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Welcome to HC Link's blog! Our blog will provide you with useful information on healthy community topics, news, and resources, as well as information on HC Link’s events, activities, and resources. Our bloggers include HC Link staff and consultants, as well as our partnering organizations, clients, and experts in the health promotion field. Please note: opinions in posts are those of the author and are not necessarily the opinions of HC Link or our funder.

We look forward to engaging in thought-provoking conversation with you!

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Public Health Ethics Part 3 of 3: Applying Public Health Ethics at Your Work

By Stephanie Massot, Public Health Practicum Student at Health Nexus

This is the third blog post in a series on public health ethics. This post focuses on how to apply public health ethics to your work.

I am starting to feel as though public health ethics is like a good sandwich you have made yourself. If you have been following my last two blog posts in this series, you will be more familiar with your philosophical orientation and differentiating between bioethics, public health ethics, and health promotion ethics. These make up the main protein and key ingredients to a good public health ethics sandwich. If you have made a sandwich before, you are going to know what your favourite ingredients are – mine is always cheese and Dijon mustard! If it is your first time making a sandwich or you have been given new ingredients, there will be a new process and new discoveries. Guidance on making a sandwich is important. You need to know how to bring your ingredients together.

In public health ethics, frameworks have been developed to provide assistance to practitioners who are deliberating an ethical issue in different contexts. Strengths of frameworks include making values explicit and thinking through potential unintended consequences of proposed interventions, from policies to programs. The National Collaborating Centre for Healthy Public Policy (NCCHPP) has an extensive list of ethics frameworks for public health. Going back to the sandwich analogy, what you use to ‘frame’ your ingredients, from a challah bun to rye bread, will change your eating experience. For instance, Nancy Kass provides a list of questions in her framework (great summary from NCCHPP) and Andrew Tannahill focuses on a list of principles or ‘principlism’ to guide his framework.

Principlism is a ‘broad approach of identifying a set of principles to be considered and specified when facing a decision that may contain ethical issues1 and a practical tool for practitioners who are not familiar with public health ethics. Principles can be separated into substantive and procedural categories:

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I was recently reading Unison Health and Community Services’ workbook (jam-packed with tasty ingredients) for community based evidence-informed practice. What I noticed was that an ethical framework(s) was not provided, even for the evaluative learning tools. Referring to another tool such as the Community Ethics Toolkit, could support you to consider and dialogue about public health ethics.

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Just like you might not enjoy the idea of combining certain ingredients on your sandwich (pickles and peanut butter anyone?), there will be conflicts between principles that will require deliberation. Frameworks for public health ethics will need refinement, perhaps they will even need to be combined, for your context – only through practice will you find out how to best apply them. For an excellent case study check out: ‘Getting Through Together: Ethical Values for a Pandemic’. The Ministry of Health in New Zealand worked closely with Māori communities because ‘shared values give us a shared basis for decisions.’ Now how about that sandwich?

 

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1 MacDonald, M. (2015). Introduction to Public Health Ethics 3: Frameworks for Public Health Ethics. National Collaborating Centre for Healthy Public Policy. Montréal, Québec.

 

 

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HC Link Blog Series on Facilitation Techniques: Wrap Up

By Kyley Alderson, HC Link

Good facilitation is an essential component to achieving success as a group. A facilitator helps a group to accomplish its objectives by ensuring comfort, fairness and good participation from all members, maximizing a group’s ability to come up with ideas/solutions, and keeping a group on track to move towards its goals.

At HC Link, we take pride in our staff and our ability to help groups achieve success through our facilitation skills. We have received a number of requests asking for more information on various facilitation approaches and techniques – so we decided to do a blog series to assist in your learning!


Here is a listing of all of the blogs in this series:

Introduction to Choosing a Facilitation Technique

Peer Sharing: the wise crowds technique

Breaking the Ice: putting a little fun into working with groups

Appreciative Inquiry

Facilitating a Priority Setting Exercise

1-2-4-all: Engage everyone in group conversation

Using “Visioning” as a Facilitation Technique

Using popular theatre as a facilitation technique


We hope you found this information and examples helpful!

Please feel free to contact us with any questions you may have – or to request a service from us to help with facilitating your community processes, meetings or events.

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Public Health Ethics Part 2 of 3: Distinguishing between different types of health-related ethics

By Stephanie Massot, Health Nexus

This is the second blog post in a series on public health ethics. This post focuses on differentiating between bioethics, public health ethics, and health promotion ethics.

Perhaps you have been entering in some Socrates-type conversations since reading ‘Public Health Ethics Part 1 of 3: Does Your Philosophical Orientation Matter?’ and now you are feeling ready for some practical ethical frameworks to work through some health-related ethical questions, such as ‘do I prioritize autonomy or community for my program?’ or ‘is my policy paternalistic?’ Just before we start driving down the road of applying ethical frameworks, we need to take a quick pit stop and make sure we are all on the same map and heading in a similar direction as far as how we define different health-related ethics.

Not only are there many definitions for public health and health promotion, but now you may feel as though you are in the weeds trying to differentiate between bioethics, public health ethics, and health promotion ethics. You may not emerge from your rabbit hole of research for days. So why might it be important to spend the time getting to know the difference between these three types of ethics?

Unearthing the origins of words or concepts helps us to appreciate their impact on the present context. For instance, the word ‘gypped’ (often spelled incorrectly as jipped) is still used by folk to refer to instances where they have felt cheated out of something because they do not know that it has a negative connation. It is derived from the word ‘gypsy’ and portrays Romani people in an offensive manner. As a student, I wish I had spent more time tracing the roots of some of my most often referenced journal articles – what was the background of the author? Did their country’s politics impact their writing? Was the methodology of the study strong? Was the sample size robust?

Through the guidance of Dr. Ross Upshur, I did get an opportunity to delve into why there are differences between bioethics, public health ethics, and health promotion ethics. What I came away with is that it really comes down to values.

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Public health ethics only became a distinct area in the late 1990s. Prior to this time, Bioethics (considered synonymous with health care ethics) was considered an acceptable theoretical base for ethical issues faced by public health practitioners. Why as members of a public health network (mentioned in Part 1 of this blog series) would it matter what base you are using to discern ethical issues in your field? This table will help you distinguish between different types of health-related ethics:

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* Reference: MacDonald, M. (2014). Introduction to Public Health Ethics: Background. Montréal, Québec: National Collaborating Centre for Healthy Public Policy.
** Carter, S., Cribb, A. & Allegrante, J. (2012). How to think about health promotion ethics. Public Health Reviews, 34(1), 1-24.


Check out this short public service announcement on obesity and use each of the different ethical approaches above to see what you perceive as an issue or non-issue. Which of the three health-related ethics comes closest to serving as the basis for the video you just watched? If you are thinking health care ethics, than we are heading in the same direction.

A campaign by the Covenant House called ‘why can’t street kids just get a life?’ takes a more public health ethics approach because it informs the general population in a public spaces, such as the subway, and includes values such as social justice and solidarity in the questions being asked. How could this campaign be changed if a health promotion ethics lens were applied in its creation? It is important to understand the ethical approach that you and your organization take, because whether you know it or not, your approach drives everything you do (e.g. policies, programs, marketing messages), much like your philosophical orientation. ‘Ethical Dilemmas in Health Promotion Practice’ can help you dive deeper into analyzing issues you may be observing in your work.

Although ethical questions such as ‘what is a good society?’ or ‘what should health promotion contribute to a good society?’ can seem daunting, engaging in ethical reflexivity to question our own assumptions can help us to uncover unintended consequences from well-intended health practices. Stay tuned for practical ethical frameworks to apply to your work in health!

