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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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By Andrea Bodkin, HC Link

I will readily and proudly admit that I am a bit of a public health geek. And of the things that I get most geeky about is public sanitation. Clean water and toilets. I have always been passionate about this issue, but became even more so when I travelled in India. There is nothing like a little trip to India to make you appreciate sanitation. My second day of my first trip in India I saw local people dumping their garbage in the Ganges: Mother Ganga, the holiest river in India is a garbage can.

toilet blog picture 1
Mother Ganga in Rishikesh, India, taken by Andrea Bodkin

One of the highlights of my second trip was my visit to the International Toilet Museum, which along with an interesting collection of western-style toilets from around the world, has a display of various toilet systems that can be installed in rural India. Fascinating!

toilet blog picture 2

toilet blog picture 3
Sulabh International Toilet Musem, Delhi, India, taken by Andrea Bodkin

World Toilet Day was this week (yes this is a thing, and yes despite my aforementioned love of the topic I missed it) so in honour of it, here are a few facts:

  • Sanitation is widely regarded as one of the most important accomplishments in public health. The ancient Roman viaducts are often referred to as the world first public health intervention.
  • 40% of the world's population does not have access to toilets, and 15% of the world's population practices open defecation.
  • In 2013, 1000 children died every day from diarrhoeal diseases as a result of poor sanitation.
  • Lack of sanitation impacts girls' educations: many girls miss out on school because of the lack of clean and safe water and toilets.
  • Lack of sanitation has economic impacts in time, productivity and health costs. It's estimated that every $1 spent on water and sanitation generates a return of $8.

If you're curious about sanitation, its effect on health, and what needs to be done about it, check out www.worldtoilet.org (yes it's a thing!) and listen to this 17 minute podcast from the BBC on World Toilet Day http://downloads.bbc.co.uk/podcasts/worldservice/bizdaily/bizdaily_20141119-1027a.mp3

And above all, appreciate the water from your tap, your clean bathroom and flushing toilet. In this world it is a privilege not to be taken for granted.

 

By Monica Nunes, CAMH Health Promotion Resource Centre

Last week the CAMH Health Promotion Resource Centre (CAMH HPRC) and the Evidence Exchange Network (EENet) co-hosted a webinar to share the recent 2013 CAMH Ontario Student Drug Use and Health Survey (OSDUHS) results. The OSDUHS is a cross-sectional, anonymous survey of students in grades 7-12 in Ontario's publicly funded schools. The survey monitors drug use, mental health, physical health, bullying, gambling, and other risk behaviours. Two reports are available from each cycle, one focusing on student drug use, the other on student mental health and well-being. Yesterday's webinar focused on sharing the mental health and well-being results.

Following an overview of the OSDUHS findings, a panel discussion was held featuring speakers from the OSDUHS research team as well as other experts from CAMH and Public Health Ontario. The panel discussed recent areas of improvement as well as topics of concern relating to student mental health and well-being. You can view the webinar recording and access the slides.

The webinar was also an opportunity to launch a new series of infographics that share the OSDUHS mental health and well-being findings. Developed by CAMH HPRC and EENet these infographics aim to make OSDUHS data accessible to stakeholders in public health, health promotion, education, social services, government, and health care, and to inform public health monitoring, program planning, and policy making.

camhinfographic
The infographics highlight data on indicators of mental health for the province as a whole as well as for individual Local Health Integration Networks (LHINs). The LHIN-specific infographics focus on students in grades 9 through 12 and compare LHIN and Ontario-wide data. An infographic focusing on the Ontario school setting is also available. Stay tuned for an additional infographic focusing on student use of opioids.

A follow-up webinar will feature organizations that have used OSDUHS data to inform programming, planning, and policy. You can register for the 2013 OSDUHS Mental Health and Well-Being Evidence to Action webinar here.



You can read the full 2013 OSDUHS report here. You can read the Mental Health and Well-being of Ontario Students, 1991– 2013: Detailed OSDUHS Findings here. And you can view webinars focusing on the 2013 OSDUHS here.

Infographics in English and French:

Limited printed versions of the infographics are available upon request from Ontario public health and health promotion professionals. Please send your requests to Monica Nunes at This email address is being protected from spambots. You need JavaScript enabled to view it. and we will do our best to meet your request.

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By Robyn Kalda, HC Link

Social media has been a popular topic for HC Link webinars, consultations and workshops this year in both English and French and we're seeing some interesting trends.

There are starting to be three levels of questions about social media, now that it's been around for some years.

First, there are the how-to and what-is-it questions. How do I set up a Facebook or Twitter account? How do I post? What's Instagram/Pinterest/Vine? What is an app and how do I get one? What new things are out there?

Second, there are questions about how to use social media tools effectively. Which tool is best for my purposes? How often should I tweet? What does the research say: is social media a good tool for making a difference? Who should run our Facebook page? Should I use my real name for my work posts?

Finally, there are some more overarching questions. What's the best way to realize the advantages of technology without being constantly attached to it? What are the best times to use social media with parents so that you'll reach them but won't distract them from their children at times they are likely to be parenting? Given the 24/7 nature of social media, how can we be effective online without worsening people's work/life balance? How much sense does it make to redeploy staff time into social media at, perhaps, some cost to face-to-face services?

As health promoters, it's important to pay attention to all three kinds of questions. It's no use to know about all the technologies that are out there but remain oblivious to the larger questions around their healthy use. It's also no help to ignore technology on the pretext of concerns about its use. There are no clear answers to the big-picture questions yet, but health promoters need to be part of the discussion.

For social media resources, you can check out:

By Linda Yoo, CAMH Health Promotion Resource Centre

The CAMH Health Promotion Resource Centre is pleased to announce the launch of its NEW website on CAMH's Portico network! Here, you can look up past and upcoming webinars including recordings and PowerPoint slides, our research reports as well as infographics and toolkits.

MH PostcardOne new resource is the What is Mental Health postcard. This postcard provides a snapshot of various definitions and descriptions of what mental health is and what it looks like. For instance, it states that mental health is more than the absence of a mental illness. It is a positive concept that is distinct from, although related to, mental illness. Mental health is a resource to help individuals cope with stressors and reach their goals. Ultimately, mental health is a component of overall health so there is no health without mental health.

infographic 1in5Another exciting, new resource from the CAMH Health Promotion Resource Centre is the population mental health infographic. This poster outlines the importance of promoting mental health across the entire population, from individuals who have no identified mental illness to those with an identified mental illness and requiring treatment. It reminds us of the importance to broaden our lens beyond the 1 in 5 or 20% of the population who will experience mental illness in any given year to the other 80% of the population. The 80% may not be experiencing a mental illness but that does not necessarily mean they are doing well mentally. It also underscores that mental health promotion approaches benefit ALL people, even those experiencing mental illness.

