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Introduction to Health Promotion Planning

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Title: Introduction to Health Promotion Planning


1
Introduction to Health Promotion Planning
  • January 30 31, 2007
  • Larry Hershfield
  • Heather Graham

2
  • You've carefully thought out all the angles.
  • You've done it a thousand times.
  • It comes naturally to you.
  • You know what you're doing, its what you've been
    trained to do your whole life.
  • Nothing could possibly go wrong, right ?

3
How do you use plans?
  • In table groups
  • introduce yourselves
  • share what you hope to get out of the workshop
  • share highlights with large group

4
Introductions
  • Purpose
  • Process
  • Paper
  • Place
  • People

5
Goal of Workshop
  • To assist those involved in health promotion with
    planning projects in organizational and community
    settings.

6
Objectives of Workshop
  • By the end of the workshop, participants will
  • be able to use a practical model of health
    promotion planning and apply it to organizational
    and community settings
  • be able to conduct a situational assessment
  • be able to develop goals and objectives
  • be able to identify strategies, activities,
    resources and timelines
  • understand the link between planning and
    evaluation and be able to incorporate appropriate
    program evaluation measures in the planning
    process.

7
Introductions
  • Purpose
  • Process
  • Paper
  • Place
  • People

8
Format of Workshop
  • During the workshop, participants will
  • apply lecture materials, worksheets, case studies
    and other practical THCU tools
  • work in small groups and share their ideas and
    experiences
  • interact with peers and workshop facilitators to
    address questions and issues arising from
    application of the workshop material to real and
    hypothetical issues.

9
Process
  • Bicycle Rack
  • Food
  • Light breakfast afternoon snack provided
  • Coffee, tea water abound
  • Lunch on own Salad King, Eaton Centre,
    downstairs café, grocery store
  • Dinner plans?

10
Introductions
  • Purpose
  • Process
  • Paper
  • Place
  • People
  • Slides
  • Workbook
  • Agenda
  • Evaluation Form
  • THCU materials
  • Resource material

11
Introductions
  • Purpose
  • Process
  • Paper
  • Place
  • People
  • Telephones
  • Washrooms
  • Anything else?

12
Introductions
  • Purpose
  • Process
  • Paper
  • Place
  • People
  • Larry Hershfield
  • Heather Graham
  • people at your table
  • online networking

13
What is Planning?
  • Planning is a series of decisions,
  • from general strategic decisions
  • (e.g., identifying priorities)
  • to specific operational details
  • (e.g., program implementation) ,
  • based on the collection and analysis
  • of a wide range of information.

14
Why plan?
  • To get from your starting point to your desired
    end point.
  • To help direct resources to where they will have
    the greatest impact.
  • To ensure the development and implementation of
    effective and appropriate health promotion
    programming.

15
Three Fs of Program Planning
  • Fluidity steps are sequential or build upon one
    another (e.g. cannot set goals objectives
    without an environmental scan)
  • Flexibility planning is adapted to the needs of
    stakeholders modified as process unfolds
  • Functionality outcome of planning is improved
    health conditions, not the production of a plan
    itself

16
Levels of Planning
Strategic
  • Program

Operational / Work / Action
17
Components of Planning
  • Vision
  • Mission
  • Values / Beliefs / Guiding Principles
  • Strategies
  • Population(s)
  • Goals Objectives
  • Activities
  • Details - , timeframe, roles

Strategic Planning
Program Planning
Operational Planning
18
Relationship Between Planning Levels
Strategic Planning Program/Operational Planning
Decisions at the organizational level that are fundamental, directional and future oriented. Decisions that primarily affect the day-to-day implementation of strategic goals/directions.
3-5 year scope 1 year scope (typically)
Board-driven process Management/staff driven process (accountable to board)
19
Relationship Between Planning Evaluation
  • Evaluation involves assessing progress toward
    goals and objectives.
  • Evaluation should be built into the planning
    process.
  • Planning can help determine if a program is ready
    to be evaluated.
  • Planning can help to identify success indicators.
  • Planning helps to identify who is responsible for
    what.

