Propel Centre for Population Health Impact
Faculty of Applied Health Sciences
University of Waterloo
200 University Avenue West
Waterloo, Ontario, Canada N2L 3G1
The Canadian Student Tobacco, Alcohol, and Drugs Survey (CSTADS) is a survey conducted in Grades 6-12 (Grade 6-secondary V in Quebec) every other year. Formerly the Youth Smoking Survey (YSS), CSTADS collects data on youth substance use, and other areas identified by schools as priorities, such as bullying, mental health and how connected students feel to their school.
CSTADS will provide Health Canada, provinces, schools, communities, and parents with timely and reliable data on tobacco, alcohol and drug use in addition to other related issues about Canadian students. School-aged children and youth are generally recognized as most at risk for experimenting with tobacco products, alcohol and drugs. With a consistent measure of student substance use it is possible to examine the factors that influence youth behaviour with respect to tobacco, alcohol and drug use.
Propel has centrally co-ordinated the implementation of CSTADS (formerly the Youth Smoking Survey) since 2004, and works with provincial partners to implement the project in each province. Propel has a reputation for conducting high quality research that is not overly disruptive to school staff and students.
01/2004 - 12/2019
This project uses school-based surveys of Canadian youth to examine risk behaviours in provincially-representative samples. We are conducting a series of natural experiments, the gold standard in population-based research, to evaluate the impact of provincial policies that may influence risky health behaviours, such as tobacco use, poor diet, poor mental health, and tanning bed use. . Timely reports of surveillance data to key stakeholders are crucial for developing effective policies to prevent and reduce chronic disease risk behaviours among youth; our linkages with policy and practice stakeholders create the potential for pan-Canadian learning and knowledge translation (KT) that impacts future chronic disease incidence.
This project also explores methods for recruiting students to participate in an online, longitudinal panel survey to track youth and their behaviours into young adulthood, and will examine the impact of policies on youth health behaviours.
Visit the CRAYS website for more information.
07/2014 – 07/2017
Young adults have the highest smoking prevalence (23%). Sixty-nine per cent of young adult cell phone users are smartphone subscribers. To date no controlled trials have been done on the use of smartphone cessation apps. The interactive nature of smartphones and their ability to integrate information, links to support networks and the ability to collect real-time data is promising for smoking cessation. This study examines a previously developed evidence-informed smartphone smoking cessation app (Crush the Crave©) for young adult smokers using a randomized controlled trial, to determine the effectiveness of the app on quitting smoking. The data collection phase of the study is now complete. More than 1,500 young adults participated in either the Crush the Crave intervention group or the Quit Guide control group. In 2016, researchers are focusing on analysis of the data and disseminating results.
10/2013 - 03/2016
This project is a comprehensive mixed methods evaluation of a tobacco-free initiative was undertaken to assess the effectiveness of the implementation. Specifically, the purpose of the evaluation was to identify whether planned activities were carried out and if planned outputs and outcomes were achieved. The key evaluation questions are:
The evaluation uses these methods: pre and post-implementation staff surveys; records review (pharmacy data, electronic medical record data, security call records, and training records); site observations; focus groups.
An evaluation team plans and co-ordinates evaluation activities. A group of in-hospital tobacco-free champions was also established to discuss and disseminate findings and recommendations, put recommendations into action, and provide leadership throughout GRH.
01/12 - 01/2015
Smoking prevalence is very high (57%) among lesbian, gay, transgender, and queer/questioning (LGBTQ) youth and young adults. This study will identify what are the most successful interventions that will induce behaviour change in tobacco use amongst LGBTQ youth (16-17 years) and young adults (18-29 years) and why. Propel is evaluating evidence on LGBTQ tobacco use prevention and cessation interventions by conducting an in-depth scoping literature review, and conducting focus groups with the LGBTQ target population. These two activities will help us determine the preferred cessation and prevention interventions and identify relevant gaps in these types of interventions for the LGBTQ population. Propel is working with the various LGBTQ stakeholders and community to develop culturally relevant and appropriate tobacco use prevention and cessation interventions for the LGBTQ population. The long-term vision is reduced smoking-related morbidity and mortality in the LGBTQ community.