The poster also highlights that there are unique factors that put individuals at risk of, or protect them from mental illness at various stages of life. So a population mental health approach also promotes mental health across the lifespan as it aims to increase protective factors at every stage of life. Increasing protective factors means addressing the various social determinants of health and inequities.

To support health promotion and public health professionals working in Ontario in the area of mental health promotion and substance use, a limited number of hard copies of our resources are available by request. Please send your name, work address and sector to This email address is being protected from spambots. You need JavaScript enabled to view it. and we will try our best to meet your request.

The CAMH Health Promotion Resource Centre is funded by the Health Promotion Division of the Ministry of Health and Long-Term Care.

By Andrea Bodkin, HC Link Coordinator

This afternoon I moderated the 3rd in our series of 4 webinars on the topic of policy development. Since municipal elections were held all across Ontario this week, what better topic than building relationships with elected officials?

I was joined by Nicole Niedra-Boirdi from Niagara Region Public Health, my colleague at HC Link Gillian Kranias, and Krista Long and Sara Haalboon from Waterloo's Food Spaces, Vibrant Spaces campaign. Our speakers discussed two important- and closely linked- concepts: identifying the priorities of municipalities and elected officials; and using storytelling as a way to engage them.

First off, Nicole shared a variety of tools that Healthy Living Niagara has developed to identify how the priorities of the region/municipality intersect with its priorities. Mapping out the municipalities' strategic plan, analyzing minutes of past council meetings and mapping media coverage are a part of this process. This information can be used to identify common goals, identify potential partners, frame issues and identify gaps/unique needs.

Next, Gillian, Krista and Sara shared their experiences with using storytelling and public narrative in Waterloo. Their campaign, around community gardens, food access and farmer's markets, had a website, social media campaign and outreach events, but a cornerstone was on using volunteers in each ward to meet with candidates running in that ward. Volunteers were trained in storytelling to bring their personal approach to the issue- alleviating the fear that many volunteers had that they were not "experts". By speaking from their experience, the conversation between the volunteers and candidates was opened up, allowing candidates to connect with what the volunteer was saying. Candidates could see how the issue of community gardens aligned with their platform issues of community building, safe spaces and elder care.

I am a political junkie- I love politics. I will admit though that the 10 month long municipal election campaign exhausted me! Today's webinar energized me, and made me think about what I can do as a private citizen (not just a health promoter) to bring the issues that I care about forward to my local council.

If you'd like to learn more- check out the slides and recording from the webinar!

You can also view the slides and recordings from Part 1 and Part 2 of the policy development webinar series.

Resources

Building Community Policy Tools on Healthy Living Niagara's Website:
http://healthylivingniagara.com/building-community-policy/

Food Spaces, Vibrant Spaces WR Website:
http://www.wrfoodsystem.ca/foodspacesWR

HC Link's online Policy Learning Community:
http://hclinkpolicylearningcommunity.ning.com/

HC Link's February 2014 Peer Sharing session Engaging the Power of Story:
http://www.hclinkontario.ca/index.php/events/slides-from-events.html/#PowerOfStory

Marshall Ganz (Harvard University) articles and media clips about storytelling and the Public Narrative approach are on his website:
http://marshallganz.com/

How Storytelling Affects the Brain:
http://www.visualistan.com/2014/05/the-science-of-storytelling-infographic.html

Pamela Rutledge (University of California and Fielding Graduate University) article in Psychology Today: http://www.psychologytoday.com/blog/positively-media/201101/the-psychological-power-storytelling

By Seher Shafiq, Parent Action on Drugs

On October 7th, 2014, the CAMH Health Promotion Resource Centre held a webinar to launch the latest version of the Best Practice Guidelines for Mental Health Promotion: Children and Youth. The Guidelines were launched by CAMH, Toronto Public Health, and the Dalla Lana School of Public Health at the University of Toronto. With four presenters representing each of the three organizations, the webinar was a rich discussion involving knowledge exchange and new ideas.

BPGSpic

Marianne Kobus-Matthews, a Senior Health Promotion Consultant at CAMH's Provincial System Support Program started the webinar by discussing the history behind the Guidelines. In 2003 a report called the Analysis of Best Practices in Mental Health Promotion across the Lifespan was commissioned. Over the years, the project got narrowed to children and youth, because it was seen that most studies with a lot of evidence focused on children (7—12) and youth (13-19). In 2007, the online tool Best Practice Guidelines for Mental Health Promotion was launched. Now in 2014, many developments show the momentum of mental health promotion:

For example, there now exist national and provincial mental health strategies that focus on the mental health of children and youth. This meant that 2014 was a good year to refresh the guide and include new literature that has emerged since 2007. The goal of the Guidelines is to eliminate risk factors and promote resiliency. Practitioners are also encouraged to take a modified approach that considers social determinants of health.

Marianne discussed how youth that belong to groups that face social and economic exclusion (such as Aboriginals, LBGTQ youth, newcomer youth, and street-involved youth) have greater problems when it comes to health. She highlighted that resources in the guidelines include a worksheet that asks an organization questions based on the Guidelines. This includes a checklist of actions that can be taken to ensure your organization follows the Guidelines as much as possible. Marianne also mentioned that the guide has outcomes and indicators to help your organization gauge the success of an initiative.

Suzanne Jackson, an Associate Professor in the Health Promotion Program at the Dalla Lana School of Public Health (University of Toronto) spoke next about the evidence base of the Guidelines. She highlighted the relevance of risk factors and protective factors, such as optimism, attachment to school or work, family harmony, etc, noting that the presence of more protective factors over risk factors lowers the risk of mental illness. We should therefore be pushing protective factors, she argued. Suzanne also went into the literature that helped provide the evidence and information to inform the Guidelines. For example, Keleher & Armstrong, 2006 have concluded that the most significant determinants of mental health are: social inclusion, freedom from discrimination and violence, and access to economic resources. She discussed the criteria for best practice program examples, some of which are: identifying at least 5 guidelines, and having an evaluation tool.

The last presenters were Claudette Holloway (Toronto Public Health, Acting Director, Healthy Communities), and Patricia Stevens (Toronto Public Health, Health Promotion Specialist, Investing in Families). Investing in Families (IIF) is "an initiative designed to improve the economic, health and social status of families receiving Ontario Works benefits in several high-needs communities across Toronto". IIF provides families: employment related services, health services, computer/literacy/homework help, recreational activities, and opportunities to be socially involved in the community (1). Claudette and Patricia discussed how the IIF project began and expanded, how Toronto Public Health formed a partnership with CAMH, and where the project is at now. They also shared how their project follows the CAMH Guidelines, as well as lessons learned. One 'lesson learned' was through using phase III of the Worksheet in the Guidelines to develop a transparent and resilient approach to their project. Toronto Public Health strongly felt that the Guidelines and the Worksheet provided a systemic approach and a framework for mental health focus, as well as an ability to incorporate organizational thinking into their project.

Questions after the presentation included topics relating to social media, mental health in the LGBTTQ community, working with vulnerable populations, and other mental health promotion initiatives for children and youth.

