Introduction to Health Promotion Planning

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Introduction to Health Promotion Planning

• January 30 31, 2007
• Larry Hershfield
• Heather Graham

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• 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, its what you've been
  trained to do your whole life.
• Nothing could possibly go wrong, right ?

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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

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Introductions

• Purpose
• Process
• Paper
• Place
• People

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Goal of Workshop

• To assist those involved in health promotion with
  planning projects in organizational and community
  settings.

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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.

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Introductions

• Purpose
• Process
• Paper
• Place
• People

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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.

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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?

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Introductions

• Purpose
• Process
• Paper
• Place
• People

• Slides
• Workbook
• Agenda
• Evaluation Form
• THCU materials
• Resource material

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Introductions

• Purpose
• Process
• Paper
• Place
• People

• Telephones
• Washrooms
• Anything else?

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Introductions

• Purpose
• Process
• Paper
• Place
• People

• Larry Hershfield
• Heather Graham
• people at your table
• online networking

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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.

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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.

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Three Fs 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

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Levels of Planning
Strategic

• Program

Operational / Work / Action
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Components of Planning

• Vision
• Mission
• Values / Beliefs / Guiding Principles
• Strategies
• Population(s)
• Goals Objectives
• Activities
• Details - , timeframe, roles

Strategic Planning
Program Planning
Operational Planning
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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)
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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.

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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

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Commonly Used Planning Models

• Precede Proceed Model
• Needs/Impact-Based Planning Mode
• Others

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

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Poll Planning Models
Aware? Use?
1. Strategic Planning Process (Bryson, 1995)
2. Precede-Proceed (Green and Kreuter, 1999)
3. Needs/Impact-Based Planning Model (Metro Toronto District Health Council, 1996)
4. Kellogg Foundation Model
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Poll Planning Techniques
Aware? Use?
1. Consultation with stakeholders/intended population 1. Consultation with stakeholders/intended population
a. Using individual consultations.
b. Using focus groups.
c. Through forums.
d. Through Delphi methods.
   2. Literature review.    2. Literature review.
3. Review of past evaluation findings. 3. Review of past evaluation findings.
4. Review of mandates, agendas, policies and/or guidelines of stakeholders. 4. Review of mandates, agendas, policies and/or guidelines of stakeholders.
5. PEEST analysis 5. PEEST analysis
6. SWOT 6. SWOT
7. Logic model 7. Logic model
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Use of social science theory
Aware? Use?
THCUs Changing Behaviours, A Practical Framework
Stages of Change
Social Learning Theory
Diffusion of Innovation
Socioenvironmental theories
Community mobilization theories
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What is your typical planning budget?

1. 0
2. Under 1000
3. 1000-1999
4. 2000-4999
5. 5000-9999
6. Over 10,000

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How long do you usually have to pull your plan
together?

1. Less than 5 working days
2. 6-10 working days
3. 11-20 working days
4. More than a month of working days

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How much of your time can you normally use for
planning?

1. Under 5 full days
2. 6-10 full days
3. 11-20 full days
4. More than 20 full days

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How much time from others is normally available
to help you?

1. Under 5 full days
2. 6-10 full days
3. 11-20 full days
4. More than 20 full days

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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?

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Step 1

• Pre-planning and Project Management

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1. Participation

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

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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

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2. Time

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

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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.

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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.

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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)

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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)

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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

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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

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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?

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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
  1999586-97.
• The conscientious, explicit, judicious use of
  the best available research evidence in making
  decisions about health promotion program policy
  development
• DiCenso, Guyatt, Ciliska, 2005

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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

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and what isnt effectiveness evidence?

• Because weve always done it this way
• Anecdotal information
• Surveillance data

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Health-evidence.ca

• 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

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Other sources of systematic reviews

• Effective Public Health Practice Project
  www.myhamilton.ca/myhamilton/CityandGovernment/Hea
  lthandSocialServices/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.ht
  m

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Other sources of systematic reviews (cont)

• The Campbell Collaboration www.campbellcollaborati
  on.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.a
  u
• The Chalmers Research Group www.chalmersresearch.c
  om
• Sara Cole Hirsch Institute http//fpb.cwru.edu/Hir
  shInstitute

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Additional Resources

• Secondary Journals
• Evidence-based Nursing www.evidencebasednursing.co
  m
• Clinical Evidence www.clinicalevidence.com
• Bandolier www.jr2.ox.ac.uk/bandolier

• Databases
• PubMed (Medline) http//www.ncbi.nlm.nih.gov
• CINAHL
• ERIC

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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

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1. Participation

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

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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

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Levels of Stakeholders
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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
• record on flipchart
• share highlights with the large group

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Step 2

• Conduct a Situational Assessment

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What is a situational assessment?

• A snapshot of the 'present' used to plan for the
  future.

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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.

