HERON Lab Current Projects

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Neurological conditions in British Columbia: A population-based study

Principal Investigator: Dr. Scott Ramsay RN, PhD

Purpose

For the first time in BC, this project aims to create case definitions in the BC context for traumatic brain injury (TBI), acquired brain injury (ABI), and spinal cord injury (SCI) using linked data consisting of hospital, ambulatory, and primary care electronic medical record (EMR) data. In doing so, the project will (1) create EMR and administrative data case definitions; (2) identify scope (incidence and prevalence rates) of neurological injuries; (3) quantify health service use, hospitalization (i.e., admissions, length of stay, and bed days per year) of cases with a neurological injuries; and (4) assess the relationship between having a neurological injury and outcome.

Impact

A comprehensive understanding of rates and trends in neurological conditions—including associated hospitalization patterns and re‑admittance—will help identify critical gaps and opportunities to strengthen care delivery in British Columbia. Study findings will offer meaningful insights for healthcare professionals, policymakers, stakeholder groups, and researchers, informing strategies to optimize the use of acute care resources and guide evidence‑based policy changes. Given the limited research in this area and the need for stronger evidence on how specific neurological conditions affect acute care services, the outcomes of this work will extend beyond the provincial context, contributing to national and international efforts to improve care for individuals with neurological conditions.

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Looking for ANSwers in the autonomic nervous system of children and adolescents with a concussion

Principal Investigator: Dr. Scott Ramsay RN, PhD

Purpose

Concussions are a significant health issue for children and youth. Symptoms can last much longer than previously believed, often months or even years after injury. Dysfunction of the autonomic nervous system (ANS) after a concussion has been proposed as a contributing factor to these persistent concussion symptoms. However, the impact of ANS dysfunction following pediatric concussion is undetermined in children 16 years of age and younger. Therefore, the proposed study seeks to assess ANS function via cardiovascular responses in children diagnosed with concussion compared to age-matched controls, and to examine the correlation between ANS dysfunction and duration of concussion symptoms.

Impact

Findings from this study will inform healthcare professionals, community members, and researchers by highlighting the critical need to better understand the role of the autonomic nervous system (ANS) in pediatric concussion. The results will support the development of evidence-informed concussion management protocols that specifically target ANS dysfunction. Ultimately, this work will advance our overall understanding of pediatric concussion, improve symptom management, and contribute to the creation of age‑appropriate, effective interventions.

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You-CAN SHRed Concussions: Canadian youth informing best practice and policy in the prevention of sport-related concussions

Co-Principal Investigator: Dr. Scott Ramsay RN, PhD

Purpose

Each year, 1 in 9 youth aged 14–24 sustains a concussion, with the majority of these injuries occurring in sport. Many experience multiple concussions, and up to one‑third face symptoms that persist for months. The You‑CAN SHRed Concussions Program brings together two successful Canadian concussion initiatives, You-CAN (Youth Concussion Awareness Network) and SHRed Concussions (Surveillance in High School and Community Sport to Reduce Concussions and their Consequences), to address this urgent public health issue by engaging equity‑deserving youth—including Indigenous, racialized, rural, 2SLGBTQIA+, girls, and Parasport communities—in the co‑design and evaluation of concussion prevention strategies and peer‑led education. The program also empowers youth to lead awareness campaigns, provide peer support following injury, and contribute to the development of sustainable, long‑term solutions for concussion prevention and management.

Impact

This innovative, youth‑driven approach will inform best practices and policy development aimed at reducing sport‑related concussion rates and improving outcomes for underrepresented youth across Canada. By centering the voices and experiences of equity‑deserving young people, the program will strengthen concussion education, enhance prevention strategies, and support more inclusive, community‑driven models of concussion awareness and care.

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Community engagement with the Community Brain Injury Program for Children and Youth (CBIPCY)

Principal Investigator: Dr. Scott Ramsay RN, PhD

Purpose

This study aims to understand the services and supports accessed by children and their families following an acquired brain injury (ABI) diagnosis. It explores the types of treatments pursued and captures families’ experiences throughout the recovery journey.

Impact

The findings will provide valuable insight into how children and families navigate care after an ABI diagnosis. This knowledge will help identify gaps in services and inform future research and initiatives aimed at improving support and outcomes for this population.

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Pediatric clinician-scientist: Making known these dual roles

Co-Principal Investigator: Dr. Scott Ramsay RN, PhD

Purpose

This study aims to generate evidence that supports the development and implementation of the clinician‑scientist role within nursing and allied health. Specifically, it will: (1) provide context‑specific recommendations for health authorities and educational institutions, and (2) establish foundational data required to inform a pilot model for nursing and allied health clinician‑scientists. Together, these outcomes will contribute to strengthening workforce capacity and advancing the integration of clinical practice and research.

Impact

Findings from this study will provide health authorities and educational institutions with clear, context‑specific guidance to support the development of clinician‑scientist roles within nursing and allied health. By generating foundational data and evidence-informed recommendations, this work will help shape workforce planning, strengthen capacity for embedded research, and inform the design of pilot clinician‑scientist programs. Ultimately, the study will contribute to building a more integrated health system in which clinical practice and research are closely connected, improving care delivery and advancing innovation across the sector.

