BEST START - Community Action For Healthy Babies
Best Start funding was provided by the Ministry of Health in 1992 to the District of Algoma, thecommunity of Barrie and a Resource Centre based in Toronto. The sites directed all their community development activities to childbearing women and the families who support them. The range of activities included all the risk factors associated with low birthweight. Risk factors included individual behaviours such as smoking, environmental factors such as poor workplace conditions and the larger determinants of health such as poverty.
Low birthweight as a health indicator lends itself to a community-wide approach. There is no composite picture of the couple at risk for having a low weight baby. Rather, the risk conditions are spread across the whole distribution of the childbearing population. To reduce risk conditions, Best Start designed large-scale interventions and directed them at this entire population.
To accomplish this community-wide approach, agencies, groups, leaders, and residents worked together. These partners used a variety of health promotion strategies. They used activities to increase awareness about risk factors, change attitudes, and teach people skills to change their behaviours. The partners planned policy changes and environmental changes to support the changed policies. Best Start activities focused on women, men, children, and families and took place in many settings
such as schools, workplaces and public meeting places.
In 1998 Best Start moved from a demonstration to a dissemination phase. Resources developed by Best Start and information about the interventions are being made available to groups planning to work
on similar issues.
Best Start's WORKPLACE HEALTH INITIATIVES
One of the major focuses of the Best Start project was workplace health because of its association with low birth weight. Several new resources were developed, and different approaches were taken. The following three workplace initiatives are described in greater detail on The Best Start internet site at http://www.opc.on.ca/beststart/pract_prod/index.html
Copies of the full papers and reference lists can also be requested from Best Start.
The Laboratory Centres for Disease Control (USA) placed reproductive health hazards on their list of top ten occupational health and safety hazards. Yet little information about these hazards is available
to workers. Every year as many as 10 percent of children born in Canada suffer from some kind of physical or developmental defect. Between 10 and 25 percent of all birth defects are attributed to environmental agents. Standing for long periods of time, heavy work, working more than 40 hours a week, commuting more than one hour per day and stressful work environments are all associated with low birth weight. In addition, some chemicals pose reproductive health hazards for males or females. Although work causes reproductive risks, there are few user-friendly resources available to concerned employees. Material Safety Data Sheets (Workplace Hazardous Materials Information System) rarely offer information about concerns before and during pregnancy. Some resources are available to teach prenatal classes in workplace situations. However they are limited to workplaces employing large
numbers of women in their childbearing years. Best Start community sites
1. PREGNANCY FRIENDLY WORKPLACE INITIATIVE
The North Algoma Coalition of Algoma Best Start based in Wawa, Ontario formed a committee to develop pregnancy friendly workplace initiatives to promote healthy pregnancies and babies. Information gained from a survey of local businesses was used to develop educational materials. The survey results showed that the majority of North Algoma's women of childbearing age worked in businesses with 25 or more employees. Respondents identified the following ways that the committee could reach their employees with reproductive health messages: summer family events held by the larger businesses, a newsletter and displays. Committee members were concerned about the reception of workplaces to policy activities. They decided to begin with the non-threatening approaches that the survey respondents recommended such as the newsletter and display. The committee developed a display, newsletters and newspaper ads for workplaces and people in their childbearing
years. They also held a workshop for interested workplaces on family friendly policies and practices with Linda Duxbury, a noted expert on workplace health from Carleton University. The relationships built with workplaces through the education campaigns generated interest from employers and employees to improve workplace policies and practices.
*Take your time and build awareness if needed. The committee members believed that they needed to build a good relationship with worksites before moving towards policy recommendations.
* If employers don't have time to sit on your committee, involve them in other aspects of your work. The committee found two worksites that gave members access to employees for input about the material.
* Know your community before you begin to plan activities. Know which workplaces to target. The process of involving the community to develop the display took time.
* It will take a long time for a committee to complete its first task. Members must realize that that is normal and acceptable. The work will speed up once the committee has explored what it wants to accomplish.
2. WORK AND PREGNANCY DO MIX.
The Sault Ste. Marie Workplace Health Committee of Algoma Best Start wanted to develop a comfortable way to approach workplaces to promote healthy pregnancies and babies. The committee in Sault Ste. Marie believed that local work sites were not ready for policy change. The committee chose an inexpensive activity to provide pregnant women with information. The committee members produced a booklet for this audience that included prenatal health information. A student from the local
university campus volunteered to research the content for the booklet. The draft booklet was focus tested with groups of pregnant women. Two physicians read the booklet to ensure that the information was accurate. The committee believed that this activity would help them to build a good relationship with workplaces.
Work and Pregnancy Do Mix... is a 10 page booklet that is easy to read and contains information that is interesting and meaningful to pregnant workers. The information informs readers of behaviours and work conditions that could harm them and their unborn babies. It provides simple recommendations to help women change these risk factors. Information in the booklet is organised under the headings:
Lifestyle, Ergonomics, Chemicals, Biological and Physical concerns.
Clearly define goals for initiatives.
The process of involving the community to develop the booklet took time. This extra time resulted in a quality product.
Start early and have a plan on how to reach employers and eventually progress to policy.
A needs assessment with pregnant employees would have helped to identify or other ways to inform them about workplace hazards.
A community information forum to begin discussion about the topic would have helped to initiate the project and to gather early innovators and advocates to promote the messages Groups need to find ways to acknowledge their successes. Since this community group was new to this type of work they had to build their credibility.
