During the 2003-04 fiscal year, IHSPR continued to focus its attention on supporting activities designed to address the goals and objectives outlined in our strategic plan1 and CIHR's Blueprint.2 IHSPR engaged in activities and investments in all of the broad focus areas in our strategic plan -- building a community of excellent researchers; expanding and enhancing research resources for the health services and policy research community; supporting strategic research; and translating knowledge to strengthen health care in Canada.
In addition to continuing to support research addressing issues identified as high priority by users of health services and policy research following the Listening for Direction I national consultation in 2001, IHSPR was also able to respond quickly to unexpected challenges that faced health care workers and Canadians. For example, in response to public health and health system issues related the SARS crisis, IHSPR and partners posted a request for applications and funded research to evaluate health care system preparedness and response.
This year our annual report is organized along a standard reporting framework that has been implemented across all CIHR Institutes. The elements of that framework are:
Our Institute Advisory Board (IAB) continued to provide thoughtful direction and advice throughout 2003-04. Board membership underwent the first of a regular renewal process and IHSPR welcomed 5 new members effective September 2003. The new members are: Chantal Maheu from Health Canada, Naomi Fulop from the London School of Hygiene and Tropical Medicine, Suzanne Lawson from the Hospital for Sick Children, Neena Chappell from the University of Victoria, and Ingrid Sketris from Dalhousie University. At the same time, we bid farewell to six members who had been with us since the birth of the Institute, and who had played instrumental roles in the evolution of our strategic plan and the development of our first funding tools and competitions: Renaldo Battista from AETMIS, Jerry Hurley from McMaster University, Ian Shugart from Health Canada, Paul Hebert from the Ottawa Hospital Research Institute, Chris Ham from the University of Birmingham (UK), and Noralou Roos from the University of Manitoba.
The year covered by this report was, again, a frenetic one, filled with many long days and exciting milestones. One event that stood out, however, was the Institute's inaugural symposium, hosted in Montreal in November 2003. This event, Strengthening the Foundations: Health Services and Policy Research ? Canadian Health Care, was attended by roughly 350 people including researchers, research users, students, fellows, and members of the public. It featured a number of highly topical plenary sessions, the usual problems of trying to figure out which of multiple interesting but competing parallel sessions to attend, about 50 fabulous posters with heavy representation from the newest generation of health services researchers in the country, and Peter Coyte's humorous launch of our new association, the Canadian Association for Health Services and Policy Research. The chair of the event, Tom Noseworthy from the University of Calgary, brought with him a whole new meaning to sitting down the job (ably chairing the event from a wheelchair).
Another key accomplishment for staff during this reporting year was significant forward movement on the development of a new health services and policy journal for Canada. A working group of our Advisory Board oversaw a process that included additional market research, and the evaluation of proposals from potential publishers of such a journal.
A third highlight for us was all the early team-building and organizational work that went into preparing for the transfer of the Canadian Health Services Research Foundation's open grants competition, projects component, to CIHR, beginning with the fall 2004 competition. This annual CIHR competition has been renamed to Partnerships for Health System Improvement.
None of this would have been possible without the continued dedication and enthusiasm of the Institute's staff, both in Vancouver and Ottawa. Our ability to continue to be innovative, responsive, relevant, and timely, is inextricably tied to the excellence of those staff. A complete list of our staff, with contact details, appears in Appendix Q at the end of this report.
Looking ahead, 2004-05 promises to be another year full of important milestones - the launch of a new journal, the first experience for CIHR with the Partnerships for Health System Improvement grants competition, and plenty of work ahead on the Institutes' five year evaluation.
We welcome comments about IHSPR's activities and the research we fund.
| Morris Barer | Diane Watson |
| Scientific Director | Assistant Director |
Our Vision
The vision of the Advisory Board of the Canadian Institutes of Health Research (CIHR) Institute of Health Services and Policy Research (IHSPR) is of a vibrant community of excellent researchers who conduct outstanding health services and policy research that informs Canadians about their health care system, is used by decision-makers to strengthen Canada's health care system, and influences health and social policy in Canada and abroad.
Our Mandate
The mandate of IHSPR is to support outstanding research, capacity-building and knowledge translation initiatives designed to improve the way health care services are organized, regulated, managed, financed, paid for, used and delivered, in the interest of improving the health and quality of life of all Canadians.
Our Goals
The strategic goals of the Institute are built around a commitment to four key areas - as the "BEST" strategy: Build a Community of Excellent Researchers; Expand and Enhance Research Resources; Support strategic research; and Translate knowledge. IHSPR is also committed to promoting and facilitating organizational excellence in all of its activities. Within each key area, the Institute has some specific goals that address the research priorities of the Institute:
For the purposes of this report, the Institute's goals listed above have been mapped to the five reporting categories in the Strategic Plan: CIHR's Blueprint for Health Research and Innovation:
For more information on IHSPR's research priorities or to view the Institute's strategic plan, please see this Web page
Outstanding Research
Policy, administrative and clinical decision-makers carry the challenge, on behalf of all Canadians, of developing and implementing health-supporting and health-improving change in health services and systems in Canada. IHSPR's strategic plan reflects our interest in making the best available research evidence available, in a timely fashion, to those decision-makers. The creation and synthesis of research evidence requires time, but the knowledge derived from these activities, if it is to be useful, must be available and accessible when decisions that could benefit from that evidence are being made. To ensure that health services and policy research in Canada is able to anticipate emerging issues and the information needs of decision-makers, we work with stakeholder and partner communities to identify gaps in knowledge, and to support strategic initiatives that address those gaps. To that end, IHSPR supports a number of strategic activities:
Goal 1: Identify and prioritize information needs of decision makers and the public.
