nt.au/health/healthdev/health_promotion/bushbook/volume1/getting.html

1. http://www.nt.gov.au/health/healthdev/health_promotion/bushbook/volume1/getting.htmlhttp://www.nt.gov.au/health/healthdev/health_promotion/bushbook/volume1/getting.html Lesson objective – to learn how to plan and prepare a health promotion activity

2. Research • It is useful to think of research as a search for answers to questions. Project planning and evaluation have different sets of questions to be answered. Effective planning and evaluation depend on using research processes and tools to collect information, in order to: • decide which issue or problem the project will address (by conducting a needs assessment) • find out what things cause the issue or problem (by analysing the chosen problem and conducting a literature search) • determine how the project is going and how effective it is in meeting its goal and objectives (by collecting baseline data and planning the evaluation) • Research tools have technical names for activities which people often do naturally to find something out. The difference is that people 'doing research' are generally more systematic in the way they go about these activities. Some ways of gathering information include: • observation: watching and listening to people as they go about the activities of a project or their daily lives; looking for any changes in the community over time • participant observation: a special kind of observation where you participate in the project activities with the people you are observing · • surveys: using a questionnaire, which is a written list of questions, used to collect the data you need from people. Questionnaires can be used either in interviews or can be self-completed • interviews: talking to people, either individually or in groups, usually using some form of questionnaire. Interviews can be done face-to-face or by telephone • analysing routinely kept records: finding specific data in health centre records such as the number of people with diabetes or who smoke tobacco; analysing store turnover records for the amount of tobacco being sold over a year looking at other documents, such as: community profiles, reports written on previous projects or work in the community, records kept during a project that give information about participants (number attending and so on) • doing a literature search to find out what people have written about a problem or issue

3. Quantitative data • Quantitative data are collected as numbers and amounts. These data can be counted, analysed statistically and used to compare with other quantitative data. • Examples: • the number of people attending the education sessions: 40 people attended this week and 25 attended last week • the number of people with diabetes: 20 people with diabetes in community X this year compared with five people ten years ago - an increase of 300 per cent (assuming the population has not changed) • Qualitative data are collected as words. These data are descriptions that can include observations, beliefs, ideas, opinions, feelings, perceptions, experiences, and so on. The way the data are collected, recorded, and analysed (sorted, grouped and summarised) should be logical and systematic. Mathematical calculations cannot be done on qualitative information. Examples: • what people thought about an education session. 'People used the following words to describe the education session: well organised, good information, new information, well presented' • what people believe about diabetes. 'People reported the following beliefs about diabetes: caused by bad food, caused by too much alcohol, caused by sitting down too much'

4. Quantitative and Qualitative data Action Knowledge Information Data • Both quantitative and qualitative data are valuable and complement each other. When used together, they give a more complete picture of the situation and provide valuable information for planning and evaluating a health promotion project. • The following Information Pyramid may be helpful for thinking about how data, information and knowledge are related.

5. Literature search • One important type of research is reading about the work that others have done and the ideas that other people have had, by reviewing the published literature (books, journals, and reports) which relates to the issue or problem that the project is addressing. It is likely that work has already been done in Australia and elsewhere on the issue or problem of interest. • Why do a literature search • Finding journal articles, books and reports on the issue or problem will help you to: • save time by learning about what others have done about the issue or problem • learn more about the underlying causes of the issue or problem • discover more about the people most affected by the issue or problem • find strategies which have been successfully used in the past to address the issue or problem • learn how successful strategies might be applied to the local issue or problem • locate research tools (for example, questionnaires) which have been used to collect baseline data or to evaluate similar projects • be able to set a realistic goal and objectives for the project based on what is learnt about the success levels of similar projects

6. Using individual approaches • Each time health professionals interact with a client in the course of their work they have an opportunity to find out more about that person and share information. Interacting with individuals on a one-to-one basis "allows better possibilities for success than perhaps any other communication medium" (Egger et al 1990:31). • Remember it is possible to assist individuals to make healthier choices by making the healthier choices the easy choices (Egger et al 1990:98). For example, providing quality fresh fruit and vegetables at prices which compare favourably with less healthy food choices means that people are more likely to buy fresh fruit and vegetables - the choice becomes easier. These wider influences are looked at in the section 'Changing the Wider Environment'.

7. Things to think about when choosing strategies • All strategies are potentially useful but combinations of strategies are likely to produce the best results • The strategy has to match the objective. The strategy selected will depend on what the project is trying to achieve and with whom • Some knowledge about current health issues (content) and knowledge about the best ways to approach them (process) are both important. Libraries and other health professionals are valuable resources • An understanding of team members' potential and limitations should be considered when choosing strategies. Additional training may be necessary • Strategies for lessening individual risk are important. Use them to complement strategies which lower average risk in a whole community (Egger et al 1990:113) • some questions to ask •   When considering which strategy or combination of strategies to use, think about the following questions: • who is the project for? • what are the objectives of the project? What does it want to achieve? • what does the community think the best strategies would be? • how ready and willing are people to become involved? • how long have you got to do the project? · what skills and knowledge do project team members have individually and collectively? • what resources (human, financial and material) are needed? What is available?

