THIS YEAR, MORE THAN 30,000 BRITISH COLUMBIANS WILL BE diagnosed with cancer, including 6,195 in the interior region. Sadly, those numbers will continue growing year on year; according to BC Cancer’s projections, the number of new cancer cases in the region is expected to increase by 27 per cent from 2019 to 2034.

Following specialist treatment, many of them will go on to live long lives in the care of their family physicians, nurse practitioners or other primary care providers, thanks in part to early detection, improvements in technology and more effective treatments.

Dr. Siavash Atrchian from BC Cancer-Kelowna.

For Kelowna-based BC Cancer radiation oncologist Dr. Siavash Atrchian, a clinical assistant professor in UBC’s Faculty of Medicine and a radiation oncologist at BC Cancer-Kelowna, ensuring the best outcomes for his patients means understanding how best to integrate family physicians into their care.

“Overall, in the patient cancer journey, I think family doctors play an extremely important role, from the start to the end,” says Dr. Atrchian. “As oncologists, we can’t follow our patients forever once their cancer treatment has been completed. I’m very interested in seeing whether we can improve this journey. How can I do a better job in my role? How can I communicate better with other care providers?”

These questions were on his mind when Dr. Atrchian was first introduced to Dr. Christine Voss, an investigator at UBCO’s Centre for Chronic Disease Prevention and Management, in 2019. Dr. Voss, who was just helping to launch the Centre’s Clinical Research and Quality Improvement (QI) Incubator Program, was intrigued at the opportunity to help tease out some answers.

“The premise of the incubator initiative is really to bring health scientists together with clinicians,” Dr. Voss explains. “In Dr. Atrchian, you have a clinician who really understands the needs around post-cancer treatment, while I’m a scientist who knows how to set up a mixed-methods study, collect and analyze the data,” Dr. Voss adds. “I recommended interviews and surveys of family physicians and oncologists in Interior Health, and was able to guide how to set those up.”

Dr. Voss and Dr. Atrchian soon became co-principal investigators of an interdisciplinary team of researchers, oncologists, family physicians and Southern Medical Program students, with the goal of examining how to best integrate family doctors into the post-cancer treatment care of the four most common cancers: breast, lung, colon and prostate.

To conduct the information-gathering for their research, Dr. Voss and Dr. Atrchian tapped then-first-year UBC Southern Medical Program student Brian Hayes, who took it on as his FLEX project. Having already completed a Master of Science in Kinesiology at UBC Vancouver, Hayes was eager to participate in research that would inform his journey toward becoming a doctor and directly benefit patients.

Dr. Christine Voss was intrigued by the opportunity to work with BC Cancer’s Dr. Siavash Atrchian to understand how to better integrate family physicians into patients’ post-cancer care.

“I wanted to research something more similar to where I saw myself practicing,” Hayes explains. “I was thinking about family medicine as a possible career path, and the project sounded really interesting, doing interviews and surveys and talking to doctors. This seemed like a big quality-improvement, big-picture kind of project that I found interesting.”

A year into the project, Hayes suggested bringing his classmate Hannah Young on board, who jumped at the chance to get involved. “Being from a rural community and wanting to practice rural family medicine, I thought this was right up my alley in terms of improving and optimizing the health care in those rural areas for cancer patients,” she says. For those living in rural areas, acute cancer care can involve additional travel for treatments like chemotherapy and radiation; when they complete their active treatment, they will be relying heavily on their family doctors for ongoing follow-up care.

Young was tasked with helping to design and distribute anonymous surveys to 943 family physicians and 39 oncologists throughout BC’s interior about their experiences working with one another to support cancer patients. When the surveys came back with a high response rate—25 per cent for the family physicians, and close to 100 per cent for the oncologists—the research team was thrilled.

“It was really neat, because when you start getting results you realize how tangible this research is, and that the work you’re doing is connecting with real people,” says Young. “By making the lives of the physicians better, by working toward different strategies to improve care, you’re also helping so many patients as well.”

