1. Keeping Pace The Health Information Prescription Project

2. Keeping Pace The Roman Army expected its soldiers to march 25 miles a day. They set the standard for what is now considered a pace. In Grey Bruce, we are trying to set a new standard.

3. Keeping Pace Who are we? Grey Bruce Rural Community Partnership for Resource Exchange for Health Living Grey Bruce Health Unit Grey Bruce District Stroke Centre Grey and Bruce Libraries Grey Bruce Health Services Health Sciences Library Regional Diabetes Program Recreation Centres Ontario Early Years Parks Canada Bruce Trail

4. Keeping Pace Library Pedometer Lending Program The process began with the pedometer program.

5. Keeping Pace Library Pedometer Program Based on a model developed by Ottawa Public Health Unit 31 libraries participating – 100% 2 pedometers in each library Borrow like a library book

6. Keeping Pace Library Pedometer Program Benefits Increase interest in physical activity More books on physical activity accessed Increased membership Challenges Late returns Lack of understanding of equipment function Extra work Lack of storage space

7. Keeping Pace Library Pedometer Program Enhancements Increase number of pedometers to decrease waiting time Libraries becoming informed health information hubs

8. Keeping Pace Library Pedometer Lending Program Based on the success of the Pedometer program in the public library system, it was decided that this might be a good way to introduce selected medical information

9. Keeping Pace Health Information Prescription The aim of the program was to provide a consistent, reliable and understandable selection of information regarding stroke easily accessible to the general public.

10. Keeping Pace Method The method chosen was to place selected resources (books – web sites) in the public library system to give easy access to information regarding stroke

11. Keeping Pace Background Why Stroke? Why Grey and Bruce? Why now?

12. Keeping Pace Why Stroke? Estimated that 4.1% of Canadians over 65 years of age (approximately 300,000 individuals) currently live with the effects of stroke. Between 2000 and 2010, the number of strokes in Ontario will have increased by 9%.

13. Keeping Pace Why Grey and Bruce? In 2000-2001, 496 individuals were hospitalized for stroke or transient ischemic attacks in the Grey and Bruce counties. It is estimated that another 473 individuals had a stroke or transient ischemic attack but were not admitted to hospital.

14. Keeping Pace Why Grey and Bruce? The population is more elderly than most areas Many seniors live in rural area or hamlets Public transport is essentially non- existent Public libraries are wide spread, convenient and trusted.

15. Keeping Pace Why Grey and Bruce? Grey Bruce Health Services was designated as a District Stroke Centre (DSC) for Grey and Bruce Counties in the spring of 2002. The District Stroke Centre is a component of the Ontario Stroke Strategy.

16. Keeping Pace District Stroke Centres District Stroke Centres provide care to stroke patients at all points in the spectrum of stroke care – promotion, prevention, acute care, rehabilitation and return to the community.

17. Keeping Pace Stroke and Community Increasingly the emphasis is on the return to the community and rehabilitation of the client in the community

18. Keeping Pace Healthy Living and Community The successful uptake of healthy living concepts needs to be at the individual and community level. Health information and motivational tools empower people to consider behaviour change to improve their health.

19. Keeping Pace Why now? Various programs have money and mandate! Ontario Stroke System, Ministry of Health Promotion Ontarios Rural Plan Active 2010 Regional Diabetes Program

20. Keeping Pace Budget We received 3000$ and used it to purchase book sets which were placed in each of libraries. The book titles: Stroke. A Comprehensive Guide to Brain Attacks Stroke and the Family: A New Guide, 1 st Edition Stroke for Dummies

21. Keeping Pace Health Prescription Project – The Journey Begins…The Original Proposal Would allow individuals to access health information at their local library Would allow health professionals to recommend credible information including websites to the individual. Would allow consistency in the message

22. Keeping Pace Objectives To allow patients/clients to access appropriate stroke and stroke prevention information close to home. To assist the libraries in obtaining and dispensing appropriate information on stroke and stroke prevention both in print and on the web. To ensure information dispensed is consistent and available across each community. To strengthen the relationship between community libraries and DSC programs and GBHS Health Sciences Library

23. Keeping Pace Evidence We decided to chose the information prescription approach on the basis of: Literature Search Paediatric Experience Webinar with Don Buchanan following his presentation at OLA Conference Internet use Library pedometer project

24. Keeping Pace Process Discussion Paper and feedback Health Unit Expresses Interest to Partner First Contact Meeting Information Packages

25. Keeping Pace Health Information Prescription Activities: Develop the prescription Develop a relationship between GBHS Health Sciences Library and the community libraries Disseminate the books and prescriptions Develop an evaluations framework

26. Keeping Pace The Prescription Instruction Suggested Resources Special Requests Books Websites

27. Keeping Pace Statistics As yet no definite results. Hard to measure who is taking and using the materials How does one measure the outcomes Sustainability

28. Keeping Pace Problems We needed to be mindful of time stresses placed on the libraries\cataloguing - Record keeping Communication Did the material fit within the collections policy of the organizations? Were we setting a precedent for other groups?

29. Keeping Pace Falling into Step Resource Exchange Library Pedometer Project Stepping out on the Bruce Trail Project Health Information Prescription Project Collaborated with 2 other projects to form Grey Bruce Rural Community Partnership for Resource Exchange for Healthy Living

30. Keeping Pace Stepping Out on the Bruce Trail

31. Keeping Pace Stepping Out on the Bruce Trail Virtual Walk of the Bruce Trail 480 km End to End 10,000 steps = 8 km Two months to complete Competition and prizes

32. Keeping Pace Stepping Out on the Bruce Trail Pilot just finished Two school boards and the Dental Association 1,300 people participated Now expanded to the public and workplaces As of Friday – 500 teams of 4 people

33. Keeping Pace Time lines Phase I (May 2005 to January 2006) Local Program Assessment Phase II (February to October 2006) Incorporation of Evidence Development of Evaluation Protocol Phase III (November 2006 to March 2007) Implementation

34. Keeping Pace Outcomes Increased use of motivational tools to improve physical activity Increase in number residents using community partners for health information. Strengthened relationships with community partners Increased community responsibility for healthy living Increase in number of participating community partners

35. Keeping Pace Conclusion When you change your attitude, You change your behaviour. When you change your behaviour, You change your performance. When you change your performance, You change your life!,

36. Keeping Pace Questions?

37. Keeping Pace Presenters Keeping Pace Mary Solomon, Grey Bruce District Stroke Centre Coordinator, Grey Bruce Health Services, Owen Sound msolomon@gbhs.on.ca Lynda Bumstead, RD Program Manager Chronic Disease Prevention Grey Bruce Health Unit, Owen Sound lbumstead@publichealthgreybruce.on.ca Elyse Pike, Health Sciences Librarian Grey Bruce Health Services, Owen Sound Library@gbhs.on.ca