We are thankful to be welcome on these lands in friendship. The lands we are situated on are covered by the Williams Treaties and are the traditional territory of the Mississaugas, a branch of the greater Anishinaabeg Nation, including Algonquin, Ojibway, Odawa and Pottawatomi. These lands remain home to many Indigenous nations and peoples.

We acknowledge this land out of respect for the Indigenous nations who have cared for Turtle Island, also called North America, from before the arrival of settler peoples until this day. Most importantly, we acknowledge that the history of these lands has been tainted by poor treatment and a lack of friendship with the First Nations who call them home.

This history is something we are all affected by because we are all treaty people in Canada. We all have a shared history to reflect on, and each of us is affected by this history in different ways. Our past defines our present, but if we move forward as friends and allies, then it does not have to define our future.

Learn more about Indigenous Education and Cultural Services

Search the:

Apply Donate Crisis Centre

Past Projects

The Ontario Tech University Mental Health and Wellness Study

Today’s university students will be tomorrow’s workforce. However, an epidemic of back pain and mental health problems is disabling undergraduate students, and little is known about the causes of this problem. In partnership with the Canadian Mental Health Association-Durham, Professor Côté secured funding from the Ontario Trillium Foundation and the Canadian Association of College and University Student Services to develop a program of epidemiologic research aimed at understanding the burden and risk factors for disabling pain and psychological distress in university students. To date, Côté and his team have completed two systematic reviews on the association between physical activity, sleep quality and mental health in undergraduate students; conducted a pilot study; and conducted a cross-sectional study of students enrolled in Ontario Tech University’s faculties of Health Sciences and Education, and CMCC.

Professor Côté has supervised four Master of Health Sciences (MHSc) students at Ontario Tech University (Nayantara Hatagandi, Nancy Fynn, Andrew Reynolds and Michael Short) and served on the thesis committee of two post-graduate residents at the CMCC (Lydia Brodie and Christine Meckamalil). The project involved collaborators from:

Ontario Tech University:
- Faculty of Health Sciences: Dr. Lori Livingston, Dr. Efrosini Papaconstantinou and Dr. Shilpa Dogra
- Faculty of Education: Dr. Jennifer Laffier
- Faculty of Social Science and Humanities: Dr. Tyler Fredrick
Ontario Shores Centre for Mental Health Sciences: Dr. Krystle Martin
CMCC: Dr. Sheilah Hogg-Johnson
University of Alberta: Dr. Linda Carroll

To date, this project has led to two peer-reviewed publications and the funding of the Sustainable University Life (SUN), a large cohort study of university students from Stockholm Sweden, at the Karolinska Institutet where Professor Côté is a co-principal investigator.

Evidence-based practice guidelines for traffic injuries in Ontario

Professor Côté was the Principal Investigator (PI) of the Ontario Protocol for Traffic Injury Management Collaboration (OPTIMa), a project that developed evidence-based clinical practice guidelines for the management of common traffic injuries. Côté received a $2.8 million peer-reviewed grant from the Ontario Government for this work. To meet the project’s goal, Côté convened a panel of local, national and international experts; led more than 40 systematic reviews; and guided the development of evidence-based recommendations. Côté’s report, entitled Enabling Recovery from Common Traffic Injures: A Focus on the Injured Person, was submitted to the Ontario Minister of Finance to guide reforms of the Ontario automobile insurance system. Côté’s report was influential in informing the study led by David Marshall who was appointed as a Special Adviser to the Minister of Finance to review and make recommendations to improve the system of auto insurance in Ontario. This research involved two trainees supervised by Côté: Maja Stupar (postdoctoral fellow, Ontario Tech University) who developed a clinical prediction rule for the recovery of whiplash; and Rachel Goldgrub (MHSc, Ontario Tech University) who conducted her thesis on the rehabilitation of shoulder injuries. More than 30 papers resulted from this research and were published in leading journals (Spine Journal, Physical Therapy, JOSPT, Clinical Journal of Pain, Manual Therapy, European Journal of Pain and European Spine Journal) and presented at international meetings in Australia, France, Germany, Sweden and the USA.

Whiplash Intervention Trial

Professor Côté was the PI of a multicentre randomized clinical trial to evaluate the effectiveness and cost-effectiveness of an Ontario government-regulated rehabilitation guideline for the treatment of acute whiplash injuries. The guideline was compared to care by general practitioners, and to a preferred-provider insurance-based rehabilitation program. This study, which included 340 participants, was the first Canadian trial to evaluate the effectiveness of a government-regulated guideline for whiplash. The study found that the government guideline was effective in promoting faster and slightly more cost-effective recovery compared to the comparison groups. The results were presented to the Superintendent of the Financial Services Commission of Ontario (Branch of the Ontario Ministry of Finance responsible for the regulation of automobile insurance) to guide the reform of the Ontario automobile insurance system. The trial was funded by grants from Aviva Canada ($2,706,767) and CIHR ($88,416) and supported the PhD thesis of Maja Stupar (PhD, Clinical Epidemiology, University of Toronto). The manuscript was published in BMJ Open in 2019.

