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Author: Linxi Mytkolli

Patient Partner Profile – Seeta Ramdass

For Seeta Ramdass patient engagement is critical to the success of any health care project. That’s one of the reasons she was excited to learn about Diabetes Action Canada, where she would have the opportunity to not only play an active role in research projects, but also to use her career experience to support the organization’s governance. Now, Vice Chair of the DAC Steering Council and a participant on multiple research and project teams, she is able to make a real impact on health outcomes for people living with diabetes.

Initially, however, she was skeptical. “Working in healthcare, I’ve advocated for patient engagement and patient partnerships in research for decades, but I still felt like patients were not being engaged very authentically in research. It was still very research-heavy, science-heavy and organizationally heavy, and the patient was really a token. I was curious if DAC was authentically integrating patient perspectives, not only from the point of view of managing the condition itself, but also from the socio-cultural context and the diversity of patients. Were diverse patient voices going to be engaged?” A colleague, who is also from a visible minority, shared his own experience with DAC and encouraged Ramdass to get involved.

“He said, “no, I think you’ll be happy with what you find.” And he was right. I found that wow, yes, there is a diversity within DAC teams in terms of leadership and research. But there was also a nice diversity in terms of the patients and the community members that have been recruited and involved. When I started going to meetings with researchers and hearing projects, yes, the patent’s voice and input was absolutely valued from the cultural context, and the interest and commitment to being socially inclusive was already in place. And I love that everyone I’ve met at DAC so far is really open to learning and they’re embracing going forward and trying to implement it. That authenticity matters.”

As a person living with type 2 diabetes, a condition with a higher prevalence in the South Asian community, Ramdass knows that token engagement does not lead to impact. She also knows that the research process is not always one that looks at diabetes through an equity lens. That knowledge drew her to take on a project with Dr. Joyce Dogba’s team, which invited her to go through the team’s research papers and provide her feedback on ways that the work could be done with a stronger EDI lens. “I came up with 15 recommendations and pointed out where there were opportunities to ensure that equity, diversity, inclusion, and accessibility, were considered in the methodology of the research, in the analysis of the research, and then in how the findings were reported,” says Ramdass. “And the team is using that input to do things. I can hear it in the way Dr. Dogba is phrasing questions, adjusting her language and her communication and terminology to the audience of patients that we’re dealing with – she is truly a model of an inclusive DAC researcher with her commitment to EDI in research! To me, that was great because we’re contributing to this work as patients and to know it is being implemented, often in real time, is valuable.”

This exchange of information is something that appeals to Ramdass. She believes that while it’s important to have voices at the table, everyone has to be engaged in a meaningful conversation for there to be real impact. She also likes that the team at DAC is respectful of the time a person has available, and the different things they may be dealing with. “Respecting people’s different religious holidays, respecting the pace at which people communicate, some people take a little longer to phrase their thoughts because we have different sociolinguistic ways of expressing ourselves, different literacy levels, different language  competencies, because not all of us are necessarily anglophones or francophones, we may be  allophones or speak Indigenous languages. I love that there is patience with allowing people to express themselves, or to not express themselves. If someone’s not comfortable addressing a topic, we understand and recognize that their silence is telling us something as well,” she says.

Moving forward, Ramdass has big goals for ways that she wants DAC to focus on. She would like to see a commitment to make research publication language more culturally sensitive, inclusive and respectful. She worries that the blaming language in some of the publications she has seen adds to further marginalization of groups. She would also like to see broader communication options for those who are not comfortable speaking in English or French, and more work done to support vulnerable populations. She is encouraged that DAC shares these commitments and looks forward to helping guide the process of implementing them more widely.

New Knowledge Mobilization Video Available Now

In the second video from our Knowledge Mobilization Basics Series, we look at WHO is involved in Knowledge Mobilization and WHY it is important to include all individuals who will use or be affected by the research results in the real world. We’ll explore how involving these individuals will ensure the best chances of successful knowledge mobilization.

Watch it now!

Knowledge Mobilization Consultation Service

The Knowledge Mobilization (KM) Consultation Service is a program to support DAC research teams with their KM needs at any stage of the research process.

DAC researchers who would like to use this service can fill in a needs assessment survey by clicking the link or scanning the QR code below.

Julie Makarski (Research Manager and Implementation Support Practitioner, DAC KM Program)will follow-up to schedule a meeting to co-create your KM plan.
 
