Lori Baugh Littlejohns | Deakin University (original) (raw)
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Papers by Lori Baugh Littlejohns
Early childhood (EC) professionals and educators (n = 159) that engage in measurement with childr... more Early childhood (EC) professionals and educators (n = 159) that engage in measurement with children aged 0-6 years were surveyed to determine their level of knowledge and current practices as it related to early childhood measurement. The survey gathered information about the respondents’ background and educational history, knowledge and competency, issues and needs, and uses of measurement tools. Given that ECD professionals are instrumental to the measurement process it is vital that they receive the appropriate supports necessary for best practice. The results presented in this summary attempt to go beyond reporting on the specific tools used and factors influencing tool selection to understand the knowledge, competencies, and training needs of ECD professionals.
PLOS ONE
Background Public health services and systems research is under-developed in Canada and this is p... more Background Public health services and systems research is under-developed in Canada and this is particularly the case with respect to research on local public health unit operational functioning and capacity. The purpose of this paper is to report on a study that will collect retrospective information on the local public health response to COVID-19 throughout Canada between 2020 and 2021. Methods/Design The goal of the study is to develop and implement a study framework that will collect retrospective information on the local public health system response to the COVID-19 pandemic in Canada. This study will involve administering a mixed-method survey to Medical Health Officers/Medical Officers of Health in every local and regional public health unit across the country, followed by a process of coding and grouping these responses in a consistent and comparable way. Coded responses will be assessed for patterns of divergent or convergent roles and approaches of local public health acro...
Health Research Policy and Systems
Background: Despite calls for the application of complex systems science in empirical studies of ... more Background: Despite calls for the application of complex systems science in empirical studies of health promotion, there are very few examples. The aim of this paper was to use a complex systems approach to examine the key factors that influenced health promotion (HP) policy and practice in a multisectoral health system in Australia. Methods: Within a qualitative case study, a schema was developed that incorporated HP goals, actions and strategies with WHO building blocks (leadership and governance, financing, workforce, services and information). The case was a multisectoral health system bounded in terms of geographical and governance structures and a history of support for HP. A detailed analysis of 20 state government strategic documents and interviews with 53 stakeholders from multiple sectors were completed. Based upon key findings and dominants themes, causal pathways and feedback loops were established. Finally, a causal loop diagram was created to visualise the complex array of feedback loops in the multisectoral health system that influenced HP policy and practice. Results: The complexity of the multisectoral health system was clearly illustrated by the numerous feedback mechanisms that influenced HP policy and practice. The majority of feedback mechanisms in the causal loop diagram were vicious cycles that inhibited HP policy and practice, which need to be disrupted or changed for HP to thrive. There were some virtuous cycles that facilitated HP, which could be amplified to strengthen HP policy and practice. Leadership and governance at federal-state-local government levels figured prominently and this building block was interdependently linked to all others. Conclusion: Creating a causal loop diagram enabled visualisation of the emergent properties of the case health system. It also highlighted specific leverage points at which HP policy and practice can be improved. This paper demonstrates the critical importance of leveraging leadership and governance for HP and adds urgency to the need for increased and strong advocacy efforts targeting all levels of government in multisectoral health systems.
BMC Public Health
Background: While frameworks exist for strengthening health care systems and public health system... more Background: While frameworks exist for strengthening health care systems and public health systems, there are no practical frameworks to describe, assess and strengthen systems for chronic disease prevention (CDP) using complex systems approaches. Methods: A systematic and integrative review of peer reviewed literature was conducted to answer the following questions: How can systems for CDP be defined? What are key attributes of effective systems? How are complex systems approaches discussed? Search terms were identified and the Medline, SCOPUS, and Global Health databases were searched December 2017 and January 2018. Reference lists and selected journals were hand searched. A working definition for a system for CDP was developed to provide a guideline for inclusion. Key exclusion criteria were literature did not address the research questions or working definition; was published in a language other than English and before 2000; focused on specific chronic diseases and/or risk factors and not CDP broadly; concentrated on the health care sector and clinical services and/or health status and surveillance data; and described evaluations of setting specific actions such as policies, programs, interventions, approaches, projects, laws, or regulations. Selected literature (n = 141) was coded in terms of the extent to which the research questions and the working definition of systems for CDP were addressed. Data was then analysed and synthesized to determine key themes. Results: A revised definition of systems for CDP and seven attributes of effective systems for CDP are reported (collaborative capacity, health equity paradigm, leadership and governance, resources, implementation of desired actions, information and complex systems paradigm). A framework was developed to provide a foundation for describing, assessing and strengthening systems for CDP. Conclusions: The results of this literature review provide a strong foundation for a framework to help strengthen systems for CDP. The framework consolidates not only well-established attributes of effective CDP but also highlights theoretical and practical insights from complex systems perspectives.
