectoral nature of Smart Cities approaches, along with a $60M investment by Infrastructure Canada in three Smart Cities Challenge Finalists and Winners focused on food and health issues to deliver a world-class, high-impact training environment that will build capacity in the design, implementation and evaluation of urban interventions to promote well-being. Led by researchers at the Universities of Guelph (Ma/NSERC), McGill (Dube/SSHRC) and Manitoba (Suh/CIHR), who have over 50 combined years of research experience in directing large multidisciplinary efforts, the proposed platform will provide trainees with a rich ecosystem of 100+ ready-to-go projects, and access to 100+ community partners and the implementation science expertise of 50+ researchers. Specifically, the national training platform will engage Smart Cities initiatives and implementation partners in three urban centres: Guelph (Ontario), Montreal (Quebec) and The Pas (Northern Manitoba), (www.infrastructure.gc.ca/cities-villes/index-eng), where they will test theories of practice, develop new tools and methods, engage in collaborative and integrative approaches and acquire professional skills that enhance job-readiness. The platform will be a transformative step toward the implementation of successful and scalable solutions to the challenges faced by complex urban communities. |
| CIHR-NSERC-SSHRC Healthy Cities Research Training Platform (HCRTP) - Letter of Intent | 2020 | Project title: Training for Healthy INterdisciplinary Knowledge in Cities (THINK-Cities) Research Training Platform Abstract/SummaryThe Training for Healthy INterdisciplinary Knowledge in Cities (THINK-Cities) Research Training Platform is a national initiative to develop a new generation of leaders with interdisciplinary expertise in implementation of research-based approaches to improve health and reduce health inequalities in cities. The THINK-Cities framework is built around three core domains: housing, mobility, neighborhoods, four overarching themes essential to achieving healthier communities: scale of implementation, sociopolitical context, sustainability, and equity, and two nodes addressing "mid-sized/small cities" and "global cities". The team is led by three established researchers and the Urban Public Health Network (UPHN). UPHN has 15 years of successful collaboration with Medical Health Officers across Canada to address public health in urban populations. The leadership team brings diversity in disciplinary expertise, gender, career stage, and are based within Canada's three largest cities. The team brings decades of experience implementing solutions-based research with partners in Canadian communities. Our program will recruit leading trainees from health, social science/humanities, and natural sciences/engineering to gain specific cross-cutting competencies in a team-focused, solution-based training initiative. Trainees will develop skills to address challenges faced by municipalities by viewing cities as complex systems (engineering lens), as communities (social science/planning lens) and as opportunities for health-enabling design, planning and delivery of services (population health lens). Our training program will focus not only on absolute health, but health disparities within cities and will emphasize sociopolitical context, geospatial approaches and cross-cultural considerations explaining these disparities. After their experience with our team, trainees will be ready to tackle challenges affecting health and health inequalities in cities across Canada and globally. |
| CIHR-NSERC-SSHRC Healthy Cities Research Training Platform (HCRTP) - Letter of Intent | 2020 | Project title: Bringing Urban-based solutions from Implementation science to future Leaders and Decision-makers (BUILD): a national certificate training program on implementation science and solutions based research. Abstract/SummaryApproach: Bringing Urban-based solutions from Implementation science to future Leaders and Decision-makers, or BUILD, is a proposed national training platform that aims to establish a multi-level certification program supported by interdisciplinary and intersectoral partnerships across Canada. BUILD will draw from real world and provide hands-on experiences to teach critical skills on the design, implementation, and evaluation of complex interventions to address a diverse set of challenges impacting population health and wellbeing in Canadian cities. Objectives: To build capacity in the design, piloting, evaluation, implementation, and scaling of interventions to reduce environmental, social, and health inequities in cities by: 1. Establishing and applying best practices in academic, professional, and experiential education in implementation science and solutions-based research; 2. Developing a core and interdisciplinary set of competencies among learners (trainees and knowledge users) that can be applied to diverse challenges facing cities; 3. Creating and fostering a national, and internationally-recognized, community of practice of experienced mentors; 4. Ensuring the multidimensional career readiness of learners; 5. Facilitating opportunities for interagency networking and intersectoral partnerships. Equity: By focusing on growing environmental, social, and health inequities between and within Canadian cities, BUILD takes an intersectional approach, integrating inclusion of populations excluded at societal and community levels based on intersecting race; sex, gender, and sexual orientation; religion; migration status; socioeconomic status; disability; and geographical location. BUILD prioritizes inclusion of these populations at all levels of the platform, including in leadership, team, partnership development plan for engaging partners and collaborators, approaches, design, curriculum, instructors, learners (trainees and knowledge users), and evaluation. |
| CIHR-NSERC-SSHRC Healthy Cities Research Training Platform (HCRTP) - Letter of Intent | 2020 | Project title: Healthy Cities Training Initiative (HCTI): an intelligent urban health and resilient monitoring, assessment, and management Platform and Network for Resilient, Healthy Canadian Cities Abstract/SummaryCanadian cities and their residents face significant challenges due to climate change and the rising frequency and severity of disasters that couple with the aging infrastructures and technological disruption. The socio-economic and environmental resilience of Canadian cities requires enabling conditions where healthy individuals and communities can thrive, and where institutions, organizations and infrastructures can adapt swiftly and appropriately to the new and emerging conditions through timely and embedded adaptation, mitigation, preparedness, response and recovery strategies that are science and evidence-based. Such conditions are not automatic but rely on political decisions, democratic process and community involvement at all stages of design and implementation. Today's challenges require a new generation of highly qualified personnel (HQP) equipped with skills and training to be able to facilitate and conduct collaboration across sectors, services and professional or disciplinary silos, as well as an enhanced ability to work directly with urban residents, decision-makers, and other stakeholders. We will develop a Healthy Cities Training Initiative, whose Network and Platform will interact synergistically to produce a new generation of leadership and innovations to enable the conditions for resilient, healthy Canadian cities. We will create a Network of academics and their collaborating stakeholders across municipal, provincial and federal levels to mentor and develop trainees for development of an effective, data driven, intelligent health and resilience monitoring, assessment, and management Platform. The Platform will draw on causal mapping, state-of -the-art artificial intelligence and big data technologies to create targeted analytics and goal oriented Data Dashboards, and for complexity agent-based simulation and Scenario Planning. Such innovations will then be applied to the social, environmental and health challenges faced by Canadian cities. |
| Data Analysis Using Existing Databases and Cohorts | 2020 | Project title: The Urban Exposome and Inflammatory Bowel Disease: Determining Environmental Factors that Increase the Risk of IBD and the Cost of Care Abstract/SummaryThe environment strongly affects our health and living in a city increases the risk of inflammatory bowel disease (IBD). This may be due to air pollution exposure, reduced green space, or other environmental factors. Our project will first describe geographic areas where IBD is more prominent, IBD surgery rates are higher, and the need for medical care for IBD is greater. We will then examine the impact of urban environmental exposures on these outcomes, such as air pollution, green space and bright lights at night. The Canadian Gastro-Intestinal Epidemiology Consortium (CanGIEC) is a team of IBD physicians and researchers from four provinces (Alberta, Manitoba, Ontario, and Saskatchewan). Using large health system databases, we will link each person with IBD living in these provinces to environmental data provided by the Canadian Urban Environmental Health Research Consortium (CANUE) and Health Canada. We will determine how combinations of environmental factors impact the risk of IBD, the need for surgery, and the need for health care. Overall, our goal is to determine the components of living in an urban area that may explain why city-dwellers have a higher risk of IBD and to inform environmental and health policy to help decrease the risk of IBD. |
| Data Analysis Using Existing Databases and Cohorts | 2020 | Project title: Cognitive Aging in Canadian Women and Men: An Exploration of Environmental Contributors and Interactions with Individual Factors Abstract/SummaryAge-related decline in cognitive performance is common among older adults; however, not all adults show the same magnitude decline, and indeed, some adults maintain cognitive performance in late life. The intent of the proposed study is to examine cognitive changes among older adult participants in the Canadian Longitudinal Study of Aging, using data collected at baseline and follow-up 1. We will first characterize cognitive changes over time and whether they are similar across cognitive domains, across men and women, and across younger old and older old participants. Next, we will link objective environmental variables collected by the Canadian Urban Environmental Health Research Consortium to the Canadian Longitudinal Study of Aging dataset and then determine to degree to which urban environmental factors (e.g., pollution levels, access to green space and walkable neighborhoods) predict the amount of cognitive aging experienced at the individual level. Finally, we will evaluate whether individual-level variables (e.g., demographic factors, health status, health behaviours) modify the association between the environment and cognitive aging. Overall, the proposed study will shed light on the nature of cognitive aging and the role of the environment in either mitigating or accelerating cognitive aging. |
| Data Analysis Using Existing Databases and Cohorts | 2020 | Project title: Characterizing mortality rates and associated modifiable determinants among people who inject drugs in a large, urban Canadian city: Implications for future population health interventions Abstract/SummaryPeople who inject drugs (PWID) often face profound socio-economic disadvantage and are one of the most vulnerable groups in society, with a global mortality rate nearly 15 times that of the general population. Largely concentrated in cities, PWID are disproportionately exposed to housing vulnerability, with up to 60% of those living in large North American cities reporting recent unstable housing. Access to safe and stable housing is a well-established determinant of health and has gained renewed focus as a structural target for intervention following the limited success of conventional public health approaches to reducing morbidity and mortality in PWID. Data on mortality rates and trends among PWID are particularly scarce in Canada. Further, despite evidence for a broadly deleterious impact on PWID health, relationships between unstable housing and mortality are not well understood. This study seeks to examine mortality rates and refine our understanding of the relationship between these aspects living context and mortality, and ultimately guide policies and interventions that address inequalities related to housing stability and service distribution within our cities. This study will capitalize on data collected as part of St. Luc/HEPCO, one of the largest prospective cohort studies of PWID, having recruited more than 4000 participants since 1992, with detailed assessment of behavioral and service use data, as well as geospatial and laboratory data. Mortality and causes of death among cohort participants will be obtained via record linkage with the Institut de la Statistique du Québec. This project will improve our understanding of how housing contexts influence this ultimate health outcome. Findings will be relevant to city planners and community organisations seeking to allocate housing solutions and services in a manner that supports our most vulnerable citizens. |
| Data Analysis Using Existing Databases and Cohorts | 2020 | Project title: Exploring inequalities of greenness accessibility to inform interventions to reduce avoidable development of allergic-related respiratory problems in children Abstract/SummaryGreenness associated with fresh air, active living environment, and psychological relaxation are considered to confer various health benefits. However, previous studies have not offered conclusive results on the health effects of greenness exposure. This may be related to the use of the normalized difference vegetation index (NDVI) as a proxy for measuring green space. This index fails to effectively reflect access to greenness and thus may misclassify exposures. The health impacts of greenness accessibility are less known, particularly on children's respiratory health. That is an important knowledge gap as children's lung development is not complete until 5~8 years of age, a period when they spend increased time outdoors. The potential for inequality of spatial greenness accessibility to affect the development of asthma, allergic rhinitis, bronchitis, and bronchiolitis in children remains unclear. Our research team attends to leverage the Better Outcomes Registry and Network (BORN) via ICES and the CANUE databases to assess if better spatial greenness accessibility could reduce the risk of the four respiratory conditions onset in children aged 13 years and younger in Ontario. Findings from this study will provide evidence to better assess for whom and where health interventions should be targeted, which communities may benefit from more green space, and where communities may consider reducing infrastructure and traffic effects to minimize inequality in greenness access. Additionally, we propose a novel method that can provide a more precise measure for spatial greenness accessibility by travel time with regard to factors on road conditions, land use, geographic barriers, season, weather, air quality, and holidays to the nearest green space by the introduction of the Ontario Ministry of National Resource and Forestry (OMNRF) to the CANUE repository. Finally, the proposed study will pave a solid theoretical and data foundation for future studies in related areas. |
| Data Analysis Using Existing Databases and Cohorts | 2020 | Project title: Neighbourhood environments as a determinant of physical and mental health outcomes in a context of smaller urban and rural settlements Abstract/SummaryChronic diseases such as diabetes are increasingly common in Canada and around the world, but many actions can be taken to promote good physical and mental health. Through our research, we will generate policy-actionable evidence for promoting interventions to improve the environments in which people live, work, and play to reduce the risks associated with chronic disease. We will use different data sets covering a wide range of contextual information on local climates, socioeconomic characteristics, and built environments that may facilitate or hinder physical activity in daily life. We will link these data sets to multiple years of individual-level data on having developed diabetes and other chronic diseases, or being hospitalized for these largely preventable conditions. This is important because using one data source alone would not give us good measurements that reflect the complexity of factors influencing people's health. We use statistical tests to examine trends over time in how living in more-walkable versus less-walkable neighbourhoods are related to chronic disease outcomes. |
| Data Analysis Using Existing Databases and Cohorts | 2020 | Project title: Injury Risks among Canadian Bicycling and Walking Commuters: A new application of the Canadian Census Health and Environment Cohort (CanCHEC) Abstract/SummaryWalking and bicycling are healthy and environmentally friendly forms of transportation. Healthy cities encourage active transportation because it has many benefits to cities and their residents. But people walking and bicycling are more vulnerable to road injury and safety concerns may affect the choice to use active transportation. While Canada has good information on the number of injuries and fatalities among pedestrians and bicyclists, this is not enough to tell us about the rates and risks of injury among users of active transportation. For risk and rate calculations, we need to know how many people use each form and how much they use it (how far and how long they travel). This will then allow "apples to apples" comparisons between groups such as men and women, or between provinces and cities, or within cities before and after changes are made to try to improve safety. Our project will help fill this gap in our knowledge. We will use data created by Statistics Canada and Health Canada: the Canadian Census Health and Environment Cohort (CanCHEC). This is a cohort that follows participants in the long form Canadian census and determines health outcomes they experience over follow-up. The long form census collects information on how people get to and from work, which will allow us to isolate bicycling and walking commuters to determine their risk of injury. We will use records of hospital treatment (including cause of injury) to determine who has been injured and death records (including cause) to determine fatalities. We will examine how risk of injury differs between men and women, by age, by measures of wealth, and by scores that measure whether their neighbourhood design encourages active transportation. This project will build new ways to evaluate, compare and monitor risk among active transportation users for cities, city planners, health care providers, injury researchers and road safety advocates. |
| Data Analysis Using Existing Databases and Cohorts | 2020 | Project title: Food insecurity in Canadian cities and the role of provincial poverty reduction policies Abstract/SummaryHousehold food insecurity, insecure or inadequate access to food due to financial constraints, is a measure of severe poverty-level living conditions and a potent social determinant of health in Canada. It is also a pervasive problem in Canadian cities with food insecurity rates among census metropolitan areas ranging from 9.7% in Quebec City to 17.2% in Halifax (2015/16). Food insecurity among urban households presents an ongoing challenge to the vision of 'healthy cities'. Municipal governments frankly acknowledge their limited ability to address the problems of poverty that underpin food insecurity. Cities' social safety nets significantly rely on provincial and federal sources of funding and the social programs most influential in reducing food insecurity fall under provincial and federal jurisdiction. This is an exceptionally opportune moment for conducting a secondary data analysis to study the influence of provincial and federal policy actions on food insecurity rates in Canadian cities. There is now sufficient micro-data available from the Canadian Community Health Surveys (CCHS: 2005-2018) for a simultaneous inter-jurisdictional (cities and provinces) and temporal trend analysis of food insecurity. This period also captures a period during which poverty reduction gradually became a political priority for successive higher-level governments. Our proposed research will determine how policy actions at higher levels of government have influenced food insecurity rates in cities, laying the foundation for more coordinated actions across these levels of government to address food insecurity effectively. We will exploit provincial variation in the timing and scope of policy actions to assess how they influence the prevalence and severity of food insecurity in cities. We propose to address the research question: What has been the macro-level effect of poverty reduction policies at higher levels of government on food insecurity in Canadian cities (2005-2018)? |
| Data Analysis Using Existing Databases and Cohorts | 2020 | Project title: Housing needs, neighborhood quality and mental health Abstract/SummaryIn 2016, 1.7M Canadian households were in core housing needs, meaning that their dwelling required major repairs, was overcrowded, and/or unaffordable. While there is geographic variation between cities, the largest variation in housing needs is within cities. International studies suggest that poor housing conditions in neighborhoods can have an impact on population health. Studies also demonstrate the spatial correlation of housing conditions with other neighborhood features associated with health. Quantifying this correlation is needed since interventions designed to build healthy cities may unintentionally widen social and health inequities by increasing housing prices and displacing people. The aim of this project is to understand the spatial distribution of housing needs and its association with population mental health outcomes, and the potential frictions between building healthy and sustainable neighborhood and housing affordability. To meet these objectives, various sources of administrative, environmental, and population data will be merged. We will focus the analyses on Montreal, given the unparalleled breadth of housing data available for this city, both at the neighborhood and individual levels. Specifically, the project will assess the spatial distribution of housing needs, and test association with mental health outcomes for 5000 tenants and with other features of healthy neighborhood environments, such as access to greenness, active living environments, and access to public transit. The type of evidence generated by the project is paramount to inform public health authorities on where, when, and how to intervene. More broadly, the project will provide critical information for laying the foundation for future research assessing housing interventions for their impacts on population health, and for anticipating the potential for healthy city interventions to increase social and health inequities by increasing housing unaffordability. |
| Data Analysis Using Existing Databases and Cohorts | 2020 | Project title: The impact of the built environment on incidence of obesity, chronic diseases and health status in Canada Abstract/SummaryIt is recognized that poorer population health outcomes are correlated with a range of features of the built environment such as neighborhood fast-food restaurants, convenience stores, urban sprawl and walkability. But the impact of these built environment features on health outcomes are largely unknown because they are likely to be confounded by selection biases (e.g., the unobservable factors that affect where a person decides to live may also affect his/her health outcome). Although this type of confounding is recognized in the literature, it is rarely addressed while studying the impact of built environment features on population health. Consequently, concrete policies to promote population health by influencing the built environment features have been quite difficult to initiate. The goal of this proposal is to undertake longitudinal analyses of the impact of the built environment features on health outcomes (self-reported health status, and health-related quality of life) and incidence of obesity, high blood pressure, type 2 diabetes and heart disease using longitudinal econometric modelling techniques and survival analysis, respectively. The data for this research will come from a) longitudinal built environment data (2002-2011) compiled from disparate sources by our previous CIHR funded operating grant (MOP-97763), b) Statistics Canada's National Population Health Survey longitudinal data (1994/95-2010/11); c) Dissemination area-level socio-economic data from the 2001, 2006 and 2011 Censuses; and d) Canadian Urban Environmental Health Research Consortium data. The findings of this research will help inform whether policies targeting the built environment features at the city level or small area-level could reduce the incidence of obesity and preventable chronic diseases and improve the health status of various socio-economic segments of the population living in Canada's urban jurisdictions. |