Please contact This email address is being protected from spambots. You need JavaScript enabled to view it. for more information regarding the Guidelines (the CAMH Health Promotion Resource Centre has a limited number of hard copies of the Guidelines resource available by request). 

The webinar recording and slides are available for viewing.

Summary of guidelines

  1. Address and modify risk and protective factors, including determinants of health, that indicate possible mental health concerns
  2. Intervene in multiple settings
  3. Focus on skill building, empowerment, self-efficacy and resilience
  4. Train non-professionals to establish caring and trusting relationships with children and youth
  5. Involve multiple stakeholders
  6. Help develop comprehensive support systems
  7. Adopt multiple interventions
  8. Address opportunities for organizational change, policy development and advocacy
  9. Demonstrate a long-term commitment to program planning, development, and evaluation
  10. Ensure that information and services provided are cultural appropriate, equitable and holistic

(1) https://www1.toronto.ca/wps/portal/contentonly?vgnextoid=eaa9707b1a280410VgnVCM10000071d60f89RCRD

Submitted by Tamar Mayer, CAMH Health Promotion Resource Centre

Last week, CAMH released its new Cannabis Policy Framework in which CAMH recommends legalization with strict regulation as the most effective means of reducing cannabis-related harms. Based on a thorough review of the evidence, the new framework provides recommendations for public health-focused cannabis control including:

  • a government monopoly on sales
  • a minimum age for purchase and consumption
  • controls on availability
  • a pricing system that curbs demand and discourages use of higher-harm products
  • a ban on marketing, advertising and promotion
  • a requirement that products be sold in standardized plain packaging

A blog by Dr. Jürgen Rehm, Director of the Social and Epidemiological Research Department at CAMH, accompanies the new framework and you will see that there is a strong focus on how the social determinants of health relate to this topic. Dr. Rehm underscores that health equity issues as they relate to the area of law enforcement are part of the reason that CAMH has moved away from its previous pro-decriminalization position towards one that favours legalization with strict regulation.

In addition, a video called "Cannabis in Canada: CAMH recommends a Public Health Approach" discusses the health risks of cannabis and discusses how our current system of criminalizing marijuana is failing to prevent harm. To move this work forward, CAMH highlights 10 basic principles to guide regulation of cannabis use.

 

By Gillian Kranias, HC Link

This Tuesday, the Coalition of Community Health and Resource Centres of Ottawa launched: Bridging the Gap - Measuring What Matters: The Ottawa Community Wellbeing Report 2014. I missed the event but wanted to grab a copy of the report as soon as possible. I had heard about their work when filming some speakers at an AOHC event in July (HC Link blogged about that event and you can watch the videos here).

It was well worth looking at. It is storyful, data sensible, dynamic, and with purpose.

"Our hope is that the findings in this report will shape election debate and discussion in meetings and forums across the city" write the report authors.

Meaningful purpose and great design

The 47 page beautifully designed report includes:

  • a summary of the research approach and results;
  • sections following the eight domains from the Community Index of Wellbeing (CIW), each with data results, analysis and a showcasing (including short video links) of community initiatives that address gaps for each domain. (See pic below of the eight domains);
  • a special section on rural Ottawa; and
  • a final section presenting policy recommendations.

The policy recommendations were developed through an extensive community consultation process orchestrated by the Civic Engagement Roundtable of the Making Votes Count Where We Live initiative.

ciw

The diversity of report authors shaped the conversation in a refreshing evidence-based and story-rich way. The result is some useful data with lots of illustrative text and pictures, a balance of focus on challenges and strengths, and an emphasis on the foundational impact of public policies on the health of communities.

Using the Canadian Index of Wellbeing

As I already noted, much of this Ottawa report is based on the Canadian Index of Wellbeing (CIW), a framework for measuring "how are we really doing", with a focus on health equity and vibrant communities for all.

At HC Link, we are still engaged in learning (and sharing) more about the CIW: its domains and indicators, and the various ways community partnerships across sectors are experimenting with CIW.

Identified strengths of CIW include:

  • a common language for talking about community health,
  • a measurement tool aligned to "what really matters" (i.e. beyond GDP),
  • part of a growing movement to solidify more common measurements and shared data in our evaluative efforts across local, regional and national geographies.

I would be interested in hearing your thoughts and experiences with the CIW. The authors of the Ottawa report muse that CIW holds the promise to "Connect the dots between social aspirations, public policy and hard evidence". What is your perspective? Please use our comment box below, or contact me directly at This email address is being protected from spambots. You need JavaScript enabled to view it. .

By Sofia Ramirez, Association of Ontario Health Centres

To achieve its vision of the best possible health and wellbeing for everyone, the Association of Ontario Health Centres launched the Shift the Conversation: Community Health and Wellbeing initiative. This is an ongoing conversation and dialogue with people and organizations who share the vision: the best health and wellbeing for everyone.

Often, the way most people talk about health care doesn't capture a big enough picture. The conversation takes too narrow a focus on just treating illness rather that all the other factors that contribute to our wellbeing.

Community Health & Wellbeing Week 2014 #CHWW2014

Between October 5th and October 11th, 111 community-governed primary healthcare organizations across Ontario will take part in the national celebration of Community Health and Wellbeing Week (CHWW) using the theme Shift the Conversation: Community Health & Wellbeing.

Ontario's week of special events is coordinated by the Association of Ontario Health Centres (AOHC), which represents organizations applying a unique and comprehensive approach, delivering medical services in combination with a wide-range of health promotion and community development initiatives.

#CHWW events spotlight the benefits of this comprehensive approach, especially in response to current stresses on health and wellbeing here in Ontario.

Please join us for this celebration. See last week's HC Link News Digest PLUS for a sample of #CHWW2014 Ontario Events and a link to the full listing of events across Ontario.

How can the Canadian Index of Wellbeing improve the quality of life in Ontario?

As part of the Shift the Conversation initiative and with a generous grant from the Ontario Trillium Foundation (OTF), an agency of the Government of Ontario, the Association of Ontario Health Centres (AOHC) and its member centres partnered with the Canadian Index of Wellbeing (CIW). The CIW is one of the world's leading instruments to measure societal progress.

This project explores the different ways organizations can increase their capacity to address the root causes of illness and shift their work upstream to keep people well. It will support Ontario's Community Health Centres (CHCs), and other community-governed Primary Health Care organizations, to build on previous early CIW work they have conducted over the past two years.

Currently, over 20 of Ontario's Community Health Centres are applying the CIW in a number of different ways. They are using the CIW across the province to improve their capacity to tackle the root causes of illness, for example, as a tool to:

  • Decide what types of services and programs will have the highest impact improving community health and wellbeing.
  • Enhance dialogue and community engagement in the development of action plans to address some of the most important determinants of health in their community.

