Dissemination in Canada CICAD Guidelines for School-based Prevention of Substance Abuse VII Meeting of the Expert Group on Demand Reduction September 13, 2005 Presentation by Halina Cyr and Doug McCall

Canada Diverse population of 31 million people Mostly urbanized but with many rural and isolated communities A federal system of government with 13 provincial and territorial jurisdictions Provincial and territorial governments are responsible for health and education delivery Federal government provides transfer dollars, research, knowledge exchange and facilitation for coordinated approaches

Overview 1. Understand Context 2. Select Strategy & Outcome 3. Recognize Capacity & Systems 4. Define & Understand Audiences 5. Analyze Proposed Innovation 6. Determine Messages 7. Engage Messengers/Agents of Change 8. Plan Stages/Activities/Budget 9. Evaluate & Evolve

1. Understand Context Social, economic, cultural, political factors and structures – (federated structure) Recent history, trends – (Canada’s Drug Strategy Renewed) Opportunities and challenges Joint Consortium on School Health Health, Education and Enforcement in Partnership

2. Select Strategy & Outcome A continuum from distribution-ongoing publicity- diffusion-dissemination to implementation Key considerations in Canada: Process supports true ownership by Provinces/Territories Multi-sectorial approach ideal Guidelines used to promote comprehensive approach, with links to existing organizations

3. Recognize Capacity and Systems Build systems capacity in: coordinated policy mechanisms for cooperation infrastructure knowledge transfer workforce skills managing emerging issues surveillance/monitoring According to WHO assessment, Canada shows gaps in these areas

4. Define, Understand Audiences Identify end-user and channels – Provincial/Territorial Intermediaries Match message and materials to audience Consider “concerns” of adopters – e.g. overcrowded curricula, overloaded professionals In Canada, comprehensive, sustained and evidence- based approach is to be achieved in small increments

5. Analyze Proposed Innovation Consider scope of innovation (for e.g., the CICAD guidelines) and “competitors” Key considerations for Canada: Some PT’s have recent guidelines WHO is launching similar document Use CICAD as springboard to extend and connect existing work and knowledge. Pool knowledge and disseminate summaries

6. Determine Key Messages The CICAD recommends: improve legal, policy framework (1, 2, 5, 6) use system approach at all levels (5, 9, 10, 12) create more and better education programs (3, 4, 8, 17, 18) Coordinate multiple interventions (15) Engage students, parents, communities, business, (7,11,13,14) Create global alliances (16) Must adapt guidelines to Canadian context -

7. Engage Messengers/Agents Consider benefits, risks and investments of various partners and how they will impact the innovation and process. Describe roles of messengers or change agents and how they will be negotiated, implemented and sustained.

8. Plan Stages, Activities, Budget Develop plans at strategic, system and individual level Key considerations for Canada: Develop action plan with key partners at strategic and systems level Identify practical first steps to create momentum

9. Evaluate & Evolve Determine criteria for success – e.g. improved legal, policy framework for school-based prevention, more engagement of youth, parents, communities, business Identify sustainability elements Determine ongoing role of CICAD and other agencies Seek baseline data Build in formative assessment Conduct summative evaluation Disseminate, evolve In Canada, evaluation plan must be determined with key partners