Health Promotion and Disease Prevention

Since 2009, Dr. Ruta Valaitis has been a Deputy Director, World health Organization (WHO) Collaborating Centre (McMaster University, Hamilton, Ontario) for Primary Care and Health Human Resources. Dr. Valaitis was elected Secretary to the Pan American Nursing and Midwifery Collaborating Centres Network (PANNMCC) and served in that role from 2011 to 2013.

A PAHO/WHO Collaborating Center is an institution designated by the Director General to form part of an international network that develops activities in support of the programs of the World Health Organization. Currently the Region of the Americas has 18 Collaborating Centers in Nursing and Midwifery.  Our Collaborating Centre was recently redesignated (see http://fhs.mcmaster.ca/globalhealthoffice/McMaster_redesignated_paho_who_collaborating_centre.html) 

PANMCC/WHO :

Collaborating Centres

Research Funding:

More Information:

• WHO Collaborating Centre for Primary Care and Health Human Resources

The McMaster University School of Nursing (SON) is dedicated to improving the health of residents in our local communities and fulfilling the School’s mission of community engaged scholarship.

To that end, in 2011 the School launched Health in the Hubs, an ongoing partnership between the SON and the local community planning teams (LPTs) from three Hamilton neighbourhoods: Crown Point, McQuesten, and South Sherman. The LPTs are made up of residents, service providers, places of worship, institutions and local businesses from each neighbourhood hub. A hub brings organizations, businesses and citizens in a community together.

Past Lead: Currently a Team Member :

Semogas D., Rolfe, S., Derbyshire, D., Murray, N., Penner, S., Slotiuk, C., Habib, N., Valaitis, R., Wahoush, O., Harrington, M.

Research Funding:

More Information:

• Website
• Health in the Hubs Phase 1 Report
• Health in the Hubs Think Tank

WHO Collaborating Centers are designated by the Director-General, WHO, as part of an inter-institutional collaborative network of centers worldwide. They are established to provide concrete activities at the national, regional, and global levels, in support of the strategic plans of specific WHO areas of work.

All WHO Collaborating Centers in the Region of the Americas are known as PAHO/WHO Collaborating Centers since the Pan American Health Organization also serves as a WHO regional office.  Currently there are over 180 Centers in 15 countries in the Americas.

Lead:

Valaitis, R.

Research Funding:

More Information:

• PAHO Advanced Practice Nursing Webinar Series 2016 English with Spanish translation
• PAHO Website

EU-GENIE is an online tool that volunteers can use with clients. It can help them describe their support network and can link them to relevant local community resources that are tailored to the interests of the client.

EU-GENIE is a UK-developed, evidence-based online intervention aimed to support self-management for adults living with long-term health and social conditions. It was adapted for use in Canada. It is currently being tested in a sub-group of TAPESTRY clients who are enroled in Health Links. Study Objectives include: 1.      To assess the usability, acceptability, and normalization of the EU-GENIE tool in a primary care environment that is used by providers, clients and volunteers. 2.      To explore if and how EU-GENIE can function as a collaborative practice tool to improve providers’ and clients’ understanding of personal support networks, as well as linkages among primary care team members and between primary care and community-based health and social services (team-based care), within the context of Health TAPESTRY and Health Links programs. 3.      To explore if and how clients perceive the use of EU-GENIE as a tool to support attainment of their health and life goals. 4.      To explore how the size, composition and function of clients’ social networks support attainment of self-identified health goals.    Our Canadian adatped version of EU-GENIE was presented at the EU-WISE Conference, Southhampton, England. November 23, 2015. (http://eu-wise.com/wp-content/uploads/2012/12/EU-WISE-Conference-Southampton-9-R.-Valaitis-21-Nov.pdf) 

Lead:

Ruta Valaitis, Cathy Risdon, Jenny Ploeg, Anita Kothari, Lisa Dolovich, Laura Cleghorn, Anne Kennedy, Anne Rogers, Ivo Vassilev, Dale Guenter, and James Gillett

Research Funding:

• Exploring the Use of Personal Network Mapping as a Component of the TAPESTRY Program

More Information:

• Website
• Conference

The purpose of this study was to describe trends in the number, types, and themes of infant feeding messages presented in a nationally distributed (monthly) Canadian women's magazine from 1945 to 1995.

Content analysis was used, with one researcher photocopying and coding all relevant items. The sample (n = 1082) included all messages related to infant feeding appearing in the magazine. Messages were coded according to sources (e.g., advertisement, article) and themes. Bandura's Social Cognitive Theory was used to explore their relationship with infant feeding behavior. Data were analyzed using frequencies and averages and presented graphically.The majority (n = 666,62%) of messages were advertisements. There were only 32 infant feeding articles (3%); the remaining 384 items (35%) were portions of articles or editorial and health columns. The total number of messages declined over time. Trends in message themes (favoring breastfeeding, neutral, favoring bottle feeding) and in the number of advertisements were roughly comparable to breastfeeding initiation rates.These media messages may have been influencing behavior or merely reflecting societal values; further analyses of print media nutrition messages can provide insight into these relationships. Dietitians and nutritionists should consider using the popular media as a vehicle for nutrition education.

Co-author:

Potter, B., Sheeshka, J., Valaitis, R.

Students:

1. Beth Potter

Research Funding:

More Information:

• Publication

The objective of this study is to evaluate the implementation and effectiveness of the Health Teams Advancing Patient Experience: Strengthening Quality (Health TAPESTRY) approach in older adults.