Propel is working in partnership with Rainbow Health Ontario, the Canadian Cancer Society (Ontario Division), and the University of Toronto and is being supported by funds from the Ontario Ministry of Health and Long-Term Care, Health System Research Fund (HSRF).
04/2014 - 03/2016
Across Canada, smoke-free policies are being enacted in multi-unit dwellings (MUDs) in both private sector and community housing. Propel is working to understand how these policies impact tobacco use and the extent to which smoke-free leases support cessation.
Waterloo Region Housing (WRH) passed a policy in 2010 that made all new leases in their portfolio 100% smoke-free, including balcony/patio spaces. Propel works closely with WRH and Region of Waterloo Public Health to evaluate their smoke-free policy.
Propel also works closely with the Non-Smokers’ Rights Association / Association pour les droits des non-fumeurs, an Ottawa-based non-governmental organization with a pan-Canadian mandate to protect people from exposure to tobacco smoke.
Build Our Kids' Success (BOKS), an initiative of the Reebok Canada Fitness Foundation, is a free before-school physical activity program that combines structured play, physical activity, team games and short nutrition talks to create life-long healthy habits. The program is designed for elementary school age children. Children typically meet two to three mornings a week for about 40 minutes.
Propel is evaluating the BOKS program to assess the theory and impact of the program and the extent to which it is implemented in schools. Schools are invited to participate in the BOKS Evaluation Project alongside their participation in the BOKS program. The evaluation is gathering data from multiple sources, including students, parents, program lead trainers, and administrators, through various qualitative and quantitative methods.
Visit the BOKS website for more information on the BOKS Evaluation Project.
10/2014 - 03/2019
Partners for Mental Health (Partners) has been in existence since November 2010 and officially launched to the public in April 2012. Propel began working with Partners in the spring of 2012 to develop a results chain and evaluation plan for the overall initiative to help with planning, learning and accountability. Propel has continued to work with Partners over the past four years to evaluate Partners for Mental Health’s overall strategy and impact, assist in using evidence to inform their actions, and to evaluate and guide continuous improvement of individual campaigns.
The Partners’ first workplace campaign, Not Myself Today, was launched in the spring of 2013, to call on companies and organizations to invest in mental health and support the creation of mentally healthy workplaces. Propel has worked with Partners to evaluate this campaign over the past three years. Results from organizational and employee surveys of workplace mental health inform the overall evaluation and are provided in customized feedback reports to individual organizations.
A mixed-methods evaluation of Partners’ Right By You campaign, which targets parents to improve mental health and reduce suicide among youth, has informed ongoing refinements and improvements and examined its impact on knowledge, intentions, and actions related to youth mental health and suicide prevention.
08/2012 - 03/2018
CAREX (CARcinogen EXposure) Canada is a national surveillance system focusing on exposures to carcinogens in workplace and community environments. CAREX helps us understand which known and suspected carcinogens Canadians are exposed to and where. The goal of the First Nations Emissions Mapping Project is to develop pilot training projects with First Nations communities to use CAREX so these communities can better understand local concerns. The communities can use that understanding to identify priorities for reducing or eliminating exposures to carcinogens in the environment.
Work began in January 2015 to develop a range of information materials about cancer for First Nations, Inuit and Metis communities. Propel’s role is to evaluate these workshop meetings as well as assess both the long- and short-term outcomes of the training and products and the sustainability of these information products and tools. This work is supported by a Knowledge to Action grant from the Canadian Institutes of Health Research (CIHR).
09/2013 - 05/2017
In September 2014, the owner of Stone’s Pharmasave in Baddeck, Nova Scotia decided to stop selling sweet beverages at his pharmacy because of the harms associated with excessive sugar consumption. Food Retail Environment Shaping Health (Fresh): Using A Natural Experiment To Evaluate The Impact Of A Retail-Led Policy Banning High Sugar Beverages On Store Sales And Sugar Sold is a natural experiment evaluates the impact of a Baddeck pharmacy’s ban on the sale of “other” drinks (e.g., pop, juice, vitamin water, energy drinks) on a) overall profit, and b) grams of sugar sold per 100g of food sold. The study takes a longitudinal approach and examines weekly sales data over three years, controlling for season, to evaluate the economic impact of the policy. To our knowledge, this is the first pharmacy in Canada to stop selling sweet beverages for health reasons, which presents an excellent opportunity to provide evidence to refine and scale up retail policies that are supportive of health.
