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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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Measuring Partnership Effectiveness

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Measuring Partnership Effectiveness: evaluating partnerships

By Andrea Bodkin, HC Link Coordinator

This blog is one of a series profiling some of HC Link’s “oldie but goodie” resources from the past several years. This resource was published under HC Link’s previous name, the Healthy Communities Consortium, by former member organization OPHA.

Evaluate, celebrate and renew is one of 6 activities for successful partnerships, which Gillian Kranias and I presented in a June webinar. According to a survey conducted with participants of that webinar, it’s one of the activities that people find the most challenging. In 2008 I wrote that the world of evaluation can seem mystical, confusing and daunting. I will cheerfully admit that 9 years later, I still often feel like that! That’s why I delved back into a two-part resource that we published in 2011 on partnership evaluation, Measuring Partnership Effectiveness.  Part one provides and overview of partnership evaluation, including the benefits of assessing your partnership and principles to guide your partnership evaluation efforts. Part Two profiles a number of tools that you can use to measure the effectiveness of your partnership.

A simple way to think about evaluation that’s relevant to those of you who work in partnership, is the three levels to partnership evaluation:

  • Level 1: Measuring coalition infrastructure, functioning and processes: how well the partnership is working together. Level 1 evaluation is process evaluation that measures short-term outcomes.
  • Level 2: Measuring partnership programs and interventions: what the partnership is accomplishing together, such as the activities delivered and populations impacted. Level 2 evaluation is outcome evaluation that measures short and intermediate outcomes.
  • Level 3: Measuring community change and community outcomes: changes in health status, community capacity, the sustainability or institutionalization of programs and services. Level 3 evaluation is outcome evaluation that measures long term outcomes.

Conducting a Level 1 evaluation can provide valuable information on how your partnership is functioning, how each partner is contributing to the partnership, and the effectiveness and efficiency of the partnership. This information can be used to help your partnership improve and make adjustments over time, resulting in improved functioning and a greater likelihood of achieving the goals and activities of the partnership. Tools used to assess partnerships typically gather data on things like:

  • Purpose of the partnership: vision, mission, goals
  • Partnership structure and meetings
  • Communication
  • Leadership
  • Member diversity and involvement
  • Sense of community/cohesion and identify
  • Task focus and sustainability
  • Use of resources
  • Membership needs and benefits

So what does a Level 1 evaluation look like? Here’s a case study from HC Link’s efforts to assess and improve its partnership functioning:

As a partnership between three provincial organizations, HC Link understands the importance of assessing our partnership functioning as well as how we meet our goals and objectives.  Our Level 1 partnership evaluation focusses on measuring the effectiveness and efficiency of HC Link, how well we are structured/organized, how well we communicate, and the quality of our relationships.

We evaluate annually, using a mixed-method approach, with different approaches each year: surveys, key informant interviews, focus groups, analysis of service statistics and document reviews. One of the more innovative approaches we use is “Evaluation Day!” where HC Link staff are paired up and answer a series of questions in a dialogue. Immediately following, individuals answer an online survey. We found that the paired interviews develop relationships and understanding, and provide a richness that is then reflected in the online results. This would be a great approach for steering committee members! You can read more about “Evaluation Day!” in this blog post.

We use the results of our partnership evaluation to celebrate our accomplishments and highlight areas for improvement. When an area(s) for improvement is identified, we develop a strategy to help us strengthen this quality. Over our 8 years of working in partnership, we have made a number of adjustments based on the results of our evaluation. For example, we make changes to our meeting structure on an annual basis, and have made several rounds of changes to our structure to adapt to our changing environment/contexts. 

 

In addition to the ten tools analyzed in the Part Two resource, here are some additional resources you may find helpful:

The Wilder Collaboration Factors Inventory has an online collaboration assessment tool with research-tested success factors.

Bilodeau, Galarneau, Fournier & Potvin have developed an 18 indicator tool: Outil diagnostique de l’action en partenariat. Currently the tool is available in French only, however Health Nexus is adapting the tool for English audiences.  

Collaborative Leadership in Practice(CLIP) was a project of Health Nexus and the Ontario Public Health Association. The aim of the project was to equip leaders to be able to collaborate with diverse partners and recognize the power structures that exist in our partnerships. On the resources page, you’ll find an excellent tool- with guide- called Equity Analysis Tool of Group Membership.

HC Link’s Participatory Evaluation Toolkit and The Power of Reflection: an introduction to participatory evaluation techniques describe techniques that can be used to help assess and strengthen your parntership.

This 2017 edition of HC Link’s Digest + is on evaluation, and contains many more helpful tools and resources. 

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Resource Profile: Engaging Marginalized Communities: Honouring Voices and Empowering Change

This blog is one of a series profiling some of HC Link’s “oldie but goodie” resources from the past several years.

Several years ago, we partnered with the Social Planning Network of Ontario (SPNO) to profile work they had been doing to engage marginalized communities within local Healthy Communities Partnership activities. engagingmargThe resulting resource, Engaging Marginalized Communities: Honouring Voices and Empowering Changeby Rishia Burke, has become a bit of a touchstone for me and the work I do with populations and communities across Ontario. Published in 2011 in English and in French, the resource summarizes the project, the engagement techniques used, and provides insights into the benefits and challenges of engaging populations who feel marginalized. 

The first lesson that I keep from this resource is the use of the term “marginalized”. Often in health promotion, we have cautions about the words that we use to talk about specific populations and communities. I often refer to the resource Let’s Talk: Populations and the power of language, which explains that the words we use to talk about communities (such as marginalized, at-risk, racialized etc) can have power implications for those who use the words as well as those who are being described. Rishia approached her work in Halton Region with that same lens: she was uncomfortable using the term “marginalized” until she understood that the community responded to this word: they wanted to be called marginalized because that’s how they felt: on the margins. Outside, excluded.

In my HC Link work I talk about building trust relationships a lot. What Rishia reminds me is that with some groups, building trust can take longer. With populations that have little power, feel like they are not heard or respected, and feel isolated, building trust before proceeding in any kind of engagement is critical. Rishia recommends going to where the people you are trying to reach are: in her case, Rishia went to food banks and chatted with those waiting in line. She went to community barbeques and coffee shops. Rishia shared information with those she was developing relationships: she talked about her own childhood, her parenting experiences, and her project. This is in stark opposition to our habit of inviting communities to our spaces, where they may not feel safe, where they may not be able to easily travel to, where they feel or fear they may not be welcomed.

The SPNO project recommends these key steps to engaging marginalized communities:

steps 2 engage marg

I hope you’ll be able to apply the learnings in this resource as I have. And if this topic is of interest to you, come to our November conference Linking for Healthy Communities: With everyone, for everyone where we will reflect, learn and share about equity, diversity and working across difference. 

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Re-framing The Golden Rule

It probably won’t come as a surprise to you that I’m really excited about this year’s HC Link conference. Because a) I’m nearly always excited about something, b) I work at HC Link and so I have a slightly biased opinion and c) the conference is at the BMO Institute, which has a specialty coffee machine whose decaf lattes I dream about on a regular basis. Beyond those reasons though, I’m excited about the conference because of the theme: equity, inclusion, and working across difference.

This is a theme that is exquisitely suited to the times that we are living in. We really want this conference to be a place where people from all walks of life, of all different identities and different experiences can come together to talk, reflect, exchange ideas and think critically about how we can transform our communities into spaces with everyone, for everyone.

KimMatrinTo compound my excitement, we have an amazing keynote speaker to kick off the conference. Kim Katrin Milan is writer, multidisciplinary artist, activist, consultant, and educator. She speaks on panels and keynotes and facilitates radical community dialogues. Her art, activism and writing has been recognized nationally. The foundation of much of Kim’s work is a re-working of The Golden Rule: do unto others as you would have them do to you. This, Kim says, assumes that everyone wants to be treated in the same way, and that we are the standard for other people’s needs. Rather, Kim advocates that we treat people the way that they want to be treated: which means that we need to engage in a conversation about the wants and needs of others. We need to ask about the gender pronouns that they want us to use; we need to ask what cultural sensitivity looks like to them; we need to ask what safety looks and feels like to them. It’s in the way that we ask and create conversations that we make communities where no one is left behind. This can, of course, seem very daunting. Kim also advises us to start where you are, with what you have, and do what you can.

In her keynote at the HC Link conference, Kim will talk about allyship, bias and its role in upholding inequities, and actions we can take (in our personal and professional lives) to do what we can. Kim’s keynote will be inspirational, practical, and though-provoking. Watch Kim’s video about her keynote. 

I hope you’ll join us at the HC Link Conference, learn and share about equity, inclusion, diversity, and working together across difference. 

Want to register now? Go directly to the registration page here. Our Early Bird pricing of $310 ends next Friday, September 15th!

See you soon!

 

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Safe BBQing techniques to enjoy a healthy Labour Day weekend

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With labour day just around the corner, I wanted to share with you some basic rules for food safety in meal preparation that was shared on on the Ontario Ministry of Health and Long-Term Care website.

