2008-2009 IHSPR Rising Star Award Recipients
IHSPR is pleased to announce the 2008-2009 IHSPR Rising Star Award recipients. Five outstanding students studying in the field of health services and policy research were recognized as Rising Stars and will receive the Rising Star Award ($1,000), a certificate of excellence, and the opportunity to present their research at the May 2009 Canadian Association for Health Services and Policy Research (CAHSPR) conference.The Rising Stars were selected by a review committee based on their demonstration of excellence in research and/or knowledge translation (KT), the innovation of their work, and the potential impact of their work within the field of health services and policy research. Congratulations to the IHSPR Rising Stars!
Mylaine Breton
PhD Candidate
University of Montreal
Research article: Integrating public health into local healthcare governance in Québec: Challenges arising from combining population and organization perspectives
Mylaine Breton is a doctoral candidate in Public Health at Université de Montréal in health services management, under the supervision of Drs. Jean-Louis Denis and Lise Lamothe. She also has training in occupational therapy and holds a MBA in business management from Laval University.
Mylaine's doctoral research builds on the restructuring of the Quebec health system and focuses on the challenges of implementing a population-based responsibility for the managers of the province's health and social services centers. Her research has been supported through a doctoral scholarship from Groupe de recherché sur l'équité d'accès et d'organisation des services de première ligne (GRÉAS1 - CIHR Interdisciplinary Capacity Enhancement team), the CHSRF/CIHR CADRE Chair in Governance and Transformation of Health Care Organizations (GETOS) and Fondation Marie-Anne-Lavallée. While working on her doctorate, she was based with a research team at Montréal's Public Health Department. This internship helped Mylaine establish close links with researchers and decision makers, while also enabling her to contribute to publications such as the article for which she received the Rising Star Award. As a 2008-2009 trainee and award recipient of CIHR's Strategic Training Program "Transdisciplinary Understanding and Training on Research Primary Health Care," Mylaine acquired specialised interdisciplinary knowledge about primary care services by working in collaboration with researchers from across the country.
Most recently, Mylaine received a postdoctoral fellowship from the Canadian Health Services Research Foundation (2009-2011) and will soon commence postdoctoral studies at Université de Sherbrooke under the supervision of Jeannie Haggerty and Danièle Roberge. Her postdoctoral research will focus on the development of a measurement tool designed to assess the degree of integration among primary care organisations within a local services network. She anticipates that the tool will be useful for both administrative and research purposes. Mylaine will also be a trainee in CIHR's Transdisciplinary Training Program in Public and Population Health Research.
Upon completion of her doctoral studies, and building on the training she will receive through her postdoctoral fellowship, Mylaine plans to develop a research program that focuses on managerial strategies implemented by different levels of governance to improve delivery and integration of primary care services.
To learn more about Mylaine's research please email her at mylaine.breton@umontreal.ca.
Emmanuel Guindon
PhD Student
McMaster University
Research article: A second look at pharmaceutical spending as determinants of health outcomes in Canada
Emmanuel is a PhD student in Health Research Methodology and a member of the Centre for Health Economics and Policy Analysis, McMaster University. Emmanuel obtained his Master's degree in 1998 and spent seven years at the World Health Organization. Emmanuel's primary research interests pertain to health care financing and tobacco control. His thesis explores both issues in Vietnam, a low-income country with inordinately high male smoking prevalence that has also recently implemented policies to increase the uptake of health insurance. Emmanuel has also investigated current Canadian issues such as private health insurance, medical savings accounts and pharmaceutical policies, and is passionate about quantitative research methods.
The paper for which Emmanuel received the IHSPR Rising Star Award, "A second look at pharmaceutical spending as determinants of health outcomes in Canada" was published online in October 2008 in the journal Health Economics. Drug spending in Canada constitutes a growing share of health care expenditures, rising from 8.4% to an estimated 17.4% between 1978 and 2008. The health gain achieved through such spending is debated: while some new drugs unquestionably improve health, high-priced me-too drugs that offer little advantage over existing, lower-cost drugs imply that much of the higher expenditure may buy little health improvement. In this context, a paper published in a leading journal that provided evidence of a positive relationship in Canada between drug spending and health outcomes received much attention and was widely disseminated. Emmanuel with co-author Paul Contoyannis, however, demonstrate that the finding evaporates under closer scrutiny: by first replicating the original analysis and then correcting a number of specification problems, their updated analysis fails to find any systematic relationship between drug spending and health outcomes. They also identify the (difficult-to-justify) feature of the original analysis most responsible for the spurious finding and explain why such a finding was implausible given the institutional design of the Canadian health care system, technological development in the last two decades and the data measures used in the original analysis. In addition to providing new evidence on the relationship between health care spending and population health, the study illustrates the need for replication in scientific research.
To learn more about Emmanuel's study, please email him at guindoge@mcmaster.ca or visit the Centre for Health Economics and Policy Analysis.