 

 

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Parachute Safe Kids Week: At Home, At Play and On The Road

safekidsweek

 

By Sunitha Ravi Kumar, KT Coordinator at Parachute

This year marks the 20th anniversary of Parachute Safe Kids Week, an annual campaign that aims to raise awareness about preventable injuries in children. From May 30th – June 5th, communities across Canada will host family-friendly events to provide education about the top childhood injuries At Home, At Play and On The Road.

The number of deaths among Canadian children in the past ten years due to preventable injury has decreased by 28 percent. Think about it - that’s 2,098 children. You might be surprised to learn that even with this downward trend, in Canada today a child dies every few hours from a preventable injury...that is unacceptable.

But what does a preventable injury look like? 

At Home

safekidsweek2Children live in an environment built for adults, making children vulnerable to injury. Leading causes of injuries in the home include:

• falls down stairs or off furniture
• choking, suffocation and other breathing-related incidents
• poisoning
• burns and scalds
• drowning in the bathtub or backyard pool.

Being aware of hazards around the home and taking safety measures such as using baby gates on stairs and locking away medications, can make the home a safe place for kids to learn and grow.

At Play

Physical activity is an important part of childhood. Whether playing organized sports or participating in recreational activities, there may be some risk of injury. Assessing a child’s skill level, recognizing hazards in the physical environment, wearing the proper gear, teaching and practicing ‘fair play’ techniques can all ensure that play remains a part of healthy, active living.

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On the Road

Children are vulnerable road users. Did you know that transport-related incidents are the leading cause of death for Canadian children between the ages of 5-14? Between 2003 and 2012, almost half of all unintentional deaths for children 0-14 occurred on the road1. Regardless of whether children are pedestrians, cyclists or vehicle passengers, practicing and modeling safe behaviors while on the road can keep young ones and you safe on the road.

--

Taking Part is Easy

As a national charity, Parachute is dedicated to closing the gap on childhood injuries. But, we need your help. Together, we can save more kids lives.

As a parent, caregiver, teacher or community partner, you can help reduce preventable injuries in children. Start by taking part in Parachute Safe Kids Week. Be sure to explore our 2016 Safe Kids Week Resources to help you roll out Parachute Safe Kids Week in your community. Make a pledge to keep kids safe and post to your social media channels using the hashtag #SafeKids20. Or visit our website and make a donation to support ongoing programs that keep kids safe.

Have a Safe Kids Week!

The Parachute Team
parachutecanada.org/safekidsweek
@parachutecanada

1. Statistics Canada. No date. Table 102-0540 Deaths, by cause, Chapter XX: External causes of morbidity and mortality (V01 to V89), age group and sex, Canada (table). CANSIM (database). Last updated December 10, 2015. http://www5.statcan.gc.ca/cansim/a05?lang=eng&id=1020540

 

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Working towards an alcohol control strategy for Ontario that prioritizes community safety

By Kyley Alderson, HC Link - Parent Action on Drugs

Last week, I was fortunate enough to attend the forum An Alcohol Strategy for Ontario: Promoting Public Health and Community Safety put on by the Working Group for Responsible Alcohol Retailing. The purpose of the forum was to bring together a variety of stakeholders to raise public awareness about the potential social and health impacts from expanding access to alcohol (i.e. alcohol being sold in grocery stores) and build political will to adopt an evidence-informed provincial alcohol control strategy that prioritizes community safety.

The forum certainly did bring together a variety of stakeholders – and while everyone there could agree on wanting safe communities, there was definitely some interesting conversations that were had.

The honourable Dipika Damerla, Associate Minister of Health and Long-Term Care discussed how Ontario has expanded beer sales to an additional 450 locations across the province to give Ontarians more convenience and choice while still maintaining a strong commitment to social responsibility through strict controls over how the beer is sold in these new locations (i.e. restricted hours, designated section of the store, certified and trained staff). During a Q&A period, concerns were raised about how the evidence has shown us that increased access to alcohol results in higher alcohol consumption and higher harms associated with alcohol use. Concerns around enforcement were also raised, as there are very few AGCO Inspectors assigned to large geographic areas. Damerla assured participants that the government wants to get an alcohol policy right for Ontario, and that the strategy will be robust and will require a cross-government approach.

Ann Dowsett Johnston, author of Drink: The Intimate Relationship Between Women and Alcohol shared why the alcohol file is so urgent. She spoke about how despite all the known harms associated with risky drinking, it is still a conversation that no one wants to have because alcohol is entrenched in our culture. We drink to relax, we drink to celebrate, we drink to de-stress, we drink to impress (i.e. if you know your vodkas you’re hip). She was passionate about her concern for how normalized drinking is in our society, and how it is slowing down progress for a successful alcohol control strategy.

Dr. Tim Stockwell, Director of the Centre for Addiction Research of British Columbia, tackled the myth that low-risk drinking can have actual health benefits (i.e. a glass of wine a day is good for your heart). Stockwell also touched upon the dimensions of a successful alcohol policy, including: price, control system, physical availability, drinking and driving, marketing and advertisement, legal drinking age, and screening and brief intervention. Increasing the minimum price of alcohol has been shown to have the greatest impact in reducing risky alcohol consumption and its associated harms.

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                                                      Dr. Tim Stockwell (Centre for Addiction Research of British Columbia)

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                                                       Pegeen Walsh (Ontario Public Health Association)


Dr. Robert Mann, shared trends in alcohol use and problems among adolescents. In Ontario, the most stunning statistic was the decreased rate of drinking and driving among grade 11 drivers (from 46% in 1977 to 3% in 2015). Since 1977, the three major drops in drinking and driving are seen when: the legal age for drinking was increased, when graduated licensing was established (where a blood alcohol level of zero is the law), and when a blood alcohol level of zero was required in all drivers under 22. While there are many programs and initiatives working towards reducing drinking and driving (and working well!), this data does show the profound effects that policies can have. While Ontario has always been the best performing province in motor vehicle fatalities involving alcohol (meaning the lowest numbers), the new data shows that Ontario has the highest rates for drug-present fatalities. There was discussion around how a zero tolerance for drugs policy for drivers under 22 years of age needs to occur.

Dr. Lisa Simon, Associate Medical Officer of Health, spoke about equity as it relates to alcohol consumption and associated harms. While those with the highest income level report the highest alcohol consumption, those with the lowest income have 2x the harms (alcohol-attributed hospitalizations). Furthermore, low income areas tend to receive disproportionate amounts of alcohol outlets. Perhaps not surprisingly, policies that increase the minimum price for standard drinks have been shown to have the most positive impact on those with a lower socio-economic status.

One participant from the audience asked the question to a few of the presenters, what ONE POLICY should be reflected in an alcohol strategy, the answers were:

  • SES should be considered when siting alcohol outlets

  • A minimum price for standard drinks should be set at $1.65

  • Guidelines for low-risk drinking should be on all drinks

  • Reduced availability of alcohol outlets


Brenda Stankiewicz, Public Health Nurse at the Sudbury & District Health Unit spoke about 3 specific challenges in the North regarding alcohol:

  1. Much higher percentage of underage youth reporting parental permission to drink (42% vs 26% in the rest of Ontario)

  2. Transportation issues. With limited or no public transit or taxis available – there are far fewer options for getting home safely after drinking... causing more drinking and driving.

  3. Very limited enforcement. There is the prevailing attitude that if you drive home on dirt roads or long stretches of deserted highways, you will not get caught. Also, because everyone tends to know each other – there is the attitude that no one will report them. Furthermore, there is only 1 AGCO in all of Sudbury, which means – enforcing and monitoring even more alcohol outlets will be even more challenging.