Measuring What Matters

Earlier this year AOHC also released a new discussion paper called: Measuring What Matters: How the Canadian Index of Wellbeing can improve quality of life in Ontario.

AOHC, together with HC Link, hosted an online discussion about the paper centering on the idea that the CIW can serve as a powerful tool to kick start a more effective community health and wellbeing movement in Ontario. You can view the online discussion here and comment on the paper here.

The CIW Ontario Composite Index Report

The Measuring What Matters paper's release coincided with the April 29 publication of the first CIW Ontario composite index report. This report tracked back to 1994, to provide baseline provincial data with respect to all eight quality of life domains that the CIW tracks.

The CIW Ontario composite report exposed a growing chasm between GDP and the wellbeing. It showed that people living in Ontario are an increasingly time crunched population, experiencing declining economic security, growing rates of long-term unemployment, and a widening gap between the rich and poor.

The CIW's recommendations included expanding access to Community Health Centres. CHCs look at the complete picture and connect the dots between the determinants of health and wellbeing.

Expanding access to Community Health Centres

Our wellbeing is shaped by a wide variety of factors, most of which occur outside of our formal health care system. The places and conditions, within which we live, learn, work, and play are the most important determinants of our health. In turn, our health is related to income inequality and education — it affects our ability to work, our ability to learn, to engage fully with our friends and in our communities. Regrettably, our current health care system was not designed to consider these. It focuses on a "downstream approach" to restore health once it has been lost, instead of an "upstream approach" that prevents illness and disease before they take hold.

Ontario's Community Health Centres (CHCs) have shown that the most effective, efficient, and affordable means of delivering primary health care is through an "upstream approach." CHCs partner with other agencies and with the community to fully integrate a wide range of health promotion and community development services. These services proactively help to overcome barriers to greater wellbeing attributable to health-related social and economic factors like income levels, access to shelter/housing, education, language, and geographic location.

While CHCs have been very successful in meeting the health needs of vulnerable populations and in managing complex chronic disease, many parts of the province do not have access to them. Currently, Ontario's CHCs only serve about 4% of the population.

To benefit the long-term health of people living in Ontario, we must:

  • Adopt a proactive and preventative approach to health care that addresses social and economic factors
  • Expand access to Ontario's Community Health Centres by creating a comprehensive network that enables people in all parts of the province — especially those facing barriers to better health — to access its benefits
  • Provide direct and targeted funding from federal and provincial governments to support a network model of community health centres throughout the province

This year, Community Health & Wellbeing events will highlight the need for healthier public policy and wider focus for health care system.

Please join us at a CHWW event near you: communityhealthandwellbeing.org

By Monica Nunes, CAMH Health Promotion Resource Centre

A new Statistics Canada report provides some highlights on the state of mental health among Canadians. The report called Positive Mental Health and Mental Illness is based on data from the 2012 Canadian Community Health Survey. Statistics Canada was interested in measuring the mental health of Canadians as a positive concept where mental health is understood as feeling good and functioning well in life.

To determine positive mental health among Canadians, Statistics Canada used the complete mental health model which combines categories of mental health (flourishing, languishing or moderate mental health) with the absence or presence of six mental disorders (depression; bipolar disorder; generalized anxiety disorder; alcohol, cannabis and other drug dependence). Flourishing, languishing or moderate mental are assessed using 14 questions that looks at emotional, social and psychological well-being.

Using the complete mental health model, Statistics Canada identified that 77% have complete mental health meaning that they are flourishing and do not identify as having one of the six mental disorders asked about in the survey. It's interesting to note that the figure for complete mental health is notably higher than in other countries. The report's authors acknowledge that more research is necessary to explain why Canadians are more likely to report complete mental health than other countries. The reasons may relate to demographic and cultural factors or simply differences in how the survey was conducted.

And, while many readers of the report might focus on the prevalence of mental health among Canadians in this report, another significant outcome of the survey is the spotlight it places on the social determinants of health. Findings from the study show that mental health is associated with several social determinants including education, income and physical health. The study finds that those with complete mental health were more likely to be people with a partner (an indicator of social support), living in an urban environment, and had strong spiritual health. Canadians in the lowest household income quintile, without a post-secondary education, without a job or ability to work were less likely to report complete mental health. Knowing about the association of these determinants with mental health can help in identifying how we plan programs and policies to promote mental health.

Read the report here. What findings stand out for you?

By Andrea Bodkin, HC Link Consultant

This week I moderated the second webinar in HC Link's Policy Webinar Series: Working with Municipalities- Stories from the field. As the title would suggest, the focus of the webinar was to discuss strategies and techniques for working with municipal staff. In addition to Paul Young from HC Link, we had 3 terrific community members share their stories: Jean Montgomery, a community volunteer from Haldimand-Norfolk; Melanie Davis from the North Bay Parry Sound District Health Unit, and Janet Dawson from the Peterborough County-City Health Unit. The inspiration for this webinar came from a workshop in North Bay in November 2012 on the topic.

There were several themes that emerged throughout today's webinar that are important to keep in mind with working with municipalities (or for that matter, working with a sector other than your own). In no particular order:

  • Do your research: know what it is the municipality/partner does, how they are structured, what their mandate is. Be familiar with the legislation and documents that they deal with/produce, such as official plans etc
  • Educate: you can't assume that the municipality/partner knows what you do! Be prepared to make them aware of the role that you can play within their mandate or work.
  • Build relationships with individuals: have conversations, coffee, lunch with key people that you will need to know and work with
  • Identify win-wins: be clear about common ground where you can each get what you want. Also identify how you can help them: for example many municipalities find it challenging to engage their communities whereas it's in the mandate of public health to do so.
  • Leverage volunteers: volunteers who are not attached to a particular agency may have more freedom/latitude to build relationships
  • Say thank you and congratulations: it might seem very simple, but acknowledgement can go a long way. Take every opportunity to congratulate staff on their accomplishments and say thank you for a job well done.
  • Be persistent, be patient and don't give up!

Resources mentioned in today's webinar:

Communities and Local Government: Working Together. This resource manual from the Ontario Healthy Communities Coalition is designed to assist local government and healthy community groups in working more effectively together.

Public Health and Land Use Planning: How ten public health units are working to create healthy and sustainable communities. This report examines the ways in which ten public health units in Ontario are working to influence land use and transportation planning processes to help create healthy and sustainable communities.

Organizations:

The Association of Municipalities of Ontario

The Federation of Northern Ontario Municipalities

Ontario Ministry of Municipal Affairs and Housing

Federation of Canadian Municipalities

Where to go to from here:

New to policy work? Check out our "Getting Started with Policy" resource to learn more about policy and how HC Link can help you with your policy development efforts.

Check out the recording and handout from the first webinar in our policy series.

Check out slides and handouts from this webinar.

Join HC Link's Policy Learning Community.

 

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Last week I had the pleasure of attending HC Link’s introductory webinar on Policy aptly entitled: Who's Afraid of the Big, Bad Wolf? De- mystifying Policy.