Listening for Direction II
Beginning in late 2003, the Institute partnered with the Canadian Heath Services Research Foundation (CHSRF), the Canadian Institute for Health Information (CIHI), the Canadian Coordinating Office for Health Technology Assessment (CCOHTA), the Advisory Committee on Governance and Accountability of the Federal/Provincial/Territorial Conference of Deputy Ministers of Health, and the Health Statistics Division of Statistics Canada, in order to examine, evaluate, and update research priorities. The 2004 Listening for Direction II consultations generated the following top 10 priorities for the nation over the next five years:
Postscript: After the end of this reporting period, the Listening for Direction II final report was released. It is available at this Website
Listening for Direction on Injury
Listening for Direction on Injury (LFD-Injury) was a multi-institute initiative co-championed by the IHSPR and the CIHR Institute of Musculoskeletal Health and Arthritis (IMHA), in partnership with the Canadian Injury Research Network, SMARTRISK and the Insurance Bureau of Canada. The main goal of the LFD-Injury initiative (which represented the first phase of CIHR's commitment to supporting injury research) was to identify strategic priorities for research, capacity building, knowledge translation and infrastructure support for the prevention and management of injury. It brought together a diverse group of researchers, decision makers and programmers from four domains: unintentional injury prevention, violence and suicide prevention, acute care of injury and rehabilitation of injury.
LFD-Injury aimed to identify strategic research priorities and potential funding sources to increase and improve injury research in Canada.
Workshops
One way that IHSPR ensures that the research it supports remains current is to fund workshops that help identify information gaps or emerging research priorities. Workshops funded in this fiscal year had to include at least one of the following objectives: to reach consensus on priority policy issues and research questions in specific areas within the general ambit of health services and policy research; to nurture new teams or networks, with an eye to developing innovative and relevant CIHR operating grant applications and/or to developing proposals for future IHSPR strategic initiatives. In the 2003/04 fiscal year, IHSPR funded 9 workshops or other community development events in partnership with other CIHR Institutes and external organizations.
See Appendix A for a list of workshop titles and dates.
Goal 2: Support strategic health services and policy research in areas identified as important to the current and emerging information needs of policy, administrative and clinical decision-makers, and the public.
The Canadian Community Health Survey on Mental Health and Well Being
IHSPR, as well as the CIHR Institutes of Neurosciences, Mental Health and Addiction (INMHA), Gender and Health (IGH), the Rural and Northern Health Research Initiative (RNHRI), Statistics Canada (StatsCan), and the Ontario Problem Gambling Research Centre (OPGRC) were funding partners for the Canadian Community Mental Health Survey (CCMHS), which provides, for the very first time, comprehensive data for a selection of major mental illnesses, addictions and problems. The purpose of this initiative was to provide an enhanced opportunity for expert analysis of this segment of CCMHS data and, by doing so, improve the availability of evidence for decision-making. Four applications were funded this year.
See Appendix B for a list of titles and principal investigators.
Staying Ahead of the Wave: Genetics, Health Services and Health Policy
In collaboration with the CIHR Institute of Genetics (IG), and the Federal/Provincial/Territorial Coordinating Committee on Genetics and Health, IHSPR developed and posted this RFA. Its objectives were to provide development funds in support of initiatives likely to lead to longer term research projects or programs of inquiry to address the most important emerging issues facing the Canadian health care system in response to new understandings about human genetics, and the burgeoning of genetic information, technologies, products and services. Three projects were funded through this competition.
See Appendix C for a list of titles and principal investigators.
Public Health and Health Care System Preparedness and Response to Severe Acute Respiratory Syndrome (SARS): Evaluation and Lessons Learned
In collaboration with the Institute of Population and Public Health (IPPH), the Institute of Infection and Immunity (III), the Institute of Circulatory and Respiratory Health (ICRH), and the Canadian Lung Association, IHSPR developed and posted this RFA in order to support the examination and analysis of the recent public health, and health care system responses to the SARS outbreak in Canada. Special emphasis was placed on finding ways to ensure that evidence-based practice, and cost-effective outbreak management strategies are utilized to the extent possible in any future outbreaks of this kind. Ten applications were funded this year.
See Appendix D for a list of titles and principal investigators.
Improving the Quality of Health Care in Canadian Hospitals
The aim of this IHSPR-, IPPH-, and CIHI-led RFA was to fund research to determine, through a systematic review of Canadian hospital charts, the extent of health system error (avoidable and otherwise) in Canadian hospitals, and the availability of routinely collected data that could serve to monitor and reduce the occurrence of health system error. IHSPR continued to support the project funded under this 2002/03 competition.
