In an ideal world, there would be no need for the University of Ottawa Heart Institute. In an ideal world, everybody would eat a healthy diet, be physically active, not smoke—and in living this healthy life, minimize the risk of cardiovascular disease (CVD) in their lives.
But this isn’t an ideal world. CVD remains the number one killer in the Champlain region of eastern Ontario—an area encompassing 15,000 square kilometres and 1.2 million people. Ninety thousand residents of the region are living with cardiovascular disease and eight in 10 residents are living with one or more risk factors, including smoking, high blood pressure, unhealthy weight, physical inactivity or diabetes. In fact, three of Ontario’s “hot spots” for cardiovascular disease are in the Champlain region.
All of this means that the number of people who will need the Heart Institute’s services is growing—that is, unless people can be convinced to trade in their unhealthy behaviours for healthy ones and get the support they need to do so.
“The emphasis really is on the environment. We are trying to make it easier for people to adopt healthy behaviours.”
– Laurie Dojeiji, CCPN Network Manager, Health Promotion, UOHI
That’s the role of the Champlain Cardiovascular Disease Prevention Network (CCPN), a partnership founded by the Heart Institute that includes the Ottawa and Eastern Ontario Public Health Units, the Champlain Local Health Integration Network and the Heart and Stroke Foundation, among others. Since 2007, CCPN has made significant gains. Among its successes are the introduction of the Ottawa Model for Smoking Cessation in 19 hospitals and to 16 family health teams in the region, development of guidelines for primary care practices to prevent and manage CVD, the “Give Your Head a Shake” Sodium Reduction Campaign and the Healthy Schools 2020 Program.
Now, under the continued leadership of the Heart Institute, CCPN is launching its second phase, with even more partners than before. The three-year program will focus on key health priority areas and gaps identified in an evaluation of the first phase. CCPN’s five priorities for 2013 to 2016 are:
- Primary Care CVD Prevention and Management Program to support family health teams, community health centres and health links in delivering CVD prevention and care through evidence-based practices
- Regional Smoking Cessation Program to support more Champlain residents in making aided quit attempts
- Healthy Schools 2020 to engage more school communities in creating physically active and healthy eating environments
- Healthy Foods in Champlain Hospitals Program to create supportive, healthy nutrition in hospitals
- Regional Integrated Heart Failure Program to facilitate a more efficient and coordinated system of heart failure care
This next phase, said Program Director Sophia Papadakis, is all about creating champions and leaders in the community and giving them the resources they need to create an environment that helps people make healthy choices. The priorities also align with provincial health priorities and initiatives, as expressed in Ontario’s Health Care Action Plan and other strategies. CCPN aims to turn successful programs into models that can be replicated throughout the province and nationally.
CCPN brought together more than 110 leaders from public health, specialty care, primary care, hospitals, schools, communities, industry and academia as expert panels that examined the outcomes and successes of the initial strategy in order to shape the new one. The primary problem, Papadakis said, is that the strategy “was not living and breathing in the community.” So the renewed strategy focuses on building capacity in settings across the community, including family health teams, schools and hospitals.
In the case of smoking cessation, for instance, the original strategy focused on hospitals and family health teams, reaching 20 per cent of smokers in the Champlain region since 2007. The new Regional Smoking Cessation Program will continue to expand programs in health care environments but will also expand programs into the community to reach smokers directly, targeting work sites and inner-city neighbourhoods in particular. For instance, the strategy includes a union partnership to introduce the Ottawa Model for Smoking Cessation into construction sites. The network will also reach out directly to the public through social media and other means.
For the Healthy Schools 2020 Program, nine school boards from the Champlain region, with 550 schools among them, have signed a declaration committing to bringing healthy foods into their schools and supporting more daily physical activity. That, said Laurie Dojeiji, who oversees the Healthy Schools activities for CCPN, has never happened before and is an important measure of progress.
“The emphasis really is on the environment,” Dojeiji said. “We are trying to make it easier for people to adopt healthy behaviours.”
To do that, the network is supporting schools with tangible ideas to help shift foods to healthier varieties and encourage more physical movement. For example, a facilitation program, which provides schools with seed funds and a dedicated facilitator, assists in initiating health-promoting activities, such as healthy snack programs or walking school bus initiatives to encourage active transportation.
Success with improving nutrition in schools in its first phase led CCPN to focus on another location where people may have limited food options: hospitals. The Healthy Foods in Champlain Hospitals Program has brought together six regional hospital CEOs who have formed a leadership table that will take responsibility for executing activities under the program.
Another priority area is primary care, supporting the health care professionals on the front lines of prevention. In its first phase, CCPN developed guidelines to help more than 1,300 primary care practitioners prevent and manage CVD in their practices. Now, through the Primary Care CVD Prevention and Management Program, the network will focus on practitioners in the region’s 22 family health teams, which together reach more than 250,000 residents.
The emphasis will be on improving the delivery of preventive care through evidence-based practices and innovative models of collaborative care. The program will also work with the province’s Health Links initiative, a new structure to coordinate acute care and primary care into a seamless partnership.
Activities focused on promoting healthy behaviours are common. But as Papadakis pointed out, many of these are small or poorly funded and do not succeed in reaching large numbers of people. And, she added, those targeting the most at-risk populations, such as those living in rural areas, often have the fewest resources.
“Through partnerships, we can do more together,” she said. “We have more power working together, combining our budgets, our expertise and our manpower.”