In our program, trained volunteers visit people where they live . In these visits, they learn about what matters most to that person and their health. They also learn more about a person’s health needs. The stories people tell our volunteers are recorded and sent to their health care team using special technology. This helps the team learn more about that person’s life, health needs, goals and how they can better work together to achieve goals and meet needs.

Co-author:

Dolovich, L., Oliver, D., Lamarche, L., Agarwal, G., Carr, T., Chan, D., Cleghorn, L., Griffith, L., Javadi, D., Kastner, M., Longaphy, J., Mangin, D., Richardson, J., Papaioannou, A., Ploeg, J., Raina, P., Risdon, C., Santaguida, P.L., Straus, S., Thabane, L., Valaitis, R., Price, D.

Research Funding:

• TAPESTRY: Teams Advancing Patient Experience: Strengthening Quality

More Information:

• Publication
• Health Tapestry Website

This systematic review investigated the relationship between early childhood caries (ECC) and breastfeeding.

The systematic review methodology used by the Cochrane Collaboration was modified and adopted for this review. 28 of 151 articles (18.5%) were relevant for the study and were rated as strong (0), moderate (3), weak (9) or very weak (16). Validity scores indicated whether a study met the reviewer's criteria for research rigour. The percentage of studies that received a passing score for each criterion examined were: study design (3.6%), confounders (21%), data collection method (54%), definition of ECC (57%), dental health practices (28%) and infant feeding practices (4%). A lack of methodological consistency related to the study of the association of breastfeeding and ECC, and inconsistent definitions of ECC and breastfeeding, make it difficult to draw conclusions. Moderate articles indicate that breastfeeding for over one year and at night beyond eruption of teeth may be associated with ECC. Due to conflicting findings in less rigorous research studies, no definitive time at which an infant should be weaned was determined, and parents should begin an early and consistent mouth care regime.

First Author :

Valaitis, R., Hesch, R., Passarelli, C., Sheehan, D., Sinton, J.

Research Funding:

More Information:

• Publication

A technical report commissioned by the Canadian Nurses Association, 1-116, 2014. This report summarizes the issues and policy options and will inform CNA’s future role and strategies for advancing a pan-Canadian primary care framework that optimizes the role of registered nurses (RNs) and advanced practice nurses in primary care interprofessional teams.

Research, practice, education and policy information and input from key stakeholders relevant to nursing roles in the delivery of primary care services from national, provincial and territorial perspectives were synthesized to provide policy guidance and actionable recommendations. The key components of this project included a scoping literature review and key informant interviews with nurses and other stakeholders.

Co-author:

Martin-Misener R, Bryant-Lukosius D, Bullard C, Campbell D, Carter N, Donald F, Kilpatrick K, McKinlay J, Parks C, Sherifali D, Tranmer, J, Valaitis, R. Viscardi V., Yuille L.P.

Research Funding:

• Advancing a pan-Canadian primary care framework: optimizing the role of Registered Nurses and Nurse Practitioners.

More Information:

• Final Report

In 2010 -2015, Dr. Ruta Valaitis became an Affiliate Network Member, Primary Health Care System (PHCS).

The lead for the Primary Health Care System (PHCS) Network was the Dr. Moira Stewart, University of Western Ontario.

Primary Health Care System :

Primary Health Care System (PHCS) Network

Research Funding:

More Information:

• System Integration & Innovation Research Network

This report describes an environmental scan that was completed in May 2009 of primary care and public health in the province of British Columbia (BC) as one of a series of steps in a larger program of research: Strengthening Primary Health Care through Primary Care and Public Health Collaboration Study (Strengthening PHC Study).

It is one of three scans being completed for provincial health care systems, which include: British Columbia, Ontario and Nova Scotia. The purpose of the environmental scans is to provide current information about the provincial context of primary care and public health that may be contributing, either positively or negatively, towards integration and collaboration between these two health sectors. Vancouver: Centre for Health Services and Policy Research, University of British Columbia. ISBN 978-0-88865-879-1. 

Co-author:

Wong, S.T., MacDonald, M., Valaitis, R.K., Kaczorowski, J. Munroe, V., Blatherwick, J.

Research Funding:

• Building Primary Health Care Nursing Leadership to Enhance Collaboration between Primary Health Care and Public Health

More Information:

• Report

This report describes an environmental scan that was completed in July 2009 of primary care and public health in the province of Nova Scotia (NS) as one of a series of steps in a larger program of research: Strengthening Primary Health Care through Primary Care and Public Health Collaboration Study (Strengthening PHC Study).

It is one of three scans being completed of provincial health care systems; the others are British Columbia and Ontario. The purpose of the environmental scans is to provide current information about the provincial context of primary care and public health that may be contributing, either positively or negatively, towards integration and collaboration between these two health sectors. Halifax, NS: School of Nursing, Dalhousie University. ISBN PDF: 978-0-7703-1887-1. 

Co-author:

Meagher-Stewart, D., Martin-Misener, R., Valaitis, R.K.

Research Funding:

More Information:

• Report

This report describes an environmental scan, which includes information up to May 2009, related to primary care (PC) and public health (PH) in the province of Ontario (ON). It is one of a series of steps in a larger program of research entitled: Strengthening Primary Health Care through Primary Care and Public Health Collaboration Study (Strengthening PHC Study).

