Appendix I

SUMMARY OF RECOMMENDATIONS

For ease of reference, the recommendations are summarized here.

1. SUSTAINABLE FUNDING

• Increase efforts to provide sustainable funding in sufficient levels to those involved in the implementation and delivery of healthy eating and physical activity strategies/programs on a population-wide basis in order achieve the intended outcomes.
• Support building of the basic infrastructure to implement physical activity and healthy eating strategies, both in terms of human resources and financial and physical plant/facilities, as necessary. Particular needs include building sufficient infrastructure (equipment, spaces, and facilities) and increasing capacity (positions at the provincial and community levels) to support an increased focus on health promotion and wellness.

2. ACCESS TO AND PROMOTION OF PROGRAMS

• Encourage steps to improve the availability of programs so that all members of the population can access services regardless of geographic location, or other barriers. Provide assistance with promotion of the programs so that the population is aware of the services available.

3. STRATEGIC LEADERSHIP AND COORDINATION

• Provide leadership, direction, and support at multiple levels to ensure an integrated, coordinated approach. Alignment of efforts and strategic planning within the region will help identify areas for action best suited to PHAC Atlantic and to each key stakeholder. Some activities are costly and/or apply equally to all jurisdictions (e.g., social marketing campaigns) and perhaps provinces/healthy living alliances could benefit by working together with PHAC Atlantic to coordinate efforts in these areas. A vast number of initiatives are under way at the national, Atlantic-wide, provincial, regional, and local levels, and it is difficult to ensure stakeholders within the region are informed of developments in order to coordinate efforts, provide complementary services, and avoid duplication.

4. PARTNERSHIP

• Continue to support/enhance the partnership networks of the healthy eating and active living alliances in recognition of the potential impact of collaboration and the need for intersectoral approaches. Joint government-community/alliance partnership is critical to move the agenda forward. 
• Build partnerships with other key sectors, particularly the food/agricultural industry, which have a contribution to make in promoting healthy eating and active living and which appear underrepresented in this scan. Seek out ways to address barriers and more fully engage existing partners where necessary.
• Strengthen the level of collaboration between diabetes initiatives and
  healthy eating/physical activity groups, as well as with initiatives related to other diseases with the same risk factors. Ensure funding allocation mechanisms support this approach.

5. TARGETED AREAS FOR ACTION

• Children and youth: Continue to focus on school-aged children and youth to help ensure the adoption of life-long healthy eating and active living practices.
• Food Security: Enhance efforts to ensure the availability of nutritious affordable food for low-income groups. The degree to which the reach of other programs extends to low-income and rural groups is also not clear, given the uneven accessibility of programs generally, and more work may be necessary to explore this sub-population, given the socio-economic status of the region as a whole.
• African-Canadian, ethno-cultural, and other communities: Examine need and opportunities for working with African-Canadian and other ethno-cultural communities in the promotion of healthy eating and physical activity. Build on initiatives such as the diversity and social inclusion initiative in primary health care as a model for action. Explore gaps in services targeted to particular sub-populations in various jurisdictions.
• Seniors: While more programs have targeted seniors, this is a population that will continue to need sustained focus, given the aging demographics of the region's population.
• The family: The family unit as a whole also merits attention since healthy eating and physical activity patterns are also influenced and shaped within the family context.

6. SUPPORTIVE POLICY AND PROGRAMS

• Continue efforts to address the risk factors of obesity, unhealthy eating and physical inactivity with the creation of supportive policy and program environments across multiple sectors. Continue to use a broad range of approaches to achieve outcomes.

7. EVIDENCE-BASED DECISION MAKING/KNOWLEDGE DEVELOPMENT AND EXCHANGE

• Ensure programs and initiatives have an evaluative component built into their work so as to provide the evidence needed for what works and what does not.
• Establish mechanisms for sharing information about programs offered in the region, research and evaluation results (in easy-to-use form), and best practices. Also explore other mechanisms to share information, network, and build partnerships on an Atlantic-wide basis so as to avoid duplication of effort. Consider establishment of a clearinghouse to maintain a body of literature - evaluation, research, programs, environmental scans, and the like that are relevant to the region.
• Assist in the development of links with the research community.

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