communities of practice in tobacco control cynthia neilson, ma,...

www.ptcc-cfc.on.ca

Program Training and Consultation Centre

The Program Training and Consultation Centre is a resource centre funded by Public Health Ontario.

Communities of Practice in Tobacco Control

Cynthia Neilson, MA, BPHE Irene Lambraki, PhD Health Promotion Specialist, Knowledge Transfer Senior Research Associate


ObjectivesProvide participants with an understanding of:•what CoPs are and why we use this model•how CoPs at PTCC function and have evolved•how we support CoPs•how we engage researchers•how we evaluate the CoPs and what we learned

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• Resource Centre of the Smoke-Free Ontario Strategy since 1993

• Funded by Public Health Ontario• Strategic Priorities include:

• Building capacity of 36 public health departments and organizations working in tobacco control in Ontario

• Support moving evidence into action• Strengthen program development and applied research

efforts• Build system capacity to support the Smoke Free Ontario

Strategy renewal

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Propel Centre for Population Health Impact

• Propel is a collaborative enterprise with a mandate to conduct solution-oriented research and knowledge exchange to accelerate improvements in the health of populations.

• Propel carries out the applied research of PTCC. Current initiatives involve conducting: – evidence-based reviews, evaluating interviews

developed with the field, documenting practices from the field; and conducting a developmental evaluation to support the PTCC program

• The Propel Centre for Population Health Impact at UW has been a PTCC partner since 2009.

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What are Communities of Practice?• A group of people who:

• share a concern,• a set of problems• passion about a topic• deepen their knowledge & expertise by interacting on

an ongoing basis.

Mechanism for learning, sharing and co-creating knowledge through fostering interdisciplinary and intersectoral relationships. (Wenger, McDermott & Snyder, 2002)

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Why we implemented CoPs?• Smoke Free Ontario Strategy (SFO) - initiative

of the Ministry of Health and Long-Term Care

• To progress SFO, need invention and innovation – this is primarily generated from the field

• PTCC instituted CoPs to support invention and innovation via provincial-level relationship building and knowledge exchange as a way to progress the SFO

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Type of CoPs• PTCC hosts formally instituted CoPs that are

externally funded and hosted by PTCC• Membership is voluntary• Priorities and activities are generated from

membership

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Purpose and Audience of CoPs

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Government

Public Health

ResearchersNGOsCoP

Members


CoPs at a GlanceCommunity of Practice Launch Date StatusTobacco Reduction for Young Adults

Sept 2008 CoP meets regularly via webinar and in-person

Organizational Learning through Tobacco Control

Sept 2008 CoP closed Apr 2009

Tobacco-Free Sports & Recreation & SF Outdoor Spaces

May 2009 CoP meets regularly via webinar and in-person

Media Advocacy for Healthy Public Policy

Nov 2010 CoP closed June 2012

Smoking Cessation Workplace Learning Collaborative

Sept 2012 LC meets regularly via webinar and in-person

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How did PTCC decide on a CoP topic area?

Domain• Originally consultations with public health practitioners

(through Tobacco Control Area Network meetings - TCANs)

• Consulted literature on other models (Garcia & Dorohovich, Wenger, etc.)

Objectives of the Consultation:• To discuss the value of province-wide CoPs• To identify key content areas for province-wide CoPs• To determine the structure of CoPs and the products

they desired to stimulate and support learning

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Evolution of Topic Selection

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Then Now

How we collect information

External Consultations with TCAN

Internal mechanisms at PTCC for collecting information

Who is involved TCAN/ PHU staff Knowledge broker, PTCC staff, current CoP members

How we examine potential topics

Developed a matrix•Weighted score

Hot topics are identified and discussed at PTCC using information from the field

How a topic is selected

Weighted score Relevance and capacity


Roles in a CoP

• Members – individuals who provide meaningful contributions to the community

• Subject Matter Experts –experienced members who can judge what is important, ground-breaking and useful to the group

