Innovative Approaches to Mapping Local Public
Health Systems Serving Aboriginal Peoples
Martin Cooke, University of Waterloo
Storm Russell, Métis Nation of Ontario
Piotr Wilk, Western University
Funding provided by the Public Health Agency of Canada
Innovation Strategy: Achieving Healthier Weights in Canada’s Communities
Outline
• Background
• The intervention context
• The evaluation plan
• The “organization survey”
• Preliminary results: structure of service delivery
networks
Background
• High rates of obesity among Métis and off-reserve First
Nations children
• Determinants at a number of socio-ecological levels
(Willows, Hanley and Delormier 2012)
• Potentially affected by the activities of agents in the local
public health systems
• For Métis and off-reserve First Nations, children, this is an
especially complex system of organizations and actors
System diagram new.graffle
Background
Education
systems
Health education
Physical activity
School meals
Local Public
Health
Health
promotion,
health
education
Aboriginal
Service
organizations
Cultural services,
Healing and
wellness
Social services,
Maternal and child
health, etc.
Child
Urban planning
Neighbourhood
services
Recreation
facilities
Local
Government
Recreation
Social
programming
“Mainstream”
nonprofits
and social
services
Intervention
• Funded by PHAC Innovation Strategy: Achieving Healthier
Weights in Canada’s Communities (Phase I, II)
• A systems-level intervention to improve how local public
health systems serve First Nations and Métis children and
families by:
•
•
Using existing resources more efficiently
•
Increasing local resources through working together
Phase II sites:
•
London
•
Midland-Penetanguishene
•
Further expansion (TBA)
Intervention activities
• Active engagement of partners to look for opportunities for
collaboration
• Information sharing through web portals and social
networking
• Participation in local bodies, circles, tables
• Assistance with proposals, program and evaluation
planning
• Proposal writing and literature search assistance
• Knowledge exchange (best practices, funding
opportunities, program design, etc.)
Process and outcomes evaluation
Process
• Collection and recording of project activities
System level
• Survey of organizations
• Focus groups with providers
Family level
• Mixed-method collection with parent and caregivers
panels
Organization survey
Outcomes measured
• Collaboration and coordination among organizations
• Services provided
• Perceptions of the benefits of “working together”
Sample
• Organizations identified by local Site Coordinators
Mode
• Online survey (Waterloo Survey Research Centre)
Organization survey
Intervention activities
Evaluation activities
Measuring connections between
organizations
1.
2.
3.
4.
5.
6.
7.
8.
Knowledge (of this organization)
Regular communication among staff
Regular communication among senior leaders
Belonging to the same formal networks or other
bodies
Jointly running programs or services
Sharing resources (space, staff, equipment)
Formal agreements (e.g. Memorandum of
Understanding)
1 to 10 rating (1 = don’t work together at all, 10 = work very
closely together)
Describing the systems:
London Network
• Connections among Aboriginalspecific providers
• Node size reflects overall
connectedness
• Node colour represents sector
• Education
• Health
• Social services
• First Nations government
• Paths weighted by 1 to 10
rating (2–10)
Describing the systems:
London Network
• Connections between
Aboriginal-specific and
“Mainstream” organizations
• Node size reflects overall
connectedness
• Paths weighted by 1 to 10
rating (2–10)
Describing the systems:
London Network
• Connections between
Aboriginal-specific and
“Mainstream” organizations
• Node size reflects overall
connectedness
• Path s indicate “strong”
connections (rating of 5 and
higher)
Next steps
• Further visual examination of networks, sub-networks
• Examination of different patterns of connectedness (e.g.
joint programming, communication, formal networks)
• Statistical measures (e.g. network density) to compare at
T1 and T2.
• Follow up with focus groups