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About the Institute

Profile of Catherine Birken

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Dr. Catherine Birken

Dr. Catherine Birken, MD, M.Sc., FRCPC

  • Associate Scientist, Child Health Evaluative Sciences
  • Staff Paediatrician, Paediatrics
  • Assistant Professor, University of Toronto, Department of Paediatrics

1. Where are you from?/Where did you study?
I grew up in Toronto and I went to the University of Western Ontario for my undergraduate degree in psychology. After two years of study, I was accepted into medical school at the University of Toronto (U of T) and I’ve been at U of T ever since. 

After my medical school training, I completed a paediatrics residency at SickKids and then I served as Chief Resident at SickKids for a year. Following that, I did a fellowship in academic general paediatrics where I did a master’s degree in Clinical Epidemiology through the Institute of Policy, Management and Evaluation at U of T. I joined the staff at SickKids in 2004.

2. What are you researching right now?
My area of focus is obesity prevention in the early years. With my colleagues Dr. Patricia Parkin and Dr. Jonathon Maguire we developed TARGet Kids!, a primary care research network in Toronto where we, as the researchers, team up with paediatricians and family physicians at seven primary care sites across Toronto. There is a research assistant integrated into these practices, who involves children and families in TARGet Kids! at their annual well-child visit. 

We have recruited over 5,000 children so far. The idea is to understand child health, growth and development in the early years, and test interventions to improve their health. There is more and more research showing that if you make an impact early in a child’s life, you can have a more important impact overall. More and more research shows that early healthy behaviours help sustain healthy growth over time so that’s why we’ve focused on young children.

We’ve had a few studies come out looking at TV time in young children and how to promote healthy screen time. We know that screen time is related to obesity and it is likely due to children eating while they’re watching TV and not being mindful of their eating. We just published a randomized control trial where we provided some anticipatory guidance to families with three-year-old children about how to improve their screen time. We found that we could reduce the number of meals that kids are eating in front of the TV. We think that if we can work with families to develop healthy behaviours, it will translate into health overall.

The other study that I am focused on is a longitudinal study looking at early growth in young children and later cardiometabolic risk. We’re trying to understand how early diet and growth relates to risk of heart disease later in life. We believe that if we can understand the patterns of early growth, then that can have an impact on later growth. That study is called PROMOTE and it’s supported by the Canadian Institutes of Health Research.

3. Who is your all-time favourite scientist and why?   
In my studies of epidemiology I learned about Dr. John Snow, a physician in the 1800s, and his research really spoke to me. At that time in London, England there was a cholera outbreak and he used very keen observation skills to determine that the source of infection was likely the result of poor sanitation of a pump located in a particular area of London. I think he’s a really important researcher because his research had direct impact on the health of the population.

It’s very important that the research that I do has direct impact on child health. That’s the idea behind TARGet Kids. Researchers working directly with the practitioners in primary care who then translate evidence-based knowledge directly to children and families. The idea is embedded knowledge translation and the results go directly to inform practice. Dr. Snow was able to identify the source of the infection and translate that knowledge. The pump was closed and the cholera epidemic was resolved. His work had direct and quick impact.

4. What in your opinion is the most important scientific breakthrough and why?
An important scientific breakthrough in the last 10 to 20 years has been the concept of evidence-based medicine. That term was coined by Canadians at McMaster University in the early 1990s. The idea is that we need to develop evidence to inform primary care practice. It’s not good enough to have opinions but those hypotheses need to be tested in the clinical realm. Whether we’re comparing two drugs or comparing two psycho-educational interventions, the question needs to be ‘what’s going to have the best impact on child health outcomes?’

5. What are your major interests outside the lab?
Outside the community lab of TARGet Kids!? I have a wonderful family and three young children and that certainly keeps me busy. We enjoy being active as a family. We enjoy bike riding, playing baseball, skiing, skating and spending time with our extended family.

6. Why science?
I love the interaction that I have with my individual patients and their families and it’s very important to me to use the skills I have been trained in to practice medicine. I also love to think of child health in a population-minded way. The questions that we think about as physicians while providing care to our patients can be translated into hypotheses. Then, through research, we can answer those questions and translate the results to have direct impact on patient care.

I work with Dr. Jill Hamilton in the Sickkids Team Obesity Management Program (STOMP) clinic to treat obesity in children and teens. We’ve just started a program in STOMP to treat severe obesity in children under six. We are developing a model of care in collaboration with Toronto Public Health. Through this project we are integrating the work we do at SickKids and helping families apply that learning in their own neighbourhoods and communities. 

Many of the interventions to treat obesity in this age group relate to interventions for prevention. That’s an example of using skills as a health care provider and researcher, and finding integrated solutions for prevention and treatment, across different settings, and for both individual patients and populations of children.     

7. Why SickKids?
SickKids is an incredible place. We are surrounded by world-class clinicians, researchers and educators. I can speak for my own division of Paediatric Medicine, which I believe has such strength across all these domains. I feel very lucky to have the time to take some of the questions developed in clinical practice and be able to translate them into research questions that can be answered and translated back into clinical practice.

8. What is the most controversial question in your field right now?
I think there is more and more evidence that early intervention is very important and that the provision of anticipatory guidance for young children is becoming more and more important, yet there is a huge gap in the evidence. The questions of: ‘How best to intervene? When to intervene? How to promote health in young children?’ remain. I think the controversy is that we may not have the knowledge yet to know how to answer these questions and put the answers into practice, but parents and the public feel this is a priority.

9. What are you reading right now?
I just finished Joseph Anton: A Memoir by Salmon Rushdie which was fascinating. A must read.

I am also lucky to be re-reading some of the important books from my childhood with my own children. Last month I finished reading Charlotte’s Web with my seven-year-old which is an amazing book that talks about friendships. I’m reading the Harry Potter series with my nine-year-old which is a great fantasy and I’m reading Dr. Seuss with my four-year-old. One of my favourite Dr. Seuss books is Oh the Places You’ll Go. It is such an inspiring book of how a person’s journey can be challenging but ultimately if you believe in yourself you can go all the way.

10. If you could give one piece of advice to someone considering a research career, what would it be?
You have to do something that you love to do – everyone says that but it is true for me. You need to have an inquiring mind and be passionate about the work that you do. I also think it is really important to surround yourself with people who you respect and who you work well with. And patience and perseverance…(I’m still working on these two).

11. What does the SickKids Centre for Research and Learning mean to you?
I think one of the main objectives of the SickKids Centre for Research and Learning is to bring people together. I’m in Child Health Evaluative Sciences and our program has the opportunity to take some of the discoveries from the other programs and see if they can be tested in practice. 

The future of research at SickKids has to have a really important impact on child health and I think we have a really good opportunity to push that to the next level with our new Program Head Dr. Martin Offringa in CHES and our new Associate Chief of Clinical Research Dr. Colin MacArthur. Also, the physical environment of where you work is actually much more important than people think. It will be exciting and invigorating to work in an innovative and fresh and open space. I feel very inspired that this will all come together in an exciting way for child health.

December 2012

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