Healthy Living Peer Leaders: A sustainable & innovative way to promote physical activity

1. Healthy Living Peer Leaders: A sustainable & innovative way to promote physical activity Karrie Cumming, Health Promoter Kim Richer, Peer Leader

2. Presentation at a Glance • Program Overview • Guelph CHC and Partners • Priority Population • Outputs and Tools • Training • Timelines & Work plan activities • Evaluation • Sustainability • Lessons Learned • Reflection

3. Our Inspiration…

4. Healthy Living Peer Leader Program Overview • Initiated by Guelph CHC in the fall of 2009 • Funded by the Ministry of Health Promotion through a Healthy Communities Fund grant • Volunteer peer leaders from two communities received training on various topics • Through partnerships the trained peer leaders then went into their communities to provide peer led programs

5. Healthy Living Peer Leader Project Flow Chart

6. Project Goals • Increase community capacity to address chronic disease issues • Provide accessible peer-led chronic disease prevention programs • Improve the health status of low-income adults

7. Guelph CHC Guelph CHC’s Mission We provide innovative primary health services and community programs, mainly for our priority groups, using an interdisciplinary team approach, and collaborating with community partners.

8. Guelph CHC Physical Activity Programs • Running Shoe Recycle Program • 1 walking group • 2 women’s yoga groups • Pre-post natal fitness classes • Physical activity consultations with Kinesiologist • Key partner in Guelph in motion committee

9. Partners

10. Priority Neighbourhood Demographics Onward Willow neighbourhood has; • Guelph’s lowest average income1. • Greatest number of subsidized housing and low cost apartments1. • Highest percentage of single parent families2. • Greatest number of families who have immigrated to Canada in the last 5 years2. • Highest percentage of residents who have no knowledge of either official language2. • Reported chronic disease rates were very high when compared to national rates1.

11. Priority Neighbourhood Physical Activity Levels • At least 50% of single parents and youth are physically active while 48% of families with young children are physically active1 • New immigrants report the lowest level of physical activity with only 27% reporting that they are active at least 3 times per week • Almost half of the Guelph CHC priority populations are not physically active to a level that will benefit health • Almost 30% of Onward Willow report depression and pain or discomfort • Depression, pain or discomfort is approximately 4 times higher in this neighbourhood than in Guelph • Approximately 25% of priority groups are not finding ways of reducing stress

12. Outputs and Tools Developed • General Chronic Disease Resource Guide • General Chronic Disease Info. Night • Healthy Living Leadership Manual with sections on; • Physical Activity • Healthy Eating • Group Facilitation • Evaluation • Healthy Living Peer Training • Peer-led Physical Activity and Healthy Eating Programs

13. Physical Activity Training • Training facilitated by Kinesiologist • Ground rules established • Review of volunteer duties, limits and conduct • Confidentiality and boundaries • Benefits of physical activity • Barriers and Motivators • FITT (Frequency Intensity Time Type) Principles • Safety • Local Opportunities • Link between physical activity and mental health

15. Healthy Eating Training • Training facilitated by Dietitian • Canada’s Food Guide • Fat & Sugar • Salt & Fiber • Being a Successful Leader • Community food resources • Label reading follow up training

17. Evaluation Training • What is program evaluation and why do it • Process and outcome evaluation • Evaluation questions, measurements and decisions • Evaluation tools   • Story collecting through group interviews with one another • Created focus group questions • Created satisfaction survey

19. Other training notes • Emergency First Aid and CPR • Transportation, food and childcare provided • Evaluation after each training session • Brainstorming potential peer lead activities at each session • Interactive, fun exercises throughout the day

21. 2009 Timelines • Meetings with partners and stakeholders • Engaging potential peer leaders • Hiring project consultant with community member on hiring committee • Research other peer led physical activity programs • Activity Buddy Training - The Haldimand-Norfolk Resource Centre • The Hamilton Diabetes and Depression Primary Care Peer Support Program – Hamilton Family Health Team

22. 2010 Timelines • Chronic Disease Information Night • Peer leaders were recruited • Physical activity training manual was developed • Health eating resources were developed • Peer leaders attended Guelph CHC volunteer orientation • Ongoing volunteer management • Ongoing evaluation • Develop communication plan

23. 2010 Timelines Continued • Peer leaders received 3 days of training • The peer leaders participated in several prioritization sessions to determine which peer lead programs they are going to implement in their community • Peer led programs initiated • Potluck supper and celebration of light

24. 2011 Timelines • Focus group with Brant Ave. neighbourhood to determine desired winter physical activities • Presenting at PARC Symposium! • 6 new peers recruited. • Self directed learning process • Review of information by program coordinator • Mentoring by current peer leaders • Will receive first aid and CPR training • Peer leaders participated in the following training: • a full day evaluation training • 2 hour evaluation follow up training

