The BHI Casebook

What does cross-cutter implementation look like in practice? The Catalyzing Research Excellence and Impact: The Brain-Heart Interconnectome Cross-Cutter Implementation Casebook addresses this very question.

This casebook features five BHI-funded research teams sharing what it’s really like to integrate the cross-cutters into their brain-heart research. Together, the cases show the various ways cross-cutters can be implemented across many types of research, whether basic science, clinical studies, or participatory community-based studies.

Each case study provides:

Practical examples of how specific cross-cutters are integrated and implemented throughout the research process across various research types

Honest reflections on the challenges teams faced and how they overcame them

Real impact on the research and the people involved

Lessons learned

Whether you are a researcher, trainee, patient partner, or knowledge user, this casebook offers inspiration and guidance for conducting co-produced, inclusive, and impactful research.

Additional Resource

Want to easily explore and compare how each research team put cross-cutters into practice? The tables below offer a snapshot of how each team integrated the cross-cutters into their research.

Organized around the 5Ws and How, these tables break down what cross-cutters were implemented, who was involved, when in the research process each was applied, where the work took place, why they chose to implement the given cross-cutters, and how they put them into action.

This resource was created by Meghan Masztalar RN, BScN, University of Ottawa School of Nursing.

This condensed overview is intended to support cross-cutter integration, for a deeper look at each team’s approach, including their reflections and lessons learned, read the full cases in the casebook! (PDF, 1.3MB)

Compare Cases

From bench to bedside: Integrating cross-cutters into complementary basic science and clinical research
WHAT cross-cutters?	Patient Engagement Open Science Indigenous Engagement Training and Mentoring
WHO is involved?	Researchers: Hanns Lochmüller, CHEO Research Institute, University of Ottawa, Ottawa Hospital Research Institute Sally Spendiff, CHEO Research Institute Heather Howley, CHEO Research Institute Tamara Burgess, CHEO Research Institute Trainee: Caroline Part, University of Ottawa		Patient Partners: Two patient partners, both parents of children with DM1, including Angela Woollam
WHEN in the research process?	Cross-cutter	Planning		Conduct	Dissemination
	Patient Engagement	X		X	X
	Open Science	X			X
	Indigenous Engagement	X
	Training and Mentoring	X		X	X
WHERE is the research taking place?	Research Setting: Laboratory and clinical-based Population of interest: Pediatric and adult patients with DM1 Geographical location: Ottawa, Canada
WHY implement the cross-cutters?	It makes research and its results more meaningful for people living with DM1. It helps patient partners learn more about basic and clinical research and build news skills in research and beyond. It ensures that the research is focused on what matters most to the DM1 community. It helps turn research results into real-world benefits for people with DM1. It strengthens trust and collaboration between researchers and patient partners.
HOW are they being implemented?	Patient Engagement Pre-clinical and clinical research: Patient partners are equal members of the research team. Patient partners contributed to the development of the research proposals. Patient partners provide feedback on methods. Patient partners help develop study materials and data collection tools. Patient partners take part in presentations and publications. Training modules developed by the team are provided to help patients learn and build confidence and skills in research (imPORTND). Lab days invite patients into the laboratory to see how pre-clinical research is done.
	Open Science Pre-clinical and clinical research: Uses best practices, FAIR principles to ensure their data is findable, accessible, interoperable, and reusable. Registers their study protocols on open access platforms. Publishes research results in open access journals.
	Indigenous Engagement Pre-clinical research: Considers ethical responsibilities in animal research by following the 3Rs’ of animal research, Replace, Reduce, and Refine to limit animal use and harm. Reflects on Indigenous values related to respect for life and responsible research practices. Uses alternative methods, such as lab-grown human cells, to study the brain-heart connections instead of relying on animal models, when possible.
	Training and Mentoring Pre-clinical and clinical research: Provides close mentorship to trainees to build their knowledge, skills, and confidence to become independent researchers. Encourages and supports trainees to take part in training opportunities, within the Brain-Heart Interconnectome and beyond.

