1. 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

2. Outline Background The intervention context The evaluation plan The “organization survey” Preliminary results: structure of service delivery networks

3. 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

4. Background

5. 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)

6. 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.)

7. 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

8. 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)

9. Organization survey Intervention activitiesEvaluation activities

10. Measuring connections between organizations 1. Knowledge (of this organization) 2. Regular communication among staff 3. Regular communication among senior leaders 4. Belonging to the same formal networks or other bodies 5. Jointly running programs or services 6. Sharing resources (space, staff, equipment) 7. Formal agreements (e.g. Memorandum of Understanding) 8. 1 to 10 rating (1 = don’t work together at all, 10 = work very closely together)

12. Describing the systems: London Network Connections among Aboriginal- specific 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)

13. 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)

14. 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)

15. 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