According to Minister of Health and Long-Term Care, Dr. Eric Hoskins and Ontario's Chief Medical Officer of Health, Dr. David Williams, reminding Ontarians of proper food preparations is key to avoiding food born illnesses.

In the summertime, food poisoning increases due to more people preparing food on the grill, defrosting raw meats like burgers, and making more salads on flat surfaces. To avoiding cross contamination and food poisoning, follow these simple rules.

Clean you hands often when preparing meals, clean surfaces and utensils with soapy warm water. Bacteria loves getting onto hands and in cutting boards, kitchen ware, cloths, knives, etc.

Keep raw meat separated from ready to eat foods like veggies, fruits, breads, and salads. Keep the separate both when you’re preparing them and as you store them.

Thoroughly cook all your food, especially meats and poultry but also veggies if you’re cooking them on the safe grill.

Keep food and leftovers in the fridge and get groceries into the fridge within 2 hours of purchasing them - especially for meat, poultry and dairy products.

To ensure you’re following the guidelines above, you can take some extra precautions such as:

Using a food thermometer to test the temperature of your food as it cooks.

Never keeping food at room temperature for more than 2 hours

Don’t defrost your meat on countertops, rather keep it in a container and let it defrost slowly in the refrigerator or under cold water in the sink.

Keep packaging of your meat firm and tight, even double bag it to be sure no juice will leak onto your ready to eat foods.

Follow cooking instructions accordingly to make sure you’re preparing your food correctly and safely.

Following these tips can help you avoid the unfortunately symptoms of food poisoning that can range from mild to severe. If you do become ill and suspect food poisoning, consult a physician or go to your nearest hospital for urgent care if symptoms appear severe. By following these rules above, however, you should significantly decrease your chances of becoming ill due to food poisoning.

Enjoy your Labour Day weekend !

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Activating Your Conference

 

We, at Ophea’s Physical Activity Resource Centre (PARC), are excited to be the physical activity partner for the 2017 HC Link Conference,  Linking for Healthy Communities: With Everyone, For Everyone.

As we draw nearer to the conference, we got to thinking about some ways that have helped us be more active at past conferences and events. Here are 5 tips to get active throughout the conference:

1. Take advantage of active breaks and opportunities throughout the event.

Ophea, through PARC will be offering energizers and active movement options through this exciting two-day conference. Come prepared to move! 

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2. Use the standing tables or open space to move and/or stand during the conference sessions.

HC Link will provide standing tables in the main conference space and these can be used to change your movement patterns!

3. Ensure you include movement between sessions.

Whether this is taking the long way around the conference setting, or changing the movement pattern (ex. skipping, rolling, etc.) to get from lunch to the keynote, making the most of the transition times and breaks can mean more physical activity!

4. Participate in the active opportunities before and after the conference.

Moving before and after the conference can also ensure a well rounded day, provide you an opportunity to meet and network with others and keep you refreshed for the sessions. If you will be staying over, this could include accessing the Wellness Center which includes a Fitness room, accessible 24 hours a day with your guest room key, or the pool area, which is open Monday – Friday 6:00 am – 10:00 pm

5. Make the most of the lunch break.

The BMO Institute for Learning has green space available if you would like to go for a walk or roll, if the weather is not ideal, you could also move around the building to keep the blood flowing.

You can also check out the PARC Blog, Energizer: Conference Setting for some additional ideas if you are planning your own conference or event!  If you have suggestions to share, feel free to Tweet us @parcontario. We would love to hear from you!

We look forward to moving with you at the 2017 HC Link Conference, Linking for Healthy Communities: With Everyone, For Everyone!

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New Resource from HC Link: Effective Meetings

I spend a lot of time in meetings: up to 50-80% of my time some weeks. There is nothing worse than spending time in ineffective meetings- while your to-do list grows and grows.  Designing and holding effective meetings is hardly rocket science, however ineffective meetings are a world-wide phenomenon. To the point where you can even purchase ribbons congratulating you for surviving a meeting…..Consider this quote from the Harvard Business Review:

meetingquote

That’s why HC Link created this French resource, which my HC Link colleague Robyn Kalda and I just adapted into English. In this resource, we outline three simple steps for effective meetings:

meeting steps

While, as I mentioned, this is not rocket science, it’s still pretty easy to hold an ineffective meeting. Here are some of the common pitfalls that I often see, and my advice for avoiding them:

  • Holding meetings for the sake of meetings: Set a clear purpose for each meeting. Think carefully about what it is that you need to accomplish, then determine if a meeting is the right mechanism for that. For example, if you simply need to provide an update, that can be done via email. One-on-one conversations might be more appropriate. In other cases, a quick teleconference might be adequate.
  • Not getting the right people around the table: Carefully consider exactly who needs to be in the meeting, given the purpose of the meeting. If decisions are being made at the meeting, ensure that meeting participants are able to make decisions in the meeting. If the meeting is about the implementation of a program/service, ensure that those who are involved in the execution of the program are at the meeting. Also consider if people actually need to be in the meeting, or if you can touch base with them before or after the meeting to provide an update. 
  • Prep work isn’t done ahead of the meeting: If this is a working meeting that depends on meeting participants doing/reviewing work ahead of time, ensure that they have enough time to get their work done before the meeting. Involve participants in the setting of the meeting date. Be willing to postpone the meeting if work isn’t done in time.
  • Unrealistic agendas: I’ll often review agendas for meetings where I think “we’ll be lucky to get through half of these agenda items”. I once had someone tell me that agendas are aspirational – that there is no need to actually finish the entire agenda during a meeting. I respectfully disagree. Be very realistic when you are setting the agenda, and be sure to include timing for each agenda item. It is the chair’s responsibility to keep the agenda on track and on time. However, there is a balance to be struck here: sometimes unexpected discussions need to take place, occasionally I’ve had to toss out entire agendas and start again. It’s important to read the group and be flexible as well.
  • Technology: Technology is a double-edged sword: it can provide a way for participation from other locations; it can also waste precious time in meetings if you are struggling to get the tech working. If you are going to use technology in a meeting, be sure that you have tested everything ahead of time and that participants are familiar with how to use it. A backup plan is a good idea too.
  • Starting late- and often ending late too. Start and end meetings on time. The end.

Now go forth and hold effective meetings! If you need advice, call HC Link! Our consultants love to give advice on how to make your meetings efficient and worthwhile.

Helpful Resources

For a little fun – check out these videos Teleconferences in Real Life and Every Meeting Ever.

HC Link’s Facilitation for Healthy Communities Toolkit and The Power of Reflection: An introduction to participatory evaluation techniques provide many excellent tips and techniques that can be used in meetings.

This excellent article from the Harvard Business Review lists the 6 purposes of meetings and the different types of meetings.

This blog post from GovLeaders.org lists 6 Golden Rules of Meeting Management. 

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"Pay-what-you-can" meals change the world.

soup bar by feed it forward

Image Source: The Toronto Star

 

Jagger Gordan, Canadian chef and founder of Feed it Forward has recently opened "Soup Bar", a pay-what-you-can soup bar located in downtown Toronto. 

The soup bar caters to people of all economic means. Chef Gordan’s concept for Soup Bar is to provide hot, healthy, and balanced meals to anyone who wants one. For every $2.50 spent, a token is placed in a jar so that those who cannot afford to pay what they can may take a token from the jar and use that as payment for their meal. 

Chef Gordan began Feed it Forward to help reduce the amount of food being wasted in supermarkets and sent to landfills. The Soup Bar provides several types of soup and a side order of bread to all that would like it. He gets his supplies from grocery stores that have planned to throw food away as he believes wasting copious amounts of food is unacceptable. Referencing France’s new law, which bans supermarkets from throwing away good unsold food, forcing them to donate it to charities and food banks, Gordon has begun an online petition in hopes of achieving similar results here in Canada.  

The Soup Bar is located at 707 Dundas Street West. For more information on Jagger Gordon and Feed it Forward, visit: http://feeditforward.ca/

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Sustainability Planning Part Three: Developing a sustainability plan

This post is part of a series of blogs on program sustainability and sustainability planning. Read the pervious posts, What is sustainability? And Components of Community Work.

I’ll be honest. I loooove planning models. When I embarked on researching models for PlanSustaindevelopingsustainability plans and did not find a pretty step model- I was disappointed. Though when it comes down to it, planning is planning! So this blog post, rather than providing a step model or planning process, summarizes important points and advice for sustainability planning.

