Using the CIW to shift the conversation about health and wellbeing

Denise Squire, Executive Director, Woolwich Community Health CentreIn June 2007, I heard Roy Romanow speak about the CIW at the annual Association of Ontario Health Centres conference, and I got REALLY excited! For the first time ever, I felt there was a systematic, evidence-based, credible tool that – despite its national scope - could readily and appropriately be applied to the community level; a tool that could measure the type of work that our CHC does in partnership with so many other agencies and groups (many of which are not health service providers), and by extension, to then drive needed change

But how to incorporate the CIW into our CHC’s work, in a way that would truly make a difference? By embedding the CIW framework into our regular strategic planning work, using it as a guide for the community-wide assessment that our CHC conducts every 4-5 years in our rural catchment area (Woolwich, Wellesley and northern third of Wilmot Townships). The purpose of our assessment is to ‘cast the net wide’, to understand the health of the rural community served by our CHC in the broadest possible sense, looking at needs and strengths, across and between all of the determinants of health. Our community assessment work is critical to supporting our CHC’s own planning: guiding our vision/mission/values, and helping to define our priority populations, strategic priorities, and partnership development. In addition, our community assessment produces valuable knowledge to share with other stakeholders: township and regional councils, our LHIN and other funders, partner agencies, community groups, and rural residents. The assessment process itself is a significant community engagement activity for our CHC, involving 400+ rural citizens through surveys, focus groups, key informant interviews, and through membership on a steering committee that guides this valuable work.

Map of Wilmot, Wellesley and Woolwich townships

Our first, tangible step to using the CIW came in the fall of 2009, when we began our year-long community assessment. At that time, we focused on using the Community Vitality domain to assess community strengths, which confirmed our historical sense that local rural residents had a strong sense of community and a solid track record of volunteerism. But how to harness that knowledge about Community Vitality to help make the lives of rural residents better? We took two concrete actions over the next few years, inspired by our Community Vitality findings: supporting community groups and organizations (not just our own CHC) with volunteer workshops to further enhance the capacity of rural volunteers to make a difference; and actively supporting a ‘newcomers group’ to help build a sense of community with those moving into new housing in Wellesley. Also, by widely sharing our community assessment report in 2010, our CHC (hopefully!) inspired action by other decision-makers, and introduced a broad, new audience to the CIW.

Now in early 2014, we are well into our next Community Wellbeing Assessment – this time in collaboration with three other rural agencies, and using all 8 domains of the CIW as the framework for our information gathering. With the release of the Ontario CIW report, and as the use of the CIW spreads across other communities, we look forward to the future potential of being able to compare our community assessment results - and progress over time in each of the domains and comparable indicators – with those of other CHCs, other communities, our regional municipality, Ontario, and nation-wide.

The CIW gives communities a ‘common language’ for describing the whole picture of health and wellbeing – and that common language is essential to truly 'shifting the conversation' in this province, and across Canada, about what makes and keeps us well.

Note: For more information on how Community Health Centres (CHC's) are using the CIW, please read the Association of Ontario Health Centre's (AOHC's) recent discussion paper. For more information on the Woolwich Community Health Centre see

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