2017 Health Check-Up!

The Ajax-Pickering Early Childhood Development Coalition is a collaborative, community planning group formed to address vulnerabilities in early child development in Ajax and Pickering.

Ajax and Pickering were chosen for this project based on lower scores on the Early Developmental Instrument (EDI), lower rates of well-baby visits, higher numbers of births and an increasingly diverse population. The EDI provides a measure of a child’s ability to meet age appropriate development expectations and is a good indicator of school readiness. The 18 month well-baby visit helps to identify any developmental concerns and is often the last well-baby visit before a child begins school.

In 2015, the coalition launched a three-year plan to help improve rates of 18 month well-baby visits and EDI scores in Ajax and Pickering. This plan focused on promoting the importance of the 18 month well-baby visit and included hosting a number of community consultation meetings with parents and caregivers. The community consultations involved parents and caregivers of children birth to six-years old who live in Ajax and Pickering. Results from the consultation meetings indicated that parents and caregivers had a lack of awareness of available community programs and supports, and felt a need to enhance inclusivity and diversity within community programs.

In 2017, the coalition addressed the key findings from the consultation sessions. The key findings were summarized into a visual infographic which was circulated widely to key stakeholders and community partners throughout Ajax and Pickering.

In partnership with the Town of Ajax, the "Healthy Me, Health Us Family Health Information Day" was held for parents and caregivers of children birth to six-years old who live in Ajax and Pickering. The event focused on key topics including healthy growth and development, early learning, healthy eating, immunization, safety, resources in the community and diversity. The event aimed to strengthen a sense of belonging between parents, caregivers and community partners, increase awareness of available community programs and supports, and included the participation of 16 non-profit community partners.

There were 193 attendees at the event which included a diverse population of parents, children, grandparents and caregivers. The 16 non-profit community partners who participated provided families with an opportunity to visit interactive educational displays and receive health information and resources, as well as supports and referrals to parenting programs and services throughout Durham Region.

The overall goal of the coalition is to increase the participation and involvement of families at local parenting groups, and to further support parents in their capacity to positively influence their child’s growth and development and readiness for school.

In 2017, Infant and Child Development (ICD) continued to surpass targets set for service delivery to infants and young children with developmental delays or risk factors for development. In total, support was provided to 1,042 infants and their families through a blended service model of home visits or preterm clinic check-ups.

Parents and physicians are the main sources of referral to the program, with 82 per cent of referrals for infants under 12-months old. The remaining 18 per cent of referrals are for young children over 18-months old who may demonstrate some early signs of Autism Spectrum Disorder (ASD). Infant and Child Development supports young children with early signs of ASD with screening and assistance to connect parents with the appropriate community supports to help with early diagnosis and treatment.

Infant and Child Development Social Media

In the second year of its Facebook pilot project, Infant and Child Development extended its reach on this social media platform to 51,207 with a total of 114 posts in 2017, providing a wide range of information and resources for families and community agencies. This project is a way to provide current and timely information on topics such as "Guidelines for screen use for young children" and also an initiative known as the "Quiet Zone", which features dates and times of community programs for young children with Autism and their families.

Infection prevention and control (IPAC) practices are required throughout Ontario in facilities operated by regulated health professionals, as well as personal services settings like tattoo parlours and nail salons. When IPAC practices do not occur, this is known as a lapse and there is a potential for the transmission of infectious disease. The Health Department has always investigated IPAC lapse complaints, but as of October 2015, the Ontario Ministry of Health and Long-Term Care (MOHLTC) has required public health units to publicly disclose such lapses that could lead to the transmission of infectious diseases to the clients, attendees or staff through exposure to blood, body fluids and/or potentially infectious wounds.

In 2017, 42 IPAC lapse complaints were filed with Durham Region Health Department on personal services settings and facilities operated by regulated health professionals, which were then investigated by specially trained public health inspectors. Thirteen of these complaints met the criteria for posting on Durham Region's website.

The posting of this information provides increased transparency of these investigations that may affect the public, providing more information to help community members make informed decisions to protect their own health.

As the public becomes more aware of expected IPAC practices, complaints in these types of facilities are on the rise and investigations can be quite time-consuming, depending on the complexity of the IPAC lapse. Health Department staff consults with professionals at Public Health Ontario and relevant regulatory colleges to access the most recent information available regarding expected IPAC practices for each facility.

Mental health is about how you think, feel and act. Good mental health helps you get the most out of life and helps you cope with life's stresses and reach your goals. By taking care of your mental health you can reduce the chance of developing a mental health problem.

Resiliency is the ability to bounce back from life’s challenges and move forward with new knowledge and skills. Qualities such as self-control, emotional awareness, capacity to handle change and challenges, as well as external factors such as parent-child attachment, social connections and work/school culture, contribute to an individual’s resiliency. Efforts that promote and foster resiliency also improve mental health.