Efforts of health professionals are shifting away from programs that "deliver health" toward thos... more Efforts of health professionals are shifting away from programs that "deliver health" toward those that build the capacity of communities to work together to create healthy places. The Healthy Communities Initiative (HCI) is a community development model in central Alberta (Canada) that involves the creation of a widely shared vision of a healthier community; assessment of community needs and capacities; selection of priority areas for action; creation and implementation of action plans; and evaluation and monitoring of actions through the development of community-level indicators. Case studies of HCI implementation in four rural communities show that four health-related issues emerged consistently: need for youth development, preservation of the natural environment, maintaining a strong sense of community in the face of changing social dynamics, and access to health services. Capacity-building issues included lack of shard vision, need for further leadership development among both adults and youth, communication difficulties, lack of knowledge about how to access resources, and lack of well-defined processes by which the communities could learn from experience. Lessons learned about integrating community capacity building and a healthy communities initiative are discussed. (TD) Reproductions supplied by EDRS are the best that can be made from the original document.
As health promotion practitioners, we have been encouraged to implement strategies that embrace a... more As health promotion practitioners, we have been encouraged to implement strategies that embrace a community-building approach for strengthening community health. In this article, we present our experience in piloting a methodology to assess the extent to which community capacity was built in a rural heart health project. We defined community capacity as the degree to which a community (and its agency partners) can develop, implement, and sustain actions for strengthening community health. An assessment protocol that included a series of guiding questions and a ranking procedure to assess seven domains of community capacity was designed for focus group application. Following from this, community capacity webs, which visually depict the extent of capacity built through the heart project, were produced for each community. The methodology requires further refinement; however, through this process we were able to further our understanding of the effectiveness of this project in building community capacity.
Community Development Journal, 2001
... Wilkinson (1989) states that 'community development means build-ing the capacity of loca... more ... Wilkinson (1989) states that 'community development means build-ing the capacity of local people to work together to address their common interests' (p. 340). In a systematic overview of the impact of community development initiatives in nursing, Ploeg et al. ...
Local Environment, 2014
ABSTRACT
Australian Journal of Primary Health, 2000
The purpose of this study was to design, test and evaluate a community capacity assessment proces... more The purpose of this study was to design, test and evaluate a community capacity assessment process within a Healthy Communities Initiative (HCI) in conjunction with model development for enhanced primary health care (PHC) services in small rural communities. This paper describes the HCI planning process and community capacity assessment methods and tools, in the context of a small rural community that identified enhanced PHC as a key priority area. A PHC demonstration project was developed and a model integrating community action with the PHC team and the services they provide was created. It is the community action component of the model that we highlight in this paper in order to further knowledge development of strategies to strengthen community action. The key learnings from this study are threefold. The assessment process appears to (a) be effective in raising awareness, stimulating dialogue and fostering learning about community capacity (both on the part of community participants and outside professional helpers), (b) be promising in terms of helping communities take action to build capacity in targeted areas, and (c) provide a forum for integrating the HCI and the PHC project, thereby allowing equal attention to be given to primary health care service delivery and to strengthening community action.
American Journal of Health Education, 2007
ABSTRACT
Health Promotion …, 2008
This paper reports on expectations for and community members' experience in the development ... more This paper reports on expectations for and community members' experience in the development of community indicators in a healthy communities initiative (HCI) in Alberta, Canada. The HCI process involved community visioning, the creation of action plans to further the vision by ...
