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MPHA 5F11 Hospice Palliative Care Ontario (HPCO) Project Coordinator -…

- - - - Management of all programs required utilizing a population health approach to guide goals. Population health approach is an approach to health that aims to improve the health of the entire population and to reduce health inequities among population groups. We learnt this approach in MPHA 5P01 and management of the programs at HPCO required taking a population rather than an individual orientation.
        
        A final reflection of my practicum and our focus on population health aligns with the concept of pragmatism touched upon in MPHA 5P04. This approach to public health focuses more on what is needed rather than what is possible. Managing these programs and targeting community needs allowed me to focus on the practical and achievable rather than focusing on improving each individual health.
  - - - The second part of the program is support. We identified that community belonging heavily influences health. We learnt this same information from MPHA 5P09 and how feelings of belonging relates to an individual's social environment. The concept of social environment is also evident in lessons learnt from MPHA 5P04 and really ties back into the project's main goal of addressing older adult's lack of social connections and increased social isolation
    - - The first part of the program we deliver is education. We provide valuable information to our participants to enable them to get, understand and use basic health information to make decisions. This is related to the concept of health literacy that was emphasized during MPHA 5P08. The program we deliver increases the health literacy of the population. A specific program we offer involves advance care planning and is founded on preparedness for future emergency which is also related to MPHA 5P08 that stresses the importance of preparedness to reduce the impact of problems in the future
    - - Due to Covid-19 and lockdown measures, all programs are held virtually. This nontraditional method of communication has been effective in making up for gaps introduced by this pandemic. MPHA 5P15 acknowledged that technology and electronic mediums have been infiltrating how health services and programs are being conducted. Our virtual program is a perfect example of this new innovative way of delivering public health services. MPHA 5P04 also focused on how technology can be used in numerous ways to improve, promote and monitor health. That is exactly what our delivered programs are doing.
      - Social media is another emerging and rapidly changing technology that lends itself to key areas of public health, particularly those that involve the sharing of information, such as improving health literacy. These are concepts from MPHA 5P04, MPHA 5P15 and MPHA 5P08 that are applicable to my project because we use social media platforms to facilitate a few of our programs
  - - - Developed a health promotion program for people with a serious illness. Before developing these programs, we conducted an assessment of the population and identified that a health concern exists, and is exacerbated by the global pandemic. As part of MPHA 5P08 emergency preparedness, we discussed the importance of Core Competencies for Public Health. An important competency is the ability to conduct assessments and analysis to identify that a health concern exists.
        
        This preliminary assessment and subsequent analysis led to the innovation of digitized health promotion. Innovation and the use of electronic means to facilitate health delivery was a key lesson in MPHA 5P15. Health promotion is also a key component of public health as it impacts health behaviour. This was a lesson we learnt in MPHA 5P04 and was incorporated into the type of program we chose to develop
    - - Collaboration
        
        Stakeholder collaboration: During program development, we identified people with lived experiences to contribute their perspectives to the topics. MHA 5P09 discusses incorporation of people with lived experience into the design, implementation, and evaluation stages of program/intervention development. We also worked with social workers to receive feedback on the program we were developing. This collaboration can also be linked to MPHA 5P01.
        
        The decision to collaborate with different stakeholders yielded very positive results for our programs. By collaborating we were able to discover a shared interest in helping communities impacted by Covid-19. As I learnt in MPHA 5P04, collaboration identifies shared interests that make consensus between partners possible. Collaboration also increased the number of participants that had access to our programs. Increased access tackled one of the barriers mentioned in MPHA 5P09 that further perpetuates health inequities.
        
        Developing this program required collaboration and partnerships from different stakeholders. MPHA 5P01 highlights the link between collaboration and quality improvement. As we worked to improve the quality of current programs, we were collaborating with other partners to also improve the quality of our new programs.
      - Research
        
        As the programs were being developed, the focus was shifted to identifying root causes of identified problems. This strategy was inspired by the upstream approach learned in MPHA 5P09 that incorporates preventative rather than reactive measures to health. HPCO acknowledges the impact that social isolation has on older adults. The upstream approach allowed us to identify that the root cause of this social isolation was lack of catered programs for older adults especially with the increased isolation caused by Covid-19 and decreased in-person interaction.
        