20
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21
Health Promotion Project Planning Model
  1. Preplanning and Project Management
  2. Conduct a Situational Assessment
  3. Identify Goals, Populations of Interest and
    Objectives
  4. Identify Strategies, Activities and Resources
  5. Develop Indicators
  6. Review the Program Plan
  7. Implement the Plan
  8. Results/Impact

22
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23
Commonly Used Planning Models
  • Precede Proceed Model
  • Needs/Impact-Based Planning Mode
  • Others

24
Terminology Varies
THCU Term Alternatives
Goal Purpose, Mission
Population of Interest Target Group, Priority Group, Audience, Community of Interest
Objectives Outcomes, Impacts, Effects
Indicator Benchmarks, Criteria for Success
Strategies Components, Initiative, Intervention
Activities Process Objectives, Implementation Objectives
Resources Budget, Assets, Inputs
25
Recommended Online Resources
  • On-line assistance step-by-step with your
    planning
  • http//www.innonet.org/
  • Tools for Change - Canadian support for
    Not-for-profits
  • http//www.toolsofchange.com/English/firstsplit.as
    p
  • Community Tool Box - planning as one of many
    supports to community health promotion work
  • http//ctb.ku.edu/

26
Poll Planning Models
Aware? Use?
1. Strategic Planning Process (Bryson, 1995)
2. Precede-Proceed (Green and Kreuter, 1999)
3. Needs/Impact-Based Planning Model (Metro Toronto District Health Council, 1996)
4. Kellogg Foundation Model
27
Poll Planning Techniques
Aware? Use?
1. Consultation with stakeholders/intended population 1. Consultation with stakeholders/intended population
a. Using individual consultations.
b. Using focus groups.
c. Through forums.
d. Through Delphi methods.
   2. Literature review.    2. Literature review.
3. Review of past evaluation findings. 3. Review of past evaluation findings.
4. Review of mandates, agendas, policies and/or guidelines of stakeholders. 4. Review of mandates, agendas, policies and/or guidelines of stakeholders.
5. PEEST analysis 5. PEEST analysis
6. SWOT 6. SWOT
7. Logic model 7. Logic model
28
Use of social science theory
Aware? Use?
THCUs Changing Behaviours, A Practical Framework
Stages of Change
Social Learning Theory
Diffusion of Innovation
Socioenvironmental theories
Community mobilization theories
29
What is your typical planning budget?
  1. 0
  2. Under 1000
  3. 1000-1999
  4. 2000-4999
  5. 5000-9999
  6. Over 10,000

30
How long do you usually have to pull your plan
together?
  1. Less than 5 working days
  2. 6-10 working days
  3. 11-20 working days
  4. More than a month of working days

31
How much of your time can you normally use for
planning?
  1. Under 5 full days
  2. 6-10 full days
  3. 11-20 full days
  4. More than 20 full days

32
How much time from others is normally available
to help you?
  1. Under 5 full days
  2. 6-10 full days
  3. 11-20 full days
  4. More than 20 full days

33
What other people are normally involved? (Yes/No)
  • Others from your team?
  • Others from your organization, on another team?
  • Others from outside of your organization?

34
Step 1
  • Pre-planning and Project Management

35
1. Participation
  • Participation of clients, staff and stakeholders
    is critical.
  • Plan with people, not for them.
  • Involve stakeholders in every step.

36
Levels of Stakeholders
  • Core - on the planning team
  • Involved - frequently consulted or part of
    planning process
  • Supportive - providing some form of support
  • Peripheral - needs to be kept informed

37
2. Time
  • Participatory planning takes longer.
  • Participatory ideals may conflict with political
    and cost issues.

38
3. Money/Resources
  • Includes funds, staff, time equipment and space.
  • Includes in-kind contributions from partners.
  • Opportunity costs.
  • Must consider short-term expense vs. long-term
    pay-off.

