Working together to address the social determinants of health: Effects of a continuing education program for public health practitioners

Implementing health promotion programs targeting social determinants of health often represents a challenge for public health practitioners working at the local level. Combining reflexivity, community of practice and competencies development, the Montreal Health Promotion Laboratory program is a continuing education program aimed at supporting local multidisciplinary teams in the development and implementation of innovative health promotion interventions. The purpose of this paper is to present the program and to report evidences of its effects at the professional and organizational levels at one community health center site. A longitudinal multi-method approach was used.  Data were collected through semi-structured interviews with program participants and colleagues (n = 9) after three years of  implementation. Questionnaires assessing work group processes and emerging states (e.g., communication, coordination, cohesion) were administered every nine month or so over 36 months. Quantitative results showed significant increases for process variables such as team learning, mutual support, cohesion, engagement and satisfaction early in the implementation phase with a return at the baseline level afterwards. Many of these results are echoed in the interview materials. Qualitative analysis revealed two classes of effects: professionals’ competencies development (e.g., work group skills, program planning) and improved networking with colleagues and external partners. Evidence of knowledge diffusion to other colleagues in the organization were also reported. The Health Promotion Laboratory appears as a promising strategy to develop new competencies among health professionals. The discussion will highlight the potential of the laboratory to overcome limitations of more traditional continuing education strategies as well as issues of applications in other jurisdictions.