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?