OLMC - Strategic Plan 2006-2010

Table of Contents

Preamble

  1. Background
    1. Legal Basis
    2. Health Disparities
    3. Creation of OLMC Initiative
      1. Vision
      2. Mission
  2. Contextual Analysis
    1. Strengths and Opportunities Intrinsic and Extrinsic to CIHR
      1. Intrinsic Strength and Opportunities
      2. Extrinsic Strengths and Opportunities
    2. Weaknesses and Obstacles Intrinsic and Extrinsic to CIHR
      1. Intrinsic Weaknesses and Obstacles
      2. Extrinsic Weaknesses and Obstacles
  3. Operational Plan
    1. Objective 1: Define and Structure the OLMC Research Field
    2. Objective 2: Fund the Three Priority Research Areas
    3. Objective 3: Create and Fund a Network of Experienced and Novice Researchers
    4. Objective 4: Mobilize and Disseminate New Knowledge on OLMC health
    5. Objective 5: Evaluate Progress
  4. OLMC Initiative Contributions

Appendix

Preamble

In development of the 2006-2009 Strategic Plan for the Official Language Minority Communities (OLMC) Research Initiative, these two language communities' needs, and CIHR's commitment and obligations with respect to promoting strategic health research in Canada's both official languages were taken into account.

This plan presents the objectives and strategies that the OLMC Research Initiative plans to adopt, as well as a projection of the timeframes that will have to be met to achieve the objectives for the next four years. Its purpose is to guide decision-making regarding the research programs dedicated to the OLMC, to facilitate management of the initiative, and serve as a basis for the detailed operational plan. The result of its evaluation will serve as the cornerstone for the next strategic plan.

In June 2006, all members of the CIHR's OLMC Consultative Committee took part in a strategic planning exercise. Together, they determined the issues and the future directions necessary to meet the current challenges facing the minority English-speaking and French-speaking communities in Canada. Since the consultative committee is made up of representatives of community groups, researchers and organizations interested in the well-being of the OLMC, it reflects the health research needs of these communities.

This document is divided into four sections. The first takes a brief look at the events that led to the creation of the initiative and presents the vision and mission of the OLMC initiative. The second section examines the context, including strengths and weaknesses, from which were extrapolated the key objectives. The third section specifies the objectives and the actions that will be implemented, as well as the indicators that will be used to evaluate progress. Finally, the fourth section indicates how the OLMC initiative contributes to the CIHR objectives.

The 2006-2010 Strategic Plan is tangible proof of CIHR's commitment to the official language minority communities in Canada. It is intended as a guide for implementation of future CIHR activities with regard to funding of health research for the official language minority communities.

Johanne A. Lapointe, PhD
Team Lead, OLMC Research Initiative
Canadian Institutes of Health Research

Valérie Bourbonnais, MA
Project Officer, OLMC Research Initiative
Canadian Institutes of Health Research


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Background of OLMC Initiative

Unlike other CIHR strategic initiatives, the OLMC initiative was created both because of the health research needs with regard to these communities and because of political and legal reasons. The following section presents the legal basis and an overview of the preliminary reports that led to the creation of CIHR's Official Language Minority Communities (OLMC) Research Initiative

Legal Basis

In 1969, the Parliament of Canada adopted the first Official Languages Act, which proclaimed English and French to be the official languages of all federal institutions in Canada.

In April 1982, the Constitution Act was officially proclaimed in Ottawa. In addition to the Act of 1867, it includes the Canadian Charter of Rights and Freedoms, in which the new linguistic rights of the official languages communities are entrenched (art. 16(1).

In 1988, the Act underwent a major transformation, the effect of which was to expand the legislative foundation for the language policies and programs adopted by the federal government. The inclusion of sections to: 1) to ensure respect for English and French as the official languages of Canada and ensure equality of status and equal rights and privileges as to their use in all federal institutions; 2) to support the development of English and French linguistic minority communities and generally advance the equality of status and use of the English and French languages within Canadian society and 3) to set out the powers, duties and functions of federal institutions with respect to the official languages of Canada1 obliges the federal institutions to promote the development of these language communities. More recently, the passage of Bill S-3 in 2005 had major consequences for the way in which federal institutions fulfil their responsibilities and in particular their obligation to take positive measures to implement these commitments (sec. 41(1) (2) (3), 2005).