Southern Medical Program students Brian Hayes and Hannah Young worked together on a research project to help improve health care for cancer patients living in rural areas.

Having seen first-hand what a diagnosis of cancer means for people living in rural areas, Young understood the importance of what Dr. Voss and Dr. Atrchian were doing. “I’ve definitely seen how difficult it can be to access treatment in a rural community when you’re having to travel far distances for specialist care. Especially if you’re in pain, and with all the stress, it can be really, really hard.”

The team is still working on analyzing the data they’ve collected and will be submitting their results for publication, with Young and Hayes as first authors—a highly valuable experience for both. While it’s too early to share details of their findings, Dr. Atrchian says the work is revealing how cancer patients’ post-treatment journey can be better supported by those caring for them. That includes bringing oncologists and family physicians together for more regular educational sessions; more robust guidelines for discharge notes from oncologists to family physicians; and creating more opportunities for them to communicate with one another.

Delivering actionable results that could result in improved patient care is something Dr. Atrchian feels particularly passionate about. “There are many components that I, as a clinician, can’t do anything about, like hiring more doctors or addressing wait times,” he observes. “But I can find out, ‘How can I help myself? How can I do a better job? How can I communicate better?’ to improve this patient journey. I hope that this research is going to trigger other people to think about it, and come up with other brilliant ideas about how we can improve.”

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IN A ONE-MINUTE ANIMATED YOUTUBE VIDEO, a bunny named BonBon sits alone in its bed in a dim room, weakly illuminated by the glow of a cell phone. Rejection letters from various universities are pinned on BonBon’s bedroom wall, and on their phone is a message from a friend, who poses excitedly by a large UBC sign: “I got in!”

BonBon, feeling blah, scrolls down to other feeds. The first reports wildfires raging across the province—another downer. But the next, from Foundry—which offers wellness services to BC youth aged 12 to 24—makes BonBon pause. “Strong people seek support,” it declares.

It’s a deceptively simple message. But bundled into it is research illuminating how young people make decisions about whether or not to seek help with their mental health and life challenges. That research, still ongoing, is led by Dr. Shelly Ben-David, an Assistant Professor at UBC Okanagan’s School of Social Work.

Years ago, when Dr. Ben-David worked at NYU and the New York State Psychiatric Institute—where there were “amazing psychosocial interventions to help young people”—she noticed many struggling youths. Adolescence and young adulthood are when important psychosocial and neurobiological changes happen. If mental health issues are tackled early, that can help a young person avoid crises that can seriously disrupt milestones in their schooling, relationships, jobs and futures.

In Canada, statistics show youth in the 15 to 24 age group have the highest rates of substance abuse and mental health disorders, yet only 20 per cent get appropriate treatment.

Dr. Ben-David wanted to know why.

“If young people aren’t accessing services, or staying engaged with services, to me, that’s a glaring issue.” But there’s been little theoretically driven research examining the decision-making process struggling youth use to decide whether to access services. What are their barriers? What factors in their lives might nudge them to seek help?

In 2018, with the help of a Social Sciences and Humanities Research Council grant, Dr. Ben-David set out to probe the mystery of what gets young people through the front doors of organizations like Foundry, which has 11 centres across British Columbia.

With a team of more than a half-dozen UBCO graduate and undergraduate students from the School of Social Work helping her, Dr. Ben-David worked with Foundry Kelowna to recruit 41 youth—aged 15 to 24—into her study. She also collaborated with the Canadian Mental Health Association in Kelowna.

“Foundry is amazing,” says Dr. Ben-David, who strives to put community engagement into the heart of her research work. Youth (including high school and university students) and parent advisory councils were formed to help Dr. Ben-David’s UBCO team recruit participants and develop questions. “It was really important that community members, including young people, were involved in the research process.”

The input of youth on the very structure and implementation of her research, says Dr. Ben-David, enhanced its validity. “After all, they have more current expertise in being a young person,” she laughs.

