July 7, 2014 – Toronto, ON – Several Bloomberg Nursing researchers have been awarded funding from the Canadian Institutes of Health Research (CIHR) for the next 2-3 years. Assistant Professor Martine Puts received a prestigious New Investigator award, while Professor Kelly Metcalfe, Associate Professor Robyn Stremler, Associate Professor (status only) Jennifer Stinson, and Assistant Professor (status only) Lianne Jeffs each received funding from CIHR’s Operating Grant program, as they embark on research to improve patient outcomes and best clinical practices in Ontario and across Canada.
Martine Puts is one of only 40 applicants from across the country selected for a highly competitive CIHR New Investigator career Award, which is awarded to independent researchers that have held a full-time appointment for less than 5 years. The New Investigator Salary Award program provides outstanding new investigators the opportunity to develop and demonstrate their independence in initiating and conducting health research through provision of a contribution to their salary. In addition, Puts is the recipient of the additional New Investigator Prize of Excellence in Research on Aging from CIHR’s Institute of Aging for this year. Puts plans to secure program funding to improve care for older adults with cancer. “Older adults often have other chronic diseases in addition to cancer,” says Puts. “These other diseases can affect how long the patient will live, and how well they can tolerate cancer treatment.” She plans to measure the feasibility of conducting geriatric assessments on this population – interventions can then be implemented to improve health and well-being for older adults with cancer as compared to standard care. “A geriatric assessment can identify health issues that may not be known to the treatment team, such as memory problems, depression, or nutritional issues,” Puts continues. “If these can be identified for the healthcare team through a GA, cancer treatments can then be modified to improve health and well-being of these elder patients.” This new investigator award positions Puts to lay the framework for future study on cancer care and treatment in older adults, and ultimately lead to improved clinical practices.
Kelly Metcalfe will be continuing her research into women with BRCA1 or BRCA2 mutations, who possess one of the highest known lifetime risks of developing both breast and ovarian cancers. A prophylactic oophorectomy – removal of the ovaries – is highly effective in lowering the risk of cancer in these women and reduces the risk of dying of all causes by 77%. It is recommended that these women have the surgery by age 35, but 45% of women over 35 with the BRCA mutation have not had the procedure performed. Metcalfe finds this low uptake of oophorectomy troublesome considering the tremendous survival benefit associated with the surgery. “This could be the result of current delivery of cancer genetics services,” states Metcalfe. “There is no formal clinical follow-up with women after the disclosure of these genetic test results.” Given growing evidence of the efficacy of follow-up telephone genetic counselling in increasing uptake of cancer screening, Metcalfe will expand this to evaluate if it is effective in increasing the uptake of prophylactic oophorectomy. In her study, titled Cancer Prevention in Women with a BRCA1 or BRCA2 Mutation: A Follow-up Genetic Counselling Telephone Intervention, women from participating cancer genetics clinics will be assessed for eligibility for the study, and randomized into one of two groups – one group will receive follow-up telephone genetic counselling, while the control receives stand care. Upon completion of the study, women in the control group will be offered the same follow-up telephone genetic counselling session. “An intervention is needed to increase uptake of oophorectomy in this high-risk population,” Metcalfe continues. “This study will allow for the translation of research findings on cancer prevention into the clinical setting, with the potential to decrease mortality in this group of women.”
Robyn Stremler has received an operating grant to research ways to improve adolescent sleep through her study Design and initial testing of a wearable sleep sensor and mHealth intervention to promote sleep for adolescents. During adolescence, changes happen in sleep patterns and circadian rhythms, resulting in a shift to later bed times and wake times. A number of psychological, environmental and social factors combine with these biological changes, creating a “perfect storm” that limits sleep quantity – over 60% of adolescents aged 13-18 sleep less than the 9 hours recommended for them. “While the amount of sleep achieved in the second decade of life has long been known to decline, a growing body of evidence indicated that this sleep restriction occurs despite an unreduced need for sleep, and that this sleep debt leads to significant health concerns, including depression and cardiovascular disease” says Stremler. “We hypothesize that a behavioural intervention delivered with a mobile app will be a cost-effective and accessible method of engaging adolescents in self-management of sleep behaviours.” Utilizing existing wearable sensors like the FitBitFlex and Jawbone UP24, in conjunction with a monitoring app, participants will be engaged in two cycles of focus groups and usability testing to determine the feasibility of the intervention and its effects. Outcomes to be measured include mean nocturnal weeknight and weekend sleep, alongside general daytime sleepiness, quality of sleep, anxiety, depression, school attendance, and others. “Mobile, user-friendly interventions with wearable sleep sensors may help many adolescents increase the amount of sleep they achieve,” states Stremler. “This type of program does not require health care provider involvement, and could lead to widespread use as a public health tool to reduce the burden of sleep debt across all age groups and populations.”
Jennifer Stinson received funding for two grants in this competition. The first is a two-year study that develops and tests an online game that helps children learn how to better manage their arthritis. The second study, running over a 3-year period, focuses on an integrated smartphone and web self-management program for adolescents and young adults with chronic pain.
Finally, funding for Lianne Jeffs and her team led through St. Michael’s Hospital is focused at building capacity to improve and sustain antimicrobial stewardship programs in ICUs. This project aims to accelerate the application of knowledge by leveraging partnerships between researchers and knowledge users (including clinicians and administrators) to bridge a knowledge-to-action gap in the area of antimicrobial stewardship in the ICU setting.
The Lawrence Bloomberg Faculty of Nursing is proud of the support it offers to its researchers. “Bloomberg Nursing researchers are conducting cutting edge research across multiple areas in an effort to improve patient care, quality of life, and inform best clinical practices,” states Interim Dean Linda McGillis Hall. “The research being conducted by Professors Puts, Metcalfe, Stremler, Stinson and Jeffs will have a direct impact on patient health and healthcare in Canada.”