Improving health: CIHR funds nearly $200,000 for immunization research project led by StFX nursing professor

April 26th, 2017

A research project led by StFX Rankin School of Nursing professor Dr. Donna MacDougall aimed at helping improve the health of children in Canada’s north, particularly in relation to whooping cough, has received a nearly $200,000 two year operating grant from the Canadian Institutes of Health Research (CIHR) in partnership with the Public Health Agency of Canada.

Dr. MacDougall is the principal investigator on an improved immunization coverage initiative entitled “Implementation of an immunization program with pertussis vaccine during pregnancy: identifying barriers, factors that predict success, and interventions to improve coverage among Inuit women.”

“This new CIHR operating research grant represents a significant success for Dr. MacDougall and for health research at StFX,” says Dr. Richard Isnor, Associate Vice President, Research and Graduate Studies.

“The application was highly ranked within the CIHR competition. The project will be carried out by an exceptionally talented research team and could result in significant long-term health benefits for Inuit and other Indigenous populations in Canada,” he says.

It’s a research partnership between vaccinology researchers at StFX, Dalhousie, the Canadian Centre for Vaccinology, Public Health Ontario as well as health authorities of Nunavut and Nunatsiavut and the communities they serve. There are 17 investigators in total, and two other investigators from StFX, Cathy MacDonald and Jacqueline vanWiijlen. Community facilitators will also participate in the research.

Currently in Nunavut, home to many of Canada’s Inuit, there is an outbreak of whooping cough, also known as pertussis, a respiratory disease that affects millions of people every year.

The topic under study was identified by partners in Nunavut who recently implemented a tetanus diphtheria, acellular pertussis (Tdap) program in response to the outbreak of pertussis.

“What we want to do, and what they want us to do, is to evaluate the effectiveness of that program and consult with the Inuit to understand some of the health factors and cultural factors that would achieve effectiveness of the program,” Dr. MacDougall says.

She says babies are more likely than older children and adults to catch whooping cough and those who do become very sick and may even die. Inuit babies, she says, may be at greater risk for catching pertussis as they often have more respiratory infections and poorer general health than non-Inuit children.

While many people receive a pertussis vaccine, called Tdap, to protect them, babies younger than six month of age are too young to receive all the doses needed to protect them. One way of protecting these babies, she says, is to give their mothers the vaccine during pregnancy.

“While many mothers are afraid of getting vaccinated during pregnancy, Tdap is proven to be both safe and effective,” Dr. MacDougall says. “In Canada, pregnant women are offered a Tdap vaccine when there is an outbreak in the area in which they live. This is currently the case in Nunavut.

“We know that the uptake of some vaccines in Inuit women and children has been strong, but we don’t know whether this will be same for a maternal Tdap program.”

While barriers in implementation exist that have been well documented in western nations, information specific to the Canadian Inuit community is largely unavailable.

The two-year study aims to explore perceptions of Tdap vaccines and preferred sources of vaccine related information among Inuit pregnant women, antibody response during pregnancy, potential pockets of poor vaccine uptake, and possible ways of improving vaccine coverage during pregnancy, she says.

The researchers will also study and compare the nearby region of Nunatsiavut, as there is no whooping cough outbreak there, to see if there are differences in attitudes, beliefs and behaviours.

She says the study will use a mixed methods research approach that will include focus groups, interviews, surveys and serotolgy testing performed in partnership with Inuit communities and key stakeholders using gender and cultural based frameworks to guide the process.

She says she’s pleased a “Two-Eyed” seeing approach will guide the process.

“It is learning to see with one eye the strengths of Indigenous knowledge and ways of knowing, and from the other eye with the strengths of western knowledge and ways of knowing. It brings strength from both world views.”

She says it is also hoped that with this project will come the potential for a longer term relationship related to research on issues of public health importance.

NT5