Financing Health Care in the Face of Changing Public Expectations
The specific objective of this RFA, led by IHSPR and the CIHR Institute of Cancer Research (ICR), was to support innovative projects that will help inform policy and management decisions relating to two of the priority areas identified during the Listening for Direction I priority-setting process carried out by IHSPR and partners during the winter and spring of 2001. Broadly conceived, these areas include implications of decisions regarding the extent and reach of public funding for health care, on accessibility, use, cost and quality; the role of public values and expectations in determining what is publicly funded; and the effects of changes in public financing on the largely hidden burden borne by families and other informal care-givers. IHSPR continued to support projects funded under this 2002/03 competition.
Improving Access to Appropriate Health Services for Marginalized Groups
This strategic initiative was designed to support excellent, innovative and cross-disciplinary research projects that will help inform policy, program and management decisions relating to improved access to appropriate health services for identifiable marginalized groups. CIHR partners for this initiative included IGH, IPPH and the Institute of Aboriginal Peoples' Health (IAPH). IHSPR continued to support projects funded under this competition in 2001/02 and 2002/03.
Building Healthy Communities Through Rural and Northern Health Research
This RFA was designed to foster research on understanding and enhancing health, and health services and policy, in small and remote communities around three key research themes: understanding and improving the health status of rural and northern populations; designing health systems and services that work for small and remote communities; and knowledge translation - making health research more accessible and useable by rural and northern practitioners, policy-makers and citizens. All thirteen CIHR Institutes as well as Agriculture and Agri-Food Canada, The Rural Secretariat, CHSRF, the Canadian Institute for Health Information's Canadian Population Health Initiative (CIHI-CPHI), CANARIE Inc., Health Canada Office of Rural Health, Natural Sciences and Engineering Research Council (NSERC), Social Sciences and Humanities Research Council (SSHRC) and StatsCan were funding partners on this initiative. IHSPR continued to support projects funded in the 2002/03 fiscal year.
Goal 3: Support research in prioritized areas of other institutes where there is potential to enhance health services and policy research tools, methods, data development or researcher capacity.
Global Health Pilot Project Grants
The goal of this strategic initiative was to build research capacity by supporting innovative high risk, pilot or feasibility research on ecological, technological, economic, political and socio-cultural forces that influence health, and/or major health and health systems problems that affect low, middle and high income countries. The objective was to have Canadian investigators working in full partnership with researchers resident in low- and middle-income countries (including researchers representing the needs of vulnerable populations in more affluent countries), to explore novel ideas and observations and conduct pilot studies and/or gather evidence necessary to determine the viability of new global health research directions. It was anticipated that these grants would lead to subsequent proposals to the investigator-initiated grant competition and/or to future Global Health Research Strategic Initiative funding opportunities for longer-term grants. In partnership with IPPH, ICRH, IGH, III, IAPH, and external partners Health Canada (HC), the Canadian International Development Agency, and the Internatinoal Development Research Centre, IHSPR funded eight pilot projects.
See Appendix E for a list of titles and principal investigators.
Reducing Health Disparities and Promoting Equity for Vulnerable Populations
The goal of this strategic initiative, originally offered in the 2002/03 fiscal year, was to build research capacity that assesses and provides evidence and policy direction necessary to reduce health disparities and promote equity for vulnerable populations. These development grants were intended to enable interdisciplinary groups of researchers in health and other sectors to develop programs of research that describe, investigate and ultimately inform policies to reduce health disparities. In partnership with Health Canada and, IGH, INMHA, IPPH, and the Institutes of Aging (IA) and Human Development, Child and Youth Health (IHDCYH), and external partners HC, the National Secretariat on Homelessness, and SSHRC, IHSPR funded five development grants. In addition, IHSPR continued to support four grantees from the 2002/03 competition.
See Appendix F for a list of titles and principal investigators from the 2003-04 competition.
Palliative and End of Life Care: Pilot Projects
The goal of this Institute of Cancer Research-led strategic initiative was to support innovative, pilot or feasibility research in the area of palliative and end of life care. These grants allow investigators with novel ideas and observations to conduct pilot studies and/or gather evidence necessary to determine the viability of new research directions. It is anticipated that applicants who validate their pilot hypotheses will then continue their research by applying to other funding opportunities. Funding partners for this initiative included IHSPR, IA, ICR, IGH, IG, IHDCYH INMHA, HC - Canadian Breast Cancer Research Initiative, National Ovarian Cancer Association, the Heart and Stroke Foundation (HSF).
See Appendix G for a list of titles and principal investigators.
Operating Grants Competitions
IHSPR invested funds during the 2003/04 fiscal year to support investigator-initiated projects that aligned with topics identified as research priorities in its Strategic Plan through the priority announcement process. IHSPR funded six grants in the areas of funding health care, accountability, and primary health care. In addition, the Institute continues to support applicants to the 2001/02 and 2002/03 priority announcement competitions.
During the 2003/04 fiscal year, CIHR and IHSPR worked closely with CHSRF in preparation for the transfer of the project component of CHSRF's Open Grants Competition to CIHR.