Health Disparities

In 2001, the report of the Consultative Committee for French-Speaking Minority Communities (CCFSMC) to the federal health minister revealed that Francophones are in poorer health than their Anglophone counterparts and that there are significant disparities in access to health services2. It also revealed that more than half the Francophones in these communities rarely, if ever, have access to health services in their language, and it hypothesized that there is a direct connection between language and the health of these populations. This problem has also been observed in the English-speaking minority communities, for which regional access to health services in the regions is often limited and even non-existent in some places3. Since the language barrier negatively affects access to health services and preventive services, as well as to timely diagnosis and treatment, access to health services in the language of one's choice (French or English) is a critical health issue.

To remedy this situation, a series of consultations with researchers, representatives of community organizations and health professionals made it possible to better define the needs and research avenues with regard to OLMC health. In these consultations, three priority research areas were identified: 1) the determinants of health; 2) the relationship between governance, management and delivery of health services; and 3) the link between language, culture and health (Appendix A).

Creation of OLMC Research Initiative

In 2004, pursuant to its mandate and its obligations to promote strategic health research in both official languages, and to better meet the health research needs of English- and French-speaking Canadians living in minority communities, CIHR created the strategic initiative for research on the health of Official Language Minority Communities (OLMC).

Vision

The aim of the OLMC Research Initiative is to reduce the health disparities between the official language minority and majority communities, so that all Canadians may have appropriate access to quality health care, regardless of their geographic location or the language (French or English) in which they wish to receive those services.

Mission

The mission of the OLMC Research Initiative is to promote the study of health determinants and the specific needs of these two communities, identify the priority research areas, increase the number of researchers interested in this area, and ensure that the newly created knowledge is communicated to the researchers, clinicians and other stakeholders, in order to improve health in OLMC.


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Contextual Analysis

No organization operates in a vacuum, and the Canadian Institutes of Health Research (CIHR) are no exception. Consequently, CIHR's inherent strengths and weaknesses and the opportunities and obstacles originating outside it influence the anticipated outcomes. After identifying factors that could impact the achievement of the initiative's objectives, the OLMC Consultative committee developed a strategic plan that takes them into account.

Strengths and Opportunities Intrinsic and Extrinsic to CIHR

The committee members began by reviewing CIHR's mandate, organizational structure and research priorities so as to determine the factors that might have a positive influence on the initiative's activities.

Intrinsic Strengths and Opportunities

Each organization has specific resources. In order to take advantage of them they need to be identified. The following are the highlights that came out of the identification process:

  1. CIHR, as the main federal organization responsible for health research funding in Canada, are reasonably well funded.
  2. CIHR have a good national and international reputation as a funding agency.
  3. As a result of CIHR's decentralized structure and young age, the Institutes are creative and dynamic.
  4. CIHR are open to crosscutting areas of research. Multidisciplinarity, interdisciplinarity, and the diversity of research areas are an integral part of CIHR's strategic plan.
  5. CIHR, as a federal agency, are subject to the Official Languages Act and have an obligation to enhance the vitality of Canada's English and French linguistic minority communities (OLMC).
  6. CIHR supported the creation of an OLMC initiative and of a consultative committee to advise them with respect to health research needs of these two communities.
  7. The diversity of programs and the existence of four research pillars at CIHR (pillars: biomedical, clinical, health systems and services; and public and population health) offers greater opportunities to match OLMC priorities to those of CIHR.
  8. The ability to launch programs that can meet the needs of the various research communities is a definite advantage.
  9. The commitment of the CIHR's official languages Champion and the dynamic leadership of the OLMC initiative management team are conducive to fostering the development of this research field.
  10. CIHR's Research Planning and Priorities Committee (RPPC) recognizes the health research needs of the OLMC.
  11. The link between the OLMCs and CIHR is becoming clearer.