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Collaborating for recovery: Co-producing and mobilizing research about prescribed exercise on the recovery of adults with concussions
WHAT cross-cutters?	Co-production/Knowledge Mobilization (KMb) Patient Engagement Open Science
WHO is involved?	Researchers: Roger Zemek, CHEO Research Institute, University of Ottawa, Ottawa Hospital Research Institute Nick Reed, University of Toronto Jennifer Dawson, CHEO Research Institute Katherine Wilson, University of Toronto		Patient Partners: 12 patient partners and caregivers Other knowledge users: Clinicians who provide concussion care TRANSCENDENT Concussion Research Program
WHEN in the research process?	Cross-cutter	Planning		Conduct	Dissemination
	Co-production / KMb	X		X	X
	Patient Engagement	X		X	X
	Open Science	X		X	X
WHERE is the research taking place?	Research Setting: Clinical-based Population of interest: Non-athlete adults with concussions Geographical location: Ottawa, Canada
WHY implement the cross-cutters?	Helps improves care for people with concussions. Makes sure that the study design and results reflect the real-life experiences and priorities of people who have had concussions. Improves the overall quality of the work. Encourages more rigorous, relevant, and useful research. Provides a valuable learning experience that supports growth and development for everyone involved.
HOW are they being implemented?	Co-production / KMb A Community Advisory Committee (CAC) works alongside the research team to guide and support all studies within their larger TRANSCENDENT research program. The CAC includes 12 members from diverse backgrounds, such as youth and adults with lived experience of concussion, caregivers, and sports coaches. The CAC meets four time a year to provide input and feedback. CAC members also take part in smaller working groups, online surveys, and one-on-one meetings as needed. The research team regularly presents their work in public forums, even before results are available. Sharing updates early and often helps raise awareness and interest in their research, which supports recruitment of diverse study participants and new CAC members.
	Patient Engagement Patients are active members of the CAC. Patients help decide which research questions are most important. Patients provide input on how studies are designed. Patients help shape data collection tools. Patients are involved in deciding how research findings are shared broadly.
	Open Science Study protocol is published in an open-access journal. Study protocol is also shared on an open online platform. Plans are in place for how research data are collected, stored, and protected. Research data are securely stored in trusted data repositories and management systems (i.e., OBI Brain-CODE). Data sharing follows Findable, Accessible, Interoperable, and Reusable (FAIR) principles, meaning they are easy to find, access, combine with other data, and reuse if and when appropriate.

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How co-production of a longitudinal population-based study with school boards advances prevention of brain-heart conditions across the lifespan
WHAT cross-cutters?	Co-production / Knowledge Mobilization (KMb) Inclusion, Diversity, Equity, Accessibility, and Social Justice (IDEAS) Open Science Training and Mentoring
WHO is involved?	Researchers: Tracy Vaillancourt, University of Ottawa Amanda Krygsman, University of Ottawa Daphne Korczak, Hospital for Sick Children Trainees: Heather Brittain, University of Ottawa Aly Julian, University of Ottawa Sarah Hobson, University of Ottawa		Knowledge users: Ontario school boards Parents and guardians, children, teachers
WHEN in the research process?	Cross-cutter	Planning		Conduct	Dissemination
	Co-production / KMb	X		X	X
	IDEAS	X		X
	Open Science	X		X	X
	Training and Mentoring	X		X	X
WHERE is the research taking place?	Research Setting: Population-based Population of interest: Children and adolescents (Grade 4 to 12 students) Geographical location: Ontario, Canada
WHY implement the cross-cutters?	Makes the research more relevant, inclusive, and useful for everyone. Co-production ensures that all partners, like the Ontario school boards, can meet their goals and stay meaningfully engaged throughout the project. Sharing findings and practicing open science allows the research findings to be used quickly to take immediate action, such as for improving food security and safety.
HOW are they being implemented?	Co-production / KMb The research was planned and designed with school boards to ensure it meets their needs. Each school board has access to a study-specific dashboard where they can quickly and easily access their data. The dashboards help schools make timely decisions about interventions to support students’ health, well-being, and safety.
	IDEAS Has an advisory committee with members from diverse genders, races, and ethnicities. Designed an inclusive and accessible survey for students grades 4-12. Broad piloting helped identify potential barriers to participation for students with learning difficulties, physical limitations (e.g., low vision), and autism. Built-in accommodations into the survey (e.g., can be used with a screen reader). Efforts ensured that every student can share their experiences and be represented in the research (including with the research ethics board).
	Open Science Uses clear and transparent methods. Shares research data with school boards through easy-to-use, study-specific dashboards in formats that are most helpful for them. Follows reporting guidelines in publications. Publishes results in open access journals.
	Training and Mentoring Involves trainees in the research design and conduct, giving them hands-on experience. Helps trainees learn and practice skills needed for community-engaged, co-produced research. Introduces trainees to the realities of equity-focused applied research, where success depends on building strong relationships, interpersonal skills, making thoughtful compromises, strategic thinking, and respecting different knowledge systems beyond academia.