Dr. Shelly Ben-David.

Using a decision-making framework called the Unified Theory of Behavior (UTB), Dr. Ben-David’s team conducted semi-structured interviews with the teens and young adults using Foundry. Those interviews were key to unearthing how youth decide to reach out for professional help with their issues—or suffer in silence.

In simple terms, part of the UTB framework that Dr. Ben-David and her student assistants employed during research interviews posits that the intention to do something is informed by five “constructs,” among them social norms, emotions and self-concept.

One example of an emotional construct, explains Dr. Ben-David, is that seeking a service could be “really scary for someone, which is going to affect their decision-making process.” For instance, depending on the social norms some youth face in their particular families or community, a young person seeking professional help for anxiety or depression might fear being stigmatized as weak.

Radha Ortiz, then a master’s student in social work, was one of Dr. Ben-David’s graduate research assistants. She undertook a variety of roles in the study; she helped build the conceptual model of the research, supported grant writing and related academic papers, and, most critically, conducted qualitative interviews with Foundry youth and their parents.

“It was a huge privilege to hear the stories of these youth and parents,” says Ortiz, who, as a young girl, immigrated with her parents to Canada from Argentina. That experience of navigating settlement in Canadian society instilled in Ortiz a passion for social work and justice, and led her to UBCO’s clinical social work program, where she focused on youth mental health.

“The earlier we can equip individuals with tools to understand themselves and their emotions, the better they fare when life throws adversity and big challenges their way.”

As she interviewed the youth at Foundry, Ortiz recalls, “Their desire to create change by participating in the research was very humbling and inspiring. For me, being a part of this study was very grounding and came at a critical time in my studies when I was feeling far removed from the people I hoped to serve afterward. This experience reinvigorated my passion for social work.”

With her research analysis in hand, Dr. Ben-David wanted to quickly translate it to a larger audience. “That’s why we did animated videos. We wanted young people to translate the data; individuals from Foundry Richmond helped write the scripts, design the animations and compose the music,” she says. So far, the team has created several short videos featuring BonBon, all designed to encourage young people to overcome any negative perceptions they might have about seeking health and social services.

“The kind of researcher I want to be is not just about writing academic papers, but also ensuring my work is translatable to general audiences,” says Dr. Ben-David. She intends for the findings in this study—and a new one about the divide among BC youth accessing digital mental health technologies—to influence health and wellness policies around the country and help shape how organizations like Foundry increase access to their services.

Ortiz, now employed as a clinical counsellor with Interior Health, continues to be involved in research with Dr. Ben-David’s youth mental health lab. Her experience as a UBCO graduate research assistant has deepened her understanding of youth mental help and shaped her own approach to her clinical practice.

“What really stands out for me from the Foundry study—which is mirrored in my work—is the role emotions play in help-seeking and mental health. The earlier we can equip individuals with tools to understand themselves and their emotions, the better they fare when life throws adversity and big challenges their way.”

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IN THE FALL OF 2018, IN ERNAKULAM, KERALA, INDIA, civil engineer Dr. Chinchu Cherian and her family were about to welcome a new son and brother into their fold. At the time, Kelowna, British Columbia, and UBC Okanagan were 13,200 kilometres away, but even further from their minds.

While UBCO is lauded for having a close-knit campus community, the significance of its global reach spanning oceans and crossing borders cannot be muted. It was through an acquaintance of Dr. Cherian’s doctoral supervisor, Dr. Dali Naidu Arnepalli at the Indian Institute of Technology-Madras, that a life-changing opportunity would present itself.

“Dr. Arnepalli used to tell me that your graph should always be going up,” says Dr. Cherian, gesturing towards the ceiling. “With family and kids, I thought it was time to settle down. I had given up on my aspirations to pursue further heights in my career. I was happy that way, but Dr. Arnepalli added wings to my dreams again.” With this enthusiastic encouragement—and while six months pregnant—Dr. Cherian applied for and received a fellowship with Dr. Sumi Siddiqua in UBCO’s School of Engineering.