Early childhood (EC) professionals and educators (n = 159) that engage in measurement with childr... more Early childhood (EC) professionals and educators (n = 159) that engage in measurement with children aged 0-6 years were surveyed to determine their level of knowledge and current practices as it related to early childhood measurement. The survey gathered information about the respondents’ background and educational history, knowledge and competency, issues and needs, and uses of measurement tools. Given that ECD professionals are instrumental to the measurement process it is vital that they receive the appropriate supports necessary for best practice. The results presented in this summary attempt to go beyond reporting on the specific tools used and factors influencing tool selection to understand the knowledge, competencies, and training needs of ECD professionals.
PLOS ONE
Background Public health services and systems research is under-developed in Canada and this is p... more Background Public health services and systems research is under-developed in Canada and this is particularly the case with respect to research on local public health unit operational functioning and capacity. The purpose of this paper is to report on a study that will collect retrospective information on the local public health response to COVID-19 throughout Canada between 2020 and 2021. Methods/Design The goal of the study is to develop and implement a study framework that will collect retrospective information on the local public health system response to the COVID-19 pandemic in Canada. This study will involve administering a mixed-method survey to Medical Health Officers/Medical Officers of Health in every local and regional public health unit across the country, followed by a process of coding and grouping these responses in a consistent and comparable way. Coded responses will be assessed for patterns of divergent or convergent roles and approaches of local public health acro...
Health Research Policy and Systems
Background: Despite calls for the application of complex systems science in empirical studies of ... more Background: Despite calls for the application of complex systems science in empirical studies of health promotion, there are very few examples. The aim of this paper was to use a complex systems approach to examine the key factors that influenced health promotion (HP) policy and practice in a multisectoral health system in Australia. Methods: Within a qualitative case study, a schema was developed that incorporated HP goals, actions and strategies with WHO building blocks (leadership and governance, financing, workforce, services and information). The case was a multisectoral health system bounded in terms of geographical and governance structures and a history of support for HP. A detailed analysis of 20 state government strategic documents and interviews with 53 stakeholders from multiple sectors were completed. Based upon key findings and dominants themes, causal pathways and feedback loops were established. Finally, a causal loop diagram was created to visualise the complex array of feedback loops in the multisectoral health system that influenced HP policy and practice. Results: The complexity of the multisectoral health system was clearly illustrated by the numerous feedback mechanisms that influenced HP policy and practice. The majority of feedback mechanisms in the causal loop diagram were vicious cycles that inhibited HP policy and practice, which need to be disrupted or changed for HP to thrive. There were some virtuous cycles that facilitated HP, which could be amplified to strengthen HP policy and practice. Leadership and governance at federal-state-local government levels figured prominently and this building block was interdependently linked to all others. Conclusion: Creating a causal loop diagram enabled visualisation of the emergent properties of the case health system. It also highlighted specific leverage points at which HP policy and practice can be improved. This paper demonstrates the critical importance of leveraging leadership and governance for HP and adds urgency to the need for increased and strong advocacy efforts targeting all levels of government in multisectoral health systems.
BMC Public Health
Background: While frameworks exist for strengthening health care systems and public health system... more Background: While frameworks exist for strengthening health care systems and public health systems, there are no practical frameworks to describe, assess and strengthen systems for chronic disease prevention (CDP) using complex systems approaches. Methods: A systematic and integrative review of peer reviewed literature was conducted to answer the following questions: How can systems for CDP be defined? What are key attributes of effective systems? How are complex systems approaches discussed? Search terms were identified and the Medline, SCOPUS, and Global Health databases were searched December 2017 and January 2018. Reference lists and selected journals were hand searched. A working definition for a system for CDP was developed to provide a guideline for inclusion. Key exclusion criteria were literature did not address the research questions or working definition; was published in a language other than English and before 2000; focused on specific chronic diseases and/or risk factors and not CDP broadly; concentrated on the health care sector and clinical services and/or health status and surveillance data; and described evaluations of setting specific actions such as policies, programs, interventions, approaches, projects, laws, or regulations. Selected literature (n = 141) was coded in terms of the extent to which the research questions and the working definition of systems for CDP were addressed. Data was then analysed and synthesized to determine key themes. Results: A revised definition of systems for CDP and seven attributes of effective systems for CDP are reported (collaborative capacity, health equity paradigm, leadership and governance, resources, implementation of desired actions, information and complex systems paradigm). A framework was developed to provide a foundation for describing, assessing and strengthening systems for CDP. Conclusions: The results of this literature review provide a strong foundation for a framework to help strengthen systems for CDP. The framework consolidates not only well-established attributes of effective CDP but also highlights theoretical and practical insights from complex systems perspectives.
