ESTABLISHING HEALTH PROMOTION PROGRAMS

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Lecture 2

• ESTABLISHING HEALTH PROMOTION PROGRAMS
• Related reading Wass. A Chapter 3

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MOVING FROM THEORY TO PRACTICE

• THREE MAJOR FACTORS TO THINK ABOUT IN DEVELOPING
  HP PROGRAMS
• IDENTIFY THE VIEWS AND NEED OF THE
  CLIENTS/USERS/RECEIVERS OF HP, AND SET PRIORITIES
  FOR YOUR WORK (needs assessment)
• PLAN AND EVALUATE YOUR HP WORK
• ORGANISE AND MANAGE YOUR WORK IN ORDER TO BE
  EFFECTIVE AND EFFICIENT

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Identifying HP Needs and Priorities

• Identifying the people who are intended to
  benefit from HP activities is a complex process
  which takes place at many levels (Global,
  National, Communities, Groups, Families,
  Individuals)
• These people may be referred to as users
• Alternatively, they may be called consumers,
  customers, clients, or, of course patients.
  

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CONCEPTS OF NEEDSBradshaws (1972) Typology of
Needs

• Useful to think of four kinds of needs
• Normative Need Defined by an expert or
  professional according to own standards. Falling
  short of these standards means there is a need
• Examples
• Levels of fluoride in water
• Recommended daily allowance of nutrients in foods

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• Normative needs are determined by experts on the
  basis of research, professional opinion and value
  judgements, which may lead to two problems
• The expert opinions standards may vary over what
  is the acceptable standard
• Values and standards of experts may differ from
  those of their clients (Note some
  normative needs are prescribed by law)

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• Felt Need Is the need in which people identify
  and say what they want or need
• Eg A pregnant woman/group of pregnant women may
  feel the need for, and want information about,
  childbirth (Note Felt need is influenced by
  education ie what to ask about)

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• Expressed need Is a felt need which has been
  turned into an expressed request through
  community action or demand often through the use
  of services
• Eg The demand for exercise classes, or fitness
  testing, or health information evenings are
  examples of expressed needs
• Waiting lists for local GPs may identify and
  expressed need for more GPs
• Note Not all felt needs are turned into
  expressed needs. Lack of opportunity,
  assertiveness and motivation may prevent
  expression of felt need
• Very similar to felt need and often used
  interchangeably

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• Comparative Need Defined by a comparison between
  similar groups of clients
• Eg Comparing similar groups of workers/companies
  with respect to their smoking policy, or food
  available at the canteen etc.
  
  If there is a no smoke policy at company A
  then company B maybe should follow the same
  example

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How Can Needs Be Identified?

• We can never assume that we know what the needs
  are in a particular situation
• Hunches may be sound but they might not be
  accurate
• Use hunches as a guide but take the time to find
  out how those affected by the problem interpret
  the situation
• We also need to develop an understanding
  regarding the seriousness of the issues facing
  the community

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How Can Needs Be Identified?

• Listening to the Community
• Social and economic indicators - Available from
  ABS and local council (Socio-economic status,
  single parent families, double/single income
  families, level of home ownership, land available
  for recreation, shopping facilities, public
  transport etc)
• Epidemiological Data (The study of distribution
  and determinants of disease in human populations)
• Available from ABS and Australian Institute of
  Health and Welfare
• These Include Death rates, cancer mortality and
  morbidity rates from state cancer registers,
  health surveys, hospital discharge records,
  reports of notifiable infectious diseases

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BEYOND EPIDEMIOLOGY

• Up until recently epidemiology was regarded as
  the only measuring stick of use in health work
• If we are solely interested in preventing
  disease, rather than HP and a social view of
  health, morbidity and mortality statistics are
  sufficient
• However, from a social perspective morbidity and
  mortality are not sufficient
• Epidemiological data is of limited use where no
  simple cause and effect relationship exists
• Nor does epidemiology measure the extent of
  wellness of a community or individuals within
  that community

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PLANNING HEALTH PROMOTION PROGRAMS
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PLANNING

• AT ITS VERY SIMPLEST
• WHAT AM I TRYING TO ACHIEVE?
• WHAT AM I GOING TO DO?
• HOW WILL I KNOW WHETHER I HAVE BEEN SUCCESSFUL?

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• Identify needs and priorities ? ? ?
  ?
• ? ?
• Set aim and objectives ? ? ?
  ?
• ? ?
• Decide the best way of achieving the aim and
  objectives ? ?
• ? ?
• Identify resources ? ? ? ?
• ? ?
• Plan evaluation methods ? ? ?
  ?
• ? ?
• Set an action plan ? ? ? ?
• ? ?
• ACTION Implement your plan including your
  evaluation ? ? ?

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• 1. Identify needs and priorities (Covered
  Previously)
• 2. Set aim and objectives
• What is wrong with these aims and objectives?
• i. To show young children the sorts of foods
  which are the most healthy to eat
• ii. To make learning about health fun
• Only identifies strategy objectives, which will
  easily be attained
• We want to bring about change in the Target group
  ie. To increase the number of kindergarten
  students (by 30) who eat breakfast

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Aim and Objectives

• An aim is a broad statement of what you are
  trying to achieve
• Objectives are much more specific and setting
  these is a critical stage in the planning process
• Objectives are the desired end state (or result,
  or outcome) to be achieved within a specified
  time period

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• Eg A dietitians aim might be to produce an
  information leaflet
• But this is also the objective and action plan
• You must ask Why produce the leaflet?
• What am I trying to achieve by producing a
  leaflet?
• Therefore becomes clearer that the Aim is to
  improve patient compliance with dietary treatment
  and one of the objectives is to improve the
  patients understanding of the dietary
  instructions
• The action is to produce a leaflet
• You must be clear about why you are doing
  something, not just what you are doing (waste
  of time and money)

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Activity

• Develop an aim and three objectives for a HP
  program with aged using either smoking, PA,
  nutrition or other