        Further, research identified social isolation as a social determinant of health (SDOH). Since the coronavirus pandemic hit and lockdown measures increased, social isolation has impacted individual mental health and wellbeing and has been branded as a social determinant of health. Both MPHA 5P09 and MPHA 5P04 advocate for the consideration of SDOH when addressing public health concerns and developing interventions
        
        We are also developing interventions aimed at tailoring each program for underserved communities: As learnt in MPHA 5P04, it is imperative to consider racial/ethnic disparities when addressing the needs of the population. Adjusting each program to make it relevant to a specific group addresses these external factors that impact health as learnt in MPHA 5P09. The key messages from both classes on this topic is that reducing disparities helps with improving health outcomes, which is the goal of this strategy.
        
        MPHA 5P06 encouraged students to critically evaluate the connects and disconnects between theory, policy, and practice. I noticed a connect between theory and practice as the work we did at HPCO was the result of evidence informed theories about the impact of disparities on health. This led to the development of special programs aimed at tackling this disparity and connecting theory into practice
        
        Unfortunately, the same disconnect and gaps/limitations that we discussed in MPHA5P06 was evident in the discussion about palliative care. While theory and literature advocate for the application of palliative care in public health, we see that there is only interest at the federal public health level than at the local and provincial level. This creates a gap from theory to practice and impacts the development of effective policy. Ideas & strategies to address this problem is under my project 4 branch (side project).
        
        In MPHA 5P04, we discovered that efforts to address SDOH involved advocacy, public education, and intersectoral collaboration. My project incorporates all the above as we are advocating for more programs for this group and other target audiences under the VCC. Our programs are a mix of education and support so we are contributing to education of the public. We are also partnered with coalition partners, hospices, LTC homes to achieve this goal of addressing social isolation and other SDOH.
        
        MPHA 5P04 indicates that there should be a focus on sustaining efforts over time. Efforts include assessing community needs and resources, addressing social determinants of health, engaging stakeholders, and improving population health. This aligns with the programs we are facilitating and developing. By addressing social determinants of health in the education and support groups, we are setting the foundation for improved health outcomes that continues even after the programs come to an end. HPCO also pledges to provide programs under the compassionate communities initiative, as long as needs exist to maintain results
        
        Before developing the program, research had to be conducted to identify evidence-informed topics that are relevant to individuals with a serious illness. This tasks was completed through the use of skills gained in MPHA 5P03. The process of critically appraising available sources to identify the most reliable, valid, and relevant information was thoroughly examined during the epidemiology class. This allowed me to carefully and systematically assess the outcomes of available evidence to judge its trustworthiness, value and relevance in the context of a serious illness program.
        
        After conducting research, we were tasked with translating it into practice. In MPHA 5P06 we acknowledged that while theory and research were beneficial, it was very important to connect it to policy and practice. Gaps between the research and practice needed to be identified and addressed in order to see results.
      - Evaluation
        
        Goal: evaluate the success of the program through participant feedback. Methods of data collection taught in MPHA 5P03 was utilized. Participants were also interviewed using skills developed during MPHA 5P02 qualitative interviewing assignments.
        
        During the program evaluation, we wanted to make sure that the programs we facilitated did not do more harm than good so we added a criteria for intended and unintended outcomes. This relates to the realist methodology learnt in MPHA 5P01 that highlights the importance of context and considering intended & unintended consequences and outcomes
        
        We incorporated qualitative data analysis into our evaluation strategy. This type of analysis was taught during MPHA 5P02 and MPHA 5P03. The data that was collected was thoroughly analyzed through data analytic techniques learnt in MPHA 5P15. The resulting analysis was appropriately interpreted to inform the development of the new programs. Data interpretation was covered in MPHA 5P15 while the application of the interpretation into practice was touched upon during MPHA 5P03
- - - - The result of this project is the development of a KT product. KT product as we learnt in MPHA 5P02 are the best way to disseminate information to a variety of audiences. We were able to create a resource page that can be accessed by our 5 target audiences.
- - - - Part of our task is to develop strategic ways to build a collaborative partnership between palliative care providers and local public health agencies. The theme of collaboration from MPHA 5P01 appears again.
      - Strategies that we have brainstormed so far include raising awareness of the benefits of palliative care to population health. Keeping population health as the main focus is a key concept we learned in MPHA 5P01
- - - - Collaboration, Quality Improvement, Communication, Digital innovation, Population health approach, Data Analysis, Public education, Social determinants of health, reducing health inequities, Qualitative methodology, improving health outcomes and KT products. These themes collectively underpin the basis of public health. Classes such as MPHA 5P01, MPHA 5P02, MPHA 5P03, MPHA 5P04, MPHA 5P06, MPHA 5P08, and MPHA 5P15 highlighted the importance and relevance of these themes to the field of public health