8. Brief interventions do work. • Research shows that a brief intervention can help people decide to change their health behaviours. • Brief interventions have been shown to be effective in reducing alcohol consumption by over 20% in people with hazardous or harmful drinking levels (Anderson 1996:16). Research has shown that just a few words from a medical practitioner can result in a 5% quit smoking rate and that a little more effort can lead to long term smoking cessation rates of over 10% (Owen 1985:177). It has also been found that the intervention is more effective with follow-up and additional interventions from other health staff (Richmond 1993:209). • More brief interventions are needed at the primary care level. Most interventions in the western health system are either very early, to prevent the beginning of a problem, or very late. There is a need for more attention on interventions which focus on people with risky behaviours which affect health, or with early signs of illness. • Brief interventions are acknowledged to be cheap, easy and effective. Brief interventions are accepted and used as an effective tool for a range of health issues. For example, interventions involving counselling and education for new mothers are part of regular infant health consultations in community health centres. • In summary, what health professionals say and do can make a difference. It can help to motivate and support people to make the decisions that are best for them. • Who can do brief interventions • Brief intervention is part of the health team's everyday work. Good reasons why health professionals are suitable people to do interventions: • people expect health professionals to give advice • their advice is personal, directed to each individual's health • the advice of the health professional provides a legitimate excuse to change • they often have knowledge of the client, the family, living conditions and what is happening in the community (Brady 1995a:12-17)

9. Service providers • Service providers have a responsibility to raise health related behaviours with people, and to give clear, factual information. Do not assume that people already know about health risks, or that they cannot change a behaviour. People decide for themselves, but what service providers say and do can make a difference. It can help to motivate and support people to make the decisions that are best for them.

10. The Stages of Behaviour Change • The Stages of Behaviour Change model was developed in the alcohol and other drugs field by Prochaska and DiClemente (1986). It is used for matching interventions with a person's readiness to take on information and make changes. The model can be used for interventions in areas such as alcohol, smoking, using other drugs, changing diet, weight loss, exercise and personal hygiene - for any behaviour change.

12. Working with groups in health promotion • There are numerous opportunities to work with naturally occurring groups in Aboriginal communities. Groups can be composed of two or three people or many. These include families and groups based on: gender, age, language, a particular disability or condition. Clubs or special interests groups, such as sporting clubs or art and craft cooperatives, also provide opportunities for group work. • Group strategies can take place in a range of settings: • where the focus is on prevention: in schools, in the workplace, out bush, at the women's centre, at the community store • where strategies may have more of an intervention orientation: in the health centre or old people's home • Useful strategies for working with groups range from providing information through presentations to school or community group, to working alongside special interest or lobby groups to facilitate community action. The skills required for giving presentations differ from those skills required for working in partnership using a community development approach.

13. Advantages of working in groups on projects • People are social beings and generally like working with others • All the resources, abilities and energy of the group are pooled • There is less chance that mistakes will be made - it is easier to see other people's mistakes than to see our own • Group discussion stimulates ideas that might not occur to an individual working alone • Group members support each other and provide security, especially for problem solving (Alcohol and Drug Programs Unit 1988

16. Evaluating health education and health promotion resources • There are a number of things to think about when choosing or making health education and health promotion resources. The following checklist may be a useful evaluation tool. • Is the information accurate and up to date? • Is the resource suitable for the target group? • Does it give information that people have asked for? • Is it culturally acceptable? Will it upset or offend anyone? • Can the target group understand the message? • Will anyone outside the target group be upset or offended by it? • Does it make the person feel like it's 'talking' to them personally? • Is the resource eye catching and interesting to look at? • Are the diagrams/photos/images clear in what they are trying to say? • Are the photos or images acceptable to people in the community? • Is information well presented? • Are written words large enough to read easily? • Does the resource use language, words and images people can understand? • What is the language? Can people read/understand it? • Does it use straightforward words and sentences? • Does it use many technical words? • Are the ideas explained clearly? • Are pictures, diagrams or images suitable and clear? • Is the message or purpose clear? • Does it give clear directions to the reader or viewer? • Is the message put in a positive way? • Are there any conflicting or hidden messages that might confuse people? • Does it seem to persuade the person to do something? • Is it worth the money you spend on it? • Can you afford to buy it or make it? • Do you need extra funds for it? • Can you share the cost with anyone else in the community or anyone else in THS? • How many copies are needed, or how many times will you be able to use it? • How long will it last?