Program Training and Consultation Centre
Communities of Practice in Tobacco Control
Cynthia Neilson, MA, BPHE
Health Promotion Specialist, Knowledge Transfer
Irene Lambraki, PhD
Senior Research Associate
The Program Training and Consultation
Centre is a resource centre funded by
Public Health Ontario.
www.ptcc-cfc.on.ca
Program Training and Consultation Centre
Objectives
Provide 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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Program Training and Consultation Centre
Program Training and Consultation Centre
• 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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Program Training and Consultation Centre
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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Program Training and Consultation Centre
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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Program Training and Consultation Centre
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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Program Training and Consultation Centre
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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Program Training and Consultation Centre
Purpose and Audience of CoPs
• Purpose- to facilitate evidence-informed practice, knowledge exchange
and cross-province communication among practitioners engaged in the
Smoke-Free Ontario Strategy.
Public Health
NGOs
CoP
Members
Government
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Researchers
Program Training and Consultation Centre
CoPs at a Glance
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Community of Practice
Launch Date
Status
Tobacco 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
Program Training and Consultation Centre
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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Program Training and Consultation Centre
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 Hot topics are identified
• Weighted score and discussed at PTCC
using information from
the field
How a topic is
selected
Weighted score
Relevance and capacity
Program Training and Consultation Centre
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
(Garcia & Dorohovich, 2007)
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Program Training and Consultation Centre
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
Public Health
Units
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Field Support
Staff
Community of
Practice
Program Training and Consultation Centre
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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Program Training and Consultation Centre
Typical Monthly Webinar Agenda
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Program Training and Consultation Centre
Online Space
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Program Training and Consultation Centre
Community Charter and Learning Agenda
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Program Training and Consultation Centre
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 bylaws
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Program Training and Consultation Centre
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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Program Training and Consultation Centre
Documentations of Practice
YA CoP
• Choose To Be…Smoke-free: Peterborough County-City
Health Unit’s Woman-Centred Program
TFSR & 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 SmokeFree outdoor Space By-Laws in Ontario
DoP Full Reports: http://www.ptcc-cfc.on.ca/learn/DoPs/
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Program Training and Consultation Centre
Evaluation of the Communities of Practice
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•
•
•
•
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•
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Background
Conceptual Framework Guiding the Study
Purpose
Methods
Selected Results
Summary
Applying the Evaluation Findings
Program Training and Consultation Centre
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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Program Training and Consultation Centre
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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Program Training and Consultation Centre
Conceptual Framework
( Adapted f rom Manske, 2 0 0 1 )
External Co ntext
Community of Practice
Knowledge Domain
Shared Identity
Psychological Safety
( Organizational Chara cteristics)
Information/Kno wle dge
Social Capital
( Interactive Process es)
Member Identification
( Individual Characteristics)
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Knowledge Use
Program Training and Consultation Centre
Purpose
To 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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Program Training and Consultation Centre
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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Program Training and Consultation Centre
Characteristics of CoPs Examined
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Characteristics
(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 Support
CoP Leadership Roles
LEARN Team
Co-Chairs
LEARN Team
Co-Chairs
Duration of Existence
At least 1 year
At least 1 year
Frequency and Mode of
Interaction
Monthly teleconference
Two face-to-face
Monthly teleconference
Two face-to-face
Membership Type
Membership Cap
Voluntary
50 members
Voluntary
50 members
Membership Size
40
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Membership Composition
Local public health, TCAN,
Research, government, NGO,
private business
Local public health, TCAN,
Research, government,
community organizations
Program Training and Consultation Centre
Phase I Study Sample
70 members across CoPs
35 of 56 eligible members completed survey
(63% response rate)
Eligibility criterion: Attended >1 meeting
YA CoP
23 of 34 members
68% response rate
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TFSR CoP
12 of 22 members
55% response rate
Program Training and Consultation Centre
Phase II Study Sample
14 members (subset of Phase I study)
7 YA CoP
7 TFSR CoP
Sampled Diverse Perspectives:
Varying levels of knowledge use (rarely, sometimes, often)
Sectors Represented
Roles Assumed in CoP
Gender and Education
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Program Training and Consultation Centre
PHASE I: SELECTED RESULTS
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Program Training and Consultation Centre
Member Satisfaction
CoP Components
Satisfied
Content addressed in CoP
(e.g., agenda topics, knowledge products, etc)
Areas for Improvement
√
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)
√
Link pictures to comembers’ contact
information and bio
Meeting management
(e.g., frequency, duration, facilitation, organization,
teleconference/webinars, in-person meetings)
(knowledge
repository)
√
General Trend √
Level of Support from Member Organization
Teleconferences/Webinars:
easy to be distracted, limits
quality of knowledge
exchange
Participation ‘on top’ of
work priorities
TFSR CoP more satisfied than YA CoP for all of above aspects
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Program Training and Consultation Centre
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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Program Training and Consultation Centre
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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Program Training and Consultation Centre
PHASE II: SELECTED RESULTS
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Program Training and Consultation Centre
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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Program Training and Consultation Centre
Knowledge use: Areas for improvement
YA CoP
Greater access to researchers as area is under-researched and underfunded
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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Program Training and Consultation Centre
Shared Identity
Shared understandings of what is ‘core’ and ‘distinctive’ about our CoP
(Corley & Gioia, 2004)
A Common Purpose
Presence/Lack
We’re inclusive
We’re very local public health focused
We’re about knowledge
sharing and learning
What we’re about aligns with my work
We’re aligned with a broader movement
Information/Knowledge
We’re a Community of Practice
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We’re evidence-based
We’re about the (CoP topic area)
Program Training and Consultation Centre
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 Participation
Forms 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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Program Training and Consultation Centre
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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Program Training and Consultation Centre
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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Program Training and Consultation Centre
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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Program Training and Consultation Centre
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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Program Training and Consultation Centre
Social Capital
The features of social organization, such as networks, trust and norms of
reciprocity
(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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Program Training and Consultation Centre
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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Program Training and Consultation Centre
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 Home
Structure CoP so it allows multiple levels of participation to keep members
connected and coming back
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Program Training and Consultation Centre
Key Mechanisms that Facilitate Cohesion and Knowledge Use
1.
Knowledge
•
2.
Procedures
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•
•
3.
Access to relevant knowledge
In-person meetings
Regular Meetings
Community Charter and Learning Agendas
Structures
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•
•
•
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Structured Time for Practice Sharing
Working Groups
Member Roles
Online Space
CoP Itself
4. People
•
•
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PTCC
Members
Program Training and Consultation Centre
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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Program Training and Consultation Centre
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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Program Training and Consultation Centre
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, coleader 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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Program Training and Consultation Centre
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.ptcccfc.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.ptcccfc.on.ca/common/pages/UserFile.aspx?fileId=103912
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Program Training and Consultation Centre
Thank you!
Cynthia Neilson
Cynthia.neilson@cancercare.on.ca
416-971-9800 x 2822
Irene Lambraki
ilambrak@uwaterloo.ca
(519) 888-4567 ext 33354
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