This is also one of a series of three scans being completed for provincial health care systems, including those of British Columbia, Ontario and Nova Scotia. The purpose of the environmental scans is to provide current information about the provincial context of PC and PH that may be contributing, either positively or negatively, towards integration and collaboration between these two health sectors. Hamilton: School of Nursing, McMaster University. ISBN PDF 978-1-894088-19-0. 

First Author:

Valaitis, R.K., Ehrlich, A., O’Mara, L.M, Brauer, P.M.

Research Funding:

More Information:

• Report

The aim of this toolkit is to develop knowledge, skills, and attitudes that support the development and maintenance of successful collaborations between primary care and public health. This toolkit is for practitioners, managers, policy makers, and students from a variety of disciplines working in primary care and public health.

This toolkit was developed based on results from a 4-1/2 year program of research supported by the Canadian Health Services Research Foundation completed in 2012. It was developed with multiple co-authors including Francophone and Aboriginal communities. It was officially launched in July 2016.

Lead:

Valaitis, R., Murray, N., Brauer, P., Green, M., MacDonald, M., Martin-Misener, R., Meagher-Stewart, D., O'Mara, l., Savage, R., Wong, S., Gendron, S.

Research Funding:

More Information:

• Website

Few studies to date have explored the relationship between the built environment and physical activity specifically in rural settings. This paper is the result of a Masters thesis project that focused on rural health units' activities to address the built environment aimed at improving physical activity.

The Ontario Public Health Standards policies mandate that health units in Ontario address the built environment; however, it is unclear how public health practitioners are integrating the built environment into public health interventions aimed at improving physical activity in chronic disease prevention programs. Public health interventions, and their evaluations, are complex. Health units who serve large rural populations in Ontario are engaging in numerous activities to address physical activity levels. There is a need to further evaluate the impact of these interventions on population health.

Co-author:

Coghill, C.L., Valaitis, R.K., Eyles, J.D.

Students:

1. Cara-Lee Coghill

Research Funding:

More Information:

• Publication

Youth are often disenfranchised in their communities and may feel they have little voice. Since computers are an important aspect of youth culture, they may offer solutions to increasing youth participation in communities. This study involved public health nurses to support the school-based community development project.

This qualitative case study investigated the perceptions of 19 (predominantly female) inner-city school youth about their use of computers and the Internet in a school-based community development project. Overall, youth perceived computers and the Internet to be empowering tools, and they should be encouraged to use such technology to support them in community initiatives related to health promotion.

Author:

Valaitis, R.

Research Funding:

More Information:

• Publication

The purpose of this study was to conduct a scoping review of current practices and recommendations for designing, implementing, and evaluating mHealth technologies to support the management of chronic conditions in community-dwelling older adults.

There is limited yet increasing use of mHealth technologies in home health care for older adults. A user-centered, collaborative, interdisciplinary approach to enhance feasibility, acceptability, and usability of mHealth innovations is imperative. Creating teams with the required pools of expertise and insight regarding needs is critical. The cyclical, iterative process of developing mHealth innovations needs to be viewed as a whole with supportive theoretical frameworks. Many barriers to implementation and sustainability have limited the number of successful, evidence-based mHealth solutions beyond the pilot or feasibility stage. The science of implementation of mHealth technologies in home-based care for older adults and self-management of chronic conditions are important areas for further research. Additionally, changing needs as cohorts and technologies advance are important considerations. Lessons learned from the data and important implications for practice, policy, and research are discussed to inform the future development of innovations.

Co-author:

Matthew-Maich, N., Harris, L., Ploeg, J., Markle-Reid, M., Valaitis, R., Ibrahim, S., Gafni, A., & Isaacs, S.

Students:

1. Sandra Isaacs

Research Funding:

• Centre for Research in Community Interventions to Promote Optimal Aging at Home

More Information:

• Publication
• Ontario Ministry of Health and Long-Term Care, Health System Research Fund ($445,194)

This review sought to answer the question: what is the use, nature and impact of electronic support groups in the prevention and promotion of health?

The findings indicate that social support can be successfully provided via a computer-mediated communication medium to support a broad range of populations and health conditions.

First Author:

Valaitis, R. Ciliska, D.

Research Funding:

More Information:

• Website
• Report

Tailoring Online Health Promotion: A Toolkit for Communities has been produced to share our learning and experiences in working to build a health promotion web site (www.youthspark.ca) to meet local needs by and for rural youth in Huron County, Ontario Canada.

Our project included an evaluation component, which helped us identify factors that enabled and hindered the process of creating, maintaining and sustaining the project. This Toolkit contains a compilation of our learning as a result of the evaluation and is presented using a step-by-step approach from the initial stages of developing a vision for the project, implementation, marketing, evaluation and sustainability.

First Author:

Valaitis, R., O’Mara, L., Bezaire, S., Savage R.

Research Funding:

• SPARK Youth Website Initiative

More Information:

• Report
• Website

This study describes the effectiveness, feasibility and effects of a volunteer program evaluation framework in primary care.