  • Like evaluation planning, planning for sustainability should be done as early in the program development process as possible. The office of Adolescent Health has identified eight key factors1 that influence whether a service, program or its activities – and therefore community benefit- will be sustained over time.
  1. There is an action strategy or program plan
  2. An environmental scan or assessment was conducted
  3. The program is adaptable
  4. The program has community support
  5. The program can be integrated in community infrastructures
  6. There is a leadership team
  7. Strategic partnerships have been created
  8. Diverse funding sources have been secured
  • As mentioned in my first blog post, sustainability planning should focus on community need: therefore assessing the environment is critical. Look at community readiness, local demographics and existing services1. Also assess the financial and political environments. Look internally as well, assessing your own organizational environment such as leadership, staffing and infrastructure1.
  • Like any comprehensive program plan, a sustainability plan contains goals, objectives, action steps, timelines, roles1 and metrics for tracking progress on each action step2.  It should be a living plan that is regularly re-visited1.
  • In your sustainability plan, consider the four components of sustainability discussed in the second post in this series: the issue, the programs, the behaviour change, and the partnership 3.
  • Share your success! Increase the visibility of your work in the community, through the media, conference workshops, publishing case studies etc. Develop a marketing strategy that promotes the success/results of your program as well as the program itself4.
 
References
  1. Office of Adolescent Health, 2014. Building Sustainable Programs: The Framework.
  2. Calhoun, Mainor, Moreland-Russell, Maier, Brossart and Luke. Using the Program Sustainability Assessment Tool to Assess and Plan for Sustainability. Preventing Chronic Disease 2014; 11:130185
  3. Heart Health Resource Centre, 1999. @heart: Heart Health Sustainability. Toronto, Ontario
  4. Office of Adolescent Health, 2012. Build to Last: Planning Programmatic Sustainability.
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Sustainability Planning Part Two: the Components of Community work

This post is part of a series of blogs on program sustainability and sustainability planning. Read the first blog in the series, Sustainability Planning Part one: What is sustainability?

 

As I often do when learning about something- in this case- sustainability- I turned first to HC Link’s resources. In this case, I turned waaaaaay back

sustain 4 componentsbeyond the 2009 inciption of HC Link, to a resource written by one of HC Link’s founding partners, the Heart Health Resource Centre. Written in 1999, the resource Health Heart Sustainability (available only as a scanned copy), was designed to support community partnerships participating in the Ontario Heart Health Program develop sustainability plans. While created specifically for the Ontario Heart Health Program, the ultimate goal of which was the reduction of behaviours that lead to cardiovascular disease (physical inactivity, unhealthy eating, smoking and stress), I think that this model is applicable to many other programs that focus on behaviour change, and in particular, involve multi-dimensional community partnerships.

This table suggests results for each component of sustainability, and gives a sense of various options within each category:

sustain table 3

What I really like about this model is that it goes beyond thinking how to replace expired program funding: it encourages us to think about what it is we are trying to change (the issue) the change we actually want to see (the behaviours), and the partnerships we’ve established to do the work.  Consider how to address sustainability of each of these components not only in your sustainability planning, but as you are designing your program.  

Read the third post in this blog series, Developing a Sustainbility Plan

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Sustainability Planning Part one: What is sustainability?

This post is the first in a series of blogs on program sustainability and sustainability planning. Stay tuned for the next posts: Sustainability Components of Community Work and Developing a Sustainability Plan.

Lately we’ve been getting service requests from organizations and partnerships who are interested in sustaining their programs beyond the end of their funding period. “Sustainability” is one of those mysterious terms that is used a lot, though we don’t always know what we mean when we say it! I decided that I needed to find out more about what sustainability is and how to plan for it.

There are many different definitions of sustainability. Sustainability can be defined simply as a continuation1: the ability to carry on program services through funding and resource shifts or losses2. In other cases, sustainability can be about institutionalizing services; creating a legacy; upholding existing relationships and maintaining consistent outcomes2. Often we think of sustainability meaning about funding3:  however sustainability planning should focus on community needs, which shift and change over time2.  Sustainability is not a single event or a linear process: like many things in healthy communities and health promotion, sustainability planning is a continuous process that may involve one-step-forward-two-steps-back and multiple components happening at the same time2.

The Office of Adolescent Health (OAH) in the U.S. has several excellent resources on sustainability. In particular, their 2012 Tip Sheet titled Built to Last3 provides an excellent, 5 page primer to sustainability planning. In the tip sheet, the OAH lists four common challenges to sustainability of programs and services:

  • Organizations have difficulty in planning far enough ahead to secure necessary resources
  • There is a lack of well-documented successes to share with the community and funders, despite the quality of the program
  • There is a lack of stakeholder ownership of the program
  • Funding streams are finite and there is competition from similar organizations

Sustainability planning should not be automatic: in other words we should ask ourselves if the program should be sustained rather than simply assume that it should. I've adapted the below questions from the OAH tip sheet and a guidebook of the Department of Housing and Urban Development in the U.S.4:

  1. Does your program or service address a need in the community?
  2. Do your evaluation results demonstrate that you are making a difference?
  3. Do you need to sustain the entire program? What parts of the program are the most effective and needed?

What I’m taking away from this wee bit of reading that I’ve done on sustainability, is that we often focus our sustainability efforts on replacing program funding, with the assumption that our programs should continue.  Sustainability is not about replacing expiring funding- though obviously that’s a part of sustainability planning. Rather, sustainability planning should be a fluid, ongoing process that is specifically tailored to local needs and the environment in which the organization operates. We need to ask ourselves the hard questions (as per above) to make sure that our program should continue. Then, we can begin sustainability planning. 

Read the next post in this series, Sustainability Planning Part Two: the Components of Community work.

References

1Heart Health Resource Centre, 1999. @heart: Heart Health Sustainability. Toronto, Ontario

2Office of Adolescent Health, 2014. Building Sustainable Programs: The Framework.

3Office of Adolescent Health, 2012. Build to Last: Planning Programmatic Sustainability.

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Join our “what successful partnerships do” series this September!

t HC Link we do a LOT of work supporting community partnerships. We’re finding that, more and more, people are working in partnership. That’s why we’ve developed this free series of webinars, consultations, workshops and resources to help you work more effectively in partnership.

Gillian and I began the series in June through a webinar in which we touched on key issues and strategies for building & maintaining successful partnerships. We then offered individual coaching sessions to help webinar participants apply their learning and identify next steps to strengthen their partnership skills.

This fall we will build upon our June webinar by moving into a more interactive stage. First, participants can use an online bulletin board to share what challenges or questions they currently face when dealing with partnerships. Then on Sept 26th, Gillian & I will host an interactive learning exchange that is completely customized to address the questions and concerns registrants sent in earlier in September. 

 

To sign up & ask your questions, click here.

 

What you can expect from this learning exchange:

  • Structured conversation lead by HC Link staff
  • Expert advice and opinion by contributors
  • A chance to build upon the ideas and challenges you face
  • Discussion on how to apply the 6 Key Activities for dynamic and effective partnerships.

 

Following the learning exchange, you can sign up for coaching sessions with HC Link consultants. Your partnership can also request consultations and workshops to help you move forward and accomplish your goals.

 

Missed part 1 in June? No problem! Get up to by speed by watching the recording or by reading this handy 2-page recap in FR and EN, which covers the topics we touched upon in webinar such as:

 

  1. Challenges organizations face to maintain strong partnerships
  2. Insight on how to define and achieve common goals 
  3. Our 6 key activities on how to achieve dynamic and effective partnerships

 

Not sure how HC Link can help? Contact us to start a conversation and see where it leads. 

 

partnership serie logo M 2017

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It takes a village: Social connections for health and well-being

By Rebecca Byers, HC Link

“Social isolation is the biggest health concern of our day,” said psychologist and best-selling author Susan Pinker during her closing keynote address at the Association of Ontario Health Centres (AOHC) Shift the Conversation conference I attended last week. She was referring to the science that shows social isolation harms peoples' health and shortens lifespans – material she covers in her latest book, The Village Effect, that explores how face-to-face contact is crucial for learning, happiness, resilience and longevity. Over the course of her talk, Susan shared the benefits of social connections and made the case for creating more inclusive communities where people know, and talk to each other, face to face.

Susan

Susan told us about her visit to a mountain village in Sardinia, Italy – one of the world’s “Blue Zone” areas as it is home to one of the highest proportion of super-centenarians. Her research of the over-100 club in Sardinia revealed that these centenarians typically had frequent and close connections with family and friends.

There is support for this observation; one study showed that social integration (loose in-person connections to many others) and close relationships (those tight bonds of friendship) are the strongest predictors of longevity – greater than perhaps more obvious things such as smoking, alcohol-use, diet, exercise, weight, hypertension.

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According to Susan, having loose in-person bonds, together with close relationships, creates a personal “village” around us, one that exerts unique effects. She went on to say that social contact (the face-to-face variety), like a vaccine, has a protective effect on our health, and it seems our bodies know it as it is a biological drive much like food and sleep. From birth to death, we are hard-wired to connect to other human beings and this connection gives us a sense of belonging.

