Case 11: Share your story, shape your care — engaging Northwestern Ontario

Citizen Engagement in Health Casebook

North West Local Health Integration Network, Thunder Bay, ON
Kristin Shields, Senior Consultant, Planning and Community Engagement


Mandated to plan, fund and integrate local health services, the North West Local Health Integration Network (LHIN) is one of 14 LHINs in Ontario. The North West LHIN covers 47% of Ontario's landmass, and with a dispersed population of only 235,000 residents, innovation in the use of local networks and communications channels is required.

To identify the priorities for the LHIN's Integrated Health Services Plan (IHSP) 2010-2013 and inform local decision making, extensive community engagement was undertaken.1 This was accomplished through the Share your Story, Shape your Care initiative by:

Stakeholders included health service providers, general public, community leaders, academics and many others identified in the North West LHIN's Community Engagement Strategy.2 Given the large geography, dispersed population, travel challenges (particularly in winter), and the need to reach as broad a group as possible, the North West LHIN embarked upon its Share your Story, Shape your Care initiative. This engagement project combined online deliberation, grassroots communications and face-to-face meetings in order to maximize participation and input.


To develop these products, key informant interviews were completed to ensure overall quality, relevance, clarity, and ease of navigation of the tools. A number of advisory teams were also involved in these reviews. Interview and advisory team participants proved to be excellent champions in encouraging their colleagues, clients and friends/family to participate.

Communications planning occurred in the six weeks preceding the launch of Share your Story, Shape your Care. This allowed for the identification of local communications channels and preferences, as well as champions in communities and sectors, across Northwestern Ontario. Contact within geographic and cultural communities was widespread, with all local school boards, seniors' centres, faith-based organizations, municipal councils, First Nations Chiefs, Health Directors, professional colleges and associations, and libraries being contacted to identify how best to inform potential participants of this opportunity. A multimedia communications strategy — from a Facebook campaign to posters in local coffee shops — encouraged individuals to have their say. Close monitoring allowed targeted marketing to have participation reflect key demographics.

The primary engagement tool of the Share your Story, Shape your Care project was an online Choicebook™ and a suite of online tools that were co-developed and supported by Ascentum.3 Participants received information about local health care needs and priorities, and they were encouraged to express their views on these topics through an online discussion board. A YouTube video, blog, and online resource section were also made available, and participants could choose to receive paper copies of the Choicebook™. Finally, a conversation guide was developed to support community-led discussions.

Outcomes and impact

Over 800 individuals participated in the Share your Story, Shape your Care initiative between January and April 2009. An additional 100 participants submitted paper copies between April and June of the same year. Through the collection of online and paper Choicebooks™, over 190,000 words were submitted, providing extensive qualitative information for planning and identifying priorities for the North West LHIN.

The priorities highlighted in the North West LHIN's Integrated Health Services Plan directly reflect those identified through this engagement process. Although some of the priorities included were outside of the direct mandate of the LHIN (such as primary care, with the exception of Community Health Centres), they remained local priorities due to strong support by local residents.

Results of the Share your Story, Shape your Care initiative were shared directly with participants and broadly with those living in Northwestern Ontario. Participants were able to request personalized reports comparing their responses with district and regional results. Summary and full reports were made available to LHIN advisory team members, contacts in the LHIN's database, and all participants who requested them. Results were also posted online.4

In 2009, the Share your Story, Shape your Care project was awarded the International Association for Public Participation's (IAP2) Core Values Award of the Year for "Innovative Use of Technology."

Lessons learned

There were many lessons learned during this project, including the value of human contact and personal messaging to support online engagement, the use of technology to overcome many barriers (such as geography, weather, dispersed population, and participants' desire for anonymity) and the importance of recognizing the unique needs and strengths of local groups and communities.

Providing face-to-face support and in-person messaging was essential to the success of this project. The two primary reasons that people participated in Share your Story, Shape your Care were because the issue was important to them and/or they were encouraged to participate by someone whom they respect. Providing formal and informal leaders with both education about the project and messaging to communicate with their contacts enabled them to be the true champions of this work.

There is a belief among some that online technologies are not effective means of communication in rural and remote settings, but this was not our experience. Providing an opportunity for people to participate online gave everyone an equal chance to be involved, regardless of their location, age or socioeconomic status. This allowed us to reach those who — due to access issues (such as geography, timing, intimidation with a group setting, or the desire to remain anonymous) — would otherwise be unable or unwilling to attend a traditional meeting. It was, however, important to overcome challenges in accessing technology by:

Each community had preferences for communicating about this project. Working with representatives of these groups enabled the creation of tailor-made communications and identified the best means to advertise. Inclusion in local newsletters, church bulletins, community newspaper articles and community-wide mail drops supported broad awareness, and ensured that communications reached a wider range of participants.


Footnote 1

The Integrated Health Services Plan identifies local priorities for health system improvements and sets out plans to address these priority health care issues.


Footnote 2

Health Services Providers included regulated and unregulated health professionals and workers who provide care in both LHIN-funded and non-LHIN funded agencies. More on the LHIN's Community Engagement Strategy (which is reviewed and updated annually as required),can be found online.


Footnote 3

Ascentum is a consulting firm that specializes in in-person, online and social media engagement tools. For more information, see the Ascentum website.


Footnote 4

All resources are available on the North West LHIN website.


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