Reinventing real-time patient-reported outcome measures (PROMs) in clinical practice: Realizing the potential of artificial intelligence (AI) to improve communication between patients and clinicians.

Patient-reported outcome measures (PROMs) are questionnaires in which patients self-report symptom severity. While PROMs can improve clinical communication and health outcomes, there are common barriers to PROMs completion, such as difficulties interpreting and answering questions and cultural differences in symptom expression, which may disproportionately affect anglophone and allophone patients, in addition to the overall challenges these groups face in navigating Québec's predominantly francophone healthcare system. Artificial intelligence (AI) has the potential to revolutionize PROMs collection for these underserved populations. Our team aims to develop an AI-driven process by which anglophone and allophone patients can report PROMs-like data verbally, in an organic, narrative format using their preferred language, with information transmitted to clinicians in real-time as a concise structured summary. As a first step, we will develop and validate a process for extracting PROMs-like information from narrative clinical notes in the electronic health record, using a large language model (LLM). We will use data from the electronic Implementation of Patient-reported Outcomes Across cancer care in Québec (e-IMPAQc) project, focusing on anglophone and allophone patients. Using an LLM on the McGill University Health Centre’s internal server, we will iteratively refine a process to extract PROMs-like data from narrative text. This project will help develop AI-powered solutions to reduce language barriers, improve clinical communication, and enhance healthcare access for Québec's linguistic minority communities.

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Outputs:

• Daskalo, C., Moore, A., Boone, E., Durieux, B., Loban, K., Kreutzer, T., Lambert, S., & Poenaru, D. (2026, July). Reimagining patient-reported outcomes with generative AI: From clinical narratives to patient voice [Abstract submitted for conference presentation]. 24th International Conference on Artificial Intelligence in Medicine (AIME 2026), Ottawa, ON, Canada. https://aime26.aimedicine.info/

Access to Psychotherapy for Minority-Language Speakers: A Scoping Review to Build Recommendations for English-Speaking Communities in Québec

Many people from minority language communities in Québec face barriers to accessing mental health services because of systemic, linguistic, and cultural challenges. For English-speaking communities, accessing psychotherapy in their first language can be especially difficult, even though research shows that therapy is generally more effective when delivered in the patient’s primary language.

This project will review research published over the past two decades on psychotherapy in linguistic minority settings. The study will examine how language affects the quality and effectiveness of mental health care, as well as existing clinical guidelines and policy recommendations related to language-concordant services.

The findings will help identify ways to improve access to effective mental health care for English-speaking communities in Québec. The project will also bring together researchers, practitioners, and community partners to develop practical recommendations for strengthening mental health services in patients’ first language.

Outputs:

Coming soon…

An environmental scan of policies and interventions to improve access to dementia care for English-speaking minority communities in Québec

English-speaking people living with dementia in Québec often face barriers to care, including delays in diagnosis and difficulty accessing timely support and services. These challenges can negatively affect both individuals living with dementia and their caregivers, while also reflecting broader inequities experienced by linguistic minority communities.

This project will examine the policies, programs, and services that support language- and culture-friendly dementia care in Québec. Researchers will review public documents and websites and interview healthcare providers, administrators, and decision-makers to better understand current practices and gaps in care.

The findings will be organized into a living online resource that brings together existing policies, tools, programs, and evidence about their effectiveness. The project aims to improve access to timely, culturally safe, and language-concordant dementia care for English-speaking communities in Québec and help guide future healthcare improvements.

Outputs:

Coming soon…

Improving Access to Anxiety Therapy for English-Speaking Communities in Québec

Title: Improving Access to Cognitive-Behavioural Therapy for Anxiety Disorders and Related Problems for English-Speaking Communities in Quebec: A Scoping Review of Adaptations and Delivery Models in Linguistic Minority Contexts

Anxiety disorders are the most common mental health condition in Québec and Canada, affecting one in three people during their lifetime. If left untreated, anxiety can interfere with work, school, relationships, and physical health. Cognitive-behavioural therapy (CBT) is an effective, evidence-based treatment for anxiety, but many English-speaking Quebecers face language barriers that limit access to these services, especially outside major urban centres.

