A. Introduction - the framework of population health promotion, settings & priorities
B. A year of Change and Challenge
i) Organizational, Structural and Health System Change
ii) Responding to Crises - Campaigns on Homelessness, Poverty, AIDS, Natural Disasters, Y2K and more
iii) Being Proactive - quality of life, spirituality, heart health, best practices, ethics & evaluation in health promotion
C. What Lies Ahead? Future Features in OHPE
A. The Framework Used For OHPE Features
In March of this year, in OHPE Bulletin #47.1 under the topic of "Acting on HP Globally and Locally", the editors of the OHPE Bulletin suggested a basic framework for features and resources, and some
guidelines for potential contributors to consider. We had taken the Population Health Promotion model developed by Nancy Hamilton and Tariq Bhatti as a way of assessing whether the OHPE Bulletin was covering the breadth of topics, issues, settings, strategies, health determinants, and foundations that make up the large field of health promotion. See the Population Health Promotion document online at:
Having proposed this general framework, as noted below, we hoped for a flood of contributions. A trickle of very welcome articles, features, resources and proposals came in - much to our delight - but the flood didn't happen. Ah well, it was a "dry year". Nonetheless, we pursued researching, writing and compiling as many of the desired features as possible, and sending out 25 letters to health promotion organizations requesting more contributions. It must have been something that we said, or did not say, as the few responses indicated some confusion about what exactly was being asked for, and who would do the writing under what time-lines. See the bottom of this message for our "guidelines" for submitting features, following the topics that we are seeking.
[March 1998] Through the features at OHPE, we hope to look at the breadth of health promotion strategies , priority populations and 'settings'; and the tools we have available to develop programs, set
indicators of progress, and evaluate best practices. The editorial team of OHPE will welcome, and seek out, contributions for features on:
STRATEGIES OF HP (building from the Ottawa Charter for Health Promotion - including Creating supportive environments; Strengthening Community Action; Developing Personal Skills; Reorienting Health Services; Creating Supportive Environments; Building Healthy Public Policy
APPROACHES that accompany such strategies: Organizational Change, Education; Media use and advocacy; Social Support, Social Marketing & Communications, including use of IT.
DETERMINANTS OF HEALTH - The elements that fix or condition "health" including:
biological or physiological (e.g. genetic endowment); healthy child development; personal health practices, lifestyle or behavioural and coping skills; and, in particular socio-environmental (e.g. income
& social status, education, social support networks, working and housing conditions), including practices such as community development, advocacy, and policy development.
PRIORITY POPULATIONS - including life-stages and ages; such as Children, Youth/Adolescents; Adults / Men/Women's health; Aging. As well as key groups such as: aboriginal; francophone; visible
minorities and multi-cultural communities; people with disabilities, with HIV/AIDS and who are isolated and/or homeless.
SETTINGS [from the Jakarta Declaration] particular settings offer practical opportunities for the implementation of comprehensive strategies. These include cities, municipalities, local communities,
families, schools, the workplace, health care facilities and leisure locations.
FOUNDATIONS OF HP - Evidence Based Decision-Making; Research, Evaluation, Experiential Learning; Ethics, Values & Assumptions.
In September and October of this year Rachel Smith had undertaken an analysis of all the OHPE Bulletin's issues was conducted to determine what kinds of topics have already been covered, what we have NOT, and what we need to focus on for feature articles.
The topics that have been covered fairly well to extensively are:
Quality of life, Indicators, and Evaluation
Breast cancer, and women's health issues (especially environmental concerns)
Heart health, and Tobacco & Substance Abuse Campaigns
Social Marketing, Health Promotion Training/Education (university & college level)
Child development, Seniors,
Information Technology and Health Promotion.
The topics that we had had less coverage of by mid October, and were the focus of our features in November and December - but still merit more indepth attention. These topics included:
HIV/AIDS [featured November 27/98],
Spirituality [featured October 30/98],
Ethics [featured November 6/98],
Marginalized +/or priority populations [see Promoting Inclusion Nov 20/98 and the AIDS feature Nov. 27/98 - needs more attention],
Family, Men's health, [both in feature Men in Families Dec 4/98, and Best Start's Workplace Health Dec 11/98]
Workplace health [see OHPE 84.1 & 2 Dec 11/98, and earlier on organizational change and health] and
Biology & genetics, and disabilities - still to be addressed.
