Population Health Promotion Plan

November 2004

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Table of Contents Summary of the Sunrise Health Region Population Health Promotion Plan

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Process for Preparing the Population Health Promotion Plan

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Environmental Scan Mental Health Well Being Decreased Substance Use and Abuse Accessible Nutritious Foods Active Communities

6 7 8 9

Vision

10

Objectives

11

Partners in the Development of the Plan

13

Action Plans for the Four Priority Areas Action Plan on Mental Well Being Action Plan on Decreased Substance Use/Abuse Action Plan on Accessible Nutritious Foods Action Plan on Active Communities

15 20 24 26

Resources

29

Supporting Long Term Change

30

Achieving Our Goals and Objectives

31

References

32

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Summary of the Sunrise Population Health Promotion Plan The Sunrise Health Region Population Health Promotion Strategy was developed using the collective wisdom and experience of a large number of agencies, organizations and community members. Throughout the development of the Plan, all who contributed recognized the importance of shared responsibility for health and the need to focus on prevention of illness, disease and injury. The process used to develop the strategy facilitated personal and professional growth in population health promotion capacity. Its’ development provided an opportunity to reflect on the Health Region’s resources and helped enhance capacity to use upstream approaches for issues facing our Region. As well, new opportunities for inter-sectoral action were identified. The development of this strategy provides a framework for future health promotion work in the Sunrise Health. Region. It engages health care professionals across a variety of disciplines to work collaboratively with a number of community partners. This strategy identifies a variety of entry points for population health promotion and allows for capacity building in a number of areas such as social marketing, evaluation, community development and healthy public policy development. The contact person for the Sunrise Population Health Promotion Strategy is: Val Churko Health Promotion Manager Sunrise Health Region 72 Smith St. E. Yorkton, SK. S3N 2Y4 Phone (306) 786-0636 Fax (306) 786-0620 Email: [email protected]

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Process Used to Prepare the Population Health Promotion Plan This strategy builds on the Community Consultation event which took place on March 20, 2003 in Sunrise Health Region. At this consultation, approximately 65 participants from various agencies/organizations and the community attended a one day event, to learn about a population health promotion approach, the health status of residents in Sunrise Health Region and to identify priority areas for health promotion. Participants from this initial consultation were invited to contribute to the development of a strategy for our region. Saskatchewan Health facilitated broad consultation with a variety of provincial stakeholders and interest groups following regional consultations. As a result of these consultations, each health region was asked to develop a population health promotion strategy in the following priority areas: • Mental well-being • Decreased substance use/abuse • Accessible nutritious foods • Active communities. Fifteen participants from Sunrise Health Region attended a two day Population Health Promotion workshop in Regina on May 10 and 11, 2004. The participants identified current health promotion programs/services for the four priority areas in the region. The group then classified the initiatives as being upstream, mid or down stream approaches. Barriers which may impede using a population health approach were recognized. Representatives at the workshop included individuals from the Metis Nation Eastern Region II, two School Divisions, Community Health Advisory Council, Parkland Recreation Association, Parkland Alcohol and Drug Abuse Society, the Medical Health Officer, Executive Director of Community Services, as well as, mental health, therapies, public health and primary care. In June, a Steering Committee for the Population Health Promotion Strategy was formed. This committee included representatives who attended the May Workshop and others who expressed their commitment in being part of development of the strategy. At the initial Steering Group meeting, information from the May workshop was shared. Terms of Reference for the Steering committee and working groups were identified. Four working groups, one for each priority area, were formed to develop draft action plans for the strategy. The chair/co-chairs of the Working Groups were assigned based on their working knowledge in the priority area, participation in the May workshop and their membership on the Steering Committee. Over the summer, a student working in Public Health, conducted research on the four priority areas, accessing a number of data bases to provide recent information and evidence of best practice approaches for each area. This research was presented at each working group meeting. Inherent in the development of the strategy is the ability to build population health promotion capacity. During August, three Sunrise Health Region staff and a community partner attended the Summer Institute on Population Health Promotion in Brandon.

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The Working Groups developed draft action plans, which were shared with a variety of forums such as the regional Public Health Nurses’ meeting, Public Health Program Staff Meeting, regional Nurse Practitioners’ forum and with the Community Program Coordinators. Feedback on the draft action plans was obtained and incorporated. At each of the Working Group meetings, members were challenged to identify if the objectives being developed enabled healthy public policy development, created supportive environments or strengthened community action. During the process of developing strategies for the action plan, connections between the four priority areas were emphasized. For example, positive mental wellbeing, impacted on by balancing work and family demands could also contribute to making healthier lifestyle choices in accessing nutritious food and impact on ability to be physically active on a regular basis. A meeting of the co-chairs of each of the working groups was held to share action plans and discuss the connections between the priority areas. The draft action plans were shared with the Saskatchewan Health Consultant, Marta England, who provided feedback via email and phone. Most of the feedback received related to being more specific regarding the objectives and the timelines. Two meetings of a small sub-committee of the Steering Group (Next Steps) were held to identify further opportunities/initiatives taking place in our region lead by other partners/organizations and potential opportunities to work together. Gathering this information serves to facilitate more inter-sectoral action in the priority areas. This Plan is a living document. The timelines taken to develop this Plan were short. This is a new process for many. Factors such as willingness, availability and ongoing commitment of our partners, as well as community readiness will impact on the future development and implementation of the Plan.

