The demonstration phase of the Canadian Healthy Heart Initiative (CHHI) was a 7-year undertaking from 1989 to 1995 involving all 10 provinces, and constituted the “back-bone” of the CHHI. The overall goals of demonstration projects were to “plan, implement and evaluate projects to build the capacity for heart health; and to carry out supporting implementation research.” Based on findings from the national heart surveys, each province designed and implemented a set of initiatives tailored to local needs. Consequently, provincial demonstration programs were diverse in terms of their management, the conceptual model used to frame activities, and the processes by which demonstration projects were selected. Approximately Can$36 million was allocated to the CHHI demonstration phase, providing support for 10 provincial programs, 35 community level initiatives, and 311 individual demonstration projects.

Projects varied widely in activity and setting. Primary strategies for addressing risk factors associated with CVD included public education (e.g., information dissemination strategies such as newspapers, cable television advertisements, school newspapers, or project newsletters); community mobilization (e.g., community granting schemes, workplace wellness programs); developing healthy public policy (e.g., developing school policies, drafting a clean air bylaw to municipal council, endorsing healthy food choices in restaurants); and strengthening preventive services (e.g., providing consultation services and resources to workplaces, training volunteers to deliver programs/testing related to heart health). Sixty percent of demonstration projects focused on reducing tobacco use, 73% on improving nutrition, and 68% on greater physical activity. These activities primarily occurred in schools (38%), community agencies (36%), and workplaces (26%).

70% of the provincial-level programs and 94% of the community-level projects had an explicit focus on supporting community partnerships/collaborations. Among the many multi-agency demonstration projects was a community-level intervention aiming to combat obesity in 700 families in low-income, low-education settings. Networks and partnerships were critical for facilitating and coordinating the wide variety of activities in this initiative, which included aerobics classes, a walking club, nutrition and food preparation classes for adults and children, information sessions, smoking prevention programs, line dancing, community gardens, and a community kitchen. Of note, many of these initiatives have now been scaled up to province-wide programs, while a number of the interorganizational and intersectoral partnerships have persisted beyond the seven-year demonstration initiative.

Source. Conference of Principal Investigators of Heart Health.⁵⁷