Through the DAC 2.0 KM Program, we aim to increase knowledge and capacity in knowledge mobilization across the DAC Network and to support DAC members in their knowledge mobilization goals and activities.

Season Three of the Actions on Diabetes Podcast is Available Now

Our popular podcast, Actions on Diabetes, is back for a third season.

This season, host Krista Lamb talks with a new group of researchers and patient partners about Diabetes Action Canada projects that are making a difference for people living with diabetes.

From islet biologists learning how to work with people with lived experience, to health coaching and mental health supports, this season is full on stories about innovative and engaging research programs you’ll want to learn more about.

New episodes can be found on our website, Spotify, Apple Podcasts, or the podcast provider of your choice.

Listen now!

Diabetes care among individuals with and without schizophrenia in three Canadian provinces: A retrospective cohort study.

Diabetes care among individuals with and without schizophrenia in three Canadian provinces: A retrospective cohort study.

O’Neill B, Yusuf A, Kurdyak P, Kiran T, Sullivan F, Chen T, Kalia S, Eisen D, Anderson E, Selby P, Campbell D.Gen Hosp Psychiatry. 2023 May-Jun;82:19-25. doi: 10.1016/j.genhosppsych.2023.02.007. Epub 2023 Mar 5.

This study explores the mental health challenges faced by individuals with schizophrenia and the impact of diabetes management in this population, particularly focusing on how mental illness affects glycemic control. It highlights the need for integrated care approaches that address both mental health and diabetes. Diabetes Action Canada supported this research by encouraging collaborations between mental health professionals and diabetes care teams to improve holistic treatment strategies and by funding this study, through a grant competition.

    To save the vision of persons with diabetes Canada needs data-informed timely screening

    To save the vision of persons with diabetes Canada needs data-informed timely screening.

    Rac VE, Whiteside C, Bowen JM, Maberley D, Brent MH.Can J Ophthalmol. 2023 Oct;58(5):e228-e229. doi: 10.1016/j.jcjo.2023.04.001. Epub 2023 May 2.PMID: 37141921

    This article examines the accessibility and utilization of vision care services, particularly for marginalized and vulnerable communities living with diabetes, highlighting disparities in screening for diabetic retinopathy. The study emphasizes the need for targeted interventions to improve access and reduce vision loss in these populations. Diabetes Action Canada supported this research by facilitating data partnerships with ICES, novel governance for a cohort disclosure and partnerships with community health centers to ensure the inclusion of at-risk groups in vision care programs.

      Diabetes Action Canada Joins the WHO’s Global Diabetes Compact

      Diabetes Action Canada is proud be a member of the World Health Organization’s Global Diabetes Compact. The Compact, which has a vision of, “responding to the increasing burden of diabetes around the world,” was launched in 2021 to coincide with the 100th anniversary of the discovery of insulin.

      Comprised of members from diabetes organizations around the globe, Diabetes Action Canada looks forward to learning from other members and supporting the Compact’s goals of “ensuring that all people who are diagnosed with diabetes have access to equitable, comprehensive, affordable and quality treatment and care.”

      DAC’s Patient Engagement lead, Linxi Mytkolli will represent the Network at Compact meetings.

      Learn more about the WHO Global Diabetes Compact.

      An exciting update about Connect1d Canada!

      We are pleased to announce that the Data Transfer Agreement requirement for researchers to use Connect1d Canada is no longer in place. Interested research teams now only need Research Ethics Board approval to use the service.

      This provides much more flexibility and accessibility for the platform and we hope it will encourage many more research teams to list their studies on Connect1d Canada.

      Interested in finding out how Connect1d Canada can help your share your study with a diverse pool of people living with type 1 diabetes? Watch our video!

      Visit Connect1d Canada to learn more.

      Congratulations to Dr. Maureen Markle-Reid on Her Retirement

      We are pleased to celebrate the career of Dr. Maureen Markle-Reid, a Diabetes Action Canada investigator and a trailblazer in designing, implementing, evaluating, and scaling-up integrated and patient-oriented interventions to improve care and outcomes for older adults with multimorbidity (> 2 chronic conditions) including diabetes. She retired in January 2023 as a Professor in the School of Nursing at McMaster University after completing 30 years of service. Markle-Reid’s work has had an indelible impact in the field and she has trained a new generation of nurse-scientists who are dedicated to continuing this critical work.