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Environmental Scan (Mental Well Being) Saskatchewan Health’s goal statement for the issue of mental well being is: To improve the conditions that support positive mental wellbeing for Saskatchewan residents by promoting resilience, connectedness and citizenship. Mental health promotion uses strategies to foster supportive environments and individual resilience while showing respect for culture, equity, social justice, interconnections and personal dignity. Mental health promotion is not driven by an emphasis on illness but rather by focusing the enhancement of well being. The World Health Organization informs 5 of the 10 leading causes of disability are related to mental disorders. According to Stats Canada, 20 % of Canadians will personally experience a mental illness during their lifetime. Mental illness affects people of all ages, educational and income levels and cultures. The economic costs of mental illnesses is estimated at over 14 billion dollars annually. Negative mental well being contributes to mortality, loss of economic productivity, poverty and low quality of life. According to Labonte (2003) the six key areas to the power of mental well being include: • Getting an early start to mental health • Lifestyles supporting mental health • Employment and work as important factors for mental health. • Mental health related to social status, education and income. • Stress and social support. • Integrated and empowering mental health services. Within the Sunrise Health Region, a number of agencies/organization such as the Canadian Mental Health Association, the Society for the Involvement of Good Neighbours (SIGN), Sunrise Mental Health services, and private counseling services are available to support those experiencing mental health issues. Numerous programs such as Kids First, Families First, School Plus, League of Peaceful Schools, Caring and Respectful Schools, Strengthening Our Circle, Child Action Plans, Circle of Strength, parenting programs and many support groups work at various levels in our region to promote/support positive mental well being. Positive mental health and well being is a result not only of individual capacities, but also of ecological, social, political and economic environments. Following discussion and review of pertinent literature, the Working Group on Mental Health, identified destigmatization of mental health, working with workplaces to promote positive mental health and development of a workshop to work with communities experiencing changing demographics as ways to positively impact on mental health in our region.

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Environmental Scan (Decreased Substance Use and Abuse) The Saskatchewan Health’s goal statement for this issue: To reduce tobacco, alcohol and drug use and the harm it causes in the population and especially in youth and children. Substance use is referring to the use of alcohol, tobacco and illicit drugs. In our strategy development, it was identified use/misuse of prescription drugs was an area in which greater awareness was also needed. Alcohol is the most popular drug used in society. In Saskatchewan, 18.8% of males and 8% of female youth, aged 13 to 18 report drinking beer more than once a week. Heavy drinking rates have increased nationally by 0.6%. Stats Canada (20030 informs Saskatchewan rates for heavy drinking have dropped by 1.4%, while Sunrise Health Region rates have jumped by over 4% . According to Stats Canada (2003) , smoking rates have dropped 6.4% for ages 12 and over in Sunrise Health Region. A local youth wellness survey identified marijuana smoking rates were 8% higher than cigarette smoking. i Comprehensive tobacco reduction strategies include taxation, legislation such as bylaws, enforcement, education as well as support for cessation. Yorkton is one of five cities in this province which has taken a leadership role in tobacco reduction efforts by adopting a smoke free bylaw in July 2004. Fifty three substance abuse cases were treated through mental health services in outpatient programs in 2003 in Sunrise Health Region. This is a 10% increase from 2001. Substance use and abuse is entwined with the values, norms, attitudes and beliefs of society. Living conditions, lack of social supports, unemployment, racism also are factors which contribute to substance use and abuse. In our Region, addiction services are offered through Saul Cohen Centre in Melville, Addictions Services in Yorkton, the Parkland Alcohol and Drug Abuse Society in Yorkton and through Community Services in Canora. The Working Group on Substance Use/Abuse has developed an inventory of the wide variety of programs/services available in our community to provide awareness, education and support in the area of substance use and abuse. The list identifies parenting programs, youth programs, injury prevention programs and programs for seniors etc. This inventory will be updated as part of the role of the Working Group. The Tobacco Reduction Working Group of Sunrise Health Region, a special interest group with representation from the Cancer Society, the Smoker’s Help Line, two school divisions and others has been amalgamated with the Substance Use/Abuse Working Group. Their contribution to the Regional Tobacco, Alcohol and Drug Stategy will result in a more coordinated effort to reducing substance use. Youth involvement is key to being able to impact effectively on youth prevention programming for substance use. Our strategy seeks to involve youth at all stages in the development of a Tobacco, Alcohol and Drug Strategy for Sunrise Health Region and also, in ongoing advocacy for smoke free environments.

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Environmental Scan (Accessible Nutritious Foods) The Saskatchewan Health goals for creating improvement in accessible nutritious foods are: To increase opportunities for people to enjoy more nutritious food in homes and community settings. To reduce the economic, social and cultural barriers that limit healthy eating habits. To advocate for food policies that promote and protect the health of Saskatchewan residents. The World Health Organization (2001) says one third of cardiovascular disease can be prevented through healthy eating. Twenty to thirty percent of all cancers are related to nutrition. More than half of the new cases of Type II diabetes can be prevented through changes in physical activity and diet. Stats Canada (2003) reports 37.9% of the residents of Sunrise Health Region, compared to 38.9% for Canada eat 5 or more servings of fruits/vegetables per day. Eating habits and obesity are contributing factors to hypertension. In our region, Stats Canada (2003) reports 24.3% of our residents have high blood pressure, compared to 14.4% for Canada. Our rate of obesity is 24.1% of the population compared to 14.9% for Canada according to the same source. In Sunrise Health Region the number of people who are moderately physically active is below the national average. According to Healthier Places to Live, Work and Play, A Population Health Promotion Strategy for the Province (2004), factors affecting accessible food include but are not limited to what food is available where people live and play, why certain foods are or are not available, as well as, the cultural, family and individual influences. Within the Sunrise Health Region, a number of programs such as the Community Kitchen, Melville Food Bank, Salvation Army Food Hamper, Kids First Coupon Program and the Canada Pre-natal Nutrition Program through Yorkton Tribal Council work to enhance the availability of food in the community. The Saskatchewan School Trustees Association and the Public Health Nutritionists of Saskatchewan have developed Nutrition Guidelines for Schools. In the past, the “Putting Prevention Into Action,” diabetes prevention project in our region involved with the Chief Gabriel Education Centre to develop a policy for enhancing healthy food choices in the school and promoting physical activity. The project also developed resource kits and providing funding to First Nations and Metis organizations for programs to support physical activity and healthy eating. The Diabetes Plan also includes strategies for the promotion of physical activity and healthy eating. The Working Group on Accessible Nutritious food has identified objectives which promote/ support/ advocate for healthy eating across all ages from breastfeeding at birth, through schools and workplaces, as well as, enhancing seniors’ nutritional status.