39
4. Data Gathering
  • On what information will you base your planning
    decisions?
  • Explored in detail in Step 2 Situational
    Assessment
  • What will decision-makers need to know?
  • Focus on health as more than the absence of
    disease.
  • Look for data on underlying determinants of
    health issues (income, education, social support,
    employment and working conditions, etc.).
  • Look to best practices on your issue.
  • Examine theories underlying priority health
    issues.

40
Theory
  • Systematically organized knowledge... devised
    to analyze, predict or otherwise explain the
    nature or behaviour of a specified set of
    phenomena that could be used as the basis for
    action.
  • Van Ryn and Heany (1992)
  • "A strategy for handling data in research,
    providing modes of conceptualization for
    describing and planning.
  • Glaser and Strauss (1967)

41
Examples of Theories
  • stages of change
  • health belief model
  • social learning theory
  • diffusion of innovation
  • socioenvironmental theories
  • community mobilization theories (e.g., Rothman's
    typology social planning, locality development
    and social action)
  • advocacy and political change theories (e.g.,
    Saul Alinsky)

42
Tips for Using Theory
  • view as guidelines, not "absolutes
  • view separate theories as complementary, not
    mutually exclusive
  • NEVER apply a theory without a thorough
    understanding of your population of interest
  • theories should not be used as short cuts
  • Base criteria for 'success' on health promoting
    changes in your community, rather than successful
    application of theory

43
Why evidence-based?
  • ? likelihood of effectiveness
  • Effective use of limited resources
  • Steps align with core functions of public health
    system (assessment, policy development, and
    assurance)
  • Evidence provides a scientific grounding
  • Professional responsibility/accountability
  • Public Health Standards/Competencies
  • Funders look for it

44
The Value of Evidence Best Practices
  • Integrate the good thinking of others
  • To get a jump start on your work so not
    starting from scratch
  • Other reasons?

45
Evidence-Based Health Promotion
  • the development, implementation, and evaluation
    of effective programs and policies in health
    promotion through application of principles of
    scientific reasoning including systematic uses of
    data and information systems and appropriate use
    of program planning models
  • Brownson RC, Gurney JG, Land G. Evidence-based
    decision making in public health. Journal of
    Public Health Management and Practice
    1999586-97.
  • The conscientious, explicit, judicious use of
    the best available research evidence in making
    decisions about health promotion program policy
    development
  • DiCenso, Guyatt, Ciliska, 2005

46
What is effectiveness evidence?
  • Systematic review Meta-analysis
  • Time saving
  • Retrieve appraise all available literature
  • Determine overall effectiveness of intervention
    on a specific population, for specific outcomes
  • Reduce large amounts of information into a
    digestible quantity
  • Objective
  • Rigorous approaches
  • Emphasize quality
  • Improves reliability accuracy of conclusions
  • Examples
  • Effective public health practice project

47
and what isnt effectiveness evidence?
  • Because weve always done it this way
  • Anecdotal information
  • Surveillance data

48
Health-evidence.ca
  • On-line registry
  • Free
  • Easy-to-use
  • Searchable
  • Quality-rated effectiveness evidence
  • Summaries of evidence with implications for
    practice, programs, and policy
  • Upcoming features
  • Targeted updates of new research
  • On-line network
  • Moderated discussion forums

49
Other sources of systematic reviews
  • Effective Public Health Practice Project
    www.myhamilton.ca/myhamilton/CityandGovernment/Hea
    lthandSocialServices/Research/EPHPP
  • CDC Guide to Community Preventative Services
    www.thecommunityguide.org
  • The Centre for Public Health Excellence at NICE
    www.publichealth.nice.org.uk
  • Cochrane Health Promotion and Public Health Field
    www.vichealth.vic.gov.au/cochrane/welcome/index.ht
    m

