Writing the Book on Community Health in Canada

Writing the Book on Community Health in Canada Kate Mulligan, Alliance for Healthier Communities, Dalla Lanna School of Public Health

Jennifer Rayner, Alliance for Healthier Communities, Western University Laura Muldoon, Somerset West CHC (Ottawa) Elizabeth Hartney, Centre for Health Leadership and Research, Royal Roads University

Merrill Cooper, The Alex CHC (Calgary)

Presenter Disclosure Presenters: • • • • •

Merrill Cooper Elizabeth Hartney Laura Muldoon Jennifer Rayner Kate Mulligan

Relationships to commercial interests: • • • •

Grants/Research Support: n/a Speakers Bureau/Honoraria: n/a Consulting Fees: n/a Other: n/a

Meet the Panel (Moderator) Kate Mulligan, PhD. Director, Policy and Communications, Alliance for Healthier Communities; Assistant Professor, Social and Behavioural Health Sciences, Dalla Lanna School of Public Health. @KateMMulligan Jennifer Rayner, PhD. Director, Research and Evaluation, Alliance for Healthier Communities; Adjunct Research Professor, Western University. @Rayner_Jen Laura Muldoon, MD, Family Physician, Somerset West CHC (Ottawa). @laura_muldoon Elizabeth Hartney, PhD. Professor, Director Centre for Health Leadership and Research, Royal Roads University @DrHartney Merrill Cooper, MA. Director of strategy, research and Evaluation, The Alex CHC (Calgary). @TheAlexCHC

#CHConnections2019

Model of Health and Wellbeing 3 Guiding Principles • Highest Quality, People- and Community-Centred • Health Equity and Social Justice • Community Vitality and Belonging

8 Attributes of Community Primary Health Care • • • • • • • •

Grounded in Community Development Based on the Determinants of Health Community Governed Interprofessional, Integrated, and Coordinated Accountable and Efficient Population Needs-Based Accessible Anti-Oppressive and Culturally Safe

Haida Model of Health Service Delivery Yahguudang | Respect Haida Art, Haida Dance, Haida Song, Potlatch, Food, Land, Gathering

Ad Kyaanang tlaagang | To Ask First Model of Service Delivery Process, Guidance, Trust, Transparency

Tllyahda | Make it Right Reconciliation, Acknowledgement, Understanding, Non-Judgement, Connection, Bridge

Gina Waadluuxan gud ad Kwagid | Everything Depends on Everything Else Governance, Partnerships, Sharing Image by Haida artist Tyson Brown for Xaaynangaa Naay (House of Life) Skidegate, BC. 5

Example of an Alex program evaluation framework Youth Health Program: Outcome Evaluation Framework – Pilot 2019 Program outputs (Sources: EMR, program records and Participant Satisfaction Questionnaire) AHS contract requirements Long-term outcomes Indicators % participants with improved quality of LT 1: Participants experience improved quality of life life score % participants with reduced acuity LT 2: Participants successfully transition to adulthood score Intermediate outcomes

Indicators Decreased number of ER visits, hospital stays

INT 1: Participants experience improved physical health

% participants with substance abuse issues/addictions whose issues have less impact on their lives (PROM)

INT 2: Participants experience improved mental health/emotional well-being INT 3: Participants experience increased social support INT 4: Participants experience improved financial stability INT 5: Participants experience improved housing stability INT 6: Improved developmental outcomes among infants born to women in the PP program

% participants with self-reported improvement on physical health issues (AHS) Decreased number of ER visits, hospital stays % participants with mental health issues whose daily functioning improves % participants with improved mental health/emotional wellbeing % participants with deceased social isolation

% participants with sufficient income to meet basic needs

% participants with a stable source of income % participants who are (i) homeless; (ii) at risk of homelessness % participants with housing that is (i) long-term; (ii) affordable; (iii) suitable; and (iv) safe

Data source QOLI 20 global subscale and overall score (Participant) Calgary Youth Acuity Scale (CYAS) (Staff)

Administration

Intake, 6 m, exit Intake, 6 m, exit

Data source HQCA data QOLI 20 - Global subscale and overall score (Participant)

Administration Annual

GAIN-SS Substance subscale (Participant)

Intake, 6 m, exit

Participant Satisfaction Questionnaire (Participant) HQCA data QOLI 20 - Global subscale and overall score (Participant)

Intake, 6 m, exit

Intake, 6 m, exit Annual Intake, 6 m, exit

OQ 10 (Participant)

Intake, 6 m, exit

QOLI 20 – Family and Social subscales and Functional Social Support Scale (Participant)

Intake, 6 m, exit Intake, 6 m, exit

Program records and QOLI 20 – Finance subscale (Participant)

Intake, 6 m, exit

CYAS(staff)

Intake, 6 m, exit

CYAS (staff)

Intake, 6 m, exit

CYAS (staff) CYAS (staff)

% infants born healthy: carried to term; normal birth weight; without addictions; without evidence of substancerelated disabilities (AHS target – 80% babies born healthy)

Program records

% infants not taken into care in the first year of life

Program records

Intake, 6 m, exit

Intake, 6 m, exit

Throughout program

What is underway right now • Evaluation frameworks for all programs have been developed; instruments/common measures have been piloted throughout The Alex.

• Final adjustments to measures have been made following data analysis.

• Agency-wide case management and data collection software, CiviCRM, is almost ready.

• Main research policies done, procedure, agreements almost ready.

• Process underway to obtain identifiable patient data in discrete form from HQCA, allowing us to do sophisticated analysis.

• Increasing our bench strength: Hello Access Open Minds!

• New “wellness” goals

Connect with Us Kate Mulligan

Kate.mulligan@allianceON.org

@KMMulligan

Jennifer Rayner

Jennifer.Rayner@allianceON.org

@Rayner_Jen

Laura Muldoon

LMuldoon@swchc.on.ca

Elizabeth Hartney Merrill Cooper

Elizabeth.Hartney@RoyalRoads.ca MCooper@thealex.ca

@Laura_Muldoon @DrHartney @TheAlexCHC

Thank You | Questions? Comments?