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Environmental Scan (Physically Active Communities) The Saskatchewan Health goal statement for creating active communities include: To increase opportunities for regular, enjoyable, physical activity in communities, schools and workplaces. To reduce the economic, environmental, social and cultural barriers that limit participation in physical activity. To create safe environments that encourage/support physical activity. Lack of physical activity contributes to the development of a number of chronic diseases such as heart disease, Type II diabetes and cancer. The Canadian Fitness and Lifestyle Institute reports as many as 59% of Saskatchewan residents are not sufficiently active for health benefits. It is estimated a 10% reduction in physical inactivity can reduce direct health care expenditures by 150 million dollars per year. Being physically active on a regular basis contributes to a healthy body weight, positive mental well being by reducing stress, anxiety and depression, an improved quality of life, including reducing the risk of injury. In Sunrise Health Region the number of people who are moderately physically active is lower than Saskatchewan and Canadian rates. (Stats Canada, 2003). There is a variety of programs to assist individuals to participate in physical activity including those through sport associations, private enterprise, leisure services, recreation associations and not for profit groups. The Sunrise Health Region is a partner in the Yorkton On the Move Program for Girls and Women. The aim of the Girls On the Move Program is to provide no cost non competitive programming for young girls. The Women On the Move program serves to promote the benefits of being active and offers low cost activity clinics for women in a variety of interests such as golf, cross country skiing etc. Sunrise Health Region staff , in partnership with the Diabetes Association, Leisure Services of Yorkton and Take Off Pounds Sensibly (TOPS) offers a cost recovery exercise and education program to the community called Stepping Out. A pilot program called Step Up to Health is being offered for the first time in Melville this fall. This program provides information on the four priority areas for the strategy through six sessions at no cost to participants. The Community Program Coordinators in the Region also promote and lead programs to promote physical activity. The Therapies department of the region recently partnered with the local housing authority and offered a Steady As You Go Program, a falls prevention program for seniors. Provincially Saskatchewan has a “Physically Active Saskatchewan! A Strategy To Get Saskatchewan People in Motion” The program focuses on strengthening partnerships, building awareness, targeting community strategies and measuring success. There are two in motion regional contacts in Sunrise. Promoting physical activity includes creating supportive physical environments which are safe and accessible. The Working Group for Physical Activity will strive to partner and advocate for low cost, safe physical activity programming and policies in workplaces, schools and communities.

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Vision of the Sunrise Health Region Population Health Promotion Strategy The vision statement of the Sunrise Health Region is “Working together…for healthy people in healthy communities.” The vision statement for the Provincial Population Health Promotion Strategy is “Healthier Places to Live, Work and Play.” This vision statement was discussed at the Steering Group meeting.

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Objectives of the Strategy Our strategic directions document for the Sunrise Health Region identifies better promotion of health and disease prevention targeting provincial and regional priorities. The objectives identified for the Population Health Promotion Strategy for Sunrise Health Region are listed below.

Mental Well Being: •

To develop and implement a public awareness campaign to foster positive mental well being by creating awareness of the social conditions which promote mental well being by 2007.

•

To develop and implement healthy workplace programs in 2-3 workplaces in the health region by 2007.

•

To develop, implement and evaluate a workshop to enhance resiliency and viability of rural communities within the health region by 2007.

Decreased Substance Use/Abuse: •

To develop a “Tobacco, Alcohol and Drug Strategy” targeting youth and children to be implemented by the end of 2007. o The strategy will promote education, health promotion, public information and treatment. o The strategy will hope to achieve a long term plan for services and ensure a consistency among service providers.

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Accessible Nutritious Food •

To designate Sunrise Health Region Baby Friendly by June 2008.

•

To provide 90% of the schools in Sunrise Health Region an opportunity to receive support for implementing the Saskatchewan School Board Association Document “Nutrition Guidelines for Schools” and the Nutrition and Food Safety Recommendations for Nutrition Programming in Saskatchewan Community Schools (Fall 2004) within the “Building Communities of Hope” document by June 2008.

•

To support reducing barriers so people can enjoy nutritious food where they live work and play: o Sunrise Health Region will develop and implement a Food Nutrition Policy by January 2006. o Sunrise Health Region will demonstrate leadership in facilitating a community coalition that addresses nutritious accessible foods by Dec. 2008.

● To develop a strategy/action plan to enhance senior’s health status in Sunrise Health Region through accessible nutritious foods by Dec. 2008. Active Communities ● To partner with local agencies, municipalities and organizations to increase access to safe, low cost physical active programming in workplaces, schools and communities by Dec. 2007.

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Partners in Developing the Strategy Sunrise Health Region Population Health Promotion Steering Group Membership Name

Affiliation

Role

Ed Sorsdahl

Director of Mental Health Services - Sunrise

Co-chair of Working Group on Mental Well Being and Decreased Substance Use

Sandy Vaughan-Hastie

Mental Health Services Sunrise Health Region

Co-chair of Working Group on Mental Health

Will Woods

Addiction Services-Sunrise Health Region

Co-chair of Working Group on Decreased Substance Use and Abuse

Heather Torrie

Public Health Nutritionist Sunrise Health Region

Co-chair of Working Group on Accessible Nutritious Foods

Marilee Hornung

Public Health Nutritionist Sunrise Health Region

Co-chair of Working Group on Accessible Nutritious Foods

Jennifer Dickie

Darryl Bangsund

Community Health Educator Sunrise Health Region Metis Nation Eastern Region II Potashville School Division

Dwayne Reeve

York School Division

Warren Vandenameele

Community Health Advisory Committee R.M of Cana

Chair, Working Group on Physical Activity Next Steps Sub-Committee member Member of Working Group on Decreased Substance Use Member of Working Group on Decreased Substance Use and Abuse Member of Working Group on Physical Activity Member of Working Group on Mental Health Member of Working Group on Physical Activity

Ryan Calder

Lorraine Bucsis Sheila Hrynuik Carol Horvath Beatrice Boychuk

In Motion Coordinator Parkland Regional Recreation Association Parkland Alcohol and Drug Abuse Society Community Health Advisory Committee