Management of lumbar spinal stenosis: Clinical Practice Guideline

Lumbar spinal stenosis is increasingly common with an aging population, and can be associated with significant disability. The CDPR developed an evidence-based clinical practice guideline for the non-surgical care of people with lumbar spinal stenosis. This guideline can contribute to preventing and limiting the burden of musculoskeletal disability in the aging population. The manuscript is under preparation. The research and technical team are interdisciplinary (medicine, orthopedic surgery, physiotherapy, chiropractic), international (Canada, U.S., Denmark) and includes trainees (master's, PhD and postdoctoral levels).

Post-surgical rehabilitation for low back pain: an integrated systematic review and evidence synthesis

Surgical rates for low back pain have been increasing. Many patients treated surgically will require post-surgical rehabilitation. Little is known about the effectiveness of post-surgical rehabilitation interventions on health outcomes, or about patients’ experiences with these interventions. With funding from the Eurospine Task Force on Research, we are conducting a systematic review and evidence synthesis of quantitative and qualitative studies regarding the effectiveness of post-surgical rehabilitation interventions; and the experiences of patients, health-care providers, caregivers, or those involved with the rehabilitation. We will disseminate findings with national and international decision makers. The research team is interdisciplinary (medicine, spinal surgery, physiotherapy, chiropractic, nursing), international (Canada, U.S., Portugal) and includes trainees (master’s, PhD and postdoctoral levels). The study protocol was published in BMJ Open 2020.

Development of an evidence-informed self-management tool for low back pain adapted for the Tobique First Nation, Canada: a pre-implementation qualitative case study

Clinical practice guidelines for the management of low back pain recommend that education and self-management are the first line of patient management. The World Health Organization has identified Indigenous people as having poorer health compared to the general population. Indigenous communities are underserved with respect to services (e.g. health care) and appropriate evidence-based information, which may contribute to this inequality. Using integrated knowledge translation, we developed a low back pain self-management tool for the Tobique First Nation. We implemented the tool for a period of time and then interviewed patients and health-care providers regarding the usefulness of the tool and any barriers to using it. We will use this information to further modify the tool. Using a similar approach, we would like to develop other self-management tools for this community for conditions such us neck pain; headache; shoulder and arm pain; hip and lower extremity pain; post-concussion symptoms; and osteoarthritis. We also aim to take what we have learned form this experience to develop relationships with other Canadian Indigenous communities and work with them to identify their needs regarding managing a variety of musculoskeletal conditions and how we might help. The research team includes trainees (bachelor's and master’s levels).

Chiropractic services in the Canadian Forces Health: Exploring opportunities and barriers

This study is funded by grants from the Canadian Chiropractic Association and Ontario Chiropractic Association ($600,000) to identify barriers and enablers for the integration of evidence-based chiropractic services within the Canadian Armed Forces. It is divided into two phases:

Phase I: A qualitative study was conducted to inform the development of a model of care that includes chiropractic services for the management of back pain. The results identified challenges, opportunities and preferred outcomes in implementing a model of care. The resultant findings were published in Military Medicine.
Phase II of the project is assessing the implementation of the model of care developed.

The model was introduced in two bases, CFB Trenton and CFB Comox, and currently in data collection. The project is conducted collaboratively with the Canadian Armed Forces Director of Health Care Services and involved regular meetings at the Canadian Armed Forces Headquarters in Ottawa. In addition, co-investigators include faculty from Ontario Tech University, CMCC, New York University, University of Toronto and Macquarie University. The project has also involved graduate students at CMCC, including one who conducted site research in Phase II.

Assessing patient-centred care in patients with chronic health conditions attending chiropractic practice: a mixed methods study

Patients with chronic health conditions tend to have different health-care needs than those in acute care. Health-care reform is increasingly focusing on patient-centred care for those with both acute and chronic health conditions. In patient-centred care, the goals and needs of patients are prioritized rather than emphasizing doctor or institutional-centred care. Chiropractic is a profession that has been historically considered as being patient-centred. Furthermore, chiropractors regularly see patients with chronic health conditions. However, to date there have been no studies that assess the degree to which chiropractic care for patients with chronic conditions is patient-centred. This study will fill this important gap and provide information from the perspectives of both patients and chiropractors on patient-centredness. This project forms part of Dr. Kent Stuber’s PhD thesis, involving collaborators from University of South Wales, and Dr. Mior sits on the committee. Two papers have already been published from this work.

Advancing patient safety for special poulations: active surveillance reporting to identify adverse events following chiropractic care in older adults

Advancing patient safety for special populations: active surveillance reporting to identify adverse events following chiropractic care in older adults. In Canada, almost 19 per cent of chiropractic patients are aged over 65 years. Although most of patients aged 65 years or older seek care for musculoskeletal conditions (such as back, neck and lower limb pain), there is inadequate prospective data on the safety of chiropractic care for these patients and the frequency of potential associated adverse events remains unknown. Our study will investigate changes in symptoms reported by older adults receiving chiropractic care, with a focus on safety. We will calculate the frequency of reported adverse events following chiropractic care; and explore patient and provider factors associated with reported changes in symptoms. We will recruit a convenience sample of 30 Canadian community-based chiropractors, who will be asked to collect data from 30 consecutive older adult patients presenting to their office using a validated electronic active surveillance reporting system (modified from SafetyNET). For the first time, an established and validated electronic active surveillance reporting system will be used to investigate adverse events reported by a special population of older chiropractic patients in a community-based chiropractic setting. This project is funded by CSRF ($50,000) and led by Dr. Funabashi at CMCC and Mior is a co-investigator. It includes others from Parker University, Macquarie University and the Memorial University.