Case 5: The CommunityView Collaboration

Citizen Engagement in Health Casebook

Saskatoon Health Region
Amanda Clarke, M.H.Sc.
Public Health Officer - Policy Analyst
Office of Public Health Practice, Public Health Agency of Canada

Introduction

What do you get when you combine a whole community, a cup of collaboration and a mixture of diverse perspectives? The CommunityView Collaboration(CVC). CVC is a web-based information system that houses local aggregate data, resources and emerging hot topics. CVC aims to: a) bring the community together to provide valuable insight into the determinants of health; and b) contribute to overall health and well-being in Saskatoon through supporting evidence-based decision making for program and service delivery, and policy making. This community project originated in 1999, when citizens expressed a need for the ability to easily access local data. Since then, the engagement process to this point has mostly included key stakeholders through a number of mechanisms such as dialogues, the formation of a Steering Committee, involvement of project champions, and "train the trainer" sessions. Moving forward, however, CVC will involve the general public more extensively in order to enhance uptake and the sustainability of the tool in the community. Through this collaboration, we are building evidence for action!

Methods

The planning stage

Over the years, the methods for CVC citizen engagement process have changed depending on the phase of the project. The project started in 1999 with discussions between community leaders, such as the Chief Medical Health Officer of Saskatoon Health Region, about evidence-based decision making and the need for local data to inform program and service delivery as well as policy. This was then brought to the attention of the Saskatoon Regional Intersectoral Committee (SRIC). The SRIC is one of ten standing committees located across Saskatchewan that coordinates linkages between human service leaders, community partners, and research support. One of their main objectives is to shape and influence program, policy, and resource allocation to meet the diverse needs and interests of Saskatoon citizens. The SRIC sponsored the CVC project.

Environmental scanning was conducted in CVC's planning stage, including literature reviews to determine best practices, similar models, and appropriate theories and principles to guide this work. Principles of citizen engagement such as capacity building, organization, coalitions and innovation were also considered. The foundation for the development of CVC was the view that "healthy communities are those that have well-integrated, interdependent sectors that share responsibility to resolve problems and enhance the well-being of the community."1

Project champions from public and volunteer sectors began to approach organizations for their support and commitment to the project. A number of planning meetings were held, and the community response was very positive about moving forward. A CVC Steering Committee was developed to ensure representation from different sectors, and it currently includes the municipality, health region, police services, local school divisions, social services and the University of Saskatchewan. As a group, they were instrumental in voicing their needs to determine the scope and design of CVC.

During the development phase, the project was primarily spearheaded by the CVC Coordinator and tool developer, ProjectLine Solutions Inc. Putting together a highly technical resource in a simple, user-friendly format took time and resources. As a result, there was less engagement during this phase. Beginning in January 2010, when the tool was nearly complete, it was necessary to actively re-engage stakeholders. The CVC Coordinator organized one-on-one dialogue, regular updates, Steering Committee meetings, developed and piloted online training videos and held "train the trainer" sessions for the sector leaders.

The launch

In June 2011, CVC was officially launched in the community. The launch had close to 100 attendees and included an introduction to CVC's history, followed by presentations by the champions from various sectors, each of whom spoke about the applicability of CVC to their own work. In the audience were representatives from the community, provincial and federal governments, ProjectLine Solutions Inc., and other organizations and initiatives, such as the Saskatoon Poverty Reduction Partnership (SPRP), university students, media, and interested citizens. An interactive training session with approximately 40 participants followed the launch. Feedback was very positive, with one member of the SRIC stating that the CVC release was, "the best launch I have ever been to."

The Steering Committee is now forming a number of working groups (technical/data, training and communications) to maintain the fluidity and sustainability of the project. Feedback has strongly pointed to the desire for community interface with interactive forums, hot topics, and the promotion of community reports, articles and activities. SPRP has also expressed interest in this development.

There are many possibilities for CVC's use that have yet to be explored. Implementing CVC knowledge exchange mechanisms targeted to appropriate audiences will be an ongoing task to promote and encourage citizen engagement.2There will also be a shift to allow a further focus on the engagement and uptake of the tool by citizens other than the key stakeholders already on board.