As someone with little policy experience, the webinar offered me a down to basics approach to policy, and guess what? Policy affects every facet of our lives: the roads we drive on, the transportation system, the water in our homes, our workplace scent policy, and even home-based policies like bedtime and screen time. You name it, and it’s likely to be linked to policy.


Likely because of its strong relationship with government, policy is often seen as a huge process (a big bad wolf) that nobody wants to tackle. But by the end of the webinar, it was clear that we all can be active in influencing policy at many levels. The webinar gave some great examples of policy and of communities and individuals who worked toward building healthy policies for healthy communities. For instance, the current booster seat legislation in Ontario was the result of four hardworking community members in Haldimand-Norfolk. You can read more about how they did it in this resource.

One great quote to take away from the webinar speaks to the collaborative nature of policy development: “Policy work is like making stone soup. Everyone brings what they have- a little of this, a little of that, and before you know it, you have a rich, community-based soup where before you only had stones.”


You can view the recording of the webinar, and download the handout, here.

New to policy work? Check out our “Getting Started with Policy” resource to learn more about policy and how HC Link can help you with your policy development efforts.

By Monica Nunes, CAMH Health Promotion Resource Centre

This week, the CAMH Health Promotion Resource Centre (CAMH HPRC) co-presented a webinar with the Centre for Innovation in Campus Mental Health (CICMH) looking at Mental Health Promotion on Campus as part of the Ask the Experts webinar series. Ask the Experts is a webinar series by CICMH which brings together specialists to share promising practices for promoting mentally healthy campuses with support from the CAMH HPRC and the Evidence Exchange Network.

Targeting student leaders and post-secondary institution administrators, this webinar offered an introduction to addressing mental health promotion on campus settings. Monica Nunes, a Research Analyst with CAMH HPRC, kicked off the webinar with a presentation that provided some basic definitions about mental health and mental health promotion. Monica described mental health as a positive concept that relates to our ability to feel, think and act in ways that help us reach our goals and cope with life's challenges.

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Next, Dr. Su-Ting Teo, Director of Student Health and Wellness at Ryerson University, provided some practical examples of how to embed mental health promotion into campus settings. Su-Ting referenced a handbook from the Canadian Association of College and University Student Services and the Canadian Mental Health Association called Post-Secondary Student Mental Health: Guide to a Systemic Approach which outlines that mental health promotion can be applied in campus settings in three main ways:

  • Though institutional planning and policy;
  • By creating a supportive and, inclusive campus environment;
  • And, by building mental health awareness on campus.

The last presenters in the webinar were John Horrox, Research and Policy Analyst, and Veronica Barahona, Communications Manager, with the College Student Alliance (CSA). John and Veronica introduced an upcoming initiative from the CSA focusing on stigma reduction called the Yellow Umbrella Project. The Yellow Umbrella Project aims to increase awareness about mental health in post-secondary education and launches at the end of October.

Click here to watch the full webinar. And you can download the slides here. CICMH will also be posting answers to questions asked during the webinar. So check back on their website for continued discussion on this topic.

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By Andrea Bodkin, HC Link

I often set myself with impossible tasks on this blog, but today's task is herculean: trying to come up with the words to describe a colleague of HC Link's and mine, Bob Gardner. Bob, long-time Director of Policy at the Wellesley Institute and life-long health equity advocate, passed away last week.

Bob-Gardner
Image from: http://www.wellesleyinstitute.com/about/staff/bob-gardner/

I was lucky enough to sit at several roundtables and working groups with Bob, and I learned something from him at every single meeting. Things like "whatever you do, don't stop", "think big, but start concrete" and to ask yourself the simple question of "what else do you think might happen?" Bob had a habit of asking the wicked questions, and of reminding us that we need to invite people from "outside of the box" to ask those questions as well.

Bob was a bit outside of the box himself, with Harry Potter glasses and an easy- yet-academic manner. One of my colleagues told me a story of Bob attending a meeting of hospital executives: he arrived on his bike wearing sandals with bike helmet in hand and talked about health equity to execs in three-piece suits, who followed his advice. Another colleague talked of Bob as a connector: someone who always knew who you should talk to about your project and someone who always talked about your project to others. It seemed like Bob knew everybody!

We at HC Link will remember Bob as someone who contributed to our workshops and conferences over the years, most recently at our 2013 provincial conference, where Bob moderated a talk-show-style panel following our keynote speaker. We recorded a video interview with him following the panel, which you can watch here.

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Bob, with Barb Willet and Noor Din at our 2013 provincial conference

I will remember Bob as a fellow lover of all things policy, a tireless advocate of the social determinants of health and social justice. Bob made a real impact on our field, and things won't quite be the same without him.

I often set myself with impossible tasks on this blog, but today’s task is herculean:  trying to come up with the words to describe a colleague of HC Link’s and mine, Bob Gardner. Bob, long-time Director of Policy at the Wellesley Institute and life-long health equity advocate, passed away last week.

By Andrea Bodkin, HC Link Coordinator

Just over a year ago, HC Link launched the Policy for Healthy Communities learning community. The Learning Community (LC) brings together community-based individuals, groups and networks that are working to develop, change and implement local policies for healthy communities. Since the launch, the LC has grown to over 122 members. More than 70 items have been posted on a variety of topics, such as news, events, questions and discussions.

With the first year of the LC under our belts, we wanted to take some time over the summer to find out how members were experiencing the community, what members liked and didn’t like about it, and what members want our of their community. With the help of MPH practicum student Louisa Pires, we conducted a brief literature scan, several key informant interviews, and a member survey.

Based on what we’ve learned, we’re making several exciting changes to the Learning Community.

The first is we are moving to a new platform! Ning is an add-free social networking site with more functionality. We’ve also added two important new features to the online platform:

  • Webwatch: Our Policy Webwatch scours the internet looking for policy related items on news sites, social media, journals and organizations that work in policy. Our Webwatch has several sources right now, and we’ll add to them as time goes on.
  • Think Tanks: we have two “Think Tanks” on the Ning site, one on food security and one on active transportation. Members can sign up for the Think Tanks, which will have discussion forums etc related to the two specific topics. The community-at-large will be more policy process oriented.

We hope that you will consider joining the Learning Community, and will pass along this information to your colleagues working in policy.

Learn more about the Learning Community in this 3 minute video.

Get an online tour of the new platform in this 3 minute video.

And to join the community, visit http://hclinkpolicylearningcommunity.ning.com/?xgi=KZqyao4iyLkVcp

We hope to see you on the new platform soon!

By Linda Yoo, CAMH Health Promotion Resource Centre

This July, the CAMH Health Promotion Resource Centre wrapped up its 3-part Implementation Science webinar series, in partnership with CAMH Provincial System Support Program (PSSP) and the Ontario Neurotrauma Foundation (ONF). With just under 900 stakeholders registering, this introductory series aimed to have participants from public health and health promotion settings in Ontario develop a working understanding of Implementation Science and the Active Implementation Frameworks developed by the National Implementation Research Network (NIRN).

