Helping hands, thriving families
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By Erika Thorkelson
When it comes to supporting maternal health, Dr. Patricia Janssen, a Peter Wall Institute Early Career Scholar and Wall Solutions awardee, believes it takes a village. In the fifteen years since she first worked with the Institute, she has collaborated with scholars in such disparate fields as genetics, biomedical engineering and business, all with the goal of creating better health outcomes for mothers and babies in British Columbia and around the world. “That's what the Peter Wall Institute is all about,” she says. “Bringing different disciplines together.”
A professor and co-lead of the Maternal Child Health Theme at UBC’s School of Population and Public Health, Janssen is a perinatal epidemiologist with a clinical background in obstetrical nursing, as well as a trained midwife. So it made sense that the first funding she received from the Peter Wall Institute was for a luncheon for people who study violence against women, her particular research interest being violence during pregnancy. To her surprise, among that group were geneticists studying possible genetic links to patterns of violent behaviour in mice.
The conversations turned into a paper entitled “Of Mice and Men,” which was published in the Journal of Interpersonal Violence, and which would go on to provide the basis for a 2006 Exploratory Workshop – a Peter Wall Institute program that is no longer active, and which provided support to UBC faculty to meet and discuss collaborative research projects, themes, and research funding proposals (similar to the currently active International Research Roundtable program).
Along with the implications around violence against women, Janssen saw the genetic research as an opportunity to lessen the blame on parents and find new ways to treat violent behaviour in children and adults.
As a 2007 Early Career Scholar, a program that has since been folded into the Wall Scholars Research Award, Janssen had even more opportunities to meet and share knowledge. One such meeting was with Andrew Macnab, a physician and professor in the department of pediatrics at UBC who was at the time a Distinguished Scholar in Residence. The two met at a dinner organized by the Institute where Macnab spoke of his work with near-infrared spectroscopy (NIRS), a technology that measures blood oxygenation levels in tissue.
Hearing him speak, Janssen was inspired by Macnab’s passion and ability to “think outside the box.” She approached him after his presentation and together they began to imagine ways to apply this non-invasive technology in her own field.
“When a fetus is in trauma, the mother's body does everything it can to preserve that fetus and to add to the fetal brain and heart,” Janssen explains. These preservation mechanisms make it nearly impossible to measure the true health of a fetus until it is too late. “If we could pick up more subtle changes that give us more of a window, then we might have a chance to prevent stillbirth.”
The resulting clinical trials of NIRS technology brought together specialists in fields such as fetal physiology, maternal fetal medicine, and biomedical engineers, to name a few.
One of the most recent of these groundbreaking collaborations is SmartMom, a program that grew out of a partnership between the Northern Health Authority and Optimal Birth BC, an organization Janssen founded to help health authorities evaluate the evidence around medical interventions into birth such as cesarean sections.
SmartMom is a tool that uses text messages to reach women in rural communities who struggle to access the kind of prenatal education that improves health outcomes in both mothers and children. Optimal Birth’s consortium of 25 academic clinicians worked together to develop the messages. They then engaged the Canadian Wireless Telecommunications Agency to lobby cell phone carriers to deliver the messages for free.
With the support of a Wall Solutions Grant, the program launched in 2017. An expectant mother can sign up on the SmartMom website, input her due date, and receive three messages a week relevant to her stage of pregnancy. With five thousand expectant mothers enrolled and 500 more joining each month, user data shows SmartMom is hitting its target audience, particularly Indigenous communities in the North.
And the program is expanding. Fraser Health Authority has already launched a version while Vancouver Coastal Health and the Northwest territories will be joining in 2020. Authorities on Vancouver Island and in Saskatchewan have also expressed interest.
Meanwhile, Janssen has fielded requests from Cyprus, Uganda and Cameroon, all places where women struggle to get evidence-based education around pregnancy. “Today, I was on the phone with an obstetrician representing a group in India that wants to work with us,” she recounts. “Yesterday, I was on the phone with midwives and obstetricians from Pakistan.”
Starting in 2019, an additional Wall Solutions Grant will be supporting her next big project. SmartParent will build on the success of SmartMom to reach out to parents of children up to one year of age through similar means.
According to Dr Janssen, these collaborations and many others would not have been possible within traditional funding bodies who expect tested partnerships with guaranteed outcomes. “the Peter Wall Institute is much more imaginative,” she says. “They’re interested in ideas, interested in moving into new areas and breaking new ground. And that suits me very well because that’s what I try to do.”