      Markle-Reid was named the very first Canada Research Chair (CRC) in the School of Nursing in 2013 and completed a second 5-year term of her Chair in 2022.  She is one of only a handful of Nurses to hold a CRC. “It was truly and honor to hold a CRC, which provided me with a unique opportunity to focus primarily on my research and mentor the next generation of nurse scientists” she says. ‘After becoming a CRC, Dr. Jenny Ploeg and I were fortunate to secure funding from both CIHR and the Ontario Ministry of Health and Long-Term Care, and co-founded the Aging Community and Health Research Unit (ACHRU).”

      The overall goal of her research has been to improve the quality of life of older adults with multimorbidity and to support their care partners . This work was something Markle-Reid had felt drawn to from early in her career. Before completing her PhD, she had spent 10 years in front-line nursing and managerial positions in both the hospital and the home and community care setting. This experience provided her with first-hand knowledge of the gaps in the healthcare system, laying foundation for her future research program. “I was really interested in how to fix some of these problems to enhance the quality of life, not only of the older adult patients, but also to improve the quality of work life for the nurses.”

      Working with older adults was of particular interest to her, as she saw them often in her work but realized there weren’t a lot of people interested in gerontology in the same way she was. Working in hospitals, she thought about this fleetingly, but she says the lightbulb moment that would change her career happened after she transition from working in the hospital to working in home and community care. “I thought, wow, you can make such a difference to people’s lives. Seeing first-hand the care and support needs of older adults living with complex chronic conditions, and the role and value of nurses in meeting these needs was really eye-opening for me.”

      She has led or co-led numerous pragmatic trials of nurse-led interventions for older adults and their care partners in real-world practice. These interventions co-designed with older adults, care partners, and policy makers to increase the relevance of the interventions, and enhance the likelihood that the interventions will be adopted into real-world practice. 

      A key focus of Markle-Reid’s career has been to integrate the findings from her studies into practice and policy. She has worked collaboratively with over 150 organizations, and clinicians, policy makers, patients, and caregivers to produce research that directly responds to the information needs of these groups. Her work has had international and national impact and resulted in evidence-based solutions that address the challenges of multimorbidity. Having collaborated with more than 100 agencies, she and her team at ACHRU have formed solid partnerships and developed studies based on the needs and issues these agencies identified as areas of concern. “We were able to co-design, test, evaluate and then scale up a variety of interventions. The exciting part for me is that many of the interventions we’ve tested over the years have already been integrated into practice, and influenced policy,” she says. “Often, when we test these interventions, we are changing practice as we study it.”

      As part of Diabetes Action Canada, Markle-Reid and her team led the older adults research program, and DAC co-funded a CIHR-funded program of research focused on examining the implementation and effectiveness of a community-based self-management program for older adults with diabetes and multimorbidity, and assessing its scalability. A pragmatic randomized controlled trial in 2 sites each in Ontario and Alberta established the feasibility and preliminary effectiveness of the program. The goal of this CIHR-funded research program was to evaluate the intervention in more diverse settings in Ontario, PEI, and Quebec. In Scarborough, a suburb of Toronto. Diabetes centres have already started incorporating elements of these interventions into their work.

      With DAC, Markle-Reid was also able to continue to nurture her passion for patient-oriented research (POR) and patient engagement, something she was already doing before it even had a name. “The meaningful engagement of patients as research partners has totally enriched all our studies and the work we’ve done. The lived experience people bring to the table helps to shape the research and ensure it addresses the needs and concerns of patients and caregivers,” she says.

      A key goal of her research program has been to develop and mentor the next generation of leaders in the area of POR in aging. The ACHRU team has trained more than 40 undergraduate, graduate, and postdoctoral fellows who have gone on to secure prestigious awards, funding, postdoctoral fellows and faculty positions. One of her postdoctoral fellows, Dr. Rebecca Ganann, is now the Scientific Director at ACHRU and co-leading the Diabetes Action Canada older adults with diabetes research program. Markle-Reid hopes that more high-caliber trainees will consider a career in gerontology and aging research.

      Though she has at least a few more months of work to do as she transitions her research program to new leadership and finishes several studies, Markle-Reid is excited about the move towards fully retired life. She is looking forward to traveling and spending more time with her grandchildren. She may even follow in her parents’ footsteps and take up painting. While she will be missed in her role as a Nurse Scientist and co-lead in ACHRU and the McMaster Collaborative for Health and Aging, , she has left a legacy that will continue to benefit older adults for decades to come.