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BRITISH COLUMBIA: Provincial Health Services Authority – The Healthy Built Environment Alliance is a hub of knowledge exchange across BC

“Our Land Use Planning for Health Professionals workshop has opened the door for a health voice.”

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Lead Organization:
Provincial Health Services Authority

Key Partners:
Regional Health Authority, Local and Provincial Government, Planning, Transportation, Recreation, Sport, Tourism, First Nations, Academic Institutions and Community Organizations

Communities:
Cranbrook, Kamloops, Kelowna, Prince George, Sechelt, Vancouver, Langley, Victoria

Setting:
Urban and rural

Target Group:
Health Professionals

Project Focus:
Knowledge Translation, Networking

Implementation Level:
Provincial

Stage of Development:
Ongoing

Background

This initiative grew out of a Provincial Forum on Health and the Built Environment hosted by the Provincial Health Services Authority (PHSA) in 2007. At the forum, participants asked for more opportunities to network. Three months later, the BC Healthy Built Environment Alliance was born. Approximately twenty-two organizations attended the first meeting representing an impressive range of sectors: Health, Government, Planning, Transportation, Recreation, Sport, Tourism, Academic Institutions, First Nations, and Community Organizations. The Alliance now has 26+ organizational/agency representatives and many more corresponding members.

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With PHSA providing secretariat support, the Alliance meets a minimum of three times a year. The group’s objectives include providing a forum for knowledge sharing, and participating and collaborating on the development of priority activities.

Cover page for Introduction to Land Use Planning For Health Professionals

“Introduction to Land Use Planning for Health Professionals” – commonly referred to as “Planning 101” – was one of the first projects identified as a priority by the Alliance. The intent was to develop a training module that would build a common language between planning and health, and begin to provide health professionals with some of the knowledge and tools to become more involved in land use planning. A curriculum was developed and in June 2008 a pilot workshop was launched in the City of Cranbrook in the Interior Health Authority. The workshop took the form of a day-long continuing education course facilitated by two professional planners. Presentations were made, resources provided, and a case study example undertaken.

The nineteen health professionals who attended also took part in a post-workshop evaluation led by a master’s student at Simon Fraser University. Participants gave high ratings to the workshop, and also provided constructive feedback. The evaluation process allowed PHSA to make changes to the module before offering it to the other four health authorities.

Other major activities of the Alliance have included the creation of Healthy Built Environment Indicators, a Conference Presentation, and a Foundations Paper on Health and the Built Environment (please see the Resources section at the end of this case study for more information). Projects have been spearheaded by PHSA with both in-kind and financial support from several partners at the Alliance table.

Partnerships

Recruiting Alliance partners was done mainly via word of mouth. PHSA fields ongoing requests from organizations wanting to join the Alliance or receive updates on their activities. At their most recent meeting, the Alliance decided to go on hiatus for a brief period of time – members identified the need to work with and evaluate the many resources that were developed during the first year. Many of the individual members needed time to debrief with their home organizations about next steps, particularly regarding how to increase the awareness, profile and priority of this work.

One challenge faced by the Alliance is that membership is still heavily weighted towards the health side. In an effort to bridge the gap between sectors, if/when the Alliance resumes, PHSA will be investigating the possibility of co-chairing the Alliance with another organization. It may also be possible that another member organization “picks up the baton” and assumes the secretariat role. Overall, the Alliance has been quite successful at forging relationships with the planning sector. There has been less success in connecting with engineers, architects and developers, and members are continuing to explore ways to get these groups to the table. Options include identifying the value-added for these groups if they were to participate (e.g., pursuing an environmentally-friendly agenda often aligns with building healthier communities).

Generating Buy-In

At the end of its first year, the Alliance undertook a self-evaluation. It was recognized that while individual members of the Alliance were definitely on board with the issues, and placed high priority on addressing them, they only represented a “slice” of their organization. There were often varying levels of support amongst both senior leadership and front-line staff at the partner organizations. To help encourage support from a larger and broader audience, PHSA is creating a four page informational piece summarizing the innovative work undertaken by the Alliance over the past year. This brochure will be used by Alliance members to increase knowledge about the subject of the healthy built environment and its importance and relevance, to make people aware of the resources that are available, and to obtain endorsement and support from existing and potential new organizations.