<p><span style="color: #1c1d1e; font-family: 'Open Sans', icomoon, sans-serif; font-size: 16px; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-style: initial; text-decoration-color: initial; display: inline !important; float: none;">Volunteers support health and social care worldwide, yet there is little research on integrating these unpaid community members into primary care. ‘Health Teams Advancing Patient Experience, Strengthening Quality through Health Connectors for Diabetes Management’ (Health TAPESTRY‐HC‐DM) integrates volunteer ‘health connectors’ into a community‐ and primary care‐based program supporting client self‐management in Hamilton, Canada. Volunteers supported clients through goal setting, motivation, education and connections to community resources and primary care. This study aimed to create and apply a volunteer program evaluation framework to explore: (a) volunteer training effectiveness (learning online content, in‐person training, self‐efficacy in role tasks, training overall); (b) feasibility of program implementation (process measures, reflections on client encounters, understanding of volunteer roles/responsibilities, client perspectives on volunteer program); and (c) effects of volunteering on volunteers (health outcomes, self‐efficacy, value of volunteering). A concurrent triangulation, mixed‐methods design was used. Data were collected in 2016, sources included: volunteer online training quizzes, focus groups, self‐efficacy survey, Veterans RAND 12‐Item (VR‐12) survey, in‐person training feedback forms and narratives of client visits; client interviews; and quantitative implementation data. Quantitative data analysis included descriptive statistics, paired samples<span>&nbsp;</span></span><em style="box-sizing: border-box; color: #1c1d1e; font-family: 'Open Sans', icomoon, sans-serif; font-size: 16px; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-style: initial; text-decoration-color: initial;">t</em><span style="color: #1c1d1e; font-family: 'Open Sans', icomoon, sans-serif; font-size: 16px; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-style: initial; text-decoration-color: initial; display: inline !important; float: none;"><span>&nbsp;</span>tests, and effect size (Cohen's<span>&nbsp;</span></span><em style="box-sizing: border-box; color: #1c1d1e; font-family: 'Open Sans', icomoon, sans-serif; font-size: 16px; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-style: initial; text-decoration-color: initial;">d</em><span style="color: #1c1d1e; font-family: 'Open Sans', icomoon, sans-serif; font-size: 16px; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-style: initial; text-decoration-color: initial; display: inline !important; float: none;">). Qualitative data used descriptive thematic analysis. Nineteen volunteers and 12 clients participated in this evaluation. Findings demonstrate the volunteer program evaluation framework in action. Online training increased knowledge. In‐person training received largely positive evaluations. Self‐efficacy was high post‐training and higher after volunteering. VR‐12 sub‐scale means increased descriptively. Volunteers understood themselves as healthcare system connectors, feeling fulfilled with their contributions and learning new skills. They identified barriers including not having the resources and skills of healthcare professionals. Clients found volunteers were a major program strength, appreciating their company and regular goals follow‐up. Using a volunteer program evaluation framework generated rich and comprehensive data demonstrating the feasibility of bringing volunteers into primary care.</span></p>

https://onlinelibrary.wiley.com/doi/abs/10.1111/hs:

Lisa Dolovich, Jessica Gaber, Ruta Valaitis, Jenny PLoeg, Doug Oliver, Julie Richardson, Dee Mangin, Fiona Paeascandalo, & Gina Agarwal

Research Funding:

• TAPESTRY: Teams Advancing Patient Experience: Strengthening Quality

More Information:

• Link to paper

Social capital has shown potential for its ability to improve physical and mental health, although findings about social capital’s impact in rural areas have been less promising. The aim of this study was to shed light on how adults in two small towns of rural Ontario experience social capital in their daily lives, and to contribute to the broader literature about the relationship between social capital and rural health.

  The qualitative findings shed light on the experience of social capital and issues of accessing it from the perspective of adults in two rural communities. The social and structural context shaped individuals’ experiences in ways that benefited some community members while marginalizing others. Familiarity, friendliness, and supportive social norms suggest that the rural idyll is not all myth. Yet the structural context left youth and young adults, seniors without transportation, and low-income residents challenged with accessing social capital. Investing in programs and policies that target the structural context may have the greatest impact on rural social capital development and health promotion. The qualitative findings shed light on the experienc e of social capital and issues of accessing it from the perspective of adults in two rur al communities. The soci al and structural context shaped individuals’ experiences in ways that benefited some community members while marginalizing others . Familiarity, friendliness, and supportive social norms suggest that the rural idyll is not all myth. Yet the structural context left youth and young adults , seniors without transportation , and low - income residents challenged with accessing social capital . I nvest ing in programs and policies that target the structural context may have the greatest impact on rural social capital development and health promotion. The qualitative findings shed light on the experienc e of social capital and issues of accessing it from the perspective of adults in two rur al communities. The soci al and structural context shaped individuals’ experiences in ways that benefited some community members while marginalizing others . Familiarity, friendliness, and supportive social norms suggest that the rural idyll is not all myth. Yet the structural context left youth and young adults , seniors without transportation , and low - income residents challenged with accessing social capital . I nvest ing in programs and policies that target the structural context may have the greatest impact on rural social capital development and health promotion. The qualitative findings shed light on the experienc e of social capital and issues of accessing it from the perspective of adults in two rur al communities. The soci al and structural context shaped individuals’ experiences in ways that benefited some community members while marginalizing others . Familiarity, friendliness, and supportive social norms suggest that the rural idyll is not all myth. Yet the structural context left youth and young adults , seniors without transportation , and low - income residents challenged with accessing social capital . I nvest ing in programs and policies that target the structural context may have the greatest impact on rural social capital development and health prom eff of social capital and issues of accessing it from the perspective of adults in two rur al communities. The soci al and structural context shaped individuals’ experiences in ways that benefited some community members while marginalizing others . Familiarity, friendliness, and supportive social norms suggest that the rural idyll is not all myth. Yet the structural context left youth and young adults , seniors without transportation , and low - income residents challenged with accessing social capital . I nvest ing in programs and policies that target the structural context may have the greatest impact on rural social capital development and health promotion.