“It’s a biological imperative to know we belong.” – Susan Pinker

Simply put, belonging matters. As mentioned by another presenter earlier at the conference, it’s the “secret sauce” to well-being. This is a belief supported by the Canadian Index of Well-being (CIW), which measures eight quality of life domains to provide a greater understanding of wellbeing and support evidence-based and community-focused decision-making. “Social relationships” is one of the categories of well-being indicators within the CIW’s Community Vitality domain - which looks at quality of life with regard to the communities we live in, how safe we feel, and whether or not we are engaged in community activities or socially isolated.

AOHC has been one of the pioneers to adopt the CIW. Over recent years, the association and its member organizations have worked to apply the CIW in a variety of innovative ways. One of the ways that community health centres are applying the CIW is by incorporating a “Be Well Survey” to collect information about the health and wellbeing of the people and communities they serve. The survey contains standardized questions that cover all eight CIW domains with a particular focus on Community Vitality and its components such as belonging, social connection, and inclusion.

Susan closed with the following recommendations for the audience of AOHC members, which I think hold true for all organizations, communities and people alike:

  • Build “third spaces” – social hubs that are neither work nor home. It doesn’t have to be fancy – can be as simple as providing tables and chairs. What’s important is that it draws people.

  • Build “villages”. Relationships help people thrive. Social contact should be built into all prevention and treatment plans.

You might also be interested in one of HC Link’s past webinars: Stress, Determinants of Health and Connectedness: Impacts on well-being 

 

 

 
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‘Everyday Superheroes’ recruited during Parachute Safe Kids Week to promote safe, active transportation and combat the #1 killer of Canadian children

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By Julie Taylor, Parachute

This week is Parachute Safe Kids Week, a national campaign to raise awareness about predictable and preventable childhood injuries in Canada. This year’s campaign focuses on promoting safe and active transportation, which includes walking, cycling, skateboarding, scootering and other wheeled activities.

Each year, non-motorized wheeled activities lead to approximately 4,700 child injuries. Another 2,400 children are injured as pedestrians. As jurisdictions and organizations across Canada (including Parachute) adopt the Vision Zero approach, it’s important to keep a focus on our most vulnerable road users including child pedestrians and active transportation users. One fatality or serious injury on our roads, especially regarding children and youth is unacceptable.

This year’s theme is everyday superhero, which encourages children to become leaders in road safety by learning how to stay active and keep themselves and their loved ones safe on their travels to and from school, to the bus stop, and around their neighbourhood. Parents can guide their child’s activities by modelling safe behaviour and practices on the road, and also being aware of their child’s skill level.

This Safe Kids Week, Parachute is encouraging children and parents/caregivers to leave the car at home and choose active transportation whenever possible. The fewer cars on the streets and the more people walking, biking and wheeling, the safer it is!

Keep kids safe and active on their travels with these top tips:

walkWalk: Pedestrian Safety Tips

  • Teach kids at an early age to look left, right and left again when crossing the road.

  • Adults or older children need to walk with younger children and teach them how to cross the road safely. Young children can’t properly judge safe gaps in traffic or speeds.

  • Always cross the street at corners. Use traffic signals and crosswalks. Up to 25% of pedestrian collisions occur at mid block locations.

  • Walk on sidewalks or paths. Sidewalks can reduce pedestrian collisions by 88%. No sidewalks? Walk facing traffic as far away from vehicles as possible.

  • Phones down, heads up when walking. Teach kids to put phones, headphones and other devices down when crossing the street. Child pedestrians are up to 30% more likely to be struck or nearly struck by a vehicle when distracted by a cellphone.

  • Be seen. Teach kids to be especially alert and visible to drivers when walking after dark. Brightly coloured clothing and reflective gear help increase 360- degree visibility. 55% of pedestrian deaths occur at night and/or with low- light conditions.

bike2Bike: Cycling Safety Tips

  • Protect your head, wear a helmet. A properly fitted and correctly worn helmet can cut the risk of serious head injury by up to 80%. Using the 2V1 rule for helmet fitting (two fingers above eyebrows, straps form a ‘v’ under ears, no more than one finger space between strap and chin) will ensure better safety before taking a ride.

  • Check your ride. Ensure your kids’ bikes are adjusted correctly for their height and have them do a bike check before riding to ensure tires are inflated and brakes are working properly.

  • Be prepared. Bike safety training and knowing the rules of the road are important for the safety of riders.

  • Pick family friendly routes. Protect young riders by using designated riding areas when possible. These areas (often governed by bylaws) are in place for the safety of cyclists and pedestrians.

  • Stay on the right side of the road. Always ride on the right side of the road in the same direction as traffic to make you more visible to drivers. Adults should lead kids by cycling single file and having them repeat hand signals. Drivers should also give cyclists space on the road and be aware of the risks when opening car doors.

  • Assess your child’s navigational skills before riding on the road. Children develop better physical and cognitive skills around age 10 – but their ability to ride on the road may depend on their experience, environment and development. Not sure if your child is ready to ride solo? Consider traffic volume, the number of intersections and your child’s level of experience before making a decision.

  • Be seen and heard. Make sure drivers can see you at all times. Wearing bright, reflective clothing and equipping your bike with flashing lights and reflectors help increase 360- degree visibility. A working bell will also alert other riders and pedestrians when you are close or passing.

wheelWheel: Other Wheeled Activity Safety Tips (skateboarding, scootering etc.)

  • Wear the right helmet for the activity. Bike helmets can be used for in-line skating and scootering, but skateboarding helmets should be used for skateboarding and longboarding; they cover the back of the head better and can protect against more than one crash (see Which Helmet for Which Activity resource).

  • Always wear the gear. Along with a helmet, wear wrist guards to help prevent broken bones, sprains and wrist and arm fractures. Elbow and knee pads should also be worn for in-line skating.

  • Be seen. Make sure drivers can see you at all times. Wear brightly coloured clothing and reflective gear to help increase 360- degree visibility.

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It’s “cannabis” not “marijuana” and other interesting learnings from the Hon. Anne McLellan


By Jane McCarthy, Parent Action on Drugs

cannabis 1131526 1920Complex. Challenging. Broad societal impact. Words that come to mind when thinking about the legalization and regulation of cannabis in Canada. I recently had the opportunity to hear the Honourable Anne McLellan, chair of the Government of Canada’s Task Force on Cannabis Legalization and Regulation, also use these words when she spoke at the University of Waterloo School of Public Health and Health Systems about the work of the task force and where we are headed. Having scanned the 106-page Task Force report, it was a welcome opportunity to learn more about the recommendations, how they came together (80 diverse position statements taken into consideration) and how quickly so (five months), in a more dynamic way. While Ms. McLellan recapped the general public health approach and principles upon which the legislation introduced last month by the federal government is based, i.e., take a cautionary approach and protect the public’s health and safety, she imparted some interesting and important side notes, a few I’d like to share here.

  1. It’s cannabis, NOT marijuana, from here on, folks! —as we go forward, we need to stop using the term marijuana in our messaging and replace it only with the correct botanical name. Marijuana is slang and typically is thought of as the dried flowers of the cannabis plant for smoking or ingesting. Cannabis can be consumed in many different forms in multiple ways, so we need to re-educate ourselves and those we work with and serve.

  2. There is soooo much we don’t know about this plant!—We know some things about THC and CBD, and there is still more to learn about them, but what do we know about the 104 other active ingredients in cannabis? Not much. Are they harmful or helpful? We need to know. There will be a huge focus on primary research in the botanical sciences and merging that knowledge into the biomedical space. Interested in studying plants? There should be plenty of work available in that field as we move forward.

  3. Why recommending the minimum legal age be 18 years makes sense—It’s true the developing brain is more vulnerable to harms associated with cannabis use until 25 years of age. Contrary to recommendations made by medial associations and others to set it higher, the task force made this recommendation for a number of valid reasons. First, it makes practical sense for Provinces and Territories to choose to harmonize it with their legal drinking age, three of which have set that age at 18. Second, although it seems counter intuitive to not set a higher age when the focus is to protect youth, setting the minimum age too high would encourage an illicit market targeting youth and thus, leaving them more vulnerable to the harms associated with unregulated substance content and criminal interaction. Third, most Canadians reporting use of cannabis in the last year are 15-24 years of age. Usage falls off dramatically after age 25 to about 10%. If the legal age were 25, it would criminalize the bulk of users and wouldn’t have much of a harm reduction impact, now would it? The Task Force believes that with quality public education, most people by age 18 can make an informed decision.

  4. It’s a gender target market, so far—Males by far out-number females in terms of recreational cannabis consumption, approximately to the tune of 3:1. However, once legalized in Colorado, consumption did see a rise among females. It will be interesting to see if that holds true in Canada as well.

  5. Education is key: from creating clarity around legalization to promoting health and safety—Ms. McLellan noted that many from the recreational use cannabis advocacy community only seem to hear the word legalization, while the word regulation goes unnoticed. Just because it will become legal, doesn’t mean it’s a free for all for cannabis to be consumed by anyone, anywhere, anytime. People must be educated to understand the rules and be held accountable to them for public safety. And while we must move away from a psychology of prohibition to legal use, proper public education is required to address both the benefits and harms to mitigate both fear among those opposed to legalization and the misguided belief that there are no harms associated with cannabis among the fervent advocates. To keep children and teens safer, longer, it is paramount that parents and other adults involved with youth, and youth themselves, receive effective education about the potential harms to the developing brain ahead of legalization and on-going.