Laurie Miller

Canadian Diabetes Association

Joanne McClenaghan

Canadian Red Cross Association

Lori Korman

Community Health Advisory

Bernice Puritch

Regional Inter-Sectoral Committee School Plus

Carmen Kraynick Vince Bornyk

Executive Director, Sunrise Health Region

Mike Redenbach

Executive Director, Sunrise Health Region

Member of Working Group on Substance Abuse Member of Mental Health, Decreased Substance Abuse and Accessible Nutritious Foods Working Group Member of Working Group on Accessible Nutritious Foods Member of the Working Group on Mental Health Member of Working Group on Physical Activity Member of Next Steps SubCommittee Member of Next Steps SubCommittee Member of Mental Health Working Group and Next Steps Sub-Committee

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Dr. S. Shahab

Name

Affiliation Medical Health Officer

Gail Remus

Director of Primary Care

Myrna Rhinas

Mental Health Services

Lesley Stamatinos

Therapies, Sunrise Health Region

Val Churko (chair)

Health Promotion Manager

Role Member of Mental Health Working Group and Next Steps Sub-Committee Member of Decreased Substance Abuse, Mental Health, Accessible Nutritious Foods and Physical Activity Working Group Member of Physical Activity Working Group Member of Physical Activity Working Group Member Steering Committee Member of all Working Groups

The Sunrise Health Region is also very appreciative of the support of those listed below who also serve on the Working Groups: Additional Members of the Working Group on Mental Health Name Homer Robertson Tom Seeley

Affiliation Canadian Mental Health Association Society for the Involvement of Good Neighbours

Additional Members of the Working Group on Substance Use and Abuse Name Dave Tillusz Sherry Shumay Gail Gorcynski Sheila Johnson Constable Erin Lockyer Ruth Wylie Brenda Kakakaway Aleksandra Hoeber Terry Wittal Brenda Kondrat Julie Martinussen Nick Schenher Wendy Griffith Tricia Challoner David DeHoey Curtis Loucks

Affiliation Parkland Alcohol and Drug Abuse Society Saul Cohen Parkland Regional College Kids First RCMP Volunteer Yorkton Tribal Council SK. Abilities/Partners in Employment Probations/Community Operations Canadian Cancer Society Canadian Cancer Society (on leave) University Student Dental Health Educator School division Smoker’s Help Line Pharmacist

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Mental Well Being – Work Plan Priority Issue:

Mental Well-Being

Goal:

1. To improve the conditions that support positive well-being for Saskatchewan residents by promoting: • Resilience • Connectedness • Citizenship. 2. Better promotion of health and disease prevention targeting provincial and regional priorities. ( Taken from the SHR Strategic

Directions document) Health Region Objectives:

1. To develop and implement a public awareness campaign to foster positive mental well-being by creating awareness of social conditions that promote mental well-being by 2007. 2. To develop and implement healthy workplace programs with 2 – 3 employers in the health region by 2007. 3. To develop, implement and evaluate a workshop to enhance resiliency and viability of rural communities within the health region by 2007. Main role(s) of Health Region: 1. Work with community partners to develop and disseminate information on mental well-being, 2. Review and support workplace programs aimed at improving mental well-being of employees, 3. Partner with existing groups and organizations within various communities to develop programs to enhance community resiliency and viability. Key Activities (indicate if the activities have a major effect on another priority issue) 1. Develop / implement public awareness campaign regarding mental well-being and positive mental health by creating awareness of social conditions that support mental wellbeing (e.g. anti-bullying campaign)

Implementation Steps

Timelines

- Find partners among community agencies, organizations and services to work on the project.

January 2005

- Provide education on mental health promotion and wellbeing at a local level.

March 31, 2005

- Develop compatible policies and procedures among agencies in specific areas (e.g. bullying).

Spring 2006

Partnerships Internal to Regional External to Regional Health Authority Health Authority • • • • •

Mental Health and Addictions Employee Services Public Health Health Promotion Director of Communications

• • • • • • • • • •

CMHA SIGN Metis Nation of Sask. IAREH at the U of Sask. College of Nursing First Nations University Media School Districts Community College SRNA

Resource Requirements Mental Health and Addictions Human Resources Financial resources for marketing ($5000 in 2005)

Progress Measures

Increased capacity in social marketing

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Mental Well Being – Work Plan Key Activities (indicate if the activities have a major effect on another priority issue)

Implementation Steps

Timelines

- Develop outline of public service announcements, public information sessions, and general awareness information (good mental health involves what’s going on around you not just what’s going on inside you). Presentations geared to policy and community issues as well as individual lifestyle issues (e.g. bullying, de-stigmatize mental health services, create a healthy workplace, etc).

Summer 2005

- Produce public service information items (video, sound and print) and prepare standard information for speakers’ bureau.

January 2005

- Survey public attitudes towards “mental health” or “mental Illness” prior to information campaign

Spring/summer 2006

Resource Requirements

Partnerships Internal to Regional External to Regional Health Authority Health Authority •

As above

•

As above

•

Summer student or contract employee for 3 – 4 months to develop outlines (1 FTE for 3 – 4 months = 0.25 – 0.33 FTE)

Progress Measures

• •

•

•

As above

•

Development of “scenarios” or scripts. Development of public presentations useable by general public and other groups. Development of “speaker’s forum” – knowledgeable individuals who can speak to groups on “mental health issues”.

As above

•

Student or contract employee for 3 – 4 months

•

Development and implementation of a tool to measure public opinion.

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Mental Well Being – Work Plan Key Activities (indicate if the activities have a major effect on another priority issue)

2.To expand healthy workplace programming for 2 – 3 employers within the Sunrise Health Region area (in addition to Sunrise Health Region)

Implementation Steps

Timelines

Resource Requirements

Partnerships Internal to Regional External to Regional Health Authority Health Authority

- Implement public awareness campaign.

Fall / winter / spring 2006/07

•

As above

•

As above

- Survey public attitudes towards “mental health” or “mental illness” following information campaign.

Summer 2007

•

As above

•

As above

- Inventory workplace programs in the Sunrise Health Region area geared to improving the “mental well-being” of employees.

January 2005

•

SHR employee services Mental Health and Addictions Public Health Health Promotion

•

- Build on work of the “Balancing Work and Family” committee to being process to inform the public (employers) about values of “health workplaces” and “workplace wellness” programs.

