The Canadian Heart Health Initiative: dissemination perspectives.

The Canadian Heart Health Initiative is a country-wide strategy for the prevention of cardiovascular disease. Initiated with a 15-year horizon, it has resulted in extensive networks and coalitions involving Health Canada, the 10 provincial departments of health and over 1,000 organizations. There are five phases: policy development through country-wide consultations (1986-88); provincial heart health surveys (1986-91); research demonstration programs (1989-97); and evaluation (1994-97). The dissemination research phase studies the adoption of interventions by communities and health systems. As a paradigm for dissemination of health policy, some key features of the Initiative are translation of the science base in prevention into community programs; consensual policy development; federal and provincial co-funding arrangements; key role played by the public health system; capacity building; organization and management model linking activities at the national, provincial and community levels. The methodologies and capacities developed are applicable to other health promotion and disease prevention areas.