Senior Author:

Buck-McFadyen, E., Isaacs, S., Strachan, P., Akhtar-Danesh, N., Valaitis, R.

Students:

1. Ellen Buck-McFadyen

Research Funding:

More Information:

• Publication

Prepared by the Professional Education Working Group of the Canadian Immunization Committee, Public Health Agency of Canada. The aim of this handbook is to promote safe and competent practices to achieve higher vaccine coverage rates. This effort will enable and maintain the highest possible degree of community protection against vaccine-preventable diseases.

The competencies range from knowledge of the scientific basis of immunization to essential immunization practices and contextual issues relevant to immunization. Each competency is supported by a learning domain and a number of guiding learning objectives.

First Author:

Valaitis, R., Appleton, M., Cantin, L., Dumaresq, G., Duval, B., Farley, C., Gemmill, I., Grenier, D., Griffin, P., Halperin, B., Henteleff, A., Johnston, J., Law, B., Leeseberg Stamler, L., Loewen, J., Marra, F., Mayotte, S., McConnery, C., NcNeil, S., Millette, J., Page, L., Parker, J., et al.

Research Funding:

More Information:

• Report

Dr. Ruta Valaitis was an invited member of Ontario’s Ministry of Health and Long-term Care’s Primary Care Advisory Group providing advice on primary care reform for Ontario.

A report on behalf of the Primary Health Care Expert Advisory Committee was prepared on behalf by the Patient Care Groups presenting a new model of population based primary health care for Ontario, May 2015.

Patient Care Groups:

Price, D., Golden, B., Hannam, R.,

Research Funding:

More Information:

• A report on behalf of the Primary Health Care Expert Advisory Committee

During 2005 - 2006, Dr. Ruta Valaitis served as an invited member of the E-Health Steering Committee for the Hamilton Niagara Haldimand Brant Norfolk Local Health Integrated Network (LHIN 4).

This report, submitted by the e-Health Steering Committee, is the culmination of the efforts that started with the priority planning process in November 2004, where the development of an e-Health strategy was identified as one of the LHIN’s key prioritis to promote system integration. The development of our e-Health strategy was actively supported by providers; they have demonstrated a tremendous enthusiasm for e-Health, and they are already leading and participating in a number of related initiatives.  The purpose of the 2006 document The Hamilton Niagara Haldimand Brant Local Health Integration Network (HNHB LHIN) e-Health Strategic Plan was a directional document to guide the implementation of e-Health initiatives in the LHIN. It encompasses the vision for e-Health and strategies which the LHIN will pursue over the next decade. It also emphasizes the objectives and clear benefits of those strategies.

E-Health Strategic Plan 2006:

Hamilton Niagara Haldimand Norfolk LHIN

Research Funding:

More Information:

• HNHB LHIN E-Health Strategic Plan 2006

During 2006 - 2007, Dr. Ruta Valaitis served as an invited member of the Ministry of health and Long Term care (MOHLTC) Family Health Team (FHT) Action Group Sub-committee on Health Promotion and Disease Prevention (HPDP).

The discussion report ‘Enhancing Disease prevention and Health promotion in Ontario’s Family Health Teams: The Public Health/Primary Health Connection’ (May 2006) served to make practical recommendations based on a review of the literature, other information and practices regarding the integration of public health services into primary care settings.

MOHLTC Family Health Teams :

Perth District Health Unit

Research Funding:

More Information:

• Enhancing DPHP Ontario`s FHTs

Invited Working Group Member: Ontario’s Ministry of Health and Long-term Care Primary Health Care Planning Group: Working Group 2: Strengthening Primary Care Access. The report was completed August 2011.

The membership of the working group was diverse and reflective of the many stakeholders and jurisdictions involved in primary care access in Ontario. Experts were drawn from across the province of Ontario including healthcare practitioners, Aboriginal health experts, researchers, administrators and policymakers participated in the Improving Access in Primary Care Working Group.

Strengthening Primary Care Access:

Primary Health Care Working Group

Research Funding:

More Information:

• Strengthening Primary Care Access

Invited Member: Canadian Nurses Association (CNA) Reference Group on Primary Health Care (2011-2014)

Primary Health Care Summit was held January 25-26 2012 in Ottawa and was hosted by the Canadian Nurses Association and the Canadian Medical Association. A summary of the event was prepared in a brief report.  

Primary Health Care Summit Report: January 2012:

Canadian Nurses Association and the Canadian Medical Association

Research Funding:

More Information:

• Primary Health Care Summit: Report

From 2006 - 2009, Dr. Ruta Valaits was a member of the Working Group: Public Health Agency of Canada (PHAC): Professional Education Working Group- Vaccine Prevention

The Immunization Competenices for Health Professionals was prepared by the Professional Education Working Group of the Canadian Immunization Committee. Approved by the Communicable Disease Control Expert Group and the Pan-Canadian Public Health Network Published by the Public Health Agency of Canada Centre for Immunization and Respiratory Infectious Diseases November 2008

Professional Education Working Group (PHAC):

Public Health Agency of Canada

Research Funding:

More Information:

• Immunization Competencies fro Health Professionals 2008

The aim of this study was to determine the association between modifiable factors and life-space mobility in older adults enrolled in the Canadian Longitudinal Study on Aging (CLSA).

