Abstract
Background: Over 60% of health is shaped by the places where we spend our time, our relationships, and the circumstances in which we live, work, learn, play, and age. Creating healthy environments with communities, workplaces, schools, and health care settings is one of the best ways to keep people healthy and well. For more than a decade, Alberta Health Services (AHS), in Alberta, Canada has implemented Healthier Together projects with partners across the province in individual settings based on funding and operational priorities. Action across settings must be coordinated and integrated to realize improvements in local and population health and well-being priorities. Healthier Together takes a super setting approach which is more than a multi setting approach. The coordination and integration of activities at a system level and across multiple settings provides the basis for synergistic effects and an impactful and sustainable approach to health promotion.
Approach: Healthier Together is a population health approach designed that can be adapted and adaptable to meet various communities' needs. From small rural communities to large urban centers, this asset-based community development approach and population health principles are designed to impact the health and well-being of whole populations.At the system level, Healthier Together breaks down silos and enhances collaboration across the health system (public health, primary care, acute care, chronic disease prevention, data, and analytics, etc.) through a connected governance structure that has implementation, research, evaluation, analytics, communication, and engagement support at its core. At the local level, Healthier Together creates opportunities for intersectoral partners in health, education, employment, municipal government, social services, and citizens within diverse communities to work together across the pillars of integrated care to strengthen collaboration, create social value, and improve health and well-being outcomes. We have collaborated with seven diverse communities in Alberta, Canada to implement Healthier Together across multiple settings. This includes the establishment of multisectoral teams (MSTs) in each community which comprise of individuals from different settings and sectors who engage with the community to understand and identify health promotion priorities, design, implement and evaluate evidence-informed action plans to address those priorities, and then sustain the health promotion interventions.An evaluation framework has been designed which aims to measure collaboration at the system and local level using the Wilder Collaboration Factors Inventory, use a multi-level perspective framework to tell the story of change in each community, and measure the social value and collective impact of implementing the integrated actions across settings on population health and well-being outcomes through a social return on investment (SROI) analysis.
Results: The Healthier Together approach has sparked collaboration across settings in the communities and has led to the identification of community health promotion priorities including food security, financial well-being, and social connectedness. Surveys have been deployed to measure collaboration at the system and local level, the data collection plan is being finalized for the multi-level perspective framework and forecast SROI analyses have begun in the communities. Initial results will be ready to share in Fall 2024.
Implications: Findings from this work are anticipated to demonstrate the value of cross-setting collaboration to implement evidence-based strategies for improving population health and well-being. There is a plan to scale-up the seven community initiatives as well as Healthier Together as a unified approach to population health improvement.