NAME:
Andrea Burrows
PROGRAM:
Doctor of Philosophy in Nursing
RESEARCH SUPERVISOR(S):
Dr. Charlene Ronquillo
HOMETOWN:
Cranbrook, British Columbia
AWARDS:
UBC Okanagan Graduate Research Scholarship
UBC Okanagan Public Scholars
UBC Okanagan Nursing Leadership Development Award
UBC Public Scholars Award
RESEARCH DESCRIPTION
The rapid implementation and adoption of virtual care during the COVID-19 pandemic moved technology-led approaches to the forefront of healthcare interactions. Virtual care is communication between patients and healthcare providers remotely through patient-facing technologies (e.g. video, text messaging, email). Existing research focuses on the functionality and utilitarian aspects of virtual care, and often overlooks diverse perspectives of how and why virtual care is used. Prior to COVID-19, virtual care was used to augment perinatal home visiting programs, making these programs more accessible to pregnant women and new parents when travel restrictions limit in-person visits. However, the increase in virtual care functionalities has raised questions about the effectiveness and influence of equity considerations. To avoid a one-size-fits-all approach and perpetuate virtual inequities, an understanding of how and why virtual care fits the unique skills and needs of parents enrolled in home visiting programs can ensure equitable service delivery. In my dissertation research, I examine how virtual care is uniquely accessed by parents enrolled in perinatal home visiting programs such as Nurse-Family Partnership (NFP) in British Columbia (BC). At the intersection of technical and person-centred approaches using individualized care and task-technology fit theories, I explore how, for whom, and under what contexts virtual care works (or not) for parents in NFP. NFP is an internationally recognized evidence-based program, and operating in BC since 2011. The program pairs young parents experiencing low income with a public health nurse from pregnancy through the child’s second birthday, aiming to improve health and life outcomes. In my research, I use a collaborative community-based approach conducted in partnership with a project advisory committee comprising parents enrolled in NFP, NFP nurses, program operations, and the BC Ministry of Health. Over the next year, I plan to consult with NFP nurses and parents enrolled in the NFP program through interactive workshops to explore how virtual care fits with the health and social care needs and skills of families. At the same time, I plan to build on a 1-year engagement with a project advisory committee to understand what we have learned. The outcomes of my research will move us beyond technical tools toward an understanding of relationship-building in the context of virtual perinatal care in BC.
WHAT DOES BEING A PUBLIC SCHOLAR MEAN TO YOU?
To me, being a Public Scholar means a decentering of the researchers’ voice by engaging and working collaboratively with community citizens, knowledge users and policymakers. I believe that a collaborative partnership approach breaks down silos and cultures, increasing appreciation of each other’s worlds and perspectives. As Public Scholars, we facilitate the translation of research outcomes into practice, leveraging creative approaches to build solutions that fit the local context.
IN WHAT WAYS DO YOU THINK THE PHD EXPERIENCE CAN BE RE-IMAGINED WITH THE PUBLIC SCHOLARS INITIATIVE?
Research is a dialogue, constantly shaped and reshaped through community engagement. The Public Scholars Initiative brings doctoral students together to support collaboration and support as we seek to ask unconventional questions and pursue innovative approaches. Expanding networks to leverage curiosity and diverse perspectives increases opportunities for collaboration and subsequently leads to other projects. Raising the profile of public research encourages the university to recognize rigorous and diverse scholarship that can support real-world decision-making and have a direct impact on society.
HOW DO YOU ENVISION CONNECTING YOUR PHD WORK WITH BROADER CAREER POSSIBILITIES?
I see my PhD as a process of developing my research skills, honing my ability to critically evaluate traditional nursing knowledge and nurturing partnerships to work with in the future. The connections made through the Public Scholars Initiative will help expand my network, allowing me to tap into professional growth and innovative interdisciplinary collaborations. It is important to me that my PhD work has practical, real-world applications. Working with community partners towards community-led goals will help translate research into context-specific evidence that can be quickly taken up in practice and policy. My hope is that my PhD work and partnerships, alongside the connections I make through the Public Scholars Initiative, will subsequently lead to other journeys.
HOW DOES YOUR RESEARCH ENGAGE WITH THE LARGER COMMUNITY AND SOCIAL PARTNERS?
As a scholar and nurse, I am uniquely positioned to leverage academic resources and health system connections. In the field of health and social care for parents with young children, I believe that the role of a scholar should be that of collaborator, ally and supporter. My identity as a white settler Canadian woman, adds another layer of responsibility, driving me to critically examine the issues of whiteness, communication and power. Academia can provide a unique space for forming collaborative partnerships that foster transformational change. Yet, on a personal level, learning when to speak and when to listen, as well as embracing discomfort in navigating complex power relationships, can help me actively serve community needs.
HOW DO YOU HOPE YOUR WORK CAN MAKE A CONTRIBUTION TO THE PUBLIC GOOD?
In healthcare, the “17-year gap” is often cited as the time it takes for research findings to be fully integrated into routine clinical practice. Drawing from my experience as a point-of-care nurse, I believe research needs to be actionable and tailored to the local context. With this in mind, I envision my research contributing to the public good by enhancing our understanding of effective virtual care approaches. Virtual care delivery remains enthusiastically, albeit uncritically, promoted as a way forward in addressing gaps in healthcare delivery despite poor understanding of how such technologies are used by healthcare providers to support meaningful and person-centred care. It is my hope that the evidence generated from my research supports nurses to make informed decisions about what virtual care approaches work, for whom and in what contexts in ways that are guided by community members. Also, I hope it prompts discussion within the academy and health system around novel approaches to making and building connections online.
WHY DID YOU DECIDE TO PURSUE A GRADUATE DEGREE?
After earning my Master’s in 2012, I found work helping healthcare teams to ask questions about their practice and develop evidence-informed responses to improve practice. I joined a team that was looking into how virtual care changes the way nurses connect and interact with people. We quickly saw there was a lot we didn’t know. Energized by the support from the public health nursing team and partners in policy, I wanted to dig deeper and learn new skills. In a way, pursuing a PhD seemed to be a logical next step in my career as a scholar.
WHY DID YOU CHOOSE TO COME TO UBC OKANAGAN AND STUDY?
Motivated to advance health equity and eager to tackle the transformational potential of technology in nursing, I chose an academic environment that fits with my life and helps me grow. Amidst the challenges of the COVID-19 pandemic, I reconnected with my Master’s supervisor, which led me to meet my current supervisor, Dr. Ronquillo. I was drawn to Dr. Ronquillo’s work of health equity in the context of health technologies in the health system. Through Dr. Ronquillo’s mentorship, I continue to be exposed to a rich academic environment within UBCO and beyond. Further, the hybrid PhD in Nursing program at UBCO was an ideal fit for me. The transformational change we imagine comes from tackling thorny and complex healthcare issues. Applying a holistic approach enables us to better integrate and evaluate technology in nursing, communicate our findings effectively to policymakers, and, most importantly, empower those who experience marginalization.
Andrea Burrows is a UBC Okanagan Public Scholar. Learn more about the Public Scholars Initiative (PSI).