Academic journal article Canadian Journal of Public Health

Heart Health Promotion: Predisposition, Capacity and Implementation in Ontario Public Health Units, 1994-96

Academic journal article Canadian Journal of Public Health

Heart Health Promotion: Predisposition, Capacity and Implementation in Ontario Public Health Units, 1994-96

Article excerpt

ABSTRACT

The Canadian Heart Health InitiativeOntario Project (CHHIOP) investigates predisposition and capacity in Ontario public health departments to implement community-based heart health promotion activities. The research draws upon diffusion of innovations theory and recent work on ecological approaches to health promotion within which public health agencies are seen to play a central role. Mail-back surveys were completed by heart health staff in all 42 health departments in 1994 and 1996. Predisposition and capacity were measured as the importance and effectiveness ascribed to 18 organizational practices supportive of community heart health activities. Level of implementation was reported for 74 activities spanning a range of risk factors and settings. Predisposition, capacity and implementation scores increased between 1994 and 1996. The findings confirm positive correlations between predisposition and capacity and between capacity and implementation.

ABREGE

L'Initiative canadienne de sante du coeur Projet ontarien (ICSCPO) examine la predisposition et la capacite des services ontariens de sant6 publique a mettre en oeuvre des activites communautaires liees a la promotion de la santd du coeur. Les travaux de recherche s'inspirent de la theorie sur la difusion des innovations et de recents travaux effectues sur les approches ecologiques de la promotion de la sante, domaines oil l'on considere que les organismes de sante publique jouent un role central. En 1994 et 1996, des personnes travaillant dans le domaine de la sante du coeur et representant 42 services de sante ditW*rents ont rempli des enquetes par courrier-reponse. La pr6disposition et la capacite ont ete mesurees au titre de l'importance et de l'efficacite conferees a 18 pratiques organisationnelles qui soutenaient des activites liees a la sante du coeur. Le niveau de mise en oeuvre a fait l'objet d'un compte-rendu dans le cadre de 74 activites diverses representant des facteurs de risque et des milieux differents. Les notes attribuces a la predisposition, la capacite et la mise en oeuvre se sont ameliortes entre 1994 et 1996. Les resultats confirment l'existence de correlations positives entre, d'une part, la predisposition et la capacite et, d'autre part, la capacite et la mise en oeuvre.

Previous papers in this journal have described the Canadian Heart Health Initiative (CHHI)' and the Ontario Project (CHHIOP),2 the first provincial project within the dissemination phase of the CHHI. This paper describes results from surveys conducted in all 42 public health departments in Ontario in 1994 and again in 1996. They reveal changes in the implementation of heart health promotion activities in Ontario communities over the two-year period and associated changes in the predisposition and capacity of health units related to heart health. They extend the findings reported in a previous paper based on the 1994 survey.3

The rationale for the research is found in diffusion of innovations theory4 and recent papers which propose an ecological approach to health promotion5-7 whereby improvements in population health are seen to depend on changes in the environments which both promote and sustain health-related behaviour.8 Modelled after Orlandi et al.9 and Green and Kreuter,lo the ecological framework for CHHIOP3 proposes a system which links the national and international heart health community with target populations. The role of public health organizations is particularly important given their political mandate and their mediating function between individuals and their environment.' Following Green and Kreuter" and Rogers,4 organizational effectiveness is linked to their predisposition and capacity, where predisposition refers to collective motivation for action; and capacity is related to the skills and resources of the organization to take action. A major focus of CHHIOP is on the relations between predisposition and capacity of health departments and implementation of heart health activities in Ontario communities (Figure 1). …

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