HEALTH PROMOTION IS MULTI-LEVEL AND CROSS-SECTORAL

The health goal for the Canadian High Blood Pressure Prevention and Control Program is:

• To reduce the prevalence of uncontrolled high blood pressure in Canada
• To reduce the incidence of high blood pressure
• To reduce the proportion of Canadians who are unaware they have high blood pressure
• To reduce the prevalence of uncontrolled high blood pressure among those diagnosed with high blood pressure

• Advocating healthy public policy
• Encouraging community action
• Creating supportive environments (school, workplace, community)
• Providing information and education
• Involving non-health sectors

• Education about healthy lifestyles for everyone
• Screening for adults
• Lifestyle education and medication for High BP
• Promotion of self-care/follow-up
• Creation of a system of services
• Interdisciplinary teams

System support

• Education resources
• Clinical practice guidelines
• Surveillance, research, evaluation
• Coalitions/networks

COMPREHENSIVE APPROACHES INCLUDE SUPPORTIVE ENVIRONMENTS

Health promotion seeks to be comprehensive. Comprehensive programs address multiple risk factors, reach different audiences through different channels or venues and use a variety of approaches. Approaches may include education, environmental support, policy development and community mobilization. Supportive environments nurture healthy choices and behaviours by making multi-level changes (personal, family, organizational, community, physical environment, society-wide systems). The creative program described below is an example of a health promotion program that creates a supportive environment for healthy behaviour and involves various sectors to promote active living for dog-owners.

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WALK THE DOG! PAWS-ITIVE STEPS TOWARD HEALTH

Walk the Dog is a contest-based program that was piloted for 6 weeks in the fall of 2002 by the Windsor-Essex County Public Health Unit.¹ The goals of the program were to increase the level of physical activity of dog owners living in the Windsor-Essex community, by appealing to their concern about the well being of their dogs. The City of Windsor reported that over 20,000 dogs were registered in this community, and veterinarians reported that the majority of the dog owners were over the age of 45.

The program partnered with local veterinarians to promote greater activity for dogs and increase their owners' activity at the same time. The goal of the program was to build blocks of 10 minutes of physical activity into daily routines to gradually reach a goal of 60 minutes per day.

165 people participated in the contest, which required fourteen consecutive days of dog walking to be eligible to win prizes. Telephone feedback on the pilot was extremely positive and the Health Unit plans to repeat the program in 2004, possibly for 8 weeks.

The contest brochure carried the following message:

"People and their dogs need to be active to be healthy. Our modern lifestyle, filled with many conveniences, has made our  dogs and us more sedentary. Sitting in front of computers, TVs and in cars is contributing to less physical activity. This modern lifestyle can be dangerous to our health as well as our dog's health!"

HEALTH PROMOTION BUILDS ON VALUES

Health promotion values include health, social justice (equity, respect for diversity), power sharing, the environment, individual/community enrichment. Also, the goal of health promotion is to achieve lasting social change.

Prerequisites for lasting social change are:

• a critical mass of people who share a common vision/goal;
• belief that fundamental change can occur;
• belief that collectively people have the innate wisdom and capacity to identify and resolve their own issues;
• recognition that change will occur only through an intersectoral effort;

More prerequisites for lasting social change are:

• effective appropriate leadership;
• ability to analyze a situation honestly, critically, creatively and openmindedly;
• ability to think strategically; ability to work in good ways with each other;
• ability to act in ways that are consistent with one's beliefs in all aspects of one's life.

The example of the Woolwich Healthy Community, a community mobilization approach, illustrates many of these values.

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In November 1988, after the discovery of NDMA (a probable carcinogen) in the ground water which supplies Elmira's and St. Jacobs' water systems,Waterloo Regional Government appointed the Woolwich Community Health Committee to respond to the resulting health concerns of the community. Committee membership included representatives from the fields of health care and government, as well as citizens from the communities affected and local environmental groups.

A broad cross-section of people from across the township formed the Woolwich Healthy Communities Planning Committee, to plan a ‘Visioning Day'. The Planning Committee wanted to bring people together from all areas of Woolwich to think about what makes a community healthy and share what they would like their communities to be. Out of the Visioning Day, the Woolwich Healthy Communities Coordinating Committee (WHCCC) was formed to promote the Healthy Communities concept and develop future initiatives.

Residents who wanted to enhance the environmental, economic, and social health of the community formed Woolwich Healthy Communities in 1991. Three groups then formed to plan and carry out a course of action in various areas.

The Woolwich Trails Group promotes hiking and biking in the Township for transportation and recreation. It works with the Region to incorporate trails into the planning process, and recently spearheaded the local "Adopt-A-Road" initiative to encourage local groups, organizations and businesses to take responsibility for the beautification of road sections. Woolwich Township boasts 8 trails totalling approximately 77 kilometres.Trail uses in the Township include walking, running, cycling, cross country skiing, snowmobiling, horse back riding. The group also distributes the Woolwich Trails booklet with maps and descriptions of all the local trails.

The Clean Waterways Group promotes clean waterways throughout the township. It works with volunteers and landowners to improve the health of Woolwich waterways through creek rehabilitation and bank stabilization projects. It also works on projects to plant native trees and shrubs, and to install fencing along upper sections of the Canagagigue Creek.These aid in reducing erosion and preventing pollutants from entering the waterway. Involvement can range from attending monthly planning and education meetings to occasional work-days maintaining stream buffers and planting trees on new and established sites.

The Sustainable Communities Group works with the community to secure a sustainable future for Woolwich Township by promoting environmentally, economically, and socially beneficial practices. It has provided input to the Region of Waterloo Official Plan and published the Woolwich Community Report.The report is a snapshot of Woolwich Township's traditions, activities, and lifestyles with the use of stories, comments, pictures, and surveys.