In order to address the current research capacity deficit, and the rapidly growing demand for outstanding health services and policy research, IHSPR is committed to working with key partners to build a community of excellent researchers. In addition to the supply of quality researchers, outstanding health services and policy research also requires continuous enhancement of theory, frameworks, data, and empirical methods, as well as measurement and evaluation tools. Accordingly, the Institute is committed to working with key partners to expand and enhance research tools and resources.
This section outlines the following types of strategic activities:
Goal 4: Increase the supply of excellent health services and policy researchers in Canada.
Capacity for Applied and Developmental Research and Evaluation in Health Services and Nursing (CADRE) - Training Centres
The CADRE program is a partnership between CHSRF and CIHR focused on developing increased capacity in applied health services and policy research, including nursing management and organization. There is a need not only for more health services and policy research capacity in Canada, but also for an increase in the orientation of the existing and developing stock of health services and policy researchers toward the application and use of research.
CADRE is composed of five initiatives designed to address these short- and long-term capacity needs on a regional basis. One such initiative is the development of regional and national training centres. These centres are designed as a primary means to ensure a flow of applied health services and nursing researchers at the graduate level over at least a five-year period. A regional approach has been taken to ensure the institutions within each region build training programs around existing strengths. There are currently five CADRE training centres operating across Canada. CIHR continued to support these training centres during this reporting period.
CADRE - Postdoctoral Awards
These two-year awards are designed to build capacity through focused development of new researchers. Emphasis is placed on working with managers and policy makers as well as on acquiring skills that maximize the dissemination and use of their future research. These awards differ from traditional postdoctoral fellowships in two ways. First, in addition to having a research-oriented position, there is a requirement to learn about the decision-making world through a placement within a decision-making organization. Second, award holders are expected to acquire communication skills. 20 post-doctoral CADRE fellowships were awarded this year.
For a list of recipients and research institutions please see Appendix H.
Strategic Training Initiative in Health Research
The CIHR Strategic Training Initiative in Health Research (STIHR), funded by all thirteen CIHR Institutes, as well as external partners HSF, Alzheimer's Society of Canada (ASC), Michael Smith Foundation of Canada (MSFC), Fonds de la recherché en santé du Québec (FRSQ), the Alberta Heritage Foundation for Medical Research, and the Institut de la santé des femmes et en securité du travail, aims to provide leadership in building capacity within Canada's health research community by supporting training programs focused on multi-disciplinary teams of investigators in universities and affiliated organizations, institutions, agencies and hospitals. Partnering with government, voluntary and private sectors, this program supports the development of innovative and integrative training environments for the next generation of health researchers. IHSPR continued to support STIHRs initially funded in both the 2001/02 and 2002/03 fiscal years.
Career Awards
In addition to ongoing support of training programs and CADRE post-doctoral fellows, IHSPR made funding available to support a number of new trainees (Ph.D. students and post-doctoral fellows) who were highly rated in CIHR's 2003/04 open competitions and whose research projects fall within the Institute's mandate.
See Appendix I for a list of titles and successful applicants.
Goal 5: Increase capacity for expert training and mentoring of future researchers.
Capacity for Applied and Developmental Research and Evaluation in Health Services and Nursing - Chair Awards
As noted earlier, the CADRE program is a partnership between CHSRF and CIHR focused on developing increased capacity in applied health services and policy research, including nursing management and organization. Another important component of the CADRE program is the CHSRF/CIHR Chair Awards. These grants are awarded to chairs who are leaders in health services and nursing research to provide funding for up to ten years to mentor and educate less experienced researchers, train graduate students, build national applied research networks, and conduct research. CIHR and CHSRF continue to support CADRE Chair Award recipients who initiated their programs in 2000 or 2001.
Summer Institute
IHSPR and IPPH, in collaboration with the Québec Public Health Research Network, sponsored the second annual Summer Institute, held in June of 2003. Summer Institutes were established to increase capacity in interdisciplinary and applied research. The events are specifically designed to:
Fifty doctoral and postdoctoral students in the fields of population and public health and health services and policy research participated in Summer Institute 2003. By all accounts, the event was a great success.
Goal 6: Encourage the emergence of new collaborations
Strengthening the Foundations
In November 2003, IHSPR hosted a national symposium in Montréal. Strengthening the Foundations: Health Services and Policy Research <-> Canadian Health Care brought together about 350 researchers, research users, students, fellows, and members of the public. The event provided an opportunity for networking and community and collaborative development, and showcased some of the innovative teams and research that have been supported by CIHR. During this symposium:
Canadian Association for Health Services and Policy Research (CAHSPR)
IHSPR encourages interdisciplinary collaborations and interactions between researchers and decision makers. To that end, IHSPR supported the Canadian Health Economics Research Association's (CHERA) transformation into a more broadly based, national health services and policy research association -- CAHSPR. IHSPR and CHSRF provided financial support during this first fiscal year, in order to assist the newly formed Canadian Association as it develops the necessary infrastructure, management and operational systems to serve an expanding membership.
New and Emerging Teams (NET) Grants
The NET grants program is intended to promote the growth of small existing teams or the formation of new research teams, as well as to provide support for the creation or development of teams of independent investigators undertaking collaborative multidisciplinary research in Canadian research institutions. In 2003/04 IHSPR, in partnership with IA, III, and ICR, as well as external partners the Ontario Neurotrauma Foundation, HSF, ASC, OPGRC, the Canadian Bacterial Diseases Network and the National Society of Clinical Psychopharmacologists funded four new NETs in the following areas:
See Appendix J for a list of titles and principal investigators.
