Healthy Living Peer Leaders: A sustainable & innovative way to promote physical activity

Karrie Cumming, Health Promoter

Kim Richer, Peer Leader

Presentation at a Glance Program Overview Guelph CHC and Partners Priority Population Outputs and Tools Training Timelines & Work plan activities Evaluation Sustainability Lessons Learned Reflection

Our Inspiration…

Healthy Living Peer Leader Program Overview Initiated by Guelph CHC in the fall of 2009 Funded by the Ministry of Health Promotion

through a Healthy Communities Fund grant Volunteer peer leaders from two communities

received training on various topics Through partnerships the trained peer

leaders then went into their communities to provide peer led programs

Healthy Living Peer Leader Project Flow Chart

Project Goals

Increase community capacity to address chronic disease issues

Provide accessible peer-led chronic disease prevention programs

Improve the health status of low-income adults

Guelph CHC

Guelph CHC’s Mission

We provide innovative primary

health services and community

programs, mainly for our priority

groups, using an interdisciplinary

team approach, and collaborating

with community partners.

Guelph CHC Physical Activity Programs

Running Shoe Recycle Program 1 walking group 2 women’s yoga groups Pre-post natal fitness classes Physical activity consultations with

Kinesiologist Key partner in Guelph in motion committee

Partners

Partner Contributions

Community Members

Contribute their time and expertise on the initiative intended to benefit them

Onward Willow Better Beginnings Better Futures

Provide expertise in working with Onward Willow residents Contribute in kind resources such as equipment usage and

space as well as staff time towards planning and implementation of activities, program evaluation, recruiting volunteers and training

New Life Church

Contribute cash resources for childcare Use of community kitchen and nursery

Brant Avenue Neighbourhood Group and

Provide expertise in working with Brant residents Contribute in kind resources such as space as well as staff

time towards planning and implementation of activities, program evaluation, recruiting volunteers and training

Priority Neighbourhood DemographicsOnward Willow neighbourhood has;

Guelph’s lowest average income1. Greatest number of subsidized housing and low cost

apartments1. Highest percentage of single parent families2. Greatest number of families who have immigrated to

Canada in the last 5 years2. Highest percentage of residents who have no knowledge of

either official language2. Reported chronic disease rates were very high when

compared to national rates1.

Priority Neighbourhood Physical Activity Levels At least 50% of single parents and youth are physically

active while 48% of families with young children are physically active1

New immigrants report the lowest level of physical activity with only 27% reporting that they are active at least 3 times per week

Almost half of the Guelph CHC priority populations are not physically active to a level that will benefit health

Almost 30% of Onward Willow report depression and pain or discomfort

Depression, pain or discomfort is approximately 4 times higher in this neighbourhood than in Guelph

Approximately 25% of priority groups are not finding ways of reducing stress

Outputs and Tools Developed General Chronic Disease Resource Guide

General Chronic Disease Info. Night

Healthy Living Leadership Manual with sections on; Physical Activity Healthy Eating Group Facilitation Evaluation

Healthy Living Peer Training

Peer-led Physical Activity and Healthy Eating Programs

Physical Activity Training

Training facilitated by Kinesiologist Ground rules established Review of volunteer duties, limits and conduct Confidentiality and boundaries Benefits of physical activity Barriers and Motivators FITT (Frequency Intensity Time Type) Principles Safety Local Opportunities Link between physical activity and mental health

Healthy Eating Training

Training facilitated by Dietitian Canada’s Food Guide Fat & Sugar Salt & Fiber Being a Successful Leader Community food resources Label reading follow up training

Evaluation Training

What is program evaluation and why do it Process and outcome evaluation Evaluation questions, measurements and

decisions Evaluation tools   Story collecting through group interviews with

one another Created focus group questions Created satisfaction survey

Other training notes

Emergency First Aid and CPR Transportation, food and childcare provided Evaluation after each training session Brainstorming potential peer lead activities at

each session Interactive, fun exercises throughout the day

2009 Timelines

Meetings with partners and stakeholders Engaging potential peer leaders Hiring project consultant with community

member on hiring committee Research other peer led physical activity

programs Activity Buddy Training - The Haldimand-Norfolk Resource

Centre The Hamilton Diabetes and Depression Primary Care Peer

Support Program – Hamilton Family Health Team

2010 Timelines

Chronic Disease Information Night Peer leaders were recruited Physical activity training manual was developed Health eating resources were developed Peer leaders attended Guelph CHC volunteer

orientation Ongoing volunteer management Ongoing evaluation Develop communication plan

2010 Timelines Continued

Peer leaders received 3 days of training The peer leaders participated in several

prioritization sessions to determine which peer lead programs they are going to implement in their community

Peer led programs initiated Potluck supper and celebration of light

2011 Timelines

Focus group with Brant Ave. neighbourhood to determine desired winter physical activities

Presenting at PARC Symposium! 6 new peers recruited.

