Medical Student Program Stream

Scientific Lead: Dr. Calvin Ke

Project Description: Type 2 diabetes (T2D) is defined as young-onset T2D (YOD) when diagnosed at age <40 years. The ethnically diverse young adults of Peel Region have among the highest rates of developing YOD in Canada. However, many people with YOD do not receive adequate education and care because services are currently not structured to meet the complex psychosocial and clinical needs of this working-age population. This study will aim to characterize the barriers to, and potential supports for, optimal care of YOD in Peel Region. This mixed-methods study will use concept mapping to generate cluster maps depicting the barriers to, and potential supports for, the optimal care of YOD. The study population includes ≈30 people with YOD and their care/service providers. The findings in the student’s first-authored peer-reviewed publication and lay language report will directly inform the development of a YOD management tool (earlydiabetes.ca) being implemented at Trillium Health Partners.

Scientific Lead: Dr. Laura Chiavaroli

Project Description: Ethnic high-risk populations have an elevated risk of diabetes. The PortfolioDiet.app is a validated health services tool for translation and implementation of the Portfolio Diet, a plant-based dietary pattern recommended by Diabetes Canada and the Canadian Cardiovascular Society for diabetes and cardiovascular risk reduction. To assess differences by ethnicity and various social determinants of health (SDoH) in the evaluation of the PortfolioDiet.app in the Peel community, in partnership with the Peel Food Action Council. We will gather quantitative data in 63 participants from the Peel community on the acceptability, knowledge acquisition, usability and cultural relevance of the PortfolioDiet.app will be analysed for differences by ethnicity and SDoH (e.g. sex, gender, age, education, immigrant status, employment, household income, marital status) using chi2 tests. Qualitative data from 42 participants will be analyzed for differences descriptively. Results will inform app modifications and shared with the Peel community for feedback.

Scientific Lead: Dr. Mavra Ahmad

Project Description: This study addresses the escalating rates of type 2 diabetes in the Peel Region by employing innovative tools to assess and monitor the food environment and understand residents' nutrition knowledge, attitudes and behaviours and dietary intakes. The goal is to inform policies that promote healthier environments. Applying a citizen science approach, the objective is to assess and address the barriers and facilitators to healthy food environments in the Peel Region. Through a mixed-methods study, participants will use an app to collect data on food environments in child-centric settings (e.g., recreational centers, schools), accompanied by surveys and dietary assessments. The anticipated results aim to understand diverse population groups' dietary habits, co-create a Mini Nutrition Report Card with citizen scientists to assess the status of Peel's food environment and relation to type 2 diabetes risk. Findings will act as a catalyst for locally informed recommendations to create healthier environments.

Scientific Lead: Dr. Terence Tang

Project Description: In Ontario, amputations (including those related to diabetic foot infections) affect those with low socioeconomic status disproportionately. In this project, we aim to address access barriers to patients with diabetes and foot ulcers to reduce rate of amputations in the Peel region. After conducting a scoping review of interventions that address access barriers for patients with diabetes and foot ulcers, we will conduct semi-structured interviews with people with lived experiences and frontline providers to understand current facilitators and barriers in our population. Leveraging findings from the scoping review and interviews, we will co-design with people with lived experiences, clinicians, and diverse health and social organizations and pilot change ideas that can reduce access barriers for people in our region. This summer, we are looking for a student to help in analysis of qualitative interviews and produce materials suitable for our co-design workshops.

Scientific Lead: Dr. Vasanti Malik

Project Description: To address the rising burden of type 2 diabetes (T2D) in Peel, we are conducting a 12-month community-based nutrition education intervention based on the Portfolio Diet (PD); a healthy eating plan that has shown clinically meaningful reductions in T2D risk factors. As an initial step, we will create nutrition education modules with input from a Community Advisory Committee comprised of diverse stakeholders from across Peel. The objective of this research is to create virtual nutrition education modules that promote the PD and healthful behavior change, and to obtain feedback from community members to ensure relevance and clarity. We will create short videos that cover topics to support adoption of the PD will be created and shared with the Community Advisory Committee for input on content and delivery. Feedback will be obtained using a mixed-methods survey that will inform revisions to the modules. Quantitative data will be analyzed descriptively and qualitative data will be analyzed thematically.

Scientific Lead: Dr. Ian Zenlea

Project Description: People who identify from Black, African and Caribbean (BAC) communities have a higher risk of type 2 diabetes (T2D) and related complications. This proposed study builds on community advocacy in T2D by mobilizing community agencies, service providers, researchers, and BAC caregivers (people who provide direct care for family members such as children, adults, or seniors) who have prediabetes, gestational diabetes, or T2D or who directly care for someone with T2D to co-design community- and family-based, culturally sensitive T2D prevention interventions for BAC comunities in Peel. The project activities include (1) assembling a community advisory board; (2) a literature review of community/family-based interventions that have been implemented and evaluated to prevent T2D in BAC communities; (3) photovoice workshops where participants will take photographs to document and reflect on their experiences visually; (4) generating actionable T2D prevention ideas in a community event; and (5) co-designing T2D prevention interventions in a Hackathon.

Scientific Lead: Dr. Gillian Booth

Project Description: Time spent in nature is associated with many health benefits, including a lower incidence of diabetes. Access to parks is therefore a key consideration in designing healthy cities and communities.  However, inequities in the distribution of quality parks may lead to lower rates of park use in lower income and racialized communities, where diabetes prevalence is high.

To understand inequities in access to high quality parks in Mississauga, the summer student will conduct in-person audits of Mississauga parks under the guidance of an environmental assessment expert at Western University, MAP Centre staff at St. Michael’s Hospital, and a team of other students. The data collected will then be linked to administrative data so the summer student can analyze whether park quality varies by neighbourhood-based income, race, and diabetes prevalence. The results of this project will be rolled into a park-based diabetes prevention study, and help future greening projects in Peel.