The Health Information Prescription Project

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Keeping Pace

• The Health Information Prescription Project

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The Roman Army expected its soldiers to march 25
miles a day. They set the standard for what is
now considered a pace. In Grey Bruce, we are
trying to set a new standard.
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Who are we?

• Grey Bruce Rural Community Partnership for
  Resource Exchange for Health Living
• Grey Bruce Health Unit
• Grey Bruce District Stroke Centre
• Grey and Bruce Libraries
• Grey Bruce Health Services Health Sciences
  Library
• Regional Diabetes Program
• Recreation Centres
• Ontario Early Years
• Parks Canada
• Bruce Trail

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Library Pedometer Lending Program

• The process began with the pedometer program.

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Library Pedometer Program

• Based on a model developed by Ottawa Public
  Health Unit
• 31 libraries participating 100
• 2 pedometers in each library
• Borrow like a library book

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Library Pedometer Program

• Benefits
• Increase interest in physical activity
• More books on physical activity accessed
• Increased membership

• Challenges
• Late returns
• Lack of understanding of equipment function
• Extra work
• Lack of storage space

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Library Pedometer Program

• Enhancements
• Increase number of pedometers to decrease waiting
  time
• Libraries becoming informed health information
  hubs

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Library Pedometer Lending Program

• Based on the success of the Pedometer program in
  the public library system, it was decided that
  this might be a good way to introduce selected
  medical information

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Health Information Prescription

• The aim of the program was to provide a
  consistent, reliable and
• understandable selection of
• information regarding stroke easily
• accessible to the general public.

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Method

• The method chosen was to place
• selected resources (books web sites)
• in the public library system to give easy
• access to information regarding stroke

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Background

• Why Stroke?
• Why Grey and Bruce?
• Why now?

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Why Stroke?

• Estimated that 4.1 of Canadians over 65 years of
  age (approximately 300,000 individuals) currently
  live with the effects of stroke.
• Between 2000 and 2010, the number of strokes in
  Ontario will have increased by 9.

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Why Grey and Bruce?

• In 2000-2001, 496 individuals were hospitalized
  for stroke or transient ischemic attacks in the
  Grey and Bruce counties. It is estimated that
  another 473 individuals had a stroke or transient
  ischemic attack but were not admitted to
  hospital.

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Why Grey and Bruce?

• The population is more elderly than most areas
• Many seniors live in rural area or hamlets
• Public transport is essentially non-existent
• Public libraries are wide spread, convenient and
  trusted.

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Why Grey and Bruce?

• Grey Bruce Health Services was designated as a
  District Stroke Centre (DSC) for Grey and Bruce
  Counties in the spring of 2002. The District
  Stroke Centre is a component of the Ontario
  Stroke Strategy.

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District Stroke Centres

• District Stroke Centres provide care to
  stroke patients at all points in the spectrum of
  stroke care promotion, prevention, acute care,
  rehabilitation and return to the community.

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Stroke and Community

• Increasingly the emphasis is on the return to
  the community and rehabilitation of the client in
  the community

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Healthy Living and Community

• The successful uptake of healthy living concepts
  needs to be at the individual and community
  level.
• Health information and motivational tools empower
  people to consider behaviour change to improve
  their health.

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Why now?

• Various programs have money and mandate!
• Ontario Stroke System,
• Ministry of Health Promotion
• Ontarios Rural Plan
• Active 2010
• Regional Diabetes Program

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Budget

• We received 3000 and used it to purchase book
  sets which were placed in each of libraries.
• The book titles
• Stroke . A Comprehensive Guide to Brain Attacks
• Stroke and the Family A New Guide, 1st Edition
• Stroke for Dummies

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Health Prescription Project The Journey
BeginsThe Original Proposal

• Would allow individuals to access health
  information at their local library
• Would allow health professionals to recommend
  credible information including websites to the
  individual.
• Would allow consistency in the message

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Objectives

• To allow patients/clients to access appropriate
  stroke and stroke prevention information close to
  home.
• To assist the libraries in obtaining and
  dispensing appropriate information on stroke and
  stroke prevention both in print and on the web.
• To ensure information dispensed is consistent and
  available across each community.
• To strengthen the relationship between community
  libraries and DSC programs and GBHS Health
  Sciences Library

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Evidence

• We decided to chose the information prescription
  approach on the basis of
• Literature Search
• Paediatric Experience
• Webinar with Don Buchanan following his
  presentation at OLA Conference
• Internet use
• Library pedometer project

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Process

• Discussion Paper and feedback
• Health Unit Expresses Interest to
  Partner
• First Contact Meeting
• Information Packages

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Health Information Prescription

• Activities
• Develop the prescription
• Develop a relationship between GBHS Health
  Sciences Library and the community libraries
• Disseminate the books and prescriptions
• Develop an evaluations framework

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The Prescription

• Instruction
• Suggested Resources
• Special Requests
• Books
• Websites

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Statistics

• As yet no definite results.
• Hard to measure who is taking and using the
  materials
• How does one measure the outcomes
• Sustainability

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Problems

• We needed to be mindful of time stresses placed
  on the libraries\cataloguing - Record keeping
• Communication
• Did the material fit within the collections
  policy of the organizations?
• Were we setting a precedent for other groups?

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Falling into Step
Collaborated with 2 other projects to form Grey
Bruce Rural Community Partnership for Resource
Exchange for Healthy Living
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Stepping Out on the Bruce Trail
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Stepping Out on the Bruce Trail

• Virtual Walk of the Bruce Trail
• 480 km End to End
• 10,000 steps 8 km
• Two months to complete
• Competition and prizes

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Stepping Out on the Bruce Trail

• Pilot just finished
• Two school boards and the Dental Association
• 1,300 people participated
• Now expanded to the public and workplaces
• As of Friday 500 teams of 4 people

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Time lines

• Phase I (May 2005 to January 2006)
• Local Program Assessment
• Phase II (February to October 2006)
• Incorporation of Evidence
• Development of Evaluation Protocol
• Phase III (November 2006 to March 2007)
• Implementation

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Outcomes

• Increased use of motivational tools to improve
  physical activity
• Increase in number residents using community
  partners for health information.
• Strengthened relationships with community
  partners
• Increased community responsibility for healthy
  living
• Increase in number of participating community
  partners

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Conclusion

• When you change your attitude,
• You change your behaviour.
• When you change your behaviour,
• You change your performance.
• When you change your performance,
• You change your life!

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Questions?
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PresentersKeeping Pace

• Mary Solomon,
• Grey Bruce District Stroke Centre Coordinator,
• Grey Bruce Health Services, Owen Sound
• msolomon_at_gbhs.on.ca
• Lynda Bumstead, RD
• Program Manager Chronic Disease Prevention
• Grey Bruce Health Unit, Owen Sound
• lbumstead_at_publichealthgreybruce.on.ca
• Elyse Pike,
• Health Sciences Librarian
• Grey Bruce Health Services, Owen Sound
• Library_at_gbhs.on.ca