In a nutshell, there is much to learn about cannabis, its effects, and how to best legislate production, distribution, and use to promote public health and safety. Every aspect of society will be impacted in some way by legalization and regulation of recreational cannabis from perceived norms to business development to educational opportunities to healthcare to law enforcement to—you name it! Thus, the Task Force has recommended legislation that is cautious and flexible to respond to evolving knowledge and experience. As health educators and promoters, we must get ahead of the legalization and teach the risks of developmental harms to youth and risks associated with problematic patterns of use at any age. We must target and engage parents, health care providers, educators, community workers, and youth themselves to develop and evaluate effective tools about facts, norms, and making healthy, safe choices around cannabis, regardless of what the laws will look like.

 

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What Program Components Are Effective for Promoting Mental Health in the Early Years, School Years, and Transition-Age Youth?

By Jewel Bailey, CAMH Health Promotion Resource Centre

May 1-7 2017, is Mental Health Awareness Week. This annual event provides another opportunity to raise awareness about the importance of good mental health and what is required to achieve and maintain positive mental well-being. The Evidence Exchange Network within the Provincial System Support Program at CAMH, produced three evidence briefs that examine program components that are effective for promoting positive mental health in the early years, school years, and among transition-age youth. Selected findings for the three groups are presented below:

earlyyearsEarly Years

Home visiting and group-based parenting programs were identified as priority areas for this evidence brief since evidence demonstrates a high return on investment for these two types of interventions.

    1. Program components associated with effective home visiting include: utilizing appropriately and/or professionally trained home visitors, applying a clearly articulated theory of change, having more intensive programs, and teaching parents responsive parenting, behavior management, and problem-solving.

    2. Components associated with effective group-based parenting programs include: teaching parents emotional communication skills, disciplinary consistency, positive interactions with the child in non-disciplinary ways, and requiring parents to practice new skills with their own child during group sessions.

Read the Early Years Evidence Brief

schoolagedSchool-Aged Children

  1. Social emotional learning (SEL) programs are one category of mental health promotion interventions that foster the core competencies and skills to help children and adolescents manage emotions, relationships, and conflict.

  2. Components of effective SEL programs include using a whole school approach, SAFE (sequenced, active, focused, and explicit) components, interactive training methods, involvement of parents, and a focus on skill development. Programs delivered across all school levels have shown to be effective, though it is inconclusive whether longer programs are more beneficial than shorter programs.

Read the School Years Evidence Brief

 

tayTransition-Age Youth (TAY)

  1. Mental health promotion, prevention and early intervention supports for TAY must include interventions both on campus and in community-based settings that are diverse, integrated, and comprehensive.

  2. Skills-based programs that incorporate supervised behavior practice and feedback, such as those aimed at building cognitive-behavioral skills, mindfulness, or relaxation, have been shown to be effective at reducing levels of psychological distress among post-secondary students.

  3. Early evidence has demonstrated that integrated service centers, on campus or in the community, are effective at increasing access to mental health supports for TAY and somewhat effective at reducing psychological distress.

Read the TAY Evidence Brief


Findings from these evidence briefs informed the recommendations presented to the Ontario government by the Mental Health and Addictions Leadership Advisory Council in its 2016 Annual Report.

 

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Improve the Built Environment to Promote Food Access in your community: Questions, Responses and Helpful Links from our online discussion

By Kyley Alderson, HC Link

builtenvirofoodaccessheaderOn April 13th 2017, HC Link consultant Paul Young from Public Space Workshop joined with 50+ participants to share ideas, resources and information to help us improve the built environment to promote food access in our communities.

This online discussion focused on the physical/built environment, which is one key component of the overall food environment. Research and our experience shows us that the built environment can affect food access. There is a distinction between programming for food access in contrast to providing physical space (e.g. a municipal parking lot available for a food market) which can then support programming.

Below, we are sharing the questions that were asked, responses from Paul and participants, as well as helpful links and resources. Feel free to scroll to questions that appeal to you, and don’t forget to check out additional resource links at the bottom of the blog! If you have any remaining questions, or want clarification on the information provided, you can email Kyley at This email address is being protected from spambots. You need JavaScript enabled to view it..

Poll 1.

The discussion began with a few poll questions to get participants thinking about how the built environment can affect food access–

How close are you to your healthy food store where you regularly shop?
Is your community designed with food disbursed throughout it or is it located in one area of town?
Some communities are disproportionately affected by lack of access to healthy food. For people in your community that may be on fixed or low income, check all that apply. (Options included healthy food stores within walking distance, having food banks, community kitchens, or food markets nearby, and having more unhealthy vs healthy places nearby).

After the poll the discussion was guided by questions submitted by participants.

Questions and Reponses

1. What is a food swamp? What is a food desert? How can we identify where there is a need in my community?

  • Food Swamp – areas with more fast food and unhealthier food options

  • Food Desert – areas with limited healthy food options

  • Taking a geographical perspective on food access – you can map out food resources (healthy and unhealthy) to see where there is a need in your community.

  • Transportation is a key issue for food desserts.

  • Working with planning departments, you can look for ways to incentivize grocery stores to come into the community.

  • Zoning – (e.g., Toronto’s Residential and Commercial or RAC zoning). Toronto has been experimenting with this and looking for ways to incorporate shops into the bottom of higher apartment residential buildings. Planning departments have started to open up this discussion – to look at introducing mixed land uses and incentives for shops to be located there (in areas where there are food desserts).

  • Toronto Public Health/ Food Share – Pop up markets and mobile food markets – having a market on a regular schedule to bring food into the community.

  • Healthy Corner Stores Initiative – Toronto Public Health has piloted a program to encourage convenience stores to sell some healthy food options.

2. What strategies can you suggest to reduce food swamps? At a policy level, when an area is zoned for commercial how do you control what types of food outlets are approved?

  • There is a chain of agreements that fall into place – planning departments can have some influence in this and can work with developers in early stages when tenants are determined.

  • Example - PAN AM games village (now the Canary District) in Toronto – they had an influence over what types of establishments could lease store front locations. There was a restriction on chains (although there could still be independent unhealthy shops), but that is example of influence.

  • Still early days on working with developers on this.

  • Montreal and NYC seem to be leading the charge on this.

Participant shared:

  • Haldimand-Norfolk Health Unit collaborates with the planning department and we are invited to pre-cons with the planners. We attend and then try to educate the developers about the benefits of healthy foods vs. risks of unhealthy foods, or highlight they are close to a school so we don't recommend fast food/convenience store. They don’t have to listen to our advice but many of the developers are interested and do take our suggestions.

3. In rural areas, where there is limited/no public transportation, do you have any suggestions for how people can access food (whether through grocery stores, farmers markets, etc.)?

  • One strategy - Work with planning department to get food stores to locate near the downtown – where people are living and where transit may be connected.

  • There is a current trend to locate retail by highways – this makes it very difficult if you don’t have a car. Speak with your planners.

  • Strategy – connect with farmers.

    • Look for opportunities for Good Foodbox model.

    • Community shared agriculture (CSA)– where there are a series of drop spots where people can pick up produce at a location that is easy/in close proximity to where they are living.

    • Farm gate retail – where farmers can bring produce into town, such as a weekly market, or set up stand/money box at the end of their driveway (may need access to car still for this option).

    • Shuttles and Ride Sharing – organize weekly trips to grocery store and share transportation costs. Some agencies might have access to a shuttle bus – might be a way to connect pick up and drop offs to food stores.

Participants shared:

4. What resources/education documents exist to assist in enabling stakeholders and decision makers to understand the impact of transportation on food access?

  • Maps can help – you can start to see where concentrations of food stores are and see where populations of higher need are living, and calculate the distance between the two. You can layer in information about the transit system and see where they are/are not connected.

  • Food By Ward – connected to the work of Toronto Food Policy Council. They have produced a number of maps that serve as a good model for mapping out resources (including community kitchens, markets, food stores, etc.)

  • Toronto Urban Growers are also doing mapping work to show where food resources are located.

  • Mapping helps to point out needs and gaps.

  • Housing and Transportation Index – looks at cost of housing and transportation combined. We might think we have affordable housing, but do we when we consider transportation in car dependent locations?

  • Shuttles, cab sharing, changing a transit system to connect higher need communities with food stores can be explored.

  • Working with planners and developers to bring in healthier food stores – real opportunity with new developments especially.

5.How can you gain public or political support for investments in the built environment as they relate to food access?

  • Drawing on experience at the South Riverdale CHC– They started a food working group with a wide representation of stakeholders. A working group is foundational for setting up strategies to address local challenges.

  • A working group adds credibility when speaking with decision makers, local elected representatives – to advocate for change.