Interdisciplinary Capacity Enhancement (ICE) Teams Grants
The ICE teams grant program, funded by the IHSPR and CIHR Knowledge Translation branch, IMHA, IG, IPPH, III, IGH, INMHA, as well as external partners FRSQ, Health Canada's Natural Health Products Department, the Ontario Ministry of Health, the Canadian Medical Association, Safe Kids Canada, aims to provide support for new or existing groups who can demonstrate that they are committed to engendering a trans-disciplinary research culture and to attracting into, engaging and mentoring junior researchers (faculty and post-doctoral fellows not otherwise funded) or established researchers who have not worked extensively in health research in the past, within teams or networks working on themes that align with the priorities identified by participating Institutes and partners. IHSPR continues to support ICE teams initially funded in the 2002/03 competition.
Workshops
IHSPR funded several workshops whose objectives included developing networks, interdisciplinary teams, or collaborative research projects. Examples of such funded workshops include:
See Appendix A for a complete list of funded workshops and dates.
Goal 7: Develop and improve researchers' access to data regarding health and health services.
Compelling Values: Privacy, Access to Data and Health Research
IHSPR, in collaboration with the other CIHR Institutes and its Ethics Office, as well as external partners (StatsCan, CIHI, Workers' Compensation Board of British Columbia, CHSRF, Privacy Commissioners (ON, AB, BC, QC), HSF, Health Canada's First Nations and Inuit Health Branch), developed and posted this new RFA. Its purpose was to provide operating grant funds in support of initiatives that address issues related to collection, use and disclosure of personal information for health research intended to improve the health of Canadians and/or strengthen Canada's health care system on the one hand, while respecting and protecting Canadians' right to privacy and confidentiality of personal information, on the other. One application was funded this year.
See Appendix K for the title of the project and the name of the principal investigator.
Harmonizing Research Privacy: Standards for a Collaborative Future
Following the Privacy in Health Research: Sharing Perspectives and Paving the Way Forward workshop in December 2002, IHSPR played a key role in facilitating partnerships to fund a workshop series entitled Harmonizing Research Privacy: Standards for a Collaborative Future, which were held in October 2003 and February 2004.
The goals of these workshops were to identify and synthesize Canadian health services and policy researchers' needs and knowledge, and to develop recommendations for harmonized privacy standards, policies and best practices, for the protection of personal health information collected, used or disclosed in the context of conducting health services and policy research. These workshops were planned in collaboration with CIHI-CPHI, IPPH, INMHA, IAPH, IHDCYH, IG, IA, ICR, the Institute of Nutrition, Metabolism and Diabetes (INMD), and the Institute for Clinical Evaluative Sciences (ICES).
Upon completion of the Harmonizing Research Privacy workshops, a privacy toolkit was published and a final report was posted on the IHSPR website.
Joint Canada/United States Health Survey
In the 2002/03 fiscal year, IHSPR, IPPH, IA, INMD, IGH, and INMHA contributed funding to support the first-ever Joint Canada/United States Health Survey. Results form this survey have been posted and data from this survey are available for research purposes. The survey was conducted by the National Center for Health Statistics (NCHS) and StatsCan and funded by CIHR, StatsCan and the Robert Wood Johnson Foundation. It was designed to enable accurate comparisons between countries regarding population health status, risk factors, health disparities, access to health care, and quality of and satisfaction with health care services.
The data and initial statistical analyses were released in 2004. A first look at the data suggests that the health status of Americans and Canadians is similar, though the range of health status was more polarized in the United States. Americans were more likely than Canadians to report that they were very satisfied with health care received, though citizens report similar access to health care.
Population-based Health and Health Services Data in Canada: Current Status, Improved Research Potential and Future Investments
CIHR's IPPH and IHSPR issued a Request for Proposals in partnership with IAPH, IA, ICR, ICRH, IG, III, IMHA, INMD, INMHA, and CIHI-CPHI, Health Canada's Centre for Surveillance Coordination, and StatsCan. The purpose of this initiative was to engage the services of a team of research consultants to describe the current status of population-based health and health services databases in Canada that are being used and show the potential for use in innovative and important health research, and provide recommendations to the partners on ways to improve the breadth, depth, range, and use-ability of these databases. In 2003/04 a team of researchers was funded to undertake this work. An advisory committee co-chaired by IHSPR and IPPH is overseeing this work.
See Appendix L for the title of the project, the specific objectives of the work, and the name of the principal investigator.
Canadian Longitudinal Study on Aging
The Institute of Aging, in collaboration with IHSPR, several other CIHR Institutes, and external partners HC - Department of Aging and Seniors, the Canadian Association of Gerontology, and StatsCan, and on behalf of the Canadian Longitudinal Study on Aging (CLSA) Steering Committee, issued an RFP for the development of the protocol of the CLSA during late 2003. The objective of the CLSA is to develop a Canadian multi-centre study that could determine the genetic, immunologic and molecular determinants of aging; the effect of physical exercise, nutrition and other habits on health on Canada's aging population; the evolution of physical, psychological, and cognitive abilities in aging; the role of psychological determinants of health; the role of social and cultural variables on health; the health services utilisation of this population; identify preventive strategies and health services that would promote healthy aging and translate the findings into clinical practices, health services and policy. The grant was awarded in January of 2004.