| Data Analysis Using Existing Databases and Cohorts | 2020 | Project title: Are Experiences of Discrimination Contributing to the Mental Health Status of Canada's Diverse Urban Population? Responding to the Call from the Federal Government's 2019-2022 Anti-Racism Strategy Abstract/SummaryAs Canada strives to understand the health of its urban population, it cannot do so without grappling with the role of race/ethnicity in producing inequities amongst urban Canadians. Indeed, urban areas are the centre of Canada's considerable race/ethnic diversity, and the 2019-2022 Federal Government Anti-Racism Strategy is clear about the near for more data on racial/ethnic inequities in Canada. Our proposed project will use the Canadian Community Health Survey, including its 2013 Rapid Response Module on Discrimination, to examine racial/ethnic inequities in the mental health outcomes of urban Canadians, which will inform this strategy, and contribute to the growing scientific and public discourse. |
| Data Analysis Using Existing Databases and Cohorts | 2020 | Project title: Advancing healthy cities intervention research: developing measures for the bicycling environment Abstract/SummaryThe Canadian Public Health Officer's 2017 Report called for greater attention to the built environment to understand how community design can support healthy living. However, research and surveillance on the impacts of built environment changes remains challenging due to huge data gaps in measuring "healthy" environments. In the realm of active transportation, the new Canadian Active Living Environment (Can-ALE) is a national dataset with measures on how supportive communities are for walking and public transit. But there is no analogous data on bicycling environments, despite the fact that bicycling is the primary travel mode for nearly 12% of commuters in some cities (e.g., Victoria, Census 2016) and the fastest growing travel mode nationally. Further, cities from coast to coast are announcing multi-million dollar investments in bicycling infrastructure networks (Victoria in 2016, Halifax in 2019). In this project, we aim to develop measures for bicycling infrastructure for all communities in Canada, at the neighbourhood level. Specifically, we will: develop a dataset with measures of the bicycling environment; validate the measures using existing national administrative datasets, including Can-ALE and Census bicycle journey-to-work data. Our work will directly advance healthy cities intervention research in Canada by providing standardized metrics that can facilitate multi-city studies, as well as those that track change over time. These new measures will be fundamental for evaluating the impacts of future bicycling-related policy and built environment interventions on population health and healthy equity. As a team of health and geography researchers leading applied bicycle research in partnership with cities across the country, we are uniquely positioned to conduct this work. Our project priorities include accessible data that everyone is able to use. |
| Data Analysis Using Existing Databases and Cohorts | 2021 | Project title: A retrospective cohort using multilevel modelling of administrative data to predict and prevent movement of low-income older adults from social housing into Long Term Care facilities: Development of the Keeping Low-income Older adults in Social housing hEalthy at home ('KLOSE') Tool Abstract/SummaryThere are three goals for this project. One is to find out the reasons why people living in social housing buildings move to long term care homes. The second is to create a tool that will help the health system know who is most likely to move to long term care. The third is to make sure that managers within the health system are aware of our results and new tool. We will review the records of people living in social housing and information about their neighbourhood. |
| Data Analysis Using Existing Databases and Cohorts | 2021 | Project title: Energy poverty in Canada: What are the implications for the health and well-being of Canadians? Abstract/SummaryHouseholds are considered to be in Energy Poverty (EP) when they are unable to afford or access adequate energy at home to meet their needs and maintain healthy indoor temperatures. While EP depends on household factors such as low income and energy needs and practices, it is also caused by several external factors, such as energy inefficient dwellings and high energy prices. EP is thus not simply a problem of low income. Depending on the measure used, some 8% to 20% of Canadian households are living in energy poverty. In certain areas in Atlantic Canada, up to 35% of households are energy poor. EP is inequitably distributed, with women, older adults, people living alone, those with lower education, rural dwellers, recent immigrants, and racialized communities being at increased risk of experiencing EP. International evidence shows that living in EP is associated with cardiovascular and respiratory diseases and poorer mental health. This project, EPIC, is the first examination of EP as a determinant of health in Canada. EPIC will: 1) map EP at small geographies across Canada, document the scale of the problem, and identify which communities are most at risk, 2) tap into national survey and linked cohort data to provide epidemiological evidence on the health impacts of EP in Canada, and 3) provide an in-depth understanding of what it means to be living in EP. EP is a modifiable risk factor with potential solutions being shared between the public and private sectors. By providing rigorous evidence, EPIC will lay the foundation for research and action to reduce EP and improve health-related outcomes and contribute to national policy discussions at the nexus of public health, housing, and sustainability. |
| Data Analysis Using Existing Databases and Cohorts | 2019 | Project title: Developing a novel indicator to measure the advertising of unhealthy food to children Abstract/SummaryCanada has recently passed Bill S-228 An Act to amend the Food and Drugs Act (prohibiting food and beverage marketing directed at children) known as the Child Health Protection Act. This law will be reviewed by Parliament 5 years after it comes into effect. In order to assess how this new law has changed the landscape of food marketing to children in Canada we propose to analyze the advertising broadcast logs of every food that is advertised during a children's TV show to determine if that food is healthy or unhealthy and how those ads have changed over time. |
| Data Analysis Using Existing Databases and Cohorts | 2019 | Project title: Heat Warning Information Systems: do they protect Canadians from the effects of extreme heat? Abstract/SummaryExtreme heat can have drastic effects on human health. During this summer's heat wave, temperatures soared in Ontario and Quebec. Over 90 people died and dozens more sought medical attention for acute heat illness. Heat Warning Information Systems are one of the main tools used by health authorities to protect the public from heat waves. However, it is unclear as to how well these systems protect our cities, especially our most vulnerable community members (e.g. elderly). In this project, we will evaluate whether the Harmonized Heat Warning Information System, launched in Ontario in 2016, has helped to protect the health and well-being of Canadians. |
| Data Analysis Using Existing Databases and Cohorts | 2019 | Project title: SynthEco: Synthetic Ecosystems for Expanding Cohort Data to Full Population-Level Representation and Visualization for Decision Support: A Novel Methodology to Improve Urban Population Health Abstract/SummaryTo answer questions in urban planning and population-level health interventions such as where to place services, where to target health interventions, and how to increase equity in services, planners and researchers need tools providing granular, geographically and temporally resolved representations of the health and characteristics of their populations. Traditionally, population-wide data collection efforts are very difficult to execute due to the level of recruiting, cost, and methodological reliability. As a result, cohort studies are used to collect detailed data. Additionally, they may lack any representation of real-world environments such as households, schools, transit, workplaces, health facilities, and food environment. Here, we propose developing the SynthEco platform to operationalize government, private and academic research for population level urban and intervention planning by combining various disparate data collection efforts into a population-level, geographically explicit representation. It will be built upon the concept of a Synthetic Ecosystem (SE), a statistically representative virtual population embedded within a real-world environment. SEs serve as a key information technology for combining disparate data sources into a realistic, coherent whole, free of privacy concerns. They can be pivotal in planning population level health interventions in three ways: 1) by filling knowledge gaps that plague the use of cohort studies in population-level intervention and urban planning, 2) elucidating inequities in services throughout a population, and 3) aiding in developing and validating new measures of population health. SynthEco will allow planners and researchers to create, visualize and download Synthetic Ecosystems and will provide a general capability to operationalize cohort studies at the full population level by placing persons in a grounded real-world environment support decision making in urban and health interventions planning. |
| Data Analysis Using Existing Databases and Cohorts | 2019 | Project title: Creating and comparing activity space measures to understand how walkability, urban sprawl, and public transit accessibility are associated with location based physical activity in 4 Canadian cities Abstract/SummaryUnderstanding how individuals interact with their cities, how the move through their environments, and how characteristics of the urban environments like walkability, sprawl, and public transit can change physical activity behaviour is an important public health objective. Technological innovations in using smartphones allow researchers to collect highly detailed location and physical activity data using global positioning systems (GPS), cell phone towers, and accelerometers. However, there are still important challenges in making the best use of the large amounts of data researchers can collect from smartphones. Our team will work to develop new measures to understand how we can better use smartphone data to understand how the way people move in cities might influence their physical activity. |
| Data Analysis Using Existing Databases and Cohorts | 2019 | Project title: Estimating and Mapping Urban Community Differences in Health Outcomes for Adults with Chronic Disease in Canada Abstract/SummaryWe know that the neighborhoods and communities in which people live affect healthy behaviors, and the likelihood that people in them develop common chronic diseases like heart disease and diabetes. However, we know less about how neighborhoods and communities affect health outcomes among persons who have already developed chronic diseases. This study will use a large health care data base on health care use and costs of people across Canada, assembled by the Canadian Institute of Health Information. We will apply advanced statistical models to this data to describe how the risk of health outcomes for persons with chronic disease varies from community to community. We will also describe attributes of communities that are associated with these risks. Estimates of these risks, for neighborhoods and communities, will be put into detailed maps for urban areas across the country. This information can then be used by policy makers to target and design interventions, and by researchers to identify communities for further study. |
| Data Analysis Using Existing Databases and Cohorts | 2019 | Project title: Creating healthier cities through monitoring Canadian retail food environments: Using a novel administrative database to establish valid, small-area, Canada-wide, open-access measures to monitor the retail food environment for population health intervention research and municipal food environment policy action. Abstract/SummaryPoor diets are responsible for the largest burden of disease in Canada, and are shaped in part by the retail food environment: food availability, accessibility, and affordability where Canadians live, work and play. Currently, the biggest barrier to conducting transformative research on Canadian retail food environments is a lack of access to a large-scale, high-quality dataset. Our team partnered with Statstics Canada to pilot the novel use of the Business Register (BR), a high-quality, central repository of baseline information on all businesses (including retail food outlets) currently in operation in Canada. This database has huge potential for filling research gaps in a number of healthy city topic areas. This project will be the first to use existing microdata from the BR to develop and validate new RFE data, and develop data visualization products for examining Canadian RFE. We will also address critical contextual questions related to scaling up of evidence-based RFE interventions in Canadian cities. We aim to test the validity, sensitivity, positive predictive value, and representativity of Statistics Canada's BR data compared to Google Street View, DMTI Spatial, and Open Street Map. Second, we will develop data visualization products and measures for presenting and comparing Canadian RFEs. Third, we will conduct qualitative interviews with RFE researchers, municipal planners, public health practitioners, and federal and provincial nutrition leads to explore 1) potential applications of the data visualization products for different audiences, and 2) how contextual issues affect product uptake between different knowledge user groups and different geographic jurisdictions and settings (e.g., urban/rural). We will leverage existing relationships with Statstics Canada, CANUE, and Health Canada's Office of Nutrition Policy and Promotion as well as our international and national networks. |
| Data Analysis Using Existing Databases and Cohorts | 2019 | Project title: Planning tools to inform interventions to reduce avoidable hospitalization and premature mortality in Canadian cities Abstract/SummaryHealth decision makers responsible for cities lack the tools to help support how to best intervene to improve population health. There are no analytic tools that have been specifically designed for planning health interventions in cities. We propose to leverage newly linked data held at Statistics Canada Research Data Centres to go from simply describing what is happening across Canadian cities to what will and can happen under different intervention approaches. We have assembled a team of experts in developing population-based tools in addition to experts in urban health and knowledge translation to support policies and programs designed to support healthy cities. We focus on two meaningful outputs for health systems, individuals and population health: premature mortality and avoidable hospitalizations. Premature mortality captures deaths that occur before the expected age in a given population. These deaths are largely considered to be avoidable including through targeted policy and programmatic interventions within cities. Avoidable hospitalizations refer conditions that can be effectively prevented, treated, or managed in outpatient care, and thus should not require hospitalization. These outcomes represent valid, reliable, and robust and meaningful to health system planners. Importantly, they are sensitive to changes in preventive programs and policies, including those with an equity focus, and represent related outcomes along the health continuum. The goal of this grant is to use the national survey data linked with mortality and hospitalization databases to develop and validate prediction models that can be used to inform health planning in Canadian cities. We will also demonstrate the application of these tools by testing various interventions. The ability to create these innovative data products using existing data yield a new way to inform and evaluate interventions that will have greatest population benefits. |
| Data Analysis Using Existing Databases and Cohorts | 2019 | Project title: Healthy Cities, Healthy Minds. Genetic and Urban Environmental Influences on Childhood Mental Health Abstract/SummaryAttention deficit-hyperactivity disorder (ADHD) and obsessive-compulsive disorder (OCD) are common (5% and 2% respectively), impairing and long-lasting mental illnesses that start in childhood. These disorders run in families and twin studies show that genetic factors are important. Environmental factors, including those relevant to urban environments such as access to green space, social deprivation and air pollution, affect risk for ADHD and OCD. What we currently do not know is how genetic and urban environment factors interact to increase or decrease risk for those disorders on a population level. This information is necessary to inform population-wide policies. Genetics and the environment are usually studied separately because the large-scale data necessary for gene x environment studies has been lacking. Knowing how genes and environment interact is critical to being able to understand what causes these disorders, identify children at risk and inform city planning to maximize mental health in our community. To study how genes and urban environmental factors interact to affect ADHD and OCD, we will integrate existing, but currently separate, data sources: Spit for Science and Canadian Urban Environmental Health Research (CANUE) Consortium. The Spit for Science study collected genetic, mental health and Postal Codes from 17,000 children and adolescents. We can use a person's Postal Code to extract information about green space, air pollution, socioeconomic status, social and material deprivation from CANUE. Linking these data sources will allow us to identify gene x urban environment interactions that make children more or less likely to have ADHD and OCD. By conducting this large-scale gene x environment study, we hope to identify specific factors that increase or decrease risk for childhood mental illness, which could potentially lead to changes in urban planning, early detection, better treatments, and improved treatment-outcomes for Canadian youth. |
| Data Analysis Using Existing Databases and Cohorts | 2019 | Project title: Healthy Cities, Healthy People: Exploring environmental and behavioural predictors of chronic disease Abstract/SummaryIndividuals face a number of stressors in the environment in which they live that can either promote or impede their health. Environmental risk can include pollution of air, water or soil, built environments, and man-made climate and eco-system change. Over the past century, the number of Canadians living in urban areas has steadily increased mostly as a result of economic changes; in 2016, over 80% of Canadians lived within urban areas. This project will make use of new sources of high-quality data from Statistics Canada and the Canadian Urban Environmental Health Research Consortium, that link information on various domains of health to urban environmental risk factors. The overall objective of this study is to contribute to addressing important knowledge gaps by conducting unique research on how exposure to natural, built, and social environmental risk factors over time affects chronic conditions in cities across Canada. Currently, more research is needed in this area, given the lack of comprehensive data sources to assess and monitor the long-term effects of the urban environment on chronic conditions. The findings can be used to inform and develop targeted and relevant population health interventions in urban areas of Canada, as well as for surveillance purposes. |
| Fall 2020 Priority Announcement - Healthy Cities Pool (funded by IPPH in alignment with the HCRI) | 2021 | Project title: Air pollution, cardiovascular disease, and cognitive health: Investigating pre-clinical and clinical effects of low levels of air pollution on ectopic adipose tissue, cardiovascular disease, and cognitive function in the Canadian Alliance for Healthy Hearts and Minds Abstract/SummaryA lifetime of exposure to air pollution produced by cars and factories increases the risk of early death, mostly from diseases of the heart and lungs. This is true even in countries with relative low levels of air pollution, such as Canada. However, whether these levels of air pollution are serious enough to cause early changes in blood vessels and heart muscle, and also increase the risk of brain diseases, such dementia or Alzheimer's disease, is not well-known. We have conducted magnetic resonance image scans of the hearts, brains, and abdomens of 8,258 adults participating in a large cross-Canada study. We also have access to data on the average air pollution levels in their neighborhoods. Using these two pieces of information, we will: 1. Learn whether exposure to low-levels of common air pollutants are associated with differences in fat stores around the heart and vital organs, narrowing of the arteries, the heart's ability to pump, and cognitive function.. 2 Learn whether exposure to low-levels of common air pollutants are associated with differences in reasoning, thinking, and communication, which may signal Alzheimer's disease or dementia; 3. Learn whether the group of people who live in a heavy-traffic region of Canada (the greater Toronto-Hamilton area) have it worse than those who live in less-traffic dense parts of the country; 4. Learn whether a person's long-term exposure to air pollution increases their risk of heart and brain diseases, and and early death, using data from Canada-wide health databases. We anticipate that this study will provide additional insight into the pathways by which air pollution is associated with heart and brain health, and inform health policies surrounding air pollution levels. |
| Fall 2020 Priority Announcement - Healthy Cities Pool (funded by IPPH in alignment with the HCRI) | 2021 | Project title: Urban environments and youth mental health: examining how adolescent mental health indicators are associated with urban design and cognitive architecture in a mid-sized Ontario city Abstract/SummaryBackground: Youth mental illness is a significant and growing societal burden. Urban environments impact youth mental health via natural settings that can aid cognitive and emotional development and built settings that may induce stress. However, existing research uses crude measures, focuses almost entirely on adult samples, and deprioritizes prevention. Goals: This mixed-methods project will examine relationships between youth mental health indicators and 1) specific urban (built, natural) designs and 2) cognitive architecture principles (concepts linked to mental states) in a mid-sized city. Our research questions are: 1) how do youth understand pedestrian- and transit-oriented designs and cognitive architecture features? 2) what mental health phenomena do youth associate with specific designs? 3) are pedestrian- and transit-oriented designs and cognitive architecture features associated with distinct mental health indicators among youth?, and 4) do observed links vary across demographic subgroups? This research will promote health equity and seek to inform inter-sectoral solutions that support mental health in urban design. Methods: This project has two phases: 1) Qualitative go-along interviews, where participants (n~40) ages 10-16 will walk with an interviewer along a predetermined route featuring seven distinct natural and built urban settings, viewing particular features, and answering questions regarding their present emotions and moods in each setting. Analysis will use a thematic approach incorporating deductive and inductive coding techniques. And 2) A repeated-measures design, where participants (same age, n~100) will travel the same route, be prompted to view specific visuals and architectural examples, and answer questions on tablets about mental health indicators. Mixed-effects models will be used for quantitative analysis. Outcomes: Results will inform urban design practice and policy recommendations in Canada to improve youth mental health. |