50
Other sources of systematic reviews (cont)
  • The Campbell Collaboration www.campbellcollaborati
    on.org
  • Database of Abstracts of Reviews of Effects
    http//www.york.ac.uk/inst/crd/crddatabases.htm
  • EPPI http//eppi.ioe.ac.uk
  • The Joanna Briggs Institute www.joannabriggs.edu.a
    u
  • The Chalmers Research Group www.chalmersresearch.c
    om
  • Sara Cole Hirsch Institute http//fpb.cwru.edu/Hir
    shInstitute

51
Additional Resources
  • Secondary Journals
  • Evidence-based Nursing www.evidencebasednursing.co
    m
  • Clinical Evidence www.clinicalevidence.com
  • Bandolier www.jr2.ox.ac.uk/bandolier
  • Databases
  • PubMed (Medline) http//www.ncbi.nlm.nih.gov
  • CINAHL
  • ERIC

52
5. Decision Making
  • challenge of managing timely decisions throughout
    process
  • decide whether to proceed with planning
  • decisions on timelines and allocation of
    resources
  • consideration of political context for planning

53
1. Participation
  • Participation of clients, staff and stakeholders
    is critical.
  • Plan with people, not for them.
  • Involve stakeholders in every step of the process.

54
Levels of Stakeholders
  • Core - on the planning team
  • Involved - frequently consulted or part of
    planning process
  • Supportive - providing some form of support
  • Peripheral - needs to be kept informed

55
Levels of Stakeholders
56
How could you involve stakeholders?
  • In table groups
  • discuss how you have involved or could involve
    stakeholders in your planning process
  • share your dos and don'ts
  • record on flipchart
  • share highlights with the large group

57
Step 2
  • Conduct a Situational Assessment

58
What is a situational assessment?
  • A snapshot of the 'present' used to plan for the
    future.

59
Is that different from a needs assessment?
  • Yes it is!
  • Like needs assessment, situational assessment
    focuses on collecting data on community needs.
  • BUT it also considers the broader social,
    economic, political and environmental context
    affecting community health needs.
  • Situational assessment also considers strengths,
    assets and capacities, not just problems or needs.

60
Why conduct a situational assessment?
  • To learn more about population of interest (i.e.,
    who's affected by your health issue).
  • To anticipate trends and issues that may affect
    the implementation of your program.
  • To identify community wants, needs, assets
  • To set priorities

61
Types of Data
  • Quantitative polling/survey data
  • Community health status indicators e.g. housing
    prices
  • Community story/testimonial
  • Policies
  • Vision or other organizational directions
  • Evaluation findings (formative, process, outcome
    data)
  • Research findings (experimental or
    quasi-experimental data)
  • Cost-benefit/cost-effectiveness data
  • Meta-analysis
  • Best practices syntheses and guidelines

62
Sources of Data
  • Polling companies (through news reports, website)
  • Key community service organizations such as the
    United Way, Heart and Stroke Foundation (Health
    status indicators report, websites)
  • Community spokespersons
  • Journals, magazines, books
  • Consultants
  • Resource centres such as THCU, other OHPRS
    centres
  • Researchers
  • Government departments.
  • Private sector (e.g. Large food, athletic
    companies)

63
Techniques, Tools
  • Consultation with stakeholders
  • Using individual consultations.
  • Using focus groups.
  • Through forums.
  • Through Delphi methods.
  • Literature review
  • Review of past evaluation findings.
  • Review of mandates, agendas, policies and/or
    guidelines of stakeholders.
  • PEEST analysis
  • SWOT analysis

64
1. Consultation with Stakeholders
  • Population of interest
  • attitudes
  • opinions
  • beliefs
  • actions
  • Organization
  • degree of importance/value accorded to the health
    issue (based on organizational mandate)
  • Potential partners
  • Mandate, and assessment of priorities
  • Funders

65
2. Literature Review
  • What theories about the health issue exist?
  • What has been learned from previous programs
    addressing the health issue?

