Applied Learning: Applied Research in Collaborative Health Promotion

by Lisa E. Boyes

George Brown College's Interprofessional Learning Clinic [ILC], a cornerstone of the college's pre-licensure interprofessional education [IPE] activities within the college's Health Promotion Hub, is a living laboratory. This student field placement implements and studies interprofessional practices in local, real-world settings.

In Ontario today, although public healthcare now focuses on interprofessional education and care as a means to provide better, faster, safer and more cost-effective care, there are still relatively few such active, on-the-ground examples as the ILC.

One such ILC project, conducted in 2008 - 2009 with community partner Annex Retirement Residence and with seed funding from the college's Office of Applied Research and Innovation, has demonstrated how IPE can impact the quality of student learning and community living. "This was the first time the clinic had worked with the Annex residence, which was keen to have a student presence," says Professor Gary Kapelus, Coordinator of IPE within the college's Faculty of Community Services and Health Sciences. "The results have provided a model for future interprofessional student placements with other seniors' residences."

Health promotion is a primary vehicle through which these placement students deliver interprofessional health services. The World Health Organization's (WHO) key guiding principle of health promotion is that health development must be defined broadly. It requires involvement both within and beyond the health sector itself: in social services, education, affordable housing, recreation, justice and equity, and other areas. WHO has also long advocated for multi-professional undergraduate health education.
Health promotion specialist Jessica Elgie, part-time faculty at George Brown College, mentored and supervised two interprofessional student practicum teams at the Annex residence and helped them focus on the aspects of health promotion they would research to advance their skills and help Annex administration support its residents. The project brought together Ryerson/George Brown collaborative Baccalaureate nursing students, along with the college's dental hygiene, fitness, activation and social service worker students. Two University of Toronto second-year undergraduate medical students, studying in the Determinants of Community Health ("Doc 2") course, led the interprofessional research teams. The students also designed and delivered several workshops for Annex residents and staff, customized to their needs.

Using surveys, interviews and focus groups with residents, the student researchers conducted two studies: respectively, on the level of older adults' participation in leisure- time physical activities and residents' satisfaction with their level of independent living in the transition to a retirement residence. In turn, GBC faculty evaluated the students' satisfaction with and quality of their interprofessional learning through the whole process.

The first study identified that there is a need for greater exercise frequency among the residents in order to achieve recommended levels. As well, residents appear to be more impacted by motivators to participate, rather than by barriers to exercise and leisure activities. Motivators included social and community connection through physical activity, greater feelings of attractiveness, and increased heart and lung function. Barriers identified included perceived physical safety in exercising, physical condition and health, age, self-consciousness and lack of willpower.

The second study found that Annex residents were generally satisfied with Annex's efforts to promote activity and independence, and so there was no correlation between decreased function and resident satisfaction. The student researchers nevertheless provided a number of recommendations to further improve resident activity planning.

The results of these studies were presented to Annex management, who found them to be highly relevant and useful in future program planning. Most important, says Kapelus, the students' research had to be designed and conducted collaboratively, within and across the health disciplines in each team. Faculty members were interested in identifying what challenged and aided students in interprofessional collaboration.

As a result, faculty and students at GBC came to a much better understanding of the students' different roles on the projects and their levels of existing and needed training in health promotion within their areas of study. "All the students," Kapelus added, "described their interprofessional experience with the Annex placement and research projects as invaluable to their education."

This work confirms earlier findings, published by Kapelus and colleagues in the July 2009 issue of the Journal of Interprofessional Care, which reported on the first two years' experience in the interprofessional Health Promotion Hub. Students have overwhelmingly praised this unique experience, which has enabled them to learn about collaborative interprofessional practice, about each others' disciplines and about the practice of health promotion in the community.