| Fall 2020 Priority Announcement - Healthy Cities Pool (funded by IPPH in alignment with the HCRI) | 2021 | 
Project title: Examining the impacts of the downtown Sherbrooke (QC) revitalization project on health equity among young adults: a mixed-methods evaluation Abstract/SummaryImproving the environment of disadvantaged neighbourhoods by building new houses or putting in public and green spaces can improve the health of the people who live there, and reduce health inequities at the population level. However, such changes can also have negative impacts if residents do not benefit from the new resources or if new people move in, disrupt existing social networks, and make the locals feel "out of place". The city of Sherbrooke (QC) is planning to improve its downtown neighbourhood in the coming years. Because the area has a high poverty rate and a large number of young people live there, local organizations are concerned about negative impacts on young residents through an influx of richer residents, disruption of social networks and social exclusion. The goal of our research is to examine how changes to the Sherbrooke downtown neighbourhood impact the way young people feel about their neighbourhood, their social connections and their well-being. We will also assess if impacts vary by gender, educational level, and employment status. Young adults aged 16 to 30 years-old will complete a survey before the changes are made and three times after that. We will compare their answers before, during and after to examine impacts. We will also conduct "go-along interviews" with participants. They will guide us on a walk through the neighbourhood to talk about how it influences their day-to-day lives, how they feel about the neighbourhood, and how it impacts their well-being. Our team includes experts in public health, geography, and statistics. Our research is done with partners from the community and the city. The project will provide high-quality information on how improving neighbourhoods in mid-size Canadian cities can influence the health of young people of diverse socio-economic groups. With this information in hand, key stakeholders will be able to act to ensure future neighbourhood improvement projects benefit all young people equally. |
| Fall 2020 Priority Announcement - Healthy Cities Pool (funded by IPPH in alignment with the HCRI) | 2021 | Project title: Gentrification, Urban Interventions, and Equity (GENUINE): advancing healthy city research on gentrification Abstract/SummaryGentrification is a process in which formerly declining, under-resourced neighbourhoods experience reinvestment and in-migration of increasingly affluent new residents. Gentrified neighbourhoods are marked by changes in physical, social, and economic environments, that can have both positive and negative consequences. However, in population health research, measures of gentrification are typically limited to socio-demographic and housing shifts, such as rising property values and increases in household income and educational attainment. By solely focusing on socio-demographic changes, we fail to understand the built environment and policy interventions that may have ignited gentrification. The Gentrification, Urban Interventions, and Equity (GENUINE) project will develop gentrification-related measures and spatial datasets to enable researchers and practitioners to assess how changing neighbourhood environments impacts population health, and aid Canadian cities in creating healthy, equitable, and inclusive cities. The proposed research leverages existing data from Statistics Canada, Canadian Urban Environment Health Research Consortium, Enhanced Points of Interest database, and the CIHR-funded INTerventions, Research, and Action in Cities Team to: 1) Develop new measures of changes in neighbourhood greenness and commercial amenities (food outlets, retail businesses) over time in Canadian cities; 2) Analyze inequities in these changes over time and space; 3) Identify how and where these changes relate to gentrification patterns; and 4) Apply these measures in a case study on well-being in Montréal, Canada. With COVID-19 we see cities changing faster than ever before, and policy makers' attention towards healthy cities is only expanding. GENUINE will provide pan-Canadian measures of gentrification that can be an integral part of solution-oriented research to support the development of healthier and more equitable communities. |
| Fall 2021 Priority Announcement - Healthy Cities (funded by IPPH in alignment with the HCRI) | 2022 | Project title: Impact of the COVID-19 Pandemic on Type 2 Diabetes Incidence: Finding synergy among science, policy, and action Abstract/SummaryThe pandemic has placed an unprecedented strain on our society. While public health measures have been effective in flattening the curve to reduce COVID-19 infections, they have led to widespread reductions in physical activity and an increase in snack food consumption. These changes, combined with ongoing stress from social isolation, job losses, and financial strain, may have negative consequences for our health. We suspect that there will be a rise in body weight in the population, causing more people to develop diabetes. Our team will use population health data from Ontario and advanced statistics to study whether the number of people who develop diabetes increases during the months and years following the pandemic, and which subsets of the population (e.g. women versus men, lower versus higher income groups) will be most affected. We will also test whether the intensity and duration of lock-down measures and unsupportive neighbourhood environments (e.g., fewer opportunities for physical activity and healthy eating) contribute to the rise in diabetes incidence, particularly in low income and racialized communities. This work will be vital for identifying potential policy scenarios to avert diabetes cases and reduce healthcare costs. With input and guidance from our multisectoral policy and community engagement committee we will identify potential solutions and create an action plan that will reduce the burden of diabetes in areas impacted the most. Collectively, this research program will provide critical information to guide decisions regarding which public health policies have the greatest potential to improve the health and wellbeing of Canadians, by 'flattening the curve' of diabetes. |
| Fall 2021 Priority Announcement - Healthy Cities (funded by IPPH in alignment with the HCRI) | 2022 | Project title: A national study of community belonging and the influence of local environments on health Abstract/SummaryCommunity belonging has been shown to be an integral part of life satisfaction, or more generally, subjective well-being. Our government and health care system have an important role in fostering social connections that are vital to our communities and health. Therefore, community belonging is an important target for research. To-date, little is known about how community belonging relates to long-term population health outcomes, such as premature death and preventable hospitalization rates. We also have limited information as to how neighbourhood factors such as air quality, walkability, and access to parks and green space might influence a community's ability to build sense of belonging. As a result, we do not know the extent to which environmental factors impact the relationship between community belonging and our health. There has been increasing recognition that social isolation negatively impacts the health of seniors; however, we lack evidence across life stages. For example, youth are an important target for reducing social isolation, but the health of young people may be differently affected by community belonging and environmental factors as compared with older age groups. This project will produce the first national studies of the impact of community belonging and neighbourhoods on the health of Canadians. This UofT, UBC and Statistics Canada collaboration brings together international experts in psychology, subjective well-being, social epidemiology, and environmental health. |
| Fall 2021 Priority Announcement - Healthy Cities (funded by IPPH in alignment with the HCRI) | 2022 | Project title: Promoting Outdoor Mobility via Enhancing Neighborhood Walkability for Racialized Older Women: A Community-Based Participatory Project. Abstract/SummaryThe COVID-19 pandemic amplified the vulnerability of older adults due to health risks, increased isolation, and difficulties accessing essential services. Racialized older women from Muslim communities have been at increased risk for deterioration in health status during the pandemic. This is directly related to increased incidences of violence against women of color and religious minorities which has translated into increased isolation and restricted mobility outside the home. We will use participatory and mixed method approaches to engage racialized immigrant older Muslim women in identifying barriers to walking outdoors in their local neighborhoods. We will then co-design and implement strategies to maximize opportunities for outdoor walking. Final study outcomes will include an intersectional analysis of barriers and facilitators of outdoor walking in this population and tailored recommendations for improving outdoor mobility. |
| Fellowship in Research and Knowledge Translation on Urban Housing and Health | 2021 | Project title: Healthy IDEAS+: A Modified Effectiveness-Implementation Trial to Improve Cognition in Community Housing Abstract/SummaryHealthy IDEAS is an evidence-based depression screening and behavioural activation program that is widely-implemented among older adults in community settings. Late-life depression increases cognitive decline. A 17-year cohort study reported 70% greater risk of dementia when one has depression. Loneliness and depression are connected in the prodromal phase of dementia. Community-based screening and treatment for depression might improve memory and reduce risk of dementia. However, the effect of mental health programs such as Healthy IDEAS on cognitive function is unknown. Its effectiveness in group settings such as community housing is also unknown. This research aims to understand (1) the effectiveness of Healthy IDEAS on depression and cognitive function in community housing, and (2) the barriers and facilitators of group-based implementation with peer support. Community housing are provided by the province and by non-profit organisations to meet the needs of healthy older adults and populations with limited income. They typically do not include social programming. As a result, some older adults may experience isolation and loneliness, which affect their mental health. The proposed "Healthy IDEAS+" program encourages activities and introduces peer support to older adults who show depressive symptoms. A trial will be implemented over three months. We hypothesise that participation in Healthy IDEAS+ will decrease depression and improve memory after 12 months. To understand barriers of implementation in community housing, we will engage housing providers and participants in interviews and focus groups. The ease and usefulness of each behavioural activation session and the overall program will be evaluated. A training manual will be developed for future implementations in community housing. This research is important to eliminate depression in community housing and create health-promoting settings. This research supports dementia prevention in urban housing. |
| Fellowship in Research and Knowledge Translation on Urban Housing and Health | 2021 | Project title: Exploring a Specialized Navigator Role as an Innovative Hospital-Based Approach to Improve the Health and Social Outcomes of People Experiencing Homelessness in Toronto, Canada Abstract/SummaryPeople experiencing homelessness experience poor health and use hospitals more frequently than the general population. When discharged from hospitals, they struggle to access health services and social supports in the community that can help them recover. Without these supports, their health may continue to decline and they are often readmitted to the hospital. Many hospital-based interventions aimed at improving the health of homeless patients try to better connect them to resources in the community. Often, this is done through a case manager. While these interventions have been successful at improving patient outcomes, creating housing stability and reducing hospital readmissions, they have primarily been implemented in acute psychiatric hospitals or hospital wards. There are no published interventions in Canada that seek to improve care transitions for homeless patients who are discharged from general medicine units in hospitals. This qualitative study will evaluate if a unique intervention - The Navigator Program - can improve the health of homeless patients after they leave general medicine units. The intervention features a Homeless Outreach Counsellor within the hospital who works with homeless patients to meet their social (e.g. housing) and health needs in the community. This is a qualitative study within a randomized control trial. I will interview homeless patients who do and do not receive the intervention to examine if the Navigator program is able to improve their health after they leave the hospital. Homeless Outreach Counsellors and community service providers will also be interviewed to help understand the patient experiences. The findings from this study will help improve hospital care transitions for people experiencing homelessness. This approach is critical to improving healthcare services that reduce health inequities for homeless populations, and connect them to social supports, such as housing. |
| Fellowship in Research and Knowledge Translation on Urban Housing and Health | 2021 | Project title: "Application of Artificial Intelligence in Evaluation of Radon Health Risk in Urban vs Rural houses of Canada and Sweden." This interdisciplinary research will apply predictive machine learning algorithms and geospatial intelligence to assess, predict and conduct time-series (1940-2020) analyses of public health risk from exposure to indoor radon, map out the causative patterns as the functions of built structural, environmental and human behavioural factors in urban vs rural houses in Canada and Sweden and generate evidence to support a healthy housing design. Abstract/SummaryIndoor air quality is one of the prime determinants of health in cold countries, as people spent most of their time indoors. In Canada, indoor air is frequently polluted by high levels of radioactive radon gas emanating from uranium rich bedrocks and accumulated inside the urban airtight energy efficient buildings and this is further deteriorating by the current pandemic restrictions. In 2019, about 40% of Canadian cancer-related deaths were from lung cancer, of which 1 in 5 occurred in never-smokers who suffer all the unjust stigmatization that smokers face. At the population level, radon inhalation is the second leading cause of lung cancer. People living in poorly ventilated urban houses are more at risk than those in rural areas. Historic radon prevention strategies have been based on the concept of volunteer testing and mitigation by individual investment that disproportionately affects distinct socioeconomic, gender and ethnic groups. In fact, Canadian radon maps built by the extrapolation of USA geologic data, created naive risk generalization that fuelled optimistic bias and resulted in missed opportunity for preventive actions. Unfortunately, radon-testing rates have remained at <6% despite >25 years of radon awareness campaigns and, thus, current strategy clearly has limited impact. Therefore, we must replace existing, ineffective prevention practices with innovative tailored actions to that are built on evidence gleaned from across disciplines. This study aims to examining a complex mix of built structural, environmental and human behavioural determinants by employing cutting edge AI analytics to predict and define the risk with highest precision. We will find answer to the question why, over the same period (1940-2020), the innate risk of high radon in newly built Swedish homes went down, whilst increased in Canada. The evidence generated will support a healthy housing design and preventive policy; thus, ensure a future free of radon-induced lung cancer. |
| Fellowship in Research and Knowledge Translation on Urban Housing and Health | 2021 | Project title: Urban Housing Instability and Substance Use Care Trajectories among Young People in Vancouver Abstract/SummaryIn British Columbia, young people ages 14 to 29 comprise 20% of the overdose deaths recorded since a public health emergency was declared in 2016. Urban young people who use drugs (YPWUD) and experience homelessness or unstable housing situations are particularly vulnerable to overdose. Over the past several years, the city of Vancouver has demonstrated a commitment to expanding access to substance use care for adolescents and young adults, including approaches that combine housing and care (e.g., the on-site delivery of harm reduction supplies, opioid agonist therapies, psychiatric medications, and contingency management programs). And yet, many pressing questions remain about how to best design, implement, adapt, and scale up substance use care and housing supports (including combined approaches) for urban YPWUD. The proposed qualitative and community-based participatory action research study will address this knowledge gap by exploring the overlapping individual, social, structural and institutional dynamics that shape YPWUD's experiences of homelessness, housing, and substance use care across time, with a focus on how these experiences intersect to create or reduce harms. A key focus will be on understanding how urban YPWUD navigate homelessness, housing and substance use care in relation to regular encounters with other kinds of services and systems (e.g., acute care, mental health, foster care, and criminal justice systems). The goal of the study is to actively collaborate with YPWUD to create new knowledge that will directly inform ongoing efforts to generate innovative substance use care and housing services for young people in Vancouver. All stages of the proposed study, including the development of a comprehensive and integrated knowledge translation strategy, will be undertaken in partnership with youth co-researchers and our research team's Youth Advisory Council. |
| Fellowship in Research and Knowledge Translation on Urban Housing and Health | 2021 | Project title: To Die Equal: A Mixed Methods Study on The Impact of Housing Insecurity on Access to End-Of-Life Care and A Good Death Abstract/SummaryResearch has shown that persons experiencing homelessness or inadequate housing are less likely to access healthcare but are more likely to experience complex health issues and early death. While researchers have documented a link between housing and health outcomes, there is little research into end of life healthcare provided to people who are homeless or living in inadequate housing. This study will address this gap by exploring the end of life health care experience for people experiencing homelessness or inadequate housing in Vancouver, BC. The first part of this study will review medical charts of people who have died in the Downtown Eastside of Vancouver from illness. It will not include deaths from overdose, suicide, or trauma such as a car accident. The aim of this part of the study is to better understand the end of life healthcare provided prior to death and to identify any issues to providing end of life healthcare for these individuals. The second part of the study will interview individuals who are at the end of their life and living in inadequate housing or homeless to better understand their experiences and needs at end of life. The results from this study will help healthcare providers care for people living in inadequate housing or who are homeless. This study fits with the existing Health Canada "Framework for Palliative Care" which aims to identify issues in providing end of life care to marginalized people, as well as identifying new and innovative practices and approaches for providing end of life care to different populations. |
| Fellowship in Research and Knowledge Translation on Urban Housing and Health | 2019 | Project title: Examining housing-based overdose response interventions in Vancouver Abstract/SummaryBritish Columbia is amidst an overdose epidemic with over 1400 overdose deaths in 2017. The majority of these preventable deaths (89%) have occurred in housing environments such as single room occupancy hotels and emergency shelters. In Vancouver, there has been an increase in overdose response interventions such as overdose prevention sites and naloxone distribution; however, the public health response within housing environments specifically has been challenging due to a range of contextual factors that have impeded the effective implementation of overdose response interventions. Through a qualitative and ethnographic approach, this study will examine the influence of physical (e.g., building conditions, geographical distribution of services), social (e.g., stigma, discrimination), and structural (e.g., policies, programs) factors that impact overdose risk, as well as the use and outcomes of overdose response interventions within housing environments by people who use drugs (PWUD). This work will also seek to identify policy and programmatic priorities to improve the health outcomes of PWUD, including the reduction of overdose risk and mortality. A range of knowledge translation activities will be included in this study, such as facilitating exchange of knowledge and best practices in collaboration with an established housing and overdose working group; disseminating research summaries to PWUD and other community stakeholders; presenting at conferences; and publishing articles in peer-reviewed journals. |
| Fellowship in Research and Knowledge Translation on Urban Housing and Health | 2020 | Project title: Peer Support: Evaluating a pilot program among homeless shelter users Abstract/SummaryAccess to shelters can be a matter of death or life for individuals experiencing homelessness or population at risk of becoming homeless. This population includes women fleeing domestic violence, runaway youth or even people in economic hardship among others. These people generally have many and varied needs to be addressed, and also face many barriers to return to their normal life, including exit homelessness. Providing quality basic services, including availability of counseling services, can play a major role in supporting the affected individuals. In perspective to improve the quality of services in Toronto shelters, the City of Toronto wants to test a New Shelter Services Model (NSSM) program that integrates a peer support approach into shelter-based services for people experiencing homelessness. Based on their own past shelter experience and their pathway to recovery, individuals will be trained and hired to provide counseling services and support in shelters. This peer support service aims at facilitating transition to stable housing and improving the well-being of shelter users. Based on the partnership agreement between the City of Toronto and MAP Centre for Urban Health Solutions, this study aims to evaluate rigorously the effects of this Peer Support approach on improving housing outcomes and recovery among homeless individuals. Hence, this research will contribute to the elaboration of evaluation design and elaboration, supporting data collection, and rigorous analysis. In addition, it will include particularly a gender-based analysis. We hypothesize that women, men, and non-binary people intersecting with diversity factors will experience peer support differently, and this may lead to different results. In sum, this study can lead to important evidence for a new avenue for shelter programs. |
