CPHA CONFERENCE

1. CPHA CONFERENCE Strengthening Chronic Disease Prevention & ManagementA Regional Pilot Project

2. OUTLINE • Overview of CPHA Pilot Project • The Planning & Assessment Tool • Key Findings and Next Steps • The Cumberland Story

3. CAPACITY-BUILDING • Organizational development • Workforce development • Resource allocation • Leadership • Partnership development • Reference: A Framework for Building Capacity to Improve Health, NSW Health, 2001.

4. AIMS TO: Engage stakeholders in dialogue Promote information exchange Assess current policy, planning and practice Identify actions, roles and shared responsibilities for strengthening prevention and management of chronic disease

6. CRITICAL SUCCESS FACTORS Common Values and Shared Goals Focus on Determinants of Health Leadership, Partnership and Investment Public Health Capacity and Infrastructure Primary Care Capacity and Infrastructure Community Capacity and Infrastructure Integration of Chronic Disease Prevention and Management Monitoring, Evaluation and Learning

7. METHOD/APPROACHEvidence-Informed The Tool was developed through: Working with an expert advisory committee Review and synthesis of peer-reviewed, indexed journal articles and grey literature Key Informant Interviews Focus Groups Piloting in Four Health Regions

8. WORKSHEETS AND RATING SCALES Cues to help assess current capacity Where are we now in our practice? What opportunities are there to build capacity/improve practice? Question with explanation/example Rating scale with qualitative indicators (0=nothing in place; 4=best/promising practice) Space for local indicators, notes

9. Chronic Disease Prevention and Management Continuum TertiaryPrevention Prevent progression to complications and/or hospitalizations Prevent movement to at-risk group Prevent progression To established disease

10. REGIONAL PILOT PROJECT

11. PROJECT OVERVIEW • Engage Stakeholders, Pilot Tool, Track Learnings and Evaluate • Identify four pilot sites • Provided process support • Partner to engage regional stakeholders • Held workshops – orientation to the Tool • Tracked site experiences using the Tool • Facilitated learning exchange across jurisdictions

12. WHAT DID WE LEARN?

13. SELECT FINDINGS Use of tool varied with each site and depended on context Flexible, multiple approaches Complex, takes time Process was as important as the Tool itself Learnings came from engagement at project level and at the regional level Participatory approach was key Nature of engagement and support provided helped to build capacity in different ways

14. HOW MIGHT THE TOOL BE USED?

15. Our CDPM Journey • Small CDPM Planning Team • Environmental Scan • Steering committee / Stakeholders – CPHA Orientation to Tool • 2 Stakeholder Forums • Criteria and Priority Setting • Identified actions to move forward

16. The CPHA Tool Stakeholder Forums Poverty workshop (Multi-sectoral partners) Indirect Staff Groups, Steering Committee HP Working Group Direct Common Values/ Health Goals / Integration / Determinants of Health Dialogue Capacity Building Understanding Validation Potential

17. Poverty Reduction Forum • How aware are people of the link between the social determinants of health and chronic disease? How do people see the social determinants as informing approaches to this work? • What are some supports for taking a social determinants of health approach to addressing chronic disease in this region? • What are some of the barriers to taking a social determinants of health approach to addressing chronic disease prevention and management?

18. Reorienting Health Services Key Strategy Areas -Increasing Awareness Knowledge translation Self Management Chronic Disease Self Management Provincial Initiative SSM Patient data – health passports Health Care providers Priority Areas

19. Community Action Workplace Setting Inter-sectoral Approach to SDOH / Health Inequity reduction Information Systems IT / IM Strategic Planning Systems and Decision support Tools Redesign Linking systems for information sharing across the system Priority Areas

20. Moving Forward with Integration • What is moving us forward? • Increased awareness - concept of Integration • Connection with CD Accreditation standards • Overlapping Collaborating committees for Self Management / Health Promotion work/CCCP • Opportunities - Self Management training in March/ Promising Health Promotion Practices

21. Moving Forward With Integration • Transformation within existing structures – CCCP shift / IM srategic planning • Provincial / National supports – resources, strategies, training opportunities

22. Moving Forward With Integration • Leadership Development and Support • Building capacity - Strong / varied partnerships and commitment – Community centre - Springhill • Health Promotion WG meeting regularly (Multi layerd approach)

23. Cumberland Health Authority Draft CDPMSupport Framework • Nova Scotia Chronic Disease Prevention Strategy Health Promotion Steering Committee (CDPM) Key Systems Level Stakeholders Health Promotion Working Group Collaborating Committee of Key (Intersectoral) Stakeholders Cumb Collective Partnerships Self Management Collaborating committee Organizational Health / Workplace Coalition Communications Social inclusion and Cultural Diversity Families Schools Workplaces Communities Healthcare Settings

24. Holding us Back • A solid strategy for introducing the tool and piloting – workplan • No provincial framework yet • Lack of a Communication Plan • Understanding the Lay of the Land – Integration points • Awareness Building is Huge – needs to come first

25. Overlapping responsibilities - Time Crunch – ie: Steering Committee – More streamlined support structure Structure required • Need to Build more capacity – tool should be useful • Competing priorities – Accreditation • Ruralness of the district – travel, time

26. Learning re: Using TOOL • CDPM Steering Committee – Values and Role • Communications is High Priority • Need an Inventory of CDPM work • Develop a working group and plan for using Tool • Tool is an extremely useful catalyst • Potential to adapt / use tool with for integration of other priority areas - Cultural Diversity and SI discussions – ie: Common Values • CDPM work needs bilateral movement of ideas

27. Next Steps

28. Taking a step back • Developing the bigger framework • Strategic plan / evidence / standards • Integrating priority goals and objectives • Healthy Discussions – knowledge exchange • Increasing awareness of what “integration” might look like • Looking at the Lay of the land – integration points and alignment

29. What will be Key • Maintain Balance - Prevention with Management • Restructuring – system support and relationship building • Maintain focus on Stakeholder Priorities – in work-plans • Continued Communication and Engagement • Use evidence to support Decisions and Redesign • Continue to Focus on the Critical Success Factors