Applying GBA Plus to Concussion Prevention and Treatment
TEXT ON SCREEN: “Very little is known about how brain injury affects a woman’s body.” Dr. Angela Colantonio
Did you know that sex and gender influence our health?
Yet they are often overlooked when it comes to health research, practice and policy development.
ANIMATION: An office desk appears and then a desktop computer appears with a health icon on the desktop-computer screen. The health icon then turns into a book.
TEXT ON SCREEN: SEX
Gender-based Analysis Plus is an analytical process that assesses how diverse groups of women, men and gender-diverse people might experience government initiatives differently.
ANIMATION: GBA Plus logo appears. Stairs with three steps appear. A stick-figure with a briefcase walks up the stairs. A stick-figure holding a cane rises out of the top step. Another stick-figure walks up the stairs. Another stick-figure pushing a stroller stops at the bottom step and looks up.
TEXT ON SCREEN: ANALYTICAL PROCESS appears on the riser of the top step.
DIVERSE GROUPS OF PEOPLE appears on the riser of the middle step.
EXPERIENCE GOVERNMENT INITIATIVES appears on the riser of the bottom step.
It's an intersectional gender lens that takes into account sex and gender as well as other identity factors such as ethnicity, religion, age or disability.
ANIMATION: The camera cuts to a tablet on the desk. A hand turns on the tablet. A plus sign appears on the tablet screen. Several intersecting lines appear around the plus sign. The words Sex and Gender appear on the horizontal bar of the plus sign.
TEXT ON SCREEN: The following words fly out from the centre of the plus sign: GENDER LENS, and IDENTITY FACTORS
ANIMATION: Four new bars appear on the plus sign forming a pin-wheel. The following 10 words appear on each arm of the pinwheel: Ethnicity, Religion, Age, Disability, Geography, Culture, Income, Sexual orientation, Education, Race.
Concussions are a kind of traumatic brain injury.
They do not discriminate, affecting people of all ages and backgrounds.
ANIMATION: The hand swipes the tablet screen. An icon of a brain appears with a injured area of the brain that is pulsing/glowing. The hand swipes the tablet screen again. A animated calendar icon appears to represent age, and an animated globe appears to represent background.
TEXT ON SCREEN: TRAUMATIC BRAIN INJURY
PEOPLE OF ALL AGES AND BACKGROUNDS
But there are a number of identity factors that influence how people experience concussions.
ANIMATION: The camera cuts to the front view of the desktop computer. On the screen, puzzle pieces form the silhouette of a head. The puzzle pieces disappear and an injured brain icon appears inside the head silhouette.
TEXT ON SCREEN: NUMBER OF IDENTITY FACTORS
PEOPLE EXPERIENCE CONCUSSIONS
Let’s take a look at how we can apply GBA Plus to improve their prevention and treatment.
ANIMATION: The GBA Plus logo appears on a lens. The lens splits into 2 lenses. The words PREVENTION and TREATMENT appear on each of the lenses.
TEXT ON SCREEN: HOW WE CAN APPLY GBA Plus
Sex refers to our physical and physiological features.
ANIMATION: A box containing the word SEX appears and 6 icons appear around it. The 6 icons are: DNA strands, a brain, molecules, lungs, a head and a heart.
After a concussion, females have been found to experience more symptoms, poorer reaction time, and greater cognitive decline than males.
ANIMATION: A female stick figure appears with the injured brain icon inside the head. An up-arrow appears with the text MORE SYMPTOMS. An down-arrow appears with the text POORER REACTION TIME. Another down-arrow appears with the text GREATER COGNITIVE DECLINE that slides down the arrow.
Yet very little is known about how brain injury affects the female body specifically, since medical studies historically have used male animals or have not given explicit consideration to sex differences.
GBA Plus ensures that medical studies increasingly include male and female subjects.
ANIMATION: The camera cuts to the tablet on the desk. A hand turns on the tablet. An icon of a mouse in the male symbol appears. The “&” symbol and a male stick-figure appear beside the mouse. The GBA Plus logo appears above the tablet. Then an icon of a mouse in the female symbol appears and a female stick-figure also appears.
TEXT ON SCREEN: HOW BRAIN INJURY AFFECTS THE FEMALE BODY
STUDIES HISTORICALLY HAVE USED MALE ANIMALS
INCLUDE MALE AND FEMALE SUBJECTS
Consider gender. Gender refers to the socially constructed roles, behaviours, expressions and identities of individuals.
ANIMATION: The hand swipes the tablet screen. One stick-figure appears in the middle of the screen, and then more stick-figures appear.
TEXT ON SCREEN: The word GENDER appears in a box. The following words appear around the box: SOCIALLY CONSTRUCTED ROLES, BEHAVIOURS, EXPRESSIONS, IDENTITIES
There is a strong gender dimension to lifestyle choices and high risk behaviours that traditionally make men more likely than women to sustain injury, including concussions.
ANIMATION: The middle stick-figure remains on the tablet screen while 2 icons appear on either side of the stick-figure: A hockey helmet icon and an exclamation point to represent risk.
TEXT ON SCREEN: LIFESTYLE CHOICES AND HIGH RISK BEHAVIOURS
At the same time, it is a conservative estimate that more than one third of all women going into transition houses and shelters have had a traumatic brain injury.
ANIMATION: A piece of paper flies onto the desk and 9 female stick-figures appear. A fill-line fills more than 3 of the stick-figures and an injured-brain icon appears in each of these stick-figures to represent "more than a third of women".
