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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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Andrea Bodkin, HC Link

This morning I co-presented a webinar with Kim Bergeron of Health Promotion Capacity Building at Public Health Ontario. We had a terrific crowd join us to talk about the importance of working intersectorally in a Health in All Policies approach.

I was excited about this topic for three reasons. Firstly it was great to work with Kim on this! Secondly, I think that the Health in All Policies approach is critical when we're looking at building healthy communities. So many of the policies that affect health lay outside of the health sector: everything from economic development, housing, transportation, education and many others impact the health of citizens and communities. Thirdly, it's for this very reason that we must work intersectorally: we must engage with the sectors outside of health who affect the policies that impact health.

Kim and I have been working in the areas of policy development and intersectoral collaboration for many years. When we started talking about some of the ways that facilitate this kind of collaboration, we decided to put them into a bit of a process or framework.

 
phoblog

This isn't exactly a step-by-step process or map, rather it's a collection of the things that we've found to be important when working collaboratively. First of all, it's vital to get folks around the same table – whether it's a new or existing table, a real one or virtual one- just having everyone together creates opportunities for dialogue, synergy and collaboration. Using the Stakeholder Wheel can be helpful to identify who to bring to the table and in what capacity. In the course of those dialogues, develop a collective understanding of the problem or issue you are trying to address and potential solutions. From that, create a vision or goal statement capturing what you want to happen as a result of working together: what is the change that you want to see? I really like the exercise "1-2-4-all" from Liberating Structures as a way to create a collective vision. Creating a document to capture your collective understanding, vision, roles and responsibilities and scope of the project is an important way to ensure that all partners are on the same page and have committed to the project. A Terms of Reference or project charter can help. Tailoring key messages for particular audiences, including "what, so what, now what" and the actions that you want them to take is also important.

I'd love to hear your experiences of working intersectorally in the area of policy! What worked well for you? Did you experience challenges? What happened as a result of your collaboration? Use the comment box below to share your stories.

 

By Gillian Kranias, HC Link

I recently participated in a hands-on learning experience that was totally unrealistic—and hugely valuable. Staff from the MaRS Solutions Lab led me and other curious participants through a series of collaborative dialogue and deliberation activities. This was all happening within the context of the Community Knowledge Exchange (CKX) Summit held in Toronto last month. I wanted to learn about the MaRS approach to partnerships for complex community change, since this is a common focus of my work at Health Nexus work and HC Link.

Mars1
MaRS #CKX Solutions Lab: Systems Mapping on Youth Employment

Food, housing or youth employment—take your pick!

Each 75-minute session was built on the work of participants from the previous session. The activities were:

  1. Understanding Complexity (systems mapping)
  2. Designing and Prototyping for Change*
  3. Scaling for Change
  4. Scaling Deep - on Youth Employment
  5. Building Partnerships - for Youth Employment

*Note: Although I participated in both sessions #2 and #4, this blog describes my experience in #2— Designing and Prototyping for Change.

The Journey Map

mars2What drew me to the MaRS approach was the mapping – starting with large empty "journey map" diagrams and then mapping our thoughts and ideas onto them with stickies. This process generated dynamic conversations and the maps became a common visual reference for collaborative decisions. However, given this was a mock session our decision-making was rushed and perhaps artificially smooth since people did not press their viewpoints.

MaRS staff kept reminding us that the activities we were attempting to complete really take anywhere from several days to several months. That mantra of partnerships for complex change emerged over and over again: effective efforts take time.

Our chosen challenge: design and prototype for changes in food security systems

I sat down at one of the Food Security tables. Ryan, the warm-mannered MaRS staff facilitating our table, explained the systems maps on the walls around us that had been created by the previous session tables (see example above). After we had introduced ourselves, we rapidly set to task.

mars3

  • On blank stickies, we were asked to individually brainstorm ideas for interventions to address the key challenges highlighted on our Food Security system map.

  • Using a Fast Idea Generator worksheet, we then expanded on our favorite idea. First we were invited to elaborate: Who is the actor? Who is the subject? What is being done? How is it being done (quality)?... Next we went on to stretch our idea following a list of prompts that encouraged us to explore, play and invent through: inversion, exaggeration, extension, replacement, addition, differentiation, and integration. Finally we had to rewrite our idea in a maximum of 150 words.

  • The DFVI Analysis tool helped us each evaluate our intervention to address:
    • Desirability: what problem is being solved for the individual user?
    • Feasibility: what do you need to make the idea happen?
    • Viability: what opportunities can it make use of? Or what barriers will it face?
    • Impact: what potential impact will the intervention have over time?
  • The pitch process helped us share our ideas to our table members. After which we were instructed to collectively pick one idea that would move forward (i.e. for further evolution in the following session).