Self directed learning process Review of information by program coordinator Mentoring by current peer leaders Will receive first aid and CPR training

Peer leaders participated in the following training: a full day evaluation training 2 hour evaluation follow up training

2011 Timelines continued

Peer leader volunteer recognition supper Peer leader webpage added to Guelph CHC site Consult and collaborate with other community

partners regarding the expansion of this initiative into other neighbourhoods

Press releases and media coverage of 2 peer led programs

Dissemination through Health Nexus Health Equity Promising Best Practice Inventory

Ongoing training and support needs are continuously being provided by Guelph CHC staff as the peer leaders and their projects evolve

Peer lead programs

Healthy Eating Label reading workshop Healthy eating potlucks

Physical Activity Zumba nights Badminton Volleyball 2 Walking groups

Combination Little chefs

Evaluation Empowerment/participatory focus Use of the Public Health Agency of Canada’s

Capacity Building Tool Process indicators (ie. hiring of staff,

completion of work according to timelines) Outcome indicators (ie. # of peer leaders, #

of peer lead programs) Quantitative data (ie. attendance records,

survey results) Qualitative data (ie. focus groups)

Quantitative Evaluation

19 peers already trained 6 new peers will be trained shortly 2 peer led healthy eating programs 5 peer led physical activity programs 1 combination program 6 peer leaders have taken on key leadership roles, while 13 have

acted in a supportive role 30 community members attended chronic disease info. night and

label reading workshop 4-12 people attend evening walking group 5 families attended Little Chefs, 5 adults and 10 children

Quantitative Evaluation

Peer leaders have transferred knowledge to neighbors, friends, partners, children and program participants

Peer leaders report better understanding of what healthy eating and physical activity are and how they can impact health

Peer leaders report that training has motivated them to eat better and get more active

Peer leaders report that training has increased their confidence in sharing knowledge with others

Reasons for participation included Learning about healthy living First aid and CPR certification Develop leadership skills Meet new people Resume and skill building Support positive change for self and others

Qualitative EvaluationImpact on Peer Leaders I feel good about progress in the community and

feel good about myself and about giving back to my community

I feel much healthier, I’m more active, I’ve walked a lot when handing out flyers, involved in the walking group, I’ve met a lot more of my neighbours

It’s been a chance to meet people, to get out of my house, to practice and improve my English, I’m less shy

I like the meetings; I learn a lot about healthy eating and living; I eat better and walk more; now I park the car a distance from my work and walk the rest of the way; I’ve lost 8 lbs.!

Qualitative Evaluation

Impact on Peer Leaders’ Families My children are more involved in their community and have

learned they can make a difference in their community I talk with my children about labels and healthy eating; my son is

walking more and eating better

Impact on Neighbours and Community The program is growing in our community People know about us, we have a presence in the community Peer leadership is a program to promote healthy eating and

proper exercise however, its also a way to bring communities together and meet new people

SustainabilitySustaining the Issue• Community leaders continue to share messages

• Tools developed used in other neighbourhoods

Behaviour Change• Empowerment and knowledge gained by individuals will have a lasting

impact on individual and community leadership, evaluation and advocacy skills.

Programs • HCF grant provides increased organizational capacity

• Guelph CHC will adopt and integrate the initiative into its operations

Partnerships3

• Strengthened partnerships with OW and Brant groups

• Potential for creation of new partners as initiative is expanded into other neighbourhood groups

Challenges Timelines delayed due to a number of factors

Delay in receiving funding Booking partner spaces Volunteer screening and orientation

Peer compensation an issue Tension between funder expectations and maintaining and

authentic community participation model Peer leader attrition due to moving, getting jobs, visiting family

abroad, pregnancy, moving neighbourhoods, etc. Barriers related to determinants of health limited volunteer’s

capacity, reliability and punctuality Language barriers Transportation barriers Childcare challenges Greater rate of physical and mental health concerns Neighbourhood crime Limited ability to connect online

Successes

Friendships formed which reduced social isolation New partnerships formed (ie. school, church

and Zumba instructors) Peers reporting they are eating better and are

more active Peer leader confidence in sharing information Peers are bringing accessible programming

to their neighbourhoods

Lessons Learned

First aid and CPR certification was a big incentive for participation

Removing barriers to participation by providing childcare, transportation and food

Unequal distribution of peer leader work Have volunteer policies and procedures in

place

Reflection

How could this program be adapted to your community?

How do you think we could improve upon this program?

Peer Leader Toolkit

Resources online at www.guelphchc.ca Resources include;

Program history and chronology Program pamphlet General chronic disease prevention manual Physical activity training manual Healthy eating training manual Physical activity tip sheets

Questions?

Thank you!

References

1) Guelph CHC (2006) Community Health Survey. Guelph Ontario: Anne Phillips

2) Guelph CHC (2009). Neighbourhood Profiles. Guelph, Ontario: Lynn Bestari

3) The Health Communication Unit (2001) Overview of Sustainability Version 8.2, April 30, 2001, Centre for

Health Promotion at the University of Toronto. Retrieved March, 2009 from http://www.thcu.ca/resource_db/pubs/698133998.pdf