01/2015 – 09/2015
Nourishing School Communities is a collaborative, evidence-based initiative that aims to give school children a fresh new perspective on food. The project’s partners are working together towards a brighter, crunchier future by engaging First Nations schools, public schools and after-school facilities in creating healthy food environments. It’s about supporting school communities with tools and resources to make important changes to their school environments – changes that aim to shift policies and practices in a way that that increase learning, access to, and consumption of healthy foods. Propel is leading the evaluation of the three-year initiative using the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework.
The evaluation of Nourishing School Communities recognizes the innovative nature of the initiative by engaging partners in the evaluation, with a learning approach called developmental evaluation. Developmental evaluation emphasizes continuous improvement, including planning and the ongoing refinement of the intervention as evaluation is occurring. Knowledge exchange and communication have been an important aspect of the evaluation to enhance learning. With respect to First Nations communities involved in the project, our approach has been based on the principles found in the revised Tri-Council Policy Statement and the principles of Ownership, Access, Control and Possession data.
10/2013 - 09/2016
Pathways to Health Equity, Local Healthy Foods to School (LHF2S) supports holistic health and chronic disease prevention in school communities supporting First Nations youth. LHF2S is an extension of the work of Propel and our partners from the Nourishing School Communities CLASP’s work in Learning Circles (LC) in Haida Gwaii, British Columbia, to three other communities. LCs are based on a successful US Farm-to-School program. They increase capacity within the local food system by forming and strengthening of community partnerships. The use of LCs has shown to increase availability of local healthy foods to schools, and to improve knowledge and attitudes to food among students. Our team partners with community members, NGOs, and academics to address four objectives: application and adaptation of the LC process in each community; reach and implementation of the program across the four school communities; effectiveness of the program on availability and consumption of local healthy foods; and how/why the LC approach contributes to these results. LC Evaluation Facilitators work with a Stakeholders Advisory Council to implement evaluation processes.
03/2016 - 01/2019
In 2010/2011 Propel partnered with Quebec en Forme (QEF) to develop and implement a survey of healthy lifestyle for youth alongside the 2010/2011 Youth Smoking Survey (now Canadian Student Tobacco, Alcohol and Drugs Survey). The data collected from the EN FORME project allows local groups to draw a portrait of the habits of young people, especially in the areas of physical activity, healthy eating and tobacco use.
In 2010/2011, 138 schools participated in the EN FORME/YSS project. Each Grade 6-12 student that participated in this project randomly received a Youth Smoking Survey (YSS) questionnaire or an EN FORME questionnaire. Grade 5 students only received an EN FORME questionnaire. In subsequent cycles, local regroupements (groupings) chose to participate, resulting in a convenience sample from eight health regions. In 2014/2015, 19,904 students from 114 schools participated, within four regroupements, generally completing the survey online.
If you would like to request a copy of the 2010/2011 QEF EN FORME User Guide, which describes the project methods and participation rates in detail, please email Laura Holtby, project manager.
The EN FORME project is funded by QEF. QEF is a population-based initiative that emerged from a partnership between the not-for-profit Lucie et André Chagnon Foundation and the Government of Quebec. The 2015/2016 and beyond data collections are funded by local regroupements. Schools from the regroupements choose to participate when they find the locally relevant data help inform planning and action to improve child and youth physical activity and healthy eating.
09/2010 - 12/2017
The RBC Learn to Play project supports the promotion of physical literacy and implementation of physical literacy principles in youth sport and physical activity programming at the community level. One major component of the three-year initiative is a grant program involving community action grants ($1,000 to $10,000) to support physical literacy, leadership grants ($10,000 to $25,000) to support policy or environmental changes in physical activity programming in the community, and innovation grants ($25,000+) to support the development of innovative, shovel ready, scalable physical literacy tools and interventions. Propel works collaboratively with RBC, ParticipACTION and Sport for Life to develop and administer an evaluation module for grantees of the RBC Learn to Play project. The purpose of the evaluation is to understand if the grants received contribute to increased awareness of physical literacy, increased integration of physical literacy principles in programs and communities, capacity development of communities and leaders, and increases in confidence, competence and motivation of children involved in physical literacy programs supported by RBC Learn to Play. The Learn to Play project is a nation-wide initiative of RBC, ParticipACTION, Public Health Agency of Canada, and Sport for Life.