Table 1: Citizen Engagement Methods
Timeline Method Description
Initiated in 1999 and ongoing Project Champions To spearhead an effective strategy to promote change3
Throughout early design phases Community outreach initiatives (dialogues and consultations) To determine the expressed needs of the community
Early design phase Environmental scanning and developing a case To engage potential partners
Early design phase Steering Committee and ongoing meetings during planning phase To represent intersectoral partners
Ongoing Presentations and briefings to federal, provincial and regional governments For example: Senate Sub-Committee on Population Health, 2008, and Provincial Ministries
2004 to Summer 2011 Dedicated Coordinator To provide support for the project and bring stakeholders together
Ongoing Email distribution lists To keep stakeholders up to date
Winter 2011 Training web videos posted to CVC To instruct on the function of CVC and ease uptake of the tool
Spring 2011 and ongoing Train the trainer sessions To develop CVC experts within each organization.
June 2011 Community website launch To release access to website; attendance of close to 100
June 2011 Media coverage Print, radio and television media on hand for the community launch
June 2011 Online user survey To inform current status and next steps
October 2011 Working groups (technical/data, training and communications) To respond to current needs; the Steering Committee is now developing specific working groups.
Ongoing Presentations at conferences Sample presentations in 2011: Housing Ideas that Matter Housing Tools that Work; Western Canada Medical Health Officers; and World Alliance for Risk Factor Surveillance
Ongoing CVC training by University of Saskatchewan students MPH students developed a training session to offer at the University on an ongoing basis
Ongoing Innovative knowledge exchange mechanisms To increase engagement and uptake of citizens

Outcomes and impact

Engagement has led to a more refined system that includes data requested by the community. When knowledge users are involved from the beginning, the chance of use is that much higher, and in the case of CVC, users also become knowledge producers and mobilizers.4 Knowledge users have already indicated how they will use CVC, including:

It is expected that a year after CVC's release (June 2012), a formal impact evaluation will be conducted to identify gaps and opportunities, as well as the uptake and use of evidence available on CVC. Data collection has already begun. One anecdotal impact is that community ties have strengthened amongst stakeholders representing different sectors. The impact of CVC, including its impact on citizen engagement, will be assessed with some of the following measures:

"Now we can quickly access local data to not only support our programs and services, but our intersectoral projects too. Using evidence to inform our work validates our decision making process."

- An Engaged Citizen

Lessons learned

There are several lessons learned from the citizen engagement process. Engagement is ongoing and does not end with the launch of CVC. There were different levels of engagement in the CVC planning, development and implementation process. The key for us was to have a "swinging door" that allowed individuals/organizations to come and go. Wenger refers to this concept as "building benches on the sidelines."5 With the SRIC as a model for intersectoral human service work, we strongly encourage others to engage with different sectors in projects as it brings richer perspectives. We also need to continue to understand how the tool can be seamlessly incorporated into users' work, since there needs to be value added to improve uptake into the future.6 Finally, the influence of project champions from different sectors cannot go unmentioned. Project "champions create and communicate strategic meaning around the innovation, persistently promote the innovation, sell the idea to top management in order to secure resources, and involve and motivate others to support the innovation."7 While CVC was just recently released, it will always be a work in progress, but with ongoing citizen engagement, it will be around for a very long time.

Footnotes

Footnote 1

Centre for Disease Control and Prevention, Principles of Community Engagement (Atlanta, Georgia, 1997) (retrieved January 15, 2012).

1

Footnote 2

Canadian Institutes of Health Research, Citizen Engagement (Modified June 1, 2011) (retrieved January 15, 2012).

2

Footnote 3

Howell, J.M., Shea, C.M., and Higgins, C.A., "Champions of Product Innovations — Defining, Developing, and Validating a Measure of Champion Behaviour," Journal of Business Venturing 20.5 (2005): 641-661.

3

Footnote 4

We use the term "knowledge mobilization" here to mean an interactive "dialogue to deliver and receive a message," "engage an individual in a process," and "exchange a process or product." See the Canadian Interprofessional Health Collaborative, Dissemination Strategy (retrieved Jan. 15, 2012). For more on the increased chance of knowledge use when the users are involved in a process from the beginning, see Abelson, J., Montesanti, S., Li, K., Gauvin, F.P., Martin, E., Effective Strategies for Interactive Public Engagement in the Development of Healthcare Policies and Programs (Canadian Health Services Research Foundation, 2010) (retrieved January 15, 2012).

4

Footnote 5

Wenger, E., McDermott, R., and Snyder, W.M., Cultivating Communities of Practice: A Guide to Managing Knowledge (Boston: Harvard Business School Press, 2002) (retrieved January 27th, 2012).

5

Footnote 6

Liebowitz,J., A Schieber, R.A., and Andreadis, J., Knowledge Management in Public Health (Boca Raton, FL: CRC Press, 2009), p. 178.

6

Footnote 7

Howell, J.M., et al., "Champions," p. 646.

7

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