Violetta Cohen



SANA SHAHRAM LOVES THINGS TO BE CONSTANTLY IN FLUX. She loves the way each season in the Okanagan morphs into the next, as opportunities to express her passion for wakeboarding on local lakes make way for the activities on snowy ski slopes high above the valley’s winter clouds. She loves it when things change.

It’s no coincidence that with her passion for fluidity, the Faculty of Health and Social Development assistant professor finds herself working in many areas where change is paramount, such as health system transformation as well as anti-colonial and anti-racist public health systems.

“My research allows me the opportunity to introduce and offer different perspectives on health equity. It’s a vehicle to change the voices that are at the table,” says Dr. Shahram.

Her current exploration—funded by a Scholar Award from the Michael Smith Foundation for Health Research—is aptly titled: “Systems transformation for health equity: The PHAIRNESS Research Program.” PHAIRNESS is an acronym for Population Health Approaches to Implementing Research (k)Nowledge for Equitable Systems and Strategies.

Her research stems from a lifelong desire to play a part in influencing what society values, and to shine a light into the dark corners where inequities are hiding.

“I’ve always wanted to bring attention to the fact that some have the benefit of living their lives with dignity where others do not,” she says. “The success of systems of oppression come from their ability to make themselves invisible, so my research is primarily concerned with making those systems visible.”

Dr. Sana Shahram

Dr. Sana Shahram.

Dr. Shahram works closely with public health institutions, communities and people who are impacted by issues that present unnecessary barriers to accessing quality health care. She aims to identify where they conflict with the values of advancing equity in health care and beyond. “Then we can generate some examples of how we can intervene with those conflicts,” she says.

Born in Canada to parents from a different country with a different language and culture, Dr. Shahram says she had a unique frame of reference from a young age. “You have to become an interloper between systems when part of you is Canadian and part of you is not,” she says. “Learning from different perspectives draws your attention to the fact that there are multiple ways of knowing and doing. It becomes obvious when things we consider ‘big T’ truths are not serving us.”

An ever-questioning mind and desire to understand problems led Dr. Shahram to pursue a Bachelor of Science at UBC Vancouver. In an interesting turn of events, she walked away with that degree and a Bachelor of Arts in English literature.

“I’ve always felt that the best way to understand humanity and to understand the reasons we are the way that we are, is through literature,” she says. “It speaks to your feelings rather than to facts and it allows you to understand information using a completely different part of your brain. Having the two degrees together makes perfect sense to me, even though it may not make sense to most people.”

Dr. Shahram counts William Faulkner as one of her favourite authors. “Books like The Sound and the Fury, that tell the stories of people who are clinging to the past while society is changing around them, are stories that are still relevant today.” She notes an understanding that people value their traditions, but questions the cost when those traditions harm others. “There are real-world parallels in these stories of resistance towards justice—hanging onto an older era—where what the characters are really hanging onto is the oppression of other people.”

When it comes to COVID-19, Dr. Shahram says it has amplified inequalities in public health systems. “The people who have been left out of and harmed by policies like the removal of tent cities, are equally left out of and harmed by policies related to the pandemic,” she says. “Staying at home, that was only possible to those who have the privilege of having somewhere safe to go, or who didn’t have to go to a job every day in order to make ends meet. This in tandem with the ongoing drug overdose crisis has been chaotic.”

On the other side of the equation are those who are resistant to vaccines and public health orders. “I think the backlash that we’re seeing is the manifestation of the abject failure of our systems to instil in us any kind of collective mindset,” Dr. Shahram says. “We’ve also seen that there are groups of people who are willing to co-opt any type of language of oppression, invoking equity when it benefits them, with little concern for actual discrimination.”

Dr. Shahram with her child.

Dr. Shahram with her son.

Dr. Shahram points out the silver lining of the pandemic in regards to health equity: “When there’s a public health emergency, it opens a window of opportunity to bring attention to the reasons we need strong public health systems, why we need resources and why we need the ability to work together. It’s sparking very important conversations about the type of future that we want.”

Having completed her PhD at UBC Okanagan, continuing an ongoing residency as Embedded Research Scholar with Interior Health, and owning a local business with her partner, Dr. Shahram has firm roots in the Okanagan. “It was really important to me to stay in the community where I’d established the partnerships, relationships and engagement necessary to do community-based research.”

She is also looking forward to contributing to the further realization of UBC Okanagan’s commitment to creating a learning environment that promotes equity, diversity and inclusion for all its community members.

For someone who works towards positive change, it’s no wonder that Dr. Shahram would describe herself as optimistic. “I’m very hopeful. In my professional career, there’s never been a time like right now, where there’s such opportunity and openness to have these hard conversations about things like white supremacy and anti-colonial action.”