• Facilitator – foster and facilitate member interaction

• Community Leader –guide the community’s purpose, intent, energizes the process

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(Garcia & Dorohovich, 2007)


Welcoming Members and CoP Growth

• Initially, we invited 2 PH practitioners from each TCAN, as well as a handful of NGOs and researchers to form our CoP- this became the core membership

• Our thoughts around membership have evolved

• Field Support Staff at PTCC identify new members

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Public Health Units

Field Support Staff

Community of Practice


HOW- Practice •Host (bi-)monthly/monthly interactive webinars•2 in-person meetings per year •Host an online community

Members learn about and share:• Research and evaluation projects• Policy development opportunities • Social marketing/social media campaigns

(prevention, protection, cessation)• Opportunities for collaboration• Lessons learned from practice • Helpful resources

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Typical Monthly Webinar Agenda

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Online Space

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Community Charter and Learning Agenda

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Evidence Summaries/Literature Reviews

• Documents to help support/guide practitioners in making evidence informed decisions.

Selected Topics:• Social marketing to influence young adults’ tobacco

behaviour• Workplace tobacco cessation initiatives for young adults• Smoke-free beaches in Ontario: Progress and

implications for practice• Compliance & enforcement of smoke-free outdoor

spaces by-laws

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Research Projects• No Butts About It- Propel & PTCC

– Evidence-based workplace health promotion project to help workplaces in the retail sector offer a SF environment and offer employees support (esp. YAs)

• TFSR Hockey Evaluation Study- OTRU & PTCC– Assess the impact of TFSR policies at the individual and

community levels within ON hockey organizations and teams

• Environmental Scan- YMCA & YWCA’s- Propel & PTCC– Understand the extent YMCA and YWCA locations in Ontario

are enacting comprehensive tobacco-free policies that go beyond provincial laws or municipal by-laws

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Documentations of PracticeYA CoP•Choose To Be…Smoke-free: Peterborough County-City Health Unit’s Woman-Centred ProgramTFSR & SF Outdoor Spaces CoP•The Development and Promotion of Guelph Soccer’s tobacco-Free Policy: Success Factors & Lessons•Partnerships Developed between Ontario’s Local Public Health Agencies & Ontario Hockey League Teams•Creating Smoke-Free Places: The Development of Smoke-Free outdoor Space By-Laws in OntarioDoP Full Reports: http://www.ptcc-cfc.on.ca/learn/DoPs/

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http://www.ptcc-cfc.on.ca/learn/DoPs/


Evaluation of the Communities of Practice

• Background• Conceptual Framework Guiding the Study• Purpose • Methods• Selected Results• Summary• Applying the Evaluation Findings

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Background

PTCC’s Communities of Practice (CoPs) are an important mechanism for provincial-level networking, knowledge exchange and innovation for the SFO

A developmental and utilization-focused evaluation undertaken to understand how PTCC’s CoPs were developing and how they could be improved (Patton, 1994)

Key stakeholders engaged: PTCC and Community of Practice (CoP) members

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Our Thinking…

Complex problems require complex solutions that get used(Best et al., 2009)

Knowledge exchange, learning and integrating diverse perspectives are critical to generating these solutions

Hard to do - requires different organizations and sectors with different values, ways of thinking and doing to work well together

(Fiol et al., 2009, LeBaron, 2003)

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(Adapted from Manske, 2 0 01)

Community of PracticeKnowledge Domain

External Context

Shared IdentityPsychological Safety (Organizational Chara cteristics)

Member Identification(Ind ividual Characteristics)

Social Capital(Interactive Process es)

Knowledge UseInformation/Knowledge

Conceptual Framework

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PurposeTo examine:

• How PTCC’s CoPs were using knowledge gained from the CoP

• How PTCC’s CoPs were developing with respect to shared identity, member identification, social capital and psychological safety

• The importance of above concepts in CoP context and why

• The mechanisms or factors that CoP offers help to strength cohesion and knowledge use

• Member satisfaction with the CoP and areas of improvement

• The value add members gained by participating in the CoP

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Methods

Embedded case study design using mixed-methods (i.e., quantitative and qualitative methods)