Spring/summer 2005

EFAP providers, labour groups, Chamber of Commerce, Provincial Government, community agencies.

- Access work done by Dept. of Labour and other departments re inventory of healthy workplace personnel policies

Spring 2005

• • •

•

•

Student or contract employee for 3 months

Summer student or contract employee to conduct research and develop presentations

Progress Measures

•

Re-administration of instrument to determine change (if any) in public opinion.

•

Survey used to establish a base line of services available for employees

•

Establish workshop to inform public about the value of “health workplaces” and need to balance work and non-work activities

•

Attempt to determine what programs and policies are required – develop a comprehensive list of services.

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Mental Well Being – Work Plan Key Activities (indicate if the activities have a major effect on another priority issue)

3.Help rural communities use their strengths to develop resiliency in light of changing demographics and the rural economic situation

Implementation Steps

Timelines

- Survey employees and employers to determine what programs, if any, should be added to the menu of services available to improve “mental well-being”

Spring /summer / fall 2005

•

Some programs (e.g. conflict resolution) are presently available as well as some EFAP programs and providers.

- Develop presentation and information regarding the value of workplace wellness programs (e.g. EFAP) for employers (e.g. reduced absenteeism, more productive employees, etc).

Summer 2005

•

Develop “cost – benefit” analysis measuring cost of programs against increased productivity / reduced lost time at work.

- Follow up survey to determine of employers have adopted programs

Winter 2006

•

Compare results to original survey.

- Develop framework for an “information gathering” session to assist communities to identify their strengths for continued viability

January 2005

•

Development of a proposal to assist communities.

Partnerships Internal to Regional External to Regional Health Authority Health Authority

• • • •

Public Health Health Promotions Mental Health and Addictions Primary Care

•

Use Sunrise Health Region “community advisory groups” as conduit to communities

Resource Requirements

Progress Measures

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Mental Well Being – Work Plan Key Activities (indicate if the activities have a major effect on another priority issue)

Implementation Steps

Timelines

Resource Requirements

Partnerships Internal to Regional External to Regional Health Authority Health Authority

- Seek community partners to participate in the community session

April 2005

•

As above and include Strategic Planning, Sunrise Health Region

- Develop and test workshop geared to assisting communities to look at factors that can positively impact on their futures. Train individuals to provide the workshop.

Summer / Fall 2005

•

As above

- Evaluate effectiveness of workshop

Spring / Summer 2006

•

Possible partners include ACRE, SIGN, SUMA, SARM, REDAs, RICs, Dept of Learning, FSIN, Towns and RMs, Economic development agencies and departments, Prairie Region Health Promotion Research Centres (U of S), U of R.

•

As above

• •

Student or contract employee for 3 – 4 months $2,000 in 2005

Progress Measures

•

Obtaining agreement and willingness to participate is crucial.

•

Development and testing of workshop format.

•

Need to develop evaluation tool

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Decreased Substance Use / Abuse – Work Plan Priority Issue:

Decreased Substance Use / Abuse

Goal: Health Region Objectives:

To reduce tobacco, alcohol and drug use and the harm it causes in the population and especially in children and youth. 1.To develop a “Tobacco, Alcohol and Drug Strategy” for the Sunrise Health Region targeting children and youth to be implemented To be implemented by the end of 2007. • The strategy will promote education, health promotion, public information and treatment • The strategy will hope to achieve a long-range plan for services and to ensure consistency among service providers. 1. To assist in the coordination of initiatives already underway in the Region. 2. To attempt to ensure the coordination of education / awareness sessions regarding tobacco use and alcohol and drug use. 3. To spearhead the development of a larger strategy as part of a regional plan to decrease tobacco, alcohol and drug use / abuse.

Main role(s) of Health Region:

Key Activities (indicate if the activities have a major effect on another priority issue)

Implementation Steps

1. Organize a working group to begin the development of a “Tobacco, Alcohol and Drug Strategy” for the Sunrise Health Region. A primary focus of the “strategy” will be to “improve the quality of life and provide healthier and safer communities by reducing the impact of addictions”.

•

Timelines

Use the Decreased Substance Use / Abuse Working group as a starting point to identify agencies, groups and individuals to be involved in the process.

January 2005

•

Convene a community / regional meeting of interested / appropriate agencies and individuals.

March 31, 2005

•

At the “community meeting” provide information on the Regina and Area Drug Strategy (process and content) and provide information on the development of a tobacco reduction strategy.

March 31, 2005

Form a “steering” group to provide

Spring 2005

•

Partnerships Internal to External to Regional Regional Health Health Authority Authority • • • • • •

Mental Health and Addictions Public Health Primary Care Health Promotion Communication Director Home Care

• • • • • • • • • • • • • • • • • •

CMHA SIGN PADAS Saul Cohen School Districts Community College Canadian Cancer Society Big Brothers Big Sisters SADD MADD School Plus Kids First RCMP Probation Families and Schools Together Yorkton Tribal Council Metis Nation of Sask. Pharmacist Physician

Resource Requirements

•

Costs of lunch, meeting room $500

•

Honorariums / travel costs for presenters $1000

•

None

Progress Measures

•

Number of attendees

•

Membership in steering group should arise from community

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Decreased Substance Use / Abuse – Work Plan overall direction to the strategy process. •

Form “working groups” to lead the development of the strategy in specific areas (see attached organizational chart).

Spring 2005

$1,500

•

•

Develop inventory of tobacco, alcohol and drug education / awareness and treatment programs to identify deficits and gaps in service.

Summer 2005

•

Summer Student or contract employee for 3 – 4 months (0.25 - 0.35 FTE)

•

•

Develop framework for consultation process and identify focus groups with specific emphasis on youth. Conduct focus groups. Compile information from focus / consultation groups. Return information to communities for feedback. Present to SHR Board Complete and publish strategy. Implement strategy.

