THE OPEN GATE

Office: 74 Kingston ST.,

Goderich, ON N7A 3K4

Mailing Address:

Box 1181 Seaforth, ON, N0K 1W0,

519-612-1053

www.gatewayruralhealth.ca

Opioid Education Partnership

Prescription drug misuse is a significant public health and safety concern that can have devastating effects on indi-viduals, families and entire communities. In 2013, an Ontario survey reported that one in eight youths are using a prescription opioid drug for non-medical purposes. On May 15th, 2015, at the Prescribing Practices Forum in Ham-ilton, Ontario, Minister of Health, Rona Ambrose announced the Government’s commitment to fighting prescription drug misuse. Health Canada, under the Anti-Drug Strategy Initiative, provided funding of $720, 330 (2015-2017) to the University of Waterloo, School of Pharmacy for an interdisciplinary initiative to reduce prescription opioid mis-use. This involved the development and implementation of a collaborative, web-based education program to target physicians, pharmacists, students and trainees that focuses on applying evidence-based opioid management guidelines. Two of Gateway’s Board Members, Dr. Feng Chang, Chair of Rural Pharmacy and Dr. Agnes Kluz, Chair of Rural Senior Wellness, along with their team will led this project. Dr. Chang and Dr. Kluz travelled to Van-couver to attend the Canadian Pain Society 2016 scientific meeting and promote the pilot phase of the educational program “Opiod Educational Partnership” for physicians and pharmacists.

Spring 2017

FACTORS INFLUENCING RURAL COMMUNITY PHARMACISTS’ WILLINGNESS

TO PROVIDE METHADONE MAINTENANCE TREATMENT SERVICES

Opioids are commonly used pain medications. In recent years, opioid misuse/abuse has been declared a public health crisis across North America. A 2012 report from Huron and Perth stakeholders noted that access to addic-tions treatment was severely limited, by inadequate funding, unmet transportation needs, and community disap-proval of addictions. Methadone maintenance treatment (MMT) service is one of the best treatment options for people suffering from opioid addiction. Community pharmacists can choose whether or not they want to provide this service for patients. In Huron and Perth counties, very few pharmacists have chosen to offer this service, con-tributing to the gap in local treatment options. This study aimed to identify community pharmacists’ perceived moti-vations and barriers to offering MMT services in the area. Data was collected through semi-structured interviews with community pharmacists from across Huron and Perth counties. By doing this, it is possible to present strongly supported arguments for changes to current addictions treatment in rural Ontario at a policy, financial, and health systems level. More importantly, this type of research gives rural stakeholders a voice in the academic literature, ensuring that rural communities are represented in health service discussions locally and provincially. This project has been a collaboration between Gateway and the University of Waterloo School of Pharmacy. Joseph Fonseca is a local student from Seaforth, currently attending Queen’s University. Joe has worked with Gateway and UW for the last two summers. His supervisor, Dr. Chang, is Gateway’s Chair, a clinical pharmacist at the Huron Family Health Team, and an Assistant Professor at the University of Waterloo School of Pharmacy.

Caregiver Support Training Workshops launched this past summer in Grey and Bruce County as part of the Rural Women’s Health Support Initiative (RWHSI). The first was on May 4th in Owen Sound and the second on May 5th at Lamlash Hall, outside of Elmwood. The two workshops in Bruce County were on June 1st in Ripley and June 2nd in Tara. Sheila Schuehlein, experienced caregiver and trained health-coach facilitated the workshops, alongside Andrea Morrison, program & communications manager for the Federated Women’s Institutes of Ontario. Gateway research student Elisabeth Miltenburg also attended to record notes and provide input for program development. The morning session focused on caregiver resources that are available in this area to help support caregivers. This featured a presentation on how to navigate the Southwest health line. The afternoon session was aimed at those interested in volunteering with the program. Participants developed health-coaching skills and helped inform program development. Many participants at these workshops recognized that being a caregiver is hard, and there is little to no training on how to do this role. By using a “neighbours helping neighbours” approach, the RHWSI will connect caregivers to a volunteer that has caregiving experience. This initiative will launch mid June. Caregivers will be able to call in to a toll-free line to set up a phone session with a program volunteer. These sessions will help connect the caregiver to resources to support them in their role. In turn, this initiative will help reduce and prevent the adverse health effects of caregiver burnout.