Background: The most common methods for measuring mobility in older adulthood include performance-based tests, such as the Timed-Up-and-Go and gait speed. While these measures have strong predictive validity for adverse outcomes, they are limited to assessing what older adults do in standardized settings, rather than what they do in their daily life. Life-space mobility, which is the ability to move within environments that expand from one's home to the greater community, has been proposed as a more comprehensive measure of mobility. The aim of this study was to determine the association between modifiable factors and life-space mobility in older adults enrolled in the Canadian Longitudinal Study on Aging (CLSA). Methods: Life-space mobility was measured using the Life Space Index (LSI). Explanatory factors included physical, psychosocial and cognitive determinants, as well as pain, fatigue, driving status, nutrition, body mass index, smoking status, and vision. To estimate the association between the LSI and explanatory variables, univariate and multivariable ordinary least squares regression analyses were performed. Results: All adults 65 years and older (n = 12,646) were included in the analysis. Fifty percent were women and the mean age was 73.0 (SD5.7). The mean LSI score was 80.5, indicating that, on average, the sample was able to move outside of their neighborhood independently. All explanatory variables were significantly associated with the LSI except for balance and memory. The top 3 variables that explained the most variation in the LSI were driving, social support and walking speed. Conclusion: To our knowledge, this was the first study to examine the association between life-space mobility and a comprehensive set of modifiable factors that were selected based on a theoretical framework and existing research evidence. This study had two important messages. First, driving, social support and walking speed emerged as the most significant correlates of life-space mobility in older adults. Second, life-space mobility is multifactorial and interventions that are pragmatic in their design and testing are needed that consider the complexity involved. A multi-disciplinary approach to examining life-space mobility in older adults is needed to optimize opportunities for healthy aging and develop strategies that support mobility in older adulthood.

Co-Author:

A Kuspinar, C P Verschoor, M K Beauchamp, J Dushoff, J Ma, E Amster, C Bassim, V Dal Bello-Haas, M A Gregory, J E Harris, L Letts, S E Neil-Sztramko, J Richardson, R Valaitis, B Vrkljan

Research Funding:

More Information:

• Link to article

The Internet is an innovative strategy to increase public participation. It is important to include pregnant and parenting teens' perspectives when planning programs to meet their needs. This qualitative study explored online discussions as a strategy to enhance participation by this population.

Findings showed that online communication was preferred over face-to-face group discussions. Being anonymous online encouraged open and honest feedback. Participants experienced various forms of social support, however, there was an overall lack of teen involvement online. Strategies to engage adolescents in online discussions and reduce barriers are discussed. Strategies included the use of teen moderators, home computer access, technical support, and engagement in naturally flowing online discussions to meet social support needs. Blending researchers' with teens' needs for social support in an online environment is encouraged. With careful planning and design, online communications can result in mutual benefits for researchers, service providers, and pregnant and parenting adolescents.

First Author:

Valaitis R., Sword, W.

Research Funding:

More Information:

• Publication

A report on behalf of the Primary Health Care Expert Advisory Committee. In late 2013 the Ministry of Health and Long-Term Care (the “ministry”) convened the Expert Advisory Committee on Strengthening Primary Health Care in Ontario to address current challenges in Ontario’s primary care system. The ministry identified four policy questions of particular interest which are addressed in this report, May 2015.

In response, the Committee has proposed a vision for an integrated primary health care system for Ontario, based on a redesign of the province’s existing primary care sector. The foundation of the redesign is a population-based model of integrated primary health care delivery, designed around Patient Care Groups (PCGs); which are fund-holding organizations that are accountable to the ministry through the Local Health Integration Networks (LHINs).

Expert Advisory Committee Member:

David Price, Elizabeth Baker, Brian Golden, and Rosemary Hannam

Research Funding:

More Information:

• Report

Report to the WHO, Series Number 16, March 2009. Primary health care (PHC) is a philosophy and an educational practice approach. Nursing is one of the key services for the delivery of PHC. The purpose of this background paper is to examine PHC education for nurses in the globalized world.

A case study approach is used to provide information about PHC education. The paper will define and describe PHC, nursing education in Canada and curriculum development. Challenges will be discussed and a policy framework will be provided. In addition, recommendations specific to PHC nursing education will be made.

Co-author:

Baumann, A., Valaitis, R., Kaba, A.

Research Funding:

More Information:

• Report

The goal of the Aging, Community and Health Research Unit (ACHRU) is to promote optimal aging at home for older adults with multimorbidity (≥2 chronic conditions) and to support their family/friend caregivers. This protocol paper reports the rationale and plan for this patient-oriented, cross-jurisdictional research program.