  • The choice came next. I am not sure we succeeded in selecting one. We joked about our unwillingness to "choose one". And I wondered about a proposal none of us had put forth: why not first fund a network coordination position to support diverse initiatives, each tackling the complexity of food security from their own interdependent vantage point? It was probably better we didn't make any decision, since our mock partnership did not include people representing a lived-experience perspective (i.e. someone living with food insecurity).

What I learned

Overall, this session was highly engaging, and I took home those stimulating questions for a future opportunity (a real one, with more time). It was noted by a colleague that the process relied heavily on individual writing, and that this could pose some inclusion problems. A real-time application of this approach could include the use of visuals and pair/small group discussions in the development of ideas to support effective collaboration among partners with different styles and approaches.

For further reading, here are the six "design principles" of the MaRS Solutions Lab approach:

  1. Start with the citizen, look at the system
  2. Create solutions with users and stakeholders, not just for them
  3. Look for the smallest possible intervention with the largest possible impact
  4. Always work towards scale, but start small and learn
  5. No action without reflection, no reflection without action
  6. Work to diagnose problems, galvanize change and deliver real improvements

Photos are from https://www.flickr.com/photos/ckxdotorg/

 

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By Suzanne Schwenger, HC Link

Last month, I attended a great conference focused on community knowledge exchange—called the CKX Summit. It was a very energizing experience, and helped me to think differently about how data can be used to support community change.

I wanted to share a few of my key takeaways with you, as I believe many of them could be of interest to all of us.

5 highlights:

  1. Wellbeing Toronto Map- is an amazing map of Toronto's neighbourhoods with indicators on topics ranging from crime to education to the environment.

  2. Use design principles for social innovation- from the plenary with Joeri van den Steenhoven, Director of the MaRS Solutions Lab. These include working 'back to the future', and making sure that there is no action without reflection.

  3. Let's move beyond pilots to create prototypes—which move to scale. We practiced prototyping ideas for youth employment at the CKX Solutions Lab.

  4. Personal storytelling is a powerful force for community change—from session with Jenna Tenn-Yuk, conference story-teller in residence.

  5. Canadian cities have a huge untapped food source—thousands of edible fruit and nut trees! —from the jam session with Hidden Harvest Ottawa.

You can view images of the summit online here: https://www.flickr.com/photos/ckxdotorg/

By Andrea Zeelie-Varga, Canadian Foundation for AIDS Research (CANFAR)

World AIDS Day is held on December 1st each year – it was first celebrated in 1988 and was the first ever global health day. The past few years have focused on the theme Getting To Zero: zero new infections, zero discrimination and zero AIDS-related deaths.

wad1

We've made incredible strides in the fight against HIV. But it is not over, not yet. There is still no vaccine and no cure, and people living with HIV still face discrimination.

Canada is one of a handful of countries with the intellectual capital, infrastructure, and resources to make a significant difference in the fight against HIV and AIDS. The Canadian Foundation for AIDS Research (CANFAR) is Canada's only independent charitable foundation dedicated to eliminating AIDS through research. Notable breakthroughs by CANFAR-funded researchers include a key component of the drug treatment that is keeping many people alive today, and findings that have nearly eliminated the risk of HIV transmission between a mother and her baby.

CANFAR's tech-savvy, youth-friendly campaign Kisses 4 CANFAR aims to help young Canadians tackle misconceptions about the disease. Kisses 4 CANFAR is a national movement that creates an ongoing dialogue about HIV and AIDS, prevention, and stigma reduction.

CANFAR is encouraging people to take a pledge and make a personal commitment to kissing HIV and AIDS goodbye!

The pledge card is formatted for the most popular social media platforms (Facebook., Twitter and Instagram) and is also available in a print-ready format. Pledges are shared online with #kisses4CANFAR and #WAD2014 (and also for #GivingTuesday2014!)

wad2

Join us and visit kisses4canfar.com/pledge to make your promise this World AIDS Day.

By Seher Shafiq, Parent Action on Drugs

On November 25th, PAD attended the 2014 Children Mental Health Ontario (CMHO) conference titled "Getting it Right for Kids and Families" at the Marriot Hotel in Toronto. I attended on behalf of PAD, and we had a poster presentation on display titled Strengthening Families for Parents and Youth: Engaging Diverse Youth in a Family-Based, Skills-Building Approach. I got there bright and early for 7:30am, and before the conference started was able to chat with many delegates about our best-practice program for at-risk teens aged 12-16. You can learn more about our SFPY program at www.sfpy-pad.org.

