Supplementary Information Tables: 2011–12 Departmental Performance Report

Details on Transfer Payment Programs (TPPS)

• Aboriginal Head Start Initiative in Urban and Northern Communities
• Canada Prenatal Nutrition Program
• Canadian Diabetes Strategy (non-Aboriginal elements)
• Community Action Program for Children
• Federal Initiative to Address HIV/AIDS in Canada
• Innovation Strategy
• National Collaborating Centres for Public Health

Aboriginal Head Start in Urban and Northern Communities

Strategic Outcome: Canada is able to promote health, reduce health inequalities, and prevent and mitigate disease and injury

Program Activity: Health Promotion

Name of Transfer Payment Program: Aboriginal Head Start in Urban and Northern Communities (AHSUNC)

Start Date: 1995–96

End Date: Ongoing

Description: This program supports locally designed and controlled early childhood development intervention strategies for off-reserve Aboriginal children and their families. The program focuses on health promotion, education and school readiness, aboriginal culture and language development, parental involvement, nutrition, and social support.

Expected Results: To provide opportunities for the healthy development of Aboriginal pre-school children in urban and northern settings, including the development of positive self-esteem and a desire for learning, and opportunities to develop successfully as young people. The program helps to reduce health disparities experienced by children and their families facing conditions of risk through increased community capacity, by helping participants make healthy choices and by promoting multi-sectoral partnerships.

Results Achieved: AHSUNC provides comprehensive, culturally-appropriate, early childhood development programming to approximately 4,800 children and their families at 128 sites across Canada. The program has had a positive effect on school readiness, specifically in improving children's language, motor and academic skills. It has also demonstrated positive effects on health by promoting behaviours such as children's access to daily physical activity and access to health services. Performance results have also demonstrated effectiveness in improving cultural literacy and enhanced exposure to Aboriginal languages and cultures. Specifically, AHSUNC sites integrated physical activity regularly in the weekly or daily programming (99%); facilitated immunization (50%); and facilitated access to dental professionals (77%), speech therapists (57%), nutritionists (52%), hearing tests (34%), vision testing (26%), and child psychologists (13%). In some communities, the program has become so integrated in the lives of participating Aboriginal children and their families that project sites have taken on a community hub function.

Comment(s) on Variance(s): NA

Audit completed or planned: The program was part of the 2009 Audit of Health Promotion Programs.

Evaluation completed or planned: The summative evaluation was completed in March 2012 as planned in accordance with TBS 2009 Policy on Evaluation.

Engagement of applicants and recipients: Funded recipients deliver comprehensive, culturally appropriate, locally controlled and designed early childhood development programs for Aboriginal pre-school children and their families living in urban and northern communities across Canada. They are engaged in knowledge development and exchange at the community, provincial/territorial and national levels through training, networking, meeting, and targeted solicitations.

Canada Prenatal Nutrition Program

Strategic Outcome: Canada is able to promote health, reduce health inequalities, and prevent and mitigate disease and injury

Program Activity: Health Promotion

Name of Transfer Payment Program: Canada Prenatal Nutrition Program (CPNP)

Start Date: 1994–95

End Date: Ongoing

Description: This program promotes the health of at-risk pregnant women, infants and their families through leadership and support to community groups. The program focuses on reducing the incidence of unhealthy birth weights, improving the health of both infant and mother, and encouraging breastfeeding.

Expected Results: To enhance community capacity through a population health approach to respond to the health and development needs of pregnant women and their infants who are facing conditions of risk. Contribute to improved health outcomes for pregnant women, infants and their families and continue partnering with multiple sectors in the community.

Results Achieved: PHAC provided funding and support to 320 CPNP community based projects in 2011–12.

An evaluation of CPNP completed in January 2010 provided evidence that the program continues to be relevant to the Canadian context, reaches vulnerable pregnant women and new mothers, is cost effective, and is effecting positive changes in the health practices of pregnant women/new mothers and promoting positive birth outcomes. CPNP participants were shown to have improved use of vitamin-mineral supplements during pregnancy; reduced alcohol consumption; to reduce smoking; to have increased initiation and duration of breastfeeding. Moreover, participants who had the highest exposure to CPNP were 34% less likely to have a low birth weight infant and were 26% less likely to have a preterm birth compared to those participants with lower program exposure.

Comment(s) on Variance(s): Actual spending was lower than planned spending due to a transfer of $850K to Community Action Program for Children (CAPC).