Durham Region Health Department promotes positive mental health throughout one’s life, including the prevention of suicide, through a variety of program and services. These services focus on promoting positive mental health, promoting and fostering resiliency, reducing stigma and supporting people in recognizing risks and to get help when needed. The Health Department provides a number of programs and services that promote mental health and resiliency including:

• Healthy Babies Healthy Children (HBHC) – public health nurses and family visitors provide support for families and children from the mother’s prenatal period until the child’s transition to school through a blended model of home visiting. Nurses and family visitors work in together with families to identify and address goals linked to healthy child development and effective parenting.
• Prenatal and postpartum parenting support – provided through groups such as Food 4 Thought, programs including Supporting Mother and Infant Learning Experience (SMILE), Teen Education and Mothering (TEAM) program and Basic Connections clinics to assist families with breastfeeding and other infant concerns. Online resources, such as prenatal education tools, are also available to support both parent and child health.
• Perinatal Mood Disorder (PMD) support group – a peer support group facilitated by a public health nurse. This group allows prenatal or postpartum mothers who are experiencing PMD symptoms or who are having difficulty adjusting to parenthood to support and learn from one another.
• Daycare and preschool program support – (e.g. EarlyON Child and Family Centres)
• Collaboration with local school boards – working with school boards to develop and implement strategies supportive of mental health and resiliency.
• Comprehensive school health programming – public health nurses support individual school communities in planning and implementing strategies to promote mental health and well-being.
• Talking About Mental Illness (TAMI) Durham – through TAMI, public health nurses participate in the planning and delivery of TAMI curriculum in Durham Region schools to promote positive mental health, decrease stigma and help children and youth seek help for mental health issues.
• Youth Suicide Prevention Action group – this is a sub-group of the Durham Children and Youth Planning Network where the Health Department works with other partners to implement a community approach to youth suicide prevention.

In addition, the Health Department has developed a variety of evidence-based resources to support adults, parents, educators, schools and workplaces in promoting positive mental health, building resiliency and accessing help when needed. See www.durham.ca/mentalhealth and www.durham.ca/ppmd for more information.

In 2017, the Health Department’s Oral Health division expanded its medical imaging ability to help improve diagnostic capacity, allowing for x-rays to be taken using digital radiography. This past year, a CariVu system was purchased, allowing for images of teeth to be taken that do not expose a child to any radiation.

The system works using transillumination with intense light in the near infrared spectrum. Use of the CariVu system allows for cavities in teeth to be seen, as well as around cavities and existing fillings. Images can be stored digitally in the same way x-rays are stored. This technology can be used on very young children who are unable to co-operate with a typical radiograph and is also more acceptable to parents as no radiation is involved. Oral Health also purchased intra-oral cameras which allows for images to be taken for education purposes, allowing the client/parent to see what the Oral Health staff sees, which can help to improve the consent process for both staff and clients.

The Rapid Risk Factor Surveillance System (RRFSS) is a residential telephone survey of adults 18 and older in Durham Region. The survey asks questions about health behaviours, attitudes and knowledge of topics such as smoking, physical inactivity, alcohol use, women’s health issues, bike helmet use, Lyme disease and more. Data from the RRFSS is used to monitor health trends over time, to evaluate and inform the planning of health programs, and to respond to local data needs by creating survey content.

Between 2000 and 2015, the RRFSS survey was used to contact Durham Region residents through landline telephone numbers. However, research shows that 21 per cent of Canadians do not have a landline telephone number and only use cell phones. To help reach this population, Durham Region Health Department decided to use a mixed approach to survey residents in 2016, using both landline telephone numbers and cell phone numbers.

An evaluation was conducted to examine whether survey respondents contacted by cell phone were different from respondents contacted by landline telephone. The results showed that the cell phone respondents represented the population of Durham Region more closely compared to the landline sample, in terms of age and gender. Differences in the health behaviours of cell phone and landline telephone respondents were also found. Cell phone respondents had a higher smoking rate and rated their mental health status as lower compared to landline respondents. The findings from the evaluation will be used to help in the planning of future RRFSS surveys.

In 2017, Region of Durham Paramedic Services (RDPS) moved from the older manual lift patient stretchers to the new Stryker Power Pro Stretcher. These new stretchers have helped to drastically reduce the amount of manual lifting done by paramedics. When previously using the manual stretchers, paramedics would lift and move approximately 6,000 lbs. on average over the course of a 12-hour shift. Since the rollout of the power stretchers, essentially all stretcher lifts have been removed from a paramedic's day. Just as important, these new stretchers are more comfortable and safer for the patients we serve.