The first webinar, Part 1 – Implementation Science: the What, the Why, and the How, walked participants through the various components of an Active Implementation Framework such as: Usable Interventions (What); Implementation Stages (When); Implementation Drivers (How); Implementation Teams (Who); and, Improvement Cycles (How). Presenter Alexia Jaouich (Director of Knowledge Exchange and Implementation, CAMH PSSP) highlighted that the gap from evidence to action in implementation occurs when what is adopted is not used with fidelity, and what is used with fidelity is not sustainable at the best scale or scope to make a critical difference.

The second webinar, Part 2 – Drivers of Implementation and Change, provided an overview of the drivers for implementing change based on NIRN's Active Implementation Framework. Alexia Jaouich provided a summary of the competency drivers, organizational drivers and leadership drivers. Next, Hélène Gagné (Program Director, Ontario Neurotrauma Foundation) and Peggy Govers (Manager of the Child Health Program, Simcoe Muskoka District Health Unit) had a conversation about Peggy's insights and learnings from her health unit's roll out of the Triple P Positive Parenting program. One insight Peggy shared was how leadership drivers provided opportunities for her health unit to start discussions and build a common language with other stakeholders.

In the third and final webinar, Part 3 – Implementation Science Tools, Alexia Jaouich provided an overview of various Implementation Science tools, some from NIRN and some that were adapted to support the Systems Improvement Through Service Collaboratives project that CAMH is supporting. The tools are meant to support movement through the various implementation stages of exploration, installation, initial implementation and full implementation. Alexia walked participants through the use of two tools, the Hexagon Decision-Making Tool and the Practice Profiles, which are both used during the exploration phase of implementation. Kim Baker (Regional Implementation Coordinator, PSSP, CAMH) joined Alexia to share how these tools were used to implement the evidence-informed Transition to Independence (TIP) model by the Hamilton Service Collaborative. To learn more about the tools of implementation, you can view the webinar recording and also download the presentation slides.

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CAMH Health Promotion Resource Centre is currently planning for more webinars on Implementation Science in the upcoming fiscal year, so stay tuned! To share your ideas and thoughts on potential topics that should be covered, please email This email address is being protected from spambots. You need JavaScript enabled to view it. .

By Lorna McCue, HC Link and Ontario Healthy Communities Coalition (OHCC)

On July 29th, HC Link hosted the final webinar of its series of three webinars based on the report of the Healthy Kids Panel "No Time to Wait: The Healthy Kids Strategy", which was released in March 2013. The panel was convened to recommend strategies for keeping more kids at healthy weights. Each of the three webinars in this series were focussed on recommendations related to each of the three main prongs of the strategy:

1. Start all kids on the path to health.
2. Change the food environment.
3. Create healthy communities.

This webinar opened with a brief summary of the panel's recommendations on co-ordinating an "all-of-society approach to create healthy communities and reduce or eliminate the broader social and health disparities that affect children's health and weight".

healthykids3

The Healthy Kids Panel reported that parents want help encouraging their kids to be more active and engaged in their communities. The food strategies the panel recommended, which were discussed in our July 17th webinar, will be most effective when they are integrated with broader, community-driven efforts to raise healthy kids. Creating community environments that support healthy and active children is a complex matter, and the Panel carefully considered a number of areas, such as:

  1. The need for social change - we live in a time-stressed culture that has completely changed eating habits and activity levels. We're coping with unprecedented technological advances and many of us worry about financial stability, feel rushed, tired, socially disconnected and are experiencing high rates of mental health problems. We need to create supportive communities that promote and protect health, and help families find balance in their lives.

  2. The potential of a community development approach - a co-ordinated, community-driven initiative will have a higher impact on reducing child obesity than a number of fragmented programs. For example, EPODE (Ensemble Prévenons l'Obesité des Enfants – Together Let's Prevent Childhood Obesity) developed in France in 1992 and is now in use in 15 countries and has a highly successful track record.

  3. The role of schools and child care settings - the panel considered school food and beverage policies, the Daily Physical Activity guidelines, play-based learning and Healthy Schools.

  4. The importance of role models and champions - the panel stressed the importance of positive role models and champions in a child's life.

  5. The potential to leverage other strategies - other strategies are working upstream to address the underlying causes of unhealthy weights, such as the Poverty Reduction Strategy and the Mental Health and Addictions Strategy.

  6. Access to timely support and treatment services - Ontario currently has a small network of pediatric weight management programs, but there may be more children who could benefit from these services.

The Panel made the following 8 recommendations relating to creating healthy communities:

  1. Develop a comprehensive healthy kids social marketing program that focuses on healthy eating, active living – including active transportation – mental health and adequate sleep.

  2. Join EPODE International and adopt a coordinated, community-driven approach to developing healthy communities for kids.

  3. Make schools hubs for child health and community engagement.

  4. Create healthy environments for preschool children.

  5. Develop the knowledge and skills of key professions to support parents in raising healthy kids.

  6. Speed implementation of the Poverty Reduction Strategy

  7. Continue to implement the Mental Health and Addictions Strategy.

  8. Ensure families have timely access to specialized obesity programs when needed

Four guest presenters gave us some insight into the healthy community and capacity-building initiatives that they are working on.

Drew Maginn, Division Manager, and Margaret Good, Consultant, are working on the Healthy Schools & Communities program at Ophea to help kids develop the necessary skills to make healthy choices. They aim to create school communities that promote healthy, active living by developing and supporting the delivery of quality school-based health and physical activity programs and services. Drew and Margaret outlined a number of Ophea programs, and pointed us to the Healthy Schools section of the Ophea website which provides supports such as videos, planning tools, posters and research information, plus access to their consultation services and opportunities to partner on Healthy Schools initiaitives.

Tamar Meyer, Manager of the Health Promotion Resource Centre and Provincial System Support Program at the Centre for Addictions and Mental Health explained that the CAMH resource centre can Provide system support, capacity building, content expertise and access to information and research for Ontario health promotion and public health audiences, related to mental health promotion and substance misuse. She talked about the "Connecting the Dots" report on how public health units are addressing child and youth mental health (see "suggested resources" in the links below), and described other mental health and healthy weight activities currently being undertaken.

Kayla Lee is the Coordinator of F.U.E.L, at Niagara Region Public Health. F.U.E.L. stands for Females Using Energy for Life. This is an innovative program that operates in several schools, with support from the Niagara Region Health Unit. Kayla noted that only 4% of children and youth meet physical activity recommendations, and that physical inactivity is associated with many physical and psychological health risks. This after-school, female-only physical activity program engages high school girls in non-competitve activities led by certified instructors, and is inclusive of any interested female student. It is peer-led and free of charge. Teachers are recruited to lead FUEL programs, with training and promotional materials provided by the Health Unit. Kayla reported that the program was very sucessful, and also told us about some of their challenges and a few things they had learned along the way.