This project will examine how CBT for anxiety has been adapted in different countries to better support people who speak a minority language within their healthcare system. Researchers will conduct a scoping review to identify strategies such as translated materials, culturally adapted resources, bilingual therapists, and telehealth services.

The findings will help identify practical approaches that could improve access to quality mental health care for English-speaking communities in Québec, particularly in regions with limited English-language services. Results will be shared through a scientific publication, an infographic, and a policy brief.

Outputs:

Coming soon…

Socio-regional inequities in breast cancer screening in Quebec: Best practices for equitable participation in the Quebec breast cancer screening program (PQDCS)

Breast cancer is a major cause of cancer-related deaths in Quebec, which accounts for nearly a quarter of Canada’s cases. Although early detection through the Quebec Breast Cancer Screening Program (PQDCS) saves lives, participation remains below the 70% target, with significant regional and linguistic disparities.

English-speaking women—especially those with limited French proficiency or living in vulnerable conditions—face added barriers such as language challenges, lower health literacy, socioeconomic constraints, and limited trust in the health system. Montreal, home to many English-speaking and diverse communities, has the lowest screening rates in the province, showing that bilingual materials alone are not enough.

This project brings together researchers, community organizations, and institutional partners to better understand these inequities and co-create solutions. Using an intersectional and equity-focused approach, the study will explore how language and social determinants affect access to screening, identify barriers, and assess the potential of community-based health navigation.

Outputs:

Coming soon…

Building healthy systems: Retaining English-speaking students enrolled in Québec’s English language, healthcare-oriented vocational training programs

English speakers are underrepresented in Québec’s healthcare workforce and are more likely to leave the province compared to French-speaking healthcare workers. They are also more likely to work in healthcare roles requiring university degrees rather than positions accessible through vocational or CEGEP training. More research is needed to understand why these trends exist and how to better support and retain English-speaking healthcare workers in Québec.

This project will examine the factors affecting the retention of students in English-language health and social assistance vocational programs and identify strategies to improve the retention of English-speaking healthcare professionals in Québec. The study will use a mixed-methods approach, including statistical analysis, interviews with students, and a review of best practices for retaining healthcare workers in minority-language settings.

The findings will help inform policies and programs aimed at strengthening the participation and retention of English speakers in Québec’s healthcare sector, improving access to English-language healthcare services and helping address workforce shortages.

Outputs:

Coming soon…

DESCREEN-Québec: Reducing Evening Screen Use and Improving Sleep in Québec Adolescents

Title: DESCREEN-Québec: Increasing Access to Evidence-Based Behavioral Interventions to Reduce Evening Screen Use Among Quebecker Adolescents Through Rapid Dissemination of Interventions via School Partnership

Adolescents in Québec are spending increasing amounts of time on screens, especially in the evening, which can interfere with sleep and negatively affect mental health, learning, and overall well-being. Although reducing evening screen time is recommended by health experts, there are currently no programs specifically designed for English-speaking adolescents in Québec.

This project will develop and implement DESCREEN-Québec, a school-based program that helps adolescents reduce evening screen exposure and improve sleep habits. The study will take place in two phases: first, an evidence-based screen-reduction intervention will be adapted to meet the needs of English-speaking youth in Québec, and second, the program’s impact on screen use and sleep health will be evaluated.

Researchers will measure changes in screen exposure and sleep using both questionnaires and objective measures collected before, after, and three months following the intervention. The findings will help improve access to evidence-based sleep health support for English-speaking adolescents and provide a scalable model for future school-based health programs in Québec.

Outputs:

Coming soon…

Speaking of Care: Comparing Indicators of Language Identity and Preference for Equitable Access to Health Services in Quebec English-Speaking Populations

Many English-speaking residents in Quebec face challenges accessing health care in their preferred language. In advancing research and changing practices to better meet their needs, a key challenge lies in how we identify individuals who are English-speaking. Shifts in Canada’s demographic composition and increases in immigration has broadened the concept of English-speakers to include not only native English-speakers, but also persons with another mother tongue who speak English most often at home, as well as those who can conduct a conversation in English but not in French. Existing studies use varied and inconsistent approaches to defining linguistic identity such as mother tongue, first official language spoken, or language most often spoken at home.

