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 F’s 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 Strategic Planning • Vision • Mission • Values / Beliefs / Guiding Principles • Strategies • Population(s) • Goals & Objectives • Activities • Details - $, timeframe, roles Program Planning Operational Planning

7. Relationship Between Planning Levels

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.

10. Health Promotion Project Planning Model • Preplanning and Project Management • Conduct a Situational Assessment • Identify Goals, Populations of Interest and Objectives • Identify Strategies, Activities and Resources • Develop Indicators • Review the Program Plan • Implement the Plan • Results/Impact

12. Terminology Varies

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.asp • Community Tool Box - planning is one support to community health promotion work • http://ctb.ku.edu/

15. Pre-planning and Project Management Step 1

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 do’s and don'ts • share highlights with the large group

29. Conduct a Situational Assessment Step 2

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 isn’t effectiveness evidence? • Because we’ve 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. Identify Goals, Population(s) of Interest and Objectives Step 3

49. Program Outcome Model