Summer 2005

•

Travel costs

•

Facilitator for groups Travel and meeting rooms

• • • • • •

meeting and should be broad based and representative of Health Region. Working Groups should include, but are not restrict to representatives from Mental Health and Addictions (Sunrise Health Region), Public Health (Sunrise Health Region). PADAS and Saul Cohen Production of inventory / list

Fall / winter 2005 – 2006 Spring / summer 2006 Fall 2006

• Spring 2007 Summer 2007 Fall 2007

•

Costs of publication and distribution

Publication of Strategy

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Decreased Substance Use / Abuse – Work Plan

TIMELINE SUMMARY

OVERVIEW OF DEVELOPMENT OF SUNRISE HEALTH REGION TOBACCO, ALCOHOL AND DRUG STRATEGY

By March 31, 2005 Community Agencies

By Spring 2005

Steering Committee

By Spring / Summer 2005

Working Group Tobacco Reduction

Public Acceptance of Activity

HIGH

Activities to consider for Working Groups Education --Training -Treatment / -------Management Other Tasks By Fall / winter 2005

Develop Inventory

Summer 2005 – Fall 2006

Establish and Conduct Focus Groups

Fall 2007

Implementation of Strategy

Working Group Alcohol and Drug Use

LOW

Working Group Misuse of Prescription and Over-the-Counter Medication

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Decreased Substance Use / Abuse – Work Plan Key Activities (indicate if the activities have a major effect on another priority issue) 2. Continue to advocate for “smoke free” public places and workplaces and promote compliance with provincial and municipal legislations.

Implementation Steps

•

•

•

•

•

Ensure elected bodies (towns / RMs / provincial) are educated regarding the health hazards of smoking. Continue to advocate for “smoke free” environments” even after the provincial legislation is enacted. Continue to advocate/adopt evidence based approaches to smoking cessation programs. Advocate for continued application of appropriate taxation to make smoking less accessible. Development and support of programs to make smoking a “negative” behavior and less socially acceptable

Timelines

Ongoing

Spring / summer 2005

Ongoing

Ongoing

Ongoing

Partnerships Internal to Regional Health Authority • Mental Health and Addictions • Public Health • Medical Health Officer

Resource Requirements

Progress Measures

External to Regional Health Authority • • • • • •

Canadian Cancer Society SMA Saskatchewan Coalition on Tobacco Reduction. Smokers’ Help Line Municipalities Other interested community partners.

•

Information/ support provided by the Saskatchewan Coalition on Tobacco Reduction

$19,000 provided by Sask. Health to increase visability of enforcement officers

• •

• • •

Adoption and compliance with non-smoking bylaws. Number of by-laws adopted

It is anticipated there will be active campaigns to have the provincial legislation repealed. Percent compliance with provincial legislation. Legal challenges to legislation.

•

Programs to help people quit smoking need broad-based support including financial, program (EFAP), employer sponsored, and government sponsored (Smoke Help Line).

•

Provincial and National campaigns to change attitudes towards smoking.

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Accessible, Nutritious Food – Work Plan Priority Issue:

ACCESSIBLE, NUTRITIOUS FOOD

OVERALL GOAL: BETTER PROMOTION OF HEALTH AND DISEASE PREVENTION TARGETING PROVINCIAL PRIORITIES AND REGIONAL PRIORITIES. Goals: 1. To increase opportunities for people to enjoy more nutritious food in homes and community settings. 2. To reduce the economic, geographic, social and cultural barriers that limit healthy eating habits. 3. To advocate for food policies that promote and protect the health of Saskatchewan residents. Health Region Objectives: 1. Sunrise Health Region will be designated Baby Friendly by 2008. 2. Ninety percent of the schools in Sunrise Health Region will have been provided an opportunity to receive support to implement the Saskatchewan School Board Association document “Nutrition Guidelines for Schools” and the Nutrition and Food Safety recommendations for Nutrition programming in Saskatchewan community Schools (fall 2004) within the communities of Hope document by June 2008. 3. Sunrise Health Region will support reducing barriers so people can enjoy nutritious food where they live, work and play. 3a. Sunrise Health Region will develop and implement a Food Nutrition Policy by January 2006. 3b. Sunrise Health Region will have demonstrated leadership in facilitating a community coalition that addresses nutritious accessible foods by Dec.2008 4. Sunrise Health Region will have a strategy/action plan to enhance senior health status through accessible nutritious foods by Dec. 2008 Main Role(s) of Health Region in this Issue: Provide support leadership and direction. Act as a role model. Work in partnership with others Key Activities Implementation Steps Timelines (Indicate if the activities have a major effect on another priority issue too.) 1. Support the Breast-feeding Initiative Implementation Plan Support Breastfeeding Matters

- Foster leadership support - Develop a regional policy on breastfeeding - Develop Implementation Plan/action plan based on the provincial Breastfeeding Initiatives Implementation plan and BFI - Educate staff/public - Support community breastfeeding support groups

Ongoing 2005 Ongoing

Ongoing Ongoing

Partnerships Internal to Regional Health Authority - Breastfeeding Mat. - Mat/Child Accreditation Team - Diabetes Prevention Team - Kids First - PHN’s - PH Nutritionists - Dieticians/food Service - Pharmacists - GP’s/OB’s/PED’s - LC’s - Nurse Managers OBS/PED - Primary Health Care

Resource Requirements External

- Breastfeeding Committee for Canada - SK Breastfeeding Committee - PHNSWG - YTC - Metis Nation Region II - Lactation Consultant - Community Support Groups - Families First

- Training for staff, who deal with breastfeeding mothers - Designated lactation consultant funding

Progress Measures

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Accessible, Nutritious Food – Work Plan Key Activities (Indicate if the activities have a major effect on another priority issue too.)

Implementation Steps

Timelines

Internal to Regional Health Authority

2. Work with schools to implement the SSBA Nutrition Guidelines For Schools and the Communities of Hope Nutrition and Food Safety Recommendations for Nutrition Programming in SK Community Schools

- Identify partners - Engage Sunrise Health Region, RIC, Diabetes Team in discussions re ensuring accessible nutritious foods in schools - Advocacy for the SSBA Nutrition Guidelines and Communities of Hope recommendations - Develop implementation strategy and/or action plan

Fall 2004

3. Advocate for reducing barriers so people can enjoy nutritious foods in their community; i.e., transportation child care

- Identify appropriate avenues for advocacy - Explore opportunities - Identify partners/stake-holders - Develop strategy/action Plan - Develop, implement and support a SHR Food/ Nutrition Policy - Role Model for other organizations/workplaces

2005

- Identify key partners/stakeholders to engage in priority - Foster leadership support (in progress)

2006

Balancing work/family workplace institutions

4. Develop a strategy action plan to enhance the health status of seniors and their accessibility to nutritious foods; i.e., transportation, social isolation cost, physiological changes, social supports, assisted living food programs * Note seniors include healthy, transitional and institutionalized.

