1. Thinking and Working as a System: Integrated Chronic Disease Prevention in Manitoba Chronic Disease Prevention Alliance of Canada Conference Tuesday, November 25, 2008

2. Objectives Identify coordination, communication and collaboration approaches that have been successful Become familiar with chronic disease prevention through a community-led, regional health authority-coordinated and government-supported approach. Identify some priority steps in becoming a chronic disease prevention system.

3. Starting the Journey Alliance for Prevention of Chronic Disease Building on the Heart Health model 3 years not long enough Suggested per capita funding High cost of chronic disease to health system, society and economy Interventions known but not always applied Need to engage high-risk populations

4. Decide on the destination Development of a CDPI Charter Consensus on accountability, management and evaluation A five year community-led initiative to support local planning and actions that create healthy settings and promote healthy living (Oct 2005-March 2010) Focuses on risk factors of smoking, unhealthy eating and physical inactivity and evidence based action Signed on October 24, 2005 by each RHA, Minister of Healthy Living of Provincial Government and a Northern Aboriginal organization

5. The journey – community led Local planning committees, champions and people to facilitate action Actions plans with per capita funding Start where community is at and address barriers to participation Leveraging additional resources Community pride and “can-do” attitude Local data collection about risk factors

6. The journey – community led 83 communities in participating RHAs including 21 First Nations and 8 Métis communities Examples of engaging communities; “Train the Trainer” approaches – ripple effect Making it easy for people to connect Community gardens

7. Community Gardens “Not just about the Carrots” Collaborating with existing partners Creating a philosophy and trust The roles of the Network and the community Looking ahead

8. Community Gardens

9. The journey – RHA coordinated Work with existing groups and relationships to build partnerships and sustainability Share learnings across the regions: monitoring forms, granting programs, RHA board buy-in, & success stories Focus on high-risk communities Draw on evidence for decisions and planning Make it easy for communities to participate

10. The journey – RHA coordinated For example: Developed Regional Committees (support for training plans, surveillance) Shared tools/resources between RHAs – cross pollination Bring partners with similar interests together (in-motion, healthy schools) Create environments to move healthy living forward

11. The journey – Government Supported Funding through the Public Health Agency of Canada and Manitoba Health and Healthy Living Leadership, accountability and evaluation Support for committees for communication, coordination and joint planning

12. The journey – Government Supported For example: Website to support Healthy Living including CDPI http://www.healthincommon.ca/http://www.healthincommon.ca/ Linkage to provincial partners such as Northern Healthy Foods Initiative Funding to RHAs for 44 new staff positions to enhance and sustain regional capacity for chronic disease prevention and healthy living

13. Elements of Success Increased ability to work together to create supportive environments Partnerships at multiple levels New communities of practice formed such as Partners in Planning for Healthy Living (PPHL) Community-led initiatives blended into existing programs and services Resources combined to expand reach

14. Elements of Success (cont.) High-risk populations working on community determined issues of priority Growing leaders Shift in attitudes and approaches to chronic disease prevention Valuing the different ways communities get things done

15. Learnings Sharing knowledge, resources, expertise, evidence based information and problem solving/solutions Communities recognize the need to prevent chronic disease Don’t let jurisdictions get in the way – people (even bureaucrats) can work around perceived barriers

16. Learnings Be flexible Get out of the way of the communities Sharing, listening and learning together takes time Understanding community traditions Use existing structures and groups

17. Detours along the way Changing the ways people think and work Learning about the impact of community- led planning and decision making Alignment of planning cycles, funding, reporting and monitoring Communication Engagement of youth and burdened families Questions from sectors outside of health

18. Not quite there yet – road signs Community Capacity Building Tool Reaching a tipping point i.e. blue light The power of sharing local data with community We need to take the time to discuss challenges, health determinants, and potential solutions Innovative ways to tell the stories Coaching and mentoring Facilitate organic community development

19. Not quite there yet Challenge to be true to the philosophy of community led, RHA coordinated and government supported approach Bring communities together to share information and communication strategies Strategic planning – looking to the future Keep it simple and make it easy for partners to stay involved

20. Acknowledgements CDPI communities Alliance for the Prevention of Chronic Disease Regional Health Authorities Manitoba Health and Healthy Living Public Health Agency of Canada