DEVOTION Legacy Projects
Early Life Environment as a Determinant of Lung Health and Disease
ENHANSE aims to facilitate integration of population health, preclinical and fundamental research capacity to build understanding of mechanisms for increased risk and severity of allergic asthma associated with in utero and early life environmental exposures.
We support early career development of new investigators, and establish new research capabilities and sustainable infrastructure with a plan for significant expansion using future external funding.
Achieving these goals will clarify risk scenarios for lung disorders caused or worsened by environmental exposure in early life, and guide further development and testing of preventative and therapeutic strategies.
DEVOTION's support helps to build local capacity to enable the team to secure external funding.
Winnipeg’s Surgical Database and Outcomes Management
One of every 25 babies has a congenital anomaly and these anomalies are the leading cause of infant death in Canada. We have created a database of all patients with life-threatening surgical congenital anomalies who were born in Manitoba since 1991. The database is called WiSDOM and contains the demographic, prenatal, surgical and peri-operative information of nearly 800 patients.
The overarching objective of this project is to determine the long-term outcomes of our surgical congenital anomalies patient cohort. During the next five years, we will link the information in WiSDOM with the MCHP databases, which contain unique, extensive and cost-effective data to elucidate the risk factors and long-term outcomes of our surgical patients. We will identify maternal factors associated with an increased incidence of a surgical congenital anomaly, compare the long-term outcomes of patients with surgical congenital anomalies to the long-term outcomes of age-matched controls and determine the patient and maternal factors that affect long-term outcomes.
EDI HCMO CHILD
This Legacy Project will facilitate novel interdisciplinary research by linking individual-level early-life and biological data from the longitudinal CHILD pregnancy cohort with Early Development Instrument (EDI) data at HCMO. The EDI is a validated tool used by Manitoba kindergarten teachers to measure children’s abilities to meet age appropriate developmental expectations. Across many longitudinal studies replicated in different settings worldwide, EDI performance has been shown to predict a child's lifelong health, learning, and behaviour. It is therefore important to understand the early-life factors that precede and influence EDI performance, yet the vast majority of EDI studies have not collected any information prior to the EDI assessment. We have a unique opportunity to do this through our collaboration between HCMO and the Manitoba CHILD cohort.
Objective: Explore and understand the early-life factors that influence early childhood development and school readiness by linking data from participants in the CHILD study with their EDI score (n=483).
Facilitating Access Across the Pregnancy Continuum of Care
A health system intervention to improve care transitions andhealth outcomes for Indigenous
women in northern Manitoba
Prenatal care (PNC) is critical: it has the potential to reduce perinatal morbidity and mortality by treating medical conditions, identifying and mitigating risks, and helping women to address behavioral factors that contribute to poor outcomes.
However, despite Canada’s universally funded health care system, prenatal care use varies widely across the province with the highest rates of inadequate prenatal care found in northern Manitoba. The pregnancy period (i.e.prenatal, birth and post‐partum periods) for Indigenous women in Mantioba's north is characterized by frequent and rapid transitions in their care. First Nations women living on reserve have the added burden of being evacuated from their home communities for birth and forced to experience transitions in care across federal and provincial health systems.Throughout these transitions, many barriers arise, including travel, transportation issues, financial constraints, poor communication, different providers, and weak referral links.
For women, relocating for care and birth away from home is characterized by insecurity, strange surroundings, and isolation from family. Women often experience a lack of choice, control and power in these transitions.
Wholistic, culturally safe interventions are needed to support continuity of care to reduce healthcare inequities and promote lifelong well-being among Indigenous women and their children. Effective transitions with improved linkages between programs and services is needed with opportunities for women to participate in shared decision making with their healthcare providers in a culturally safe manner. A northern pregnancy network is proposed to improve access to care, assist with navigation of complex system transitions, and improve linkages between service providers across systems. The network will be made up of system navigators linked to a core team of service providers, community members andguided by Elders. Culturally safe care and shared-decision making are foundational. These strategies are expected to increase use of care, decrease low birth weight and premature birth, increase breastfeeding, increase use of well-child care and vaccination rates, and improve patient experiences.
This will be the first health systems intervention to improve health systems transitions during the perinatal period for Indigenous women living in northern regions in Canada. It will serve a model for improving health systems and jurisdictional transitions among Indigenous women throught the pregnancy continuum of care.