Partnerships

Ongoing

2005

Resource Requirements External

- PHP Committee - PH Nutritionists - DHE’s - Diabetes Team - PHN’s - MHO - HP Manager - CH Educator - PH Inspectors - Public Health

- PHNSWG - In Motion School Divisions (Div., Teachers, principal) - Parents - PTA - SK school board assn - Dept. of Learning - School Plus Coord. - FAST program - PEPP - Community School coordinators

- School Nutritionist (Population Health Facilitator) funding from Diabetes Prevention Funds $5000 from HRDC

- Workplace Wellness Committee - CH Educator - Staff Educator - PH Nutritionists - PHN’s - PHE’s - Home Care/MOW - PHP Committee - MHO - HP Manager - Community DT’s

- Good Food Box - Community Kitchen - Balancing Work & Family Committee - Building Caring Communities - CPC’s - Grocery stores - R.M./Town Council - Rec. Boards - In Motion

- Primary Care Sites Needs Assessment and Community Development Programming

- MHO - PH Nutritionists - Comm. Dietician - Home Care - LTC- Food Services - Mental Health - Clinical Dietician

- church/service groups - Soc. Services - Activities Coordinator - Seniors Groups

- Dietitian

Progress Measures

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Active Communities – Work Plan Priority Issue: Goals:

ACTIVE COMMUNITIES 1. To increase opportunities for regular, enjoyable physical activity in communities, schools and workplaces. 2. To reduce the economic environmental, social and cultural barriers that limit participation in physical activity. 3. To create safe environments that support/encourage physical activity.

Over Arching Goal for Sunrise Health Region: Better promotion of health and disease prevention targeting provincial and regional priorities Health Region Objectives: 1. To partner with local agencies, municipalities and organizations to increase access to low cost, safe physical activity programming in workplaces, schools and communities by December 2007. Main Role(s) of Health Region in this Issue: Advocate and support enhanced opportunities and partnerships that support active living Work closely with In Motion coordinators in the Region to promote active living. Support the development of policy change relating to promotion of active communities, workplaces and schools throughout the Region. Key Activities (Indicate if the activities have a major effect on another priority issue too.) Create an inventory of the physical activity programming offered in Sunrise Health Region in schools, workplaces and communities.

Implementation Steps

Survey local fitness facilities regarding programming. Contact local recreation/sports associations Distribute the survey, collect, and analyze the information Identify potential gaps/demographic groups to target programming and services.

Timelines

September 2004

Partnerships Internal to Regional Health Authority Community Health Educator Director of Primary Care Director of Therapies Health Promotion Manager Mental Health ServicesChild and Youth Community Program Coordinators

Resource Requirements

Progress Measures

External Metis Nation Region II In Motion activators Canadian Diabetes Association Local Municipalities Recreation Assoc. Sports Council Businesses involved in the promotion of physical activity.

Mail distribution of survey provided in kind through SHR

Development of inventory of the programs promoting physical activity in schools, workplaces and communities.

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Active Communities – Work Plan Key Activities (Indicate if the activities have a major effect on another priority issue too.) Work with identified schools in the Health Region to support their ability to ensure health benefiting physical activity levels in their schools

Market benefits of physical activity in workplaces.

Implementation Steps

Timelines

Secure human resources to provide local schools with opportunities to enhance access to nutritious food choices and increased physical activity opportunities.

October 2005

Incorporate the Stairway to Health Signage in appropriate venues.

Ongoing

Use Workplace Wellness newsletter to promote physical activity to selected worksites Market physical activity using the Workplace Wellness Newsletter

Develop electronic health newsletter to distribute to local businesses in the region

November

*Develop a media marketing campaign for chronic disease prevention including the benefits of being physically active. Designate Sunrise Health Region as an In Motion Workplace

Development, implementation and evaluation of the campaign

January 2005

Work with the Healthy Workplace Committee and In Motion to develop a policy promoting physical activity in the workplace

September 2004

Partnerships Internal to Regional Health Authority Health Promotion Manager Community Health Educator Public Health Nurses MHO Director of Primary Care

Resource Requirements

Progress Measures

External Representatives from Learning Principals School Boards Parent Advisory Community School Coordinators/ School Plus Coordinators

Population Health Facilitator in School

Community Health Educator Yorkton Regional Health Centre Staff and visitors Kuziak building employees and visitors

Local businesses Senior Facilities

Signage provided in kind

Community Health Educator Public Health Nutrition Therapies Department Mental Health Pharmacy Community Health Educator Director of Communications Health Promotion Manager Medical Health Officer Community Health Educator Workplace Wellness Committee Sunrise Employees

Local Chamber of Commerce and businesses

Development of quarterly newsletter

Number of businesses requesting the newsletter

Media Local Businesses and agencies

Advertising $5000 (Diabetes Plan)

Number of messages marketed

In Motion Coordinator

Securing human resource to work with schools and public health to develop programs/policies using the Guidelines for Nutrition in schools Number of businesses involved in the program

Sunrise Health Region will be designated as In Motion

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Active Communities – Work Plan Key Activities (Indicate if the activities have a major effect on another priority issue too.) Partner with the Leisure Services, Schools, recreation directors, In Motion and others to establish a community walk.

Support the development and sustainability of low cost safe physical activity programming in a minimum of three communities.

Implementation Steps

Timelines

Organize and promotion and implementation of the Community Walk

June 2005

Identify barriers to participation in physical activity in the Health Region through a community consultation process.