See Appendix M for the project title and principal investigator.
Goal 8: Support the development and use of new tools, frameworks and methods for health service, health policy, and knowledge translation research.
Advancing Theories, Frameworks, Methods and Measurement in Health Services & Policy Research
This strategic initiative was launched by IHSPR in order to support research likely to lead to new breakthroughs in theory development, conceptual frameworks, research methods or measurement approaches (qualitative or quantitative) that have broad application to health services (including public health), systems and policy research and population health research, or to understanding the translation of research into a strengthened Canadian health care system and improved health for Canadians. In collaboration with IA, IPPH, and the INMD, as well as the CIHR Office of Ethics, 29 grants were funded.
IHSPR is committed to enhancing the supply of researchers who engage in, or teach others how to engage in, best practices in the area of knowledge translation. In line with the goals outlined in the Institute's strategic plan, and with the mandate of CIHR, we continue to work with our partners to develop and sustain continuous, long-term interactions between health services and policy researchers and research users.
In this section of the annual report, we include the following types of activities:
Goal 9: Enhance the supply of researchers who engage in, or teach others how to engage in, best practices in the area of knowledge translation.
The Centre for Knowledge Transfer
One component of the CIHR-CHSRF CADRE partnership is the development of regional and national training centres, each of which consists of a consortium of universities. As noted earlier, there are currently five training centres operating across Canada. One of these is the Centre for Knowledge Transfer, a national training centre dedicated to knowledge utilization and policy implementation, led by scholars at the University of Alberta, in partnership with the University of Manitoba, University of Saskatchewan and Laval University. The mandate of the Centre for Knowledge Transfer is "to provide training to researchers and to students to do knowledge transfer in the health sector; to train scholars in the field of knowledge transfer with the aim of building capacity; to engage decision makers to maximize policy relevance of knowledge transfer training and scholarship; and to increase knowledge transfer skills among health care managers and professionals to promote research/evidence based decision-making." CIHR continued to support this Centre in 2003-04.
Knowledge Translation Strategies for Health Research
IHSPR collaborated with the other 12 CIHR Institutes to develop and fund the Knowledge Translation Strategies for Health Research RFA. The goals of this RFA were to strengthen the foundations of research that underpin knowledge translation; to encourage researchers in knowledge translation to focus their work increasingly on the thirteen CIHR Institutes and their health research priorities; and to promote research on how best to integrate knowledge translation principles and practice into the training and continuing education of health professionals. IHSPR continues to support projects funded in the 2002/03 competition.
Goal 10: Support the development of environments involving, and tools for, sustained interactions between researchers and research users.
Health Services and Policy Research Journal
Building on the work of previous years, IHSPR made significant progress in 2003/04 toward development of a new peer-reviewed outlet for health services and policy research of direct relevance to Canadian health care system policy-makers and managers.
Early in 2003, IHSPR retained a consultant to conduct a survey to refresh its understanding of the level of perceived need for, and interest in, additional capacity for communicating peer-reviewed Canadian-relevant health services and policy research to interested researchers, policy-makers, and decision-makers. A survey and key informant interviews were conducted, and discussions with potential publishers and editors regarding the feasibility of, and their interest in, expanding publication capacity in this area were initiated.
Postscript: At the time of writing, IHSPR has just announced the creation of a new journal to be published by Longwoods Publishing Corporation. Key partners on this initiative are IHSPR and CAHSPR. IHSPR anticipates that the first issues of this important new knowledge translation vehicle will appear during the 2005-06 fiscal year.
Goal 11: Support and promote the use of effective approaches to knowledge translation.
Knowledge Translation Casebook
The Scientific Director of IHSPR initiated, and began planning for, development of a health services and systems casebook to showcase knowledge translation success stories. Objectives include communicating CIHR's commitment to knowledge translation, providing a vehicle for researchers to share knowledge translation experience, providing concrete examples for training purposes, and demonstrating the potential impact of research evidence. A first version of the casebook is anticipated for late in the 2004/05 fiscal year or early in the following year.
Workshops
A number of workshops, funded in part by IHSPR in 2003/04, addressed knowledge translation in their objectives, for example:
Requests for Applications
All of IHSPR's RFAs have some knowledge translation component; however, in the 2003/04 fiscal year, IHSPR developed and posted two RFAs whose objectives specifically emphasized the translation of knowledge:
(see a full description of this RFA under "Outstanding Research")
This section covers activities in the following areas:
Maintaining and fostering partnerships with CIHR Institutes and external organizations to identify, focus, and support research priorities.
As detailed throughout this annual report, through RFAs, workshops, symposia, the development of collaborative agreements and other initiatives, IHSPR has developed many partnerships, within and outside CIHR. Indeed, partnership development, maintenance and growth pervades virtually all the Institute's activities. Partnerships have been identified for each of the initiatives described earlier in this report, and will not be repeated here. Please see Appendix O for a list of some of IHSPR's internal and external partners and the initiatives they supported.