“I’m particularly proud of the way the students at UBCO are leading this work, and are continuing to hold us accountable. I’m hopeful that we will rise to the occasion and make the students and the next generation proud.”

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MORE THAN 6.2 MILLION CANADIANS LIVE WITH SOME FORM OF DISABILITY that affects their quality of life. But researcher Dr. Femke Hoekstra is working in partnership with community organizations and people with lived experience to improve the health and wellbeing of people with disabilities. Known as an implementation scientist, Dr. Hoekstra’s research focuses on improving the use of health research findings in practice, like in rehabilitation or community settings. She has a particular interest in researching how to promote healthy lifestyles in people with physical disabilities.

Originally from the Netherlands, Dr. Hoekstra’s doctoral research focused on the nationwide implementation of a physical activity promotion program in Dutch rehabilitation care. The project was conducted in collaboration with over 70 rehabilitation professionals from 18 organizations across the country and was funded by the Dutch government to improve physical activity levels in people with disabilities.

“The two key components of the program were the integration of physical activities and sports in rehabilitation for people with disability, and then providing counselling after discharge. The idea was that if people are doing different types of physical activities during their rehabilitation and we support them in the transition to the home setting, they’ll be able to stay more physically active in the long term,” she explains.

During her time as a doctoral student, Dr. Hoekstra had the opportunity to connect with Canadian researcher Dr. Kathleen Martin Ginis during a visit to the Netherlands. “We started chatting and realized we could learn from the work being done in our respective countries.”

A few months later, that conversation spurred an eight-week project in Canada for Dr. Hoekstra in Dr. Martin Ginis’ lab, comparing the disability sport policies in Canada and the Netherlands. A year after this first collaboration, the pair reconnected and Dr. Martin Ginis had an opportunity for a postdoctoral fellow to join her at UBC Okanagan. It didn’t take much convincing for Dr. Hoekstra to realize this was a great fit for the next stage of her academic journey.

“I think the key in choosing UBC Okanagan was the strong partnerships its research labs have with the local community, especially the spinal cord injury community. I knew I could learn a lot from my supervisors in terms of how to build and sustain these kinds of unique relationships.”

“My husband and I visited Kelowna in June and it was beautiful,” says Dr. Hoekstra. “So that made for an easy decision! But I think the key in choosing UBC Okanagan was the strong partnerships its research labs have with the local community, especially the spinal cord injury community. I knew I could learn a lot from my supervisors in terms of how to build and sustain these kinds of unique relationships; I’m thankful that I was also able to establish a meaningful relationship with both my supervisors, who have provided so much support along the way.”

In the early years of her fellowship, Dr. Hoekstra worked with Dr. Heather Gainforth and Dr. Martin Ginis to better understand how researchers can more meaningfully engage community stakeholders in their research process—not just as participants, but as research partners. Her research ultimately supported the development of the first Integrated Knowledge Translation Guiding Principles for conducting and disseminating spinal cord injury (SCI) research in partnership.

“The idea is that if you do your research in partnership with your knowledge users, you can do better and more relevant research that will be applied in practice.”

Dr. Hoekstra is now doing her second postdoc research project after being awarded a Craig H. Neilsen Foundation Fellowship, a Michael Smith Foundation for Health Research Trainee Award and a Canadian Institute of Health Research Fellowship. Her current research, which takes place jointly at the SCI Action Canada Lab and the Applied Behaviours Change Lab, focuses on understanding and improving exercise counselling services for people with SCI.

“We’re studying conversations about exercise between therapists and clients to better understand how counselling leads to positive changes in health behavioural outcomes. We’re then using that knowledge to create best practices for spinal cord injury-specific exercise counselling, as well as training modules for therapists. For this study, I established my own international partnership including SCI researchers, therapists and people living with an SCI from Canada, the Netherlands and North America.”

Femke Hoekstra

Dr. Femke Hoekstra.

For Dr. Hoekstra, the ability of international partners to bring different experiences and expertise to the table is incredibly valuable to the project. The Netherlands, Canada and North America as a whole are leading regions in terms of where effective physical activity behavioural support interventions for people with SCI have taken place. The most exciting part of her work is being able to collaborate with diverse people to make a difference in peoples’ lives.

“The purpose of knowledge translation is to apply research findings outside of academia and to make a difference. I don’t want my research to just sit in a journal somewhere and no one reads it—I want to make sure it’s relevant and helpful for people in the community.”

As a postdoctoral researcher, Dr. Hoekstra also enjoys working with other researchers and trainees, to help mentor students and see people grow and develop their skills. Continuing her cross-continent collaborations, Dr. Hoekstra also co-supervises graduate students back in the Netherlands who are continuing her doctoral work.

“We’re following up with our physical activity program participants to see how they’re doing six to seven years after discharge from rehabilitation,” she explains. “It’s so rewarding to continue to work with my Dutch colleagues and see the impact of past research.”