Audit completed or planned: The program was included in the 2009 Audit of Health Promotion Programs.

Evaluation completed or planned: The Summative Evaluation of the Canada Prenatal Nutrition Program 2004-2009 was completed in January 2010. The program will undergo its next evaluation in 2016–17.

Engagement of applicants and recipients: Funded recipients provide access to programs and services that promote the health and social development of pregnant women, new mothers and babies facing challenging life circumstances. Recipients are engaged though monitoring and program support. PHAC also helps address recipients' concerns about the multiple monitoring and reporting by streamlining requirements. In addition, knowledge development and exchange and engagement in national strategic projects on emerging issues is supported through the CAPC/CPNP National Projects Fund, which provide partnership and training opportunities.

Canadian Diabetes Strategy (non-Aboriginal elements)

Strategic Outcome: Canada is able to promote health, reduce health inequalities, and prevent and mitigate disease and injury

Program Activity: Disease and Injury Prevention and Mitigation

Name of Transfer Payment Program: Canadian Diabetes Strategy (non-Aboriginal elements) (CDS)

Start Date: 2005–06

End Date: Ongoing

Description: The CDS engages provinces, territories and stakeholders at the national and regional levels in order to improve information and services available to Canadians living with or at higher risk of developing diabetes. This is achieved through community-based programming, support for diabetes surveillance systems, and collaboration on knowledge development and exchange related to risk factors and determinants for diabetes and its complications.

Expected Results: The provision of information to Canadians living with diabetes or who are at higher risk of developing diabetes has the direct effect of increasing awareness of diabetes risks and complications. Canadians who are at high risk for developing diabetes will have information to increase their awareness of their risks and will have skills to prevent the onset of diabetes. Canadians living with diabetes will have increased awareness of complications and will be provided with skills for self-management of their disease. Moreover, surveillance and knowledge development, along with community-based programming, enhances the capacity of researchers and practitioners to apply best practices to better detect, educate and counsel. Finally, the activities of the CDS assist policy makers at all levels to improve public policy regarding diabetes. Ultimately, these activities will lead to earlier detection and better management of diabetes.

Results Achieved: In 2011–12, 37 organizations received funding from the CDS in two streams. National organizations carried out their activities across the country, whereas the regional stream supported local organizations which targeted the unique needs of their communities. For example, the Canadian Centre for Activity and Aging (CCAA) developed a physical activity program for older Canadians (55+) living with diabetes – Get Fit for Active Living with Diabetes (GFAL-D). The program is geared to helping people better manage their disease through regular physical activity sessions and healthy lifestyle education. It provided information for participants to learn more about the latest research in the field. Diabetes educators were given access to a virtual community of practice to encourage the sharing of innovative ideas on physical activity and diabetes management. To date, the CCAA has trained 97 GFAL-D facilitators across Canada. Project results suggest that all measures of participant fitness improved significantly, thus improving their overall health and ability to manage their condition.

The Active Living Coalition for Older Adults (ALCOA) developed measurement and evaluation tools for community primary and secondary diabetes prevention programs for older adults (55+) including a Community Leaders Guidebook, and Your Passport to Healthy Living. The tools are now available to be used by non-clinical, community-based leaders responsible for program delivery in community and municipal settings. The Passport focuses on supporting people with Type 2 diabetes by providing detailed information on the relationship between healthy lifestyle choices and chronic diseases. This helps inform, educate and motivate older adults. As a result, working relationships were established among educational professionals, community and health organizations that have an interest in the field of aging as well as those that promote healthy living and well-being among older adults. In addition, due to extensive promotional activities, the program achieved widespread awareness, and ALCOA received orders for more than 6800 copies of the Passport nationwide.

Through continued support and dissemination of the CANRISK diabetes risk assessment questionnaire—an innovative tool to help Canadians understand their risks—the Agency continued its efforts to prevent diabetes. To this end, the Agency launched a partnership with pharmacies to increase the reach in raising Canadians' awareness of their diabetes risk factors. To meet the needs of high-risk ethnic populations and the health professionals who serve them, the questionnaire and guide have been translated into 11 languages and pharmacy partnerships were expanded.