The 13,200-kilometre span between Ernakulam and Kelowna seemed to narrow with the help of social media. “My husband found an online video of Dr. Siddiqua and looked at the names of people who liked it on Facebook. He saw a familiar Indian name and sent her a personal message.”

Dr. Cherian with Dr. Sumi Siddiqua of UBCO’s School of Engineering.

As luck would have it, this stranger―Dr. Anupama Pillai―had done a post-doctoral fellowship at UBCO and hailed from their home province in India. “After meeting her online, she gave us some advice about relocating and information about Canada. She was very supportive. We finally met in person when we arrived in British Columbia and have been great friends since.”

Having a female role model such as Dr. Siddiqua in an industry that is commonly perceived as being male-dominated has been crucial to Dr. Cherian. “I consider myself lucky to have a supervisor in Dr. Siddiqua,” she says. “Only another woman can 100 per cent understand the challenges faced by a working mother. The positive and welcoming environment at UBC Okanagan has given me the confidence to achieve a high calibre of work.”

Dr. Cherian notes that while there are considerate male supervisors, communication is much easier when there’s a shared understanding of what it means to be a mother. “When female role models that have kids and families continue to pursue their dreams and succeed, they tell us that nothing is impossible.”

A keystone project for Dr. Cherian has been her research conducted with support from a Mitacs Elevate Scholarship and in partnership with BC’s pulp-mill industry. Over the course of two years, her team looked for ways to recycle wood fly ash, a pulp-mill waste product, into a green alternative to portland cement in the construction of concrete roads and buildings. “The fundamental technologies are well developed,” Dr. Cherian says. “It’s our job to make them more sustainable and environmentally friendly.”

She adds: “While these are small steps, this type of research is happening globally. The cumulative result will have a positive impact on our future.”

After completing her Mitacs fellowship, Dr. Cherian immersed herself in teaching opportunities in the School of Engineering. “I tell my friends that when you’re a teacher, you don’t age, you always feel like a student yourself.” She has formed strong relationships with her diverse group of students and credits being a mother as having informed her teaching style. “Through my son and daughter, I’ve learned to appreciate that different people have different perspectives and needs that must be met.”

This appreciation was the catalyst for Dr. Cherian’s esteem for the Disability Resource Centre and the Equity and Inclusion Office. “We see such positive outcomes with the implementation of these services at UBCO,” she says. “It’s my goal to advocate for the support of students from a variety of facets including mental health and the removal of barriers to education, especially in places where these pillars don’t exist.”

Dr. Cherian is thrilled to be extending her work with Dr. Siddiqua as a Research Engineer in the School of Engineering and hopes to continue sharing her passions for civil engineering, diversity and sustainability with students as a Sessional Instructor this fall.

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IN A SMALL ONTARIO TOWN MID-WAY BETWEEN TORONTO AND WINDSOR, a young Dr. Jennifer Jakobi figure skated, danced and ran track, with aspirations of one day becoming a coach and high school physical education teacher. For the Faculty of Health and Social Development professor, a career as an exercise neuroscientist could not have been further from her radar.

“I was so fortunate to have someone in my life who recognized how I lit up when I was involved in science during my undergrad,” Dr. Jakobi says. “Although I laughed at them and tried to discourage the idea of pursuing it.” It was this mentor’s partner—a school principal—who made all the right arguments, and Dr. Jakobi soon put teaching on hold in favour of a master’s degree in exercise science.

“I followed some sage advice when choosing my master’s degree,” she says. “More so than the field you choose for a master’s, it’s important to make sure you like the person you’re working with; that you can get along with them and be mentored by them. For me, it was Dr. Enzo Cafarelli at York University. A bigger-than-life personality, he got me hooked on human motor science, especially motor unit physiology, and that was the start of my academic journey.”

“Dr. Jakobi has been instrumental in helping me further my research. While encouraging independence in her lab, she is tremendously supportive of her students, and it’s clear she values and actively seeks to facilitate student success and personal growth opportunities.”