BACKGROUND: The goal of the Aging, Community and Health Research Unit (ACHRU) is to promote optimal aging at home for older adults with multimorbidity (≥2 chronic conditions) and to support their family/friend caregivers. This protocol paper reports the rationale and plan for this patient-oriented, cross-jurisdictional research program. OBJECTIVES: The objectives of the ACHRU research program are (i) to codesign integrated and person-centered interventions with older adults, family/friend caregivers, and providers; (ii) to examine the feasibility of newly designed interventions; (iii) to determine the intervention effectiveness on Triple Aim outcomes: health, patient/caregiver experience, and cost; (iv) to examine intervention context and implementation barriers and facilitators; (v) to use diverse integrated knowledge translation (IKT) strategies to engage knowledge users to support scalability and sustainability of effective interventions; and (vi) to build patient-oriented research capacity. DESIGN: The research program was informed by the Knowledge-to-Action Framework and the Complexity Model. Six individual studies were conceptualized as integrated pieces of work. The results of the three initial descriptive studies will inform and be followed by three pragmatic randomized controlled trials. IKT and capacity building activities will be embedded in all six studies and tailored to the unique focus of each study. CONCLUSIONS: This research program will inform the development of effective and scalable person-centered interventions that are sustainable through interagency and intersectoral partnerships with community-based agencies, policy makers, and other health and social service agencies. Implementation of these interventions has the potential to transform health-care services and systems and improve the quality of life for older adults with multimorbidity and their caregivers.

Co-author:

Markle-Reid, M., Ploeg, J., Valaitis, R., Duggleby, W., Fisher, K., Fraser, K., Ganann, R., Griffith, L., Gruneir, A., McAiney, C., and Williams, A. for the Aging, Community and Health Research Unit Team

Research Funding:

More Information:

• Link to paper

The Ontario Ministry of Health Promotion’s (MHP) goal is to improve the health and well-being of Ontarians and to help contribute to the sustainability of our publicly funded health care system. MHP is moving forward to achieve its vision of “healthy communities working together and Ontarians leading healthy and active lives.” MHP will achieve this vision by focusing on several core goals and priorities including the Smoke-Free Ontario Strategy.

Tobacco use continues to be a major public health issue in Ontario, The secretariat team for the Smoke-Free Ontario Scientific Advisory Committee (SFO-SAC) has joined Public Health Ontario (PHO). The SFO-SAC brings together scientific experts in the tobacco control field from Ontario and around the world to provide scientific and technical advice to the Ministry of Health Promotion on the renewal of the Smoke-Free Ontario Strategy.

Scientific Committee Working Group:

Public Health Ontario Smoke-Free Ontario Scientific Committee Working Group

Research Funding:

More Information:

• Public Health Ontario Smoke Free Documents
• Final SFO-SAC report

This paper reports on the quantitative phase of a sequential explanatory mixed methods study using data from Canada's 2013 General Social Survey (data collected 2013–14) to explore mechanisms that link social capital and health..

The concept of social capital shows great promise for its potential to influence individual and population health. Yet challenges persist in defining and measuring social capital, and little is known about the mechanisms that link social capital and health. This paper reports on the quantitative phase of a sequential explanatory mixed methods study using data from Canada's 2013 General Social Survey (data collected 2013–14). An exploratory factor analysis revealed six underlying dimensions of social capital for 7,187 adults living in Ontario, Canada. These factors included trust in people, neighbourhood social capital, trust in institutions, sense of belonging, civic engagement, and social network size. A logistic regression indicated that having high Trust in People and Trust in Institutions were associated with better mental health while high Trust in Institutions, Sense of Belonging, and Civic Engagement were associated with better physical health. When comparing rural and urban residents, there were no differences in their self‐reported health, nor did social capital influence their health any differently, despite rural residents having higher social capital scores. The study findings are important for understanding the nature of social capital and how it influences health, and provide direction for targeted health promotion strategies.

Senior Author:

Elen Buck McFayden, Akhtar‐Danesh Sandy Isaacs Beverly Leipert Patricia Strachan and Ruta Valaitis

Students:

1. Ellen Buck-McFadyen

Research Funding:

More Information:

• Link to Paper

This was a CD-ROM program designed to teach community health nursing students and other professionals about the process of community action. It focused on the principles of primary health care, community assessment and community development. Child pedestrian injury prevention was the main issue addressed in this programme

This was a joint project of the Faculty of Health Sciences, McMaster University and the Hamilton-Wentworth Social and Public Health Services Division, a Teaching Health Unit affiliated with McMaster University and the University of Guelph.  It was presented at the 2nd Annual Conference on Community Health Nursing Research at Heriot Watt University, Edinburgh, Scotland, United Kingdom. The CD-ROM was distributed internationally by the Canadian Public Health Association for a over 5 years. 

Lead:

Valaitis, R., Chambers, L., Cole, D., Ehrlich, A., O'Mara, L., and VanBerkel, C.

Research Funding:

More Information:

• Website

This article describes the development, implementation, and evaluation of an interdisciplinary undergraduate course embedded within a campus–community partnership initiative involving McMaster University School of Nursing, and three urban priority neighborhoods in Hamilton, Ontario, Canada. The experiential course focuses on building knowledge and skills in community participation and community improvements for health and continues to be offered today. This primary health care collaboration between the campus and three Hamilton neighbourhoods was led by Dr. Valaitis and supported by the Health in the Hubs team.

Students worked together with community residents and faculty to address selected priority community issues identified by neighborhood members. Using the qualitative interpretive description method, the evaluation explored different partners’ (students, community residents, and faculty) perceptions of the course (SWOT analysis: strengths, weaknesses, opportunities, and threats, as well as outcomes) as a community engagement and knowledge exchange intervention. Results provide lessons learned and recommendations for future campus–community engaged courses that can be transferred to similar contexts.