| Fellowship in Research and Knowledge Translation on Urban Housing and Health | 2020 | Project title: Assessing the impact of residential care on the quality of life of autistic adults Abstract/SummaryResearch shows that approximately one third of the autism spectrum (AS) also has intellectual disability (ID) and important behavioural challenges. Once grown up, families are facing many challenges due to insufficient or inadequate services. Residential care is an important component of quality of life, yet there is still very few autistic-adapted residential programs and limited research on the evolution of autistic adults through these programs. The limitations related to their condition (e.g. language and communication impairment) make it even more challenging to evaluate their quality of life. In collaboration with the CISSS Montérégie-Ouest and the Vero & Louis Foundation, the aim of the current project is to assess the impact of an autistic-adapted residential program on the quality of life of adults with autism and complex comorbidities. In this longitudinal study, the goal is to explore whether autistic adults benefit from an autistic-adapted residential program in regards to 1) their quality of life; 2) the trajectories of their behavioral problems and 3) their socio-emotional wellbeing. To do so, 40 adults with AS-ID will be followed for 6 months before their entry in an adapted home and 18 months after their integration. Multiple biological/physiological, functional and subjective measures will be collected at multiple time points. Their evolution will be compared to 40 adults still waiting for autistic-adapted residential care (staying at home or in a traditional program). We hope that this project will give a deeper understanding of quality of life in adults with autism, and more specifically of the ways in which environmental and individual components might interact. |
| Fellowship in Research and Knowledge Translation on Urban Housing and Health | 2020 | Project title: Using an implementation Science approach to design and evaluate an integrated service model for seniors social housing Abstract/SummaryHousing an important determinant of health; however, a quarter of Canadian seniors have a core housing need, lacking access to affordable, suitable, or adequate housing. As a result of rising housing needs, more seniors have joined the waitlist for social housing. Seniors in social housing tend to live alone in poor health, experience high rates of loneliness, and have increased risk of hospital admission and nursing home placement. Toronto Community Housing (TCH) is home to 27,000 seniors, half of whom live in seniors' designated buildings; however, there is inadequate and inconsistent delivery of services in these buildings, negatively impacting tenants' ability to age in place. To better support senior tenants, the City of Toronto has been collaborating with TCH and the Toronto Central Local Health Integration Network to develop a new Integrated Service Model (ISM) to better integrate the delivery of housing and support services to senior tenants. Using an implementation science approach, the objective of this research project is to help the City of Toronto and its partners co-create and evaluate the ISM. To carry out this project, we will: a) help identify relevant stakeholders who should be involved in the implementation and evaluation of the ISM; b) employ a variety of methods (e.g., scoping review, qualitative interviews, environmental scan) to generate evidence on seniors social housing to support the policymakers; c) use consensus-building approaches to support the creation of an action plan to implement the ISM; and d) evaluate the impact of the ISM on tenancy stability and access to support services. As a result of this project, the City of Toronto will be better positioned to support senior tenant's physical, social, and housing needs. The lessons learned from this initiative will be packaged into a toolkit that other municipalities can use to develop their own social housing models for their senior residents. |
| Health System Impact Fellowship in Healthy Cities | 2021 | Project title: Analyzing linked safety data to improve active transport safety in BC Abstract/SummaryActive transport users (e.g., walking, cycling, e-mobility, etc.) are more vulnerable to serious injury or fatality than drivers of motor vehicles are, as these modes do not offer physical protection from injury in the event of a crash. In the province of British Columbia (BC), like elsewhere, active transportation users have higher fatality and injury rates compared to drivers of motor vehicles. The Ministry of Health has a mandate to reduce the risk of injury and fatalities for active transport users, and, wishes to address potential inequities in bicycling and pedestrian trauma amongst vulnerable populations. To develop injury prevention strategies and to promote road safety in BC, the Ministry needs baseline information on the overarching patterns in active transportation crashes and/or injuries. To address this need, this fellowship will use a comprehensive database of crashes that include police records, insurance claims, emergency visits, and hospital admissions. It will provide detailed results regarding where, when, how and to whom crashes are occurring. The results of this project will provide decision makers with a foundational understanding of the current state of road safety for active transportation users, and generate evidence to create policies to increase the safety of active transport within BC. |
| Health System Impact Fellowship in Healthy Cities | 2021 | Project title: Évaluation économique d'interventions qui touchent le logement et la santé : éclairer les décisions, réduire les inégalités sociales de santé et préparer l'avenir pour une société résiliente post-pandémie. Abstract/SummaryLes évaluations économiques en santé sont des outils qui permettent de prendre en considération l'efficience économique d'interventions en santé, c'est-à-dire d'en comparer les coûts et les bénéfices en fonction des objectifs visés. Dans le secteur public, l'efficience économique est un enjeu ayant un grand pouvoir d'influence sur les décisions, et cela est tout à fait compréhensible : il en va de l'intérêt public de s'assurer que les ressources collectives sont mobilisées de façon à produire les meilleurs résultats possibles. Le présent programme de recherche place le logement sous la loupe des évaluations économiques en santé pour plusieurs raisons. D'abord, le logement est une responsabilité qui touche l'ensemble des paliers de gouvernements et qui concerne la totalité de la population : tout le monde a besoin d'un toit. Ensuite, l'exposition aux conditions de logement est importante et répétée, puisqu'il s'agit d'un lieu central du quotidien, particulièrement dans le contexte actuel. La pandémie a d'ailleurs mis en lumière les inégalités de logement et les conséquences disproportionnées pour les groupes les plus vulnérables (personnes âgées, groupes autochtones, victimes de violence, etc.). Les décisions quant aux investissements publics ayant pour effet de modifier l'offre de logement ont des impacts à grande portée sur la santé physique et mentale des populations. Les autorités canadiennes de santé publique ont identifié le logement comme un des quatre domaines d'intervention à fort potentiel d'impact pour favoriser la résilience et l'équité en santé post-pandémie. Comme son titre l'indique, ce stage postdoctoral vise à réaliser une analyse des coûts et bénéfices d'interventions qui touchent le logement et la santé, au Québec, de façon à guider les décisions et réduire les inégalités sociales de santé. Les conclusions seront applicables à l'ensemble du Canada et seront utiles dans la transition péri/post-pandémie. |
| Health System Impact Fellowship in Healthy Cities | 2019 | Project title: Using Evidence to Inform Health Policy: Supportive Housing as a Case Study Abstract/SummaryGovernment health policies rooted in evidence and collaboration are essential for safe and effective health care delivery. While the steps in policy development and the use of evidence to guide this process are well documented, the ways in which policy cycles work in 'real-world' and complex government settings are less well defined. This is especially the case for supportive housing (SH) services in Canada, where current policies inadequately describe the program purpose and recipients of care. Using SH as a case study, the purpose of my fellowship is to (i) understand how policy cycles 'work' in a complex government setting, (ii) explore how evidence can be used more effectively to ensure that policies achieve their intended goals, and (iii) investigate ways in which other stakeholders (e.g., regional planners, SH clients and their families) can contribute meaningfully to policy development. From these activities I will establish an enriched understanding of government context and the ways in which policies are developed, create synergistic partnerships with key government personnel and health service researchers, develop additional core competencies to help ensure my short- and long-term career success, and produce several publications and related knowledge translation activities (e.g., showing how evidence and intersectoral collaborations can be used to improve policy cycles). My fellowship will occur at Manitoba Health, Seniors and Active Living (MHSAL; Brie DeMone as primary supervisor) and the University of Manitoba (Dr. Malcolm Doupe as academic supervisor). These organizations and preceptors have a rich collaborative history through previous grants and government initiatives designed to train graduate students in applied health services research. Building on their experiences, my preceptors will meaningfully combine the research and policy aspects of the fellowship in ways that help to enrich my training experience and foster a learning health system. |
| Health System Impact Fellowship in Healthy Cities | 2019 | Project title: Traffic calming implementation around Calgary elementary schools Abstract/SummaryAcross Canada, collisions with motor-vehicles are a leading cause of child bicyclist and pedestrian injuries. Each year in Alberta, over 300 children are admitted to hospital due to a severe pedestrian or bicyclist injury. Injury rates and severity can be associated with higher vehicle speeds and traffic volume, and specific traffic calming features. Active transportation can provide significant health benefits to children that last into adult-hood. However, concerns regarding injury risk can influence decisions to participate in active transportation. Given that a third of child pedestrian and bicyclist injuries occur within 300m of a school, it is important to ensure vehicles travel in a safe manner at these locations. Installing specific traffic calming features designed to reduce vehicle speed around schools can lead to a reduction in injury risk for child pedestrians and bicyclists, and increase active transportation, if traffic calming measures are appropriately aligned to the current built environment. This project will therefore seek to install specific traffic calming features around various Calgary elementary schools, and evaluate their impact on traffic behavior. This project will use a stepped wedge cluster randomized trial design to sequentially evaluate implementation of a specific traffic safety feature at all public Calgary elementary schools. Schools will be randomly ordered for traffic calming installation. Vehicle traffic volume and speed in front of the school will be monitored one month prior to installation, one week prior to installation, and one week following installation. School administration and parents will be contacted before and after the intervention to determine changes in perceived traffic safety. Schools will be clustered by traffic calming installation date and stratified by traffic calming feature. Traffic behavior and perceived safety will be compared between baseline, pre-intervention, and post-intervention. |
| Healthy Cities Research Partnership Development Grants | 2019 | Project title: Feasibility of engaging IMGs (International Medical Graduate) in the community-based health literacy initiatives among immigrant communities. Abstract/SummaryCanadian immigrant populations come from a number of ethno-geographical backgrounds. These populations exhibit differences in their culture and life practices related to disease and disease pre-disposition that influence how, when, and why individuals seek healthcare. Healthcare systems and care providers face significant challenges in the development and implementation of appropriate, relevant healthcare interventions to overcome barriers to healthcare access to immigrant and refugee populations. Given that there is strong evidence that proper utilization and accessing healthcare has an important influence on health outcomes, it is imperative that we take a solution-oriented approach towards improving the use of healthcare by immigrants. Through our community-engaged initiatives to identify community-prioritized issues to work on, health literacy is an issue that the community members identified as a priority to work further on. Focusing on health literacy of immigrants in Canada is particularly important, as many immigrants are from countries with languages and/or cultures which are different from Canada. During our informal stakeholder consultations, we identified the possibility of engaging the International Medical Graduates (IMG) from the immigrant communities in the work around health literacy. IMGs are immigrants who have completed their medical education and/or training outside of Canada. Majority of the immigrant communities in Canada includes IMGs and they can provide tremendous value through the possible roles they can play towards improved community health literacy. We are proposing to build further on our budding collaboration and develop capacity by undertaking a project focusing on community based health literacy improvement initiatives through IMGs. |
| Healthy Cities Research Partnership Development Grants | 2019 | Project title: Creating an Urban Mobility Consortium for an Active, Green, and Healthy City. Abstract/SummaryGetting around a city can be challenging, especially when one does not have access to their own car. Traditional cars are also problematic as they increase air pollution, which can negatively impact our health and quality of life. There are electric options, but cities often do not have the infrastructure to support these options. The purpose of this grant is to create a group of people in the City of Oshawa and Region of Durham who are committed to coming up with creative solutions to the issue of urban mobility. This group will include researchers, staff from local municipalities, community partners, and industry partners, who will create research groups and action items that can be achieved over the next 5 years. It is hoped that this will help shift the focus from traditional transportation to the broader topic of urban mobility with a particular emphasis on increasing physical activity, decreasing air pollution, creating more space, and ultimately, creating a healthy city. |
| Healthy Cities Research Partnership Development Grants | 2019 | Project title: Building Roads Together Global: Planning a multi-city implementation science partnership and research program Abstract/SummaryThis planning grant aims to develop Building Roads Together Global (BRT-G), an implementation science partnership to plan, implement, and investigate the process and impact of scaling BRT. BRT is a community-based peer support walking and rolling (with mobility aids) program designed to promote inclusion and reduce health and mental health inequities by building capacity for people to lead peer walking groups in urban green space. This proposal builds on implementation and evaluation of a program pilot in Regent Park, one Toronto Neighbourhood Improvement Area (NIA) that is Canada's first social housing development undergoing transformation to a mixed-income neighbourhood. Based on evaluation findings that BRT reduces social isolation; improves physical health; improves mental health; and builds leadership capacity, this proposal aims to scale BRT to other Toronto NIAs, and other cities in Canada, and evaluate its process and impact. The project team will do so by planning and hosting three days of meetings to: develop the partnership; co-develop a print and online BRT Toolkit, and co-develop a multi-year, multi-site research proposal. |
| Healthy Cities Research Partnership Development Grants | 2019 |
Meghan McDonough Project title: Moving Together: Building an Academic-Municipal-Community Partnership to Support Physical Activity and Social Inclusion among Older Adults Abstract/SummaryMoving Together is an emerging collaboration among researchers at the University of Calgary and staff at the City of Calgary working to address social inclusion and physical activity for older adults, particularly vulnerable populations including those with low income, living alone, from diverse cultures, who are newcomers to Canada, who are women, and who identify as LGBTQI2S. The goal of Moving Together is to strengthen this partnership through collaborative discussions with academic, municipal, and community stakeholders to develop a program of research on age-friendly cities related to physical activity and inclusion for older adults, including vulnerable populations. Physical inactivity and social isolation are critical issues facing older Canadians, and there is potential for researchers, municipalities, and communities to develop innovative solutions to better support physical activity and social participation among older adults, particularly those from vulnerable populations. Project activities include collaborative events aimed at identifying key issues and priorities with municipal and community stakeholders, identifying prospective sites for innovation and research, and developing a grant proposal for a program of research on supporting active, socially inclusive cities for older adults. Moving Together will create opportunities for collaboration across City of Calgary initiatives addressing age-friendly cities, active aging, mental health, active transportation, healthy cities; University of Calgary researchers focused on aging; and community programs with innovative ideas and unique opportunities for engaging older adults. The project will identify research questions that address key priorities and emerging issues related to physical activity, social inclusion, aging, and engaging vulnerable populations, and develop a program of research focused on closing the knowledge-to-practice gap in creating healthy, active, inclusive cities for older adults. |
| Healthy Cities Research Partnership Development Grants | 2019 | Project title: Healthy and Resilient Cities: A Connected Community Approach Abstract/SummaryCity departments, academics, and community groups are engaged in efforts to define and build community resilience in the face of climate change, extreme weather events, and other social, economic, and environmental shocks. However, these efforts are rarely well coordinated or undertaken in partnership. Building on innovative community resilience building undertaken by the Centre for Connected Communities and ResilientTO, we are adding researchers and other city departments and civil society groups to this emerging partnership in order to advance and better understand and support a 'Connected Communities Approach' to building healthy & resilient cities. In addition to expanding the partnership, we will undertake purposeful conversations with a range of stakeholders, complete a comprehensive review of the literature, convene a symposium of key players, and do a preliminary assessment of the potential for a 'developmental evaluation' of the 'Connected Communities Approach' to community resilience building. |
| Healthy Cities Research Partnership Development Grants | 2019 | Project title: Smart cities, Healthy citizens? Optimizing health and equity in city policy making Abstract/SummaryUrban planning, investment and innovation is driven by policies outside the health sector, such as sustainability, housing, or transportation. However, there is rarely explicit consideration of health. The smart cities movement-fueled by great financial investment, and political and public interest-is a driving force of urban transformation with immense potential to impact population health. A smart city aspires to improve city life using better (and often bigger) data and technology. But will smart cities actually lead to healthier citizens? The paradox of 'smart' solutions is the potential for unintended consequences that may instead damage health. Using Infrastructure Canada's $75M Smart Cities Challenge competition as a testing ground, the overall goal of this planning grant is to convene Canadian researchers and citizen- and city-partners to move forward in optimizing health and equity in city policy making. Through case studies and a planning symposium, our objectives are: 1. to uncover how health and equity are considered in smart city policies, map pathways to health outcomes, and craft plausible policy implementation scenarios; and 2. to formalize an interdisciplinary, intersectoral team interested in modelling health impacts and creating a decision support platform for healthy city policy making. The proposed activities were envisioned and will be executed together with researchers (spanning population health, geography, urban planning, and policy) and diverse stakeholders, including primary partners Evergreen and CityInclusive, practitioners (Smart Cities teams, city staff), public health actors, and research organizations. Ultimately, our vision is a resource that invites stakeholders at all levels to reflect upon, review, and (where needed) adapt policies to more effectively translate investments into health benefits for those who live in cities today or tomorrow. |
| Immersive Urban Healthy Policy Workshop | 2020 | Project title: Implementing Active Transportation Initiatives for a Healthier Region of Waterloo Abstract/SummaryTransportation is the fastest-growing source of greenhouse gases in Canada and a priority concern for all levels of government. Indeed, the rise of private automobile use in North America is associated with a wide range of negative health, environmental and social outcomes i. Accordingly, governments are actively promoting and incentivizing active (i.e., walking/cycling) transportation in an attempt to reduce the negative impacts of widespread automobile use. Despite the well-known health benefits of walking and cycling, their uptake in many North American cities lags well behind their European counterparts. The science in support of building active transportation infrastructure to facilitate healthier and more sustainable communities is ubiquitous, but implementing that evidence-base has proved more challenging for many communities. The broad aim of this grant is to help the Region reach its goal of achieving 12% active mode share before 2031. More specifically, we would like to leverage our recent light rail transit investments to increase the number of persons who are commuting to school or work using active modes of transport for part of their trip. Through this urban health policy opportunity, we will focus on improving high-risk intersections where collisions between automobiles and active road users are highest. Our mobilization plan includes three objectives: 1) to disseminate knowledge from the workshop to key staff members and councillors in the Region and municipalities; 2) to mobilize knowledge from community members, advocacy groups, staff and experts on a specific active transportation issue (high-risk intersections); and, 3) to foster new collaborative relationships between various stakeholders in the Region for future research and policy-making. In meeting these objectives, we will host a five-part Regional Tour and host a day-long immersive workshop to mobilize knowledge to improve high-risk intersections for increased AT in the Region. |