This project will explore how traditional variables about language translate to the application of healthcare encounters. We will begin by forming a Patient Partner Council to collaborate closely with our research team throughout the project. Using existing large surveys of the Quebec population, we will identify different ways used to measure language and examine patterns and associations between these measures of language and health care access. Finally, we will present these results to English-speaking patients and health care providers in Quebec to obtain their perspectives of the most appropriate measures for capturing language identity and preferences as they relate to healthcare access. Ensuring language is measured in a way that reflects people’s healthcare preferences is a critical step toward building more inclusive, equitable health systems that meet the needs of the diverse English-speaking minority communities in Quebec.

Outputs:

Coming soon…

Improving Mental Health Care for Migrant and Minority Patients for English-Speaking Communities in Québec

Quebec’s English-speaking communities include people from migrant and minority backgrounds who differ in their cultural background and first language (while preferring English as first official language). Access to mental health care for these communities benefits from training and retaining clinicians from a wide range of cultural and linguistic backgrounds. Unfortunately, these clinicians often leave Québec due to limited French-language support and lack of training in multicultural practice. The loss has direct implications for quality of care: psychological interventions are most effective when delivered in a culturally-sensitive way, in the patient’s first language. We propose a bilingual mini-conference and training workshop to help tackle this challenge.

The event will bring together clinicians, students, educators, and policy stakeholders from those disciplines granting the right to (a) practice psychotherapy in Quebec, or (b) pursue a psychotherapy license: clinical psychology, psychiatry, nursing, social work, and occupational therapy. Through interactive workshops, applied training sessions (e.g., the Cultural Formulation Interview), and collaborative discussions, participants will explore how we can better support the training and retention of multilingual and multicultural mental health professionals. Speakers will also present findings from recent studies, including those funded by Dialogue McGill, investigating clinician retention and language-related barriers to care. The goal is to share knowledge, co-develop solutions, and foster a province-wide dialogue on inclusive training.

The event will be hybrid and fully bilingual: speakers will have the option to present in French or English. Concordia University will host the event, supported by research assistants, a keynote speaker, and trained facilitators. The results will be translated where necessary and shared widely across Québec’s mental health networks. By focusing on both language and culture, this initiative aims to help build a more sustainable, accessible, and culturally safe mental health care system for English-speaking Quebecers, especially those from migrant and minority backgrounds.

Outputs:

March 2026 - Hosted a conference on Language, Culture, and Mental Health.

Helping members of English-speaking communities in Quebec make good health decisions thanks to digital patient decision aids.

Many people in Québec face questions about everyday health decisions but do not always have easy access to a trusted health professional who can provide detailed guidance in their preferred language. This challenge can be especially significant for English-speaking communities, particularly outside major urban centres such as Montréal, where access to English-language care may be limited. As a result, people often turn to the internet for health information.

While online health information is widely available, its quality varies. Some sources are accurate but highly technical, others are easy to understand but limited in detail, and some are misleading or false.

To address this gap, our team has developed digital health decision support tools that provide clear, evidence-based information to help people make informed decisions about their health and that of their families. These tools are designed as interactive websites that can be tailored to users’ needs, including the level of detail they wish to receive.

This project will evaluate whether these tools help members of English-speaking communities in Québec make better-informed health decisions, particularly when access to in-person, language-appropriate care is limited.

Outputs:

Coming soon…

Exploring Pediatric Trainees’ Experiences Using AI-Supported Deliberate Practice to Improve Serious Illness Conversations with English-Speaking Families in Quebec

Talking with patients and families about serious illnesses is one of the most important—and hardest—parts of being a pediatric doctor. Residents (doctors in training) need to be able to guide these conversations with care and empathy. But they often do not get enough chances to practice, and sometimes their first serious illness conversation happens with a real family. This can be stressful for families and for the resident, and it can affect how well information and support are shared.

For English-speaking families in Quebec, there are extra challenges. Most medical training and many clinical discussions happen in French. This means residents have very few chances to practice these important conversations in English. When doctors are not able to practice in a family’s preferred language, it can lead to misunderstandings or less compassionate care. This is especially important for English-speaking patients and families in Quebec’s Official Language Minority Communities.

 This project will test a new way to help residents practice. An artificial intelligence (AI) training tool will let pediatric residents practice serious illness conversations in English in a safe and realistic way. The tool gives residents repeated opportunities to try difficult conversations and learn from feedback, without risking distress for real families.