Ongoing

Work with local authorities to identify strategies to enhance physical activity in these communities. Continue to support the On the Move Program- Girls and Women Stepping Out Program Step Up to Health - evaluate pilot and identify future of program

Partnerships Internal to Regional Health Authority Community Health Educator

Community Health Educator Health Promotion Manager Therapies Primary Care Community Program Coordinators

Resource Requirements

Progress Measures

External City of Yorkton Leisure Services In Motion activators in the region Community Program Coordinators Schools Canadian Diabetes Association Take Off Pounds Sensibly Leisure Services Zone 4 Sports Council In Motion Coordinator Municipalities City Planners Recreation Coordinator Other interested community groups

Promotional material Designated pathways for walking Volunteers for coordination of the events Exercise Coordinator Program Coordinators

Number of participants in each community

Number of local cost programs available. Number of community consultations held. Development of new programming/incr eased number of participants reporting daily physical activity.

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Resources A variety of health region staff have committed their time, expertise and energy to the development of this strategy. Equally our community partners have made significant commitments. As the strategy evolves, it may be necessary to re-allocate time and resources to a particular issue in order to implement the strategies identified in this document. The Health Promotion Tracking Exercise carried out in the Region from January 1, 2004 to June 30, 2004 will be analyzed in the future. Following this analysis the Region will be more capable of identifying the specific resources which will be committed for the development of this strategy, including the re-alignment of services. Saskatchewan Health has provided funding for this fiscal year to support the development of the strategy. These funds have been used to support education on population health promotion and to provide mileage for those who travel to be part of the Steering Group or Working Groups. Funding has been allocated from the Diabetes Plan (Primary Prevention) resources to support a new position for a Population Health Facilitator to work in schools in the region to promote good nutrition and physical activity. The Southeast Regional Intersectoral Committee has agreed to provide funding to support food nutrition policy development in schools. In motion offers community grants through application to the Recreation Associations to build and implement strategies to increase participation in physical activity. Saskatchewan Health will provide a regional workshop/training event based on our identified needs prior to the end of March, 2005. An integrated approach to health promotion is needed. In the coming months, plans for training, skill development and other areas will be undertaken both within our region and with our community partners.

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Supporting Long Term Change The Sunrise Health Region will continue to engage and work with community partners for the purpose of promoting health and well being of the residents of the Region. As communities become more involved in the various priority areas, support for long term change will be enhanced. The development of the strategy to this phase has enhanced the ability of health care providers to work closely with community members/organizations using a population health approach. This capacity to work collaboratively will be enhanced by having a common vision and goals. Policy changes supported by the work being done in this strategy will have the opportunity to improve health in the long term. By enhancing our capacity to work in a population health approach, we will be able to utilize these skills and abilities in other issue areas as well.

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Achieving Our Goals and Objectives The evaluation plan/progress measures for the strategy continue to be developed. Support will be needed from Saskatchewan Health to develop evaluation capacity in this area, in particular, relating to our ability to evaluate resilience, connectedness and citizenship of communities. Appropriate evaluation tools will be used. Each of the Working Groups will be asked to report on their progress measures to the Steering Group who will then share the information with the Sunrise Health Region Board.

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References 1. A Systemic Approach to Food Security: A Role for Public Health http://www.opha.on.ca/ppres/2002-01_pp.pdf., 2002 2. Community Food Security: A Role for Public Health and Health Promoters, Ontario Health Promotion, E-Mail Bulletin 370.1, July 16, 2004 3. Resources on Community Food Security: A Role for Public Health and Health Promoters, Ontario Health Promotion E-Mail Bulletin 370.2, July 16, 2004 4. Food Security Tool Kit, PHNSWG, 1998 5. Health Region Food & Nutrition Policy document, PHNSWG, revised 2002 6. Nutrition in Saskatchewan Schools; Policy, Practice and Needs Dr. S. Berenbaum, Heart & Stroke Foundation of SK, April 2004 7. School Food Policy document, Saskatchewan School Board Association, 2004 8. Building Communities of Hope, Saskatchewan Learning, Revised 2004 9. Breastfeeding Committee for Canada website, www.breastfeedingcanada.ca 10. The Baby Friendly™ Initiative in Community Health Services: A Canadian Implementation Guide. Breastfeeding Committee for Canada, 2002 11. Breastfeeding Committee for SK strategic plan, 2004 12. Saskatchewan Breastfeeding Implementation Committee Strategic plan, 2004 13. The Growing Burden of Heart Disease and Stroke in Canada, Heart and Stroke Foundation, 2003. 14. Evergreen Action Newsletter: Lessons Learned Planning and Implementing Nutrition Education for Seniors using a Community Organization Approach. Journal of Nutrition for the Elderly Vo l:21 (4) 2002 15. Nutrition Guidelines for Senior Citizens http://www.seniors-site.com/nutrition/guidelines.html 16. Saskatchewan Provincial Policy Framework and Action Plan for Older Persons. Saskatchewan Advisory Committee of Older Persons. May 2003 17. Bringing Nutrition Screening to Seniors. Executive Summary, Dietitians of Canada and Prof. Heather Keller, University of Guelph, August 2003.

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References (Continued) 18. Healthier Places to Live, Work and Play: A Population Health Promotion Strategy for Canada.. Saskatchewan Health May 2004 19. Improving the Health of Canadians. Canadian Institute for Health Information. 2004 20. Overweight and Obesity in Canada: A Population Health Perspective. Canadian Institute for Health Information August, 2004. 21. Mental Health is our Collective Wealth: A Discussion Paper by Ron Labonte. SPHERU. August 2003. 22. Workplace Prevention and Promotion Strategies: A Discussion Paper. Healthcare Papers Vol.5 No.2 23. Guide to Community Preventive Services. http://www.thecommunityguide.org 24. Sunrise Health Region Health Status Report. 25. In motion http://www.saskatchewaninmotion.ca/ 26. A Framework for Support: 3rd Edition. Canadian Mental Health Association. 27. Statistics Canada (2003) 28. The Regina and Area Drug Strategy Report. June 2003 29. The Business Case for Active Living at Work- Health Canada http://www.hc-sc.gc.cs/hppb/fitness.work/main_a_e.html

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Sunrise Health Region, Youth Wellness Survey, 2004.