title: Chronicling changes to the chronic disease prevention landscape in Canada's public health system 2004-2010.
abstract: The collective impact of major shifts in public health infrastructure and numerous new chronic disease prevention (CDP) capacity-building initiatives that have taken place in Canada over the last decade is unknown. The objective of this study was to determine if CDP capacity (i.e., skills and resources) and involvement in CDP programming improved in public health organizations in Canada from 2004 to 2010. Data for this repeated cross-sectional study were drawn from two waves of a national census of organizations mandated to carry out primary prevention of chronic disease and/or promotion of healthy eating, physical activity and tobacco control. Medians for continuous variables and frequencies for categorical variables were compared across time. Neither resources nor level of priority for CDP increased over time. There was little difference in the proportion of organizations with high levels of skills and involvement in core CDP practices (i.e., needs assessment, identification of relevant practices, planning, evaluation). Skills and involvement in CDP risk factor programming showed some gains, some steady states and some losses. Specifically, skill and involvement in tobacco control programming declined markedly while the proportion of organizations involved in healthy eating and physical activity programming increased. Skills to address and involvement in programming related to social determinants of health remained low over time as did involvement in programming addressing multiple risk factors concurrently. The lack of marked improvement in CDP capacity between 2004 and 2010 against a backdrop of initiatives favourable to strengthening the preventive health system in Canada suggests that efforts may have fallen short.
authors.affiliation: Centre de recherche du Centre hospitalier de l'Université de Montréal (CRCHUM), Montréal, Québec, Canada. Electronic address: nancy.hanusaik@mail.mcgill.ca.
authors.forename: N
authors.initials: N
authors.lastname: Hanusaik
authors.affiliation: Université de Montréal, Faculté de sciences infirmières, Montréal, Québec, Canada; Institut de recherche en santé publique de l'Université de Montréal (IRSPUM), Montréal, Québec, Canada.
authors.forename: D
authors.initials: D
authors.lastname: Contandriopoulos
authors.affiliation: Program Evaluation & Beyond Inc., Montréal, Québec, Canada; Université de Montréal, Département de médecine sociale et préventive, Montréal, Québec, Canada.
authors.forename: N
authors.initials: N
authors.lastname: Kishchuk
authors.affiliation: University of Alberta, Department of Public Health Sciences, Edmonton, Alberta, Canada.
authors.forename: K
authors.initials: K
authors.lastname: Maximova
authors.affiliation: McGill University, Department of Epidemiology, Biostatistics, and Occupational Health, Montréal, Québec, Canada; Institut national de santé publique du Québec (INSPQ), Montréal, Québec, Canada.
authors.forename: G
authors.initials: G
authors.lastname: Paradis
authors.affiliation: Centre de recherche du Centre hospitalier de l'Université de Montréal (CRCHUM), Montréal, Québec, Canada; Université de Montréal, Département de médecine sociale et préventive, Montréal, Québec, Canada; Institut national de santé publique du Québec (INSPQ), Montréal, Québec, Canada.
authors.forename: J L
authors.initials: JL
authors.lastname: O'Loughlin
mesh_terms: D002170:Canada; D057191:Capacity Building / Q000458:organization & administration*; D002908:Chronic Disease / Q000517:prevention & control*; D003430:Cross-Sectional Studies; D006293:Health Promotion / Q000458:organization & administration*; D006801:Humans; D011322:Primary Prevention / Q000458:organization & administration*; D015397:Program Evaluation; D011635:Public Health Administration / Q000639:trends*
keywords: Canada; Chronic disease prevention; Follow-up study; Organizational capacity; Public health services and systems; Survey