Strategic Conclusions

On the basis of CIHR's commitment to OLMCs, the diversity of programs and the financial resources available, it is important to:

  • develop an innovative OLMC strategic plan, on the basis of CIHR's four pillars, to promote health research in relation to the OLMCs;
  • create synergy among CIHR, OLMCs, governments, researchers and health institutions; and develop a communication plan built on CIHR's reputation.

Extrinsic Strengths and Opportunities

Certain cultural, societal and environmental conditions favour the development of OLMCs and the success of activities aimed at developing their research communities. If these conditions can be recognized, they can then be put to good use. The main findings from the committee's analysis of these conditions were as follows:

  1. Society values health research, because creation of new knowledge regarding health and the application of that knowledge helps improves the health of the Canadian population, provides better health products and services and strengthens Canada's health system.
  2. The OLMCs, which are increasingly organized and co-ordinated, are able to better express their needs.
  3. The knowledge of the needs of the OLMC, acquired over the past few years, is conducive to the creation of health research partnerships between the initiative and the institutes.
  4. The time is ripe to mobilize the researchers and other stakeholders who are interested in the health research issues that are priorities for the OLMCs.
  5. Convergence of the interests of the key actors and organizations (for example, the World Social Forum) working with the OLMCs gives more weight to their recommendations concerning these communities' needs.
  6. The existence of a research framework (needs, priorities, approaches, pillars) promotes a structured approach and channels research efforts.
  7. There is an opportunity to develop a national research program that will encourage alliances with the key players who can best apply the knowledge obtained through this research.
  8. Support from Health Canada promotes the development of research on the OLMCs.
  9. The amendments to the Official Languages Act (Bill S-3, 2005, ch. 41, sec.1) promote the development of research areas related to the OLMCs.
  10. The renewal of the federal government's Action Plan on Official Languages (2003) and the existence of the Departmental Advisory Committee on Official Languages (DACOL) support the legitimacy of the OLMCs' needs.

Strategic conclusions

To take advantage of the legal support provided by the Official Languages Act, the increased knowledge of the OLMCs' health research needs, and the growing interest in this research field among members of the research community, it is essential to:

  • Identify the ways of examining those health research issues that are priorities for the OLMCs, and the key partners (NGOs, businesses, and governments);
  • Develop funding programs that will mobilize the key researchers and promote productive partnerships;
  • Promote alliances among multiple disciplines and professions to better address the complex, multifactorial health research issues that the OLMCs face.

Weaknesses and Obstacles Intrinsic and Extrinsic to CIHR

Although it is important to identify the strengths on which the future activities will be based, it is just as essential to identify the contextual weaknesses and obstacles standing in the way of the anticipated progress. To this end, the members of the consultative committee identified environmental and organizational factors having the potential to interfere in the fulfilment of the strategic plan.

Intrinsic Weaknesses and Obstacles

The consultative committee members examined CIHR's policies and organizational structure to identify inherent factors that could interfere with the implementation of the strategic plan. The following are the highlights that came out of the identification process:

  1. The many regulations governing the funding programs and the application process are major challenges for new researchers.
  2. The grant process is centred too much on the researchers' interests and not enough on the communities' needs.
  3. There is much competition to obtain grants.
  4. CIHR and the research community are not sufficiently aware of the challenges facing the official language minority communities.
  5. CIHR and the research community are not sufficiently aware of the challenges facing the researchers interested in OLMC research as well as the universities and health institutions serving these minority communities.
  6. The fact that CIHR is decentralized does not facilitate the emergence of a unified approach in the area of official languages.
  7. CIHR do not have a clear vision of their obligations to the OLMC according to the Official Language Act and within their mandate.
  8. The CIHR organizational cultures are often closed to new areas of endeavour.
  9. The OLMC initiative is not integrated into CIHR's knowledge translation strategy.
  10. The means currently employed to transfer new knowledge between researchers and the general public are inadequate.
  11. The partnerships between the universities and communities need to be promoted and developed more.
  12. The OLMC health research priorities can be lost among CIHR's many research priorities.
  13. The perception that OLMC health research is not a priority scientific research area is an obstacle to arrive at a critical mass of researchers and to create new knowledge in that area.
  14. The link between researchers, health sectors and the communities needs to be better articulated.