In addition, IHSPR has also funded several CIHR-external workshops, symposia and other events, that have been collaborative ventures with key national, provincial and territorial partners. Examples of funded workshops can be found throughout this report as well as in Appendix A.
Public Engagement
IHSPR continues to focus its attention on research that is important to Canadians. All of the Institute's newly developed RFAs, funded workshops, and other initiatives, reflect the Institute's commitment to supporting important research in areas of concern to the Canadian public.
Through Institute staff and IAB member interaction with the media and federal and provincial commissions and committees, IHSPR has worked to engage the public by increasing their understanding of health services, systems and policy. In April of 2003, the Scientific Director, in partnership with Dr. Robert Evans (from the University of British Columbia Centre for Health Services and Policy Research) authored an article in the Winnipeg Free Press, entitled "W(h)ither National Pharmacare?". This article addresses the issue of the feasibility of a national pharmacare program, based on the results of the National Forum on Health, and the Romonow and First Minister's Reports. In addition, the Institute's Scientific and Assistant Directors are frequently called upon to speak with the media, on studies supported by CIHR or its partners, or more generally regarding pressing health services/policy issues of the day.
IHSPR is committed to assuming a key national role of leadership and coordination with regard to identifying and focusing health services and policy research and translation priorities in Canada, through the development of innovative institute programs, initiatives, activities and structures, the effective management and operation of those programs, the creation of mutually beneficial partnerships, and the creation and maintenance of a work environment that encourages excellence in all aspects of the Institute's mandate.
This section reports on activities and events in the following areas:
Goal 12: Assume a leadership and coordination role in identifying and focusing health services and policy research and knowledge translation priorities for Canada.
Institute Advisory Board
The 2003/04 IHSPR IAB was chaired by Dr. Paul Lamarche, University of Montreal), with the able assistance of its vice-chair, Dr. Martha MacLeod, University of Northern British Columbia. It included fifteen other members, from Canada and abroad. The IAB continues to represent an impressive diversity of expertise, geography, areas of research, and sectors. Board meetings are an essential focal point for discussion and deliberation regarding IHSPR priorities, activities and investments, and members are heavily engaged between formal meetings through a working group structure. The IAB met four times in the 2003/04 fiscal year (three face-to-face meetings and one teleconference).
For a complete list of 2003/04 IAB members, please see Appendix P.
The Advisory Board has evolved a number of working groups designed to monitor, report on, advise regarding priorities and actions, and participate in evaluation of, IHSPR goals and objectives related to each of the major areas articulated in the strategic plan (Building Capacity/Community, Enhancing Research Resources, Strategic Research, and Knowledge Translation). In addition, the Advisory Board has structured working groups focusing on the development of Partnerships, on Evaluation, and on Communications. The Evaluation working group is involved in planning, overseeing and reporting on IHSPR's 5-year evaluation as well as the Institute's efforts at designing and implementing performance measurement and management, while the Communications working group provides assistance to staff in developing and enacting IHSPR's communication strategy.
During the reporting period, Dave Clements from CHSRF served on the Knowledge Translation working group and Krista Connell from CIHR served on the Partnerships working group. The Advisory Board extends its gratitude to these individuals for their contributions to the achievement of the Institutes goals.
Official Language Minority Communities (OLMC)Research Agenda
CIHR is committed to supporting health research related to issues facing official language minority communities.CIHR has appointed the Scientific Director of IHSPR as the research champion to advance work in this area. An invitational workshop, "Needs, Gaps & Opportunities:Improving Access to Health Services for French and English Speaking Minorities", was held in March 2004. Over 40 stakeholders from across Canada convened to discuss pertinent issues and to define a health research agenda.Eight themes/priorities and suggested mechanisms to address them emerged from the workshop. These will guide CIHR's multi-year action plan to respond to the needs of minority language communities in Canada.
Goal 13: Encourage innovation and effectiveness in IHSPR, CIHR programs, initiatives and structures.
CIHR Programs, Initiatives and Structures
The ability of CIHR to identify and support strategic research in Canada is made possible through a complex organizational and governance structure and an extensive and interconnected set of committees, working groups, and less formal staff interactions. IHSPR is committed to furthering the excellence of the organization as a whole; in 2003/04, IHSPR's Scientific Director, Assistant Director, and staff served on several internal CIHR committees and working groups, including:
Communications and Relationship Building
The Scientific Director, members of the IAB, and IHSPR staff, have continued to establish and strengthen relationships with a number of individuals and organizations external to CIHR, which have a broad range of roles and interests in the provision and funding of health research, or health care services for Canadians. These relationships are central to effective communications and knowledge translation.