02/2014 - 03/2018
The RBC Youth Mental Health Project is a multi-year philanthropic commitment to support community and hospital based programs that help youth and families access the right care at the right time. This project funds programs that address youth and families’ immediate needs to access mental health services, and is focused on navigation programs, technology-based solutions, and other programs that are collaborative, have proven results, and can demonstrate successful outcomes. Through this project, RBC aims to help achieve integration not only within the mental health system, but between the mental health and other systems of care. In order to understand the impacts of the various mental health programs across Canada, Propel offers continued support for RBC’s internal evaluation process and is working with RBC to develop and administer an evaluation to measure how youth and their families are affected by these programs and how participants assess their own mental health. This growing pilot project continues to build on the collaboration between RBC and Propel.
07/2015 – 2018
School Health Action, Planning and Evaluation System - Prince Edward Island (SHAPES-PEI) supports school communities in promoting healthy living through the use of local data. SHAPES-PEI is funded by the PEI Department of Education and Early Childhood Development (DEECD) and the PEI Department of Health and Wellness and is implemented by the Comprehensive School Health Research (CSHR) Group at the University of Prince Edward Island. The implementation of SHAPES-PEI is made possible by leveraging funds from the national implementation of Health Canada's Canadian Student Tobacco, Alcohol and Drugs Survey (CSTADS)
Each cycle of CSTADS, all Island schools with Grades 5-12 are invited to participate in the CSTADS/SHAPES -PEI project. Each student in Grade 6 to 12 that participates randomly receives a CSTADS questionnaire or a SHAPES-PEI questionnaire. The results help schools, communities, and government take action to support and improve the health of young people in PEI. Data can be aggregated at various levels to identify trends for policy and planning, and develop strategies for intervention.
SHAPES-PEI is funded by the PEI Department of Education, Early Learning, and Culture and the PEI Department of Health and Wellness. The project is implemented by the Comprehensive School Health Research (CSHR) Group at the University of Prince Edward Island. Propel offers implementation, processing and analysis support.
For more details, visit the SHAPES website.
Propel launched a campus-wide chronic disease prevention initiative (CDPI) in 2012 on behalf of the Faculty of Applied Health Sciences at the University of Waterloo. The aim of the CDPI is to catalyze and support interdisciplinary collaborations that focus on preventing chronic diseases and reducing their burden. A hallmark activity of CDPI is awarding seed funds to new multi-disciplinary teams that are working towards at least one research application for external funding. As of October 2015, $340,000 has been awarded to 35 teams that include researchers across six Faculties. CDPI also brings researchers together via networking events, workshops and discussion sessions. To date, 25 CDPI events have taken place with more than 295 researchers. Other features of the CDPI include a database, which houses information on chronic disease prevention researchers at the University of Waterloo, and a chronic disease prevention primer used as a resource for preparing applications and grants.
04/2016 - 04/2021
The Health Evaluation Collaborative is a partnership of the University of Waterloo's School of Public Health and Health Systems and the Propel Centre for Population Health Impact, to build capacity for evaluative thinking and practices to improve public health and health system actions and outcomes. The Collaborative engages external organizations to help meet their evaluation needs and, at the same time, provides training and mentoring opportunities for students, interested faculty and staff of organizational partners.
The Health Evaluation Collaborative aims to increase evaluation capacity through
an annual, collaborative learning institute in evaluation that helps to build capacity for evaluation and evaluative thinking, strengthen enduring relationships among faculty, students and public health professionals and organizations to plan, conduct and use evaluation studies, and identify priorities and plans for mentoring, academic outputs and practical contributions following the institute.
Applied prevention research centres in health make important contributions to solving population and public health problems. While a number of research impact evaluation frameworks exist, none have been designed or tailored for use with applied prevention research centres, and different perspectives (e.g., research, funding, policy/practice) on the value of evaluation indicators are unknown. As a result, centres, their funders and their policy/practice collaborators are struggling with ways to best capture the contributions of these centres.