Strategic Conclusions

In response to the lack of knowledge that some researchers and institutions may have of the funding programs offered by CIHR, of the challenges facing OLMCs and of the need to communicate the new knowledge to the researchers, primary care workers and decision makers, it is important to:

  • develop a strategic communication plan to increase knowledge that community, institutional partners, and universities (small and large) have of CIHR's funding programs and OLMCs health research needs;
  • promote OLMC research area within the Institutes and have it acknowledged as a priority research area;
  • support knowledge dissemination to researchers, health practitioners and decision makers by collaborating with organizations entrusted with knowledge transfer

Extrinsic Weaknesses and Obstacles

Certain factors can negatively impact the achievement of objectives. Although many depend on circumstances over which no control is possible, it is important to take them into account. The highlights of this exploration are as follows:

  1. The difficulty in defining the concept of language minorities theoretically, the absence of statistical methods that can take small samples into account and the problems related to interpretation of data from small samples are major challenges for the researchers interested in this research field.
  2. Among Francophones, the declining birth rate and the rising assimilation rate are threatening the survival of this community and increasing the problems associated with building research capacity and with access to and delivery of health services in their mother tongue.
  3. Among Anglophones, the declining birth rate and their relocation outside of Quebec are threatening the survival of this community and increasing the problems associated with building research capacity and with access to and delivery of health services in their mother tongue.
  4. The mobility of the OLMC members makes it difficult to study these populations and to plan and deliver health services.
  5. The difficulty in advancing OLMC matters in the large universities/institutions is an obstacle to increasing the number of active researchers in this research field.
  6. The limited resources of the small French-language universities are a major obstacle for researchers interested in the OLMC research field.
  7. The adoption by Canada's provinces of strategies that link the development and organization of services to needs demonstrated by the presence of critical masses and to limitations on available resources makes it difficult to respond to the needs of French-speaking and English-speaking minority communities.
  8. The existing prejudice alleging that health discoveries apply universally to all groups is an obstacle to the development of the OLMC research field.
  9. Research capacity in the OLMC field is small and insufficient.
  10. The government's new health priorities (public health, SARS, reduction of wait times) are pushing the OLMCs' health research needs to the background.

Strategic Conclusions

In response to the small number of researchers interested in health in OLMCs and lack of resources to support research in OLMC health, it is important to undertake the following measures to maximize the impact of available funds:

  • develop a national strategy to promote researchers' interest in this field of research and thus encourage creation of a critical mass of interested and competitive researchers, with special attention paid to the small OLMC universities;  
  • define the French- and English-speaking minority communities, as well as these populations' specific problems and health research needs.
  • Identify the priority research issues and then provide targeted funding possibilities.

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Operational Plan

The chosen objectives and the strategies for action related to them reflect the identified strengths and weaknesses. The plan includes five (5) objectives aimed at promotion of health research in relation to OLMC and strategic funding that allows for creation of new knowledge in this field. While the objectives promote decision making, the strategies for action make it possible to translate the objectives into measurable indicators. This plan focuses on the targeted objectives and maximizes the factors for success present in the environment.

Objective 1: Define and structure the OLMC research field

While seemingly easy, clearly defining OLMC is a major challenge for researchers interested in official language minority communities (OLMC) and decision makers having to establish programs and public policies. In light of the theoretical and methodological challenges involved in defining these communities and this research field, the committee has set the objective of developing a consensus on the way of defining the OLMCs, of promoting a better knowledge of the challenges that these populations face and of securing recognition of the importance of this research field.

To achieve this objective the following strategic measures will be taken:

  • 1.1 Reach a consensus on a definition of English- and French-speaking minority communities in relation to the CIHR mandate.
    • 1.1.1 Create a working group to examine OLMC health research issues.
    • 1.1.2 Reach a consensus on a generic definition of what French-speaking and English-speaking minority communities are.
    • 1.1.3 Document the existence and relevance of the operational definitions in the OLMC research field.