(Yin, 2009; Creswell et al., 2011)

Phase I Quantitative Study (Online Survey)Assessed: member satisfaction, how CoPs were developing re: study,

differences between the CoPs, relationships between concepts

Phase II Qualitative Study (interviews, CoP documents)Phase I findings informed focus of Phase II and sample

Data coded and analysed for common themes using NVivo 9

(Strauss & Corbin, 1990; Glaser & Strauss, 1967)

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Characteristics of CoPs ExaminedCharacteristics

(at time of Phase I study)Young Adult Tobacco Reduction (YA CoP)

Tobacco Free Sports and Recreation (TFSR CoP)

Funding Provincial government Provincial government

Secretariat SupportCoP Leadership Roles

LEARN TeamCo-Chairs

LEARN TeamCo-Chairs

Duration of Existence At least 1 year At least 1 year

Frequency and Mode of Interaction

Monthly teleconferenceTwo face-to-face

Monthly teleconferenceTwo face-to-face

Membership TypeMembership Cap

Voluntary50 members

Voluntary50 members

Membership Size 40 30

Membership Composition Local public health, TCAN,Research, government, NGO, private business

Local public health, TCAN,Research, government,

community organizations

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Phase I Study Sample70 members across CoPs

35 of 56 eligible members completed survey(63% response rate)

Eligibility criterion: Attended >1 meeting

YA CoP23 of 34 members68% response rate

TFSR CoP12 of 22 members55% response rate


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Phase II Study Sample14 members (subset of Phase I study)

7 YA CoP 7 TFSR CoP

Sampled Diverse Perspectives:Varying levels of knowledge use (rarely, sometimes, often)

Sectors RepresentedRoles Assumed in CoPGender and Education


PHASE I: SELECTED RESULTS

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Member Satisfaction

General Trend

TFSR CoP more satisfied than YA CoP for all of above aspects

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CoP Components Satisfied Areas for ImprovementContent addressed in CoP (e.g., agenda topics, knowledge products, etc) √

Knowledge Exchange Opportunities(e.g., guest speakers, networking, practice sharing)

√ Greater access to researchers

Online Space (knowledge repository, asynchronous communication features like discussion posts, access to members)

√(knowledge repository)

Link pictures to co-members’ contact information and bio

Meeting management (e.g., frequency, duration, facilitation, organization, teleconference/webinars, in-person meetings)

√ Teleconferences/Webinars: easy to be distracted, limits quality of knowledge exchange

Level of Support from Member Organization √ Participation ‘on top’ of work priorities


Differences between CoPs

TFSR CoP had consistently higher average ratings across all concepts assessed than YA CoP (i.e., they used CoP knowledge more, had stronger shared sense of identity, etc)

• However only significant difference between TFSR CoP and YA CoP was based on shared identity and psychological safety

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Relationships between Concepts and Knowledge Use

Shared identity, member identification, social capital and psychological safety positively and significantly

E.g., the more strongly shared the CoP identity the greater the social capital (or vice-versa)

Shared identity, member identification, social capital and psychological safety each significantly related to knowledge use

E.g., the more strongly shared the CoP identity, the more often knowledge gained from CoP would be used

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PHASE II: SELECTED RESULTS

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Knowledge Use Per CoP

Both CoPs used knowledge in conceptual and instrumental ways

Conceptual (sharing, increased awareness, learning with no immediate behaviour change)

“most of my knowledge that I’ve learned about this area has come from this community of practice. So anything about how to start …policy…all the how-to’s, what campaigns seem to work…all that…”

Instrumental (planning to use knowledge, making decisions, implementing changes)

“(name of intervention), it had been evaluated and (when I took it) forward to management, I got an immediate ‘Yeah sure. Look into this and see if we can partner with them’”

TFSR CoP more instances of instrumental knowledge use than YA CoP

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Knowledge use: Areas for improvement

YA CoP

Greater access to researchers as area is under-researched and under-funded

Move beyond discussing CoP knowledge to actual implementation: “there’s a show and tell kind of feel to teleconferences and not

enough ‘let’s problem solve here. Let’s look at general strategies. What should be happening. Who could orchestrate that?’”