Residents who use the tool will take part in interviews to share what they thought about it, how it helped them, and how it could be improved. The results will help create better training programs and improve communication and care for English-speaking children and families in Quebec

Outputs:

Coming soon…

Empowering Communication: The perspective of English-speaking patients with ALS in Quebec on voice cloning technologies

Amyotrophic lateral sclerosis (ALS) is a neurodegenerative motor neuron disease that often leads to the loss of speech, significantly affecting communication and quality of life. As speech deteriorates, persons with ALS (pALS) increasingly rely on augmentative and alternative communication (AAC) tools (e.g. text-to-speech apps). Traditional voice preservation methods require extensive recordings and may not fully capture the emotional expressiveness or identity of the speaker. Voice cloning – a technology using artificial intelligence – can replicate a person’s voice using only a short audio sample. It offers a faster, more accessible, and potentially more natural-sounding alternative.

This project aims to evaluate the perception of voice cloning technologies among Anglophone pALS in Quebec.

Through a mixed-methods approach involving interviews, questionnaires, and hands-on use of voice cloning tools, we will explore how pALS perceive the naturalness, expressiveness, and identity preservation of their synthetic voices created with voice cloning technology. We will also assess how factors such as the severity of speech impairments, recording length, and recording tasks influence their perception.

The findings will inform the development of clinical guidelines for speech-language pathologists and support shared decision-making between clinicians and patients. Ultimately, our research seeks to empower pALS to maintain their voice, identity, and social participation throughout the progression of their disease.

Outputs:

• Kheloufi, Y. and Bouvier, L. (December 2025). Empowering Communication: Evaluating Voice Cloning for Anglophone ALS Patients in Quebec. Allied Professionals Forum. Toronto, ON, Canada. Poster presentation.

• Kheloufi, Y (November 2025). AI Voice Cloning in ALS. Communauté de Pratique Orthophonique en SLA/MMN du Québec. Montreal, QC, Canada

Collaborative Creation of Podcasts to Promote the Implementation of Virtual Reality in Children’s Health Care

Medical procedures can cause significant pain and anxiety in children, which may be exacerbated in language minority contexts. Virtual reality (VR) is an effective non-pharmacological distraction that can reduce pain and anxiety without requiring language proficiency. Although Shriners Hospitals for Children–Canada has integrated VR into its bilingual care, gaps in structure and resources remain, and broader implementation faces barriers.

In Quebec, English-speaking children may experience increased communication anxiety and reduced healthcare use when care is not delivered in their preferred language, potentially leading to poorer outcomes. Addressing language barriers is therefore essential.

To support VR implementation, our team will co-develop a 5-episode English-language podcast series targeting healthcare professionals in Quebec. The series will address barriers, facilitators, and real-world use of VR in pediatric care, with a focus on improving equity for English-speaking children. It will be disseminated via the McGill website and major podcast platforms, with the goal of promoting VR adoption to reduce pediatric pain and anxiety across language contexts.

Outputs:

• A manuscript on podcasting as a knowledge translation tool has been completed and will be submitted to Digital Health Journal (April 2026).
  (Audience: research community, knowledge brokers)

• A second manuscript on integrating podcasting into academic curricula is in development (submission: Summer 2026).
  (Audience: research community, educators)

• A podcast series was produced (7 interview episodes + intro and summary) with accompanying educational materials.
  (Audience: healthcare professionals and stakeholders in pediatric VR implementation)

• Findings were disseminated at multiple national and international conferences (posters and oral presentations).
  (Audience: research community, knowledge brokers)

• Educational integration included a course assignment (Mount Allison University) and a lecture to ~150 nursing students at McGill.

• A workshop and national presentation (PICH2GO 2025) trained ~250 participants on podcast-based knowledge translation.

