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Conference Abstracts

Overcoming Hidden Barriers to Health System Integration


Troy Stooke ,

IMAGINE Citizens Collaborating for Health, CA
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Jo-Louise Huq,

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Robert Bear,

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Gail MacKean

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Fully-integrated regional and provincial healthcare systems should increase system efficiency and effectiveness. Development of these systems is typically spearheaded by acute care organizations. However, there are hidden barriers that that lie outside of these organizations that must be overcome if we are to realize the benefits of integration. IMAGINE Citizens Collaborating for Health (IMAGINE) is an Alberta-based, citizen-led non-profit organization focused on engaging with Albertans in their communities on important matters related to health and healthcare. IMAGINE's iKNOW Health (Knowledge, Navigation and Ownership) program is a co-designed effort of citizens with health organization leaders to understand and increase health literacy.

Aims Objectives Theory or Methods

IMAGINE’s initiatives are surfacing and engaging with critical barriers to health system integration including health literacy, inequitable service design, access, delivery, an inconstant, still weak person-centred care culture and rapidly transforming digital health landscapes. Many barriers limit integration. Integration cannot be achieved absent a citizenry with personal health, digital health, and health systems literacy.

IMAGINE’s iKNOW Health project aims to surface and address these literacy barriers.   Guiding principles of the project include engaging with the public to build relationships, surface and use information in co-design activities, and support empowerment. These activities are undertaken in various in-person (pre-covid)/virtual environments.

 Highlights or Results or Key Findings

IMAGINE’s projects related to building literacy/reducing barriers to integration include:

• Healthcare Basics for Albertans - a plain-language resource about

 Alberta’s health system.

• The first ever Alberta health navigation survey offered in nine first languages – first languages are critical to building literacy.

• A youth-led research project - “What health information do youth need & how do they want to receive it?”

• Best practices for working with ethnocultural communities to improve health literacy via the Sound Mind/Sound Body partnership.

• Co-designing a community health ambassador model to create two-way dialogue between people and Alberta health system partners.

• Community conversations- to develop a Digital Health Literacy Map. People asked for help to understand why and how to navigate publicly available digital health tools in Alberta.

IMAGINE is working on other fronts to promote wide understanding and effective implementation of of health literacy concepts in Alberta communities.


Co-design of health literacy materials enables local people (ambassadors of trusted health information in their communities) to select, share and adapt information tailored to their own unique situations. Together with health system leaders we found some answers to the hidden barriers that obstruct peoples’ acquisition of deeper health literacy.

Implications for applicability/transferability sustainability and limitations

Integration will only be possible when people are health literate. Digital health literacy requires more than access to a full and complete electronic health - it will require that people can use digital information with system providers. Partnering with people is required to unleash the potential value of health integration.

How to Cite: Stooke T, Huq J-L, Bear R, MacKean G. Overcoming Hidden Barriers to Health System Integration. International Journal of Integrated Care. 2022;22(S2):47. DOI:
Published on 16 May 2022.


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