Comment(s) on Variance(s): The grant funding of $1.2M was transferred fully to contributions. Transfers supported Agency activities that are consistent with the authorities of the Integrated Strategy on Healthy Living and Chronic Disease and addressed risk factors common to major chronic disease. A one-time transfer from the Integrated Strategy for Healthy Living and Chronic Disease was undertaken to address multiple sclerosis (MS), an unforeseen priority. MS has been integrated into the Strategy as part of a more fulsome approach to addressing neurological conditions.

Audit completed or planned: In February 2012, the Office of the Auditor General of Canada began an audit of chronic disease with a focus on diabetes activities. In addition, the Agency conducted an Internal Audit of the Chronic Disease Prevention and Control Program in 2010–11.

Evaluation completed or planned: The Diabetes Prevention and Mitigation program is scheduled to be evaluated in 2013–14 as part of a broader evaluation of the Chronic Disease Prevention and Mitigation program.

Engagement of applicants and recipients: Open G&C solicitations posted on the Agency's Web site, targeted G&C solicitations amongst regional or national networks, recipient in person or teleconference meetings to promote collaboration, evaluation and knowledge synthesis, development of case studies to share learnings from funded projects.

Community Action Program for Children

Strategic Outcome: Canada is able to promote health, reduce health inequalities, and prevent and mitigate disease and injury

Program Activity: Health Promotion

Name of Transfer Payment Program: Community Action Program for Children (CAPC)

Start Date: 1993–94

End Date: Ongoing

Description: CAPC provides funding to community-based groups and coalitions to develop and deliver comprehensive, culturally appropriate prevention and early intervention programs to promote the health and social development of children (0-6 years) and their families facing conditions of risk.

Expected Results: To enhance community capacity through a population health approach and to respond to the health and development needs of young children and their families who are facing conditions of risk. Contribute to improved health and social outcomes for young children and parents/caregivers facing conditions of risk, and continue partnering with multiple sectors in the community.

Results Achieved: PHAC provided funding and support to 435 CAPC community based projects (CAs) for 2011–12. An evaluation of CAPC completed in January 2010 provided evidence that the program continues to be relevant to the Canadian context; reaches children and families living in conditions of risk; and contributes to their health and social development. A qualitative analysis of CAPC provided evidence of improved child development outcomes, enhanced community capacity and parental improvement.

Comment(s) on Variance(s): Actual spending exceeded planned spending due to a transfer of $850K from CPNP and $500K from other programs.

Audit completed or planned: The program was included in the September 2009 Audit of Health Promotion Programs.

Evaluation completed or planned: The Summative Evaluation of the Community Action Program for Children: 2004-2009 was completed in January 2010. The program will undergo its next evaluation in 2016–17.

Engagement of applicants and recipients: Funded recipients provide access to programs and services that promote the health and social development of pregnant women, children from birth to six years of age and their families facing conditions of risk. Recipients are engaged though monitoring and program support. The Agency also helps address recipients' concerns about the multiple monitoring and reporting by streamlining requirements. In addition, knowledge development and exchange and engagement in national strategic projects on emerging issues is supported through the CAPC/CPNP National Projects Fund, which provide partnership and training opportunities.

Federal Initiative to Address HIV/AIDS in Canada

Strategic Outcome: Canada is able to promote health, reduce health inequalities, and prevent and mitigate disease and injury

Program Activity: Disease and Injury Prevention and Mitigation

Name of Transfer Payment Program: Federal Initiative to Address HIV/AIDS in Canada (FI)

Start Date: January 2005

End Date: Ongoing

Description: Contributions towards the Federal Initiative to Address HIV/AIDS in Canada.

Expected Results: Projects funded at the national and regional levels will result in increased knowledge and awareness of the nature of HIV and AIDS and ways to address the disease; increased individual and organizational capacity to address HIV and AIDS; and enhanced engagement and collaboration on approaches to address HIV and AIDS.

Results Achieved: In 2011–12, national funding streams supported six projects under the Specific Populations Fund, seven projects under the National Voluntary Sector Response Fund, one under the Knowledge Exchange Fund.

Twenty-one projects across Canada under the Non-reserve First Nations, Inuit and Métis and Inuit and Métis Communities fund were approved for funding starting in 2011–12. These projects aim to promote the prevention of HIV infection; facilitate access to diagnosis; treatment and social supports for Aboriginal people living with HIV/AIDS and those at risk; and enhance the capacity of service providers to deliver culturally relevant, community-based interventions among Canada's off-reserve First Nations, Inuit and Métis populations.

