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Looking Back and Looking Ahead in Health Promotion

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I Introduction

In our last issue before the holidays, we summarized some of the behind-the-scenes work at OHPE, some news from the field, provided a handy list of all the feature articles from 2007, and shared how the E&M team would spend their holidays. This week, we asked some of our colleagues to reflect on key issues in 2007 and to look to the year ahead.

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II LHINear Development
--by Robb MacDonald, Consultant, The Health Communication Unit

Six months ago, members of the Communication Advisory Committee within the Ontario Health Promotion Resource System (OHPRS) began working with the Local Health Integration Networks (LHINs) to increase their knowledge of OHPRS and identify opportunities for collaboration. At the same time, FOCUS Resource Centre, Ontario Prevention Clearinghouse, the Centre for Health Promotion, and the Centre for Addiction and Mental Health have been identifying ways to assist health promoters and the LHINs review the LHINs' individual Integrated Health Service Plans through a health promotion lens.

On January 10, 2008, Larry Hershfield and Suzanne Jackson made a presentation at the Planning, Integration and Community Engagement (PICE) Senior Directors meeting. The main purpose of the presentation was to introduce OHPRS to the Directors and highlight the health promotion services available to the LHINs. Larry and Suzanne delivered this presentation via videoconference to PICE Senior Directors from all 14 LHINs across the province.

Although a number of OHPRS members have already worked with one or more LHINs, this presentation represents an important and exciting first step for profiling the overall system. We hope this will also be the first step in the process of identifying ways the LHINs and OHPRS can collaborate in the area of health promotion.

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III Consultation for Ontario Public Health Program Standards
--by Kevin Churchill, Chair, Health Promotion Ontario Executive

Health Promotion Ontario (HPO) has been one of many stakeholder organizations involved in the consultation and development process for the Ontario Public Health Program Standards, which will establish the new scope of service and accountability framework for Ontario's public health units. Pending final government approval, it is anticipated these new standards and the accompanying protocols and performance management framework will be released in summer 2008, with training in the fall of 2008, for implementation in 2009.

The Public Health Standards Branch of the Ontario Ministry of Health and Long Term Care has been leading the consultation process, which most recently included the development of protocols to support the standards. Protocol Development Teams have been drafting detailed supporting documents throughout the fall of 2007. The next step in the process will be consultation on the draft protocols, which will happen in two phases, the first of which has been scheduled to take place between January 28 and February 15, 2008. HPO has been invited to participate in this consultation process, and we will be seeking input from our membership through the consultation period.

The HPO Executive feels the proposed standards represent a significant advance over the current document, and we are pleased to see that comprehensive health promotion strategies are called for across all of the standards. We feel strongly that within a multi-disciplinary public health workforce, Ontario's health promoters are well positioned to act as "integrators" and provide strong linkages between epidemiology, program planning, evaluation and implementation, particularly in the domains of policy development, creating supportive environments and community capacity building and engagement.

Up to date information regarding the Ontario Public Health Standards, including the draft standards, can be accessed on the Ontario Public Health Portal, http://www.publichealthontario.ca.

Note: this article was put together based on information published and presented by the Ministry of Health and Long Term Care (1, 2). Any errors or omissions are the responsibility of the author.

1. Turner, M. Ontario Ministry of Health and Long-Term Care, Public Health Division, (2007) Draft Ontario Public Health Standards, Presentation to ASPHIO (Association of Public Health Inspectors of Ontario) December 10, 2007, Toronto, ON.
2. Ontario Public Health Portal, http://www.publichealthontario.ca.

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IV The Canadian Health Network
--by Alison Stirling, Knowledge Development Manager, The Ontario Prevention Clearinghouse

This year has been a roller-coaster ride for the Canadian-Health-Network.ca. Almost all indications point to the ride being shut down in March 2008.

The CHN reached a peak in popularity in 2007 with 70% greater website usage, increased subscribers, greater national and international conference profile, health professionals being 40% of CHN visitors, and 94% of users recommending the site to others. The health promotion capacity building among the 20 Affiliates led by CHN's Health Promotion Affiliate focused on online social marketing and networking using web tools. Many Affiliate organizations saw the potential for a vigorous and engaging new year using podcasting, RSS feeds, online communities and more.

In November 2007, CHN's funder, the Public Health Agency of Canada (PHAC), informed all Affiliates that, to meet funding cuts, the CHN would be closed down at the end of March 2008. Since then, the Friends of CHN (http://www.friendsofCHN.ca) have campaigned to save CHN with petitions, media coverage, and letter blitzes to MPs and organizations.

If and/or when CHN dies we will lose

  • The health promotion networks of 2, 500 CHN contributing organizations.
  • The bi-monthly articles on wide ranging issues of aging, environmental health, disability, income, mental health, work conditions, etc.
  • The virtual Canadian health library of 20,000 credible, high quality and diverse resources from non-profit organizations, universities, hospitals and agencies.