In the Q&A portion of the webinar, an interesting question was asked by Michael Kerr, Coordinator, Colour of Poverty - Colour of Change:

"In order to achieve the desired equitable health outcomes - how do you go about ensuring coherent and consistent data capture ( by you, your transfer or other partners ) with respect to the demographic characteristics ( ethno-racial, gender, (dis)ability, sexual orientation, first language, faith-spirituality, gender identity, age, immigration or citizenship status, etc. ) of various sub-populations, program participants and relevant diversities of the clients served - particularly with respect to historically disadvantaged or equity-seeking groups and communities - we need a consistent template or protocol for the collection or capture of these demographic characteristics across all relevant and appropriate service delivery, program areas, regulatory platforms and policy environments?"

The presenters didn't respond directly to the question of disaggregated data collection within their programs, but they did explain their efforts to ensure that their programs were culturally sensitive and appropriate, and tailored to the specific needs and interests of the particular school or students.

Subsequently, Michael sent me some links to a new multi-dimensional disaggregated data collection template tool and OHRC data collection guidelines, which he thought might be of interest to others.
http://fluidsurveys.com/surveys/rupa/disaggregated-data-project/?TEST_DATA=

The Ontario Human Rights Code (the "Code") permits the collection and analysis of data based on race and other grounds, provided that the data is collected for purposes consistent with the Code, such as to monitor discrimination, identify and remove systemic barriers, address historical disadvantage and promote substantive equality. More information can be found at:

Count me in! Collecting human rights based data - Summary (fact sheet)
Count me in! Collecting human rights based data - Full Guide

This concluded the Healthy Kids Strategy webinar series, which was very successful. We have received a lot of positive feedback about the sessions and would like to thank all those that participated. I would like to stress, however, that there is much more in the Healthy Kids Panel report than was covered in these sessions. It really is worth your while to read the whole report from cover to cover.

Presentation Slides | Recording | Suggested Resources

By Gillian Kranias, HC Link

How do we shift the conversation - and the measurements – to really notice and foster wellbeing in our communities? Community Health Centres (CHCs) across Ontario, in collaboration with their Association of Ontario Health Centres, have taken bold and creative leadership on this topic, adopting and experimenting with the Canadian Index of Wellbeing (CIW).

On Wednesday July 23, four CHCs shared their stories of adopting and experimenting with the Canadian Index of Wellbeing.

  • From Woodstock we learned how CIW fostered a "twinning" between public knowledge and expert knowledge.



  • From Woolwich we heard a story of how research with CIW's community vitality domain led to one new initiative supporting volunteer development at CHC partner organizations and another that will enhance welcoming activities for newcomers.



  • From Bourget, we gained mid-project insights on just how important each methodological choice can be along the way (and how early adopters must be adapters too!)



  • From Ottawa, we were inspired by a city-wide coalition that will use key CIW findings to inform and enhance civic engagement initiatives.

What we learned from the combined presentations was:

  • The CIW is a multi-purpose tool! ...and seeing others using the tool is a great way to build one's own capacity and confidence to do it yourself (DIY).
  • There are limitations with this tool – like any. It was great that the speakers were willing to articulate those limitations. With more information, we will know better how to meet some of them.
  • The language of CIW is as valuable as the indicators. Several stories spoke to how it fostered bridges across organizations and sectors, and most importantly between expert knowledge and community-based knowledge.

You can watch the videos yourself to take away your own learnings. You can also use these videos in conversation with your community. You can even join in "shifting the conversation" - check out AOHC's website http://communityhealthandwellbeing.org for more resources.

At HC Link, we celebrate the collaborative leadership of Ontario organizations and communities who are ushering the Canadian Index of Wellbeing in to our ways of conversing, measuring, celebrating and acting: for healthier communities for everyone.

Here are some links to earlier dissemination events where HC Link partnered with AOHC:

The CIW Early Adopter story video footage was recorded at AOHC's Summer Institute titled "Community Health and Wellbeing: Moving from Information to Transformation" held in Orillia on July 23, 2014. This event was co-hosted with the Simcoe County Resilience Collaborative.

By Lorna McCue, HC Link & Ontario Healthy Communities Coalition (OHCC)

On July 17, HC Link hosted the second it its series of three webinars based on the report of the Healthy Kids Panel "No Time to Wait: The Healthy Kids Strategy", which was released in March 2013. These webinars are focussed on the recommendations related to the three main prongs of the strategy:

  1. Start all kids on the path to health
  2. Change the food environment
  3. Create healthy communities

As with the first webinar of the series, over 100 people registered for this webinar. When we were planning this series we were concerned that attendance might be low if we held them in the summer, but that is clearly not an issue when there is such strong interest in the topic.

A blog recapping the first webinar on the first prong of the Healthy Kids Strategy: Start all kids on the path to health can be viewed at http://bit.ly/HKS1-blog. In the second webinar, we considered recommendations related to second prong of the strategy: "Change the food environment".

HKS 2

This webinar was organized in partnership with the Nutrition Resource Centre (NRC). NRC staff, and most notably Christina Tran, a NRC consultant , recruited and liaised with the guest presenters, and moderated the session. She opened the webinar with a brief overiew of the panel's recommendations for changing the food environment.

Sandra Laclé and Tracey Weatherbe of the Sudbury District Health Unit spoke on behalf of Penny Sutcliffe, Medical Officer of Health for Sudbury District, who is a member of the Healthy Kids Panel. They explained the rationale for creating the Healthy Kids Panel and its role and process. The Healthy Kids Strategy calls for a 20% reduction in rates of child obesity in 5 years. The panel was brought together to service two main goals:

  • identify specific factors affecting childhood obesity rates, and
  • identify comprehensive, innovative, multisectoral interventions for sustainable childhood obesity rate reduction.

The panel's resulting 3-pronged strategy recommends practical actions to achieve this goal, along with ABCs of successful action:

  1. Make child health everyone's priority
  2. Invest in child health
  3. Use evidence, monitor progress, ensure accountability

Sandra and Tracey reviewed the panel's recommendations and provided examples of actions that address them. The ten recommendations are:

  1. Ban the marketing of high-calorie, low-nutrient foods, beverages and snacks to children under age 12.

  2. Ban point-of-sale promotions and displays of high-calorie, low-nutrient foods and beverages in retail settings, beginning with sugar-sweetened beverages.

  3. Require all restaurants, including fast food outlets and retail grocery stores, to list the calories in each item on their menus and to make this information visible on menu boards.

  4. Encourage food retailers to adopt transparent, easy-to-understand, standard, objective nutrition rating systems for the products in their stores.

  5. Support the use of Canada's Food Guide and the nutrition facts panel.

  6. Provide incentives for Ontario food growers and producers, food distributors, corporate food retailers, and non-governmental organizations to support community-based food distribution programs.