In addition, IHSPR produced three newsletters in the 2003/04 fiscal year, each of which communicated important activities and funding opportunities. The newsletters were circulated to more than 7000 readers in the health services and policy research community. Past newsletters are available on the Institute's website at http://www.cihr-irsc.gc.ca/e/13931.ht|
CIHR Institute of Health Services and Policy Research | ||
|
AVAILABLE FUNDS |
$ 1,906,058.10 | |
|
EXPENDITURES INCURRED FOR CURRENT YEAR | ||
|
Institute Development | ||
|
Conference, symposia and workshops |
$ 394,621.40 |
|
|
Institute Advisory Board expenditures |
$ 43,242.69 | |
|
Professional Services |
$ 37,995.40 | |
|
Travel Expenditures |
$ 11,486.27 | |
|
Other costs (Can. Assoc. HSPR Support) |
$ 40, 700.00 | |
|
$ 528,045.78 | ||
|
Institute Operations | ||
|
Employee salaries and benefits |
$ 421,837.55 |
|
|
Office accommodations |
$ 22,913.00 |
|
|
Telephone and communication services |
$ 12,754.64 |
|
|
Supplies, material and other services |
$ 34,752.63 |
|
|
Computer equipment and IT support |
$ 2,144.44 |
|
|
Professional services |
$ 26,542.74 | |
|
Travel expenditures |
$ 51,453.27 | |
|
Other expenditures |
$ 2,893.17 | |
|
$ 575,291.44 | ||
|
Total Expenses |
$ 1,103,337.20 | |
|
UNSPENT BALANCE |
$ 802,720.90 | |
|
CIHR Institute of Health Services and Policy Research | ||||||
Investments through Grants and Awards |
||||||
|
Strategic Initiatives |
Number |
2003/04 |
2004-05 |
2005-06 |
2006-07 |
Total |
|
Canadian community health survey: mental health and health services |
4 |
$ 140,000 |
$ - |
$ - |
$ - |
$ 140,000 |
|
| ||||||
|
Staying ahead of the wave: Genetics, health services, and health policy |
3 |
$ 112,089 |
$- |
$ - |
$ - |
$112,089 |
|
| ||||||
|
Advancing theories, methods and measurement |
25 |
$ 215,280 |
$ 786,855 |
$ 755,395 |
$ 459,742 |
$ 2,217,272 |
|
| ||||||
|
Reducing health disparities and promoting the health of vulnerable populations |
4 |
$ 75,870 |
$ 19,110 |
$& - |
$ - |
$ 94,980 |
|
| ||||||
|
Interdisciplinary Capacity Enhancement (ICE) Teams |
12 |
$ 1,504,117 |
$ 1,655,304 |
$ 1,643,852 |
$ 2,922,299 |
$ 7,725,572 |
|
| ||||||
|
Healthy and successful aging (New Emerging Team) |
1 |
$ 25,000 |
$ 25,000 |
$ 25,000 |
$ 50,000 |
$ 125,000 |
|
| ||||||
|
Cognitive impairment in aging (New Emerging Team) |
1 |
$ 25,000 |
$ 25,000 |
$ 25,000 |
$ 50,000 |
$ 125,000 |
|
| ||||||
|
Global health and health system research |
5 |
$ 247,429 |
$ - |
$ - |
$ - |
$ 247,429 |
|
| ||||||
|
Anti-microbial resistance, health system implications and health outcomes (New Emerging Team) |
1 |
$ 50,000 |
$ 50,000 |
$ 50,000 |
$ 100,000 |
$ 250,000 |
|
| ||||||
|
Operating grants to open competition |
1 |
$ 16,711 |
$ - |
$- |
$ - |
$ 16,711 |
|
| ||||||
|
Knowledge Translation Applications |
15 |
$41,615 |
$ 49,995 |
$ - |
$ - |
$ 91,610 |
|
| ||||||
|
Financing health care and changing public expectations |
2 |
$ 235,920 |
$ 196,908 |
$ - |
$ - |
$ 432,828 |
|
| ||||||
|
Access to health care for marginalized groups |
9 |
$ 295,157 |
$ 207,213 |
$ 94,353 |
$ - |
$ 596,723 |
|
Training awards to open competition |
22 |
$ 573,549 |
$ 539,084 |
$ 343,999 |
$ 559,832 |
$ 2,016,464 |
|
| ||||||
|
Adverse events in Canadian hospitals |
1 |
$ 19,989 |
$- |
$ - |
$ - |
$19,989 |
|
| ||||||
|
Capacity and Developmental Research Environments (CADRE) |
3 |
$ 198,750 |
$91,250 |
$ 25,000 |
$ - |
$ 315,000 |
|
Health Research Partnership Program |
1 |
$ 25,500 |
$17,812 |
$ - |
$ - |
$ 43,312 |
|
| ||||||
|
CIHR training program grants |
16 |
$ 1,485,579 |
$ 1,506,187 |
$ 1,511,939 |
$ 3,607,494 |
$ 8,111,199 |
|
| ||||||
|
SARS - Evaluation and lessons learned |
0 |
$ - |
$ 392,157 |
$ 140,507 |
$ - |
$ 532,664 |
|
| ||||||
|
Compelling values - privacy, access to data and health research |
0 |
$ - |
$ 86,753 |
$ - |
$ - |
$ 86,753 |
|
| ||||||
|
Palliative and end of life care (New Emerging Team) |
1 |
$ 50,000 |
$ - |
$ - |
$ - |
$ 50,000 |
|
Totals |
127 |
$ 5,337,555 |
$ 5,648,628 |
$ 4,615,045 |
$ 7,749,367 |
$ 23,350,595 |
