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Centre for Research in Integrated Care

Current projects


NaviCare/SoinsNavi

NaviCare/SoinsNavi is a research-based navigation centre for children/youth 25 years of age or younger with health care needs and their families in New Brunswick.

This personalized bilingual service is FREE for families and care providers.

The primary aim of the NaviCare/SoinsNavi centre is to help facilitate more convenient and integrated care to support the physical, mental, emotional and social needs of children and their families.

Funded through the New Brunswick Children’s Foundation, children are assigned a patient navigator. The navigator – a registered nurse – helps families coordinate access to appropriate services and resources for their children.

In addition, they act as a resource for the child’s care team, ensuring the care remains integrated.

To help ensure NaviCare/SoinsNavi meets the needs of children and families, they have a Family Advisory Council made up of volunteers. These volunteers are parents of children with health care needs or youth/young adults who have experienced growing up with health care needs, or experienced health care needs as a youth themselves.

The aim of the Family Advisory Council is to advise the research team, staff and patient navigators.

Using Readers Theatre as an Innovative Knowledge Translation Approach for Health Research

Arts-based knowledge translation (KT) in health research allows researchers to share findings in creative ways with the aims to increase engagement, create spaces for dialogue, and improve the accessibility of research findings. Theatre, as a type of arts-based KT, has been used in health research as a powerful tool when sharing qualitative research findings with a variety of audiences, however, Readers Theatre has the capacity to act as a more accessible and novel approach.

Our project employed Readers Theatre as a framework for the creation of a variety of scenes using qualitative data that explored the experiences and needs of families who have children and youth with complex care needs. 

Our team interviewed 120 stakeholders, including families, as well as care providers across health, education, and social sectors. 

Drawing on the experiences of families who care for children and youth with complex care needs, this project involves presenting our scenes in a variety of settings, such as health professional classes and workshops, as a way to allow diverse stakeholder groups to embody the lives of these families and to foster patient-centred care.

In summary, Readers Theatre is an innovative KT tool that allows researchers to creatively share qualitative findings from health research focused on children and youth with complex care needs with a diverse range of groups.

To learn more about this project, please contact aluke1@unb.ca

CHILD-BRIGHT

CRIC members partnered with over 100 stakeholders across Canada to lead a national innovative network called CHILD-BRIGHT. This network aims to improve life outcomes for children with brain-based developmental disabilities and their families. CHILD-BRIGHT is one of five nationwide projects that are funded by CIHR under their SPOR Networks in Chronic Disease program. The network received a $25M grant over five years, with $12.5M from CIHR that was equally matched by other funding partners, including $250K from NBHRF. The NaviCare/SoinsNavi team is the Atlantic Canadian hub for a clinical trial to determine whether an innovative e-health intervention (named iReady) with content to promote education, empowerment, navigation, and integrated care, will result in improved transition readiness and efficient healthcare processes in youth between 15 and 17 years of age compared to usual care, when preparing to transition from pediatric to adult healthcare.

Comparative Program and Policy Analysis

CRIC researchers partnered with stakeholders across Canada to conduct a Comparative Policy Analysis that was funded through CIHR and matching partners.

This team is engaged in comparing current programs and the structures and policies in Canadian provinces and territories that govern primary health care, community-based social services, public health and community supports required for children and seniors. Namely children/youth with high functional needs and community-dwelling older adults experiencing functional decline.

Case Management in Primary Care

A central focus of CRIC is to improve the integration of care for individuals with complex care needs.

Individuals with chronic conditions and complex care needs require a range of services from various systems (e.g. health, social, education) and community networks. This often leads to difficulties with the integration of care. One solution to address the frequent use of healthcare services and improve the integration of care is case management (CM). CM is a collaborative approach used to assess, plan, facilitate, and coordinate care to meet individual/patient and family healthcare needs across all sectors to improve individual and health system outcomes. Over the past five years, members from a CRIC research team evaluated a CM intervention in Quebec primary care settings tailored for individuals/patients with chronic conditions who frequently use healthcare services. The pan-Canadian research team is employing this CM intervention to answer the following research questions: 1) What are the facilitators and barriers of CM implementation in primary care clinics across Canada? 2) What are the relationships between the actors, contextual factors, mechanisms, and outcomes of the CM intervention? 3) What are the next steps towards scalability (expansion within similar contexts and extension to different contexts) across Canada? 

The CM intervention will be implemented in 10 primary care clinics across 5 Canadian provinces (QC, NB, SK, NL, and NS). In NB, the team will implement the intervention at the St. Joseph's Community Health Centre in Saint John and the Charlotte County Collaborative Wellness Centre in St. Stephen. This project has the potential to improve the experience and health status for Canadians who are frequent health system users with complex healthcare needs, as well as improve the performance of healthcare systems, curbing ineffective use and costs. Dr. Shelley Doucet is a Co-Principal Investigator of this pan-Canadian four-year study funded by CIHR and other matching partners totaling $2,000,000. 

Knowledge Synthesis in Transitions in Care

Children and youth with health care needs experience many transitions from childhood to adulthood, between care settings or from hospital to home/school (or vice versa). Transitions are often challenging as they move across different stages, not only for children, but for their families and care providers as well.