CMHO Seher Nov 25

After the conference breakfast and poster presentations, the day opened with a speech by Mr. Aryeh Gitterman, Assistant Deputy Minister for Policy Development and Program Design at the Ministry for Children and Youth Services. Gitterman emphasized the importance of "shared responsibility", as well as collaboration at the local level. Recognizing that a lack of knowledge and lack of planning is a hurdle, he suggested that lead agencies should reach out to the LIHNs, as the two have a common objective and work together. Gitterman discussed the education system at length, stating that all 72 school boards in Ontario have a superintendent with responsibility for mental health, a mental health leader, and mental health teams. He noted that school boards now have a Mental Health Strategy and Action Plan in place, which is a big change from the past. Gitterman also touched on data, measurement and public reporting about performance indicators, stating that the public should know how the system is working.

After Gitterman's speech, I attended the morning session on youth engagement titled How to Give Youth an Opportunity to Speak Up, Speak Out! We talked quite a bit about the National Youth Advisory Committee – a group of 110 youth aged 12-24 from across Canada, who work on their own projects while also playing an advisory role for projects within and outside CAMH. The discussion focused around how to best engage youth and make them feel comfortable and welcome while doing so. We discussed that accountability means many things: being accountable to the process, letting youth know how their input will be used, encouraging diverse voices, and allocating money and staff into youth engagement. Integrity was also discussed as being key to youth engagement, and organizations should not just participate in youth engagement to "check the box"; they should do it wholeheartedly or not at all. We also touched on the importance of trust and respect, and talked about concrete ways to engage youth effectively: have food and incentives that youth will like, have more youth than adults in the room, support conversations rather than directing them, and ensure that the environment is comfortable, flexible and accessible. The best part about this session was the play-doh, pipe cleaners and pom poms on each table that participants were encouraged to play with!

play dough

After a healthy lunch and great keynote about mental illness and stigma by Professor Patrick Corrigan of the Illinois Institute of Technology, I headed over to another session on youth engagement titled Youth-Adult Partnerships: Working Together to Achieve Desired Outcomes and Impact System Change. A youth-adult partnership (YAP) is a relationship between adults and youth that focuses on joint work, common values, shared power and works on collective issues. The principles of a YAP include authentic decision-making (active participation of youth), community connectedness (increases community engagement, fosters relationships), natural mentorship (support without taking over), reciprocal activity (everyone is a teacher and student). The session discussed how youth can join an organization, as well as the challenges and solutions associated with YAPs. We ended with a short workshop where we discussed in groups what our organizations are currently doing to engage youth, and what we hope to do in the future.

Pyramid

The conference closed with a panel discussion and another engaging workshop. Overall, it was a great day!

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By Andrea Bodkin, HC Link

This week we held the fourth-and last- webinar in our policy development webinar series. A group of very enthusiastic folks from Ottawa joined us to talk about their experience in implementing Healthy Eating and Active Living (HEAL) guidelines in municipal daycare centres from start to finish: Helen Parker and Ellen Lakusiak from Ottawa Public Health, Ginette Perron from the City of Ottawa, and Fadi Chouhaibar, chef from Centre Educatif Beausoleil.

The impetus for the HEAL guidelines came from the municipality: they approached Ottawa Public Health for their support in developing and implementing the guidelines. The guidelines were developed under the guidance of a multi-disciplinary advisory committee informed by a literature review. The guidelines were then implemented in municipal daycare centres.

Often times, I think that we put a lot of energy into the development stage of policy development: identifying the policy issue, building community and stakeholder support, identifying policy options. This webinar focussed on the implementation of the guidelines: staff from Ottawa Public Health were seconded to provide support to daycare centres; a variety of training and sharing opportunities were held; parent engagement strategies used to garner support; a comprehensive evaluation plan identified changes made as a result of the policy; a sustainability plan was developed. It reminded me that getting a policy developed and adopted isn't the goal: getting it implemented is.

The presenters identified three main drivers for the successful implementation of the HEAL guidelines:

  1. The partnership between the municipality and public health: the municipality approached public health and asked for their participation in developing and implementing HEAL guidelines. Support for the guidelines within the child care centres was already there.
  2. Parents: a cornerstone of the implementation of the HEAL guidelines was open communication and sharing with parents through newsletters and conversations. Parents became engaged in what was happening at their child's centre: asking for recipes, sending in photos of their kids being active at home etc.
  3. Political will

The HEAL guidelines have been successfully implemented in all municipal child care centres in Ottawa. Next, Ottawa Public Health hopes to implement the guidelines in community centres and has their eye on home-based centres as well!

To learn more, check out the recording and slides from this webinar.

Review resources from previous policy development webinars.

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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.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.

camhsept10

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.

DSC 0259
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.

HC_Link RT @maytree_canada: RT @SustainNtwk: Looking to improve your #volunteer program? Take a look at this Volunteer Engagement toolkit: http://t…
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HC_Link A MUST WATCH VIDEO - Wealth #inequality is much worse than Canadians think - or want. Watch: https://t.co/gBK9jajqgT #wealthgap
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