There were many other great attendees who presented, asked thoughtful questions, and engaged in stimulating dialogue. All in all it was a worthwhile forum, and hopefully a stepping stone in the direction of developing an alcohol control strategy for Ontario.

Although the discussion of the forum was focused on a provincial strategy, the role for local players was highlighted. To support your efforts CAMH HPRC is offering free promotional materials to public health and health promotion professionals in Ontario who are interested in supporting low risk drinking: https://www.porticonetwork.ca/web/camh-hprc/resources/substance-use.  You can also check out the Parent Action on Drugs website for information and resources on issues that impact substance use and youth geared towards youth, parents, and professionals.

 

 

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Public Health Ethics Part 1 of 3: Does Your Philosophical Orientation Matter?

 

By Stephanie Massot, Public Health Practicum Student at Health Nexus

This is the first blog post in a series on public health ethics. This post focuses on the importance of understanding your/your organization’s philosophical orientation.


One of my first year-long courses during my undergraduate degree in Health Education at the University of Victoria was Philosophy 100. I know I spent many hours poring over the writings of well-known philosophers but what seems to have stayed with me are disordered images of Waking Life, a film that captures a range of philosophical issues, and an overall feeling that philosophy was a ‘nice to know’ but not a ‘need to have’.

Fast forward 11 years later to the final academic term of my Master of Public Health at the University of Toronto and I am creating a course in Public Health Ethics, which has strong roots in philosophy. Since I worked in the nonprofit sector, I know that many decisions have ethical implications, such as resource allocation or selecting which organizations to collaborate with. You have an impact on the public health system if you or your organization puts any energy towards keeping people healthy and preventing injury, disease and premature death. For many of us this occurs by taking action on the living conditions that affect our community members. As members of a public health network, having an understanding of public health ethics and tools available will result in better decisions and improvements in the health and satisfaction of the people we serve.

Now how to take on ethical decisions in public health?

Whenever you have to make decisions, whether you are aware or not (typically therein lies the problem) you always come from a particular philosophical orientation. Since you may not be cognizant of your philosophical orientation, as a public health practitioner it is important to develop reflexivity and understanding of your orientation because if tough, moral decisions occur in your public health work (which they will) and especially if the decisions have to be made quickly, you want to be aware of where you and your colleagues stand.

Population and Public Health Ethics: Cases from research, policy, and practice is a useful resource for familiarizing yourself with philosophies that are particularly influential in the public health arena and to use case studies to expand your understanding. A quick summary is below and you can ask yourself, ‘in Canada, our governmental system is most aligned with which philosophy? Our neighbours down south?’

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The answer for Canada is liberalism and for the United States it is libertarianism. Although these philosophical orientations sound similar, libertarianism is about having individual freedom through as little government involvement as possible whereas liberalism is basically about having individual freedom guaranteed by governments (see bolded text in the above chart). The context of your work (country, specific organization) should always be a consideration when you are thinking about ethics because context will influence your decisions.

I may not be able to quote you passages from Socrates and Plato, but I will aim to create a space for discussion where colleagues can co-inquire about values, assumptions and concepts that build a foundation for equitable decision-making and of course, ask more questions.

 

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Using Popular Theatre as a Facilitation Technique

By Gillian Kranias, HC Link Consultant

This is the eight blog post in a series on facilitation techniques and approaches written by HC Link staff. This post focuses on using popular theatre for warmup/centering activities and even as a learning tool.


Without being an actor or director in any way whatsoever, I have pursued a lifelong passion for using popular theatre activities in community learning, community development and social change settings. These activities all value equity and inclusion, as well as a holism that engages creativity, non-verbal communications and full body awareness in our analysis, learning and organizing efforts.

Some techniques take a significant amount of time and are difficult to explain in writing. For this blog post, I am sharing few warmup/centering activities and the technique of image theatre, which can take anywhere from 5-90 minutes.

For more reading on popular theatre and theatre of the oppressed, try these titles:

Practical Books

Games for Actors and Non-Actors
By Augusto Boal. (New York: Routledge, 1992)

Educating for a Change
By Rick Arnold, Bev Burke, Carl James, D'Arcy Martin, Barb Thomas
(Toronto: Doris Marshal Institute for Education and Action & Between the Lines, 1991)

Essays

Playing Boal: Theatre, Therapy, Activism
Edited by Mady Schutzman and Jan Cohen-Cruz (London: Routledge, 1994)


In the right group, your courage to do things differently will pay off in surprising ways!


Centering Activities (5 minutes)

Source Augusto Boal’s book: Games for Actors and Non Actors

DSC 0507There are hundreds of theatre and improv games that can help “center” members of a group together, build listening skills, and exercise people’s timing in response. Here are two fun ones that I learned from Augusto Boal’s book. To choose games appropriately for your group, consider the lightness or seriousness of the gathering, how well people know each other already, as well as physical ability and language differences among group members.

 

 

 

“Name & Motion”

* Engages group members to listen, observe, and move

* Requires only limited “theatrical risk-taking”

* Generates lots of smiles and breaks down inhibitions

Instructions:

- Have everyone stand up in a circle. As the facilitator, explain and demonstrate how this introduction game works:

- Each individual, when they are willing, takes one step towards the center of the circle and makes a motion (preferably large) while calling out their first name. Everyone else must then together repeat the person’s “name and motion” two times (like an echo response).

- Allow time for each person to introduce their “name and motion” and be welcomed by the group through their “name and motion”.

“Pass the Clap”

* Engages group members to listen, observe, and move

* Focuses group members attention to one collaborative challenge

* Encourages a lighthearted approach to mistakes

Instructions:

- Seated or standing in a circle, the facilitator claps in the direction of someone next to them. This person is asked to pass the clap to the next person in the circle, and so on the clap will pass from person to person around the circle.

- Do this a few times around, so that the clap passes around the circle and past the facilitator several times. Then, while the clap is passing on the opposite side of the circle, the facilitator can begin a second (and later a third) clap that will travel in its own timing around the circle (so several claps will be circling at once).

- The facilitator can keep passing the clap through the circle for a while, and then eventually gather the claps (by not passing them past the facilitator) to close the activity.

- Variation: It is also possible to shift from sending the clap around the circle, and send it instead to someone across the circle.

 

Personal Style Reflection - What animal am I most like in a group? (5 – 20 minutes)

Typecasting by others can heighten conflict. Allowing each individual in a group to share their uniqueness and offer insight into the qualities of their “animal” creates an appreciative and collaborative dynamic. I learned and used this activity from colleagues at the Self Help Resource Centre.

* Engages group members to reflect on what they bring personally to the group

* Uses metaphor to convey complex ideas in a non-restrictive way

* Provokes laughter – being lighthearted about the strengths and challenges of our unique personalities

Instructions:

- Post pictures, or a list, of 6-8 different types of animals.

- Ask people to reflect on which animal they most behave like, when working in a group setting.

- Invite each participant to share which animal they identified with most, and why.

- With larger groups, the same question can be explored more dramatically/playfully by asking people to act out their animal, find others acting like them, and then sit together in their animal group to create a list of what they see as the significant qualities of their animal in groups.

 

Image theatre (10 - 90 minutes)

(Source: Headlines Theatre, Vancouver & Mixed Company, Toronto)

Image theatre is a wonderful technique! It is less intimidating than roleplay, and can be used on its own or as a warm-up activity before roleplaying. This technique is also known within popular education groups as “human sculptures”.

