SPARK Conversations

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Description: 

COVID served as a catalyst for the spread and uptake of mis- and disinformation, threatening the trust Canadian citizens have in vaccines and, frankly, putting lives at risk. Further, the extra disease burden on the healthcare system exacerbated pre-existing problems, including in the area of health human resources (e.g., staff burnout and shortages). Some may ask, So what? Why are these problems so concerning? How do we go about rebuilding trust in healthcare and science? Dr. Katharine Smart has been tackling these problems as President of the Canadian Medical Association (CMA). As she transitions to the role of Past-President, Dr. Smart joins us to reflect on these issues, speaking to the importance of the longitudinal patient-provider relationship and innovative ways that clinicians can meet people where they’re at.

This is Part 1 in a two-part series. To hear Dr. Smart discuss staff burnout and bringing our healthcare system back from the brink of collapse, listen to Part 2 of this series, “Healing the Healthcare System: Staff burnout, honest leadership and collaboration”.

Note: This interview was recorded in July, 2022, prior to Dr. Smart’s transition to CMA Past-President.

Speaker Bio: 

Dr. Katharine Smart is a pediatrician in Whitehorse, Yukon and Past President of the Canadian Medical Association. Her work is centered on developing collaborative partnerships with community and government services to serve marginalized children using a model of social pediatrics. She works primarily with children who have experienced trauma and adverse childhood events, and she witnesses the broad and lasting impact these events have on children and their development daily. She is passionate about improving services for marginalized children in an effort to change their life trajectory.

In addition to her community-based work, Dr. Smart enjoys acute care and provides on-call services to the hospital. Before moving to the Yukon, she was a pediatric emergency medicine physician at the Alberta Children’s Hospital in Calgary. Dr. Smart is the past president of the Yukon Medical Association.

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Infancy is a developmental period when children are most vulnerable and when they present with the greatest potential. Infant and early mental health (IEMH) involves the social, emotional, cognitive wellbeing of infants and young children. IEMH care aims to ensure every child has the best possible start in life.

Research tells us that:

• Infant and early child development sets the stage for later development and functioning.
• Babies and young children who experience adversity are at increased risk of poorer health and social outcomes in childhood and later in life
• Such adverse childhood experiences influence development of the baby’s brain, the number and type of connections between brain cells, how they respond to stress, and even their DNA
• Young children are the most vulnerable with the least access to mental health services and supports
• The development of infants and young children is strongly affected by the quality of their relationships with adults (parents or other caregivers)
• Love and nurturing can protect against some of the negative experiences of young children

We know what to do. We have the evidence and practice and policy requirements are clear. Changes are required to training and education of healthcare practitioners. Early intervention services must be accessible in a timely manner and responsive to the needs of the child and family. Policy change is required to support at-risk families and involves partnership between families, healthcare, community services, and child welfare. Listen while Dr. Chaya Kulkarni discusses leadership, evidence-informed practice and policy, resources, and educational opportunities to increase Canadian capacity to ensure all babies get off to a great start.

This session will be of interest to:

• Healthcare professionals
• Families & Caregivers
• Social service providers
• Legal services

Speaker Bio

Dr. Chaya Kulkarni is the Director of Infant and Early Mental Health Promotion (IEMHP). This national organization, at The Hospital for Sick Children, also known as SickKids, aims to improve outcomes across the lifespan through translating and promoting the science of early mental health into practice with families during pregnancy, infancy, and early childhood. Chaya is also an advisor to Dolly Parton’s Imagination Library, a member of the Strategic Advisory Committee at the Ontario Centre of Excellence on Child & Youth Mental Health, and a member of the Board at Family Day Care Services. Prior to joining IEMHP, Chaya was VP, Parent and Professional Education at Invest in Kids, and has also served as Senior Policy Analyst and Researcher for the Office of the Official Opposition, Queen’s Park. 

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The ongoing COVID-19 pandemic has taught us many lessons, including best practices for immunizing populations efficiently. To retain what we have learned, and continue to improve vaccine confidence and uptake, the Canadian population will rely on experts like Dr. Manish Sadarangani to lead robust infectious disease and prevention research. On this episode of SPARK: Conversations, we sat down with Dr. Sadarangani to discuss natural and vaccine immunity to COVID-19, approaches to combatting new variants, and how we can improve vaccine and science communication. We explore the possibility of the COVID-19 vaccine becoming a routine vaccination, and how to best promote the importance of keeping up with those routine childhood immunizations.

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Guest:
Susa Benseler, MD, PhD; Director, Alberta Children’s Hospital Research Institute at the Cumming School of Medicine; Strategy Lead, Child Health and Wellness Research Strategy; Husky Energy Chair in Child and Maternal Health; Alberta Children’s Hospital Foundation Chair in Paediatric Research; University of Calgary

Children’s Healthcare Canada’s strategic priorities include informing the development of innovative and integrated health systems and advocating to improve children’s health and health systems. The SPARK: Conversations podcast series is a new solutions-focused podcast that connects the child health community with system leaders who tackle wicked problems and discuss ideas to inform the development of innovative and integrated systems serving children and youth.