  7. Provide incentives for food retailers to develop stores in food deserts.

  8. Establish a universal school nutrition program for all Ontario publicly funded elementary and secondary schools.

  9. Establish a universal school nutrition program for First Nations communities.

  10. Develop a single standard guideline for food and beverages served or sold where children play and learn.

Rhonda Hanning a professor at the University of Waterloo, working with the Waterloo Public Health and Health Systems, presented on her work with school nutrition programs in remote First Nation communities of the western James Bay region. Extensive health disparity has been identified between Aboriginal and non-Aboriginal populations in Canada, with increased prevalence of obesity, metabolic syndrome and diabetes, even in youth. The population has poor diet quality and a high level of household food insecurity. She described how their research program developed tailored approaches to assist communities in planning, implementing and evaluating student nutrition programs. Their research showed that School Nutrition Programs can support healthier food environments and sustainable improvements to the diets of vulnerable children.

Alexandra Lacarte of the North Bay Parry Sound District Health Unit discussed creating a healthy eating environment in childcare centres. She particularly focussed on the Healthy Eating Environment Toolkit (HEET) that was developed by staff at the health unit. They compiled best practice resources and provide training sessions to educate child care centre personnel, including supervisors, cooks and early childhood educators. She concluded that public health can support and help implement nutrition standards in partnership with early learning partners.

Gayle Kabbash-Cruikshank and Meaghan Richardson of the Halton Region food Council described their work with "Feeding Halton", a community food distribution program. Feeding Halton is a collaborative of social service organizations and the agricultural community working to create efficiencies in local food procurement. The Feed Halton collaborative members serve over 40,000 people a month.

A big thank you goes to all the presenters, for sharing their work with us, and kudos to Christina for her superb coordination of the webinar. A note of appreciation also goes to Hélène Lussier of HC Link for her professional management of the technical end of the webinars. The practice session she held with the presenters helped the webinar to run smoothly.

Links to the webinar recording and the presentation slides are shown below.

Stay tuned for a blog on the third webinar of this series, "Create Healthy Communities", held on July 29.

Presentation Slides  |  Recording  |  Suggested Resources

By Lorna McCue, HC Link & Ontario Healthy Communities Coalition (OHCC)

On July 8 HC Link hosted the first of a series of webinars based on the report of the Healthy Kids Panel "No Time to Wait: The Healthy Kids Strategy". The registration for this webinar had to be cut off at 100, showing that there is great concern about the increase in childhood obesity and a strong interest in working to change this trajectory.

Intro slide

Obesity can lead to diseases such as diabetes, cancer and heart disease, and costs Ontario's health care system about $4.5 billion annually. In January 2012 the Ontario government announced an ambitious target of reducing childhood obesity by 20 per cent over five years. They then convened the Healthy Kids Panel to develop recommendations for strategies to meet this target.

When I read the report of the Healthy Kids Panel I was impressed with the thoroughness of the research and consultation process that went into developing it. Thus I was pleased to have the opportuntity to help organize this series of three webinars, each one addressing one of the three main prongs of the Healthy Kids Strategy. A similar series in French will be held in October 2014.

The first webinar opened with an overview of the report and its recommendations. Following their investigation of the subject, the panel concluded that: "No one policy, program or strategy will solve the problem of childhood overweight and obesity." They also recognized that health is about more than weight. "A child who is a little overweight and who is fit and active is healthier than a child who is the "right" weight for his or her age and height but is more sedentary." Focusing too much on weight is stigmatizing and will not address many of the factors that contribute to unhealthy weights.

The Panel developed a comprehensive three-pronged strategy to address this complex issue. They unanimously adopted a series of recommendations on how we can best promote the health and well-being of children and youth:

  1. Start all kids on the path to health. Laying the foundation for a lifetime of good health begins even before babies are conceived.

  2. Change the food environment. Parents know about the importance of good nutrition but while trying to provide healthy food at home, many feel undermined by the food environment around them. They want changes that will make healthy choices easier.

  3. Create healthy communities. Kids live, play and learn in their communities. We need a co-ordinated all-of-society approach to create healthy communities and reduce or eliminate the broader social and health disparities that affect children's health and weight.

This webinar focussed on the first prong "Start all kids on the path to health". Our first guest, Dr. Zach Ferrar, is a recognized leader in prenatal health and wellness and co-author the Best Start report "Obesity in Preconception and Pregnancy." He oberved that pregnancy is a critical period of growth, development and physiological change in the mother and child. Prenatal obesity, due to being obese prior to conception or gaining excessive weight during pregnancy, poses significant health risks to both the mother and baby during pregnancy and beyond.

Zach's talk centred around research findings related to gestational weight gain (GSW). One of the concepts he described was the "complexity energy balance", which identifies the many determinants involved in maintaining a positive energy balance and avoiding unhealthy body weight. He noted that 55% of North American women of childbearing age are overweight or obese, and that the situation is compounted by the weightism, bias and discrimination shown by society, including health professionals. He explained that as GWG increases so too does the proportion of neonates that are larger at birth; i.e. overnutrition in pregnancy may result in the fetus having an increased risk for obesity through life. He also talked about epigenetics, referring to genetic control by factors other than an individual's DNA, such as nutrition. These factors can affect future generations, creating intergenerational cycles. Dr. Ferraro also dispelled a number of myths about physical activity and food consumption during pregnancies, and stressed that during pregnancy is not a good time to try to lose weight. He concluded his talk by inviting participants to join the Canadian Obesity Network for free at www.obesitynetwork.ca and inviting them to follow him on Twitter at @DrFerraro.

The second speaker in this webinar was Hiltrud Dawson, a health promotion consultant with the Best Start Resource Centre (BSRC) at Health Nexus. Hiltrud provided an overview of the consultation services, resources and training available through the BSRC. She then described several current projects that are relevant to the recommendations of the Healthy Kids Panel, including :

  1. The development of an online learning module about healthy weights in children to increase the knowledge and skills of service providers in promoting healthy weights in children aged 0-12 in Ontario.

  2. Provision of consistent prenatal information to women in Ontario, including information that supports healthy weights before and during pregnancy, as well as for children, and the development of tools, resources and training to support the uptake of the key messages.

  3. Baby-Friendly Initiative Strategy for Ontario: This project involves several partners in creating engagement strategies, tools, resources and training to encourage baby-friendly policies, programs and locations.

  4. Breastfeeding Community Project: Since breastmilk is ideal nutrition for babies, and may have several mechanisms to prevent later obesity, the BSRC is providing small grants for community projects to reach and support populations with lower rates of breastfeeding.

Evaluations from the webinar indicate that it was well-received and provided important information to the participants. The webinar slides, recordings and a list of suggested resources are available below.

Stay tuned for a blog on the second webinar of this series, on "Changing the Food Environment".

Presentation Slides | Zach Recording | Hiltrud Recording | Suggested Resources

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