Starting the Planning Process

1. Starting the Planning Process • Gaining Support of Decision Makers • Creating a Rationale • Identifying he a Planning Committee • Parameters for Planning

2. Gaining Support of Decision Makers • Consider support from the highest level • The administration, chief executive officer, church elders, board of health, or board of directors of the community for which the program is being planned. • Chance for success increases if all levels of management, including the top, are committed and supportive • Starts with a good rationale

3. Creating a Rationale • Needs assessment data • Epidemiological data about a specific health problem • Cost-effectiveness data of health promotion programs • Values and benefits that are important to decision makers • Data from other successful programs • Comparability between the proposed program and the health plan of a state or the nation • Protecting human resources

4. Identifying a Planning Committee • Comprised of individuals who represent a variety of subgroups with the target population. • Comprised of wiling individuals who are interested in seeing the program succeed (e.g., dowers, influencers). • Include an individual who has a key role within the organization sponsoring the program • Include representatives of other stakeholders • Have a good leadership

5. Parameters for Planning • Understand decision makers’ philosophical perspective on health promotion programs • Type of commitment to the program • Type of financial support • Whole target population vs. subgroups • The level of decision making by the committee

6. Assessing Needs • What Is a Needs Assessment? • Acquiring Needs Assessment Data • Conducting a Needs Assessment

7. What Is a Needs Assessment? • Defined: the process of determining, analyzing and prioritizing needs, and in turn, identifying and implementation solution strategies to resolve high-priority needs” (Altschuld & Witkin, 2000, p 253).

8. What Is a Needs Assessment? • Should answer the following questions • Who is the priority population? • What are the needs for priority population? • Which subgroups within the priority population have the greatest need? • Where are these subgroups located geographically? • What is currently being done to resolve identified needs? • How were ha the identified needs been addressed kin the past? Source: Petersen and Alexander (2001)

9. Acquiring Needs Assessment Data • Types of data: primary data (data you collect…); secondary data (data already collected) • Sources of Primary Data • Surveys • Multistep survey (e.g., Delphi technique) • Community forum • Focus group • Observations • Sources of Secondary Data • Archive data, government, state, or local agencies, existing records, literature, PsycINFO (database), Medline

10. Conducting a Needs Assessment • Step 1: Determining the Purpose and Scope of the Needs Assessment • Step 2: Gathering Data • Step 3: Analyzing the Data • Step 4: Identifying the Factors Linked to the Health Problem • Step 5: Identifying the Program Focus • Step 6: Validating the prioritized Needs

11. Measurement, Measures, Data Collection, and Sampling • Measurement defined: the process of assigning numbers or labels to objects, events, or people according to a particular set of rules (Kerlinger, 1986). • Quantitative measures vs. qualitative measures • Levels of Measurement: Nominal, ordinal, interval, ratio • Nominal: put data into categories that have to be mutually exclusive (gender) • Ordinal: put data into categories that are mutually exclusive and exhaustive (who would you describe your level of satisfaction with this workshop?) • Interval: put data into categories that are mutually exclusive and exhaustive, and rank-orders the categories (e.g., what was the high temperature today?”) • Ratio: a scale with an absolute zero (what was your score on the test?) • Types of Measures: demographic characteristics, awareness, knowledge, attitudes, motivation personality traits, skills, behavior, environmental factors or conditions, health status (risks, morbidity, or mortality), and quality of life

12. Measurement, Measures, Data Collection, and Sampling • Desirable Characteristics of Data • Reliability: consistency in the measurement process • Internal consistency, test-retest, rater reliability, parallel forms • Validity: measures what it is intended to measure • Face validity, content validity, criterion-related validity (predictive, concurrent validity), construct validity (construct validity, convergent validity, discriminant validity) • Unbiased: data that have been distorted • Culturally appropriate: values, beliefs, traditions, and perceptions

13. Measurement, Measures, Data Collection, and Sampling • Methods of Data Collection • Self-Report • Observation • Existing Records • Meetings

14. Measurement, Measures, Data Collection, and Sampling • Sampling • Probability Sample: each person in the survey population has an equal chance and known probability of being selected, thus creating a probability sample • Nonprobability Sample: samples in which all individuals in the survey population do not have an equal chance and a known probability of been selected to participate • Sample Size: based on practical and statistical needs

15. Measurement, Measures, Data Collection, and Sampling • Pilot Test • A procedure used to try out various processes during program development on a small group of subjects prior to actual implementation. • Purpose: identify and if necessary, correct any problems prior to implementation with the target population. • Processes: preliminary review, prepilot, pilot tests, and field tests