| Immersive Urban Healthy Policy Workshop | 2020 | Project title: Co-developing an Innovative Active Transportation Plan with Citizens to Address Health Inequities in Structurally Disadvantaged Neighbourhoods in Winnipeg Abstract/SummaryIncome and racially-based inequities are among the biggest urban public health challenges in Canada. These inequities have their roots in structural barriers to being healthy. One example is poor active transportation. Winnipeg Manitoba has one of the worst rates healthy inequities between it'srichest and poorest citizens. Many of these citizens are Indigenous people that have suffered from past on-going structural barriers to well-being/health. Winnipeg has committed $13M to improving active transportation infrastructure in poor neighbourhoods but need a plan for how to spend this budget. Attending the the Healthy Cities Workshop provides a unique opportunity for our team to combine Scandinavian best practices with local and Indigenous knowledge to envision a unique AT plan designed to reduce health inequities in our city. The main objectives of our proposal are to (1) learn from Copenhagen on how they prioritized chnages in active transportation AT within structurally disadvantaged neighbourhoods, and meaningfully engaged citizen of those neighbourhoods in the plan; (2) develop a set of plans to maximize the benefits of new investment in active transport to meet the needs of citizens in structurally disadvantaged neighbourhoods in Winnipeg and (3) bring this information to leaders and community champions within these neighbourhoods to co-develop an active transportation plan for their neighbourhood and a grant to study the impact. |
| Immersive Urban Healthy Policy Workshop | 2020 | Project title: Just getting from 'A' to 'B' misses what you could 'C': Active school travel ABCs to improve health and engage with public spaces Abstract/SummaryEdmonton is one of the fastest-growing cities in Canada, with a population set to double in 30 years. As such, the City has developed a municipal vision to support growing 'up' (higher density), 'in' (infill development) and 'out' (new neighborhoods). As Edmonton grows, novel ways to promote active transportation and engagement with public spaces are needed. Active School Travel (AST), or walking and wheeling to/from school, is an innovative way to support healthy cities and aligns with Canada's Common Vision. AST improves mental and physical health and provides social, economic, and environmental benefits. However, current AST initiatives focus on getting from 'A' to 'B' (home/school). To create a healthy cities culture, active transportation, including AST, must prioritize the journey and the destination - engaging youth with public spaces. We propose a new model of AST: Active School Travel ABC's: Just getting from 'A' to 'B' misses what you could 'C'. This work will build on our existing knowledge, experience, and momentum for active transportation and public spaces in Edmonton and directly aligns with the City's Vision 2050. Edmonton has the necessary infrastructure to support AST. Our River Valley has over 160km of maintained multi-use pathways, all protected by Edmonton's Open Space policy. Cyclists are supported by Edmonton's Bike Plan with a growing system of bike lanes, shared roadways, and paths. Collectively, these assets support a connected, accessible city - one that is ripe for AST. Our strong team represents a diverse group of city leaders, researchers, developers, architects, health services, government, education, and the arts who have the capacity to implement our plan. We will: 1) co-develop an AST/public space strategy for Edmonton informed through youth engagement, 2) design implementation research projects to operationalize our plan, and 3) use our networks to ensure pan-Canadian impact and inform the scale-up of healthy cities initiatives. |
| IPPH Building Healthy Cities – Dragons’ Den | 2019 | Project title: Levelling the Playing Fields: Creating the conditions for outdoor free-play to emerge in cities. Abstract/SummaryChildren have been called an indicator species for cities. The visible presence of children and youth of different ages and backgrounds, with and without their parents, outside in city streets, sidewalks, yards, and open spaces is a sign of the health of human habitats. Indeed, the extent to whcih a neighbourhood supports children's outdoor play - i.e. its playability - can be directly linked not only to children's health, levels of obesity and psychological well-being, but also to the population's well-being as a whole. Recent concerns about stranger-danger, traffic accidents and a general lack of safe, enticing places for children and youth to play outdoors, have been partially responsible for children and youth becoming more sedentary and remaining indoors to play. Concomitantly there has been an increasing interest in promoting children and youth's outdoor play due to the myriad of benefits it is shown to provide. This proposal takes children and youth's outdoor play as a critical public health issue that can help municipal policy makers, public health practitioners, active transport advocates, urban designers, child advocates and society in general join the dots between complex issues like pollution and global warming, active transport planning and community cohesion on the one hand, and concerns regarding the physical and mental health of both children and adults on the other. |
| IPPH Building Healthy Cities – Dragons’ Den | 2019 | Project title: The INTErvention Research and Action for CiTies and InnOvatioN (INTERACTION) Program Abstract/SummaryCities are constantly changing. For example, new cycling lanes are put in place, new trees are planted in parks, and new highways are built. All these decisions and investments in our cities can be seen as opportunities to create neighbourhoods that contribute to people's and communities' health. Positive urban changes can make our society more just, and more sustainable, so that future generations will have a good quality of life. Our project aims to help us design cities that will contribute to these goals of improved health, equity, and sustainability. Our approach has six steps. For each step, we consider concepts and theories that can help us think about these issues, tools and methods to help us find solutions, and a number of outputs or products. The aims of the six steps are as follows: 1) Understand how decisions changing the city are made, including citizens' and decision makers' vision for the future ; 2) Improve our measure of how the urban environments actually change, data that is needed to see how these changes have an impact on people, 3) measure individual and community health and differences in health between social groups, 4) From data collected in 2 and 3, create meaningful indicators that will feed statistical models to be developed in 5) where we will establish which changes to the urban environment have positive effects on health and equity, and finally, 6) Share these discoveries and develop a simulation tool that will allow decision makers to test different scenarios on how they could change the city. All this work is organised by a large group of researchers, community organizations and decision makers who have already joined forces in an existing team called INTERACT. This proposal is extending this work so that it can be applied to various cities, contexts, and health outcomes. |
| IPPH Building Healthy Cities – Dragons’ Den | 2019 | Project title: Optimizing Health and Sustainability Interventions on Schoolgrounds (OHASIS): Increasing Green Infrastructure for Healthy Cities Abstract/SummaryWe propose to Optimize Health And Sustainability Interventions on School grounds (OHASIS), with the aim to improve children's health and quality of learning environments, and to create improved public spaces for local communities, while simultaneously contributing to increased resilience of cities to environmental, social, and economic changes. One in four Canadian children are at risk of not reaching their full developmental potential, and these challenges present a concern for younger generations, especially since early life development is a strong predictor of health and performance across the life course. The task of increasing resilience to these challenges depends on the scaling up of urban innovations that support healthy living for everyone, protect vulnerable populations, especially children, and fundamentally change the way we approach land use in our communities. The OHASIS project is about transforming school grounds into green "oases" that will create healthy cities by mitigating and adapting to exposures to noise, urban heat islands and harmful pollutants, and promote healthy development and behaviours. Greening school grounds involves increasing access to natural elements such as trees and plants, natural materials, and water features. For children, interaction with green infrastructure improves health and well-being by increasing physical activity, supporting mental health and behaviour, and restoring attention, and improves cognitive function and academic performance. The objectives of the OHASIS project are to: 1.Compile an inventory of the physical and environmental characteristics of the school grounds for all public elementary, middle, and high schools in Canada. 2.Implement interventions to improve the environmental features of school grounds. 3.Evaluate the health, social, environmental, and financial impacts for students, schools, and surrounding communities associated with the school ground greening interventions. |
| Operating Grant: Emerging COVID-19 Research Gaps & Priorities - Urban Populations | 2021 | Project title: Using behavioural science approaches to optimize Public Health and Social Measures (PHSM) that prevent COVID-19 transmission and infection in priority populations in diverse urban settings Abstract/SummaryThe WHO has identified Public Health and Social Measures (PHSM; e.g., physical distancing, mask-wearing, vaccination) as "critical to limiting transmission of COVID-19 and reducing deaths." PHSM remain vital given variants of concern that are more infectious and/or reduce vaccine effectiveness. It is still unclear what influences whether Canadians engage in PHSM behaviours, what enablers and barriers they face when engaging in them, what influences their long-term use and how these factors differ across specific groups especially historically excluded and equity-deserving groups. This hinders our ability to design tailored, behaviourally optimized, culturally appropriate programs to promote PHSM. We will address this by setting up a responsive, nimble and inclusive platform that will enable our knowledge users (public health units & community groups in 3 Ontario cities) to leverage behavioural science in ways that reflect their evolving priorities as the pandemic continues. We will generate a rapid understanding of what influences engaging in PHSM to create strategies to promote greater uptake and engagement in PHSM in ways that reflect the realities of priority groups in each city (including historically excluded and equity-deserving groups). We will work with our public health and citizen partners to recruit diverse samples that we will interview using a validated behavioural science framework. This will generate information about enablers/barriers to taking up and sustaining PHSM to enable tailoring to each group. We will investigate whether sex, gender, age, and other social identity factors modify enablers/barriers for each PHSM. The results will inform a) public health programs targeting sustained and effective PHSM to reduce risk of transmission and infection and b) management of future infectious disease outbreaks. We will conduct an arms-length evaluation of the behavioural science platform and its perceived value and impact for our knowledge user partners. |
| Team Grant: Healthy Cities Implementation Science (HCIS) Team Grants – Letter of Intent | 2022 | Project title: Developing, administering, and evaluating online psychotherapy and psychoeducation programs to address common mental health challenges faced by post-secondary students in Kingston, Frontenac, Lennox & Addington (KFL&A) Abstract/SummaryThe high prevalence of mental challenges and disorders in post-secondary students demands accessible and efficacious mental health care. Electronic psychotherapy (e-psychotherapy) and online psychoeducation programs have shown promise in mitigating clinical symptoms of mental disorders. Therefore, the primary objective of this proposed multi-phase study is to collaborate with knowledge users and stakeholders to develop, administer, and evaluate the efficacy of these digital mental health interventions in post-secondary students. The study will focus on students enrolled in post-secondary institutions within Kingston, Frontenac, Lennox & Addington (KFLA) who are across the mental health spectrum. Initially, focus groups will be conducted with diverse student samples to identify common mental challenges and how to best address them. The qualitative findings will then be used to inform the development of online psychoeducation and e-psychotherapy programs as well as increasing city-wide mental health awareness initiatives. The three-week psychoeducation program will be compared to a treatment as usual control and aims to educate participants on general mental health, when to seek help, and appropriate physical activity and dietary strategies. The 12-week e-psychotherapy programs will be administered to students diagnosed with specific mental disorders. The seven e-psychotherapy programs will focus on generalized anxiety disorder (GAD), social anxiety disorder (SAD), depression (MDD), substance use disorder (SUD), eating disorders (ED), borderline personality disorder (BPD), and attention-deficit hyperactivity disorder (ADHD). To improve upon customized and efficient care, the efficacy of e-psychotherapy programs with machine learning, artificial intelligence, and stepped care approaches will be evaluated. These interventions aim to provide the most cost-effective and efficacious programs that support students' psychological health and well-being. |
| Team Grant: Healthy Cities Implementation Science (HCIS) Team Grants – Letter of Intent | 2022 | Project title: Improving population health through addressing social determinants in urban primary healthcare Abstract/SummaryA key aspect of improving population health in urban primary healthcare organizations is addressing the social determinants of health (SDoH). Actions to address SDoH go "upstream" of illness and premature death and are key to primary prevention and reducing health inequities. Addressing SDoH has long been a central part of population health. More recently, healthcare organizations have explored how they can address SDoH, but such actions remain concentrated in a small number of organizations. In 2017, we published a key framework on how primary healthcare organizations can address SDoH. This stepwise, data driven approach integrates actions on SDoH at multiple levels. In the proposed multi-year project will engage six urban jurisdictions: Toronto, Barrie, Kingston, Calgary, Winnipeg and Montreal. We will apply implementation science methods to adapt, implement, and evaluate multi-component approaches to improving population health through addressing SDoH through urban primary healthcare organizations, engaging community and social services, local public health and municipal collaborators. Our vision: Networks of primary healthcare clinics in urban settings working together to implement data-driven, evidence-based actions on SDoH at the individual-, organizational- and community-level to improve population health. |
| Team Grant: Healthy Cities Implementation Science (HCIS) Team Grants – Letter of Intent | 2022 | Project title: Reimagining Naturally Occurring Retirement Communities (NORCs) for 21st Century Cities: What Works Best to Support Older Adults to Age in Place? Abstract/SummaryMany older adults live clustered in buildings or communities, known as Naturally Occurring Retirement Communities (NORCs). These communities provide an opportunity to deliver on-site social supports and health services in efficient and creative ways to prevent loneliness, improve health and well-being, and support older adults to age in place. Few NORCs, however, have been enhanced like this because little is known about how to create, implement or sustain these types of models. Our research will fill these gaps by identifying which NORC sites are best suited for enhancement, and what factors promote or hinder their successful implementation. We will also examine if the level of support (or degree of enhancement) provided by the model changes how it is implemented and its effectiveness. Exploring sex and gender differences in how the models work and their impact will be important as most older adults living in NORCs are women. We will implement three enhanced NORC models at 6 sites - first in Toronto, one of the most diverse cities in the world, and then later in Barrie, a quickly growing mid-sized city. The models will vary in the intensity of support they provide (low, medium, and high) to older adults. We will evaluate both the process of implementation to understand what works, for whom and in what circumstances, and the impact of the models on older adults and the healthcare system. The project will be guided by a strong implementation science team and researchers with expertise in aging. We will engage a diverse Stakeholder Advisory Committee of residents, building owners, municipal representatives, and program and research staff so that our findings are useful and actionable. This first of its kind project will reimagine aging in place and deliver practical tools - an implementation toolkit and a community of practice - to support the spread and scale of enhanced NORCs in ways that benefit all, across Canadian and international cities. |
| Team Grant: Healthy Cities Implementation Science (HCIS) Team Grants – Letter of Intent | 2022 | Project title: Implementation of Municipal Housing Interventions to improve Healthy Aging and Quality of Life in Canadian Cities Abstract/SummaryThere are many groups of people who experience aging differently due to their race, ethnicity, immigration status, income, or other factors. One reason is that they often face additional barriers in accessing primary care. For example, they may have language barriers or mobility challenges. When they cannot access primary care, this results in higher rates of chronic disease and poor health over their lifespan. By bringing healthcare to where individuals live, it can help to overcome these barriers. The result is better healthcare in the short term and better aging in the long term. This research project will focus on two interventions to help overcome these barriers: the Community Paramedicine at Clinic (CP@clinic) Program, and the At Home/Chez Soi program. The CP@clinic Program uses community paramedics to improve the health and quality of life for older adults living in social housing. The At Home/Chez Soi program provides both housing and mental health treatment for individuals experiencing homelessness. This research project proposes to implement the CP@clinic and At Home/Chez Soi programs in new municipalities (Surrey and Victoria, British Columbia; Hamilton, Ontario). This process will be evaluated to find out how the program works best, for whom, and in what settings. We will be working with many community partners, including social housing organizations and paramedic services, to achieve this project. 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. |
| Team Grant: Healthy Cities Implementation Science (HCIS) Team Grants – Letter of Intent | 2022 | Project title: Implementation Science Team in Healthy Aging Abstract/SummaryAs one-third of Canadians will be older adults (>65y) by 2050, it is no surprise that healthy aging is a public health priority. Older adults who are physically active are more socially connected and interact more fully with their communities. However, 85% of older adults in Canada are not active enough to enjoy health benefits. Therefore, with our community partners we co-designed Choose to Move (CTM)-a flexible, community-based program that improved physical activity, mobility, social connectedness and diminished loneliness in older adult participants. From small beginnings, CTM was scaled-up across 7 years to reach >6000 older adults in one province. However, CTM engaged primarily white older adults, most of whom were women. Our Implementation Science Team in Healthy Aging aims to address this inequity. We propose to adapt CTM for three more diverse groups of older adults who live in large- (Vancouver, Surrey) or medium-sized (Prince George, Waterloo) cities. Specifically, we will focus on older adults marginalized by one or more of: ethnicity, geography, sex/gender. We will work with community-based seniors' services (e.g., not-for-profits; cultural centers; neighbourhood houses) to adapt CTM for 'best fit' and to help organizations build the capacity (support and training) they need to deliver the CTM program. Our research objectives are to: 1) describe how CTM is adapted to meet the needs of older adults of different ethnicities, older adults in northern BC and older men; (an engagement/adaptation outcome); 2) evaluate factors that affect implementation (e.g., feasibility) (an implementation science outcome); and 3) measure health indicators among older adults who participate in CTM (a health outcome). Our impact will be an implementation science research network, engaged community organizations, an evidence-based and more equitable intervention (CTM), a new generation of implementation scientists, and healthy, engaged and connected older adults. |
| Team Grant: Healthy Cities Implementation Science (HCIS) Team Grants – Letter of Intent | 2022 | Project title: PROACTIVE - Optimizing real-world interventions for older adults: Community-tailored implementation of person-valued interventions through continual evaluation Abstract/SummaryCanadians are living longer but many have reduced quality of life and trouble with day-to-day activities, and often develop frailty. Older adults with frailty are vulnerable to catastrophic decreases in their health from minor stressors, which can lead to hospitalization or death. There is increasing evidence that aging can be positively altered such that frailty and disease is delayed or prevented. Many of the causes of frailty are preventable, including muscle loss, poor nutrition, and loneliness. Our research focuses on implementing a city-wide, population-based healthy-aging strategy called AVOID Frailty. AVOID Frailty promotes regular Activity and exercise, adult Vaccinations, Optimization of medications, regular social Interaction, and improved Diet and nutrition. AVOID Frailty proposes behaviour-change methods to educate, encourage and help people adopt and maintain these behaviours over time. Our project will identify the community barriers and facilitators that are responsible for people's adoption of AVOID Frailty behaviours in cities like Kingston and Trois-Rivières. Our plan is to first identify all community care and social programs available to community members to maintain their health and include them in the AVOID Frailty strategy. We will then consult older adults and city representatives and from community organizations to study how AVOID Frailty can be further tailored to the needs of older adults who live in various types of residences. In a last step, we will assess the extent to which adoption of the AVOID Frailty behaviours improves the well-being and quality of life of older adults. Our findings will allow us to evaluate the effectiveness of this tailoring strategy in meeting older adults' needs, and implement it in other Canadian cities so that older adults can live longer in good health and with high quality of life. |