  • 1.2 Define, structure and guide the OLMC health research field.
    • 1.2.1 Define the research field, the research areas and the priority research questions:
      1. comprehensive review of the scientific literature
      2. sort the existing knowledge on the basis of the three already identified research areas
    • 1.2.2 Include in a document the definition of OLMCs, their research fields, the research areas and the priority research questions:
      1. update the document regularly
    • 1.2.3 Write a scholarly article on the definition and the field of OLMC health research (legal, demographic, health challenges, etc.).

  • 1.3 Increase CIHR peer review committee members' awareness.
    • 1.3.1 Send a memorandum to the Chairs and the Scientific Officers of the peer review committees that evaluate applications relating to the OLMCs.
    • 1.3.2 Present the definitions and research areas to the Chairs and Scientific Officers of the peer review committees.

  • 1.4 Bring about recognition and acceptance of the legitimacy of the field of health research in relation to OLMCs through a comparison with the CIHR mandate and strategic priorities.
    • 1.4.1 Examine the thirteen (13) Institutes' priorities and identify those that are similar to three (3) OLMC research areas previously identified:
      1. write a brief synthesis document
      2. explore the programs that are mutually beneficial
    • 1.4.2 Work with targeted Institutes to specify details regarding implementation and assignment of resources to the identified programs.
    • 1.4.3 Present the strategic and operational plan for the OLMC initiative, and the definitions and research areas to the Research Priorities and Planning Committee (RPPC) and the Governing Council of CIHR. Post the strategic and operational plans on the CIHR Web site.

Objective 2: Fund the Three Priority Research Thrusts

Advancing OLMC-relevant research is a commitment of CIHR's OLMC initiative. However, to achieve this, the participation and commitment of other key partners interested in the promotion and the well-being of the OLMCs are necessary. To that effect, the following strategic actions will be implemented:

  • 2.1 Choose and implement the appropriate funding programs.
    • 2.1.1 Launch funding opportunities (planning and development) in relation to the three (3) OLMC areas and CIHR priorities. They will be forerunners to the emerging team grant programs planned in three (3) years.
    • 2.1.2 Annually launch priority announcements for fellowships and studentships.

  • 2.2 Establish partnerships (within and outside CIHR) to fund the OLMC research areas.
    • 2.2.1 Identify the potential financial partners, then approach them and explain to them the research areas:
      1. list of the Institutes with similar interests
      2. list of former partners (NGOs)
      3. use the networks of the OLMC Consultative Committee members
      4. list of government departments with similar interests
      5. perform an environmental analysis to identify the type of research that has been financially supported by the potential partner

Objective 3: Create and Fund a Network of Experienced and Novice Researchers

To increase the researchers' knowledge of the programs offered by CIHR and the OLMC-specific funding opportunities, promote the study of health determinants and the needs specific to these two communities, and increase the number of researchers interested in these issues, the following strategic actions will be implemented:

  • 3.1 Build OLMC research capacity, while strengthening the links between the researchers and communities.
    • 3.1.1 Identify active researchers and students interested in research on the OLMC priority topics ( CIHR, Social Sciences and Humanities Research Council (SSHRC), Health Canada, Canadian Heritage, Canadian Health Services Research Foundation, chairs of the Canadian Foundation for Innovation (CFI)).
    • 3.1.2 Launch, in partnership with the communities (e.g. action research), a funding opportunity (emerging team) focused on the OLMC priority subjects.
    • 3.1.3 Offer scholarships (doctoral, postdoctoral, young researchers) targeting the OLMC priority subjects.
    • 3.1.4 Organize a summer institute dedicated to the OLMCs.
      1. establish financial partnerships with interested organizations
      2. provide a link between CIHR and the summer institute Website
    • 3.1.5 Promote the OLMC research programs among researchers and students.

