Grant: Operating Grant - Secondary Analysis of Databases

Chronic diseases (cardiovascular, cancer, diabetes, chronic respiratory illness) are the leading causes of morbidity and mortality in Canada. Organizations within the public health system that have specific mandates for chronic disease prevention (CDP) and health promotion, are vital entities in terms of reducing this chronic disease burden. However most health services research to date focuses on organizations with mandates to treat illness, so that we know very little about the structure, resourcing, and functioning of the 'preventive health system' or about its impact on population health. Further little is known about the specific programs, practices, and policies (PPPs) undertaken in the context of CDP programming, and how these PPPs are transferred from one organization to another so that "best public health practices" are widely disseminated. To address the lack of nationally representative data on CDP organizations, our team developed the Public Health ORganizational CApacity STudy (PHORCAST) Research Program, which comprises the first series of Canada-wide surveys of public health organizations engaged in CDP. The first survey was conducted in 2004; the second in 2010. PHORCAST has already identified areas that need improvement (in human resource planning, development and training, in monitoring changes in organizational capacity for CDP over time; and in evaluating PPPs), but wide knowledge gaps remain in our understanding the Canadian public health system. The objective of this proposal is to conduct secondary analyses of the PHORCAST datasets to assess changes in organizational capacity for CDP in the five year period between the two surveys, and to continue our work investigating how best practices are disseminated within the preventive health system. The results will aid in more rational allocation of scarce public health resources, and they will inform the development of an effective chronic disease prevention strategy in this country.