| Team Grant: Healthy Cities Implementation Science (HCIS) Team Grants – Letter of Intent | 2022 | Project title: Zoomers on the Go: Implementation of a Peer-Led Exercise Program for Falls-Prevention Across Canada Abstract/SummaryMany Canadian adults fall every year. The consequences can be catastrophic for older adults, including being hospitalized for long periods and moving to a long-term care facility. In some cases, falls can even result in death. Of all strategies, regular exercise is the best approach to prevent falls in older adults. Even if many exercise programs are offered to older adults, long-term plans and funding towards programs that truly reduce the risk of falls are rare in many Canadian communities. Consequently, there is a need to implement exercise programs that do not solely rely on short-term funding but benefit from partnerships with existing community resources. When such community partnerships are formed, it ensures that programs can continue. In New Brunswick, Zoomers on the Go, a community exercise program that specifically targets a reduction in the risk of falls for people age 50+ years, has shown promising results. Through this 12-week program, we have demonstrated that participants improve their physical abilities (e.g., strength, speed, balance), making them more functional and reducing their risk of falls. Importantly, this program is delivered at no cost to the participant, is provided by a volunteer peer, and is supported by local resources. Due to the success of this program and the resources required, it could be implemented across Canada. The Healthy Cites Implementation Studies Team Grant will be used to: 1) Extend the offering of Zoomers on the Go to Canadian municipalities from all provinces, and 2) Understand the elements that make this program a success. All Canadian adults can benefit from regular exercises, such as a reduction in the risk of falling. Although it is clear that regular exercise leads to a reduction in falls, there is a lack of long-term programs available across the country that were proven to truly reduce the risk of falls. |
| Team Grant: Healthy Cities Implementation Science (HCIS) Team Grants – Letter of Intent | 2022 | Project title: Implementing Digital health, Evidence-based physical Activity programs and Supportive environments for Healthy Cities: IDEAS for Healthy Cities Abstract/SummaryImpaired mobility, social isolation and chronic health conditions can compromise health and wellbeing in older adults. There is strong evidence that meeting Canada's 24-Hour Movement guidelines, by getting adequate sleep, reducing sedentary time, and participating in regular physical activity can improve many health outcomes. Also, certain types of exercise can prevent falls, or arthritis pain, such as specific balance exercises and muscle strengthening exercises. However, implementing the guidelines and exercise programs in the real-world is hard. Health care providers interact with a large proportion of the population, but don't have time to teach exercise, and don't know where to refer patients. Community program providers often deliver falls prevention or other exercise programs, but are often not aware of the latest research or guidelines, so evidence-based programs may not get implemented. In a collaboration between researchers and community service, primary care, digital health and advocacy organizations, we will: a) build a physical activity eReferral tool into medical record systems, so health care providers can seamlessly refer patients to community-based physical activity programs; and b) collaborate with community organizations to develop an IDEAS for Healthy Cities Implementation guide, so that organizations across Canada can implement exercise programs that have been shown to be effective for preventing falls, fractures and arthritis pain. eReferral exists in Ontario, but is not designed for physical activity referrals. We will interview patients and health care providers, and collaborate on the development of programs and eReferral processes (Phase 1), test usability (Phase 2), pilot test them in Kitchener, Waterloo and other cities (Phase 3), and then scale them up more broadly and evaluate them. Our vision is physically active Canadians, achieved by creating supportive environments in health care and community. |
| Team Grant: Healthy Cities Implementation Science (HCIS) Team Grants – Letter of Intent | 2022 | Project title: Development and Implementation of a Parks Prescription Intervention for Diabetes Prevention (PARKS-DP) Abstract/SummaryLifestyle interventions consisting of physical activity and weight loss can prevent or delay the onset of diabetes in people who have earlier stages of disease (known as prediabetes). While these interventions have been tested in randomized controlled trials, they have not proven to be feasible to deliver in primary care settings. Furthermore, those who enroll in these programs often find it unsustainable. Park prescriptions (whereby a health care provider gives a written recommendation for a person to visit a park or trail) are a potential solution within the growing field of 'social' prescribing. Our international team of researchers, health care professionals, knowledge users, urban planners, and community organizations will evaluate the effectiveness of an intervention based on park prescriptions which will be co-designed with community partners. We will test our intervention in populations in Canada and Australia to assess whether it can reduce the likelihood that someone with prediabetes will convert to diabetes. Because exposure to nature may result in other 'co-benefits' we will test whether park prescriptions lead to better mood and quality of life. In addition, we will examine whether a digital smartphone app and/or 'nature coaches' are an effective way of supporting people with prediabetes to make positive behavior changes after they receive their park prescription. If successful, this research will transform diabetes prevention practices by offering a simple, effective, and sustainable solution to support people who have a high risk of developing diabetes to become more physically active and to stay socially connected within their own communities. It will also guide urban health policy decisions to create more supportive environments for communities that need it most. This first-of-its-kind transdisciplinary research will enable us to implement evidence to achieve equitable and impactful solutions for diabetes prevention in 'real world' settings. |
| Team Grant: Healthy Cities Implementation Science (HCIS) Team Grants – Letter of Intent | 2022 | Project title: Small Steps for Big Changes: Implementing an Evidence-Based Diabetes Prevention Program into Diverse Urban Communities Abstract/SummaryMore than 6 million Canadians are at risk for developing type 2 diabetes (T2D). Laboratory-based diabetes prevention programs have not been effective when translated into community settings, mainly due to their low-quality delivery and inability to reach people in the community who need it most. Small Steps for Big Changes is a diet and exercise counselling intervention that significantly reduces the risk of developing T2D. Designed for feasible, scalable, and sustainable implementation into communities, Small Steps for Big Changes is delivered by community-dwelling peers to ensure the content is ethnoculturally relevant. Small Steps for Big Changes can now be delivered virtually through a state-of-the-art online platform. The next phase of research is to test the implementation of this program in diverse urban communities across Canada, where T2D rates are high and diabetes prevention programs remain inaccessible. In partnership with 9 regional YMCAs in Canada, we are well-positioned to evaluate the implementation and effectiveness of Small Steps for Big Changes across 29 distinct municipalities. In Year 1, the program will be adapted through our provincial delivery teams and YMCA staff will receive virtual training to deliver program. Small Steps for Big Changes will be delivered to patients in-person or virtually, in Years 2 and 3. To evaluate implementation, we will examine number of staff trained/patients enrolled, attendance, sessions delivered as planned, delivery costs, and number of sites continuing to deliver the program in Years 3-5. YMCA staff and patients will also be interviewed on program receptivity. To evaluate program effectiveness, changes in patient health (e.g., blood glucose, weight, exercise, diet) will be measured over 2 years following program completion. This research offers an innovative, cost-saving, and sustainable solution for the prevention of T2D in traditionally underserved, at-risk populations by partnering with communities. |
| Team Grant: Healthy Cities Implementation Science (HCIS) Team Grants – Letter of Intent | 2022 | Project title: From Equity to Economics: Tackling type 2 diabetes in urban settings by supporting physical activity with urban trails Abstract/SummaryType 2 diabetes is a leading cause of death and disability in Canada. To date, the majority of the proposed solutions for reducing the burden of type 2 diabetes in Canada focus on "individualized" interventions aimed at changing behaviours, like becoming more active or eating healthier foods. Population-level interventions, that nudge large segments of the population towards a healthy lifestyle, have been understudied as solutions for reducing the burden of type 2 diabetes in urban centres in Canada. The main goal of our team is to complete a series of studies that determine if the expansion of urban trail networks reduces the risk for type 2 diabetes and related conditions (obesity and gestational diabetes) in the neighbourhoods where they are built. Urban trails are tracks of land, dedicated for walking and cycling that are separate from roads and traffic. Between 2022 and 2026 the urban centres of Brandon and Winnipeg will expand the number of urban trail networks, affecting ~500,000 urban citizens. We plan to conduct 4 studies that will (1) determine if this expansion reduces the burden of type 2 diabetes in these two urban centres; (2) determine if the trail networks and health outcomes were equitable between First Nations and non- First Nations people; (3) calculate the economic benefits of trail expansion and (4) use qualitative methods to determine the essential conditions for implementing and sustaining urban trail networks. |
| Team Grant: Healthy Cities Implementation Science (HCIS) Team Grants – Letter of Intent | 2022 | Project title: Supporting Heathy lifestyle choices to promote mental health and wellbeing in Indigenous youth aging out of care to urban settings. Abstract/SummarySupporting Healthy Lifestyle Choices to Promote Mental Health & Wellbeing in Indigenous Youth "Aging-Out-of-Care" to Urban Settings An intent of this research is to examine and explicate implementation science and implementation testing from within Indigenous contexts. The study plans to identify Indigenous principles inherent and foundational to implementation science, such as integrated KTE or knowledge mobilization, but it will also further develop the scholarly dialogue around 'implementation testing' within vulnerable populations who experience multiple and complex inequities to health. In Canada, 52.2% of children in foster care are Indigenous, but account for only 7.7% of the child population according to Census 2016. This means 14,970 out of 28,665 foster children 'in-care' homes under the age of 15 are Indigenous. The aim of this research is to support Indigenous youth, ages 12-17, as they 'age-out-of-care' in making healthy lifestyle choices that can impact their mental health and overall wellbeing while preventing chronic illness later in life. three areas of focus include: Implementation research based on implementation science and Indigenous holistic concepts of health to produce evidence of scalable and sustainable interventions that support the healthy lifestyle choices of Indigenous youth as they 'age-out-of-care' to an urban setting; Strengthen and build the capacity of health practitioners and trainees in implementation science and enhancement of services and resources to support the mental health and wellbeing of Indigenous youth; and, Mobilize evidence-based outcomes to support Canadian cities in planning and implementing a model and framework unique to urban contexts and needs of the Indigenous youth, who will 'age-out-of-care' to an urban setting. |
| Team Grant: Healthy Cities Implementation Science (HCIS) Team Grants – Letter of Intent | 2022 | Project title: Caring for the Thunderbird's Nest: Characterizing and Monitoring Inequitable Exposures to Ground and Air Pollution with Fort William First Nation, Using Machine Learning Tools Abstract/SummaryDifferent sources of air and ground (i.e., soil and water) pollution around the Fort William First Nation (FWFN) region in NW Ontario might be causing public health issues allegedly linked to a conspicuous leukemia cluster about 500 times the national average. All the environmental information available for this region is contained in a series of Environmental Site Assessment (ESA) reports for different years and pollution sources. The ESA includes a preliminary interpretation of the extent of contamination based on fragmented and limited data, preventing a thorough understanding for informed decision-making. The long-term goal of this project is to build environmental monitoring capacities within FWFN by developing an integrated machine learning-based methodological approach that allows high-resolution characterizations of ground and air pollution and their likely influences on the community's health. In accomplishing the objectives of this project, it will be possible to locate and track the pathways of the contaminants of concern, as well as nurture, together with the FWFN community, an Integrated Knowledge Translation (IKT) strategy grounded in Listening and Sharing. As a result, based on quantitative evidence, we will be able to assess the feasibility of implementing appropriate prevention, mitigation and/or remediation techniques with the active participation of community members and leaders. |
| Team Grant: Healthy Cities Implementation Science (HCIS) Team Grants – Letter of Intent | 2022 | Project title: CHANGE Health - Building Communities and Changing Lives Abstract/SummaryThe CHANGE Health Community Program is a program to help families "re-learn" healthy living by providing lifestyle intervention programming in four main areas (physical activity, nutrition, mental health, and social connections). Targeting Alberta families, this innovative health care program responds to the need for health care to take a community-relevant, preventative, and holistic approach to health and wellness. The program uses a preventative, proactive, community-based model of care that focuses on lifelong wellness, which is in direct contrast to our current disease management models of care. Supported by Alberta Blue Cross, a pilot study has shown the that The CHANGE Health Community program can be implemented with positive results. It is now important to evaluate the effectiveness of this intervention within a variety of settings and evaluating why the intervention works and for whom with a focus on implementing in culturally diverse population include indigenous families. If the CHANGE Health Community Program intervention can be shown effective in decreasing diabetes risk in diverse settings, widespread implementation could save millions of dollars for Canadians and the health care system relating to medications and procedures for this expensive medical condition. |
| Team Grant: Healthy Cities Implementation Science (HCIS) Team Grants – Letter of Intent | 2022 | Project title: EX-SPEED: Eliminate excess speed: Pedestrian/cyclist equitable engineering design Abstract/SummaryVehicle speeds in Canadian cities are excessive and dangerous for human health. Vulnerable road users- pedestrians and cyclists - account for increasing proportions of fatalities every year, especially in cities and in marginalized communities. Dangerous traffic, and vehicle-centric road design deter people from walking and cycling (active transportation) and impedes the health benefits of physical activity, neighbourhood quality of life and environmental sustainability. Canadian cities are piloting or implementing a variety of speed reduction strategies. With this research program, we will advance the field of implementation science by investigating the methods by which our 4 partner cities (Montreal, Toronto, Calgary, Surrey) take up evidence-based vehicle speed reduction interventions. Along with the tracking of the implementation process and the assessment of how and where interventions are implemented, we will examine multiple outcomes of speed reduction including injuries prevented, increases in active transportation and livable neighbourhoods. This work will encompass different urban contexts with an equity lens across ages and deprivation. The knowledge gained will be useful for our knowledge-users to promote safer roads and active neighbourhoods. This research comes at an opportune time to help "build back better" by addressing potential transportation mode shifts towards active transportation due to the COVD-19 pandemic. |
| Team Grant: Healthy Cities Implementation Science (HCIS) Team Grants – Letter of Intent | 2022 | Project title: INTErventions, Research, and Action in Cities Team for Implementation Science (INTERACT IS) Abstract/SummaryActive transport and public transit are important to provide accessible and affordable physical activity as part of everyday life and to improve population health. In 2020-2021, the Canadian federal government announced major investments for active and public transit. While the health and environmental benefits of sustainable transport interventions have been demonstrated, their equity aspects (who benefits?) and how they move from policy to on-the-ground changes are not well understood. Most cities face difficulties in making sustainable transport infrastructure changes because of practical and political issues. An implementation science approach is needed to develop a better understanding of how and for whom sustainable transport interventions impact health and health equity. Our overarching goal is to advance the field of implementation science applied to sustainable transport and create the framework that is necessary for cities to make sustainable transport interventions that can improve health and reduce inequities. This proposal builds on the work of the CIHR funded INTErventions, Research, and Action in Cities Team (INTERACT; 2017-2026), a project examining the health and equity impacts of sustainable transport interventions. INTERACT has successfully developed and conducted mixed methods natural experiment studies in three Canadian cities (Vancouver, Saskatoon, and Montreal) since 2017. We will expand our work to two Canadian cities, Kingston and Sherbrooke. We will also partner with Australian researchers in sustainable transport and implementation science. Our specific objectives are to: 1.Document factors influencing the implementation sustainable transport interventions; 2.Develop a preliminary evidence based sustainable transport implementation framework; 3.Evaluate the impact of sustainable transport interventions on implementation, health, and equity outcomes; 4.Refine the framework and develop practical tools for wide use among cities. |
| Team Grant: Healthy Cities Implementation Science (HCIS) Team Grants – Letter of Intent | 2022 | Project title: Building for Cycling in Canadian Cities Abstract/SummaryThe 2020 Declaration for Resilience in Canadian Cities called for "'everywhere-to-everywhere' networks that makes cycling a safe mobility choice for people of all ages and abilities and every resident, in every neighbourhood". These All Ages and Abilities (AAA) bicycle networks are population health interventions with established health, transportation, and environmental benefits via physical activity, safety, air quality, congestion mitigation, and social equity. However, creating connected, safe networks of bicycle infrastructure in Canadian cities has been a major challenge, and consequently cycling uptake is low in many places, and for many population groups. To get more people cycling, more often, for more trips, and improve health and healthy equity for all Canadians, we need to pursue implementation science approaches that will help build out bicycle infrastructure in urban contexts across the country. Our team of intersectoral partners and interdisciplinary researchers from across Canada, US, and Australia will assess the current state of AAA bicycle networks in Canadian cities, identify barriers and facilitators to building out bicycle infrastructure within and across different settings, and generate new knowledge on the health, transportation, and equity impacts of AAA bicycle networks. This work will accelerate Canada as a cycling nation where all cities have bicycle networks, appropriate to their local context, which enable cycling as an option for all. |
| Healthy Cities Implementation Science (HCIS) Team Grants | 2022 | Project title: Supporting Healthy Lifestyle Choices to Promote Mental Health & Wellbeing of Indigenous Youth Aging-Out-of-Care in Urban Settings Abstract/Summary"Supporting Healthy Lifestyle Choices to Promote Mental Health & Wellbeing of Indigenous Youth Aging-Out-of-Care in Urban Settings" will support the development and adaptation of interventions designed to support Indigenous youth aging out of care in urban settings. Rooted in Indigenous holistic concepts of well-being and a cultural land-based model, the project will centre collaborative work with Indigenous youth, Indigenous care practitioners, Elders/Knowledge Holders and Friendship Centres to develop creative and innovative action plans to address the complex challenges that arise prior to and during the transition out-of-care in urban settings. In this way, the model and method will focus on building and implementing interventions in urban Indigenous community settings that enable increased access for Indigenous youth to physical, social, and cultural supports that support them in utilizing wellbeing centered decision-making ("healthy lifestyle choices"). The goals of the study include: 1) adapting interventions designed to support mental health and well-being for Indigenous youth aging-out-of-care in urban settings that emphasize wellbeing centred decision-making ("healthy lifestyle choice"); 2) developing culturally based wellbeing indicators with and for Indigenous youth (ages 12-24); 3) expanding the knowledge based of care practitioners working with Indigenous youth aging-out-of-care to be inclusive of Indigenous life path preparations that support holistic wellbeing and life preparedness in an urban environment; 4) evaluating the intervention to assess scalability and adaptation to other relevant populations in urban contexts; and 5) developing and sharing knowledge resources for Indigenous and non-Indigenous care practitioners aimed at supporting the mental health and well-being of Indigenous youth aging-out-of-care in urban contexts. |