66
3. Review Evaluation Findings
  • What have you learned from your previous
    experience?

67
4. Mandates
  • Review
  • your existing mission, vision, values,
    principles
  • missions, vision of potential partners
  • related legislation and regulations (e.g.,
    Health Protection and Promotion Act)
  • related policies
  • professional ethics

68
Sample Vision Statement
  • We envision communities supporting families so
    that every child in Haldminand-Norfolk develops
    to his or her full potential.

69
5. PEEST Analysis
  • Systematic approach to identifying the
  • Political
  • Economic
  • Environmental
  • Social
  • Technological
  • Demographic
  • Legal
  • factors affecting the topic and possible
    responses to the issue.

70
6. SWOT Analysis
  • Systematic approach to identifying the
  • Strengths
  • Weaknesses
  • Opportunities
  • Threats
  • around your topic / issue /responses to it.

71
Tips for Data Collection
  • Include data on strengths and assets, not just
    needs and problems.
  • Asset-Based Community Development
  • http//www.northwestern.edu/ipr/abcd.html
  • Use a mix of quantitative and qualitative methods
    to collect data.

72
Use Qualitative and Quantitative Data
  • Talk to people to understand the true "meaning"
    behind the numbers.
  • Numbers may tell you what is happening, but will
    not tell you why it's happening.
  • "Not everything that can be counted counts, and
    not everything that counts can be counted.
    Albert Einstein

73
What to do with all the situational assessment
info?
  • Distill it down to the critical issues that need
    to be addressed in your plan.
  • Use the data as a baseline for change.
  • Use it as rationale to make the case for your
    plan.

74
Step 2 Exercise Trade Fair
  • In table groups
  • Show and tell promising practices and sources
    related to situational assessment work AND/OR
  • Discuss your biggest challenges and successes
  • Share highlights with large group

75
Step 3
  • Identify Goals, Population(s) of Interest and
    Objectives

76
Program Outcome Model
77
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78
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79
Five Minute Course in Objective Setting
  • In pairs, carefully observe one another.
  • Turn your backs to each other, changing three
    things about your personal appearance.
  • Now, face each other, and in turn, try to
    identify the three changes in the other person.
  • To be discussed..

80
Typical Service Delivery
  • Inputs resources dedicated to or consumed by
    the program
  • Activities what the program does with the
    inputs to fulfill its mission
  • Outputs direct product of program activities
    and are usually measured in terms of work
    accomplished

81
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84
Your goal is their objective, his action step and
their vision.
  • Many terms are contextual they depend on the
    situation, scope, and players
  • Use of terms Inputs, outputs, outcomes are
    pretty universal (but NOT completely so)
  • More specific terms like short term objectives
    can vary in meaning
  • Example of one interpretation if outcome and
    within one year, then it is a short term
    objective.

85
Goals vs. Objectives
  • A goal usually
  • Is much more encompassing or global.
  • Is written to include all aspects or components
    of a program.
  • Provides overall direction for a program.
  • Is more general in nature.
  • Usually takes longer to complete.
  • Does not have a deadline.
  • Usually is not observed, but rather must be
    inferred because it includes words like evaluate,
    know, improve, and understand.
  • Is often not measurable in exact terms.
  • From Planning, Implementing Evaluating Health
    Promotion Programs A Primer. McKenzie et al. 2005

86
Goals
  • Goals summarize the ultimate direction or desired
    achievement of a program.
  • Most health promotion programs have one goal,
    although more complex programs may have several
    goals.

87
Program Goal
  • Examples
  • To increase the number of schools that foster a
    school environment that enables students to make
    healthy choices (positive outcome goal).
  • To reduce the incidence of alcohol-related harm
    in Community X (problem reduction goal).

88
Types of Objectives
  • Process/activity/output describes what YOU will
    do
  • Example To implement 2 peer-led substance abuse
    prevention programs at all area high schools by
    September 2006.
  • Short-term outcome describes what will happen to
    the intended population/system
  • Example To increase the level of knowledge of
    low-risk drinking practices.
  • Long-term outcome
  • Example To reduce the proportion of youth
    (12-19 year olds) who consume alcohol at least
    once a week.

