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You are here: Home Modules Module Examples Introduction Examples Example 2 - A day in the life of an Ontario Public Health Multiple Intervention Program planning team
Example 2 - A day in the life of an Ontario Public Health Multiple Intervention Program planning team Print E-mail
Introduction Examples

Ontario Public Health PractionersAs part of its regular planning cycle, the reproductive health team in a mid-size Ontario city’s public health unit is reviewing its program, for the first time using the new Ontario Public Health Standards, which may require some adjustments to its activities. They’re looking at their current program through two lenses: the principles, goals and standards of the new reproductive health standard and the multiple intervention program tool kit guidelines. They have previously used the tool kit’s introductory module to consider need, potential impact, appropriateness and capacity for several reproductive health issues they’re working on.

We meet them mid-way in a planning session using the tool kit.

Task #1 related to determinants of health

The “foundational standard” of the new standards says "Addressing determinants of health and reducing health inequities are fundamental to the work of public health in Ontario. Effective public health programs and services consider the impact of the determinants of health on the achievement of intended health outcomes." The team goes to Note H in Module 1 of the tool kit to find a useful summary of determinants of health.

As the team reviews this section, they are reminded it’s important to clarify assumptions about how health disparities are created and maintained. To help them discuss that, they use the tool kit’s link to the Canadian Nurses Association decision tree on social justice.

The tool kit also reminds them to "Explore how determinants of health potentially interact." For example, age, gender, and immigration status may each be separately related to health issues and behaviour, which would affect what interventions are chosen for a given target group. But they all interact in ways that affect income and education levels, which are also determinants of health that will affect intervention choices.

Task #2 related to priority populations

The team reads the expected outcomes the board of health is accountable for in reproductive health programs. They include working with community partners to get reproductive health information to priority populations. Boards are also expected to make community partners aware of the importance of creating supportive environments for healthy pregnancies and birth outcomes, and of preparing people for parenthood.

The team goes back to its logic model and operational plan and finds it has not specified priority populations, such as ethno-cultural populations or young single parents. Current interventions include small-group sessions and smoking cessation groups for pre-pregnant, pregnant and parenting women, but one team member notes few women from ethno-cultural minorities attend the smoking cessation groups. The team decides it needs more information from various resources (see STEP 4) about the ethno-cultural minority population in the region and on factors that might be keeping women from participating in the groups.

They note the new standards emphasize working with the community to reach priority populations, instructing boards of health to “provide, in collaboration with community partners, outreach to priority populations to link them to information, programs and services.”

They go back to the tool kit’s socio-ecological assessment activities form, which they filled out when they were planning their intervention, and decide to contact:

  • the board’s internal epidemiology resources;
  • the community health unit’s multicultural task force;
  • three organizations that serve immigrants; and
  • a university-based health researcher who has studied tobacco use among newcomers.

    They plan a meeting to discuss priority populations with these experts.

    Task #3 related to levels of intervention and synergy

    STEP 1
    The team knows the standards call for boards of health to consider whether scientific literature and reviews of best practices show reasonable evidence that the interventions will be effective.

    STEP 2
    The team turns to Module 2 to think about the evidence underpinning their interventions for mainstream populations, and use Table 1, Interventions influencing various socio-ecological systems, to map out the levels the interventions are aimed at.

    STEP 3
    The team reflects on the levels of current interventions by looking at the target groups, outputs and types of interventions in their operational plan.

    STEP 4
    The team finds their current activities directed at priority populations all seem to focus on individuals. They begin to consider interventions at other levels, including policy, because the reproductive health standard requires boards of health to try to "influence the development and implementation of healthy policies."

    STEP 5
    The teams’ next step, as Module 3 recommends, is to use the tool kit to assess whether there are possible synergies or antagonistic effects among current interventions and those that might be added for priority populations and other system levels.

    STEP 6
    The team’s evaluator points out the new standards expect boards of health to find performance measures to assess the impact and effectiveness of programs and services, and the foundational standard calls for program evaluation. The team decides to use Module 4 to plan evaluation. At this point, however, the team has done a lot of work, and is ready to call it a day. Tomorrow they will again sign on to the multiple intervention programs tool kit website, where their working documents and plans have been saved and are easily accessible.

    Last Updated on Sunday, 31 May 2009 18:03