Dr. Benseler has completely re-organized and improved the research environment for basic and clinical research. Dr. Benseler has strengthened the relationship between the Department of Paediatrics and the research institute with transparency, inclusiveness, and teamwork. This has led to remarkable new research partnerships between basic scientists and clinical researchers. Dr. Benseler has been able to develop a new level of community engagement which is extra-ordinary. Dr. Benseler has successfully stewarded the Child Health Research Platform as one of two winning submissions for the Cross-Cutting multi-million dollar initiative at the University of Calgary. ACHRI is the only research institute with a clear focus on research within the University, across campus, and in our community. These developments have all been the brainchild of Dr. Susanne Benseler and her team at ACHRI.

Summary:
Children are the foundation of Canada’s future, and as such, research in child health is research on the future of our nation. Conducting health research with children is an ethical imperative to understanding treatment and prevention effectiveness, relative costs of child healthcare, and tactics to advance equitable healthcare. We had the opportunity to sit down with groundbreaking child health researcher, Dr. Susa Benseler, to understand the current landscape and trajectory of child health research. Dr. Benseler explains the need for an ongoing, national conversation, outlines why a cross-sectoral approach is impactful, and gives advice to others hoping to ‘scale up’ their child health research plans. She sheds light on her interdisciplinary vision to advance children’s healthcare in a positive direction. 

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Children and their family members have unmatched, dyadic impacts on each other’s health. This is especially prominent in children and families that, due to unfortunate circumstances, are frequently connected with hospitals, researchers, and health systems. As such, it is imperative that we engage families in healthcare processes, and recognize their stories, experiences, and input as the valuable forms of knowledge that they are. We recently had the opportunity to sit down and discuss family partnership with Rachel Martens. Rachel provides a unique perspective on this topic as she has seen child healthcare from the lenses of both a parent and a professional. On this episode of SPARK: Conversations, Rachel helps us dig into best practices in family engagement and the importance of the human aspect in child healthcare. She also offers advice to practitioners on the balancing act between involving family partners, while avoiding causation of potential burnout and discomfort.

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Misinformation and even disinformation are not new concepts in science. This has been evident during the COVID-19 pandemic while the world has monitored, shared, and re-shared information on the spread of the virus, public health restrictions, and immunization. Recently, the COVID-19 discussion has become even more emotionally charged with a vaccine available for some children in Canada. Unfortunately, we can see that the skills required for critical consumption of evidence appear lacking in many areas. We live in a world driven by metrics, and unfortunately, headlines are often misleading, and people share information without reading the full text or confirming the accuracy of the information. Uncertainty, discomfort, and mistrust are lingering as Canadians are having difficult, divided conversations with their loved ones around the dinner table, on the phone, and on Zoom. To combat this, Dr. Krishana Sankar and the team at ScienceUpFirst focus on the clear and accurate distribution of scientific evidence. On this episode of SPARK: Conversations, we sit down with Dr. Sankar to discuss the importance of simple, clear, and up-to-date evidence distribution, and how to do so effectively.

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While COVID-19 has resulted in a global health crisis with considerable negative health impacts affecting children and youth, climate change has been an evolving and escalating global threat to child health for even longer. The global mean temperature warming is escalating and will have lasting momentum for centuries to millennia. However, immediate action can mitigate future warming in the next two decades and will immediately improve air quality. Unfortunately, the impact of climate change on child health and the healthcare system is multifaceted and today’s children are expected to bare disproportionate burden in their lifetime. The health impacts span the full pediatric age-range and can affect almost any organ system through acute illness and injury or chronic, complex stressors, including both mental and physical aspects.  In sum, climate change can have negative effects on long-term neurodevelopment, alters the social and environmental determinants of health, and can potentially amplify burdens for children with pre-existing medical conditions. Join us for an evidence-informed discussion with pediatric intensive care doctor, Dr. Anna Gunz, in which we explore the impact of climate change on child health, healthcare systems, and beyond.

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This podcast focuses on patient partnership for child health research, practice,  and systems. Listen in as Dr. Katie Birnie shares her perspective on patient partnership and Partnering for Pain, an award-winning research program which she leads and which integrates patient and family partnership and multi-stakeholder engagement to improve the prevention, assessment, and management of pain experienced by children and their families. At the time of the rollout of a COVID vaccine for children, this initiative has many resources available to ensure #ItDoesntHaveToHurt (https://partneringforpain.com/2020/12/12/resources-and-strategies-for-managing-fear-of-needles-and-vaccination-pain/). We discuss terminology  (engagement, partnership, family- and child-centred care), the value of patient  partnership to child health research, clinical care, and system planning. Dr. Birnie also shares practical advice to help embed patient partnership into the routines of children's healthcare.

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Health inequities are “unfair, avoidable, and remediable differences in health status between countries and between different groups of people within the same country” (WHO, 2013, p 3). 

COVID has revealed inequities that many in healthcare, some more than others, already knew existed. We’ve noted differences in who is exposed to and infected by COVID, who ends up in hospital or ICU, and who is able to or choses to follow public health guidance (masks, social distancing, vaccines). For example, Ontario data show a higher risk for COVID exposure and infection among racialized and low-income communities. As well, vaccine uptake is lower, and hesitancy higher among these same groups for whom there has been a disproportionate burden of COVID-19 outcomes, and in whom vaccination will prevent more infections and severe outcomes. Vaccine passports have been implemented to incentivize vaccination and reduce COVID risk in our communities. But does this public health intervention have the potential to further disparities? How do we reap the benefits while reducing the inequities?

Listen into this SPARK: Conversations podcast as we discuss COVID, Kids, and health equity with Dr. Kwadwo Kyeremanteng.

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