II The Portal Put into Practice
III Become Part of the Canadian Best Practices Portal
-- submitted by Nina Jetha, Canadian Best Practices Portal, Public Health Agency of Canada
The Canadian Best Practices Portal (“the Portal”), launched in 2006 by the Public Health Agency of Canada, is an online tool that links public health practitioners to well evaluated and effective interventions for chronic disease prevention and health promotion. The Portal acts as a single point of access to evidence-based best practices.
The Portal (http://www.phac.gc.ca/cbpp) is a virtual front door to community and population health interventions that have been evaluated, shown to be successful, and have the potential to be adapted and replicated by other public health practitioners working in similar fields. Portal interventions are selected based on consistent criteria and expert review.
New content recently added to the Portal focuses on topics such as:
- Asthma and lung disease
- Children and youth aged 3 to 17
- Hypertension and cardiovascular disease
- Misuse of medications
- Adults and seniors
- Tobacco and alcohol
- Injury prevention
- Chronic gambling
- Food security
- Physical activity
- Aboriginal populations.
The Portal’s main components are:
- a searchable database of community level interventions
- a searchable database of resources to help with public health planning, chronic disease prevention and health promotion goals
- a catalogue of best practice systematic review sites.
II The Portal Put into Practice
Here are examples of how three public health practitioners have used the Portal.
Vancouver Coastal Health
Three years ago, Maylene Fong, of Vancouver Coastal Health, faced her biggest hurdle as a public health nurse – to create a diabetes prevention program aimed at high-risk adults from the ground up. The only firm parameter was the budget. Maylene had to determine the program scope, staffing and programming.
“It’s a good thing I had some excellent resources to help me in the planning!” says Maylene. She had heard about the Portal at a chronic disease prevention conference, and decided to give it a try. The Portal provided a number of examples of other healthy living programs and she found a number of good programming ideas and ready-to-use materials. The site even identified the range of professionals who could support the type of programming she had in mind, complete with job descriptions.
To meet the needs of her high-risk target population, Maylene knew that she had to be innovative in applying a population health approach. While the program focuses on the three pillars of health promotion - nutrition, physical activity and smoking cessation – its delivery is unique within Vancouver Coastal Health. Maylene felt that her clients would not deal well with a prescriptive approach, and thankfully, she had a lot of latitude in staffing. But who could best reach members of a high-needs community, to take action on physical activity, for example?
Maylene’s program started with a nurse and a nutritionist, then, following the lead of an evaluated US program, she hired a recreation therapist. Maylene also added active living coordinators, who focused on readily accessible, low-cost activities such as walking, rather than organized sports. The information on the Portal showed Maylene who was successfully running such programs, how they were planned, and what they had learned through formal evaluations.
While the materials Maylene found usually required some adaptation to meet the needs of Vancouver Coastal Health’s clients, Maylene found that relatively easy to do. “In some cases, I contacted the originators of the material, spoke with them about their experiences and got the resources in formats I could adapt.”
The Portal also linked Maylene to planning and training resources. For example, the online planning tool available from The Health Communication Unit, University of Toronto, proved invaluable in helping her lay out the details of her plan. Direct links to other resources, including the Cochrane Reviews, were also very helpful.
“As a manager, I particularly like the way the Portal helps me determine how other programs are organized and lets me identify the staffing mix and expertise I need,” says Maylene. It makes planning a new program or writing a funding proposal so much more efficient.”
Victoria Order of Nurses
The Portal is one source of evidence for Janis Leiterman and Karen Curry, two members of a national team from the Victoria Order of Nurses (VON) focused on chronic disease prevention and management. Both are experienced home care nurses. Janis works at the national office in Ottawa, using research and innovation to develop programs to improve conditions for people living with chronic disease. Karen is at the Halifax office, providing project management to implement those plans in the field, and develop some new initiatives.
VON national office does most of the developmental work for programs, while planners and front-line care providers at the branches look after implementation. They often have to adapt their approach and materials to respond to local needs and, once in a while, funding opportunities that arise.
Janis was part of the original chronic disease team, formed before the Portal was in existence. She learned about it at a chronic disease prevention conference, and found it “a God-send.”
“Having a centralized, credible source of information was very helpful in developing our overarching chronic disease prevention and management program,” Janis notes. Now she tends to refer to the Portal at the beginning of planning for a project and in responding to requests for proposals for project funding.
“I find the (population health approach) organizing framework very helpful. It’s a comprehensive, but simple place to start, helping me identify what I may be missing in program planning. It’s a core document I use to guide the whole process,” says Janis.
Janis will often direct people in the branches to the Portal, particularly to the organizing framework to help them plan their programs. “That is the real value of the site for novices. You aren’t taken into a huge planning document. It takes you through step-by-step, using plain language. For example, evaluation is often a challenge for people. The Portal lays it out very easily. It gives people options on how to develop an evaluation, and then provides links to specific evaluation questions. That’s phenomenal!”
Karen tends to begin her quest for evidence with the “Advanced Search” or “Keywords” option and follows the links to “sites and support I didn’t even know existed.” When she started in her new role about a year ago, she went to the site as part of her initial effort to come up to speed on chronic disease prevention. “The Portal showed me what programs were in place across Canada, helped me learn the terminology, and directed me to experts and practitioners applying the information.”
Karen has recently used the information on the Portal to help her plan a chronic disease management program for Aboriginal people on reserve. She is working with communities to develop toolkits for care providers, to help them guide individuals in chronic disease self-management. She found the Portal very helpful for her initial literature review and environmental scan. “The Portal led me down some roads that would have taken a long time to find otherwise. I connected with groups and researchers doing similar work. Being able to speak to the person in charge of programs I was interested in was very useful. The Portal was a spring-board to more of their work, and sources of data, like the National Collaborating Centre for Aboriginal Health, for example.”
Karen has used the Portal to lead her advisory committee to practical tools to guide planning of the initiative. As for implementation, while some communities are very advanced, others are at a basic level. “The Portal has been helpful in making managers aware of other communities struggling with the same issues, programs they have adopted and even potential sources of funding.”
III Become Part of the Canadian Best Practices Portal
The Portal currently includes 255 interventions and 41 resources. Like any online tool, it needs constant updating of its content to remain relevant. Health practitioners are encouraged to nominate interventions and resources for inclusion on the Portal.
Partnerships are also a key to the Portal’s continued success. “We can broaden the scope and reach of the Portal through new partnerships with organizations that share our goals of encouraging knowledge exchange and evidence based decision making among health care practitioners,” says Nina Jetha, Manager, Canadian Best Practices Initiative, Public Health Agency of Canada.
For more information on the Portal or to find out how to become a partner in the Portal, please contact Nina Jetha at (613) 952-7608, or [email protected].