Grant: Catalyst Gr: Impacts of financial/organizational restructuring of public health

Periodic assessment of the capacity for chronic disease prevention (CDP) in the public health system in Canada is fundamental to optimizing CDP. Specifically, we need to monitor capacity for planning, target-setting, implementation and scaling up, and assessing the impact of interventions and policies that aim to reduce the chronic disease burden. Numerous important CDP capacity-building initiatives have taken place in Canada since the 1980s, and the public health systems in all 10 Canadian provinces have undergone major health system restructuring and reforms. Considering these ongoing structural changes in the public health system, periodic assessment is key to understanding progress and achievements in expanding CDP capacity as we work towards implementing and scaling up effective CDP programming across Canada. To address the lack of nationally representative data on CDP capacity, our team developed the Public Health ORganizational CApacity STudy (PHORCAST), comprising two Canada-wide surveys of public health organizations engaged in CDP. In 2005 and 2010, we surveyed all organizations in Canada with mandates for population-level primary prevention of chronic disease (cancer, CVD, diabetes, chronic respiratory illness), healthy lifestyle promotion, or with a single-focus mandate for healthy eating, tobacco control or physical activity. PHORCAST has already provided unique empirical insights into Canada's preventive health system and identified areas that need improvement (human resource planning, development and training, monitoring changes over time in organizational capacity for CDP; evaluating CDP programs, policies and practices). We propose to conduct a third survey, now 10-15 years since the original surveys, using the same methods used in 2005 and 2010. Results will update the evidence base on organizational capacity for CDP to support strategic expansion of CDP interventions and policies to better respond to the growing chronic disease burden in Canada.