* Engages group members in holistic thinking and analysis, and learning

* Works equally well for multi-lingual groups

* Helps groups analyze patterns within shared issues or experiences

* Great for experiential learners

Instructions:

- Begin with people’s experience. In small groups, on a given theme, share stories or jump right into identifying patterns or key elements of a problem. Ask the group to create a frozen image (no words) to convey their perspectives. For example: How does inclusive leadership work? Or What keeps you [parent] from getting more involved in your child’s school?

- Each group takes turns “exhibiting” and “viewing” the sculpture of other groups. Encourage people to explore all sides of the sculpture by touring around it. If the image includes people playing specific roles, after the sculpture has been viewed, the facilitator can point to the people one at a time and ask each of them to say a few words about “what is your character thinking/feeling?”

- Another variation is to ask people to return to their groups and develop a series of 3-5 images – evolving from the first – that bring about a positive change. When these image series are being shared, the facilitator claps her/his hands to signal the group to change from one image to the next.

Augusto Boal’s book: Games for Actors and Non Actors has an entire chapter on different image theatre techniques and describes dozens and dozens of such games.

SPOTLIGHT –Organizations are using popular theatre as a learning tool!

Popular theater uses theatre as a tool for social transformation. It typically involves the “audience” as participants and invites groups to explore attitudes and social problems and imagine a range of potential solutions.

Reflet Salveo, an organization that promotes access of Francophones to quality health services in French, used the popular theater approach as a learning tool within a workshop context. They hired actors from a French language community theater group (Les Indisciplinés de Toronto) to role play and demonstrate a series of possible scenarios in the context of hiring people with various disabilities. They allowed for audience feedback and found this was a great tool to generate discussion amongst participants.

 

Companies in Ontario who work with communities and are using theater as a tool for positive change:

Mixed company theatre uses forum theatre (an interactive approach that involves the audience in developing real-time strategies for dealing with social and personal issues) to educate, engage and empower audiences in schools, communities and workplaces.
Website: http://www.mixedcompanytheatre.com/

Sheatre uses issue-based theatre to find solutions to social problems. Artists and community members work collaboratively to express and explore a wide variety of issues that are important to their community.
Website: http://sheatre.com/

In Forma Theatre aims to engage community members in meaningful dialogue through participatory theatre.
Website: http://www.iftheatre.org/

Branchout Theatre believes in the use of popular theatre as a branch towards social change by connecting and empowering individuals and communities to communicate and transform the world around them.
Website: https://sites.google.com/site/branchouttheatreworkshops/home

 

 

 

 

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Webinar recap: new technology trends, tools, and applications

By Robyn Kalda, HC Link

May4webinar
Star Wars Day (May the 4th Be With You), seemed like a good day for a webinar on new technology trends and uses and some health promotion implications. As health promoters, we like to be sure we stay on the light side of the Force, and to do that we need to think about new technology as it develops as well as paying attention to research findings about the best ways existing technologies are used.

I discussed trends in new technology generally, including the Internet of Things, wearable technology, virtual reality / augmented reality, and the growth of the Internet as a shrinking collection of walled gardens.

Design trends I mentioned included the massive growth in mobile traffic, leading to trends such as responsive design (where the various parts of the page display differently depending on the size of your screen) and infinite scrolling (endless webpages that keep loading content, such as your Facebook homepage); the tendency for design to now be slightly less "flat" than has been the trend for the past few years; the increased use and acceptability of images and video; and the inclusion of nonstandard interface controls such as sideways scrolling (instead of the usual vertical scrolling).

I encouraged health promoters not to ignore the world of apps, which suffers from the same content-quality controls as the rest of the Internet. Whether we choose to create our own apps or whether we choose to help highlight the pros and cons of various existing apps, health promoters can play a useful role.

While research on social media has challenges -- by the time you conduct and publish your research, the technology has probably changed -- I discussed some findings from existing studies and reviews.

One main finding is that two-way communication in any kind of health promotion social media effort is critical for success. Just putting information out there is not enough.

Another main finding is that while many studies have assessed the reach of social media -- and of course it can be very good at expanding an intervention's reach -- many fewer have assessed behaviour change. However, one meta-review did find no negative behaviour changes occurred as a result of social media interventions, so at the very least we can be reasonably sure we are not causing harm.

HC Link has a number of resources on social media including policy and plan outlines, a starter sheet to fill out before you set up a social media account, and a communications inventory to help you figure out what you already have that you might effectively repurpose with social media.

You can view the webinar recording and download the accompanying handout on our webinar archive page.

 
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PAD’s SFPY program featured in United Nations commissioned study on global “good practice” programs

By Seher Shafiq, Parent Action on Drugs


After a long process, PAD’s Strengthening Families for Parent and Youth (SFPY) program has been selected as a global good practice in a report published by the American University of Beirut (AUB).

Background

In March 2014, the UN Inter Agency Technical Task Team on Young People (UNIATTTYP) for the Middle East and North Africa/Arab States, began a process to document good and promising practices in adolescent and youth. The geographic focus was the Middle East and North Africa (MENA) region, but the project also looked at programs globally in order to recommend some “best buys” in adolescent programming that could be applied in the MENA region.

This project was spearheaded by UNICEF MENARO, who had partnered with the Outreach and Practice Unit (OPU) of the Faculty of Health Sciences at the American University of Beirut. The age group the project focused on was 12-24 year olds, and thematic areas included employability, social protection, civic engagement, and health (among many others).

The process

The first phase was research on the part of AUB, who selected a few of PAD's programs that could be considered good/best practices for youth aged 12-24. PAD’s programs were among the 169 potential good practices that the AUB had found regionally and globally. After looking at several of PAD’s programs, the AUB decided to focus on PAD’s SFPY program.

Second, the programs were rated based on a number of criteria: Effectiveness, Sustainability, Replication, Equity Analysis, Evidence-based, Innovation, Values Orientation, Youth Involvement. The SFPY program met this criteria and was selected as a potential good practice.

To validate the research made by AUB to this point, PAD participated in an in-depth interview about the SFPY program, where we shared more details with the researchers.

After the interview, the SFPY program was deemed by AUB to still meet the criteria listed above, and the researchers completed a report that explained the various aspects of the program.

The entire process above took around 8 months. After 8 months, the final stage of the process was for PAD to “validate” the write-up by the researchers. PAD and AUB had a back-and-forth consisting of report edits, and a few months later we were asked to provide some photos of the program.

Results

Last month, we were contacted by AUB who had finalized the report. After such a long process, it was exciting for us to see the final result. The AUB did a great job at summarizing the key aspects of the program and why it is considered a “good practice”. It’s interesting to see that a Canadian-based program has potential for global audiences as well!

To read the full report, click here.

To see the other programs featured by the AUB, click here.

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Mental Health Week Gets Loud!

By Monica Nunes, CAMH Health Promotion Resource Centre

This week Canada is celebrating both Mental Health Week and Children’s Mental Health Week using the hashtag #GETLOUD to raise awareness about mental health and mental illness. Mental Health Week celebrations have traditionally been an opportunity to impact stigma by talking candidly about mental illness. These same celebrations are now evolving beyond conversations of illness to also consider the role of mental health and well-being in our lives. Earlier this week, Prime Minister Justin Trudeau commented that Mental Health Week is an opportunity to not only support those struggling with mental illness but also encourage conversations “...about what mental health is and what we can do to increase our collective well-being”.