  • Mapping – Paul is currently making food (and recreation) maps that list food resources within a 2 km radius around schools in Toronto’s tower neighbourhoods. Maps have icons for a variety of resources, e.g. – Farmers markets, community kitchens, etc. When decision makers see there is no icon on the map for one of the resources (food markets for example) they might begin to think – we don’t have this and we should. Maps are helpful and compelling tools for pointing things out to decision makers, especially food desserts and food swamps.

Participant shared:

  • In my experience, one needs to provide clear evidence to help people understand what the problems are and, especially, what the problems are not (e.g. in Toronto "food deserts" are not a big problem, but "food swamps" are). Then being very clear on potential solutions and what you need from decision makers to realize it. Precision and clarity is not something that's been a priority among public health actors but we need to get better at it.

6. How do you evaluate success/use of map by public?

  • Just in process of doing this with the school maps - sending out survey to teachers, asking if they are aware of the map and if they are using it in the classroom, etc.

  • If maps are available online – you can look at how many people are downloading the map from your website.

7. What criteria, resources or standards could be used to establish what is deemed a healthy vs an unhealthy food outlet?

  • Dieticians can visit each store and do an analysis on what is sold there. For the school maps we are relying on their expertise and their criteria to tell us whether it is a healthy food store or not and the percentage of healthy/unhealthy food in the food outlets.

Participants shared:

  • Developing a food charter as a first step to incorporating food access and influencing the food environment could be useful. Food charters could be the basis for food strategy and food policies. Find out more about Toronto's Food Policy Council here: http://tfpc.to/

  • In Toronto we created definitions of "healthier" and "less healthy" food outlets that we applied to public health inspection data as part of food envir't mapping. It's meant for use as an analytical tool, not in any way as a public designation. Happy to share that approach with anyone.

Poll 2.

Before moving on to further questions, we asked two more poll questions to get participants thinking about how land use planning policies might be affecting the built environment and its effect on food access.

If you have any new developments where you live, does the new community have shops (including food stores) located near homes (within walking distance)?

  • Development patterns are changing. We are coming out of an era where we put all the residential areas in one part of town and all the retail in another – which made us very depending on driving.

  • More recent developments have started to incorporate retail on ground floor.

  • Still a lot of urban sprawl going on.

The Provincial “Places to Grow” plan is in place to protect farm land and natural features in the Greater Toronto and Hamilton Area. Has your municipality set out land use policies in the Official Plan to protect agricultural lands?

  • Most municipalities have an urban growth boundary – a boundary line that development is permitted to occur within to prevent sprawl and preserve farm land.


8.
What municipal policies have shown impact for improving access to healthy foods in a community and/or at the neighbourhood level?

  • Growth boundaries to prevent sprawl and preserve farm land

  • Mixed-use zoning – to encourage a retail and place to work in the community

  • Supporting existing downtowns – bring food shopping into downtown where people are living. Look for ways to support this in planning policies.

  • Story in The Star a few years ago – a couple moved to downtown Milton to be closer to shops and leave car at home. But as development unfolded, large format retailers (including food stores) were located on the outskirts of town and the downtown became more of a boutique retail area. Couple had to use the car to get their everyday shopping needs. Policies that enable new retail areas outside of existing communities can have an impact on food access.

  • Residential Commercial Zoning. Communities can introducing retail (even small scale convenience) into residential areas that don’t have any retail currently.

  • Municipalities can also introduce policies to enable community gardens at various scales. Fresh City Farms at Downsview park for example.

  • Designating areas for markets – Bellville has a formalized market downtown. Can also look at simpler models where policies allow parking lots to be used for markets at certain times.

  • By-laws such as allowing hens in the backyard for fresh eggs.

Participant shared: http://www.rentthechicken.com/


9. Erinn Salewski: Are there opportunities to insert food access language into municipal planning documents ie. City Master Plan, etc.?

  • Yes - see examples above

  • There are a number of documents that shape community planning - Official Plan, secondary plans with more detail (e.g., park space schools and lot sizes).


10. People living in poverty (whom, they themselves or people they know, also tend to experience higher levels and frequency of crisis) may not have energy or time (due to life as well as working multiple jobs) to go to a community garden/participate in a community garden - ideas for options?

  • Look for ways to overlap community gardens with other services/programs (i.e. have a garden in close proximity to other services)

  • Support people in having small scale gardens (i.e. balcony, vertical gardens). South Riverdale CHC has a demonstration rooftop garden set up.

  • Making it easier for people to garden by bringing it closer to where they are. It can be incorporated right on to the front lawn of a community organization, for example.

  • Note about Equity – food banks are a piece of the food access picture, but other models like a community kitchen or a subsidized good food market (Food Share is making it easier to get these markets set up in Toronto) are good options as well, and are often less stigmatizing.

Participants shared:

  • Connecting people to other services (i.e. social services) in the community is also important


11. Teaching children about respect for the environment is an important aspect of sustainability, and may contribute to how children make decisions about the environment as they grow older. I firmly believe that this process should start while children are young. A large number of Child Care Centres are located in strip malls, where children have limited access to gardening. What do others think about having Child Care Centres located in 'safe environments' (geographically) which provide greenspace opportunities for children to grow their little gardens, and develop physical literacy at the same time?

  • With regard to engaging students in schools, when students and teachers are involved in the garden design process first – it builds up support for the idea.

  • If space is restrictive, might need to look at vertical gardens or gardening indoors (planting seedlings in the window and taking home)

  • In terms of child care centres in strip malls (may be a health impact when located near a busy road).

12. How can schools be supported to provide healthy options for students and contribute to the food security issues in the larger community?

  • Paul is working with Toronto Public Health to show students where food is located in their neighborhood (as well as recreation resources). Teachers have a toolkit to incorporate this map into their class lessons/curriculum. Into Kids Health

  • At South Riverdale CHC Paul assisted schools in designing and planning gardens, and getting commitment from principals and teachers to support the garden (schools don’t often have resources to initiate this process).

  • Evergreen Learning Grounds – has resources and dollars for school ground greening programs (including gardens).

  • The Good Food Café (Food Share) – looks at how cafeteria food can be made healthier.

Participants shared:

  • In our community, the high school construction classes build all of the plots for the community gardens/ greenhouse. The Local Food Co-Op has a plot in their greenhouse that they provide for free to schools who do not have school gardens. Connections to other organizations can be key. www.cloverbeltlocalfoodcoop.com

  • The Ministry of Education does incorporate well-being (including physical literacy) in their How Does Learning Happen - Ontario's Pedagogy for the Early Years. NRC was involved in consulting with the Ministry of Education on how to incorporate Food literacy in to this document as well.

  • The tower garden/ vertical aeroponics approach has always looked interesting. A high school in Toronto has used them, good for areas with limited space.

  • Student Nutrition Program supports schools to provide healthy foods to students.

  • Interesting stuff happening with vertical hydroponics happening in the far north too. This is a fun story (one of many) http://www.cbc.ca/news/canada/north/naujaat-nunavut-growing-north-project-1.3633295

13. In Canada, over 6 million tonnes of food that is perfectly good, and wholesome to eat is thrown in the garbage every single year; Yet 1 in 8 homes struggle to put enough food in the table. What models have you encountered that reduces food waste while improving food security and food access?

  • Second Harvest – Food rescue matching. Electronic app to connect consumers to food. If you’re running a business that has food that will expire, this app helps you connect.

  • South Riverdale CHC – has relationship with some bakeries – provides bread at the end of the day.

  • Important to build relationships between agencies and local food providers.

  • Urban fruit harvesting programs - Not far from the Tree

Participants shared:

For more resources on this topic, please see our Resource Sheet that was prepared for this online discussion.

 

 

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Connecting Through Stories: an exploration of relationships through art making and connection to the Land

 

An HC Link Regional Gathering: March 30, 2017
Baggage Building Arts Centre in Thunder Bay.

Written by Lorna McCue, HC Link/OHCC

Every two years, HC Link works with local community organizations and groups to plan and co-host regional gatherings across the province that respond to regional needs and issues. These gatherings support the development of cross-sectoral and diverse community partnerships by providing opportunities to engage stakeholders across the region in a community-building event.

In Thunder Bay, a connection was made by HC Link with Alana Forslund, Coordinator of the Community Arts & Heritage Project, which initiated a discussion about the role of the arts in a healthy community. She brought Carol Kajorinne, Public Programming Coordinator for the Art Galley of Thunder Bay into the conversation who, in turn, invited others to join in.

The gathering was co-sponsored by HC Link and the Thunder Bay Art Gallery, with the organizing group doing the bulk of the work to develop the program, promote it to prospective participants, recruit facilitators and procure the art materials.