B. A YEAR OF CHANGE AND CHALLENGE
I) ORGANIZATIONAL, STRUCTURAL AND HEALTH SYSTEM CHANGE
From our very first issue of the OHPE Bulletin on May 2, 1997, there has been a continuing look at the changes happening to the field of health promotion, public and community health and to health services in Ontario and abroad. The first issue of OHPE noted the creation of a working group on integrated health delivery systems; followed by two editorials offering critiques of the hospital restructuring commission and provincial funding of sexual health education. Given the enormous
changes evoked by the provincial government's move to down-load social, health and infrastructure responsibilities to municipalities, we started 1998 with a look at the impact of downloading, featuring the efforts to highlight the importance of public health, social housing and social assistance in municipal well-being.
By the end of January, what came to the OHPE Bulletin editors was beginning to reflect HP in 'Changing Times'. The topics of the workshops and forums coming in were indicative of shifts within
the general field of health promotion - 'what works', 'accountability', 'staying on the agenda' and so on.
The recent World Health Organization resolution on Health Promotion started the 'feature' on HP in Changing Times [January 30] and this was followed in late March by "A Global Perspective on Health Promotion".
At our first anniversary, May 1 1998, we had 430 subscribers (we now have 666 subscribers!) and a growing collection of valuable features and resources. To celebrate the anniversary there were two features related to organizational and structural changes in the health promotion field. Bryan Hayday, executive director of Ontario Prevention Clearinghouse, reflected upon changes in process for health promotion resource centres in Ontario, and how they are reshaping their organizational relationships.
Simon Mielniczuk, information systems manager at OPC and a key initiator of the OHPE, challenged us to think about how information systems and technology, directly or indirectly, now drive much of
social change. Simon followed up this feature late in July when he reflected on his 13 years at OPC, and how he was applying his beliefs of community focused information systems in moving to Web Networks.
One aspect of these critical reviews, news and perspectives, has been an ongoing series of features prepared by Peter O'Donnell, senior consultant with Innovaction, on organizational change and health.
The third in a series of articles on the topic of creating healthy organizations, came out December 11th, providing further insight into the first level or foundation of this model. The first appeared in the
#51.1 issue of the Bulletin (4/24/98), and outlined a developmental model of organizational health. A follow-up article by Penny Paucha appeared in the #73.1 issue of the Bulletin (9/25/98), and summarized the result of her work in developing ways of assessing organizational health.
ii) RESPONDING TO CRISES - Campaigns on Homelessness, Poverty, AIDS,
Natural Disasters, Y2K and more
Despite our best attempts to plan for almost anything that "determines health" in health promotion, information and examples of how to respond to crises that arise, seem very needed. The ice storms in eastern Ontario and in Quebec at the beginning of this year were sober reminders of how "readiness for change" (to borrow from the Stages of Change model) is something that health promoters need to constantly consider for themselves.
Although there were no features on "natural disasters", there was a feature early in summer (Hot Time- summer in the city #57.1) about the impact of heat exposure on the homeless, and environmental threats to community well-being from air quality hazards, ozone depletion and water quality damage.
Shortly after that bulletin, we focused on welfare "reform" in Ontario, and what health promoters should do about it (a focus on research and advocacy), which complemented the resources about community action developed by the Caledon Institute's "Speaking Out" Project highlighted in March (#45.2). The national disaster of homelessness, and the campaign to address it was featured in early October (#58.1), with lengthy resources for follow-up.