89
Types of Objectives
  • Closed vs. Open-ended
  • Closed To increase the proportion of smoke-free
    homes in Anytown to 90 by the year 2010
  • Open-Ended To increase the proportion of
    smoke-free homes in Anytown by the year 2010.

90
Closed-ended Objectives
  • Choice to set specific change targets depends on
  • Knowledge of existing situation in community
    (ie., baseline)
  • Knowledge of what amount of change is possible
  • Confidence in ability of intervention to bring
    about desired change
  • Ability to collect data identifying degree of
    change

91
Characteristics of Good Program Objectives
  • specific
  • credible to key stakeholder groups
  • Measurable
  • compatible with overall goal, mission/vision and
    other program objectives
  • information needed to assess objective is readily
    available and accessible
  • Use action-oriented verbs (increase, reduce)

92
Elements of a Well-Written Objective
Outcome (what)
Priority Population (who)
Conditions (when)
Criterion (how much)
A well-written objective
93
Objectives Game
  • You have received one piece of different
    communication objectives.
  • There are four pieces for each objective, each
    with a different colour.
  • Work with the people in the room to piece
    together the objectives. In the best way!

94
Secret Objectives Santa
  • Write out an objective for something you have ,
    are, or will be working on it can be process
    versus outcomes, properly or poorly written
  • Hand them in to the facilitators
  • Now take on from the pile and go to the corner
    that most accurately categories the objective you
    were given
  • The gift is good feedback (anonymous from the
    group and facilitators)

95
Developing Program Objectives
  • Arguably the most important part of the program
    planning process
  • SMART objectives are critical for successful
    program delivery and evaluation
  • Difficult to do by committee

96
Tips for Writing Objectives
  • Give yourself enough time most objectives go
    through multiple rewrites.
  • Brainstorm collectively, but appoint a designated
    writer to produce draft objectives.
  • Beware of goals disguised as objectives (e.g, "to
    promote physical activity").
  • Use a mix of process (activity) and outcome
    objectives.

97
Population(s) of Interest
  • a.k.a. audience, target group, priority group,
    segment of community
  • Which group, or groups, in your community require
    special attention to achieve your goal?
  • Some programs may focus on a change to a system
    or environment in the short term but the
    long-term objective is about change to a
    population
  • Often one of the most difficult decisions to make
    hard to say no to some
  • Look to your situational assessment to assist in
    the decision

98
Barriers to Planning
  • We welcome a few volunteers to identify a common
    barrier (practical challenges) to successful
    planning
  • Each will take a flipchart to a given table
  • Groups will identify potential solutions, and
    record on flipchart
  • Join whichever group you like (you can even move
    around)
  • Modest reporting back, but we will collect, type
    up and circulate the flipchart content

99
Review / Preview
  • Steps in the planning model
  • Bike Rack items
  • Reflections on today
  • Evaluation forms
  • Social time this evening
  • Clean tables off
  • Day 2 preview

100
Warm up Exercise Planning in Everyday Life
  • Why are you having the party?
  • What are the key steps involved in planning a
    party?
  • What factors can you control?
  • What factors do you have to 'leave to chance'?
  • How will you know if your party planning has been
    successful?

101
Step 4
  • Identify Strategies, Activities, and Resources

102
Strategies and Activities
  • Strategy broad type of intervention or approach
    to change (e.g., community mobilization).
  • Activity a specific action to be taken within a
    certain time period (e.g., organizing a community
    forum as part of the community mobilization
    process)
  • Many activities are a part of each strategy.