In 2014, Gateway Centre of Excellence in Rural Health (Gateway) partnered with Alexandra Marine and General Hospital (AM&GH) in Goderich to develop this unique volunteer facilitated self-management support program aimed at reducing falls for Goderich residents, specifically those without access to a primary healthcare provider. The volunteer team has received more than twenty hours of education related to fall prevention best practice, health coaching skills and local community support services through the South West Healthline. In fall 2015, the South West LHIN’s Assess and Restore Project provided additional funding. Interested participants are encouraged to call 519-524-8689 ext. 5717 to arrange for a fall risk assessment, no referral needed. Eligible participants can request a volunteer in-home visit which includes a Get Up and Go assessment, nutrition screening and a Home Safety checklist. Participants will create a personal action plan with their volunteer ‘coach’, who will also provide follow-up and support to help the participant achieve their self-directed goal(s) for fall prevention. The program recently received funding to implement the program through to March 2017. The Peer Health Support Program will be accepting clients for home visits to start in September. If you are interested in participating in the Peer Health Support Program, please contact (519) 524-8689 ext. 5717. For more information, please visit: http://www.gatewayruralhealth.ca/peer-health-support-falls-prevention-program.html

Rural Women’s Health Support Initiative (RWHSI) Update

www.gatewayruralhealth.ca

Spring 2017

Peer Health Support Program Update

Huron County Healthy Rural Policy Lens

Originally developed as a collaboration between Sustainable Huron and Dr. Wayne Caldwell, the Huron County Healthy Rural Lens is a tool that can be used to help policy makers create programs, services and policies that do not adversely affect the well being of the Huron County community. As with any lens, it helps the user gain perspective of their situation. In the case of the Healthy Rural Lens, it will help minimize unintended consequences and maximize positive outcomes. Using the lens for your project is as simple as completing a one-page worksheet, that asks you to consider the target population, transportation needs, the natural environment, energy conservation, the economy and agriculture among many other facets of rural life. By rating each of these facets on a scale from positive-neutral-negative, the user creates a visual representation of how their policy or program will impact our county. In the end, a completed Rural Lens worksheet will give you something like the image to the right.

A policy with largely positive impact will have a large circle, or a wide -open lens. Conversely, a policy with negative impact will have a small circle, or closed lens. This helps the decision makers evaluate their policy in the context of rural life, and ultimately helps improve our community. Gateway recently received funding from the Rural Ontario Institute and Sustainable Huron to evaluate the use of this tool in Huron County. The lens was developed and launched in 2014, and our evaluation of the tool will focus on how well it has been used by policy makers, and spreading awareness of the tool throughout the county. The Huron County Healthy Rural Lens can be easily adapted to other rural communities, or potentially even non-rural communities given the right circumstances. You can read more about the Rural Lens on our project page of our website.

Gateway Summer Volunteer

Two students that joined us late in the summer of 2016 missed appearing in our summer newsletter. Alexis Willbee joined Gateway for a highschool co-op placement and was instrumental in organizing the Hometown Heroes Hockey Game fundraiser (page 4), as well as assisting at the Grand Sparks summer camp (page 5). Craig Perkes lent his artistic skills to Gateway’s mission and created some artwork that will be featured in upcoming Gateway projects. Thank you to all our summer students for the incredible work that you have done!

www.gatewayruralhealth.ca

Spring 2017

Hometown Heroes: Raise a Little Health 2016

Www.gatewayruralhealth.ca

Spring 2017

On Thursday July 21st, 2016, Gateway Centre of Excellence in Rural Health, the Alexandra Marine and General Hospital and the Goderich-Huron YMCA hosted the 3rd annual Hometown Heroes “Raise a Little Health” charity hockey game at the Maitland-Recreation Centre located in Goderich. The hockey game featured local NHL players, including Boyd Devereaux, Ryan O’Reilly, Cal O’Reilly, and Dave McLlwain; local doctors, including Dr. Paul Gill and Dr. Dan Noel; and, local Huron-Bruce M.P. Ben Lobb. The event was a great success this year as we were able to raise over $40,000, while all attendees thoroughly enjoyed themselves! The funds raised were split evenly between the Alexandra Marine & General Hospital, Gateway Centre of Excellence in Rural Health and the Goderich-Huron YMCA’s Strong Kids Foundation. The money will be used to help these local organizations improve the health of our community.