Recognizing mental health as a positive concept and a resource for living creates space for promoting behaviours, activities, programs and strategies meant to improve resilience and well-being. This is a sentiment that is growing in Ontario. For instance, Phase 2 of Ontario’s Mental Health and Addictions Strategy includes an area of focus on mental health promotion, prevention and early intervention.

CAMH Health Promotion Resource Centre has also created a video called Finding a Shared Language (ENG)/(FR) that reflects the growing importance of mental health promotion in our communities. The video outlines simple strategies for promoting mental health individually and in our communities by:

• Knowing and accepting that everyone in faces daily challenges
• Getting involved in your community and giving back
• Supporting and including different types of people in your community

Promoting Mental Health: Finding a Shared Language from CAMH HPRC on Vimeo.


These tips are just one way to #GETLOUD about mental health. How do you plan to join the conversation this week? Check out the events on the websites below to get you started!

Centre for Addiction and Mental Health
Canadian Mental Health Association
Mental Health Commission of Canada

For mental health promotion resources, check out the CAMH HPRC website!

 

 

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Moving Ahead on Rural and Community Transportation: March 29th, 2016 Forum

By Lisa Tolentino, HC Link Community Consultant

On March 29th, 2016 HC Link partnered with the Rural Ontario Institute (ROI), Ontario Healthy Communities Coalition (OHCC) and Routes Connecting Communities to organize and host a forum for rural and community transportation stakeholders. Moving Ahead on Rural and Community Transportation was held to enable participants to share experiences and lessons learned, and help support peer-to-peer networking. Significant steps are being taken by many municipalities and other stakeholders to improve community transportation in rural areas around Ontario. Representatives from diverse organizations that are implementing community transportation initiatives were in attendance as over 100 people from across the province attended both in-person and online, via live-streaming/webinar.

RuralTransportationForum
Things kicked off with an exercise to provide opportunities for networking and to get to know who was in the room, and online. The majority of participants represented municipal and regional government, followed by the non-profit sector. Others working within the private and education sectors were also in attendance. Representatives attended from the following regions and districts:

•Grey-Bruce                      

• Haliburton

• Hastings

• Kawartha Lakes

• Kenora (Dryden)

• Lambton (Sarnia)

• Lanark

• Leeds and Grenville (Brockville)

• Lennox-Addington

• Muskoka 

• Niagara

• Norfolk

• Nipissing

• Northumberland

• Perth County (Stratford)

• Peterborough

• Simcoe

• Timiskaming

• Wellington/Waterloo

• York (Georgina)

A presentation was then given by Cathy Wilkinson from Routes Connecting Communities, which is a transportation provider serving the northern part of York Region. Their volunteer drivers use their own vehicles to provide available, accessible and affordable transportation to people who are restricted due to life circumstances such as financial hardship, health issues, and geographic, social or cultural isolation.

Cathy’s presentation was followed by a panel discussion with three other transportation service providers in the province, including: 1) Brad Smith from Ride Norfolk, 2) Heather Inwood-Montrose from The Rural Overland Utility Transit (TROUT), and 3) Rick Williams from Muskoka Extended Transit (MET). The panelists focused on sharing the challenges and successes that they have experienced in delivering public transit in their respective areas.

Next the Ministry of Transportation offered an overview of what Community Transportation (CT) is to them, and highlighted a few examples of initiatives that they are currently funding across the province. This is a $2 million, 2-year pilot grant program to provide financial assistance to Ontario municipalities for the development and implementation of community transportation initiatives. As part of the CT Program, 22 municipalities have undertaken projects to either start or expand collaborative projects in their regions. MTO representatives also announced that they will soon be supporting communities around the province with increased networking and engagement opportunities with respect to Community Transportation.

 Following lunch, participants broke into small groups to discuss five topics:

  1. Building Community Support - demonstrating the need and/or making the case for community transportation

  2. Collaboration & Partnership Building - managing different organizational mandates and moving forward

  3. Revenue Generation & Funding - using both traditional and innovative or creative approaches to generating funds

  4. Marketing & Promotion - of new and/or existing transportation services

  5. Technology - procuring vehicles, using integrated software, and other forms of technology

The day ended with a live streaming presentation by Caryn Souza from the Community Transportation Association of America (CTAA). The CTAA consists of organizations and individuals who support mobility for all Americans regardless of where they live or work. Their membership includes community transit providers, public transit agencies, organizations providing health care and/or employment services, government, college and university planners, private bus companies, taxi operators, people concerned with the special mobility needs of those with disabilities, manufacturers and many other organizations who share a commitment to mobility. Caryn explained that there are many different programs that the CTAA is currently involved in, from mobility management to transit planning and ridesharing across the nation.

Overall, the day was full of information about Community Transportation in both Ontario and across the USA. Participants said that it was great to be in a room with others who have the same struggles as they do, and that they had the opportunity to learn from one another and as well as brainstorm solutions. Many said that they were able to foster connections with other people working on-the-ground and that they learned something that they will be able to apply in their own communities. HC Link was also pleased to have had the chance to help facilitate this group of passionate and committed people!

If you would like more information about this event, please contact Lisa Tolentino, Community Transportation Network Coordinator, This email address is being protected from spambots. You need JavaScript enabled to view it.

 

 

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Paving the Way: A peer sharing session on defining the policy problem

By Andrea Bodkin, HC Link Coordinator

This blog post is part of a series on the topic of developing health public policy written by HC Link staff and our partner organizations. If you would like to contribute to this series, please contact This email address is being protected from spambots. You need JavaScript enabled to view it.">This email address is being protected from spambots. You need JavaScript enabled to view it.

Today I hosted a peer sharing session, along with Kim Bergeron from Health Promotion Capacity Building at Public Health Ontario. Called “Paving the Way”, today’s peer sharing session built on last month’s online discussion (of the same name) on defining the policy problem. Using a teleconference line and webinar platform, we had an interesting discussion about some of the approaches to and challenges with defining the policy problem. Our discussion focused around four main themes:

Language

Developing a shared and common language is important, particularly when working with a variety of stakeholders on policy development. One of our participants is working with community members, the police, landlords and service provides to develop a policy. I can imagine that such a diverse group would not only use different language, but might even use the same words to mean different things. Kim suggested drafting a glossary to create and define common terms to use throughout the policy development process. Developing a common agenda, part of the collective impact process, has useful tips for this step.

Evidence

A participant shared their experience of using evidence in the problem definition stage, by collecting data such as literature reviews, rapid reviews, community assessments etc and analyzing these data sources to identify the nature of the problem and identify potential policy solutions. This gave rise to an excellent question from another participant: Do you collect all of the evidence and then consult with stakeholders and the community, or do consult with stakeholders and the community and then collect the evidence that you need to support it?

I suggested trying to find the “sweet spot” between collecting evidence and working with the community. At HC Link, our definition of evidence includes not only published literature and population health data, it also includes lived experience and cultural knowledge. We view the experiences and input of the community and stakeholders as one source of evidence, rather than separate from it.

Another participant who does international development work in the area of maternal and child health shared that their organization does data collection and community engagement concurrently through two different departments.

Timing

Developing health public policy is one of those health promotion strategies where time seems to operate differently from the rest of our work! By that I mean the sheer length of time that it can take to develop, implement and evaluate a policy (often having to go back and repeat a step, or jump ahead when there is sudden media support around the issue, and go back again). Kim reminded us that we may have to work with the election cycle, and sometimes at different levels of government (each running on their own election cycle). And of course, carving out the time to work with partners and do policy work!

Knowledge Exchange Strategy

Kim’s takeaway from today’s peer sharing session was on the important of developing a knowledge exchange (KE) strategy that runs the entire length of the policy development process: planning, implementation and evaluation. We often stop to develop a KE strategy at certain points of the policy development process, when actually KE should be continued at each and every stage, in particular when the community and stakeholders are involved.

