c8 how do we move collaboration upstream?_vanessa parlette

June 5, 2014 Prevent More to Treat Less

How Do We Move Collaboration Upstream? Building Strategies Together

Disclosure of Commercial Support

CFPC Conflict of Interest

Presenter Disclosure Presenter: Vanessa Parlette, Phd Project Manager, City of Hamilton PHS Jennifer Vickers-Manzin, RN MEd Program Manager, City of Hamilton PHS Keyna Bracken, MD Assistant Professor, McMaster University Physician Director, Maternity Centre of Hamilton Relationships with commercial interests: • Grants/Research Support: None • Speakers Bureau/Honoraria: None • Consulting Fees: None • Other: None

Outline

Low Birth Weight in Hamilton Taking Action as a Community Collaborating Upstream

Motivation: Low Birth Weight in Hamilton “Of the 20 neighbourhoods in Ontario with the worst rates of low birth weight babies, three of them are in the former City of Hamilton”

• Hamilton’s citywide LBW rate: 6.5% • Canada LBW rate: 6.2% • Ontario LBW rate: 6.6% • Code Red: Inner city neighbourhoods

see rates above 7.1%, seven above 10%

• Complex SDoH, lower SES, high inequity

LBW Risk Factors • Low Income • Smoking • Stress • Mom Age <20 or >35 • Poor Nutrition • Drugs; Alcohol • Low Education • Fetal Growth Restriction LBW Impacts • Higher costs and risk at

birth • Risk of long-term

chronic health problems • Impaired brain and

physical development

Determinants of Health and Low Birth Weight

Social Disadvantage

Strengthening Our Community by Supporting Healthy Lives and Healthy Relationships for Moms, Babies, and Neighbourhoods

Taking Action as a Community: The Healthy Birth Weights Coalition

Public Health and Primary Care PHS and Maternity Centre of Hamilton, moving in

together One-stop hub of care and services Integration of perinatal supports Collaboration with PHS, Family Health Teams,

Hospitals, Community Organizations, and School Boards

FSA LBW Low Income

Smoking during preg.

<20 Smoking during preg.

Age <20 No Prenatal in 1st Tri (1st time moms)

No prenatal classes (1st time moms)

L8M 8.6 24.5 27.3 32.4 12.3 9.5 74.7

L8L 7.9 28.6 35.5 33.3 12.1 12.1 71.7

L8K 7.6 14.7 20.4 48.2 6.7 6.5 70.9

L8H 7.6 21.3 29.5 37 8.1 9.6 63.2

L8N 7.2 33.7 29.2 44.4 8.7 9.9 74.7

City 6.5 14.0 16.7 40.1 4.8 6.3 63.2

LOR 5.6 4.0 7.4 28.6 … 3.7 49.2

L8T 5.1 10.3 17.3 16.5 … 6.2 59.7

L8S 4.9 19.2 15.5 14.1 … 6.2 59.7

Local Data

Target Priorities

3 Priority Strategies

1. Care Pathway for Young Parents

2. Professional Education

3. Smoking Cessation Supports

Smoking Cessation

Best Possible

Care

Teen Pregnancy Prevention

Care Pathway

Prof Ed

Improve Collaboration

Strengthen System

Target Risk: Smoking, Teen Pregnancy, Education and Supports

LBW

Reduce LBW Risk

Structure of Coalition and Work Groups

Current State of Collaborative Impact Broad base of local multi-sector partners Supportive local context Strategic City Initiative Media attention on SDOH LHIN Priorities; Health Links

Collaborative strategic priorities Shared goals

High potential to impact local system and experience of

care

Barriers to Moving Upstream Leadership changes Complexity Code Red Stigma “Too many tables” –competing priorities Funding models Upstream initiatives less measurable Federal and provincial austerity

Think Tank

What actions and strategies can we take to break past those barriers and move collaboration upstream?

• Leveraging Partnerships

• Overcoming system and institutional barriers

• Models of collaboration

Let’s Talk

Vanessa.parlette@hamilton.ca Jennifer.vickers-manzin@hamilton.ca bracken@mcmaster.ca