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Interactive Domain Model (IDM) / Mod


Developing a user-friendly context-sensitive best practices ... Brant Community HealthCare System (Paris and Brantford) Peterborough County-City Health Unit ... – PowerPoint PPT presentation

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Title: Interactive Domain Model (IDM) / Mod

Interactive Domain Model (IDM) / Modèle des
domaines interactifs (MDI) Developing a
user-friendly context-sensitive best practices
approach to achieve health promotion public
health goals
  • Barbara Kahan (Member, Centre for Health
    Promotion, University of Toronto)
  • Christiane Fontaine (Consultant, Ontario
    Prevention Clearinghouse)
  • Peggy Schultz (Consultant, Ontario Prevention
  • Michael Goodstadt (Member, Centre for Health
    Promotion, University of Toronto)

  • poster display for
  • A Workshop on the Canadian Best Practices System
    for Chronic Disease Prevention
  • Toronto (Canada), March 10-11, 2005

IDM/MDI information resources are available
  • centre/proj

  • IDM/MDI definition of best practices
  • Best practices are those sets of processes and
    activities which are consistent with health
    promotion/public health values, goals and ethics,
    theories and beliefs, evidence, and understanding
    of the environment, and that are most likely to
    achieve health promotion/public health goals in
    any given situation.
  • In brief, the IDM approach is about increasing
    consistency between practice and a range of
    decision making factors such as values, theories,
    beliefs, evidence, and understanding of the

  • Définition des meilleures pratiques
  • Ensemble des processus et activités les plus
    susceptibles datteindre les objectifs de
    promotion de la santé dans une situation donnée
    tout en respectant les valeurs, buts, principes
    éthiques, théories, croyances, constatations et
    contextes environnementaux de la promotion de la
  • En résumé, lapproche du modèle des Domaines
    interactifs permet dêtre consistent entre la
    pratique et les facteurs qui peuvent influencer
    la prise de décision (valeurs, théories,
    croyances et lenvironnement)

  • Les meilleures pratiques
  • en promotion de la santé
  • Permet de maximiser les avantages associés à des
    meilleures pratiques et den minimiser les
    risques potentiels en promotion de la santé
  • et
  • Prend en considération
  • tous les facteurs importants qui influencent la
  • les circonstances uniques de chaque situation
  • la relation entre les procédés (processus) et

  • Le Modèle des domaines interactifs (MDI)
  • Peut servir doutil de planification,
    dimplantation et dévaluation que ce soit pour
    un projet, un programme ou un exercice de
    planification stratégique
  • Permet une cohérence entre les valeurs et les
    activités qui découlent de la planification
  • Cest un outil qui encourage la discussion
    portant sur le développement dune vision commune
    et des valeurs partagées au sein du groupe qui
  • Met en évidence une approche basée sur la
    promotion de la santé
  • Son application qui ne se limite pas au domaine
    de la promotion de la santé mais il est aussi
    adaptable culturellement et linguistiquement et
    ce, dans différents milieux de travail.

  • Le MDI permet
  • de jeter un regard critique qui nous permet de
    faire des choix et prendre des décisions (p.ex.
    pratique actuelle ou proposée) basés sur des
    données probantes
  • danalyser plus profondément les lacunes et les
    besoins ce que lon doit changer, arrêter,
    commencer ou continuer
  •  de développer un plan daction qui assure une
    cohérence entre les objectifs, activités et
    évaluation sont cohérentes entre eux
  •  et davoir un regard critique sur ce qui a été
    fait (évaluation).

  • Timeline 1996-1997
  • Practitioners at the International Symposium on
    the Effectiveness of Health Promotion express a
    desire to actively participate in resolving
    issues related to evaluation and effectiveness of
    health promotion.
  • The Centre for Health Promotion, University of
    Toronto, creates the Continuous Quality
    Improvement (CQI) Work Group members represent a
    variety of sectors ? public health units ?
    community health centres ? hospitals ?
    community groups ? provincial government ?
    federal government ? academic institutions ?
    private sector
  • Health Canada, Population and Public Health
    Branch (currently Public Health Agency of Canada,
    Ontario and Nunavut Region), funder of the
    Symposium, also funds the next five years of what
    becomes the Best Practices Project.
  • CQI Work Group Members clarify their
    understanding of concepts and practices related
    to CQI and how CQI might contribute to health
    promotion practice.

  • Timeline 1997-1998
  • A literature review and synthesis by one of the
    members results in two background papers (on CQI
    and best practices) for reference use by the CQI
    Work Group.
  • Members decide to become the Best Practices Work
  • Members participate in a series of hands-on
    workshops. Through these workshops they explore
    best practices, in the process identifying
    potential benefits and risks and developing their
    own set of best practices principles.

  • Timeline 1998-1999
  • The original best practices Model evolves. It is
    now based on three interactive components or
    domains which exist in the context of social,
    political, psychological, and physical
    environments underpinnings, understanding of the
    environment, and practice.
  • A Framework, designed to implement the Model in
    practice, is developed. It contains a cycle of
    steps which are applied to the Models domains.
    The Frameworks questions are ? Where are we
    now? ? Where do we want to go? ? How do we get
    there? ? What principles guide us? ? What did we
    do? ? How did we do it? ? What were the
    results? ? What do we need to change?
  • A set of suggested guiding principles and
    criteria is drafted.