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Embracing the Etuaptmumk approach: Strengthening Indigenous community capacity through brain-heart research
WHAT cross-cutters?	Indigenous Engagement Co-production / Knowledge mobilization (KMb) Inclusion, Diversity, Equity, Accessibility, and Social Justice (IDEAS) Open Science
WHO is involved?	Researchers: Alexandra King, University of Saskatchewan Malcolm King, University of Saskatchewan Kehinde Ametepee, University of Saskatchewan Ashley Secundiak, University of Saskatchewan		People with lived and living experience Knowledge users: Mitewekan Knowledge Holders Circle Elders and Knowledge Holders Caregivers Youth
WHEN in the research process?	Cross-cutter	Planning		Conduct	Dissemination
	Indigenous Engagement	X		X	X
	Co-production / KMb	X		X	X
	IDEAS	X		X	X
	Open Science	X		X	X
WHERE is the research taking place?	Research Setting: Indigenous Communities Population of interest: First Nations, Métis and Inuit people in Canada Geographical location: Île-à-la-Crosse, Saskatchewan and Sturgeon Lake First Nation, Saskatchewan
WHY implement the cross-cutters?	Using a two-eyed seeing approach brings together the strengths of both Indigenous and Western ways of knowing, leading to better and more meaningful outcome for everyone. The team supports communities to take the lead on how knowledge is shared, both within their own communities and beyond. A commitment to working collaboratively with people who have been underserved and historically overlooked in research, helps reduce systemic barriers and promote health equity.
HOW are they being implemented?	Indigenous Engagement The project is based within Mitewekan, an Indigenous-led health research and engagement hub guided by First Nations and Métis Elders, Knowledge Holders, and people with lived and living experience across Canada. The team recognizes that Indigenous communities are diverse, and that individuals and communities have different priorities, perspectives, and needs. The team prioritizes listening, building long-term relationships, and respectful partnerships as the foundation of how research is done.
	Co-production / KMb The researchers co-led the project with community research associates and a community guiding circle composed of Elders, Knowledge Holders, youth, people with lived and living experience, and their caregivers ensuring community leadership and shared decision-making. The team works with the community research associates to co-create a flexible work plan with clear weekly goals and deliverables, with administrative support, making sure everyone has the tools and resources to succeed. Knowledge is shared in meaningful and culturally respectful ways such as community gatherings, storytelling, and sacred circles that reflect Indigenous values and ways of knowing and being.
	IDEAS The team is composed of staff and trainees who are diverse in their Indigenous and racial backgrounds including non-Indigenous members, age, gender, career stage, and knowledge systems. The team fosters an inclusive and reciprocal learning environment, where all members of the team are committed to sharing and learning from each other.
	Open Science The team understands that sharing data can be sensitive for Indigenous people, who want more control over how their knowledge and data are being used to benefit their communities and beyond. CARE (Collective benefit, Authority to control, Responsibility, and Ethic) principles are combined with OCAP (Ownership, Control, Access, and Possession) and OCAS (Ownership, Control, Access, and Stewardship) which reinforces Indigenous leadership and decision-making in data and research processes. Data agreements are co-created with communities, which grant them authority over how their data is collected, used and shared.

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Bridging Brains and Hearts: Co-Producing Equitable Research on Cannabis, Mental Health, and Cardiovascular Risk with Equity-Deserving Communities at The Bridge
WHAT cross-cutters?	Patient Engagement Co-production / Knowledge mobilization (KMb) Inclusion, Diversity, Equity, Accessibility, and Social Justice (IDEAS) Training and Mentoring
WHO is involved?	Researchers: Smita Pakhale, Ottawa Hospital Research Institute, The Bridge Engagement Centre, University of Ottawa Trainee: Sadia Jama, University of Ottawa		Knowledge users: Community researchers/people with lived experience embedded within The Bridge
WHEN in the research process?	Cross-cutter	Planning		Conduct	Dissemination
	Patient Engagement	X		X	X
	Co-production / KMb	X		X	X
	IDEAS	X		X	X
	Training and Mentoring	X		X	X
WHERE is the research taking place?	Research Setting: Community-based Population of interest: Equity-seeking groups, such as people who are racialized and people without stable housing Geographical location: Ottawa, Canada
WHY implement the cross-cutters?	Recognition that these principles and practices make research more accessible and equitable. It creates safe and supportive spaces where patient partners can meaningfully contribute to the research. Results are shared directly with the people and communities most affected by the findings, and the people who can benefit the most. Hands-on research training through The Bridge benefits everyone, whether academics, trainees, and community peer researchers, fostering mutual learning and skill building.
HOW are they being implemented?	Patient Engagement People with lived experience of cannabis use, mental illness, and heart conditions are involved at every stage of research. The Bridge’s research agenda, vision, and goals are co-created with community peer researchers, ensuring the work reflects what matters most to them. Community peer researchers are voting members of The Bridge’s shared governance and decision-making structures.
	Co-production / KMb The team builds strong, direct relationships with communities by taking time to listen, build trust, and understand past experiences before starting any research. Research is done in partnership with community members at every stage, from shaping research questions, developing data collection tools, interpreting results, and shaping the direction of future studies. Lessons learned are shared with others through published methods papers that serve as practical resources for other research teams interested in adopting the Bridge ModelTM in their own work. Research updates and results are shared in clear and accessible formats, including plain language summaries, social media and blog posts, and policy briefs so the information reaches a wide range of audiences.
	IDEAS The team actively involves people from equity-deserving groups (e.g., Indigenous, people who are unhoused or insecurely housed, low-income, and racialized), as both research participants and as community peer researchers. The team recognized the need for deeper exploration into the complexities of cannabis use in Canada, especially among communities that face systemic barriers and are often overlooked in research. Data are collected and analyzed using an intersectional approach.
	Training and Mentoring Trainees are supported to attend BHI workshops, networking events, and to take part on advisory committees, helping them build skills and professional connections. Facilitates connections with a network of researchers and mentors who share a commitment to equity-focused research. The team supports trainees from underrepresented and equity-deserving groups. The team offers guidance on how to better support trainees from underrepresented groups.

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