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Bridging divides: Concussions among migrant youth

Co-Principal Investigator: Dr. Scott Ramsay RN, PhD

Purpose

Concussions, or mild traumatic brain injuries (mTBI), are among the most frequently sustained injuries in youth across Canada, yet little is known about how these injuries affect migrant youth. This study seeks to address this gap by examining the occurrence, experiences, and impacts of injuries and concussions among migrant youth.

Impact

This project represents an essential first step in building foundational knowledge about concussion in migrant youth—an area where evidence is notably limited. Findings will help identify key gaps and inform future research aimed at developing culturally relevant education, resources, and supports. Over time, this work will contribute to improving concussion awareness, care, and outcomes for migrant youth across diverse communities.

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AI x Team-based care

Co-Principal Investigator: Dr. Scott Ramsay RN, PhD

Purpose

This project aims to examine how artificial intelligence (AI) has been conceptualized, designed, and studied as a support for team‑based work in healthcare. By mapping existing approaches, the study will identify the ways AI technologies are intended to function within collaborative care environments and how they influence interactions among team members.

Impact

Findings from this study will clarify how AI can most effectively enhance team‑based work by operating at the interfaces between team members—facilitating shared information, coordinating roles and tasks, and supporting collective decision‑making. Insights gained will help guide the development and evaluation of AI tools that strengthen collaboration in healthcare teams, ultimately improving care coordination and supporting more efficient, informed, and integrated clinical practice.

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Childhood Research on Overcoming Obstacles With Neurotrauma (CROWN) Van

Principal Investigator: Dr. Scott Ramsay RN, PhD

Purpose

The Childhood Research on Overcoming obstacles With Neurotrauma (CROWN) project is bringing concussion research out of traditional research settings and directly into communities. Through the mobile CROWN van, researchers will bring advanced brain-health and physiological assessments to children and adolescents in Indigenous, racialized, 2SLGBTQIA+, rural, and Northern communities—groups that have historically faced significant barriers to participating in research. For families in rural and Northern communities, participation can mean travelling hours to a research centre, with substantial financial and time costs. Indigenous and racialized communities may also face accessibility barriers, structural inequities, and historical mistrust of traditional research environments. By meeting children and families where they are, CROWN aims to overcome these barriers through a community-based, culturally responsive approach to research and build a more inclusive understanding of brain health and recovery following pediatric concussion.

Impact

Who participates in research shapes what we know about concussion—and who ultimately benefits from that knowledge. Pediatric concussion research has historically failed to represent many of the children and adolescents it is intended to serve, including research in which males have accounted for approximately 80% of participants. CROWN directly addresses these inequities by making advanced concussion research accessible to communities that traditional research models have too often excluded. A more representative understanding of concussion and physiological outcomes will help identify meaningful markers of brain health, inform the development of targeted interventions, improve diagnosis and recovery, and reduce the risk of recurrent concussion. More than a mobile research lab, CROWN represents a shift toward a community-based model of pediatric concussion research in which equitable participation is not simply convenient—it is essential to producing research that can improve outcomes for every child.

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Athletic Health Equity & Injury Tracking (ATH-EQUITY) Study

Principal Investigator: Dr. Scott Ramsay RN, PhD

Purpose

Our current understanding of sport-related concussion (SRC) comes largely from studies in adults, leaving important gaps in what we know about concussion outcomes and long-term effects in children and adolescents. This is particularly concerning because childhood and adolescence are critical periods of ongoing neurodevelopment. ATH-EQUITY will follow youth at risk for persistent symptoms after concussion to better understand the natural history of youth concussion and identify biomarkers that can improve diagnosis and help predict recovery. Through partnerships with local organizations and communities, the project will engage youth in settings that reflect their experiences and help ensure the research reaches the populations it is intended to serve.

Impact

Findings from ATH-EQUITY will provide the evidence needed to strengthen concussion prevention, diagnosis, prognosis, and treatment for children and adolescents. Better diagnostic and prognostic tools will support clinical decision-making, while improved prevention programs and treatments have the potential to reduce the number of sport-related concussions, speed recovery, and lessen short- and long-term consequences. Ultimately, this work aims to enable more youth to return to health and daily activities—including school, work, and sport—while improving quality of life, reducing disability associated with concussion, and decreasing its direct and indirect costs.

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Nurse-led Telehealth Use for Pediatric Concussion: A Feasibility Study

Principal Investigator: Dr. Scott Ramsay RN, PhD

Purpose

This study will assess the feasibility, acceptability, and preliminary clinical significance of a nurse-led telehealth intervention for children and adolescents recovering from concussion. Through virtual follow-up, nurses will systematically monitor post-concussive recovery using evidence-based measures while providing individualized care and identifying ongoing challenges that may affect recovery. The study will examine families’ willingness to participate, their completion of the intervention, their experiences with nurse-led telehealth care, and health-related quality of life following concussion.

Impact

Access to timely concussion follow-up remains a significant challenge, particularly for children and families living in rural, remote, and resource-limited communities. Telehealth offers an opportunity to extend concussion care beyond traditional clinical settings while reducing the travel and physical exertion that may exacerbate symptoms during recovery. By evaluating a nurse-led model of virtual follow-up, this study will provide important evidence on whether accessible, individualized concussion care can be successfully integrated into pediatric outpatient practice. Ultimately, this work could support a more equitable and sustainable approach to monitoring recovery, identifying children who require additional support, and improving access to concussion care across geographically diverse communities.