First Author:

Ruta Valaitis,Olive Wahoush, Nancy Murray, Sandy Isaacs, David Derbyshire, Dyanne Semogas, and Steven Rolfe

Research Funding:

• Street Smarts Book Smarts: Evaluation of a Knowledge Exchange Intervention (Health in the Hub Phase 2)

More Information:

• Publication

Final Report to Canadian Health Services Research Foundation (CHSRF), 2012. ISBN 978-1-927565-02-5.

First Author:

Valaitis, R., MacDonald, M., Martin-Misener, R., Meagher-Stewart, D., O’Mara, L., Wong, S., Akhtar-Danesh, N., Baumann, A., Brauer, P., Burge, F., Green, M., Kaczorowski, J., Savage, R., & the Strengthening Primary Health Care through Public Health and Primary Care Collaboration Team.

Students:

1. Sandra Isaacs
2. Jennifer Nicholl
3. Sally Binks
4. Dr. Judy Burgess

Research Funding:

• Building Primary Health Care Nursing Leadership to Enhance Collaboration between Primary Health Care and Public Health

More Information:

• Link to final report
• Link to program of research website

Tailoring Online Health Promotion: A Toolkit for Communities has been produced to share our learning and experiences in working to build a health promotion web site (www.youthspark.ca) to meet local needs by and for rural youth in Huron County, Ontario Canada. The Toolkit is loosely organized according to the phases of project development that we experienced in the YouthSpark project.

Our project included an evaluation component, which helped us identify factors that enabled and hindered the process of creating, maintaining and sustaining the project. This Toolkit contains a compilation of our learning as a result of the evaluation and is presented using a step-by-step approach from the initial stages of developing a vision for the project, implementation, marketing, evaluation and sustainability. We used a participatory approach with our work with youth, which is reflected throughout this Toolkit. We believe this approach is essential for any successful youth-centred program.

First Author:

Ruta Valaitis, Linda O'Mara, Sherri Bezaire,Erica Horbaniuk,Brian Gould

Research Funding:

More Information:

• Tailoring Online Health Promotion Toolkit

Tailoring Online Health Promotion: A Toolkit for Communities: This toolkit was produced based on our experience and evaluation of working with public health staff and youth in a rural community to build a health promotion website for youth by youth.

This Toolkit contains a compilation of our learning as a result of the evaluation and is presented using a step-by-step approach from the initial stages of developing a vision for the project, implementation, marketing, evaluation and sustainability.

Lead:

Ruta Valaitis, Linda O'Mara, Sherri Bezaire, Erica Horbaniuk, and Brian Gould

Research Funding:

• SPARK Youth Website Initiative

More Information:

• Tailoring Online Health Promotion: A Toolkit for Communities

Tailoring Online Health Promotion: A Toolkit for Communities has been produced to share our learning and experiences in working to build a health promotion web site (www.youthspark.ca) to meet local needs by and for rural youth in Huron County, Ontario Canada. The Toolkit is loosely organized according to the phases of project development that we experienced in the YouthSpark project.

Our project included an evaluation component, which helped us identify factors that enabled and hindered the process of creating, maintaining and sustaining the project. This Toolkit contains a compilation of our learning as a result of the evaluation and is presented using a step-by-step approach from the initial stages of developing a vision for the project, implementation, marketing, evaluation and sustainability. We used a participatory approach with our work with youth, which is reflected throughout this Toolkit. We believe this approach is essential for any successful youth-centred program. Produced by Huron Country Health Unit and McMaster University, School of Nursing. http://fhs.mcmaster.ca/OHPToolkit/index.html. 

First Author:

Valaitis, R., O’Mara, L., Bezaire, S.

Research Funding:

• SPARK Youth Website Initiative

More Information:

• Website

A technical report commissioned by the Public Health Agency of Canada to inform the 2014 Chief Public Health Officer’s (CPHO) Report on the State of Public Health in Canada.

First Author:

Valaitis, R. K., Hunter, D., Lam, A., Murray, N., Spark, R. & Valaitis R. F.

Students:

1. Danielle Hunter
2. Rebecca Spark

Research Funding:

• Literature Review: In What Ways and How Effectively is Technology Being Used to Support Health Behaviour Change

More Information:

• A technical report commissioned by the Public Health Agency of Canada

This two-part field study compared researchers’ recorded observations to mothers’ perceptions of attention they received while publicly breastfeeding.

In part 1, four breastfeeding and four bottle-feeding mothers each made eight restaurant visits. On average, there were more neutral looks from customers (P = .01) during breastfeeding visits, but no differences in the amount of overtly negative or positive attention given during breastfeeding versus bottle feeding. In part 2, four breastfeeding mothers made a total of 24 visits to shopping malls. There were more neutral looks given while mothers were breastfeeding and more smiles and comments while they were not feeding, but no difference in total amount of attention received. Breastfeeding mothers acknowledged they had anticipated some undesirable attention but instead received little attention. Nevertheless, they felt “vulnerable” nursing in public. Certain proactive behaviors and personal attributes as well as support from other women enabled them to breastfeed successfully in public.

Co-Author:

Sheeshka, J., Potter, B., Norrie, E., Valaitis, R., Adams, G., Kuczynski, L.

Students:

1. Beth Potter

Research Funding:

More Information:

• Publication