Members of the regional gathering organizing group were:
• Lorna McCue, Ontario Healthy Communities, a member of HC Link
• Carol Kajorinne, Public Programming Coordinator, Art Galley of Thunder Bay
• Crystal Nielsen, Community Artist
• Michelle Richmond-Saravia, founder of beSuperior Consulting and representative of Thunder Bay Indigenous Friendship Centre’s Long Life Care Program
• Michelle Kolobutin, Community Clothing Assistance

In planning the gathering, the group agreed that racism against Indigenous people was a pressing issue in Thunder Bay, and felt there was a need for non-Indigenous people to gain a greater understanding of the historical impacts of colonization and residential schools. They saw the regional gathering as an opportunity to make a contribution to Article 63 of the Call to Actions contained in the Truth and Reconciliation Report, which calls for “building student capacity for intercultural understanding, empathy, and mutual respect”, and to Article 83, which calls for “a strategy for Indigenous and non-Indigenous artists to undertake collaborative projects and produce works that contribute to the reconciliation process”.

This event aimed to create intergenerational connections through art and story. It brought together more than 45 people, including about 20 Gr. 6 & 7 students from a neighbouring school, elders and seniors from the Thunder Bay Indigenous Friendship Centre and Community Clothing Assistance, college students, artists, storytellers, and other community members. People from different cultures, from ages twelve to people in their eighties, were engaged in a creative process that combined sharing their stories with a collaborative weaving project, with a focus on learning and growth.

The event began with an opening smudge ceremony, led by Elder Diane Michano-Richmond. Michelle Richmond Saravia, of beSuperior Consulting, shared a story of her journey and invited other to share their stories throughout the day. One elder reminisced about his negative experience at a residential school.

       lornablogpic11    
Elder Diane Michano-Richmond    
Photo by Lorna McCue

Eleanor Albanese, a community-engaged artist, guided the collaborative weaving project. The participants were seated in groups of 6-8 around tables with a weaving frame and strips of cloth of a variety of colours and patterns. Eleanor laid out about a large number of pictures of a variety of subjects, such as people of different ages and races, different plants and animals and landscapes, along the windowsills that spanned the long room. She invited participants to go up, one table at a time, to view the pictures and select one to bring back to their table. Once seated again, they took turns explaining what they liked about the picture and what meaning it had for them. Many stories were shared in this way. Each person then took a marker and wrote meaningful words or drew a picture or symbol on a strip of cloth. They shared their words or symbols with others at their table, then, as a group, they worked on weaving the strips of cloth into the weaving frame.

 

 

 

 

  lornablogpic2 
A weaving created by a group of elders. Photo by Michelle Richmond Savaria

The group took a break for lunch, which was catered by Fox on the Run, a locally owned restaurant and catering service. Managing the lunch service was challenging, due to the narrow shape of the somewhat overcrowded room and the diversity of the participants regarding mobility, dietary needs and cultural considerations. However, with several helping hands from students and other helpers it all worked out.

 

 

 

lornablogpic3

Students explain the meaning of their weaving.  
Photo by Lorna McCue

When the groups completed their weavings, they showcased them at the front of the room and explained the meaning of some of the elements. There were many exclamations about the beauty of the weavings and a warm, positive mood was apparent at the close of the gathering.

 

 

 


Because of the diversity of the participants and varying literacy levels, it was decided not to have each participant complete an evaluation form, but to pose a series of reflective questions to the members of the organizing group. While there were some suggestions for improvements, all felt that the gathering was successful in meeting its objectives. As Eleanor Albanese said: “Community-engaged art making breaks down barriers of all kinds.” Other comments from the organization group included:


It was moving for me to see how people really did share their stories, and wove their stories together, both symbolically and literally.


For the seniors and Elders, it provided a creative and social opportunity. The youth had the opportunity to share and hear stories through art making as well as devour some nurturing food. I heard some profound stories come out of the youth! I feel that no matter the age, everyone had a valid and meaningful story to share.


For something like this to be successful, it takes a high level of experience in community-engaged arts and also cultural knowledge; it takes humility; it takes a group of people all working together with a common goal; it takes a spirit of helping each other and helping the participants feel both welcomed into a space and comfortable in the space; it takes hot tea and coffee, and food to share!  It takes courage and a positive view of the future, as well as acknowledgement of the pain of the past (in the instance of residential schools and our history.)   In other words, it takes tremendous thought and planning.  And even though things did not go perfectly, in my view, it was a special day.  And, of course, there is always room to grow and learn. 




For those interested in viewing the “Connecting Through Stories” weavings, they will be on exhibit at the Thunder Bay Art Gallery Community Room from May 9-24.

 

       

Thank you for your generous support throughout organizing this wonderful event. It’s been a pleasure working with you and OHCC/HC Link.

Carol Kajorinne and the Thunder Bay Art Gallery

       
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Discharge Planning in Hospitals: How can we improve?

By: Megan Ferguson BSW, RSW


social work 1

Discharge planning is a vital component of a patient’s hospital stay, it is the moment where the healthcare team connects patients and their close family members with integral resources so that they can receive follow up healthcare services in the community. However, as I am developing my career as a hospital social worker, I notice that in many hospitals social workers are tasked with both coordinating discharge planning and providing emotional support to patients and families (Mizrahi & Berger, 2001). However, within these two tasks, social workers perform multiple sub-tasks including 1) Assessing a family’s social situation, 2) Consulting with interdisciplinary team members about patient care planning, 3) Identifying the psychological, emotional, social or spiritual barriers that interfere with treatment or discharge planning, 4) Engaging in advocacy on behalf of patients and families, 5) Providing crisis and emotional counselling and/or intervention, 6) Counselling around end-of-life, grief and bereavement issues, 7) Counselling around suspected abuse, 8) Addressing substance misuse issues, as well as 10) Engaging in writing, teaching and research activities (Gregorian, 2005, p.4). Patients that are typically seen by social work are patients who lack social supports, need assistance with income, need assistance with locating accessible and stable housing and individuals who may struggle with addiction or mental health challenges. Social workers are also the core discharge planners and lead the team to transition patients back into the community with the resources and support that they require.

Although I quite enjoy my work as a hospital social worker, my experience as a frontline social worker has allowed me to understand the obstacles and limitations that social workers in health care have to face in order to advocate for their patients while following multiple policies, standards, and guidelines. Tensions exist between “advocacy and collaboration” as well as, “commitment to patients and the organization” (Mizrahi & Berger, 2001). I find it challenging at times to maintain provincial, and regional guidelines of social work, while also following the Canadian Association of Social Workers’ (CASW) Code of Ethics (2005) and Guidelines for Ethical Practice (2005). The health care system also requires social workers to abide with hospital patient flow and length of stay standards, which can also further complicate patient care when many social issues are prevalent. Within these challenges Dr. Anna Reid, Former President of Canadian Medical Association, stated that “An estimated one in every five dollars spent on health is directly attributable to the social determinants of health,” in her final address (Eggertson, 2013, p. E657). However, these social determinants of health bring forward multiple barriers. Some of the most prevalent barriers may include income, housing, and food insecurity, which is further maintained by oppression and discrimination against minority groups such as women and First Nations individuals (Raphael, Curry-Stevens, & Bryant, 2008). These barriers force social workers to advocate on behalf of patients and families in order to work towards change and make social and policy adjustments to empower patients to better their health and well-being.

Social workers have a very large role and this role may differ depending on the client, and the unit that a social worker is working on. Collaboration is also so important when working in healthcare, unlike other social services agencies where social workers may make up the majority of professionals working in that area (Gregorian, 2005). Instead, hospital social workers play a more consultative role where they aim to collaborate with many disciplines each day (Gregorian, 2005). However, more emphasis must be placed on the importance of collaboration and interdisciplinary teamwork in order to initiate better patient outcomes and eliminate the power struggle between healthcare disciplines.

As social workers, we often work in collaboration with community social services agencies such as income and housing government organization as well as nonprofit organizations that assist with mental health and addiction. However, not enough of these organizations exist and we must continue to support these agencies in order to have resources that community members can draw on in times of crisis.

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Megan Ferguson is a Master’s student in the School of Social Work at the University of Calgary. Megan holds a BSW as well with a Specialization in Aging. She also sits on the Board of Directors for A & O: Support Services for Older Adults. Megan currently works as a Social Worker for the Acquired Brain Rehabilitation Program and Stroke Rehabilitation Program at a hospital in Winnipeg.

References

CASW. (2005). Social work Code of Ethics. Ottawa: CASW.
CASW. (2005). Guidelines for Ethical Practice. Ottawa: CASW.
Eggertson, L. (2013). Health equity critical to transforming system, says outgoing CMA president. Canadian Medical Association Journal, 185(14), E657-E658, DOI: 10. 1503/cmaj.109-4588.
Gregorian, C. (2005). A career in hospital social work: Do you have what it takes?. Social Work in Healthcare, 40(3), 1-14. DOI: 10.1300/J010v40n03_01
Mizrahi, T. & Berger, C.S. (2001). Effect of a changing health care environment on social work leaders: obstacles and opportunities in hospital social work. Social Work, 46(2), 170-182
Raphael, D., Curry-Stevens, A. & Bryant, T. (2008). Barriers to addressing the social determinants of health: insights from the Canadian experience. Health Policy, 88(2-3). DOI: 0.1016/j.healthpol.2008.03.015

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Considering the effect of economically mixed communities on children’s wellbeing

By Kyley Alderson, HC Link

On Thursday last week, I listened to a 20 minute webcast presentation by Candice Odgers from Duke University, as part of the Canadian Institute for Advanced Researched (CIFAR) event titled “Building Neighborhoods that Thrive.” Candice shared a few study results on the impact of economically mixed communities on children with low-income, and left us with a few thoughts to consider for future work. Here were some highlights for me:

  • Using data from the Environmental Risk (E-Risk) Longitudinal Twin Study, as well as community mapping, and resident surveys – they investigated the effect of living in an economically mixed community on a child’s wellbeing.

