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Health Education Research Advance Access originally published online on December 21, 2004
Health Education Research 2005 20(5):499-513; doi:10.1093/her/cyh006
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Health Education Research Vol.20 no.5, © Oxford University Press 2004; All rights reserved

Using linking systems to build capacity and enhance dissemination in heart health promotion: a Canadian multiple-case study

Kerry Robinson1,7, Susan J. Elliott1, S. Michelle Driedger2, John Eyles1, Jennifer O'Loughlin3, Barb Riley4, Roy Cameron5, Dexter Harvey6 on behalf of the CHHDP Strategic and Research Advisory Groups*

1 School of Geography and Geology, McMaster University, Hamilton, Ontario L8S 4K1, 2 Department of Geography, University of Ottawa, Ottawa, Ontario K1N 6N5, 3 Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec H3A 1A2, 4 Centre for Behavioural Research and Program Evaluation, University of Waterloo, Waterloo, Ontario N2L 3G1, 5 Department of Health Studies and Gerontology, University of Waterloo, National Cancer Institute of Canada, Centre for Behavioral Research and Program Evaluation, Waterloo, Ontario N2L 3G1 and 6 Faculty of Education, University of Manitoba, Winnipeg, Manitoba R3T 2N2, Canada

7 Correspondence to: K. Robinson; E-mail: krobins{at}mcmaster.ca

The purpose of this paper is to examine the utility of linking systems between public health resource and user organizations for health promotion dissemination and capacity building, and to identify factors related to the success of linking systems. The design is a parallel-case study using key informant interviews and content analysis of project reports (synthesized qualitative and quantitative data) of three provincial dissemination projects of the Canadian Heart Health Initiative—Dissemination Phase. Each provincial project used linking activities with public health user groups including meetings, skill building, resources, collaboration, networking and research feedback to facilitate capacity building for and implementation of heart health promotion activities. This paper presents empirical examples of linking system designs, activities, and qualitative and quantitative changes in the public health user groups' health promotion capacity, program delivery and sustainability. The findings indicate enhanced health promotion skills, partnerships, resources, infrastructure, and increased programming and sustainability in the targeted public health organizations of all three provincial projects. Identified barriers to the success of linking systems included lack of appropriately skilled personnel, funds, buy-in and leadership. We conclude that linking systems can be flexibly used to build capacity and disseminate health promotion innovations, and suggest conditions for success.


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