103
Health Promotion Strategy Menus
  • Ottawa Charter Actions
  • build healthy public policy
  • create supportive environments
  • strengthen community action
  • develop personal skills
  • reorient health services

104
Health Promotion Strategy Menus (cont)
  • Metro Toronto DHC Strategies
  • counseling and skill development
  • education
  • social marketing
  • self-help/mutual support
  • community mobilization and development
  • healthy public policy

105
Health Promotion Strategy Menus (cont)
  • Centre for Health Promotion
  • education
  • health communication
  • organizational development
  • community development
  • policy development
  • advocacy
  • intersectoral collaboration
  • research

106
Health Promotion Strategy Menus (cont)
  • CDC
  • health communication
  • health education
  • health policy / enforcement
  • health engineering
  • health-related community service
  • community mobilization

107
Health Promotion Strategy Menus (cont)
  • Ontario Heart Health Program Taking Action for
    Healthy Living
  • increasing awareness
  • education and skill building
  • supportive environments
  • policy
  • community mobilization

108
Processes for Identifying Strategies Activities
  • Brainstorm potential strategies for achieving
    objectives
  • Select the best strategies and identify specific
    activities.
  • Review current activities (if program is not
    new), decide what to stop, start, continue and
    cluster them into strategies
  • Look back to your SA data, and consider the
    needs, impacts, mandate, capacity.

109
Resource Considerations
  • What do you need to implement your activities?
  • What do you have available?
  • What could you get from others?
  • What, if any, activities need to be dropped or
    delayed until new resources can be found

110
Step 5
  • Develop Indicators

111
Indicators
  • Variables that can be measured in some way.
  • Indicators are used to assess the extent to which
    program objectives have been met.

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Common Activity/Process Indicators
  • Members participating, new members, affiliates
  • Services provided classes, workshops,
    newsletters, support groups, etc.
  • Member satisfaction

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Common Outcome Indicators
  • Short-Term Outcome Indicators
  • changes in awareness,
  • changes in knowledge and attitudes
  • Long-Term Outcome Indicators
  • changes in skills and capacities
  • changes in health-related behaviour
  • changes in policies or practices
  • changes in supportive environments
  • changes in morbidity and mortality

114
Matching Indicators to Objectives
  • To promote healthy food choices in the workplace.
  • Process/Activity/Output indicators
  • of educational sessions
  • of participants
  • of participants rating sessions as excellent
    or good
  • of brochures distributed
  • of meetings with key stakeholders re
    development of supportive environments and
    policies promoting healthy eating in the
    workplace.

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Matching Indicators to objectives
  • Short-term outcome indicators
  • of employees reporting increased knowledge of
    healthy food choices
  • of employees reporting increased knowledge of
    health risks associated with unhealthy choices
  • of employees reporting intentions to practice
    healthy eating
  • of workplaces committed to creating healthy
    environments and policies supporting healthy food
    choices

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Matching Indicators to Objectives
  • Long-term outcome indicators
  • of employees making healthy food choices
  • of workplaces adopting policies promoting
    healthy food choices
  • of workplace cafeterias offering healthier
    range of food choices, long-term change in
    incidence of heart disease at workplaces taking
    part in program.

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Characteristics of Good Program Indicators
  • credible - reflects available evidence
  • user friendly - understandable and relevant
  • balanced - appropriate mix of process and outcome
    indicators
  • measurable - should be 'evaluable
  • continuous - contribute to comprehensive
    understanding of program
  • compatible - identical or comparable with those
    adopted in similar programs
  • linked to available data - sources of data needed
    to apply indicator are accessible

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Steps in Developing Program Indicators
  • Review the objectives for your program
  • For each program objective think about the
    intended result. Consider
  • Can the intended result be divided into separate
    components? (e.g., safe sex depends on awareness,
    motivation, resources, etc.).
  • Can the intended result be measured in some way?
  • What is appropriate time for observing a result?
  • Are the sources of data required to assess this
    result accessible?
  • Do you have the resources needed to assess the
    result?