In this one-year project, the team is engaged in conducting a review on literature in order to shed light on interventions that support transitions in care during two phases of the children’s lifespan:

  • Diagnosis to 19 years of age
  • Pediatric to adult care (for youth aged 14 to 25 years of age)

Findings from this project, which are in line with primary care priorities established by N.B., N.S., P.E.I., and N.L., will lead to recommendations for policy and practice, and will inform future research to support transitions in care for children with health care needs and their families.

COGNISANCE

Dementia is characterized by a decline in memory and day-to-day functioning, resulting in life changing physical, emotional, and psychological stress on the person with dementia and their family. In New Brunswick (NB), there are approximately 15,000 people living with dementia and seven people develop dementia each day. The projected impact of new dementia cases poses challenges for NB primary care providers (PCPs) around diagnosing and supporting the growing number of patients and their families affected by this condition. The proposed project aims to design, deliver, and evaluate an awareness campaign to improve how PCPs diagnose and support persons with dementia and their care partners. This research will be embedded in a larger, international funded project co-led by teams in Canada, Australia, Netherlands, United Kingdom, and Poland.  

The project will proceed through five phases over three years. Phase 1 will consist of surveys and focus groups with people at-risk or with dementia, their care partners, as well as PCPs and other health care providers (HCPs) to explore experiences of the current diagnostic process and post-diagnostic supports in NB, including barriers and facilitators across settings. Lessons learned from this phase will be carried forward to Phase 2, which will consist of the creation of bilingual dementia care toolkits that will enhance HCPs knowledge of diagnostic and post-diagnostic support, and promote changes in help-seeking behaviors in those at-risk or currently diagnosed with dementia. Phase 3 will involve the implementation of these toolkits across NB through an awareness campaign. Phase 4 will consist of evaluating the awareness campaign using the Reach Effectiveness Adoption Implementation Maintenance (RE-AIM) framework. Phase 5 will focus on sustaining and scaling the project, including helping other locations beyond those involved in this project to develop their own awareness campaigns.

The awareness campaign will improve the knowledge of PCPs and other HCPs around the diagnosis and delivery of dementia care, which will enhance access to care and improve communication and quality of care in NB. The campaign will improve the awareness of programs and services for NB seniors who are at-risk for dementia and their care partners, to better direct them to the appropriate supports and level of care, which is a central focus for this funding call. This study provides the opportunity to share lessons learned and improve dementia care at a provincial, national, and global level.

To learn more about this project, email us at cric@unb.ca

CIHR Catalyst Grant: Patient-Oriented Research 

Goals of this project include determining research priorities and building research capacity to in order to improve health service delivery for individuals with complex care needs and their caregivers. Individuals with complex care needs represent a small percentage of the population, but account for a high percentage of healthcare and social services utilization. As a result, these individuals often require care from a team of providers. Failure to connect to needed services leads to negative experiences for patients, caregivers, and the care team. There is a need for more research to improve health service delivery for individuals with complex care needs and their caregivers. There is also an important shift in the way that health research is being conducted; whereby, patients and their caregivers are involved as much, and as meaningfully as possible, throughout the research process. The purpose of this project is to build capacity for engaging patients and their caregivers throughout the research process and to identify research priorities for individuals with complex care needs and their caregivers. This study will lead to three main outcomes: a list of top research priorities that will inform the development of future grant applications, an online patient-oriented research training course, and a patient panel to partner on future grant applications.

Improving Transitions from Pediatric to Adult Healthcare for Youth/Young Adults with Complex Care Needs and their Families 

Care providers across settings and sectors are often ill-equipped for the successful transition of youth/young adults with complex care needs (CCN) from pediatric to adult healthcare across North America. These are the 15-18% of pediatric patients who are the highest volume users of health, social, and educational care systems, and who often experience discontinuity during transitions in care. This study explores the experiences and needs of these youth/young adults with CCN, their caregivers, and care providers prior to, during, and after transitions from pediatric to adult healthcare in an Atlantic Canadian province. This needs-assessment uses a mixed-methods, cross-sectional design to collect data through self-report surveys and semi-structured interviews. The survey will produce demographic data, as well as data from open-ended questions exploring the service needs of youth/young adults with CCN, through the lens of the patient, caregiver, and care provider. Interview data will provide in-depth information on the experiences and diverse needs of these individuals during the transition process. Data collection is scheduled to close in September 2020. Findings will provide local organizations with tools to better facilitate convenient and integrated care; provide information on what interventions, programs, and policies could support transitions in care; and provide future direction to improve services through a transition strategy for youth/young adults with CCN. This project will build on existing partnerships among various stakeholders, including youth/young adults with CCN and their families that will yield family-centered integrated healthcare approaches in New Brunswick, thus leading to measurable economic and social impact through service and policy improvements. 

NB PIHCI Network

The NB SPOR PIHCI Network is able to offer a number of key services to stakeholders who are interested in pursuing research in primary care.

These services include:

  • Project planning
  • Grant proposal preparation
  • Methodology / study design
  • Access to administrative data
  • Ethics application
  • Stakeholder / patient engagement
  • Cross-jurisdictional linkages
  • Networking
  • Evidence synthesis
  • Knowledge translation
  • Letter of support

Support Contacts