From heart health promotion to chronic disease prevention: contributions of the Canadian Heart Health Initiative.

BACKGROUND: The Canadian Heart Health Initiative began in 1987 as an 18-year undertaking to address the epidemic of cardiovascular disease in Canada. There is growing recognition in Canada of the need for an integrated approach to prevention that addresses common risks for many chronic diseases. CONTEXT: Research and intervention activities of the Canadian Heart Health Initiative have shifted toward chronic disease prevention and health promotion. This study explores the contributions of the Canadian Heart Health Initiative to document how single-disease strategies can evolve into integrated chronic disease prevention efforts. METHODS: Key informant interviews were conducted with project researchers and health system stakeholders from seven Canadian Heart Health Initiative provincial projects. A review of provincial health policy documents was also performed. CONSEQUENCES: Findings indicate that the Canadian Heart Health Initiative projects contributed to public health capacity development, including coalition and partnership building, and development of health knowledge and resource infrastructure. The Canadian Heart Health Initiative projects helped put chronic disease prevention issues onto local and provincial health agendas and provided community-based models to help develop public health policies. INTERPRETATION: Experience with the Canadian Heart Health Initiative shows the need for integrated health programs to build on existing infrastructure. Other requirements for integrated chronic disease prevention programs include shared goals, partnerships at various policy levels and in multiple sectors, ongoing information sharing, and funding that is flexible and long-term.