The purpose of this study is to understand the importance and feasibility of evaluation practices for applied prevention research centres in health. Using a modified, 3-round Delphi technique, this study aims to refine a set of meaningful and feasible indicators for evaluating the public health impacts of applied prevention research centres, and identify promising directions to improve their use by and for applied prevention research centres. Research, policy/practice and funding perspectives are collected, compared and contrasted.
The purpose of this Canadian Institutes of Health Research (CIHR) - funded realist review and synthesis is to increase understanding of the effective scale up of complex interventions aiming to improve public health outcomes and their lifestyle and environmental causes. The review examines pathways for scaling up complex interventions, with a particular focus on relationships between contextual conditions, underlying mechanisms for change, and scaling up outcomes. A User Panel helps to optimize benefits for relevant Canadian government and voluntary organizations that are involved in scaling up effective approaches for preventing cancers and other chronic diseases with shared risk factors, and to promote overall health. An international Expert Panel, consisting mainly of academics with expertise in scaling up and/or realist review methods, guides knowledge synthesis.
Based on a review of the scaling up literature, an initial program theory was developed to guide the realist review. This program theory is being tested and refined using case examples of scaling up to determine what works, for whom, under what conditions and how. Interpretation of the review findings for research, practice and policy implications occurred in partnership with the User Panel at a one-day meeting in 2015 (see report on a planning meeting).
The findings from this review will contribute valuable knowledge to a growing evidence base on the design, implementation, evaluation and sustainability of complex interventions to improve population health outcomes.
The Public Health Agency of Canada’s (the Agency) Multi-sectoral Partnerships to Promote Healthy Living and Prevent Chronic Disease brings together multiple segments of society to design, implement and advance innovative approaches for improving the health of populations. The Agency’s multi-sectoral initiative provides support for multiple partnership projects that vary in size, purpose, partners and financial support. A key component of the initiative is the engagement of non-traditional partners, including private for-profit organizations and those working outside the health sector, which requires new ways of establishing relationships and working within them. The Agency is now aiming to maximize the learning that can be gained from the multi-sectoral initiative and its projects, and to apply that learning to improve the reach, impact and effectiveness of multi-sectoral activities. This project implements a learning and improvement process that explores key areas of interest to the Agency, including partnership reach and partnership impact. A mix of qualitative and quantitative methods are used.
The Program Training and Consultation Centre (PTCC), founded in 1993, is a resource centre of the Smoke-Free Ontario Strategy (SFO). The PTCC focuses on building the capacity of public health departments and community partner agencies to deliver effective and comprehensive tobacco-use reduction interventions in Ontario. Since 2009, Propel has partnered with the PTCC and conducts research and evaluation activities to advance PTCC’s programs and services. One way we achieve this is through the Documentations of Practice Project (DoP), which documents what public health units in Ontario are doing to advance tobacco control in their communities. To support PTCC’s program development and planning, Propel also actively works with PTCC to implement a developmental evaluation. Through this evaluation, we are examining their programs to learn what works for whom and in what context.
In order to build population health intervention research capacity in Canada, the Population Intervention for Chronic Disease Prevention (PICDP) program (2009-2015) trained graduate students as impact-oriented scientists. Students from across Canada worked collaboratively across disciplines and sectors to address the most relevant questions with the most appropriate and rigorous methods to improve population interventions for chronic disease prevention.
Interested and eligible graduate students from diverse disciplines applied to an annual competition. Applications were reviewed by a panel with equal representation from researchers and public health professionals working in policy/practice settings.
Each year, 20 to 30 trainees had a specialized training experience that supplemented their graduate programs. The PICDP curriculum included a for-credit online graduate course, monthly web-based dialogue and debate sessions, and opportunities for practical learning experiences in research and policy/program settings. In addition, trainees met in person at a two-day annual meeting.
Program evaluation continues with follow-up of funded trainees across all 6 years of PICDP. The PICDP Training Program is a collaborative initiative of four institutions — University of Waterloo University of Toronto, University of Alberta, and The University of British Columbia. Seventy academic mentors from 18 institutions in nine provinces were involved. The program is funded by the Canadian Institutes of Health Research with additional support from Heart and Stroke Foundation (2010-2015) and Cancer Care Ontario (2011-2015).
Propel Centre for Population Health Impact
Faculty of Applied Health Sciences
University of Waterloo
200 University Avenue West
Waterloo, Ontario, Canada N2L 3G1