We conduct research and provide cross sector training in 5 key areas.
Community Engagement and Capacity Building
We engage communities, their residents, private, public and non-governmental community agencies and local businesses as co-researchers in a wide variety of community-identified projects related to, for example, health, chronic conditions, walkability of communities, emergency preparedness of seniors in emergency or disaster situations and environmental safety.
Together we identify community priorities and challenges related to aging and co-design practical solutions to overcome these barriers to enable active aging at home and sustained independent living.
- Lao Tzu
Community Knowledge Mobilization
With these partners, and as part of these various projects, we have co-created evidence-based processes to optimize multi-stakeholder engagement, build community capacity, ensure sustainability of projects, scale findings to other communities and developed multi-level participatory evaluation frameworks, tools and outcome measures.
We believe that actively engaging citizens both as partners in research and users of research findings leads to faster identification of priority issues, faster development of practical, feasible solutions and builds better relationships among all key stakeholders.
Local businesses provide infrastructure and resources; key stakeholders share their expertise. In turn, residents learn about community resources and businesses learn to better respond to the needs of their aging clientele. This creates a shared, cost effective mechanism which maximizes the positive collective abilities and resourcefulness of the community as a whole.
We actively engage trainees from different disciplines to work together, think creatively and innovate community design for lifelong active living. Our aim is to ensure that our leaders of the future can learn first-hand the complex individual, system, environmental and policy issues related to aging.
Community Management of Chronic Disease
The predominant approach to managing chronic disease during the past decade has been a comprehensive self-management approach that encourages individuals to learn about their health conditions and to improve their own health and well-being. Although the self-management approach has gained widespread popularity, numerous limitations with this approach have been identified, particularly for individuals in advanced age with multiple morbidities and reduced physical and cognitive abilities. In addition, despite consistent clinical practice guideline recommendations for patient education there is still a large gap in bringing information to community settings. Information is only part of the process. Facilitating, and most importantly, sustaining behaviour change is essential.
We propose the management of chronic diseases for older individuals is best done in a collective community context using a capacity building approach that actively engages residents of the community as a whole in raising awareness, identifying neighbours at risk and providing peer-led education and ongoing monitoring to improve persistence with positive lifestyle changes and improve continued independent living.
With our model, volunteer community advocates are trained; provided with the knowledge and skills required to implement strategies that modify musculoskeletal disease outcomes. They become leaders within their community, establish relationships among their peers, disseminate evidence-based information and provide collaborative reciprocal links to health resources through a knowledge sharing system. These advocates become catalysts for change within their community, providing peer education, mentoring and support. Our osteoporosis demonstration project has demonstrated statistically significant positive behaviour change and we are now exploring the value of this approach for osteoarthritis. This collective community approach to chronic musculoskeletal disease management is economical and sustainable, using peer-driven rather than traditional resource-intensive support systems that depend on healthcare professionals.
Multi-Level Participatory Community Evaluation and Outcome Measurement
Evaluating collaborative community health initiatives presents unique challenges, including engaging community members and other stakeholders in the evaluation process and measuring the attainment of goals at the collective community level.
We have developed a multi-level participatory community evaluation and outcome measurement framework that captures change at 3 levels: individual (micro), collective community (meso), and community-system (macro) levels. The individual level focuses on change in knowledge, attitude, skills, engagement, etc.; the collective community level focus on the collective capacity of a community to identify issues and mobilize resources to bring about desired change; the community-system level focuses on the abillty of a community to work with the health system (or other formal systems) to mobilize internal and external resources to bring about desired change.
In addition, Goal Attainment Scaling (GAS) provides a flexible evaluation approach that involves community members, research partners and other stakeholders in the evaluation process. GAS is user friendly and easily understood by seniors and other community partners not familiar with program evaluation.
In 2017 the Sam Katz Community Health and Aging Research Unit partnered with the Caregiving Research Laboratory (CaRe Lab) to expand research in the area of community dementia care and formal and informal caregiver support.
Research in the CaRe Lab focuses on communication problems and burden among family caregivers of persons with dementia. The goal is to improve caregiver relationships through enhanced communication, identify ways to enhance personhood for individuals with dementia, and to uncover the mechanisms by which caregiver interventions are effective.
Dr. Fitzsimmons’ research in the Faculty of Education, Health and Community at Liverpool John Moores University in the UK focuses on technology-enabled care models for community care.