Current Projects – Canada

Managing Asthma with Tele-health Technology: A Feasibility Study (British Columbia)

Principal Investigator: Dr. Mark Fitzgerald

Co-Investigator: Dr. Richard Lester

The Asthma Telehealth project is a randomized trial testing the adaptation of the WelTel platform to link patients with moderate to severe asthma to their previously validated Asthma Action Plans, thus supporting outpatient self-management.

EmPhAsISEmpowering Pharmacists in Asthma management through Interactive SMS (British Columbia)

Principal Investigator: Dr. Mary de Vera

Co-Investigator: Dr. Richard Lester

This clustered randomized control trial at 75 pharmacies in BC is designed to examine whether an adaptation of the WelTel intervention into pharmacy’ services improves adherence to asthma medication.

Cedar Project: mHealth Study (British Columbia)

Principal Investigators: Patricia Spittal, Marin Schechter

Co-Investigator: Dr. Richard Lester

This project tests the feasibility, acceptability, and efficacy of using text messages to improve treatment adherence and resiliency for young First Nations people who are HIV-positive or at high risk of HIV.

WelTel Big River: Engaging people living with HIV and Hepatitis C in a text-message intervention (Saskatchewan)

Principal Investigator: Dr. Richard Lester

Co-Investigator: Dr. Stuart Skinner

This new study emerged from a CIHR/CTN funded Rural Engagement in HIV Care meeting of national researchers and stakeholders in Saskatoon in 2013, at which WelTel was voted as the highest priority research area. Additional funding was secured through CTN to initiate a pilot study using WelTel to improve engagement in HIV services in the northern First Nations community of Big River.

WelTel OAKTREE: Text Messaging to Support Patients with HIV/AIDS in British Columbia (British Columbia)

Principal Investigator: Dr. Melanie Murray

Co-Investigator: Dr. Richard Lester

Following a successful pilot study of the intervention at the Oak Tree Clinic, additional funding was secured by the Oak Tree team to recruit 100 participants for a further evaluation involving clinical outcomes one year before and one year after implementation of the intervention, as well as its cost-effectiveness.

University of Toronto - Postexposure Prophylaxis (Toronto)

Using text messaging to improve health system efficiencies in the treatment of latent tuberculosis (British Columbia)

Funder: CIHR Foundation Grant

Principal Investigator: Dr. Richard Lester

This is a dually funded project by the BC Lung Association and CIHR PHSI. It evaluates the effect of WelTel on treatment completion among patients with Latent Tuberculosis Infection (LTBI) in a randomized controlled trial at two TB clinics. The study includes a cost-effectiveness evaluation and stakeholder assessment for healthy system integration ( identifier: NCT01549457).

Engaging clients in the field: WelTel Outreach (British Columbia)

Funder: BCCDC Foundation for Public Health

Principal Investigator: Dr. Victoria Cook

Co-Investigator: Dr. Richard Lester

In this study, WelTel digital health platform will replace the existing practice of individual client-provider text messaging and immediate deletion as per agency policies, and will provide a secure, centralized platform where all text-message correspondence between team members and between clients and providers can be accessed by relevant TB Services clinicians with a user name and password with eventual upload to the clinical registry. The team will apply lessons learned from this pilot to pursue further application of the digital health platform in the area of Video Observed Therapy. The overarching goal of this proposed study is to support communications and delivery of care throughout the Lower Mainland.

WelTel Haida Gwaii (British Columbia)

Funder: Doctors of BC

Principal Investigator: Dr. Tracy Morgan

Co-Investigator: Dr. Richard Lester

This project will utilize a digital health technology in a primary care setting to improve access to care and self-management for patients diagnosed with one or more chronic illnesses (chronic obstructive pulmonary disease, congestive heart failure, diabetes mellitus and/or hypertension). This study will assess the impact of the technology on health indicators, including HbA1c and blood pressure, and self-efficacy and health-related quality of life.

Smart Text Analytic Tools (STAT) for analysis of patient-centred communications to strengthen health systems in BC (British Columbia)

Funder: Michael Smith Foundation for Health Research (MSFHR)

Principal Investigator: Dr. Richard Lester

Co-Investigator: Dr. Giuseppe Carenini

Healthcare stakeholders, including health authorities, facilities, pharmaceutical companies and insurers are increasingly acknowledging the importance of big data to enhance understanding of health behaviours and health systems. Existing analytic tools available to navigate the volume of diverse data types at a frequency that can match the speed at which data is generated are in early stages of development, and often lack validation due to limited access to health data. The ability of healthcare stakeholders to make sense of this valuable data is restricted by a lack of capacity and user-friendly analytic tools.

The UBC mHealth research group will further develop STAT into a minimum viable product that can analyze a variety of open natural language text data using natural language processing. This tool will allow both public health systems and private enterprise to streamline approaches to analyzing large volumes of text-based data.

Current Projects – Kenya

WelTel Kenya2

Principal Investigator: Dr. Richard Lester

This second phase ‘transition to scale’ project, Changing Global Health One Text at a Time, is co-supported by Grand Challenges Canada and Amref Health Africa. The aim is to scale-up the WelTel intervention in Kenya’s vast northern and arid lands as part of a government-hosted consortium of health-strengthening initiatives, using the Integrated InnovationTM framework (social, technological, and business innovation).

WelTel Retain

NIH Funded

Principal Investigator: Dr. Richard Lester

This randomized control trial ( identifier: NCT01630304) aims to assess whether the WelTel intervention improves retention in care in the first year of care after HIV diagnosis.

Grand Challenges

Principal Investigator: Dr. Richard Lester

To implement a text-messaging service (WelTel) to improve maternal and child health at several clinical sites across Kenya.

Grand Challenges

Principal Investigator: Dr. Richard Lester

To implement a text-messaging service (WelTel) for TB treatment adherence at several clinical sites across Kenya.

Current Projects – Global

WelTel Implementation Science

CIHR Foundation Grant

Principal Investigator: Dr. Richard Lester

This implementation science project is focused on culminating information gathered from our international sites who implemented WelTel during the COVID-19 pandemic. Our validated, published tool, mCFIR (modified Consolidated Framework for Implementation Research), can be used to survey the experience patients, health care practitioners, clinical implementation managers, external stakeholders, and policy makers had during WelTel implementation. The priority of this research project is to determine what facilitators and barriers were present during WelTel implementation and how they varied between our Canadian, Rwandan, and Kenyan sites. We anticipate being able to use this knowledge to optimize mHealth implementation at various future sites.

COVID-19 Public Health Monitoring

Operating Grant: COVID-19 Rapid Research Funding Opportunity

Principal Investigator: Dr. Richard Lester

Co-Investigators: Michael Li, Giuseppe Carenini, Carmen Logie

Our lab has been granted the opportunity to deploy the mHealth Tool, WelTel, in a variety of health care scenarios to assess its efficacy at managing public health and facilitating virtual care. The platform has recently implemented a function to manage contact tracing of patients, allowing both COVID-19+ patients and their close contacts to communicate virtually with health care practitioners during self-quarantine. This strategy has been implemented nationwide in Rwanda. We are also assessing virtual care capabilities in a variety of settings throughout Rwanda, Kenya, and Canada. MENTION STIGMA