The Newfoundland and Labrador Heart Health Program dissemination story: the formation and functioning of effective coalitions.
Newfoundland and Labrador is the most easterly province of Canada (O'Loughlin et al., Figure 1) with a population of 537,000. Rural in nature, 50% of the population resides in widely-dispersed communities of less than 2500 people. The economy traditionally relied on the fishing industry, but with the closure of the once lucrative cod fishery in 1991, the poorest province in Canada faced a difficult economic climate with up to 20% unemployment rates. With little funding available to supplement or sustain expensive initiatives, the Demonstration Phase of the Newfoundland and Labrador Heart Health Program (1990-1996) focused on how community-based programs are developed and sustained, with a view to diffusion throughout the province. The whole province was defined as the demonstration site for the project, and a community mobilization strategy was used with extensive reliance on community health professionals and volunteer contributions.
Holmes
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Newfoundland and Labrador Heart Health Program, Department of Health and Community Services, Confederation Building, West Block, P.O. Box 8700, St. John's, NF, Canada A1B4J6. PHolmes@mail.gov.nf.ca
Neville
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Donovan
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MacDonald
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D002318:Cardiovascular Diseases / Q000517:prevention & control*; D004059:Diffusion of Innovation; D006265:Health Care Coalitions / Q000458:organization & administration*; D006293:Health Promotion / Q000458:organization & administration*; D006801:Humans; D007255:Information Services / Q000458:organization & administration*; D009313:National Health Programs / Q000458:organization & administration*; D009523:Newfoundland and Labrador; D016730:Program Development / Q000379:methods; D012424:Rural Population