Mentorship is something Dr. Jakobi has valued throughout her career—not just as a mentee, but as a mentor—and she doesn’t hesitate to say that her students are the heart of her research. School of Health and Exercise Sciences master’s student Eli Haynes has worked with Dr. Jakobi in her Healthy Exercise and Aging Lab for the past few years. “Dr. Jakobi has been instrumental in helping me further my research,” he says. “While encouraging independence in her lab, she is tremendously supportive of her students, and it’s clear she values and actively seeks to facilitate student success and personal growth opportunities.”

As a way to increase opportunities for girls to experience science, Dr. Jakobi developed the integrative STEM Team Advancing Networks of Diversity (iSTAND) program in 2014. It has since grown to embrace intersectionality and strives to remove labels from learning environments.

“It doesn’t matter who you are,” she says. “People are people. We’re engaging with youth, families and teachers to build an inclusive environment.” She applies this approach to her role as the Natural Science and Engineering Research Council (NSERC)-sponsored Chair for Women in Science and Engineering. Dr. Jakobi is one of five national chairs. And for the BC and Yukon Region, the West Coast Women in Engineering, Science and Technology (WWEST) program aims to empower individuals to make organizational change.

“Through iSTAND and WWEST, we’re going to build a vibrant community of diverse individuals to advance science and generate knowledge.”

The motor unit

“Motor units are individual nerves that exit the spinal cord and go to many muscle fibres,“ explains Dr. Jakobi. “They’re the final neural element of controlling movement.” She adds with a smile that she could study it until she retires. “But there’s more to it than contributing to the scientific literature.”

An older adult study participant once posed the question during her PhD, “Why does this matter to me?” After some deep introspection, Dr. Jakobi realized that what she does in the lab ultimately needs to benefit people.

Dr. Jennifer Jakobi (left) in the lab.

In her NSERC research program, Dr. Jakobi’s team seeks to realize how sex-specific differences influence the adult aging process. “Our hope is that by understanding neuromuscular adaptations between men and women, we can hone in on specific areas of focus when it comes to lessening functional decline for a man or a woman.”

Dr. Jakobi uses the example of an older man and woman who don’t have the strength to stand up from a chair. “Sex-specific physiological differences exist, so to prevent functional decline with increased age we recommend resistance training for the woman starting in her 40s or 50s. For the man, this might be put off until he’s in his 60s for both of them to experience the same net abilities with increased age.”

Campus collaboration

A highlight of Dr. Jakobi’s recent career has been leading the Aging in Place Research Cluster. The cross-campus collaboration brings together a dynamic team of engineers, psychologists, health and behavioural researchers and volunteer study participants to understand what older adults need and want.

“We want to figure out the physiology that will support those needs and wants, and to use that physiology to inform interventions, self-management, and the design and engineering of products. This is where the work is collaborative, but encompasses the older person.”

She adds: “What I love about it is that we’re able to look at things from a societal perspective. We’ve really engaged with older adults in our research planning.” Key initiatives of the cluster help older adults retain functional independence, improve social connections and promote their physical activity.

“One thing I really appreciate about UBC Okanagan’s smaller campus,” Dr. Jakobi says, “is how many close friends and colleagues I’ve developed. If I need the expertise of someone from a particular faculty, I don’t have to go to a website, I can just pick up the phone and call someone I already know in that faculty.”

UBC Okanagan’s close-knit community also offers the type of teaching environment that Dr. Jakobi relishes. “The smaller environments allow for a real connection with the next generation of scientists and leaders,” she says. “It’s the connection of science impacting life and life impacting science. When students make connections in the lab that are genuine from a place of learning, that’s what I love about teaching.”

She adds: “People are here because they want to make a positive change. They want to keep an institution at the heart of the people, with the people and for the people. UBC Okanagan has a small-town attitude but on a grand scale of international influence through its teaching and research.”

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