    • While there was not a statistical effect on girls, boys with low family income living in an economically mixed community (and presumably going to better schools) tended to have lower school performance and engage in more anti-social behaviour, compared to boys in a concentrated low-income neighborhood.

    • Results indicate it is not just about how much you have, but also how much you perceive you have – creating a double disadvantage for those who have less AND believe they have less in comparison to others. To this point, twins who come from the same household but perceive they have less compared to others, score lower on wellbeing than twins who perceive they have more.

    • High levels of collective efficacy in the community, as well as supportive parents, were protective factors to a child’s wellbeing (or factors that reduce disparities).

    • While this presentation did not get into details on this, factors such as perceived safety in an economically mixed community might play a role in the different effects observed between boys and girls on well-being.

Candice was very clear to say that this research does not indicate that communities should be segregated based on income, and mentioned that some efforts to create economically mixed communities have been very successful at reducing disparities. However, it is important to learn from the data and realize that if economically mixed communities are not properly supported, they may actually create more disparities.

One RECENT shocking example of the WRONG way to create such environments is a luxury residential building in Manhattan that created 55 low income units in their ritzy 33-story building. Upon moving in, residents that qualified for these low income units learned that they had a separate entrance to the building (including a separate address), were not permitted access to common areas in the building (such as the courtyard, pool, gyms, etc.) and lacked basic features to their room (such as light fixtures and a dishwasher).

snippetwebcastSnapshot taken of the live webcast.

Clearly this is no way to create a sense of belonging, or to engage with others in a safe and meaningful way. When efforts are made to create economically mixed communities (which has been one proposed way to improve the life outcomes of children growing up in poverty), or to look at reducing health disparities in existing mixed communities, we need to be very mindful of the potential consequences, and make sure that proper supports are in place to improve the well-being of all children (and adults).

For more information on this event and the presenters: https://www.cifar.ca/events/building-neighbourhoods-that-thrive/

 

 

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Just Add Bikes! How cycling can help build a healthy, vibrant community

By: Sue Shikaze, Health Promoter, Haliburton, Kawartha, Pine Ridge District Health Unit

“Every time I see an adult on a bicycle, I no longer despair for the future of the human race” H.G. Wells


While it might be a stretch to claim that the bicycle can solve all the ails of the world, it can certainly be one solution to many challenges facing communities today. Making communities bicycle-friendly and getting more people on bikes can address issues of public health, safety, air quality, and traffic congestion. Cycling is a healthy, economical and sustainable transportation option as well as an attractor for tourism and economic development. It is an important quality of life feature that many people look for when choosing where to live, work or play. Not everyone can afford a car or wants to drive and a good cycling environment offers more mobility options. And let’s not forget: cycling is fun!

bikesmeanbusiness

Biking attracts people and brings business to the community


Evidence indicates that there is demand and need for improved conditions for cycling in Ontario. A 2014 poll conducted by the Share the Road Cycling Coalition indicated that 32% of Ontarians cycle at least once a month and 54% of Ontarians said they would like to cycle more often. What would most encourage people to cycle more often is better infrastructure, such as bike lanes and trails.1 The Ontario Medical Association recognizes cycling as an important solution to help address rising rates of chronic diseases associated with physical inactivity. They advocate for better and safer infrastructure in urban, suburban and rural settings, and that, “much more must be done by provincial and municipal transportation departments to make this form of exercise safer.”2

So what does a bicycle-friendly community look like? Assessment of the cycling environment is typically done around the “5 E’s”: engineering, education, encouragement, enforcement and evaluation and planning. These indicators address the range of needs to accommodate cycling.

Engineering refers to on-the-ground facilities and infrastructure. Good cycling facilities are carefully planned, designed and maintained to accommodate bicycles safely, conveniently and comfortably. A well-planned cycling network has good connectivity between routes and destinations, as well as things like secure bike parking and bike racks on buses to provide inter-modal connections. Facilities could include on-road accommodations such as designated bike lanes, separated cycle tracks or paved shoulders, or off-road paths and trails. There are also innovative design treatments such as bike boxes, which provide a designated space for cyclists to wait at an intersection, separated from cars.

greenbikelane
Green bike lane being installed in Thunder Bay


Education needs to address both cyclists and motorists to ensure that they know how to safely share the road. The goal of public education programs is to increase the knowledge and awareness of all road users on their rights and responsibilities, as well as to build practical skills. Education initiatives can include cycling skills workshops, share the road campaigns and tip sheets.

sharetheroad

Share the road promotion – an example of education


Encouragement initiatives are intended to get more people on bikes and to normalize cycling as a viable activity for both transportation and recreation. While it may be true that “if you build it, they will come”, many people still need encouragement to get rolling. Encouragement includes promoting the benefits of cycling, and of places and opportunities to cycle. Initiatives such as the Commuter Challenge, Active and Safe Routes to School and SMART Trips give information and incentives to support and encourage people to cycle more often. Cycling maps, signage and clubs are also ways that communities encourage cycling.

Enforcement ensures that all road users follow the rules of the road and share the road safely. In addition to traditional methods such as issuing tickets and fines, enforcement can also include education and public relations programs that remind cyclists and motorists of their responsibilities under the law. Recent updates to the Highway Traffic Act are intended to improve safety for cyclists, including the requirement for motorists to leave at least 1 metre of space when passing a cyclist, increased fines for dooring a cyclist and increased fines for cyclists who don’t use lights when needed.

Evaluation and planning refers to having systems in place to evaluate current activities and programs, and planning for the future. Becoming a more bicycle-friendly community is a process that requires ongoing measurement and monitoring in order to identify and meet future needs. The amount of cycling taking place, rate of crashes, and economic impact are all aspects of tracking progress. The development of a Cycling Master Plan is a key tool for planning, implementation and evaluation.

Plus a ‘P’: Partnerships

Cycling has multiple benefits for communities and can help address many issues including health, economic development, environment, sustainability and equity. Potential partners who have an interest in cycling include municipalities, public health, law enforcement, schools, community organizations, cycling clubs and committees, workplaces, business community, tourism and economic development, trails and environmental groups. Different partners have different skills, knowledge and resources; no one group can do it completely on its own.

If you are looking for an opportunity to learn more about making your community bicycle-friendly, meet other like-minded professionals and find out about innovative cycling initiatives, consider attending the annual Ontario Bike Summit hosted by the Share the Road Cycling Coalition. It is THE premier cycling networking and professional development event in Ontario. Whether you are an advocate or elected official, a professional in planning, transportation, health, tourism or economic development, there is something for you at OBS to get informed and inspired.

The 9th annual Ontario Bike Summit takes place on April 11 & 12 at the Eaton Chelsea in Toronto. This year’s theme is “Just Add Bikes: The role of cycling in urban mobility and community building”. The agenda features speakers from across Ontario and North America who will share successes for building bicycle-friendly communities. Presentation themes will include advocacy best practices, risk management, complete streets implementation and more. You will also hear from municipal and provincial elected officials about why cycling matters to them. Keynote and workshop sessions are carefully curated by a panel of professionals with cycling expertise from across the province, and selected to create a program that features the most innovative, current, and state-of-the-art initiatives for cycling. Sessions address issues and opportunities that are most relevant to communities, from policy to implementation to evaluation.

The Ontario Bike Summit has put cycling firmly on the radar of decision-makers at all levels of government. Find the 2017 draft agenda, registration information and more details at http://www.sharetheroad.ca/ontario-bike-summit-p157286 

pre summit

Participants in the pre-summit bike tour led by the City of Toronto.

 

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About Share the Road:
The Share the Road Cycling Coalition is Ontario’s premier cycling advocacy organization working to build a bicycle-friendly Ontario – a place where a cyclist of any age or ability can ride safely, wherever they need to go. Share the Road works with municipal, provincial and federal governments, the business community, public health practitioners, road safety and other not-for-profit organizations to enhance access, improve safety and educate the public about the value and importance of safe cycling for healthy lifestyles and healthy communities. www.sharetheroad.ca

 

1 Share the Road Cycling Coalition, (March 2014), polling conducted by Stratcom Communications
2 Ontario Medical Association, (2011), Policy Paper: Enhancing Cycling Safety in Ontario.

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