Abstract
Community-based heart health promotion is viewed as an effective means of reducing cardiovascular disease risk. Although public health agencies have a central role in the implementation and dissemination of heart health programmes, their effectiveness is being challenged by major structural changes to Provincial public health systems across Canada, although the impacts of the changes have received relatively little attention in the research literature. As part of the Canadian Heart Health Initiative–Ontario Project (CHHIOP), this study used a qualitative approach to address the perceived implications of these changes to Ontario’s public health system for heart health promotion. Interviews (n=38) were conducted in eight public health units with staff most familiar with managing and/or delivering heart health activities. The results are mixed; that is, while many see the future of heart health promotion programming in Ontario as being at risk, others see recent changes as a step forward toward their institutionalization, particularly in light of recent funding decisions made by the Ministry of Health’s Health Promotion Branch.
Résumé
La promotion de la santé cardiaque en milieu communautaire est considérée comme un moyen efficace de réduire le risque de maladie cardiovasculaire. Bien que les organismes de santé publique jouent un rôle primordial dans la mise en oeuvre et la diffusion des programmes de santé cardiaque, l’efficacité de ceux-ci est remise en cause par d’importants changements d’ordre structurel effectués dans les systèmes de santé publique au Canada. Les divers documents fournis par la recherche n’ont toutefois pas encore vraiment prêté attention aux répercussions de ces changements. Effectuée dans le cadre de l’Initiative canadienne en santé cardiaque–Projet ontarien, cette étude a eu recours à une approche qualitative pour aborder les implications perçues quant aux changements apportés au système de santé publique ontarien pour promouvoir la santé cardiaque. Des entretiens (n = 38) ont été menés dans huit services de santé publique auprès de membres du personnel sachant gérer et/ou fournissant des activités liées à la santé cardiaque. Les résultats sont variables: d’un côté, beaucoup considèrent l’avenir de la programmation dans le domaine de la santé cardiaque en danger; de l’autre, certains estiment que les récents changements opérés constituent un pas vers leur institutionnalisation, tout particulièrement grâce aux récentes décisions financières prises par la Direction générale de la promotion de la santé au sein du ministère de la Santé.
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