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, it’s 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. To assist those involved in health promotion with planning projects in organizational and community settings. Goal of Workshop

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

18. Relationship Between Planning Levels

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.

21. 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

23. Commonly Used Planning Models: • Precede – Proceed Model • Needs/Impact-Based Planning Mode • Others……

24. Terminology Varies

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.asp • Community Tool Box - planning as one of many supports to community health promotion work • http://ctb.ku.edu/

26. Poll: Planning Models

27. Poll: Planning Techniques

28. Use of social science theory

29. What is your typical planning budget? • $0 • Under $1000 • $1000-$1999 • $2000-$4999 • $5000-$9999 • Over $10,000

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

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

32. How much time from others is normally available to help you? • Under 5 full days • 6-10 full days • 11-20 full days • 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. Pre-planning and Project Management Step 1

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 1999;5:86-97. • 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 isn’t effectiveness evidence? • “Because we’ve always done it this way” • Anecdotal information • Surveillance data

48. 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 Health-evidence.ca

49. Other sources of systematic reviews • Effective Public Health Practice Project www.myhamilton.ca/myhamilton/CityandGovernment/HealthandSocialServices/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.htm

50. Other sources of systematic reviews (con’t) • The Campbell Collaboration www.campbellcollaboration.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.au • The Chalmers Research Group www.chalmersresearch.com • Sara Cole Hirsch Institute http://fpb.cwru.edu/HirshInstitute