  • Timeline 1998-1999 continued
  • The Work Group conducts an Ontario scan of
    practitioners needs and capacities regarding
    best practices, using interviews and a survey.
  • A years-long series of national and international
    workshops, presentations and consultations begins
    with groups ranging from the Ontario Public
    Health Association to the International Union of
    Health Promotion and Education.
  • The Centre for Health Promotions Best Practices
    Work Group joins with the Association of Ontario
    Health Centres and the Ontario Public Health
    Benchmarking Partnership to form the Best
    Practices Partnership.

  • Timeline 1999-2000
  • The Best Practices Partnership pilots the draft
    IDM approach (based on the Model and its
    operational Framework) with three Ontario
    sites - Durham Region Health Department -
    East End Community Health Centre (TO) - The
    Willett Hospital (Paris)
  • Facilitators consult extensively with each site
    to take into account local internal and external
    conditions. As a result, focus issues and
    processes for working through the Framework vary
    from site to site.
  • Facilitators conduct workshops and provide
    supporting materials to introduce basic concepts.
    In between workshops site participants work to
    develop their own frameworks, contacting the
    facilitators as required when questions arise.

  • Timeline 1999-2000 continued
  • Positive pilot test results include ? for the
    approach confirmation that the Model and
    Framework are flexible enough to be used in
    different situations, in different ways, and for
    different purposes and, identification of ways
    to improve IDM processes and materials (e.g. gaps
    to fill, concepts to clarify, explanations to
    reword, exercises to reorganize, essential
    supports to put in place) ? for one or more
    sites increases in knowledge, skills,
    understanding, group cohesion, consensus,
    enthusiasm, systematic planning, credibility, and
    ability to identify and address work-related
    issues (e.g. clinical vs. non-clinical
    perspectives, restructuring, funding)
  • Possible negative/lack of impact on individual
    pilot sites include volunteer disaffection,
    resistance, no change in planning process.
  • Based on facilitator and participant observations
    and evaluation results (group discussions and
    written feedback) the Framework and materials are

  • Timeline 1999-2000 continued
  • The Francophone sub-committee is formed, with a
    mandate to adapt the Interactive Domain Model
    (IDM) to the Franco-Ontarian context. Members
    include representatives from academic, government
    and community sectors. What is currently the
    Public Health Agency of Canada, Ontario and
    Nunavut Region, provides funding.

  • Timeline 2000-2001
  • The Francophone sub-committee conducts a needs
    assessment to document the needs of Francophone
    practitioners and their capacities and interest
    regarding best practices in health promotion.
  • The Ontario Hospital Health Promotion Network
    joins the Best Practices Partnership.
  • The first version of the IDM Manual for Best
    Practices in Health Promotion is produced.
  • The peer-reviewed journal Health Promotion
    Practice publishes an article explaining IDM Best
    Practices key concepts.
  • Following a suggestion from one of the original
    pilot sites, the IDM Computer Program is

  • Timeline 2000-2001 continued
  • The Ontario Ministry of Health and Long Term Care
    funds the development of an IDM bridging the gap
    between research and practice learning module.
    Six sites participate ? Access Alliance
    Multicultural CHC (Toronto) ? Brant Community
    HealthCare System (Paris and Brantford) ?
    Peterborough County-City Health Unit ? Sudbury
    and District Health Unit ? St. Joseph's
    Healthcare, Women's Detox and Mary Ellis House
    Treatment Program (Hamilton) ? West Hill
    Community Health Centre (Toronto) Results are

  • Timeline 2002-present
  • The Francophone sub-committee ? adapts and
    translates into French the IDM Manual and article
    ? develops French-language IDM training
    modules ? conducts three workshops with 30
    participants from health and education sectors
    and community-based groups in Sudbury, Ottawa and
    Toronto ? develops a website
  • An IDM Best Practices Road Map for Coaches and
    Best Practices Check-In Forms are produced.
  • Groups continue to use the IDM, for example ?
    The Association des communautés francophone de
    l'Ontario Toronto, which has a multi-cultural
    membership and is volunteer based ? Womankind
    Addiction Service, a new approach to womens
    addictions which provides a complete range of
    services in one place

  • Timeline 2002-present continued
  • The IDM continues to influence models and
    frameworks being developed by other groups, for
    example ? The IDM was an insightful resource in
    developing this Nova Scotia Best Practices
    Framework. ? The IDM informed the best
    practices work we did at the AOHC Association of
    Ontario Health Centres, particularly the
    principles piece. ? The development of Core
    Domain 2 - The Underpinnings of Best Practices
    in a not yet released practice framework was
    inspired and influenced significantly by the

Moving into the Future
  • The holistic IDM/MDI, which considers a wide
    range of decision-making factors ? from values
    and theories to evidence and context ? is a
    usable and effective approach for achieving best
  • The approach is constantly evolving, to reflect
    users needs. IDM tools are helpful at different
    levels of work, e.g. to ensure that the key
    elements of health promotion and/or public health
    are included in a program, to assist in
    reflection on processes, activities and outcomes,
    to encourage inclusivity.
  • Providing support to further develop, improve and
    disseminate IDM/MDI processes and resources will
    contribute significantly to the achievement of
    best practices and health promotion/public health

  • IDM
  • Key concepts
  • Engagement of all key stakeholders
  • Ongoing reflection
  • improvement
  • Practice based on values, theories, evidence,
  • MDI
  • Mots-clés
  • Vision commune
  • Engagement
  • Collaboration
  • Flexibilité
  • Perseverance
  • Complémentarité

A few Best Practices Work Group members in front
of the Centre for Health Promotion, University of
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IDM Framework (Kahan Goodstadt, 2001)
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