Dissemination of Heart Health Promotion
Bibliographic record
Abstract
The research reported in this dissertation examines the dissemination of heart health promotion within the Ontario public health system. It contributes to a relatively new research agenda to understand how to enhance implementation of the new public health; to apply knowledge of effective community- and population-based prevention. Three studies are reported, which extend research conducted in Ontario from 1994 to 1998 as part of the Canadian Heart Health Initiative Ontario Project (CHHIOP). Study one combined diffusion and social ecological theories to examine the dissemination process at the level of the public health system and over a ten year period. Studies two and three examined the implementation stage in more depth, with a view to understand variability across Ontario communities. Study two was a quantitative path analysis to identify determinants of 1997 levels of implementation, and study three was a comparative case study to understand change in implementation from 1994 to 1996. Main data sources were quantitative and qualitative data from CHHIOP. Findings reinforce the need for a systems view of dissemination; that dissemination is a long-term, iterative process; and that organizational capacity building is a vital part of the dissemination process, especially when new practices represent a significant departure from traditional concepts and ways of doing business. The research demonstrates that the interplay of internal organizational factors (e.g. champions, leadership, organizational structure) and external system factors (e.g. research, political priorities, experiences of other jurisdictions, partnerships) helps to explain movement within and across dissemination stages. Findings suggest promising areas for dissemination research, including replicating similar research in other public health systems. Findings also suggest promising strategies to accelerate the dissemination of effective health promotion, including specific strategies to further enhance heart health promotion in Ontario.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.032 | 0.072 |
| Meta-epidemiology (narrow) | 0.000 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.005 | 0.005 |
| Science and technology studies | 0.005 | 0.004 |
| Scholarly communication | 0.007 | 0.003 |
| Open science | 0.002 | 0.006 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.010 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".