Gestational diabetes and preeclampsia in Anglophones of Québec: dissemination of results through open access

Previous research suggests that Anglophones in Québec may face an increasing risk of adverse birth outcomes. Earlier analyses have shown that, compared with Francophones, Anglophones have a higher risk of stillbirth and preterm birth. To better understand the factors underlying these disparities, funding was awarded by Dialogue McGill in 2023 to support two complementary studies examining the risk of gestational diabetes and preeclampsia among Anglophones versus Francophones. These conditions are significant pregnancy-related morbidities with important implications for maternal and infant health. The researchers plan to publish the findings from both studies in peer-reviewed open-access journals to ensure broad dissemination. In parallel, they are collaborating with knowledge user Marianne Bilodeau-Bertrand to translate the results into surveillance-related activities aimed at informing the Québec Ministry of Health and Social Services.

Outputs:

Two manuscripts were published in peer reviewed journals:

1) Auger, N., Ayoub, A., Bilodeau-Bertrand, M., Lafleur, N., & Wei, S. Q. (2025). Ethnocultural status and risk of preeclampsia in a Canadian setting. Pregnancy Hypertension, 39, 101202. https://doi.org/10.1016/j.preghy.2025.101202

2) Auger, N., Bilodeau-Bertrand, M., Ayoub, A., Lafleur, N., & Wei, S. Q. (2025). Increasing risk of gestational diabetes in an ethnocultural minority of Canada. Journal of Immigrant and Minority Health, 27(2), 191–199. https://doi.org/10.1007/s10903-024-01667-6.

Output recipients include members of the academic community as well as data and knowledge users at the Institut national de santé publique du Québec and Ministry of Health and Social Services of Quebec.

Catalyzing Capacity Building In Rehabilitation Post-Solid Organ Transplant - Knowledge Translation Proposal

Solid organ transplant (SOT) patients have low levels of physical activity before and after transplantation which has a negative impact on their health and survival. Despite this, in Quebec, there is limited availability of rehabilitation and physical activity programming for transplant candidates and recipients. Importantly, many healthcare professionals do not feel confident in counselling SOT recipients about physical activity that is appropriate for them due to lack of specific education about transplantation in their training.

Our objective is to develop a free online continuing education course on exercise prescription in SOT recipients for English-speaking exercise professionals in Quebec that will include interactive lectures, case studies and evaluation materials. This will ultimately improve the confidence of exercise professionals when they deal with SOT recipients and the quality of rehabilitation that they are able to offer. The development of the course will involve 4 steps.

1. A scientific committee, including both professionals and patient partners, will participate in a video conference call to define the learning objectives and the most relevant content (theory, case studies, evaluations) to be included in the course.

2. The Co-PIs, the coordinator, a trainee, patient partners, Maria Sedeno (RESPIPLUS) and Becky Zucco (Wilkin) will draft the first version of the online course including the learning objectives, content, case studies, evaluation materials as well as visual aspects and interactive components of the module.

3. Feedback from the scientific committee will be sought via email. At least two rounds of revision are planned.

4. Feedback will be integrated into the module.

Outputs:

Coming soon…

Health outcomes of Anglophones after pregnancy: differences in access compared with Francophones in Québec

In Québec, Anglophones are more likely to have pregnancy complications than Francophones. Our research has shown that Anglophones are at risk of outcomes such as preterm birth, stillbirth, preeclampsia, and gestational diabetes. These pregnancy complications have been associated with the onset of medical problems later in life, including mental illness and type 2 diabetes. This proposal aims to examine if Anglophone women are more likely to require care for mental illness and type 2 diabetes than Francophones in the long-term period after pregnancy.

During the previous funding cycle, we built a longitudinal cohort that allows us to study the long-term health of Anglophones after pregnancy. The cohort contains demographic and health information for all Anglophones and Francophones who were pregnant in Québec between 2006 and 2022. In the present study, we will examine two outcomes that led to hospitalization anytime after pregnancy: mental illness and type 2 diabetes. We will assess the association between maternal language and the risk of having a mental illness or diabetes admission up to 17 years after pregnancy, comparing Anglophones with Francophones. We will also study whether characteristics such as socioeconomic deprivation and education modify the long-term risk of each outcome. Our results will provide much needed information on the health of Anglophones in the years after pregnancy, and help identify groups that could benefit from better access to mental health and medical services.

Outcomes:

• Presentation of findings at the “Building Together 2026” conference organized by CHSSN.

• Presentation of the findings at the “Dialogue McGill 2026: Growing Capacity and Retaining Talent in Health Care and Social Services” conference.