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Under our current healthcare system, some children are set up to manage pain under far more difficult conditions than others. Bianca Matthews, a third‑year Clinical Psychology PhD student at Dalhousie University supervised by Dr. Christine Chambers and Dr. Alexandra Neville, studies how racism and systemic injustices shape the pain management behaviours of racialized youth.

We spoke with Bianca to learn more about her research. Here’s our Q&A.

What are your research interests?
I'm interested in looking at the psychosocial and systemic factors that affect how racialized children manage their pain. I think it's super important to take the focus away from the individual when looking at what affects health behaviours and to really critique the system and the external environment that shape those behaviours. When considering racialized populations, something I'm especially interested in are the mechanisms behind the negative effects of systemic injustices on pain management behaviours and what protective factors buffer those effects.

Can you give us a high-level description of your research?
In previous work, I conducted a narrative inquiry study exploring how Black youth and caregivers experienced anti-Black racism during pain management conversations with healthcare professionals, and how that racism shaped their overall pain management experiences. Using this Black way of knowing (storytelling-based interviews), themes of invisibility and dismissal were generated across participants. So that project was a bit broader in its scope. And then my current dissertation, I'm still in the planning stages, but right now I'm planning to identify the top 10 research priorities for pediatric Sickle cell disease (SCD) pain management in Canada according to interest-holders (youth 8-25 years old with SCD, caregivers, and SCD clinicians), and will potentially look at how engaging in community-engaged activities can empower youth with SCD and positively impact their pain management behaviours.

Sickle cell disease is a genetic blood disorder that causes your red blood cells to be shaped like a crescent moon. When shaped this way, it blocks your blood flow and leads to really painful episodes called vaso-occlusive crises. It’s highly prevalent in minoritized populations, which often leads to a whole host of systemic injustices (e.g., racism and pain-related stigma) when they're seeking pain management treatment. The mechanisms underlying how these systemic injustices impact pain management confidence in this population remains poorly understood.

What led you to this topic?
My research interests are really deeply rooted in my own lived experience as a Black woman navigating the healthcare system in search of affirming pain management care and being met with racism. And as terrible as my story is, I also recognize that my story isn't unique. In talking to other people in my family and other Black people within the community, I’ve realized that we've all had similar encounters within the healthcare system when trying to find pain management solutions. And even though we're able to relate to each other, you're not seeing that highlighted within research. Unfortunately, due to the colonial nature of our healthcare system, anecdotal stories of lived experience are rarely seen as sufficient evidence on their own. Research and data are still required to "corroborate" them before equitable, evidence-based pain management solutions can be developed and made widely accessible. Recognizing that gap is really what fueled my passion for studying pain management injustices in Black children and building up that evidence base. So for me, my research is kind of a form of advocacy and an opportunity to really ask those critical questions about how we can create those more equitable pain management solutions for Black people.

How will this research affect the daily lives of people?
To develop evidence-based solutions, we first need research that identifies exactly where the problems are. If we don't understand the inequities children face in the pain management system or how those inequities affect their experiences, we can't create solutions that actually work. Also, I think it's important to highlight voices that historically haven't been heard within research so priorities accurately reflect their needs and experiences. So, this research will help us pinpoint what's driving those disparities and then turn that knowledge into more equitable pain care.

What inspired you to pursue graduate work at Dalhousie?
When I was deciding between different universities and where exactly I wanted to apply, specifically for clinical psychology, there were several things that were important to me.

First, it was important for me to be in a city that was livable and that I would enjoy living in. So, Halifax, that was a check there.

Second, it was really important for me to choose a university with a strong pediatric pain research program. So, Dr. Chambers’ Lab was a perfect fit.

Third, I was looking for a dedicated community of Black health researchers and community advocates. That was also a check. There's the Black Advising Centre, there's PLANS (Promoting Leadership in Health for African Nova Scotians) which is another outreach group here at Dal, and there's a new Black Health Researchers’ Hub that's been created. Being able to partner with these groups and build community has been really important to me.

Finally, I was really looking for a university with a genuine culture of interdisciplinary collaboration. I feel lucky that our lab collaborates with researchers outside of our faculty and even outside of the university, which has really helped me broaden my perspectives. I also have someone outside the department on my committee, Dr. Barbara Hamilton-Hinch, who brings incredible Black health expertise and is a Black health equity scholar herself. That culture of collaboration, both within the program and at Dalhousie more broadly, was a major draw for me. My work focuses on Black health equity, and I needed a program that would support my use of critical Black research methods and allow me to critically examine the traditional psychological approaches that have contributed to these inequities. Dalhousie offered all of that, and so far, it has proven to be a really good choice.

What advice would you give to aspiring graduate students?
This is really general advice, but once you start grad school, I think it's really important to find a community that you can lean on. I truly don't think I could have made it this far into the program without support from my lab-mate and good friend Blair, my cohort-mates, friends outside of the program, and my tennis community. Grad school is challenging enough on its own and it's important to not try and navigate it by yourself. Getting involved in activities outside of the program was important for me, because it helped me to meet new people and surround myself with people who really understand, encourage, and support me as I go through this hard program.

What do you want for your future?
That's a big question, and honestly, I don't have a perfectly clear answer yet. What I do know is that my goal is to help Black children and other Black people feel empowered and confident in managing their pain so they can live meaningful, fulfilling lives. Whether that ends up looking like a purely research-based career, a clinical one, or some combination of both, that's what I hope to dedicate my work to.