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Introduction to Health Promotion Planning

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Review the Program Plan. Implement the Plan. Results/Impact. 12. Terminology Varies ... Asset-Based Community Development. http://www.northwestern.edu/ipr/abcd.html ... – PowerPoint PPT presentation

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Title: Introduction to Health Promotion Planning


1
Introduction to Health Promotion Planning
  • April 4, 2007
  • Larry Hershfield
  • Heather Graham

2
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.

3
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.

4
Three Fs of Program Planning
  • Fluidity steps are sequential or build upon one
    another
  • 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

5
Levels of Planning
Strategic
  • Program

Operational / Work / Action
6
Components of Planning
  • Vision
  • Mission
  • Values / Beliefs / Guiding Principles
  • Strategies
  • Population(s)
  • Goals Objectives
  • Activities
  • Details - , timeframe, roles

Strategic Planning
Program Planning
Operational Planning
7
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)
8
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.

9
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10
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

11
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12
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
13
From Planning, Implementing Evaluating
Health Promotion Programs A Primer. McKenzie et
al 2005
14
Recommended Online Resources
  • On-line assistance step-by-step with your
    planning
  • http//www.innonet.org/
  • Tools of Change - Canadian support
    http//www.toolsofchange.com/English/firstsplit.as
    p
  • Community Tool Box - planning is one support to
    community health promotion work
  • http//ctb.ku.edu/

15
Step 1
  • Pre-planning and Project Management

16
Five elements to manage
  • 1. Participation
  • 2. Time
  • 3. Money/resources
  • 4. Data
  • 5. Decision-making

17
2. Time
  • Participatory planning takes longer.
  • Participatory ideals may conflict with political
    and cost issues.

18
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.

19
4. Data Gathering
  • On what information will you base your decisions?
  • Explored in detail in Step 2 Situational
    Assessment
  • What will decision-makers need to know?
  • Focus on health as more than absence of disease.
  • Look for data on underlying determinants of
    health (income, education, social support,
    employment and working conditions, etc.).
  • Look to best practices on your issue.
  • Examine theories underlying priority health
    issues.

20
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)

21
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)

22
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

23
About Theory
  • Changing Behaviours A Practical Framework
  • www.thcu.ca
  • Tipsheet Summaries of Social Science Theories
  • www.thcu.ca
  • Theory at a Glance
  • http//www.cancer.gov/PDF/481f5d53-63df-41bc-bfaf-
    5aa48ee1da4d/TAAG3.pdf

24
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

25
1. Participation
  • Participation of clients, staff and stakeholders
    is critical.
  • Plan with people, not for them.
  • Involve stakeholders in every step of the process.

26
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

27
Levels of Stakeholders
28
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
  • share highlights with the large group

29
Step 2
  • Conduct a Situational Assessment

30
What is a situational assessment?
  • A snapshot of the 'present' used to plan for the
    future.

31
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.

32
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

33
Types of Data
  • Quantitative polling/survey data
  • Community health status indicators (census data
    ward profiles)
  • Community stories/testimonial
  • Evaluation findings
  • Research findings
  • Cost-benefit/cost-effectiveness data
  • Best practices syntheses and guidelines

34
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)

35
Techniques, Tools
  • Consultation with stakeholders
  • Using individual consultations.
  • Using focus groups.
  • Through forums.
  • Literature review
  • Review of past evaluation findings.
  • Review of mandates, agendas, policies and/or
    guidelines of stakeholders.
  • PEEST analysis
  • SWOT analysis

36
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

37
2. Literature Review
  • What theories about the health issue exist?
  • What has been learned from previous programs
    addressing the health issue?

38
Literature Search Strategy Flowchart
39
3. Review Evaluation Findings
  • What have you (or others) learned from previous
    experience?

40
The Value of Evidence Best Practices
  • Integrate the good thinking of others
  • To get a jump start on your work so you are not
    starting from scratch
  • Other reasons?

41
and what isnt effectiveness evidence?
  • Because weve always done it this way
  • Anecdotal information
  • Surveillance data

42
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

43
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.

44
6. SWOT Analysis
  • Systematic approach to identifying the
  • Strengths
  • Weaknesses
  • Opportunities
  • Threats
  • around your topic / issue /responses to it.

45
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.

46
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

47
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.

48
Step 3
  • Identify Goals, Population(s) of Interest and
    Objectives

49
Program Outcome Model
50
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52
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

53
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56
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.

57
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

58
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).

59
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.

60
Closed versus Open_Ended Objectives
  • 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.

61
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

62
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)

63
Elements of a Well-Written Objective
Outcome (what)
Priority Population (who)
Conditions (when)
Criterion (how much)
A well-written objective
64
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!

65
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 one from the pile and give feedback
    and/or suggestions for improvements
  • Later on, take your own card back, with the gift
    of anonymous feedback from the group

66
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.

67
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

68
Barriers to Planning
  • From previous workshops, we have identified a
    number of common significant barriers to planning
  • Choose one that most interests you, and go to the
    table with the matching tent card (you can even
    move around during the discussion if you want)
  • Groups will identify potential solutions, adding
    to the existing information (need a Recorder)
  • Modest reporting back, but we will collect, type
    up and circulate the revised Notes for your
    review later

69
Step 4
  • Identify Strategies, Activities, and Resources

70
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)
  • Each strategy will likely have many activities
    some activities are a part of more than one (even
    all) strategy.

71
Processes for Identifying Strategies Activities
  • Brainstorm potential strategies for achieving
    objectives
  • Select the best strategies and identify specific
    activities.
  • Review current activities, decide what to stop,
    start, continue and cluster them into strategies
  • Look back to your SA data, and consider the
    needs, impacts, mandate, capacity.

72
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?

73
Step 5
  • Develop Indicators

74
Indicators
  • Variables that can be measured in some way.
  • Indicators are used to assess the extent to which
    program objectives have been met.

75
Common Activity/Process Indicators
  • Members participating, new members, affiliates
  • Services provided classes, workshops,
    newsletters, support groups, etc.
  • Member satisfaction

76
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

77
Processes 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?

78
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.

79
Step 6
  • Review the Program Plan

80
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.

81
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

82
Logic models contribute to effective planning by
  • clarifying connections between key parts of a
    program (e.g., how activities help achieve
    objectives)
  • identifying gaps and inconsistencies within a
    program
  • 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.

83
Useful Tools
84
Identifying Other Useful Tools
  • At your tables, work from the existing list of
    useful tools (which relate to a step or general
    process in our planning model).
  • Add any additional tools you have or would find
    helpful.
  • Identify one tool that you would like to learn
    more about today.

85
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

86
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87
Check-in
  • What are the most important learnings/messages
    you will take away from todays workshop?
  • How do you intend to apply what you have learned?

88
Materials for Future Reference
  • Case Studies
  • Create Your Own Planning Process worksheet

89
Ongoing Learning
  • Recommended resources www.thcu.ca
  • THCU consultation regional training supports
  • Service Request Form - http//www.thcu.ca/consult
    ation/request_form.htm

90
A big thank you to
  • Ontario Ministry of Health Promotion
  • Jodi Thesenvitz, Cathy Duerden and Cam White
  • Wellesley Institute
  • Our workshop participants.
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