| Healthy Cities Implementation Science (HCIS) Team Grants | 2022 | Project title: Small Steps for Big Changes: Implementing an Evidence-Based Diabetes Prevention Program into Diverse Urban Communities Abstract/SummarySix million Canadians are at risk for developing type 2 diabetes (T2D). Laboratory-based diabetes prevention programs have not been effective when translated into community settings due to their low-quality delivery and inability to reach people in the community who need it most. Small Steps for Big Changes is a diet and exercise counselling intervention that significantly reduces the risk of developing T2D. Designed for feasible, scalable, and sustainable implementation into communities, Small Steps for Big Changes is delivered by community-dwelling peers to ensure the content is ethnoculturally relevant. Small Steps for Big Changes can now be delivered virtually through a state-of-the-art online platform. The next phase of research is to test the implementation of this program where T2D rates are high and diabetes prevention programs remain inaccessible. In partnership with YMCAs in Canada and Australia spanning 8 provinces and the state of Queensland, we are well-positioned to evaluate the implementation and effectiveness of Small Steps for Big Changes across 16 urban municipalities. In Year 1, the program will be adapted through our regional delivery teams and YMCA staff will receive virtual training to deliver program. Small Steps for Big Changes will be delivered to patients in Years 2, 3 and 4. To evaluate implementation, we will examine number of staff trained/patients enrolled, attendance, sessions delivered as planned, delivery costs, and number of sites continuing to deliver the program in Years 4-6. YMCA staff, municipality stakeholders, and patients will also be interviewed on program receptivity. To evaluate program effectiveness, changes in patient health (e.g., blood glucose, weight, exercise, diet) will be measured over 2 years following program completion. This research offers an innovative, cost-saving, and sustainable solution for the prevention of T2D in traditionally underserved, at-risk populations by partnering with communities. |
| Healthy Cities Implementation Science (HCIS) Team Grants | 2022 | Project title: Understanding how to Attract, Adapt, IMplement and Sustain an evidence-informed fall prevention exercise program in Community Settings: The AAIMS project Abstract/SummaryWhen someone falls, there are many consequences for the person and the health system. Almost 100,000 people in Canada are admitted to the hospital annually because of a fall! The best way to reduce the number of fall injuries is to exercise regularly. As a result, many communities offer exercise programs for older adults to help reduce falls. However, according to the latest Canadian report, fewer than one in ten fall prevention exercise programs provide the best program possible, meaning that programs should be offered all year long, a least three hours per week, and focus on balance activities. In addition, some Canadians do not have such a program in their region. Our team includes local, provincial, and national partners, in addition to researchers and students from Canada and Northern Ireland. They have all collaborated to plan the Attract, Adapt, IMplement and Sustain (AAIMS) project to understand how to: 1-attract people who currently do not participate in fall prevention exercise programs; 2-adapt the programs currently offered that do not meet the recommendations; 3-offer a program that follows recommendations if needed; 4-keep offering a program in community settings. The exercise program will be offered in-person, online, or in a combination of the two. We will collect information by interviewing key people over the course of the project and will test how many people registered for the program, if they come with different characteristics, if there are signs that programs will last, and if people who were doing the program fall fewer times compared to the general public. This program will help us understand how to better spread a program that works in many different places while reducing participant falls. |
| Healthy Cities Implementation Science (HCIS) Team Grants | 2022 | Project title: Building CapaCITY/É for Sustainable Transportation Abstract/SummaryCapaCITY/É is a team working to understand why and how cities implement sustainable transportation interventions, specifically infrastructure with safe and inclusive design to support the uptake of walking, cycling, and public transit use. Our focus is on All Ages and Abilities (AAA) bicycle networks and speed management interventions. AAA routes separate bicycles from motor vehicles; connections of AAA routes in a network create conditions that allow cycling to be a choice for more people, more often, for more trips. Speed management interventions make roads safer and more accessible for all users: our work focuses on specific interventions including removing lanes for motor vehicles to create space for people to walk, wheel, and cycle; automated speed enforcement programs; and speed limit reductions (e.g., from 50 km/hr to 30 km/hr). The goal of CapaCITY/É is to accelerate the implementation of sustainable transportation interventions that will support health, mobility, and equity in cities. Working with cities, community groups, and people living in cities, we will build new understanding of how, why, and for whom sustainable transportation interventions are implemented. Our partner cities (Halifax, Montréal, Kingston, Guelph, Toronto, Saskatoon, Calgary, Surrey, Victoria, and Melbourne, Australia) provide a broad array of contexts for comparative case studies. By assessing how cities are similar or different in implementing interventions, and by developing and sharing tools from what we learn, we aim to help more cities implement sustainable transportation interventions to improve the health of their populations. |
| Healthy Cities Implementation Science (HCIS) Team Grants | 2022 | Project title: Healthy Cities-Implementation Science Team in Healthy Aging Abstract/SummaryOur Healthy Cities-Implementation Science Team in Healthy Aging tackles the epidemics of physical inactivity and loneliness that plague older adults who live in medium- and large-sized cities. Physically active older adults have better mobility, mental and social health than their inactive counterparts. Therefore, guided by implementation science principles (e.g., tailored for participants; adaptable to context), we co-designed Choose to Move (CTM) with older adults, community and government partners. CTM is a flexible, scalable community-based program that improved physical activity, mobility, social isolation and loneliness in older adults. From small beginnings, we scaled-up CTM over 8 years to reach >6000 older adults in British Columbia (BC). Our reservation was that CTM engaged primarily white older adults in Metro Vancouver; 77% were women. We now aim to expand the reach of CTM to better serve the needs of more diverse groups of older adults. We will support community-based seniors' services organizations (e.g., not-for-profits; neighbourhood houses) to adapt CTM to 'best fit' the older adults they serve, and build capacity in these organizations to deliver CTM. Through 5 projects, we will address 4 broad research objectives. We will: 1. Undertake evidence syntheses to identify knowledge gaps; 2. Describe how the CTM program and implementation strategies are adapted and implemented in older adults who are South Asian, older men or older adults in northern BC; 3. Evaluate whether readiness (e.g., organizational capacity), implementation strategies (e.g., training and technical support) and implementation factors (e.g., acceptability) influence how CTM is implemented; 4. Measure impact of CTM on physical activity and other health outcomes of older adults. Our impact will be engaged community organizations, a program that has been adapted to serve diverse older adults, a new generation of implementation scientists, and healthy, active and connected older adults. |
| Healthy Cities Implementation Science (HCIS) Team Grants | 2022 | Project title: Reimagining Naturally Occurring Retirement Communities (NORCs) for 21st Century Cities: What Works Best to Support Older Adults to Age in Place? Abstract/SummaryMany older adults live clustered in buildings or communities, known as Naturally Occurring Retirement Communities (NORCs). These communities provide an opportunity to deliver on-site social supports and health services in efficient and creative ways to prevent loneliness, improve health and well-being, and support older adults to age in place. Few NORCs, however, have been enhanced like this because little is known about how to intentionally create, implement or sustain these types of models. Our research will fill these gaps by identifying which NORC sites are best suited for enhancement, and what factors promote or hinder their successful implementation. We will also examine if the level of support (or degree of enhancement) provided by the model changes how it is implemented and its effectiveness. Exploring sex and gender differences in how the models work and their impact will be important as most older adults living in NORCs are women. We will implement three enhanced NORC models at 7 sites - first in Toronto, one of the most diverse cities in the world, and then later in Barrie, a quickly growing mid-sized city. The models will vary in the intensity of support they provide (low, medium, and high) to older adults. We will evaluate both the process of implementation to understand what works, for whom and in what circumstances, and the impact of the models on older adults and the healthcare system. The project will be guided by a strong implementation science team and researchers with expertise in aging. We will engage a diverse and pan-Canadian National Stakeholder Advisory Committee of residents, building owners, municipal representatives, and program and research staff so that our findings are useful and actionable. This first of its kind project will reimagine aging in place and deliver practical tools - a NORC Implementation Toolkit - to support the spread and scale of enhanced NORCs in ways that benefit all, across Canadian and international cities. |
| Healthy Cities Research Partnership Development Grants | 2022 |
Project title: Sowing the seeds for healthy active lifestyles among new immigrant families in Hamilton: Building new multi-sectoral partnerships for future grant opportunities Abstract/SummaryThere are systemic barriers preventing children and youth from low income communities - particularly new immigrant and refugee families - from accessing and participating in activities and programs that promote healthy active lifestyles. Thus, many children and youth spend most of their free time participating in sedentary screen-based activities, which places them at increased risk of developing mental health disorders such as anxiety and depression, obesity, and adult-onset type 2 diabetes. Effective long-term solutions must consider the intersectional context of these families. Nature-based and multi-component health interventions (e.g., access to low-cost outdoor activities, community gardens) offers great opportunity to promote and sustain physical, mental, and social wellbeing. These interventions may be most salient and impactful in communities such as Riverdale in Hamilton, Ontario, which has been identified as an "arrival community", whereby many newcomers come to settle when they arrive in Canada. We must, however, be better equipped to meaningfully engage with this unique and heterogeneous population. Therefore, to be in a stronger position to apply for future granting opportunities that are inclusive of new immigrant perspectives and experiences, our planning grant is intended to cultivate new and deep multi-sectoral partnerships between our team of academic partners (McMaster University Chanchlani Research Centre; McMaster Children's Hospital; Brock University Infant/Youth/Child Lab; University of Toronto Canadian Urban Environmental Health Research Consortium) and critical community partners within Riverdale: Local families; Municipal leadership (Neighbourhood Development Sector at the City of Hamilton, Community Action Program for Children Hamilton); Education (Hamilton Wentworth District School Board, Hamilton Wentworth Catholic District School Board); and Community Organizations (Green Venture, The Starfish Canada, Trees for Hamilton, Today's Family). |
| Healthy Cities Research Partnership Development Grants | 2022 |
Project title: Fresh food prescriptions in Ontario: Knowledge dissemination, priority setting, and planning Abstract/SummaryFood insecurity and suboptimal diet are tandem public health concerns in urban settings across Canada. Food prescription programs, in which healthcare providers prescribe and link patients with sources of community food support, are an innovative approach to addressing food insecurity and improving nutritional health. This research proposal builds on the preliminary success of a fresh food prescription (FFRx) project in the Wellington-Guelph-Dufferin region of Ontario. It aims to analyze and disseminate research findings, strengthen intersectoral partnerships, and set an agenda for an Ontario-wide network to initiate a collaborative research project evaluating the effectiveness of fresh food prescriptions. Furthermore, this project addresses health equity by improving food security and health among low-income, urban residents. Specific objectives are to: (1) develop and disseminate outputs from the FFRx project ; (2) disseminate research findings from the FFRx project to multiple local stakeholders in the Wellington-Dufferin-Guelph region through a knowledge dissemination workshop; and (3) establish an Ontario-wide food prescription Community of Practice network and plan for a new research initiative through an agenda-setting meeting. |
| Healthy Cities Research Partnership Development Grants | 2022 |
Project title: The Forgotten North: Adapting an effective health-promoting program for northern British Columbia Abstract/SummaryPhysically active older adults are healthier, more socially connected and interact more fully with their communities. However, 85% of older adults in Canada are not active enough to enjoy health benefits. Therefore, with our community partners we co-designed Choose to Move (CTM)-a flexible, community-based program that improved physical activity, mobility, social connectedness and diminished loneliness in older adult participants. CTM was scaled-up across 8 years to reach >6000 older adults in British Columbia (BC). However, our reach was primarily in Metro Vancouver. As northern cities face different challenges implementing health-promoting initiatives (e.g., dispersed geography, climate, isolation from metropolitan centres, transportation), 'what works' in southern urban centres may not translate to northern communities. To address this inequity, we aim to build capacity in the community-based seniors' services sector to enable them to adapt and deliver health-promoting programs (CTM) in northern BC. Our objectives for this planning grant are to: 1. develop a specific plan of action to identify/fill gaps in capacity that would enable the community-based seniors' services sector to effectively implement health-promoting interventions for older adults living in northern communities; 2. develop a CIHR Project Grant in Healthy Aging that evaluates implementation and health benefits of CTM, adapted for older adults in northern BC. To achieve these objectives, we propose to bring together researchers who work in healthy aging (in northern communities), physical activity and implementation science, sex and gender science, and key knowledge users representing community-based seniors' services organizations who engage with a diverse range of older adults living in northern communities, to Prince George, BC for a planning meeting. What we learn can be applied to adapting health-promoting interventions for northern BC, and other more remote geographies across Canada. |
| Healthy Cities Research Partnership Development Grants | 2022 |
Project title: Catalyzing Community Connection - Population Health Cross-Border Project Abstract/SummaryPeople living in border cities face barriers connecting to healthcare and health care resources. The cities of Windsor, Ontario and Detroit, Michigan are border cities that have been described as "downturn" and "broken" cities. Both cities share social and economic problems such as high unemployment, poverty, poor social support, homelessness, and addiction, and these problems worsened in 2020 when Windsor and Detroit became hotspots for COVID-19. When compared to other cities, people living in Windsor and Detroit have poorer health, and higher rates of disease and deaths that could be prevented. Catalyzing Community Connection (CCC) is an intervention created to help cities and communities work together to overcome obstacles to health for their citizens. The CCC intervention matches trained volunteers to help people who might otherwise fall through the cracks of care systems because of race, gender, disability, age, or other barriers. CCC helps people navigate the care system, build social connections, and find community resources. In this project, we form a new Windsor-Detroit partnership with that will bring together regional health experts and citizens to plan how to implement and evaluate the cross-border CCC intervention and share the learnings. This project will also be a beginning step in forming a group of stakeholders who are motivated to discuss research and other opportunities that could improve the health of people living in the cities of Windsor and Detroit. Our international team is made up of health researchers, computer science and data experts, Canadian and US health care leaders, and legal/policy experts. We will complete a scan of relevant community programs to identify new stakeholders, and lead a series of meetings to generate ideas, understand priorities, and create opportunities for advancing cross-border population health. |
| Healthy Cities Research Partnership Development Grants | 2022 |
Project title: Planning and developing Canadian intersectoral partnerships and knowledge sharing for sustainable LD risk mitigation in peri-domestic high-risk areas Abstract/SummaryLyme disease and other tick-borne diseases (TBD) are an emerging public health threat in Canada. Although ticks are often associated with forested areas, urban and peri-urban exposure are frequently thought to be the source of tick exposure for LD cases, particularly in municipalities where private yards are bordered by forests or where municipal parks host significant populations of deer and rodents. Healthy Cities benefit from greening public and private spaces and promoting access to green spaces. However, in some urban and periurban settings, green spaces may be associated with LD risk, which may induce significant psychological stress and may limit outdoors activities. Hence, risk mitigation strategies that maximize the benefits of spending time in vegetated areas while reducing TBD risk are required for urban and peri-urban settings. Various interventions have been developed in the last two decades to reduce the risk of human encounter with B. burgdorferi infected questing ticks. However, few of these interventions have demonstrated consistent effectiveness at reducing the risk of tick exposure in humans or the risk of Lyme disease and even fewer are considered efficient, feasible and socially acceptable. Citizens or municipal authorities may find some interventions hard to implement or resource-intensive and the sustainability of such interventions is thus questionable if the requirements of local day-to-day management are not considered in the development phases of interventions. We thus propose to create a network of researchers and empowered municipal end-user stakeholders and citizens to codevelop, based on the best scientific knowledge available on LD risk management, locally adapted integrated interventions that could eventually be supported by urban or peri-urban communities. This work will support the development of the network and evidence-informed risk reduction strategies for urban and peri-urban communities in Canada. |
| Healthy Cities Research Partnership Development Grants | 2022 |
Project title: Developing intersectoral partnerships for health promoting neighbourhoods Abstract/SummaryPeople's health and well-being depend, in part, on the physical and social attributes of the neighbourhood where they live. If we want to design health promoting neighbourhoods, we need citizens, researchers, institutions (e.g., school, health and social services, housing), community organizations, and actors from the municipal and private sectors to partner together and collaborate. Evidence regarding how to develop and maintain such intersectoral partnerships is scarce. In this project we will formalize an interdisciplinary team committed to better understanding and supporting intersectoral partnership and collaboration for health promoting neighbourhoods. Through a literature scan and a one-day symposium with researchers and partners from a diversity of sectors, we will (1) identify potential enablers and barriers to intersectoral partnership development and action plan implementation in the context of the Marie-Reine neighbourhood (Sherbrooke, QC), our case example, and (2) develop clear research and intervention priorities to create health promoting neighbourhoods more widely. The intersectoral partnership we build, and research agenda we establish with this planning grant can support other mid-size cities in their quest to (re)design healthy and equitable neighbourhoods, and ultimately, healthy, equitable and resilient cities. |
| Healthy Cities Research Partnership Development Grants | 2022 |
Project title: Visions of Community Health for the Inclusive Smart City: Building a Collaborative Research Program Abstract/SummarySmart cities initiatives involve using digital technologies to improve services and collect data about cities to improve things like traffic, public health, and parks. Relying on digital technologies and data collection can benefit some residents, but can also exclude or harm other residents. In this project, we are building a team of community members, government staff, researchers, and community agencies to build a research project focused on how smart city projects might focus better on health equity and community health. Supporting health equity would involve focusing on the health of marginalized communities, which are those communities that have been excluded from opportunities and benefits of services in cities in the past and present. We will partner with 5-7 community members from marginalized communities co-lead our project. Community members will be given smart phones and will take photographs of aspects of their everyday lives that relate to community health, to better understand opportunities and challenges for community health in different neighbourhoods of Toronto. We will then bring a big group together to discuss what community members found, and plan a bigger research project. We will also write a research paper about what we found in this research planning effort. |
| Healthy Cities Research Partnership Development Grants | 2022 |
Project title: Identifying the Needs and Preferences of Children and Youth with Chronic Medical and Mental Health Conditions for Active Living Programming and Infrastructure in Toronto Abstract/SummaryYouth with chronic medical and mental health conditions (CMC) have low rates of physical activity that may stem, in part, from barriers to accessing programming and infrastructure. Our objective is to (1) identify barriers to physical activity participation in youth with CMC and (2) propose local solutions to combat these barriers. Our collaborative group, which includes pediatric exercise researchers, pediatricians, community health organizations, policy makers, children/youth with CMC and their parents, proposes to accomplish this through a community research-centered approach that draws upon the Delphi technique and nominal groups methodologies. We will use group consensus processes specifically to identify practical ways to support the active living needs of youth with CMC residing in Toronto. These priorities will serve as catalyst for future collaborations within our group, with a goal of creating a template for healthy cities oriented towards supporting the needs of youth with CMC. |
| Healthy Cities Research Partnership Development Grants | 2022 |
