Thinking and Working as a System: Integrated Chronic Disease Prevention in

Manitoba

Chronic Disease Prevention Alliance of Canada ConferenceTuesday, November 25, 2008

Objectives

• Identify coordination, communication and collaboration approaches that have been successful

• Become familiar with chronic disease prevention through a community-led, regional health authority-coordinated and government-supported approach.

• Identify some priority steps in becoming a chronic disease prevention system.

Starting the Journey• Alliance for Prevention of Chronic Disease

• Building on the Heart Health model• 3 years not long enough• Suggested per capita funding

• High cost of chronic disease to health system, society and economy

• Interventions known but not always applied• Need to engage high-risk populations

Decide on the destination

• Development of a CDPI Charter• Consensus on accountability, management and

evaluation• A five year community-led initiative to support local

planning and actions that create healthy settings and promote healthy living (Oct 2005-March 2010)

• Focuses on risk factors of smoking, unhealthy eating and physical inactivity and evidence based action

• Signed on October 24, 2005 by each RHA, Minister of Healthy Living of Provincial Government and a Northern Aboriginal organization

The journey – community led

• Local planning committees, champions and people to facilitate action

• Actions plans with per capita funding

• Start where community is at and address barriers to participation

• Leveraging additional resources

• Community pride and “can-do” attitude

• Local data collection about risk factors

The journey – community led

• 83 communities in participating RHAs including 21 First Nations and 8 Métis communities

• Examples of engaging communities;• “Train the Trainer” approaches – ripple effect• Making it easy for people to connect• Community gardens

Community Gardens“Not just about the

Carrots”• Collaborating with

existing partners• Creating a philosophy

and trust• The roles of the

Network and the community

• Looking ahead

•

Community Gardens

The journey – RHA coordinated

• Work with existing groups and relationships to build partnerships and sustainability

• Share learnings across the regions: monitoring forms, granting programs, RHA board buy-in, & success stories

• Focus on high-risk communities• Draw on evidence for decisions and planning• Make it easy for communities to participate

The journey – RHA coordinated

• For example: • Developed Regional Committees (support for

training plans, surveillance)• Shared tools/resources between RHAs –

cross pollination• Bring partners with similar interests together

(in-motion, healthy schools) • Create environments to move healthy living

forward

The journey – Government Supported

• Funding through the Public Health Agency of Canada and Manitoba Health and Healthy Living

• Leadership, accountability and evaluation

• Support for committees for communication, coordination and joint planning

The journey – Government Supported

• For example:• Website to support Healthy Living including

CDPI http://www.healthincommon.ca/• Linkage to provincial partners such as

Northern Healthy Foods Initiative• Funding to RHAs for 44 new staff positions to

enhance and sustain regional capacity for chronic disease prevention and healthy living

Elements of Success• Increased ability to work together to

create supportive environments • Partnerships at multiple levels• New communities of practice formed such

as Partners in Planning for Healthy Living (PPHL)

• Community-led initiatives blended into existing programs and services

• Resources combined to expand reach

Elements of Success (cont.)

• High-risk populations working on community determined issues of priority

• Growing leaders

• Shift in attitudes and approaches to chronic disease prevention

• Valuing the different ways communities get things done

Learnings• Sharing knowledge, resources, expertise,

evidence based information and problem solving/solutions

• Communities recognize the need to prevent chronic disease

• Don’t let jurisdictions get in the way – people (even bureaucrats) can work around perceived barriers

Learnings• Be flexible• Get out of the way of the communities• Sharing, listening and learning together

takes time• Understanding community traditions• Use existing structures and groups

Detours along the way

• Changing the ways people think and work• Learning about the impact of community-led

planning and decision making • Alignment of planning cycles, funding,

reporting and monitoring • Communication• Engagement of youth and burdened families• Questions from sectors outside of health

Not quite there yet – road signs• Community Capacity Building Tool

• Reaching a tipping point i.e. blue light

• The power of sharing local data with community

• We need to take the time to discuss challenges, health determinants, and potential solutions

• Innovative ways to tell the stories

• Coaching and mentoring

• Facilitate organic community development

Not quite there yet

• Challenge to be true to the philosophy of community led, RHA coordinated and government supported approach

• Bring communities together to share information and communication strategies

• Strategic planning – looking to the future • Keep it simple and make it easy for

partners to stay involved

Acknowledgements

• CDPI communities

• Alliance for the Prevention of Chronic Disease

• Regional Health Authorities

• Manitoba Health and Healthy Living

• Public Health Agency of Canada