Efforts of health professionals are shifting away from programs that "deliver health" toward thos... more Efforts of health professionals are shifting away from programs that "deliver health" toward those that build the capacity of communities to work together to create healthy places. The Healthy Communities Initiative (HCI) is a community development model in central Alberta (Canada) that involves the creation of a widely shared vision of a healthier community; assessment of community needs and capacities; selection of priority areas for action; creation and implementation of action plans; and evaluation and monitoring of actions through the development of community-level indicators. Case studies of HCI implementation in four rural communities show that four health-related issues emerged consistently: need for youth development, preservation of the natural environment, maintaining a strong sense of community in the face of changing social dynamics, and access to health services. Capacity-building issues included lack of shard vision, need for further leadership development among both adults and youth, communication difficulties, lack of knowledge about how to access resources, and lack of well-defined processes by which the communities could learn from experience. Lessons learned about integrating community capacity building and a healthy communities initiative are discussed. (TD) Reproductions supplied by EDRS are the best that can be made from the original document.
As health promotion practitioners, we have been encouraged to implement strategies that embrace a... more As health promotion practitioners, we have been encouraged to implement strategies that embrace a community-building approach for strengthening community health. In this article, we present our experience in piloting a methodology to assess the extent to which community capacity was built in a rural heart health project. We defined community capacity as the degree to which a community (and its agency partners) can develop, implement, and sustain actions for strengthening community health. An assessment protocol that included a series of guiding questions and a ranking procedure to assess seven domains of community capacity was designed for focus group application. Following from this, community capacity webs, which visually depict the extent of capacity built through the heart project, were produced for each community. The methodology requires further refinement; however, through this process we were able to further our understanding of the effectiveness of this project in building community capacity.
Community Development Journal, 2001
... Wilkinson (1989) states that 'community development means build-ing the capacity of loca... more ... Wilkinson (1989) states that 'community development means build-ing the capacity of local people to work together to address their common interests' (p. 340). In a systematic overview of the impact of community development initiatives in nursing, Ploeg et al. ...
Local Environment, 2014
ABSTRACT
Australian Journal of Primary Health, 2000
The purpose of this study was to design, test and evaluate a community capacity assessment proces... more The purpose of this study was to design, test and evaluate a community capacity assessment process within a Healthy Communities Initiative (HCI) in conjunction with model development for enhanced primary health care (PHC) services in small rural communities. This paper describes the HCI planning process and community capacity assessment methods and tools, in the context of a small rural community that identified enhanced PHC as a key priority area. A PHC demonstration project was developed and a model integrating community action with the PHC team and the services they provide was created. It is the community action component of the model that we highlight in this paper in order to further knowledge development of strategies to strengthen community action. The key learnings from this study are threefold. The assessment process appears to (a) be effective in raising awareness, stimulating dialogue and fostering learning about community capacity (both on the part of community participants and outside professional helpers), (b) be promising in terms of helping communities take action to build capacity in targeted areas, and (c) provide a forum for integrating the HCI and the PHC project, thereby allowing equal attention to be given to primary health care service delivery and to strengthening community action.
American Journal of Health Education, 2007
ABSTRACT
Health Promotion …, 2008
This paper reports on expectations for and community members' experience in the development ... more This paper reports on expectations for and community members' experience in the development of community indicators in a healthy communities initiative (HCI) in Alberta, Canada. The HCI process involved community visioning, the creation of action plans to further the vision by ...