Resources mentioned during today’s peer sharing session

FOCUS ON: Relevance of the stages heuristic model for developing health public policies http://www.publichealthontario.ca/en/eRepository/Focus_On_Stages_Model_and_Policies.pdf

Are We Ready to Address Policy? Assessing and building readiness for policy work http://www.hclinkontario.ca/images/Are_We_Ready_To_Address_Policy.pdf

Tools from Healthy Living Niagara to track municipal decisions

http://healthylivingniagara.com/active-transportation/understanding-municipal-decision-makers/

Recent comment in this post
Kim Bergeron
Great summary of the discussion Andrea. It was helpful to have a focused conversation on defining the policy problem. Often there ... Read More
Friday, 22 April 2016 12:50
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Policy Talk: An ounce of prevention is worth a pound of cure

By: Seher Shafiq, Parent Action on Drugs

This blog post is part of a series on the topic of developing health public policy written by HC Link and our partner organizations. If you would like to contribute to this series, please contact This email address is being protected from spambots. You need JavaScript enabled to view it.

The Canadian Centre on Substance Abuse recently released a free online learning module to help better understand the Portfolio of Canadian Standards for Youth Substance Abuse Prevention — a resource that guides teams on how they can improve their prevention work in the area of substance abuse.

I had the opportunity to go through the online learning module, and found it concise, informative, evidence-based, and interactive.

The module provides tools to help professionals in various sectors prevent youth substance abuse. It encourages the user to recognize that regardless of what sector they are working in, the work we all do as community service providers plays a role in substance abuse prevention. The module recognizes the importance of setting a strong foundation in the “youth years”.

The module also explains risk factors that youth are exposed to when growing up (ex. Conflict with the law, relationship issues, mental illness, etc.), as well as protective factors, noting the importance of minimizing the former and promoting the latter. CCSA also notes that substance abuse prevention does both of these things.

I have to admit, the discussion about risk and protective factors reminded me of Parent Action on Drugs’ Strengthening Families for Parents and Youth program, which is an evidence-based, preventative program that promotes youth resiliency.

What interested me the most in the module was the data on costs associated with substance abuse. In 2006, Canada spent almost $40 billion on substance abuse. These costs were often associated with healthcare, law enforcement, and the court system. I also found it interesting that 30% of charges in violent crimes are associated with alcohol abuse use.

However, the most surprising data for me was that for every dollar spent on substance use prevention, the government saves $15-$18 dollars. This data should be eye-opening for policymakers. Two years ago, I did a project for the MaRS Centre for Impact Investing and similarly found that reducing recidivism rates (i.e. people going back into jail after they’ve been released) through promoting preventative interventions like mental health counselling, affordable housing, and employment skills workshops can also produce similar cost savings for the government.

I can’t help but think of the billions of dollars the government could save if it prioritized prevention initiatives. Policymakers need to recognize that prevention initiatives work and show results – not just in dollar terms, but also through the positive impact on society.

As the saying goes “an ounce of prevention is worth a pound of cure”.

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New Resource - Strategic Planning: From mundane to meaningful

By Pam Kinzie, Consultant 

Strategic planning is not a new process. In fact, the first mention of it in the literature related to military strategy in the fourth century B.C.! The Harvard Business School presented it as a new discipline in the 1960’s and by the 1970’s the elements of strategic planning commonly used today appeared.

Those who have participated in strategic planning before may be either enthusiastic about the prospect of developing one or jaded by a previous experience that did not accomplish the anticipated results. There is also a great deal of confusion about what a strategic plan is, why and how one should be developed.

StratPlanThumbTo that end, HC Link has released a new resource on strategic planning, Strategic Planning: from mundane to meaningful. This resource provides an overview of strategic planning including why, when and how to do it, who to involve, the key elements and what to consider when developing a strategic plan. It provides a simple, clear guide to strategic planning for community groups, coalitions and small non-profit organizations drawing on literature aimed at similar organizations. The resource will also provide information that will help you to develop a plan that will not sit on a shelf, but rather act as a living document to guide your program planning, budgeting and measurement of performance. “The best plan is useless unless it is acted upon.”1

Strategic planning is defined as “a process through which an organization agrees on and builds key stakeholder commitment to priorities that are essential to its mission and responsive to the organizational environment. Strategic planning guides the acquisition and allocation of resources to achieve these priorities.”2

Another way to think of a strategic plan is as a flight plan for a pilot. Without one, the pilot and crew have no direction and no specific destination to inform the ticket-sellers or the passengers. The fueling station has no idea how much fuel to provide and the meteorologist can’t anticipate the weather en route. Indeed the mission is unclear. If you don't know where you want to go, it doesn't matter which road you take (to paraphrase the Cheshire cat in Alice in Wonderland).

Consultants may be helpful in providing objective assistance in the overall design of your planning process to involve all key stakeholders. They can obtain sensitive information through interviews and share it in a constructive way. Their key role is to focus on the process and provide relevant background information. Some organizations find it useful to have consultants facilitate planning meetings or retreats so that the stakeholders are free to participate actively. HC Link offers customized consulting services to community groups, organizations, and partnerships to support their work in building healthy communities. HC Link’s consultants can provide valuable resources, tools, problem-solving, advice and mentorship in a variety of areas. HC Link’s consulting services are funded by the Government of Ontario and are provided free of charge, when possible. Contact us to learn more!

We hope that you will find this resource useful in your strategic planning efforts. To learn more about facilitating strategic planning sessions, please read HC Link’s ongoing blog series on facilitation techniques:

 
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1 A. Suchman, P. Williamson, and D. Robbins. (2002) Strategic planning as partnership building: engaging the voice of the community a new perspective on strategic planning. AI Practitioner Newsletter
2 M. Allison and J. Kaye. (2015) Strategic Planning for Non-Profit Organizations: A Practical Guide for Dynamic Times, Third Edition, John Wiley and Sons Inc. 1.
 
 
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Emerging trends in tobacco use among youth


By: Kristy Ste Marie and Vicki Poulios, Youth Advocacy Training Institute (YATI)


When you hear the phrase, “tobacco use”, what comes to mind? My guess would be “smoking” or “cigarettes”. People might assume that this is the most common form of tobacco use, and indeed, among adults it might be. Among youth, however, the landscape has shifted, and things are not what they used to be. On March 22nd, we went over this in our webinar: Vapes, Hookah, and Chew: Emerging Trends in Youth Tobacco Use. The webinar was developed by the Youth Advocacy Training Institute (YATI), and was a partnership between YATI, PAD, and HC Link.

The webinar started with an overview of Vapes (e-cigarettes), Hookah, and Chew, where we defined the products and discussed their evolution. For instance, we took a closer look at the three generations of e-cigarettes, and provided a quick overview of what we know about the health effects and their effectiveness as a cessation aid. One common element among all of these products is the flavours – did you know that there are over 7,764 flavours for e-cigarettes alone?! Chew and Shisha (which is the product that is placed in the hookah or waterpipe to be smoked) also come in an assortment of flavours, like wacky watermelon, or Sex on the Beach. Flavours are a deliberate strategy by Big Tobacco (those who produce, promote and profit from tobacco) to make their products more appealing and get youth hooked on tobacco from an early age.

flavours

The next section of the webinar provided an overview of new provincial legislation that regulates these products, and examples of municipal by laws, and local policies that fill in some gaps. As of January 2016, the provincial government has banned the sale of flavoured tobacco products (with menthol being phased in by January 2017), and has prohibited the sale of e-cigarettes to anyone under 19. This is very exciting, and a huge step forward for protecting youth from tobacco initiation. The government has also promised to soon introduce legislation that will regulate where e-cigarettes can be used, and how they can be displayed for sale, so stay tuned for that.