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Shared IdentityShared understandings of what is ‘core’ and ‘distinctive’ about our CoP

(Corley & Gioia, 2004)

We’re about knowledge sharing and learning

We’re a Community of Practice

What we’re about aligns with my work

We’re about the (CoP topic area)

We’re inclusive A Common PurposePresence/Lack

We’re aligned with a broader movement

Information/Knowledge

We’re very local public health focused

We’re evidence-based

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Importance of Shared identity

Facilitates Coherence: “Contributes to a more collaborative process” by “putting us all on the same page…so we all know what our purpose is of being here,” creating one shared voice… a synergy… so you’re really working towards something together”

Facilitates Sense of Belonging and Member ParticipationForms anchor point for member identification“…helps with building a sense of belonging to the group as well as a reason to attend meetings (because) if you catch people with what they’re…passionate about, they’ll likely be much more involved”

Knowledge Use: “…if you’re in it for the same reasons, then I think you’re more committed and you’re going to share more and listen more attentively and so on…”

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Shared Identity: Area(s) for Improvement

YA CoP:

“I feel somewhat disjointed in understanding exactly what we’re trying to accomplish.”

Reason? Lack of Common Purpose

“Well the TFSR CoP … there is a shared understanding (there) because those working actively in that CoP are all working with similar goals. They have the Public Health Standards, TSAG Report from the province telling (them they) must be working on this…They also have that provincial campaign to be working on…so they’re more action-based where ours has been more idea-based. So I think there has been more interest from this CoP to do the same because that’s what’s keeping them together and that’s what’s really working.”

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Shared Identity: Area(s) for Improvement

YA CoP lacked clarity about ‘who we are’ as a CoP because no clear government directives to guide them: “…I think the disconnect here is…how are we working in the context of what the Ministry of Health and Long-Term Care is doing…do we (as a CoP) espouse their

philosophy?... We need to understand their perspective, direction…goals for young adult tobacco reduction if we’re to have any coordination…and it’s just sort of the elephant in the room. Nobody’s talking about it”

TAKE AWAY:Need to create “alignment” between ‘who we are’ as CoP and mandates /

priorities of key entities in broader system even when such mandates don’t exist

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Member Identification and Importance“Who I am” is defined in part by “who we are” as a group, creating a sense of belonging (Ashforth & Mael, 1989)

Contributes to development and strengthening of social capital:Enhances active participation and accountability to members: it makes you “feel motivated,” “more engaged,” and “some sense of obligation to work with people in the group,” and “you get better reception when you approach people to work with them on something”

Knowledge Use:“When you feel that sense of belonging…you’re going to be more motivated to work. You’re going to feel like you’re a part of the CoP, and then you’re going to facilitate these initiatives out in your local community…and then the public will see the benefits as well”

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Member Identification: Area(s) for Improvement

Non-local public health sector tended to have weaker sense of belonging to CoP • this detracted from their motivation to network, actively participate or use CoP knowledge because CoP knowledge wasn’t relevant to their sector’s needs

Why? Non-local public health sectors commonly defined CoPs as “very local public health focused,” which shaped focus of information that circulated in CoP

TAKE AWAY:

To encourage member identification and in turn motivation, create a shared identity that encompasses values and needs of their organizations/sectors

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Social CapitalThe features of social organization, such as networks, trust and norms ofreciprocity (Putnam, 1993)

Some Key Findings:Members from both YA CoP and TFSR CoP made new connections with“members…across the province,” “in different health units,” and “beyond public health”

Members also felt: • “comfortable” to contact other members, • co-members were trustworthy (i.e., benevolent- and competence-based

trust), and • co-members were “…very receptive when you approach them for things”

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Importance of Social Capital Empowerment:

Networking and learning what others are doing and see “that the work that we are doing here (in our health unit) is very similar to work that’s been done around the province (increases) the comfort factor that yes, we’re on the right track…Let’s keep going down this road”

Knowledge Use: “when you trust your coworkers and their opinions…you’re going to go to them for more information” and more likely of “giving their ideas a shot”

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Social Capital: Area(s) for Improvement

Getting active participation from peripheral members or “lurkers” was like “pulling teeth”

Why? • Technology: “with teleconference meetings, everyone is

unseen….You’re vulnerable, you don’t know who is listening”• Level of Experience or % time spent at work on CoP topic area

Is it really so bad? ‘lurkers’ liked the flexibility the CoP offered

Take HomeStructure CoP so it allows multiple levels of participation to keep members

connected and coming back

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Key Mechanisms that Facilitate Cohesion and Knowledge Use

1. Knowledge• Access to relevant knowledge

2. Procedures• In-person meetings• Regular Meetings• Community Charter and Learning Agendas

3. Structures • Structured Time for Practice Sharing• Working Groups• Member Roles• Online Space• CoP Itself

4. People• PTCC• Members

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Value Add for Members• “Awareness of what’s going on around the province”

• ability to access evidence and resources via online space and members

• “Networking” and “provincial-level relationships I didn’t have before”

• “Creating linkages and having a greater impact by working together,”

• “…Not reinventing the wheel”

• CoP is a space that validates for members that they are on the right track with their initiatives

• “Developed a level of expertise in content area that would not have had otherwise”

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Summary

Shared identity, member identification, social capital important to diverse members cohering in ways that enhance knowledge use

Members from both CoPs satisfied with CoP, but TFSR CoP moreso

TFSR CoP developing ‘better’ than YA CoP due to clear common purpose that aligned with priorities of government

Several mechanisms contributed to development or strengthening of shared identity, sense of belonging, social capital and knowledge use

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Applying the Evaluation Findings

• Confirmed that many of the activities or decisions we’ve made are working and should continue (e.g. in-person meetings, co-leader role, learning agenda, practice sharing, etc.)

• Created an online practice sharing• Provide additional support for working groups• Selected a new online platform• Recruited additional researchers and created co-leader roles for

them

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References & Resources Related to CoPs

Garcia, J., & Dorohovich, M. (2007). The truth about building and maintaining successful communities of practice. Defense Acquisition Journal Review, 12(1), 19-33.

McDonald, P. & Viehbeck, S. (2007). From evidence-based practice making to practice-based evidence making:Creating communities of (research) and practice. Health Promotion Practice, 8(2), 140-144.

Lambraki, I.A. (2012). Identity, Psychological Safety and Social Capital: A mixed methods examination of their influence on knowledge use in the context of LEARN Communities of Practice. Dissertation, University of Waterloo. http://hdl.handle.net/10012/7284

Nowaczek, A., Lambraki, I., Manske, S. (2010). Knowledge use among PTCC’s LEARN communities of practice: Tobacco use reduction for young adults and tobacco-free sport and recreation. Developmental evaluation of LEARN communities of practice. http://www.ptcc-cfc.on.ca/cms/one.aspx?pageId=100781

Wenger, E., McDermott, R. & Snyder, W. (2002). A guide to managing knowledge: Cultivating communities of practice. Boston, Massachusetts: Harvard Business School Press.

CP Squared - “The Community of Practice on Communities of Practice” http://cpsquare.org/

Program Training and Consultation Centre, LEARN Project. CoP reading and resource list. http://www.ptcc-cfc.on.ca/common/pages/UserFile.aspx?fileId=103912

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http://hdl.handle.net/10012/7284

http://www.ptcc-cfc.on.ca/cms/one.aspx?pageId=100781

http://cpsquare.org/

http://www.ptcc-cfc.on.ca/common/pages/UserFile.aspx?fileId=103912


Thank you!

Cynthia [email protected] x 2822

Irene [email protected](519) 888-4567 ext 33354

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communities of practice in tobacco control cynthia neilson, ma,...

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