Naomi Jones
PhD Student
Queen's University
Knowledge Translation initiative: Optimizing Nutrition Therapy in the Critical Care Setting Through Creating a Culture of Excellence
Naomi's interest in knowledge translation (KT) stems from her training and work experience as a registered dietitian. Rather than remain exasperated by the evidence-practice gaps she observed, she was compelled to try and rectify some of this discrepancy through her own research activities. Consequently in 2004, she commenced her Master's degree in Community Health and Epidemiology at Queen's University. Her thesis was a mixed methods study examining the barriers and enablers of adherence to the Canadian Critical Care Nutrition Clinical Practice Guidelines (CPGs). Following her masters she worked as a Project Leader at the Clinical Evaluation Research Unit, Queen's University where she co-ordinated an international KT initiative involving over 160 Intensive Care Units and almost 3,000 critically ill patients from across more than 20 countries.
This KT initiative - consisting of the dissemination of evidence-based CPGs, annual audits of nutrition practices coupled with individualized benchmarked performance reports, web-based quality improvement tools, and acknowledging top performers and their practices - has transformed nutrition practice and increased the likelihood that critically ill patients are receiving the right nutritional strategy, at the right time, with the right amount.
This KT initiative is ongoing, and Naomi will once again lead the international audit of nutrition practices in September 2009. In addition, she is preparing her doctoral thesis proposal entitled 'PERFormance Enhancement of the Canadian nutrition guidelines through a Tailored Implementation Strategy: The PERFECTIS Study', a before-after study evaluating tailored change strategies to overcome identified barriers to adherence of the Critical Care Nutrition guidelines.
After completing her PhD in September 2011, Naomi aspires to continue this work by developing an independent research program as a Clinician Scientist.
To learn more about Naomi's research and KT initiative, please visit the Critical Care Nutrition website or email her at jonesn@kgh.kari.net.Andrea Tricco
PhD Candidate
University of Ottawa
Research article: Following 411 Cochrane protocols to completion: a retrospective cohort study
Andrea C. Tricco completed her MSc in Epidemiology at the University of Toronto. During her MSc she gained interest in knowledge synthesis and participated in several systematic reviews on topics related to Canada's healthcare system. She is currently a PhD candidate in Population Health at the University of Ottawa, studying under the supervision of Dr. David Moher.
Andrea's thesis deals with publication issues surrounding systematic reviews. She received a CIHR Frederick Banting and Charles Best Canada Graduate Scholarship, as well as a grant from the Canadian Agency for Drugs and Technologies in Health to conduct her PhD thesis. The results of her thesis have been disseminated through three conference presentations and three first author publications.
Andrea received the Rising Star Award for one of her thesis publications entitled "Following 411 Cochrane protocols to completion: a retrospective cohort study". In this study, Andrea and her colleagues examined the frequency of published and unpublished Cochrane reviews and factors predicting the publication of Cochrane reviews. They found that 1/5 Cochrane reviews were unpublished and that some reviews took over 8 years to be published. A shorter time to publication was associated with the review subsequently being updated and a longer time to publication was associated with the review having two published protocols, indicating changes to the review plan. Andrea's study identified a large proportion of unpublished Cochrane reviews. She and her colleagues concluded that strategies to decrease time to publication should be considered, such as increasing support for authors when protocol amendments occur.
Andrea plans to defend her thesis in the summer of 2009. Her long-term aspirations include post-doctoral training and an academic career. To learn more about Andrea's research please contact her at atric060@uottawa.ca.
Mike Wilson
PhD Candidate
McMaster University
Knowledge Translation initiative: The PPD/CCNC database: Helping healthcare managers and policymakers find and use systematic reviews efficiently
After receiving a BHSc (Hons.) from McMaster University, Mike completed one year of political science training at the University of Toronto and then returned to McMaster to pursue an MSc in Health Research Methodology. After transferring from the MSc to the PhD program, Mike is now in his third year of his PhD and is concurrently pursuing a diploma in Health Services and Policy Research.
From working with John Lavis in the Program in Policy Decision-Making (PPD) at McMaster University since 2003, Mike developed a keen interest in knowledge transfer and exchange (KTE) for healthcare managers and policymakers. Through this work, Mike is now leading the development of the PPD/CCNC database (named after a partnership between PPD and the Canadian Cochrane Network and Centre), which is the knowledge translation work for which he has been recognized as a Rising Star.
The PPD/CCNC database, which contains more than 800 policy-relevant systematic reviews, is designed to help managers and policymakers find and use systematic reviews efficiently. Mike is also leading work to expand the database by including quality appraisals, user-friendly summaries and relevance assessments. He has also developed a protocol for its evaluation in a randomized controlled trial (RCT). The database has been an important "hands-on" training resource for managers and policymakers participating in a series of five workshops that Mike has co-facilitated with John Lavis at the Ontario Ministry of Health and Long-Term Care and in similar workshops that Dr. Lavis delivers for the Executive Training for Research Application (EXTRA) program and for the World Health Organization.
Mike is now expanding this work through his thesis to include community-based organizations (CBOs) by developing a searchable online database of systematic reviews with user-friendly summaries for CBOs in three sectors (HIV/AIDS, cancer, and mental health and addictions) and evaluating it in an RCT. Upon completing his PhD, Mike hopes to pursue an academic career.
To learn more about Mike's work, please email him at wilsom2@mcmaster.ca