Next up, we had Tonya Hopkinson and DeiJaumar Clarke, from Toronto Public Health give us an overview of their youth-led action on Hookah Smoking. Their campaign assessed young people’s awareness of the harms associated with hookah smoking, and they then developed and disseminated various resources to address those knowledge gaps. They also advocated for a ban on hookah smoking in indoor public spaces in Toronto and were successful – it came into effect in April, 2015.

Finally, we had Jacquie Uprichard from the Central East Tobacco Control Area Network, with a presentation on their youth-led campaign, Know What’s In Your Mouth. This campaign aims to increase awareness about chew tobacco, decrease high-school aged youth’s intention to use it, and to reduce the use of chew among students.

We were so lucky to have these two examples of youth-led initiatives that aim to denormalize tobacco use among youth in Ontario – Big Tobacco’s favourite new customer is a young one, because then they get a customer for life. So it’s great to see youth involved in taking action, and saying “no” to Big Tobacco’s tricks.


Watch the webinar recording or view webinar resources for more information!

 

 

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Paving the Way: an online discussion on defining the policy problem

By Andrea Bodkin, HC Link Coordinator

This blog post is part of a series on the topic of developing health public policy written by HC Link and our partner organizations. If you would like to contribute to this series, please contact This email address is being protected from spambots. You need JavaScript enabled to view it..


This afternoon, Kim Bergeron (Health Promotion Consultant with Health Promotion Capacity Building Services at Public Health Ontario) and I were joined by 22 people to talk policy. Kim and I normally get pretty excited about the topic of policy, and we enjoyed having others to share our enthusiasm with. The purpose of the online discussion was to explore three concepts in defining the policy problem that we will be diving into more deeply over the course of the year.


The topic of the online discussion was on defining the policy problem. This is a tricky step in policy development, where often times we jump to policy solutions (or are given policy solutions by our agency/funder) rather than taking the time to explore the nature of the problem that the policy is intended to solve. It’s important to take the time to define the nature of the problem so that a) you can articulate it b) you can get the support that you need from community and stakeholders and c) you can select the policy option that best solves the problem.


Kim began by introducing the concept of determining the type of problem we have on our hands:

  1. Tame problems: are those where stakeholders agree on the nature of the problem and on the best way to solve it;

  2. Complex problems: are those where stakeholders agree on the nature of the problem, but not on how to best solve it; and

  3. Wicked problems: stakeholders agree neither on the nature of the problem, nor on its solution. They are not evil, but are those problems that are considered highly resistant to resolve. The first action to define the problem is to recognize what type of problem it is.


We then had a conversation about wicked problems, using the example of safe injection sites. We discussed that values, personal bias, political opinion and ideology often affect how people see the problem and solutions. The public and various stakeholders often disagree about the precise nature of the problem, and whether it is a downstream, mid-stream or upstream one. We discussed the importance of developing a shared understanding amongst your stakeholders, engaging them in the conversation, on the nature of the problem and the possible policy solutions to it. We identified techniques and shared resources on how to develop that shared understanding, including:

  • Dialogue mapping

  • Collective Impact: a recent blog post from Tamarack discusses the tensions in light of a “wicked problem” in Collective Impact

  • Deliberative dialogue: the National Collaborating Centre for Healthy Public Policy has a collection of resources on Deliberative Processes

  • Finding areas of agreement and building relationships from there

  • Policy narratives: an article by Steven Ney and Marco Verweij discusses “Messy Institutions for Wicked Problems: how to Generate Clumsy Solutions”


Once you have identified the type of problem to be addressed and have developed a shared, collective understanding of the problem, there is a need to identify ways to communicate this information to others to build support and/or increase awareness. We discussed communication vehicles that we have used to communicate a shared understanding of a problem:


Kim and I are looking forward to diving into this subject more deeply at our peer sharing session on April 21. During this session, we’ll hear from 3 or 4 people about their experiences in defining the policy problem, and we’ll have the opportunity to talk more about our experiences, challenges and solutions. Registration for the peer sharing session is limited to 20 people to ensure that we can have a deep conversation. Register soon!

 

 

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Video Interview with Dave Meslin on advocacy and how to influence change

At our 2015 Conference Linking for Healthy Communities: Action for Change we were fortunate to sit down with keynote speaker Dave Meslin, community choreographer, to ask for his views on advocacy and what we can do to influence change.

“Everyone has an idea of how to make their neighborhood or their city or world a better a place, but most people have no idea how to take that idea and act on it.” In this interview, Dave shares the one thing everyone can and should do to influence change, and two things he has learned through his advocacy work.

Watch the full 2 minute video interview below!

 

 

A few key points from the interview:

  • Advocacy is the idea of people coming together and finding their voice.
  • Unfortunately, people tend to have a negative perception of what advocacy means (such as angry people marching in the streets), but there are so many fun ways to do advocacy.
  • One thing everyone can do to influence change is to start from within, and to find out what you are truly passionate about.
  • In advocacy, it is important to find a group that is totally aligned with your values. If a group does not exist that is fighting for what you think needs to be fought for – create your own! “There is nothing more fun than political entrepreneurialism.”
 

For more on our conference, please see highlights below:

confhighlightsimage
Linking for Healthy Communities 2015 Conference Highlights
offer photos and highlights from all plenary and concurrent sessions, including links to slides and additional information. It also provides ways HC Link can help build upon the connections and momentum started at the conference.

 
 
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Video Interview with David Courtemanche on what makes for effective advocacy

At our 2015 Conference Linking for Healthy Communities: Action for Change we were fortunate to sit down with keynote speaker David Courtemanche, leadership consultant, to ask for his views on what makes for effective advocacy and how policy change can impact health promotion.

In this interview, David talks with us about the skills that are often neglected in advocacy and how we can better develop these to become more effective advocates. He highlights that our perspective is a very big part of influencing change and encourages us to think about policy in terms of people taking action or taking a different direction. David goes on to demonstrate through an example, “the magical power of policy.”

Watch the full 4.5 minute video interview below!

 

 

A few key points from the interview:

  • “Advocacy is a process of influence.” It requires strong leadership and relationship skills because you need to connect with people in positions of influence that can affect change.
  • Advocacy training focuses a lot on how we speak and present, but skills that are necessary and often neglected include effective listening and trust building. We need these skills to better understand the people we are trying to work with.
  • People often view policy work as dry and boring, but when you understand how policy can affect the health of a community it becomes much more powerful.
 

For more on our conference, please see highlights below:

confhighlightsimage
Linking for Healthy Communities 2015 Conference Highlights
offer photos and highlights from all plenary and concurrent sessions, including links to slides and additional information. It also provides ways HC Link can help build upon the connections and momentum started at the conference.

 
 
 
 
 
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Using “Visioning” as a Facilitation Technique

By Lisa Tolentino, HC Link Community Consultant

This is the seventh blog in a series on facilitation techniques and approaches written by HC Link staff. This post focuses on using guided visualization or “Visioning” to identify Healthy Community goals.


Visioning is considered a critical step in developing healthy communities and creating change. It is a creative way to bring community members with diverse perspectives together to develop a collective vision of a Healthy Community. Used in many sectors and spheres of life, from business to mental health and sports, this tool can be very effective in assisting with problem-solving, inspiring hope and building confidence. It is also a method for generating joint ownership and commitment for taking action toward achieving change.