Sometimes crises and disasters are not natural, social or policy related - they occur because of human error or lack of planning for the long-term. The OHPE Bulletin has had a number of features and resources related to the use of information technology for HP (#52.2, #64, #65.1 #82), but only one related to planning for crises and disaster due to the Year 2000 problem. It is a global issue and much larger than a personal computer problem. It was thinking about the inter-relationship of all of our systems and the networks we use everyday that lead to this feature on the issues, different perspectives, the potential risks to public health and safety, and what can be done to act responsibly and be proactive, ready for change.
iii) BEING PROACTIVE - quality of life, spirituality, heart health, best practices, ethics & evaluation in health promotion
One area that the OHPE Bulletin has fairly thoroughly explored has been the foundations of HP practice, and the ways to assess our progress and activities. We started the year with a look at indicators of children's well-being, and returned a couple of times in resources and news about
community quality of life indices and reports, report cards and progress reports on poverty, housing and health. A regular theme in OHPE features has also been "best practices" in health promotion and
effectiveness of our work (see #55 in May, also Intervention Mapping #53), as well as challenging our own assumptions and ethics (see #79, Nov. 6). A less well-travelled road in health promotion has been the area of spirituality, and also self-help and mutual aid. Both of these topics were examined by guest writers and contributors - spirituality by Gary Machan of Barrie CHC (#78 Oct 30); self-help and mutual aid by Jennifer Poole and Shawn Chirrey of the Ontario Self-Help Resource Centre (#80 Nov 13).
While heart health has been frequently covered in the OHPE - it is a broad subject, addressing many risk factors, strategies, approaches and concerns about partnerships and networks. Heart Health and Tobacco issues in OHPE have been looked at in regards to social marketing and policy advocacy campaigns, regional initiatives, use of email lists and web-sites, developing and keeping coalitions and community partnerships, and program planning. Possibly we have only begun to explore what health promotion is actively engaged in through heart health initiatives - there is much more coming up in the near future.
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C. FUTURE FEATURES
The new year, 1999, will see a continuation of targetted features, and also contributed and suggested articles. Currently being researched and pursued for upcoming features are the following (we welcome
submissions of features, articles and resources for these topics!):
Using Data for Community HP - Geographical Information Systems and Capacity Building (January);
Aboriginal/Native Health - January
Developmental Disabilities - January
Tobacco - National Non-Smoking Week campaigns "Smoke Free Workplaces" - January
Workplace and Organizational health programs and articles - January-February
Physical Activity - the effective use of Canada's guide to physical activity and links to determinants of health
Year of the Older Person - Active Living Coalition for Older Adults; The Millenium Trail Project
Rural Job & Leadership Development
Regional Reports - southwestern Ontario and Eastern Ontario
Sustainability, Resource Networking and Funding - staying alive through to 2000
Not to limit ourselves - we are interested in hearing from many organizations involved in health promotion - tell us about your initiatives, approaches, critical perspectives, new resources and more.
We now have more than 666 people who are subscribers - from across Ontario and far beyond, across Canada and the US, and in New Zealand, Australia, Central America, Europe, Asia and Africa. Let's learn from each other and share news, views, and resources. Below please find a brief description of the Guide for Submission of Features. Don't hesitate to contact any one of the editors of OHPE for further assistance and information.
Alison Stirling - email: firstname.lastname@example.org
Noelle Gadon - email: email@example.com
Rachel Smith - email: firstname.lastname@example.org
Lorraine Telford - email: email@example.com
Larry Hershfield - email: firstname.lastname@example.org
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GUIDES FOR SUBMISSION OF FEATURES
Feature articles should be approximately 750 words in length and should include:
- An Introduction or Overview of the issue, including a perspective or context
- Steps or Process or Key points to a particular issue/theme
- Example Program/Organization descriptions of one or two paragraph length with contact information including email address where possible
- Key Resources or References for further investigation. The resources may be print, organization, journals, websites, lists and events, and may be used in the Resources message (typically the third message in the OHPE bulletin) with contact info, address, URL or email address.
should be sent by email, preferably in plain text, or as attachments in either Word 6.0, or Word Perfect 6.0 (or lower) with minimal formatting
by, at the latest, Thursday morning of the week they are to be published. This assumes that there has been some previous contact with the OHPE editors to discuss the topic and fit.
Have a healthy happy holiday and new years! See you "next year".