A total of 35 projects were funded through national funding streams for a total of $9.7M, and the regional AIDS Community Action Program (ACAP), supported 43 time-limited and 84 operational projects across Canada, for a total of $12.2M.

In 2011–12, PHAC developed a consolidated invitation and review process for applications for projects addressing public health priorities between 2012–14. Three invitations to submit applications were launched in December 2011. One hundred and sixteen projects were funded—they focused on public health interventions and outcomes, integrated HIV, hepatitis C, STI prevention and control, and the determinants of health.

Increased Knowledge and Awareness

Thirty-three of 35 projects funded through the Knowledge Exchange, Specific Populations, Voluntary Sector Response, and Non-Reserve First Nations, Inuit and Métis Communities funding streams reached over 30,000 participants in efforts to increase knowledge and awareness of the nature of HIV/AIDS and the ways in which to address the disease. Sample surveys conducted by five projects showed that about 90% of participants indicated that their knowledge of HIV transmission and risk factors had increased as a result of their participation in a range of funded activities.

Individual and Organizational Capacity

Twenty-eight out of 34 projects reporting under national funding streams (over 80%) showed that target populations were included in the management and delivery of projects. Of these, 22 focussed on Aboriginal communities, five focussed on people living with HIV and AIDS; and one targeted youth at risk of contracting HIV. Service providers were targeted by the other 20% of projects, and were included in the delivery of knowledge and skills building components of the work.

Nationally-funded projects reported 51 capacity-building activities for non-governmental and community-based organizations during 2011–12. These activities were geared towards the acquisition of skills, and reached more than 12,000 participants, including over 10,000 workshop participants. Projects funded through the Voluntary Sector Response fund offered the most capacity building activities with 20, followed by Non-Reserve First Nations, Inuit and Métis Communities projects, with 17 and the Specific-Populations Initiatives fund with 13.

Participant surveys indicate improved capacity. In two projects, over 80% of attendees reported increased capacity and skills to address HIV and AIDS as a result of their participation. Moreover, three projects report that approximately 85% of participants indicate that they intend to change their practices for addressing HIV and AIDS (responses varied between 72 and 93%), and another project reports that 86% of its participants have already changed their practices.

In 2011–12, nationally-funded projects reported an estimated 320 new volunteers and an estimated 14,000 volunteer hours. Additionally, approximately 150 volunteers were given training over the course of the same period.

Individuals or communities who face specific risk conditions were directly involved in a committee or group that provides advice to the governing body in over half of all AIDS Community Action Program (ACAP) projects, and were employed by over one-third of ACAP projects. People living with HIV or AIDS were involved in providing advice to a governing body in over 40% of ACAP projects and were employed by over a quarter of ACAP projects.

Engagement and collaboration on approaches to address HIV and AIDS

Forty-two percent of ACAP projects strengthened organizational capacity, including organizations with a provincial scope, which focussed on capacity-building and training to AIDS service and other frontline organizations. Regional capacity-building events including cultural competence training for health and corrections sector workers; information about treatment as prevention; and promoting evidence-based practice in community agencies.

Thirty-one projects funded through the Knowledge Exchange, Specific Populations Initiatives, Voluntary Sector Response, and Non-Reserve First Nations, Inuit and Métis Communities funding streams reported over 325 partnerships in 2011–12. Three quarters of the partnerships involved not-for-profit or voluntary sector organizations, while the remainder involved mostly public sector and research organizations. Thirteen partnerships with private sector firms were reported. Sixty percent of reported partnerships were undertaken by projects funded under the Non-Reserve First Nations, Inuit and Métis Communities funding streams, and involved mostly local, municipal and provincial territorial organizations.

Comment(s) on Variance(s): $0.4M was transferred to the Canadian Institutes for Health Research in support of research related to HIV and Aboriginal populations, and other strategic priorities. $0.2M was transferred to other organizations concerned with HIV, hepatitis C and related communicable diseases.

Audit completed or planned: One audit was completed in 2011–12.

Evaluation completed or planned: An evaluation of the Federal Initiative is planned in 2013–14.