WORKPLACE HEALTH PROMOTION
Knowing that workplaces can have a significant impact on the health of employees, Best Start Barrie wanted to help workplaces implement policies that could have a positive impact on the health of employees.
The demographics of workplaces in Barrie made it difficult to sell employers or employees on reproductive health promotion. For that reason, Best Start Barrie used a work and family balance approach. Whenever possible, Best Start addressed reproductive health needs and provided workplaces with examples of exemplary maternity policies and resources such as the ones developed by Algoma Best Start. We believed that this approach was the best way to improve the health of women and their families before, during, and after pregnancy.
Best Start Barrie recognized the workplace as a determinant of health and not a setting. Using The Workplace Health System
(http://www.hc-sc.gc.ca/hppb/ahi/workplace/pube/workplacehealth/system.htm) as a framework, we followed a community mobilization / empowerment model . Organizers helped employees and employers to work together to identify needs, mobilize resources and plan and carry out initiatives to create a healthier workplace.
It was often a challenge to convince employers to consider policy changes when responding to issues identified by employees. Often, the simple solution to problems such as increased stress and concerns about ones physical well-being was to implement programs that addressed the individual. Work and family friendly policy changes at workplaces can have a positive effect on vast numbers of employees and their families.
Staff who want to implement a worksite health promotion program should seek training for Health Canada's Workplace Health System program.
The survey designed by Health Canada is an excellent tool to identify employees' needs. This is a good place to start when designing health promotion programs in the workplace.
The services of any community college with a Research Analyst Program could be used to complete the analysis of a workplace survey and document the results.
Staff need to work with the whole organization when implementing health promotion programs.
It is important to have labour and management on side.
Treat the workplace like a community. The same principles that apply to community mobilization apply to workplace health promotion.
BEST START RESOURCE CENTRE
#1900 - 180 Dundas Street West
Toronto, Ontario CANADA M5G 1Z8
Tel: (416) 408-2249 or 1-800-397-9567 Fax: (416) 408-2122
The Best Start Resource Centre disseminates the practices and products of the two Best Start demonstration sites that operated from 1992-1998. The centre is funded by the Ontario Ministry of Health and supported by the Ontario Prevention Clearinghouse. The two sites, Algoma and Barrie,
mobilized their communities to improve the health of mothers and families before, during, and after pregnancy. The staff, volunteers, and community partners used a community-wide approach. The Resource Centre web-site provides links to Algoma Best Start's web-site, to a large number of publications and resources, and description of services.
THE BEST START CONSULTANTS http://www.beststart.org
They are the staff and the volunteers who designed and carried out the activities of the demonstration phase of the program. The consultants are available to help communities to:
* Learn more about a specific topic.
* Replicate a successful innovation.
* Find ways to mobilize community members to get involved in your work
* Solve problems in the implementation of projects.
* Think about ways to sustain your work.
Topics incude, but are not restricted to: Anti-Poverty, Ant-Violence, Environmental Health, Folic Acid, Health Before Pregnancy, Healthy Body Image, Prevention of Preterm Birth, Teen Pregnancy, and Workplace Health
To arrange a consultation contact Best Start
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POSTERS & BOOKLETS
The following resources - Workplace Health English Poster (maximum 50), English Booklet (Maximum 100), French Poster (maximum 50), and French Booklet (Maximum 100)
are available free of charge, while supplies last, to groups in Ontario that work on maternal-newborn health promotion activities. Best Start reserves the right to limit the number of orders per community. Please coordinate any orders with groups in your own community that address similar issues. An order form is available on their website.
BEST START'S RECOMMENDED REFERENCE LIST:
Public Health Departments often provide reproductive health & workplace health related programs.
Call your local health Department to see if they provide reproductive health seminars or other resources.
The Canadian Centre for Occupational Health and Safety (CCOHS); 1-800-668-4284 has an Inquiry Service Line. "Reproductive Hazards in the Workplace" selected monograph titles from CCOHS.
Prevention of Low Birth Weight: Community-Based Strategies (Revised Sept. 1993). Best Start: Community Action for Healthy Babies. *** the 1998 update will soon be available***
Benedict, S. And Moos, M.K., 1994.
New Beginnings: A Worksite Program for Reproductive Health Promotion. Centre for Health Promotion and Disease Prevention. The University of North Carolina at Chapel Hill.
Double burden: womens' experience of workplace injury and disease in Ontario / Bonita Clark and Stan Gray. Ontario Workers Health Centre, 1991 (84 p.)
Eakin, J., 1992. Leaving It Up to the Workers: Sociological Perspectives on the Management of Health and Safety in Small Workplaces. The International Journal of Health Services. Vol 22,
No. 4, 1992.
Eakin, J., The Health and Safety of Women in Small Workplaces. Forthcoming in: Messing, K. et. al., 1995. Invisible: Health Problems of Women at Work. Gynergy Press, Charlottetown.
Material Data Sheets OnLine http://www.msdsonline.com/
MSDS Online, Inc. is dedicated to providing Windows based software tools for obtaining, maintaining and distributing Material Safety Data Sheets (MSDSs) throughout a company.
National Action Committee on the Status of Women;
Materials: Workplace Reproductive Hazards, Sept. 6,7, 1985.
Reproductive Health Hazards, Patricia Baird;
In: Labour Canada's national conference: Workplace Safety and Health: the 21st Century, March 11-13, 1991. Labour Canada, 1992, p.129-140.
The U.S. Occupational Safety & Health Agency web-site, full of links
More resources follow in the next message