Promoting health with research

Dr. RenŽe Lyons

Heart disease, stroke and cancer statistics show the Atlantic region has some of the highest rates of these diseases in Canada, even though it«s possible to prevent many of their contributing factors. However, in predominantly rural areas like Atlantic Canada, scarce resources often make it difficult to modify health systems to improve outcomes for those who become ill, and to change the conditions resulting in ill-health.

Dr. RenŽe Lyons, Canada Research Chair in Health Promotion, sees opportunity in these situations. Using Atlantic Canada as her "lab", she investigates how low resource areas mobilize their efforts to prevent disease and improve health — something that can help the many parts of the world facing similar challenges.

As Director of the Atlantic Health Promotion Research Centre (AHPRC) at Dalhousie, Dr. Lyons works with more than 40 staff, including researchers and students, to understand and address important health challenges in Atlantic Canada, such as stroke. AHPRC projects currently involve over 250 collaborators across many disciplines and at many universities, as well as important community, clinical and government partners. "In order for this work to have impact, we must include the potential users of it right from the beginning," says Dr. Lyons.

"Health promotion is about using research to make change. In our projects, we try to understand the basic health issue and the factors that influence it," Dr. Lyons explains. Those factors might include social networks, workplace safety, preventative health care, access to community recreation facilities, or junk food in schools. "Once we know what those factors are in a community, then we try to figure out approaches to deal with the issue." Overall, Dr. Lyons describes this kind of research as "environmental diagnostics." Usually, we might think of a doctor diagnosing someone«s health problem. Instead, this approach considers the physical and social environments in which we live, and how they influence our health as individuals and communities.

For example, the Yarmouth Stroke Project involves working directly with residents of Yarmouth County, Nova Scotia, and health care providers in that region. Now entering its final stages, the project seeks to analyze the needs of persons with stroke and their caregivers, compared to available resources and services. Using best practice evidence gained from stroke research matched with local conditions, the team has been working to transform the services for stroke in Southwestern Nova Scotia.

"In Yarmouth, we«re trying to reform the health system based on this research. We started out by understanding the stroke population and the health care issues in that community," she remarks. "We wanted to understand what it takes to make an evidence-based integrated stroke strategy work in one small community, which could really help the other 5000 rural communities in Canada as well as informing the Canadian Stroke Strategy generally." Such a strategy would involve a continuum of services that work together to prevent stroke, give proper acute care and rehabilitation services, as well as community reintegration support for stroke patients.

The Yarmouth Stroke Project has led to several other stroke research endeavours. One is a set of four collaborative projects involving researchers at Dalhousie and the AHPRC, Laval University, and University of Toronto. One of these projects tests the idea of using stroke policy "navigators" to transform stroke service in the Atlantic provinces, with all four provinces working together versus each province working alone.

Other projects have focused on oral health, food security, bikeways systems and mental health, each with an Atlantic provinces researcher providing leader to a health promotion research team. A recent project, funded by Manulife Financial has focused on the midlife bulge - improving health in the burgeoning midlife population in Canada.