Lessons Learned

The Planning 101 workshops in particular have cemented the understanding that health professionals have valuable contributions to make at the planning table. Health professionals can bring a depth of understanding about the determinants of health, and also understand the urgency of addressing the built environment to avoid significant increases in an already alarming rate of chronic disease.

The Planning 101 workshop was launched with significantly large goals in mind. After the first pilot workshop in Cranbrook, these goals had to be revisited; it is now seen as a “Phase 1” or a first step – recognizing that follow-up work and support will be required. In some cases, simple but unanticipated spin-offs resulted. It was apparent right away that in many cases, the people attending the workshops, often from different cities, and from different parts of the organization, were meeting each other for the first time. The simple value inherent in bringing these regional health professionals together for networking was an unanticipated benefit. Another spin-off identified at one of the workshops was the potential creation of a Regional Health Authority “Who’s Who” – a list of health professionals that local planners could contact for input and recommendations. As it stands now, whether and how this contact occurs often depends on individual personalities and relationships (i.e. who knows who), which hampers consistency and sustainability.

In addition to further work with the health sector, another next step will be getting the message out to planners and elected officials. It is recognized, however, that this will likely need to employ a different approach than that used for “Planning 101.” It will be important to explore the needs of these two groups so that any knowledge translation tools and mechanisms that are developed are appropriate. It will also be important to identify which organizations, in addition to those in the health sector, need to be key partners in these knowledge translation efforts. It is also recognized that there need to be more opportunities for joint professional development events with planners and health professionals to ignite more inter-disciplinary conversations.

Many of the Regional Health Authorities are already carrying forward the torch and building new partnerships with the planning sector. For example, Northern Health is building a relationship with Smart Growth BC, and the Vancouver Island Health Authority will be partnering with the BC Recreation and Parks Association to host a regional Summit on active transportation.

Advice to Other Communities

The Planning 101 workshop can be applied at almost any scale. Since the initial pilot workshop in Cranbrook, the training module has been adapted to large urban centres and small communities. Adaptations to the workshops are being made in many ways - from using local examples, to including planners as both presenters and participants, to having local senior management from the health sector give introductions. All of this has required a lot of planning and preparation time, but has been invaluable for improving the success of the events.

While the workshop evaluations have yet to be completed, many lessons have already been learned. Whether taking place in an urban or rural community, you need to set the stage. At the pilot workshop, facilitators realized the importance of having senior leaders from within the Health Authority present at the workshop to signal that it is a priority. At subsequent workshops, local health champions (e.g., Medical Health Officers) were present to describe the link between health and the built environment, rather than leaving it up to the facilitator.

Other advice for communities wanting to conduct a workshop includes:

  • Know who your audience is and what they need;
  • Build ownership into the workshop;
  • Demonstrate ways in which the work can be incorporated into what health professionals are already doing – not as an “extra workload”;
  • Create a Regional Health Authority “Who’s Who”;
  • Use local examples/case studies in any hands-on or small group activities; and
  • Situate the workshop within a longer-range plan that identifies how the work can be sustainable.

Evaluation and Impact

Now that Planning 101 sessions have recently been completed in all five Health Authorities, PHSA will host a debrief with representatives from each region to discuss the learnings and talk about possible short and long-range next steps. It will be important to identify the appropriate roles that the Health Authorities, PHSA and other Alliance members can play in moving this work forward - it needs to be a collaborative effort, approached on many fronts and at many levels.

The student who was hired to evaluate the Cranbrook pilot project will be completing another post-workshop follow-up to see how health professionals are implementing the skills they learned seven months earlier.

It became evident at the workshops that many health professionals are already on board and are ready for a formal input mechanism into the planning process. For others, the idea of integrating into planning processes is new. All eight workshops completed to-date have shown a wide range of players and buy-in. For many, however, this work has opened the door for a health voice, and has demonstrated how health professionals’ knowledge and skills can be leveraged as community planning functions occur.

Contact

Tannis Cheadle
Provincial Manager, Population & Public Health Initiatives, PHSA
700 - 1380 Burrard St.
Vancouver, BC V6Z 2H3
Telephone: 604-675-7421
E-mail: tcheadle@phsa.ca

Resources

Visit the PHSA Population Health webpageExternal Link to download the Paper, Foundations for a Healthier Built Environment (2009); Introduction to Land Use Planning for Health Professionals; and other resources.

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