In a community visioning session, the vision is often “expressed in pictorial form, using images and symbols to convey [an] ideal community” (pg. 4). It allows participants to travel beyond the current political, economic, social and/or environmental challenges being experienced, to articulating what they would like to see occur in the future. The result is an idea, dream, mental image or picture that is shared by many people living, working and playing in a community. (From the Ground Up: An Organizing Handbook for Healthy Communities, Ontario Healthy Communities Coalition, http://www.ohcc-ccso.ca/en/from-the-ground-up)

Visioning is different than traditional problem-solving in that it offers hope, encouragement and the possibility of fundamental change by generating a common goal. With traditional problem solving, a group can become bogged down in details and even disagree on how to define the problem. It also focuses on the negative, whereas visioning allows a group to move away from this toward something more positive. With visioning, passion and creative thinking are spawned, and people are given a greater sense of control. (The NGO Café, Global Development Resource Centre, http://www.gdrc.org/ngo/index.html)


What is needed to hold a Healthy Communities Visioning Session?

This is a list of some key elements that will help to make any visioning session a success:

  • Involvement from a large number of people from a defined geographic area, community of interest and/or affiliation.
  • A diverse cross-section of people who are able to participate in a meaningful way (such as those who are marginalized and/or representative of various ages, incomes, abilities, etc.).
  • Multi-sector participation (e.g., from education, government, business, health, media).
  • A location that is familiar, inviting and physically accessible for participants.
  • Ideally, access to transportation, refreshments and childcare should be available or provided.

How do you facilitate a Visioning process?

There are various ways that you can facilitate a visioning session, depending on who is in attendance and the circumstances involved. Regardless of the situation, each one has the same premise, which is that participants are asked to envision the kind of community that they would like to be a part of in the future. The objective is to allow people to dream and collect as many ideas as possible; no concept is too small, big, or “out there” to be included.

The first step usually involves asking participants to make themselves comfortable and close their eyes. They are then asked to spend a few minutes quietly thinking their own thoughts. Sometimes a facilitator will take them on a hot air balloon ride above their community and into the future. Or they may be asked to simply go for a walk and imagine a newspaper headline 20 years from now. In each case, the facilitator will also ask them something along the lines of: "What would your community be like if you had the power to make it the way you wanted?”

Participants are then asked to formulate pictures in their minds as they travel through the physical space. The questions a facilitator asks can be both abstract and quite detailed. For instance, “How are buildings and public spaces arranged? What do they look like?” They might also be asked where people are, what they are doing, and how they are interacting. Questions could focus on topics like workplaces, transportation or the natural environment. In every instance the goal is to help participants actually “see” what they hope for.

This technique has been used in many real-life situations with great success!

Following this exercise, the facilitator will slowly bring participants back to the present day and into the room again, asking them to keep the features that they just saw in their minds. Then, in small groups, participants will be asked to talk about what they saw using key words or phrases that capture their image of a Healthy Community. The facilitator may even provide some guides or categories like housing, health care, crime rates, and/or public engagement.

In each case, group members will be asked to make short, clear and positive statements about how the community will be in the future. The statement will be in the present tense, like a newspaper headline. Statements may include things like: “There are lots of bike trails”; “You can walk safely at night” and “Transportation is efficient and affordable”. These statements will be generated until they run out of ideas or time.

These will be read aloud as a large group and then members will be asked to highlight the major differences between the present and the future that they have created. People may express that some things are impossible to achieve. The facilitator will remind them that 50 years ago it was difficult to imagine some of the changes that have taken place today, such as the existence of the internet, and that anything could be possible.

When today's problems seem overwhelming, visioning presents an opportunity to move beyond them and focus on a positive idea of the future.

Next the facilitator will work with the group to gather elements of the vision under common themes, and find areas of consensus. These vision statements could then be made into a list of ideas or even presented in a graphic form. Some communities have had the ability to hire an illustrator to draw images as participants spoke, such as the one below from Haldimand-Norfolk. Maps, photos and other images can also be added after the fact.

 HNHCvision


Simply articulating a vision can be a powerful tool for making a Healthy Community a reality. The next step after any visioning process is to develop a plan to achieve that vision. In Healthy Communities processes, visioning is usually followed by community-wide priority-setting and decision-making.

If you would like help hosting a Healthy Communities Visioning session in your community, be sure to request a service from HC Link!

 

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Peer-led health promotion interventions: The importance of collaborative, multi-sectoral approaches

By Seher Shafiq, Parent Action on Drugs

On March 7th 2016, Parent Action on Drugs (PAD) and HC Link hosted a webinar titled “Effective peer programming on substance use for the transitional years”. Peer education is defined as “the teaching or sharing of health information, values and behaviours between individuals with shared characteristics”.

To my knowledge, PAD has the longest standing peer education programs (in the area of substance use) in all of Canada! The numbers don’t lie: over the past 30 years, PAD’s peer education programs have reached 3000 classes, trained 10,000 peer educators, and had approximately 90,000 youth involved overall. Having done a backgrounder on peer education effectiveness before the webinar, I was excited to hear the diverse, real life experiences from our webinar presenters.

Suzanne Witt-Foley (Consultant, PAD/HC Link) and Patricia Scott-Jeoffroy (Consultant, PAD/HC Link) opened the webinar by noting that it’s important for educators to focus on ‘health literacy’, and that PAD’s Challenges, Beliefs and Changes (CBC) program has information that is balanced, accurate and promotes skills practice. Patricia did an overview of PAD’s peer education programs, recognizing that the Masonic Foundation of Ontario has provided almost 30 years of support to these programs.

Next up was a panel presentation from diverse voices that have been involved in the CBC program. Both Allison Haldenby (Guidance Counsellor, East Elgin Secondary School) and Jacky Allan (Public Health Nurse, Elgin-St. Thomas Public Health Department) emphasized the importance of a collaborative approach to coordinating a peer education in schools, and discussed how they worked with school nurses, public health units, elementary schools, high schools, and students to organize, promote and deliver the CBC program.

As a Youth Addictions Counsellor at the Canadian Mental Health Association of Muskoka Parry Sound, Brittany Cober provided an interesting mental health perspective. Brittany mentioned that she often notices the youth in peer education programs form an “automatic bond with each other” in a way that they don’t with adults, and this is what makes peer education programs so successful. Brittany was speaking anecdotally from her own personal experience, but I couldn’t help but think how similar her experience was to the research on peer education effectiveness. For example, a 2009 study on peer education found that “peer educators were...seen as very credible by the majority of the participants...with the experimental group significantly more likely to find the peer educator more credible than the control group”.

The most interesting part of this webinar was that the audience was able to hear from two students who participated in the CBC program for three years: Jack Gaudette and Kennedie Close from East Elgin Secondary. Jack shared a powerful story about how he was “pushed around” in elementary school and was worried about starting high school. However, high school wasn’t what he expected – in a good way! Being involved in the peer education program helped both Jack and Kennedie “fit in”, get involved, and have fun. Jack and Kennedie keep participating in the program each year because it’s “been a blast every year”, and I’m sure their enthusiasm motivates other students to join the program. Having helped develop PAD’s youth engagement model as part of our strategic plan, I was particularly happy to see that youth voices were represented in this webinar!

Overall, it was a great webinar that illustrated the importance of taking a collaborative, multi-sectoral approach to a preventative health intervention. With drug policy staying high on our new government’s policy agenda, I am sure PAD’s peer education programs will be even more important moving forward.

Webinar slides and recording

 

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