16. Mission Statement, Goals, and Objectives • Mission Statement: A short narrative that describes the general focus or expectations of the program • Program Goals: a statement concerning a desired outcome, typically involves verbs such as improve, increase, promote, protect, minimize, prevent, and reduce (CDC 2003) • Objectives: more precise and represent smaller steps than goals – steps that, if completed, will lead to reaching the program goal(s)

17. Examples • e.g., of Mission Statement: It is the mission of the ABC company to provide a work environment conductive to facilitating a healthier lifestyle both at the worksite and in the employees’ personal functioning. The programs will focus on enhancing activity levels, following proper nutritional guidelines, reducing stress and promoting a nonsmoking environment • e.g., Program Goals: Reduce the job-related stress of fall employees • e.g., Objectives: • Short-Term: Relaxation classes for reducing stress will be provided with 65% participation rates of 75% of the employee population. • Long-term: fifty percent of the workforce will participate in some form of exercise program and (b) reported stress will be reduced by 50% over a three-year period

18. Relationship of Mission Statement, Goals, and Objectives Mission Statement Goals Objectives

19. Theories and Models Commonly Used for Health Promotion Interventions • Social Cognitive Theory • Theory of Planned Behavior • Health Belief Model • Stage Theories

20. Theories and Models Commonly Used for Health Promotion Interventions • Social Cognitive Theory (Bandura 1977) Person Behavior Outcome Efficacy expectations Outcome expectations

21. Theories and Models Commonly Used for Health Promotion Interventions • Theory of Planned Behavior(Fishbein & Ajze, 1975; Ajzen, 1998) Attitude Toward the behavior Subjective norm Intention Behavior Perceived behavior control

22. Theories and Models Commonly Used for Health Promotion Interventions • Health Belief Model(Glanz & Rimer, 1995). • A widely used model in health promotion • Addresses a person’s perceptions of threat of a health problem and the accompanying appraisal of a recommended behavior for preventing or managing the problem. • People must believe they are susceptible to health problems and that those health problems have undesirable consequences before they will make the effort to change current behavior. • People must also believe that those health problems can be prevented, delayed, or minimized.

23. Individual Perceptions Modifying Factors Likelihood of Action Demographic variables (age, gender, race, etc.) Sociopsychol9ogical variables (personality, social class, peer groups, etc.) Structural variables (knowledge about disease, Contact with disease, etc.) Perceived benefits of Preventive action Minus Perceived barriers To preventive action Perceived susceptibility to disease Perceived seriousness of disease Perceived Threat of Disease Likelihood of Taking Recommended Preventive Health Action Cues to action Mass media campaigns Advice from others Reminder from physician/dentist Family illness/illness of friend Newspaper or magazine article

24. Theories and Models Commonly Used for Health Promotion Interventions • Stage Theories(Transtheoretical Model) • Use stages of change to integrate processes and principles of change from across major theories of intervention • Core constructs: stages of change, the processes of change, the pros and cons of changing, self-efficacy, and temptation. • Best known for the stages of change • People move from precontemplation, not intending to change, to contemplation, intending to change within 6 months, to preparation, actively planning change, to action, overtly making changes, and into maintenance, taking steps to sustain change and resist temptation to relapse Source: Prochaska et al. (1998)

25. Precontemplation Contemplation Relapse Preparation Maintenance Action Termination

26. Suggestions for Applying Theory to Practice • Have a basic grasp of the theories • Examine their applicability to the problem • Consider levels of influences (individuals vs. community) • Examine evidence • Consider culture settings • Consider multiple theories • A theory that make sense to the planners

27. Interventions • Types of Intervention Strategies • Creating Health promotion Interventions

28. Types of Intervention Strategies • Health Communication Strategies • Health Education Strategies • Health policy/Enforcement Strategies • Health Engineering Strategies • Health-Related Community Service Strategies • Community Mobilization Strategies

29. Creating Health Promotion Interventions • Criteria and Guidelines for Developing Health Promotion Interventions • Address one or more risk factors • Reflect a consideration of the special characteristics, needs, and preferences of its target group(s) • Include interventions that will clearly and effectively reduce a target risk factor and are appropriate for particular setting • Identify and implement interventions that make optimum use of the available resources • Be organized, planned, and implemented in such a way that its operation and effects can be evaluated.

30. Creating Health Promotion Interventions • Designing Appropriate Interventions • Consider several major components

31. Figure of Intervention Model