Innovation Strategy

Strategic Outcome: Canada is able to promote health, reduce health inequalities, and prevent and mitigate disease and injury

Program Activity: Health Promotion

Name of Transfer Payment Program: Innovation Strategy (IS)

Start Date: 2009–10

End Date: Ongoing

Description: The Innovation Strategy is a federal grants and contributions initiative designed to foster and support effective action on and across a broad range of factors that affect the health of Canadians. The IS focuses on innovation and learning in population health to address the determinants of health and to reduce health inequalities. The Strategy supports the development, adaptation, implementation and evaluation of innovative interventions and policy initiatives in various settings and populations in Canada as well as knowledge translation and dissemination based on the systematic collection of results and outcomes of interventions and the promotion of their use across Canada.

Expected Results: To increase effective action to reduce health inequalities and their underlying causes by implementing innovative and promising population health practices. Performance measures include the:

• Extent of design and implementation across Canada of innovative and promising interventions and practices;
• Extent of knowledge exchange regarding effective interventions to take action on priority heath issues; and
• Increase in the number of intersectoral collaborations to address specific determinants of health and reduce health inequalities.

Results Achieved: The program invested more than $27 million over five years to support mental health promotion across Canada. This funding supports the implementation of ten innovative, multi-centre mental health promotion interventions during 2010–15. These initiatives will include thousands of children, youth and families in over 50 communities. The program invested $7 million during 2010–12 in projects to promote healthy weights and prevent obesity. In November 2011, the IS launched a call for proposals to build on these projects. The IS undertook capacity building initiatives to support implementation and evaluation of funded innovative interventions. These initiatives strengthened capacity to develop and implement inter-sectoral partnerships. Knowledge collected from these projects on the affect and effectiveness of interventions will be shared with stakeholders across the country and will help shape future projects and programs.

Comment(s) on Variance(s): The variance in grant spending was $6.3M due to transfer of $7.1M from grants to contributions. Actual spending in contributions exceeded planned spending by $9.7M and was offset by transfer of $7.1M from grants; $0.5M from Health Canada through Supplementary Estimates; and reallocation of funds from within the Agency of $2.1M in support of emerging priorities.

Audit completed or planned: The IS was included in the 2009 Audit of Health Promotion Programs.

Evaluation completed or planned: The Population Health Fund Evaluation 2008 covering the period of 2005–08 was completed in 2009. The next evaluation is planned for completion by 2014–15.

National Collaborating Centres for Public Health

Strategic Outcome: Canada is able to promote health, reduce health inequalities, and prevent and mitigate disease and injury

Program Activity: Public Health Preparedness and Capacity

Name of Transfer Payment Program: National Collaborating Centres for Public Health (NCCPH)

Start Date: 2004–05

End Date: Ongoing

Description: Contributions to persons and agencies to support health promotion projects in community health resource development, training/skill development and research. The focus of the NCCPH program is to strengthen public health capacity, translate health knowledge and promote and support the use of knowledge and evidence by public health practitioners in Canada in collaboration with provincial/territorial and local governments, academia, public health practitioners and nongovernmental organizations.

Expected Results: Improved public health decision-making stemming from:

• Increased opportunities for collaboration and networking between health portfolio partners, NCCs and other external organizations;
• Increased knowledge translation activities (including knowledge synthesis, translation and exchange) and the application of environmental scan and research findings by researchers and knowledge users;
• Knowledge gap identification, acting as catalysts for new research;
• Increased availability of knowledge for evidence-based decision making in public health with consequent increased use of evidence to inform public health programs, policies and practices; and
• Improved public health programs and policies.

Results Achieved: Individually and collectively, the NCCs have worked very closely with public health experts and enhanced network capacity of public health. For example, they have developed outreach planning guides to help public health practitioners plan outreach programs that are meant to reach marginalized groups in ways that help them to improve their health and prevent disease in their own environments. The Centres increased awareness and influenced the use of evidence-based decision-making and public health practice, and played an active role in supporting the objectives of the Agency's Strategic Plan 2007-2012 by introducing a series of free, online learning modules on evidence-informed decision-making and critical appraisal skills that have been completed by more than 850 practitioners. These modules are used for faculty development and graduate courses in Canada and internationally.

Comment(s) on Variance(s): Additional funding has been provided from other Agency program areas to support expanded work plan activities.

Audit completed or planned: Recipient audits are planned to occur on a rotating basis or as required. The report from the 2012 audit of the NCC for Infectious Diseases project is expected to be completed in July, 2012.

Evaluation completed or planned: The evaluation of the NCCPH Contribution Program will be part of the 2013-2014 PHAC Evaluation of Public Health Tools (1.3.1.2).

Engagement of applicants and recipients: The program did not issue solicitations in 2011-12.