25. 2011 Timelines continued • Peer leader volunteer recognition supper • Peer leader webpage added to Guelph CHC site • Consult and collaborate with other community partners regarding the expansion of this initiative into other neighbourhoods • Press releases and media coverage of 2 peer led programs • Dissemination through Health Nexus Health Equity Promising Best Practice Inventory • Ongoing training and support needs are continuously being provided by Guelph CHC staff as the peer leaders and their projects evolve

26. Peer lead programs Healthy Eating • Label reading workshop • Healthy eating potlucks Physical Activity • Zumba nights • Badminton • Volleyball • 2 Walking groups Combination • Little chefs

29. Evaluation • Empowerment/participatory focus • Use of the Public Health Agency of Canada’s Capacity Building Tool • Process indicators (ie. hiring of staff, completion of work according to timelines) • Outcome indicators (ie. # of peer leaders, # of peer lead programs) • Quantitative data (ie. attendance records, survey results) • Qualitative data (ie. focus groups)

30. Quantitative Evaluation • 19 peers already trained • 6 new peers will be trained shortly • 2 peer led healthy eating programs • 5 peer led physical activity programs • 1 combination program • 6 peer leaders have taken on key leadership roles, while 13 have acted in a supportive role • 30 community members attended chronic disease info. night and label reading workshop • 4-12 people attend evening walking group • 5 families attended Little Chefs, 5 adults and 10 children

31. Quantitative Evaluation • Peer leaders have transferred knowledge to neighbors, friends, partners, children and program participants • Peer leaders report better understanding of what healthy eating and physical activity are and how they can impact health • Peer leaders report that training has motivated them to eat better and get more active • Peer leaders report that training has increased their confidence in sharing knowledge with others • Reasons for participation included • Learning about healthy living • First aid and CPR certification • Develop leadership skills • Meet new people • Resume and skill building • Support positive change for self and others

32. Qualitative Evaluation Impact on Peer Leaders • I feel good about progress in the community and feel good about myself and about giving back to my community • I feel much healthier, I’m more active, I’ve walked a lot when handing out flyers, involved in the walking group, I’ve met a lot more of my neighbours • It’s been a chance to meet people, to get out of my house, to practice and improve my English, I’m less shy • I like the meetings; I learn a lot about healthy eating and living; I eat better and walk more; now I park the car a distance from my work and walk the rest of the way; I’ve lost 8 lbs.!

33. Qualitative Evaluation Impact on Peer Leaders’ Families • My children are more involved in their community and have learned they can make a difference in their community • I talk with my children about labels and healthy eating; my son is walking more and eating better Impact on Neighbours and Community • The program is growing in our community • People know about us, we have a presence in the community • Peer leadership is a program to promote healthy eating and proper exercise however, its also a way to bring communities together and meet new people

34. Sustainability Sustaining the Issue • Community leaders continue to share messages • Tools developed used in other neighbourhoods Behaviour Change • Empowerment and knowledge gained by individuals will have a lasting impact on individual and community leadership, evaluation and advocacy skills. Programs • HCF grant provides increased organizational capacity • Guelph CHC will adopt and integrate the initiative into its operations Partnerships3 • Strengthened partnerships with OW and Brant groups • Potential for creation of new partners as initiative is expanded into other neighbourhood groups

35. Challenges • Timelines delayed due to a number of factors • Delay in receiving funding • Booking partner spaces • Volunteer screening and orientation • Peer compensation an issue • Tension between funder expectations and maintaining and authentic community participation model • Peer leader attrition due to moving, getting jobs, visiting family abroad, pregnancy, moving neighbourhoods, etc. • Barriers related to determinants of health limited volunteer’s capacity, reliability and punctuality • Language barriers • Transportation barriers • Childcare challenges • Greater rate of physical and mental health concerns • Neighbourhood crime • Limited ability to connect online

36. Successes • Friendships formed which reduced social isolation • New partnerships formed (ie. school, church and Zumba instructors) • Peers reporting they are eating better and are more active • Peer leader confidence in sharing information • Peers are bringing accessible programming to their neighbourhoods

37. Lessons Learned • First aid and CPR certification was a big incentive for participation • Removing barriers to participation by providing childcare, transportation and food • Unequal distribution of peer leader work • Have volunteer policies and procedures in place

38. Reflection • How could this program be adapted to your community? • How do you think we could improve upon this program?

39. Peer Leader Toolkit • Resources online at www.guelphchc.ca • Resources include; • Program history and chronology • Program pamphlet • General chronic disease prevention manual • Physical activity training manual • Healthy eating training manual • Physical activity tip sheets

40. Questions? Thank you!

41. References 1) Guelph CHC (2006) Community Health Survey. Guelph Ontario: Anne Phillips 2) Guelph CHC (2009). Neighbourhood Profiles. Guelph, Ontario: Lynn Bestari 3) The Health Communication Unit (2001) Overview of Sustainability Version 8.2, April 30, 2001, Centre for Health Promotion at the University of Toronto. Retrieved March, 2009 from http://www.thcu.ca/resource_db/pubs/698133998.pdf