TEXT ON SCREEN: IT IS ESTIMATED THAT OVER ONE THIRD OF ALL WOMEN
TRAUMATIC BRAIN INJURY
GBA Plus ensures that the impact of gender on incidence and recovery are considered.
ANIMATION: Another piece of paper flies onto the desk with an image of a female stick-figure undergoing an MRI exam.
TEXT ON SCREEN: IMPACT OF GENDER ON INCIDENCE AND RECOVERY
Consider how sex and age intersect, creating additional challenges.
ANIMATION: Another piece of paper flies onto the desk. Puzzle pieces form the silhouette of a head. The words SEX and AGE are on 2 of the puzzle pieces.
The highest incidence of concussion is found among children and adolescents.
Young children of both sexes have similar concussion rates and symptoms.
ANIMATION: Another piece of paper flies onto the desk. Photos of a female child, a male child, a male adolescent and female adolescent appear on the paper. The camera zooms to the photos of the children. A horizontal bar with an equal sign expands next to each child. The bars are the same length and have equal signs to represent that male and female children have similar concussion rates.
TEXT ON SCREEN: CHILDREN
THE HIGHEST INCIDENCE OF CONCUSSION IS FOUND
BOTH SEXES HAVE SIMILAR CONCUSSION RATES
However, with the onset of puberty, females increasingly experience more concussions, different and more severe symptoms, and are often slower to recover from the injury.
ANIMATION: The photos of the adolescents replace the photos of the children. A horizontal bar expands next to each adolescent. The bar next to the female grows longer than the male to represent that female adolescents have higher concussion rates.
TEXT ON SCREEN: FEMALES EXPERIENCE MORE CONCUSSIONS
DIFFERENT AND MORE SEVERE SYMPTOMS
SLOWER TO RECOVER FROM THE INJURY
The symptoms of both sexes begin to converge again after females go through menopause.
ANIMATION: Photos of older adults appear. One female and one male, with horizontal bars growing next to each adult photo. The bars are the same length and are shorter than the adolescent bars.
TEXT ON SCREEN: THE SYMPTOMS OF BOTH SEXES BEGIN TO CONVERGE AGAIN
Applying GBA Plus to research will help us better understand the relationship between sex, gender and other identity factors, allowing us to develop more targeted health policy and training.
ANIMATION: Another piece of paper flies onto the desk. The GBA Plus logo animates on the paper. A new plus sign spins out from the plus sign in the GBA Plus logo as the GBA Plus logo disappears. Several intersecting lines appear around the plus sign. The words Sex and Gender appear on the horizontal bar of the plus sign. Four new bars appear on the plus sign forming a pin-wheel. The following 10 words appear on each arm of the pinwheel: Ethnicity, Religion, Age, Disability, Geography, Culture, Income, Sexual Orientation, Education, Race.
TEXT ON SCREEN: TARGETED HEALTH POLICY AND TRAINING
For example, the Canadian Institutes of Health Research asks researchers who apply for funding to indicate if and how sex and gender are integrated into their research design.
This ensures that sex and gender are taken into account in research that aims to improve
ANIMATION: The camera pans over to a clipboard. The words FUNDING APPLICATION appears on the clipboard paper as the application is being filled out. The camera pans to a stack over paper on the desk. The word RESEARCH appears on the stack of paper.
TEXT ON SCREEN: CANADIAN INSTITUTES OF HEALTH RESEARCH
SEX AND GENDER
SEX AND GENDER ARE TAKEN INTO ACCOUNT
prevention, diagnosis and treatment for populations most at risk of concussions, including diverse
prevention, diagnosis and treatment for populations most at risk of concussions, including diverse groups of children, youth, women, and seniors.
ANIMATION: The camera cuts to the front-view of the desktop computer. Three up-arrows appear. Each arrow contains an icon representing the following themes: prevention; diagnosis; and treatment.
TEXT ON SCREEN: IMPROVE PREVENTION, DIAGNOSIS AND TREATMENT FOR POPULATIONS
ANIMATION: Photos of diverse people appear on screen.
TEXT ON SCREEN: DIVERSE GROUPS OF CHILDREN, YOUTH, WOMEN, AND SENIORS
What we are learning about the role of sex, gender and age in the prevention and management of concussions could be applied to awareness and prevention of a broad range of issues,
ANIMATION: The icon of a brain appears with an injured area of the brain pulsing/glowing as words from the narration appear around it.
TEXT ON SCREEN: LEARNING ABOUT THE ROLE OF SEX, GENDER AND AGE
such as illness, gender-based violence, safety, or sports injuries.
ANIMATION: Three icons appear representing the following themes: illness, gender-based violence, and sport safety.
TEXT ON SCREEN: ILLNESS, GENDER-BASED VIOLENCE, SAFETY, OR SPORTS INJURIES
Use GBA Plus to examine the intersecting identity factors of diverse groups of people so that your initiatives are effective and inclusive.
ANIMATION: A stick-figure appears inside a circle with several intersecting lines moving all around it. The GBA Plus logo appears.
TEXT ON SCREEN: INTERSECTING IDENTITY FACTORS
DIVERSE GROUPS OF PEOPLE
EFFECTIVE AND INCLUSIVE
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TEXT ON SCREEN: VISIT
TEXT ON SCREEN: Copyright Her Majesty the Queen in Right of Canada, as represented by the Minister of Status of Women, 2018
TEXT ON SCREEN: Canada wordmark with waving flag
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