Is the Canadian Health Network experience a warning of what may lie ahead for the field of health promotion? Ironically, in last year's OHPE bulletin "Looking Ahead" feature, I wrote "there are uncertainties as we look at wavering support for health promotion across the country, and at the federal level of government."

Go to http://www.canadian-health-network.ca and use it as much as possible until March 31, 2008. Read through the resources, save them, use them, and support health promotion where it is happening--in the multitude of non-profit groups.

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V Core Competencies in Health Promotion
--by Alison Stirling, Knowledge Development Manager, The Ontario Prevention Clearinghouse

Health Promotion Ontario (HPO) has spent the last two years building up momentum toward the development of Canadian health promotion competencies. Will 2008 be the year health promoters in Ontario see the establishment of a skill-based set of criteria, or competencies, to measure the practice of health promotion? We'll have to wait and see.

On October 25, 2007, OHPE featured an article on health promotion competencies. It is available at http://www.ohpe.ca/index.php?option=com_content&task=view&id=9068&Itemid=78).

Brian Hyndman, author of the OHPE article, and the HPO discussion paper, warned that: "Health promoters working in the field of public health risk further marginalization if they fail to take ownership on a set of competencies that best reflects their unique contribution."

The Public Health Agency of Canada (PHAC) launched "Core Competencies for Public Health in Canada: Release 1.0" in September 2007 (available at http://www.phac-aspc.gc.ca/ccph-cesp/index-eng.html). These 36 core competencies are organized into categories primarily related to the practice of individuals--including frontline providers, consultants/specialists, and managers/supervisors--and are not discipline specific. The Public Health Agency of Canada expects the core competencies will be used to support the development of discipline- and program-specific sets of competencies. Health Promotion Ontario has contributed a draft set of competencies that need to be widely discussed, accepted and adopted.

As Brian Hyndman stated in October, "Over the coming year, HPO hopes to undertake further activities to foster consensus on the shared knowledge and skills that constitute effective health promotion practice. HPO welcomes feedback from any individual or organization that shares its commitment to defining and raising awareness of the core competencies required to promote health effectively."

But, like other public health initiatives (the CHN, standards and protocols), the operative word is "hope"--no further word has come from PHAC on funding for action on discipline-specific core competencies such as those for health promotion practice.

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VI - Moving Forward in 2008: Seize the Day
--by Connie Clement, Executive Director, Ontario Prevention Clearinghouse

Moving into 2008, health promoters must help numerous sectors promote health by building strong linkages, popularizing ideas, defining health broadly, and sharing evidence.
 
I'm a cup-more-than-half-full person and I see numerous openings. The Ontario government has promised action to reduce poverty and increased its investment to fight diabetes. For the first time, in my memory, a national poll doesn't show health as Canadians' top concern--the environment sits in top place, escalating the opportunity to improve health-environment analysis and action. Nationally, the Mental Health Commission of Canada, the Canadian Index for Wellbeing and chronic disease strategies are moving ahead. Federally, the Early Learning and Child Care Act is scheduled for third reading in February. In Ontario, the Health Equity Council has formed and an informal GTA network is pushing strategic investments in prevention, primary care, and public health. This year, we have a fresh Minister of Health Promotion; we'll finally see the launch of the Ontario Health Protection and Promotion Agency; the Ontario Health Promotion Resource System meets with Local Health Integration Network leadership; and possibilities are growing to enhance health promotion within the health care sector.
 
The test will be in how we seize these openings and act effectively to improve the health of Ontarians and Ontario. 

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VII  Larry Hershfield's Top 10 Wishes for 2008 and Beyond
-- by Larry Hershfield, Chair, OHPRS, and Manager, The Health Communication Unit

  1. That everything we are learning about social networks (yes, that Facebook thing) pays big dividends for Health Promotion!
  2. That social media (yes, that videophone thing) helps us document and disseminate important information about our communities and us!
  3. That the OHPRS Strategic Planning process is just that!
  4. That we go to dozens of websites so you only have to come to our THCU site!
  5. That we always remember how good decision-making and good process depend on each other!
  6. That our new Minister's energies and values prove a match for the universal risk aversion machine our governments have become!
  7. That everyone enjoys "This is Your Brain on Music" (by author Daniel Levitin), "Juno" (by director Jason Reitman) and "Raising Sand" (album by Alison Krauss and Robert Page) as much as I do!
  8. That we think more about communication for social change!
  9. That we identify priorities and specific policy changes among the broad determinants of health, and never forget the E-words (empowerment and engagement)!
  10. That we all learn how to not drown in information, while quenching some of our thirst for wisdom!

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VIII Conclusion

The OHPE editorial team thanks our contributors!

Many others wanted to contribute but were unable to during the busy post-holiday season. Not to worry--there will be plenty of opportunity to contribute feature articles as the year unfolds! If you're not sure what you can contribute, have a look at our Most Wanted List from OHPE 546 (http://www.ohpe.ca/ebulletin/index.php?option=com_uvmnewsletter&Itemid=7...) for some ideas. Send your ideas and contributions to features@ohpe.ca.