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Steps in Developing Program Indicators (contd)
  • Define indicators to measure each of your program
    objectives.
  • Perform a 'quality check' on your proposed
    indicators. Are they valid, reliable, free from
    bias and sensitive to potentially significant
    changes? Modify as required.
  • Apply the indicators to determine extent to which
    program objectives have been met.
  • Review indicators periodically to ensure
    continued relevance for your information needs.

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Sources of Health Promotion Indicators
  • Health Canada website (search indicators)
    www.hc-sc.gc.ca
  • U.S Healthy People 2010 Local Health Indicators
    www.healthypeople.gov/LHI
  • Canadian Council on Social Development
    www.ccsd.ca
  • Federation of Canadian Municipalities quality of
    life reporting system www.fcm.ca

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More Sources of Health Promotion Indicators
  • Indicators that Count Measuring Population
    Health at the Community Level http//www.phac-asp
    c.gc.ca/ph-sp/phdd/resources/subject_determinants.
    html
  • APHEO http//www.apheo.ca/
  • Health Evidence Network
  • http//www.euro.who.int/HEN/Syntheses/20030820_1
  • Empowerment Paper http//www.euro.who.int/Docum
    ent/E88086.pdf

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The Great Indicators Challenge
  • Identify a potential indicator
  • Volunteers will work with facilitators and the
    whole group in Find that Indicator Online

123
Step 6
  • Review the Program Plan

124
Process for Reviewing Plan
  • Assemble information gathered and documents
    developed in Steps 2-5 (including situational
    assessment)
  • Consider the following questions
  • Are the objectives clear and measurable?
  • Are the "causal linkages" plausible (the
    ifthen logic)?
  • Do the indicators get at what you need to know?
  • Will the core stakeholders be satisfied?
  • Review resources (human and financial) - Are the
    type and amount of resources adequate?
  • Adjust as appropriate.

125
Review of Planning process
  • In table groups
  • Review the case study provided.
  • Highlight strengths, weaknesses, recommended
    changes
  • Be prepared to share a few highlights with the
    large group.

126
Check-in
  • Revisit the expectations you had at the beginning
    of the workshop
  • Reflections on what we have learned
  • Identify unmet needs, things we still want to
    learn
  • Suggest best learning methods

127
Create your Own Planning Model
  • Consider your next planning project.
  • Based on learning to date, complete the
    worksheet.
  • Be prepared to share learnings, challenges, plans
    to implement in the field.

128
Useful Tools
  • Generating Ideas Making Decisions

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Useful Tools
  • For generating ideas
  • Affinity diagrams, cards
  • Narratives, stories
  • Others
  • For making decisions
  • Logic Models
  • Debates
  • Decision rules, tables, grids
  • Polling, voting
  • Others

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Building the Logic Model
  • A logic model is a graphic depiction of the
    relationship between the key elements of a
    program (i.e., goals, objectives, populations of
    interest, strategies, activities, and
    indicators).
  • The specific components / terms and the layout
    are completely flexible
  • If then logic is key

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Logic models contribute to effective planning by
  •  clarifying connections between key facets of a
    program (e.g., demonstrating how activities help
    achieve objectives)
  • identifying gaps and inconsistencies within a
    program (e.g., activities that are not
    contributing to specific objectives)
  • providing an effective communication tool
  • building a common understanding of what the
    program is about and how the parts fit together.
  • Make your decisions first and then fit the pieces
    into a logic model.

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Issues in Application
  • How do you intend to apply what you have learned
    over the last two days?
  • What barriers might arise to prevent you from
    applying your learnings from this workshop?
  • What promising practices and successful
    experiences can we offer as solutions?

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Ongoing Learning
  • Recommended resources www.thcu.ca
  • THCU consultation regional training supports
  • Service Request Form - http//www.thcu.ca/consult
    ation/request_form.htm

134
A big thank you to
  • Ontario Ministry of Health Promotion
  • Jodi Thesenvitz, Cathy Duerden and Cam White
  • Staff of Oakham House, Ryerson University
  • Our workshop participants.
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