Project title: ACTIVE for Health Symposium: Moving forward together for a stronger, healthier community Abstract/SummaryPhysical inactivity is the 4th leading risk factor for death worldwide. The World Health Organization developed the Global Action Plan on Physical Activity to help countries respond to this problem. In 2021, a diverse research team at Western University created the Western Research Hub for Physical Activity and Health (the 'Hub'). The Hub is the first of its kind in the world to study how to put the Global Action Plan into practice. Citizen engagement is fundamental to our research. We formed a Community Advisory Council (the 'Council') with patient partners and community members. This Council co-designs our whole strategy. We have reached out to researchers in all different fields. We have developed a website together to help people with barriers become more active. With funding, we plan to deliver a city-wide event called the ACTIVE for Health Symposium. ACTIVE stands for Activity, Community, Translation, InnoVation & Engagement. The event will create new partnerships between Western University researchers and community members. It will help increase our knowledge of how to put physical activity research into practice in London. It will continue to build on the foundation we have created in the past year. We have five goals: 1) Share Western-led research in the application of physical activity. 2) Highlight resources and physical activity success stories within the London community. 3) Share ideas between Western University researchers and community members. 4) Develop and strengthen partnerships between researchers and community members. 5) Engage under-represented groups. With this Symposium, our Hub can help local initiatives make it easier for more people to be more active. Together we will be able to help other cities and regions succeed as well. Ultimately, this means more Canadians will have access to life-saving physical activity and we can be a part of the solution. |
| Healthy Cities Research Partnership Development Grants | 2022 |
Project title: INTERACT Knowledge Hub: Partnering to unlock the equity potential of sustainable transportation interventions Abstract/SummaryMajor government investments in urban design and transportation infrastructure are shaping Canada's cities. These investments happen outside of the health sector, yet they have an impact on both health and health equity. Cities are increasingly prioritizing equity through the development of equity frameworks. Practical guidance on how to meaningfully integrate equity in the planning, implementation, and evaluation of transportation interventions is lacking. Further, there are few opportunities for those on the front lines of transportation planning in Canada to connect over best practices for advancing equity, and to learn from leading researchers and advocates in this space. This proposal aims to establish the INTERACT Knowledge Hub, a pan-Canadian collaboration of partners involved in planning, implementing, and evaluating transportation interventions that promote healthy and equitable cities. It aims to strengthen partnerships and knowledge exchange between urban researchers, professionals, advocates looking to unlock the equity-promoting potential of sustainable transportation interventions across Canada. The Knowledge Hub will: 1.Document equity frameworks in Canadian cities; 2.Capture lessons learned and best practices on using equity frameworks for sustainable transportation; 3.Establish a common research and action agenda for integrating equity in the planning and implementation of sustainable transportation interventions in Canada. Key activities proposed in the grant include an environmental scan to document equity frameworks in cities; interviews with planning staff from jurisdictions identified as leading in the transportation equity space; and case studies summarizing lessons learned, best practices, and growing pains. The project will close with a summit gathering Knowledge Hub members and leading experts to strengthen partnerships, discuss case studies, and establish a common agenda for integrating of equity in transportation planning. |
| Healthy Cities Research Partnership Development Grants | 2022 |
Project title: Strengthening Toronto's response to violence against women: advancing an academic-community partnership to plan and mobilize an evidence-informed agenda Abstract/SummaryThe COVID-19 pandemic has worsened social problems in Canadian cities, including violence against women, with significant negative consequences for women's health. Organizations that support women experiencing violence have had to rapidly adapt their programming to address these emergency conditions. As a team of academics, violence against women service providers, advocates, and women with lived experience of violence, we conducted a study in Toronto that produced important findings around how services can be improved to better respond to the changing and diverse needs of women facing violence. We aim to now share our findings with key stakeholders throughout the city and plan next steps for research and policy that strengthen Toronto's response to violence against women during and beyond the COVID-19 pandemic. In particular, this project has three objectives. First, we will strengthen and expand our existing intersectoral partnership in Toronto, including with funders of violence against women organizations, city housing and shelter representatives, private landlords, public health professionals, newcomer support services, and social assistance programs. Second, we will create snapshots of our Toronto study findings (such as infographics, policy briefs, and presentations) to facilitate engagement with these intersectoral actors and set a research and policy agenda for violence against women in Toronto. Finally, we will plan the next steps for our partnership, including policy recommendations, implementation of best practices, and evaluating interventions to prevent and respond to violence against women. Our goal is to improve the supports available to women experiencing violence in Toronto. |
| Data Analysis Using Existing Databases and Cohorts | 2022 |
Project title: Informing Policy to Regulate Parabens Use in Canada: Investigating the Risks of Parabens on Obesity using the QUALITY Cohort of Children and Adolescents Abstract/SummaryPrior to the 2000s, parabens, a class of antimicrobials widely used as preservatives in a variety of products, were listed as "generally recognized as safe" compounds; however, a recent draft assessment by Health Canada and ECCC determined that parabens may pose health risks. There is growing concern that parabens may be implicated in the development and maintenance of obesity and related cardiometabolic risk. If exposure to parabens were shown to adversely impact adiposity, the government could implement measures to limit exposure. Unfortunately, studies assessing the impact of paraben exposure on pediatric obesity are limited. We propose to estimate the association between paraben exposure and obesity using the QUebec Adiposity and Lifestyle InvesTigation in Youth (QUALITY) cohort, an ongoing longitudinal investigation of the natural history of obesity and Type 2 diabetes mellitus. The QUALITY Study is a rich infrastructure that provides rigorous and comprehensive assessments of individual and environmental factors. Our primary aims are to estimate associations between paraben exposure at ages 8-10 years and indicators of adiposity: i) cross sectionally, at ages 8-10 years; ii) prospectively, at ages 10-12 and 15-17 years; and iii) using trajectories of adiposity from childhood to adolescence. Secondarily, we will explore associations between: i) baseline paraben exposure and cardiometabolic outcomes; ii) baseline paraben exposure and pubertal development status; and iii) neighbourhood food environment and exposure to parabens. |
| Data Analysis Using Existing Databases and Cohorts | 2022 |
Project title: Exploring where Canadians work and live and their association with active transportation Abstract/SummaryIn Canada, 81.5% of full-time working adults are insufficiently active and, therefore, at greater risk for chronic disease and premature mortality. Active transportation (AT), involving walking or cycling are important modes of physical activity (PA) in adults, accounting for 33 to 68% of daily levels. The quality of built environments can support AT. Built environments refer to aspects of the physical environment that are either human-made or human-modified and include the places and spaces where we work, live, play and travel. Research examining the role of built environments on AT has largely focused on neighbourhood design and has highlighted the importance of walkability, accessibility of facilities and destinations, and AT infrastructure (e.g., bike and walk paths). In contrast, the role of the built environment around workplaces is not as well understood. Built environments around the workplace offer the potential for increasing PA by supporting AT to/from work. This study, therefore, provides an opportunity to describe and characterize the built and social environments where Canadians work and live, and understand how these environments are associated with AT use, with a focus on differences by occupation and individual-level socioeconomic factors, age and between men and women. We will analyse existing population-based datasets: the 2016 Canadian Census Health and Environment Cohort (CanCHEC) and linked to the Canadian Urban Environmental Health Research Consortium (CANUE) to describe and characterize the built and social environments around the homes and workplaces of Canadian workers and their importance for AT to/from work. Findings can inform potential targets of interventions in the places where Canadians spend most of each day - at work and in their home communities. |
| Data Analysis Using Existing Databases and Cohorts | 2022 |
Dr. Aaron Goodarzi, Scientific Director of The Evict Radon National Study Project title: Towards Data Symmetry for a Balanced Understanding of Canadian residential housing radon gas exposure Abstract/Summary1 in 5 lung cancers arise in Canadians who have never smoked, with ~110,000 cases since 2001. The most common lung cancer trigger in never-smokers is inhalation of radioactive radon gas. The amount of life spent 'at home' correlates with radon exposure, modifying lung cancer risk. Regrettably, Canadian construction practices of the past century have produced urban residential environments with buildings that capture, contain, and concentrate radon to unnatural and unsafe levels. Globally, Canadians are among the most radon-exposed people, this is worsening still. Our team has studied the relationship between radon and region, property metrics, as well as human behaviour. In this project we will place into context our detailed understanding of radon exposure as a function of building features and people, with the most recently understood diversity of properties and demographics of the Canadian population. The GOAL of this project is to place the most up to date residential radon gas exposure data available within the context of the most recently understood Canadian housing, health and population information. This 'data symmetry' is needed to inform physical, social and policy interventions required to reduce lung cancer risk attributable to radon inhalation within the urban built environment. The critical IMPACTS of this work will be to: (1) generate reliable measures of residential radon exposure risk in Canada that are sensitive to regional differences, and (2) to develop a clear understanding of the scale and scope of the health consequences of radon exposure, to inform the need for action. By doing this we will advance health outcomes by developing actionable, well-informed knowledge of radon exposure and lung cancer risk, and use this to address one of the most prevalent built environment-based health threats to our future cities. |
| Data Analysis Using Existing Databases and Cohorts | 2022 |
Project title: Developing population health indicators for natural neighbourhoods using existing housing datasets Abstract/SummaryNeighbourhoods and communities have a significant role in the health and health equity of residents. Housing is an important aspect of community health, but is much more complicated than simple availability. There are several datasets containing housing data that could be combined to create indicators of community health, particularly for marginalized groups. This project will use existing data from Canada Mortgage and Housing Corporation, Statistics Canada, and other sources. The Ottawa Neighbourhood Study will incorporate these data into their neighbourhood measurements and produce a dashboard of neighbourhood health indicators. These indicators will then be used to measure progress on the City Of Ottawa's Community Safety and Well-Being Plan, which has housing as one of its priorities. |
| Data Analysis Using Existing Databases and Cohorts | 2022 |
Project title: Comparing Canadian area-based socioeconomic indices to advance healthy cities research Abstract/SummaryCanadian researchers and policymakers who want to understand neighbourhood health inequalities must make choices around which data to use. Many use indexes to measure neighbourhood social and economic characteristics. These indexes are widely used in research, health initiatives, and resource allocation. In Canada, there are three prevalent indexes that have been developed for use across the country (the Pampalon Material and Social Deprivation Index, the Canadian Marginalization Index, and the Canadian Index of Multiple Deprivation). However, to date, there is no evidence about how similar or different they are. Given this lack of understanding, we do not know if studies of health outcomes and behaviours result in different findings depending on what index is used and what the impact of this is on health policy. Therefore, the primary purpose of this study is to empirically compare three commonly used and widely available Canadian area-based socioeconomic indexes. We will examine how they are different or similar, where they are different or similar, and if relationships between neighbourhood socioeconomic conditions and health vary depending on which index is used. Additionally, we will develop a set of recommendations for researchers and policymakers to use. Thus, the proposed research will make the use of socioeconomic indexes more effective, efficient, and transparent. This research is crucial for enabling robust, comparable, and equitable healthy cities research and policymaking. |
| Data Analysis Using Existing Databases and Cohorts | 2022 |
Project title: Developing Novel Urban Residential Mobility Indicators to Advance Environmental Measurements for Health: Applications for Premature Mortality in Canadian Cities Abstract/SummaryResidential mobility (i.e., moving) is a common experience among people living in cities and an important but often overlooked social determinant of health. Postal code information from Canadian tax return data can be used to measure residential mobility. By linking tax information to data on health outcomes, measures of residential mobility can be used to understand its effects on health and support decision-makers by providing quantitative evidence to inform city planning and policy. Our research will create the first-ever standard indicators of residential mobility, based on historical postal code data, for health research in Canadian cities. We will develop the indicators using national data, validate them by comparing them to gold-standard data from Ontario's health care system, and use them to enhance our team's existing population health planning tool for premature mortality. We plan to focus on two dimensions of residential mobility: frequency of moves (residential instability) and direction of moves (whether a move is to a better- or worse-off neighbourhood). The frequency of moves describes whether a person moves often and can signify unstable housing and potential hardship. The direction of move describes whether a family's neighbourhood environment is improved after moving, compared to their past neighbourhood. Both frequency and direction of moves can have important consequences for health. By creating new, standardized measures for these two dimensions of residential mobility, we will provide others working in urban health research and planning with a valuable tool to use in their future work. Incorporating the measures into population heath prediction models will provide our city partners with meaningful evidence and tools to inform policy and planning decision-making. |
| Data Analysis Using Existing Databases and Cohorts | 2022 |
Project title: Naturally Occurring Retirement Communities: Understanding the health and social needs of older adults aging in urban environments to support aging in place Abstract/SummaryOlder adults face challenges accessing health and social services that can lead to suboptimal care and social isolation. An innovative way to respond to these challenges in urban environments is through naturally occurring retirement communities (NORCs). In Ontario, 1 in 10 older adults live in high-rise buildings with a high concentration of older people. This density allows for onsite social supports and health services to be delivered efficiently and affordably. Enhancing NORC buildings this way has proven benefits to residents and health systems. Despite this, few formalized support programs exist in NORC buildings in Canada. This may be because little is known of who is aging in NORC buildings. For the first time in Canada, we can answer this question with the availability of a novel NORC registry. We will link this registry with existing datasets that capture health encounters with our universal health care system, and environmental datasets that describe neighbourhoods. Our goal is to use these existing datasets to describe the health of older adults in NORC buildings and assess their needs for support. We will describe the health status and healthcare use of older adults in NORC buildings and compare them to other older adults living in the community but not in NORC buildings. We will map neighbourhoods where NORC buildings are located to look at spatial patterns in health, healthcare use and the physical and social environment, to identify sites that could benefit most from intervention. Lastly, we will look at what factors are associated with application to the long-term care waitlist in NORC building residents to learn what supports they may need to age in place. Our team includes knowledge users who will use our findings to plan and deliver NORC-based interventions that improve health and health equity for this population. More broadly, our research will help cities understand how they can support aging in place and improve urban population health. |
| Data Analysis Using Existing Databases and Cohorts | 2022 |
Project title: Environmental exposures in Canadian urban areas and incident breast cancer in young women Abstract/SummaryBreast cancer is the most commonly diagnosed cancer in Canadian women, and a leading cause of death in young women. There are several established risk factors for breast cancer including reproductive history, physical activity, alcohol consumption, and diet. Environmental exposures are recognized to play a role on the development of breast cancer, but their impacts are less understood. Emerging evidence suggests that several environmental exposures contribute to sociodemographic disparities in breast cancer incidence. For example, urban areas that are more walkable and provide access to green spaces may contribute to lower breast cancer rates by promoting physical activity. On the other hand, some studies have shown that exposure to traffic-related air pollution, and outdoor light at night increase the risk of breast cancer. Our proposed research will study how environmental features of where we live, namely, walkable neighbourhoods, access to green spaces, air pollution, and light at night impact the risk of developing breast cancer in young women. We will address our research objectives using previously collected data from the Ontario Environmental Health Study (OEHS), and environmental exposure data from CANUE that are linkable participants' residential addresses. The OEHS collected questionnaire data from 216 women diagnosed with breast cancer and 414 healthy controls. These data include information on breast cancer risk factors including physical activity, alcohol consumption, and reproductive history. We will use statistical models to describe the associations between these environmental exposures and the risk of breast cancer. We will also evaluate whether these associations vary based on the timing of the exposure, and by sociodemographic status. Findings from this study will fill knowledge gaps on how environmental exposures in urban areas impact the health of women, and inform urban planning policies and interventions designe to reduce harm. |
| Data Analysis Using Existing Databases and Cohorts | 2022 |
Project title: Preparing cities for climate change Abstract/SummaryClimate change is unevenly impacting different populations and locations. For example, Edmonton, Alberta, experiences extreme weather events and poor air quality (from wildfire events and local sources) related to climate change. These climate change-induced health risks are higher for the growing population of older adults and immigrants, which are worsen by factors like social isolation and societal inequities. As such, actions involving collaboration from different fields of science, government, communities, and organizations are necessary. A critical step toward climate change action is generating information for planning and policies that consider locally affected populations and regional differences. We aim to further develop and expand on a previously created climate change and health vulnerability index for Edmonton. These are necessary steps to help inform equitable interventions based on implementation science research. The project builds on this pilot study work that identified critical factors such as location, population demographics, community characteristics, and social factors contributing to climate change and health vulnerability. Investigating factors that can affect urban mitigation and adaptation measures is key for lowering risks and building resilience across affected populations. Specifically, this study considers the use of indices for informing equitable climate change and health policies and programs. In addition, it increases the involvement and options available to higher-risk groups like older adults and immigrant communities. It also promotes equity-based implementation science and can be tool for assessing interventions. The team has expertise in several different areas and has built strong relationships with the City of Edmonton and older adult and immigrant communities to facilitate this work. We aim to promote healthy cities while including equity in the design of climate change and health mitigation and adaptation strategies. |
| Data Analysis Using Existing Databases and Cohorts | 2022 |
Project title: Finding the right "paths" to heart health for First Nations and Métis people living in Winnipeg Manitoba Abstract/SummaryFor the past 4 years, our team has been studying the impact of cycling and walking trails on the health of people living in urban areas. We discovered that when cities build trails, people use them. In Winnipeg, over 1.6M people were counted on four large cycling trails since their construction. The trails also are linked to better health outcomes, including lower rates of heart disease. Unfortunately, these trails were not constructed in an equitable way however. First Nations and Metis people living in Winnipeg we less likely to have access to the trails. We will leverage the databases used to make these discoveries to address several important questions related to the urban built environment that support physical activity (PA) and heart health for First Nations and Metis people living in Winnipeg. To respond to the Truth and Reconciliation Commission (TRC) Call to Action #19 our team of Indigenous organizations, Indigenous scholars, Elders, policy makers and scientists will made inequities in heart disease worse for First Nations and Metis people. Using a community-based participatory approach, we will address UNDRIP articles #23 and 24 by identifying parts of the urban environment in that support PA to see if they protect urban First Nations and Métis people for heart disease. Lastly, we will respond to TRC calls to Action #7 and #23 we will pilot a novel Healthy Cities summer research institute that will train First Nations and Métis undergraduate students in Indigenous and western research methods and use existing databases. |
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