Rural Talks 2 Rural Conference

In September, the Canadian Centre for Rural Creativity hosted the first Rural Talks to Rural conference in Blyth, Ontario. The confer-ence aimed to gather people from around the county and outside our borders who share an interest in rural . In this respect, the confer-ence was a huge success, seeing speakers and attendees from far and wide. Stories of success, and challenges were shared to help add tools to the toolbox and make our rural communities stronger. Three speakers representing Gateway were heard at the conference: Gwen Devereaux talked on a panel about Rural Health and Well Be-ing; Sheila Schuehlein informed the group about her Huron County Rural Lens & Peer Health Support programs; Dr Wayne Caldwell talked about the importance of Storytelling and Innovation. The audi-ence was made up of academics, politicians, local leaders, entrepre-neurs, farmers, artists, community groups, and rural citizens. The ideas shared were definitely inspiring, and created a strong founda-tion for future rural conferences hosted by CCRC. Plans are already in motion for 2017.

Jay McFarlan, Gateway’s Vice-President and Research Chair of Rural Nutrition and Exercise, was in charge of operating Grand Sparks, an activity camp for grandparents and grandchildren. The camp was held this year between July 4th and July 8th. The goal of Grand Sparks was to promote activity among grandparents by having them interact with their grandchildren through outdoor activities. Campers participated in canoeing, yoga, adventure hiking, climbing high ropes, obstacle courses and various other fun activities.

Along with promoting healthy activity, Grand Sparks also taught participants important nutritional facts about functional food, accompanied by freshly cooked lunches. Everyday, grandparents and grandchildren would be given the supplies to cook their own lunches as a means for additional bonding time.

Grand Sparks participants also aided in crucial rural health research. The primary research question: What motivates people to get active and stay active? Many people will start an exercise program with good intentions, but often lose interest or motivation to sustain that activity over time. We are curious whether a program like Grand Sparks, that focuses on building relationships through a shared activity, is a more sustainable exercise program. Grand Sparks will request follow-up surveys of all adult participants at 1-month and 6-months after the camp. The secondary research question of interest: What do children know about nutrition, and are they putting that knowledge to use? Although adults usually do the grocery shopping, their meal choices are heavily influenced by their children's requests (or demands). Grand Sparks will be developing a quick survey tool to measure children's knowledge of nutrition, and how much they are putting that knowledge into practice. Currently, no tool exists that can quickly gauge nutritional knowledge/practice in children. Grand Sparks will request short follow-up surveys of the children who attended the camp at 1-month and 6-months.

This program, Grand Sparks, was funded by the Healthy Kids Community Challenge - County of Huron, who provided funding to help promote water as the first-choice beverage for kids, and reduce sugar-sweetened beverages. Their funding also assisted in covering the costs of food, and development of our nutritional information handouts.

Www.gatewayruralhealth.ca

Spring 2017

Local Poultry Farmers involved in Lung Health Study: Research is Making Tracks

The Poultry Producers Lung Health pilot study was a great success, thanks to the Poultry producers of Huron and Perth counties. We completed lung health education sessions and spirometry testing for 16 farmers on August 3rd and 4th, 2016, at clinics held in Seaforth and Clinton Ontario. The success of these clinics was due in great part to support from Kelly Buchanan, Executive Director of the Huron community Family Health Team, and Kim Van Wyk, Executive Director of the Clinton Family Health Team. All of the poultry farmers who participated in the study went through a formal N95 respirator fit-testing protocol, completed lung health questionnaires in paper and on-line formats, and received lung health spirometry testing. The spirometry report has been sent to the family physician of each participant for follow-up with their health care provider. Preliminary results suggest that participants found that N95 fit testing confirmed that the respirators they used passed the fit-test. Participants found the on-line lung health questionnaire easy to use, when compared to the paper copy. Twenty-five percent of participants (25%) indicated that they wanted more information about respirators. The lung health study has final data collection in early November 2016. Funding for this study was provided by The Lung Association through an Ontario Respiratory Care Society Fellowship Award. Also, for the past three years, the local Poultry Producers have donated the proceeds of their annual Chicken Classic Golf Tournament to Gateway. The Poultry Producers Lung Health Study could not have happened without the great support of Brian Falconer and Alex Westerhout, Poultry Producers of Huron County, and Gwen Devereaux and Jim Whaley of Gateway Centre of Excellence in Rural Health.

Two local Huron County Nurse Practitioners, Karen Atkinson and Stephanie Greenfield, have been gaining expertise in rural lung health assessments for farmers. Both Karen and Stephanie completed their research placement last year with Gateway Centre of Excellence in Rural Health, as part of the University of Western Ontario, Master of Nursing-Nurse Practitioner program, looking at best-evidence for lung health assessments. Both Stephanie and Karen have now graduated as NPs from UWO, and are hoping to continue their lung health assessments for farmers in Huron county, in their new role as primary health care nurse practitioners.

Www.gatewayruralhealth.ca

Spring2017

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