Objective 4: Mobilize and Disseminate New Knowledge on Health in the OLMCs

In order that the newly created knowledge is communicated to researchers and clinicians, with a view to improving the health of Canadian populations, and to policy makers, so that the knowledge may serve as a scientific foundation for policies and programs aimed at these populations, the following strategic actions will be implemented:

  • 4.1 Implement Strategies for management of knowledge and communication that reach all OLMC partners.
    • 4.1.1 Develop a strategic knowledge transfer plan.
    • 4.1.2 Implement the knowledge transfer plan.

Objective 5: Evaluate Progress

A good strategic plan must be reviewed periodically. The purpose of the review is to measure the progress made and ensure that the chosen solutions made it possible to achieve the proposed objectives. To that effect, the following strategic action will be taken:

  • 5.1 Evaluation of the impact of the operational plan
    • 5.1.1 Identify the criteria for assessing the feasibility of the planned activities (time, money allocated to each activity):
      1. develop an impact plan for each activity

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OLMC Initiative Contributions

The 2006-2010 Strategic Plan for the OLMC Research Initiative of the Canadian Institutes of Health Research (CIHR) will contribute to the realization a number of CIHR priorities, including:

  1. encouraging and supporting the submission of creative proposals by excellent Canadian researchers in the health research field as a whole;
  2. encouraging and supporting interdisciplinary and collaborative research designed to resolve complex issues related to health of Canadians including members of OLMC;
  3. building researchers' capacity in the health research field as a whole, in a dynamic, innovative and stable research environment;
  4. advancing research in the area of use of health knowledge;
  5. establishing partnerships with organizations in Canada with shared values and objectives in the health research field, and ensuring that they are maintained;
  6. providing leadership and co-ordination in setting the direction with regard to the major issues related to health research.

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Appendix A: The Three Priority Areas of Research

Determinants of Health

The importance of language has a particular dimension for health issues in the areas of health promotion, disease prevention and effective communication between patients and health workers. The few studies done on the official language minority communities (OLMCs) reveal a negative health differential when these communities are compared with the official language majority communities, as well as a stronger role for some determinants, such as living in a language minority community.

Population health research looks at all determinants of health: the social and physical environment in which populations live, resources available to them, health services, lifestyle, cultural practices and biological determinants. This view incorporates two major factors that may explain health inequalities: the personal factor, which explores the characteristics of individuals, and the contextual factor, which looks at living environments (resources and infrastructures) and the collective functioning (sociocultural and historical characteristics of the community, degree of integration, mobility, norms and values).

This research area seeks to identify the bio-psycho-social determinants of health and the health needs of OLMCs, document the access these populations have to health services and determine how accessibility affects their health.

Health Service Governance, Management and Delivery

Health institution governance by official language minorities and its impact on those communities is still not clearly documented. It is important to reinforce knowledge to gain a better understanding of the effects of greater participation by official language minority communities in health institution governance bodies and for decision making.

Language, Culture and Health

The connections between language, culture and health have to do with the effects of the linguistic experience on, among other things, access to health promotion and prevention services and to primary and specialized health care. The connections between "language, culture and health" particularly affect certain "client groups": young children, youth, seniors, women, new Canadians and people with mental health or psychosocial problems. Speech, verbal and non-verbal communication, the meaning of "symbols" and general comprehension are closely linked to culture and language. When it comes to health problems, it is particularly crucial for people to be able to use their own language to explain their symptoms, state of mind, difficulties and pains to a professional who understands their language. It is important to better understand the situation of members of OLMCs, how they view the limited access to services they encounter and the impact this situation has on their health. With an active immigration policy, the specific situation of new Francophones from Africa, Asia and the West Indies is among the shifting issues of access to French-language services. The importance of language and culture becomes even clearer for seniors with memory problems or depressive people experiencing great psychological distress.

  1. Official Languages Act
  2. Report to the Federal Minister of Health: Consultative Committee for French-Speaking Minority Communities - September 2001
  3. Consultative Committee for English-Speaking Minority Communities: Report to the Federal Minister of Health. Ottawa, July 2002