Loading presentation...

Present Remotely

Send the link below via email or IM

Copy

Present to your audience

Start remote presentation

  • Invited audience members will follow you as you navigate and present
  • People invited to a presentation do not need a Prezi account
  • This link expires 10 minutes after you close the presentation
  • A maximum of 30 users can follow your presentation
  • Learn more about this feature in our knowledge base article

Do you really want to delete this prezi?

Neither you, nor the coeditors you shared it with will be able to recover it again.

DeleteCancel

Make your likes visible on Facebook?

Connect your Facebook account to Prezi and let your likes appear on your timeline.
You can change this under Settings & Account at any time.

No, thanks

Canadian Diabetes Policy Presentation

No description
by

joanna shnall

on 23 October 2012

Comments (0)

Please log in to add your comment.

Report abuse

Transcript of Canadian Diabetes Policy Presentation

Strategy:
Yes
Yes
Yes
Yes
No
No
Yes
No
No
Yes
No
Yes
No Conclusions and the Way Forward Provincial Diabetes Strategy Methods and Strategies Project Rationale and Overview Background The Canadian Diabetes Policy Odyssey Basic Research Question Basis of Analysis Motivation "Is Canada implementing the most cost-effective policies and strategies related to diabetes prevention?" Cost-effective interventions identified by previous HSI interns
Cost-effectiveness threshold: <$50,000/QALY
Comparison with policies implemented by Canadian provinces Motivations for the project: influence smart policy based on tried and tested research, to create a unique tool that: includes all provinces,
includes primary, secondary, tertiary interventions
is an interactive tool Resources Search Strategy Mindmapping Software Legislation index of the Parliament of Canada
CanLII
Federal and Provincial ministries, including Annual Reports
PHAC, Health Canada, Canadian Institute of Health Research
Drug formularies and health insurance plans
Nation-wide/provincial-wide associations (i.e. Canadian Diabetes Association)
Google searches Change in Strategy Types of included literature Inclusion Criteria 1. exhaust government websites first
2. systematic keyword search to check for oversight Acts and accompanying Regulations
Policies, Bills, By-laws
Codes, Requirements
Strategies, initiatives, programs, frameworks, etc.
All funded by public/governmental agencies Exclusion Criteria Time Frame:
Most up-to-date programs/initiatives
Length 1+ years
Active throughout 2012
Budget:
Publicly funded
Organisation:
At provincial level (i.e. excluding municipal/local level programs) Pregnancy/infant/early childhood development
School breakfast and milk programs
Built environment/Infrastructure funding
“Empty frameworks”
Smoking prevention programs
Drug plans not relevant to diabetes or diabetes risk factors
“Tool kits” etc.
Any funding or programs for
elite-level athletes Public Health Campaign School Nutrition Policy Strengths and Limitations of Data and Approach Conclusions Search Strategy:
Locate relevant Acts and Regulations
Identify designated provincial professional regulatory body
Locate document defining scope of practice

Criteria:
Must be able to diagnose and treat illnesses, prescribe medications, and work autonomously Are there nurse-led clinics? Coordinated approach to child health intervention program (focus on education, diet, lifestyle, and prevention for grades 3-5), $900/QALY (Brown, 2007) Province
AB
BC
MB
NB
NL
NS
ON
PEI
QC
SK
NT
NU
YK Policy:
No
Yes
No
Yes
No
Yes
Yes
No
No
No
No
No
No Province
AB
BC
MB
NB
NL
NS
ON
PEI
QC
SK
NT
NU
YK Province
AB
BC
MB
NB
NL
NS
ON
PEI
QC
SK
NT
NU
YK Province
AB
BC
MB
NB
NL
NS
ON
PEI
QC
SK
NT
NU
YK Are School Nutrition Policies Mandated? Is there a Provincial Diabetes Strategy? Primary Intervention Keywords:
Diet OR Nutrition
Exercise OR Physical Activity
Education
School Clinic:
No
Yes
No
Yes
No
Yes
Yes
No
No
No
No*
No*
No* Campaigns:
4
2
2
2
3
2
1
2
2
1
1
1
1 How many public health campaigns are there? Primary Intervention "The media campaign interventions appear highly cost-effective at AU $46 (US $34, £18) for ‘2 fruit 5 veg’ and AU $5600 (US $4200, £2200) per QALY gained for FFFF, but are associated with considerable uncertainty, and may be dominated under certain assumptions." Drop The Pop! Campaign Tertiary Intervention Specialist Nurse-led clinics to improve control of hypertension and hyperlipidemia in diabetes, $4020/QALY (Mason, 2005) all three territories covered
originated in NU in 2003
2011 evaluation 26 of the 31 sample schools (83.9%) participated in the evaluation
76.6% of schools reported that their students brought healthier beverages and foods to school during Drop the Pop.
Similarly, students in all three territories reported that they drank or ate more healthy foods/ beverages both at school and at home.
The majority of parents felt that their children’s consumption of pop decreased while their consumption of healthy foods and drinks stayed the same during the Drop the Pop.
They also indicated that their children had asked them to buy healthy foods for them to eat at school or at home. Lifestyle intervention: Educational (multi-media) public campaigns on diet or nutrition (Dalziel/Segal, 2007) Keywords:
Education
Diet OR Nutrition
Media OR Multi-Media OR Media campaign
Health Québec Example: Ontario Nutrition standards are stated in the Education Act
Healthy Food for Healthy Schools Act
Drops trans-fat from food and beverages sold in schools
School Food and Beverage Policy
Mandatory nutrition standards Nurse Practitioners (NP) recognized in the Health Professions Act
However, may NOT bill BC's Medical Services Plan on a fee-for-service basis
Meaning NPs must either...
Work alongside a general physician OR
Work in a clinic funded by a health authority
=> Legislation does not match on-the-ground practices Example:
British Columbia Quebec’s prevalence rate is lower than the national average
They do not even have a chronic disease strategy, let alone a diabetes strategy
Ontario has a higher rate than the national average
But they have a comprehensive diabetes strategy
Political priorities vs. public health approach
Correlation vs. causation
Flip cause and effect Nurse-led Clinics To Consider: Limitations of Data and Approach: http://mind42.com/pub/mindmap?mid=854d4cfb-4129-4fe1-adc5-1670e5935ed1&rel=url Strengths of Data and Approach: Comprehensive and thorough search of provincial-level activity surrounding diabetes
Easy to determine whether or not a practice is legislated (a yes or no)
...and therefore easily comparable, identifiable, concrete
Relates best practices to actual practices
An easy, visual way to understand provincial-level policies and programs
Our search strategy and visual approach can be replicated for other chronic level disease policy projects Policies and Programs at the Federal Level Does our research really tell us what Canada is doing and not doing?
Legislation
Community/Municipal level
Private programs
A strategy does not equal results
Comparability
Lack of information on how programs are carried out on the ground
Are cost-effective interventions applicable to Aboriginal populations? Next Steps Website Development Evaluations and Impact Assessments Is Canada doing enough?
Where provinces are doing well:
Smoking cessation counseling
Nurse-practitioners
Drug coverage consistent
Where provinces are lacking:
Screening
Programs geared towards adult populations
Workplace programs
Conclusion:
The problem is clear, but solutions are slow-moving Final Document Compares the ideal cost-effective policies with the closest-matching policies that are currently in place Janina Grabs, Jasmine Lam, Joanna Shnall
Full transcript