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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

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Types of Data

• Quantitative polling/survey data
• Community health status indicators e.g. housing
  prices
• Community story/testimonial
• Policies
• Vision or other organizational directions
• Evaluation findings (formative, process, outcome
  data)
• Research findings (experimental or
  quasi-experimental data)
• Cost-benefit/cost-effectiveness data
• Meta-analysis
• Best practices syntheses and guidelines

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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)

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Techniques, Tools

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

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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

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2. Literature Review

• What theories about the health issue exist?
• What has been learned from previous programs
  addressing the health issue?

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3. Review Evaluation Findings

• What have you learned from your previous
  experience?

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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

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Sample Vision Statement

• We envision communities supporting families so
  that every child in Haldminand-Norfolk develops
  to his or her full potential.

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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.

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6. SWOT Analysis

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

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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.

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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

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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.

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Step 2 Exercise Trade Fair

• In table groups
• Show and tell promising practices and sources
  related to situational assessment work AND/OR
• Discuss your biggest challenges and successes
• Share highlights with large group

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Step 3

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

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Program Outcome Model
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Five Minute Course in Objective Setting

• In pairs, carefully observe one another.
• Turn your backs to each other, changing three
  things about your personal appearance.
• Now, face each other, and in turn, try to
  identify the three changes in the other person.
• To be discussed..

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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

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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.

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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

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Goals

• Goals summarize the ultimate direction or desired
  achievement of a program.
• Most health promotion programs have one goal,
  although more complex programs may have several
  goals.

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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).

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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.

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Types of Objectives

• Closed vs. Open-ended
• 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.

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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

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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)

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

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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 on from the pile and go to the corner
  that most accurately categories the objective you
  were given
• The gift is good feedback (anonymous from the
  group and facilitators)

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Developing Program Objectives

• Arguably the most important part of the program
  planning process
• SMART objectives are critical for successful
  program delivery and evaluation
• Difficult to do by committee

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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.

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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

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Barriers to Planning

• We welcome a few volunteers to identify a common
  barrier (practical challenges) to successful
  planning
• Each will take a flipchart to a given table
• Groups will identify potential solutions, and
  record on flipchart
• Join whichever group you like (you can even move
  around)
• Modest reporting back, but we will collect, type
  up and circulate the flipchart content

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Review / Preview

• Steps in the planning model
• Bike Rack items
• Reflections on today
• Evaluation forms
• Social time this evening
• Clean tables off
• Day 2 preview

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Warm up Exercise Planning in Everyday Life

• Why are you having the party?
• What are the key steps involved in planning a
  party?
• What factors can you control?
• What factors do you have to 'leave to chance'?
• How will you know if your party planning has been
  successful?

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Step 4

• Identify Strategies, Activities, and Resources

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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)
• Many activities are a part of each strategy.

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Health Promotion Strategy Menus

• Ottawa Charter Actions
• build healthy public policy
• create supportive environments
• strengthen community action
• develop personal skills
• reorient health services

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Health Promotion Strategy Menus (cont)

• Metro Toronto DHC Strategies
• counseling and skill development
• education
• social marketing
• self-help/mutual support
• community mobilization and development
• healthy public policy

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Health Promotion Strategy Menus (cont)

• Centre for Health Promotion
• education
• health communication
• organizational development
• community development
• policy development
• advocacy
• intersectoral collaboration
• research

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Health Promotion Strategy Menus (cont)

• CDC
• health communication
• health education
• health policy / enforcement
• health engineering
• health-related community service
• community mobilization

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Health Promotion Strategy Menus (cont)

• Ontario Heart Health Program Taking Action for
  Healthy Living
• increasing awareness
• education and skill building
• supportive environments
• policy
• community mobilization

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Processes for Identifying Strategies Activities

• Brainstorm potential strategies for achieving
  objectives
• Select the best strategies and identify specific
  activities.
• Review current activities (if program is not
  new), decide what to stop, start, continue and
  cluster them into strategies
• Look back to your SA data, and consider the
  needs, impacts, mandate, capacity.

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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

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Step 5

• Develop Indicators

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Indicators

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

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Common Activity/Process Indicators

• Members participating, new members, affiliates
• Services provided classes, workshops,
  newsletters, support groups, etc.
• Member satisfaction

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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

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Matching Indicators to Objectives

• To promote healthy food choices in the workplace.
• Process/Activity/Output indicators
• of educational sessions
• of participants
• of participants rating sessions as excellent
  or good
• of brochures distributed
• of meetings with key stakeholders re
  development of supportive environments and
  policies promoting healthy eating in the
  workplace.

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Matching Indicators to objectives

• Short-term outcome indicators
• of employees reporting increased knowledge of
  healthy food choices
• of employees reporting increased knowledge of
  health risks associated with unhealthy choices
• of employees reporting intentions to practice
  healthy eating
• of workplaces committed to creating healthy
  environments and policies supporting healthy food
  choices

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Matching Indicators to Objectives

• Long-term outcome indicators
• of employees making healthy food choices
• of workplaces adopting policies promoting
  healthy food choices
• of workplace cafeterias offering healthier
  range of food choices, long-term change in
  incidence of heart disease at workplaces taking
  part in program.

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Characteristics of Good Program Indicators

• credible - reflects available evidence
• user friendly - understandable and relevant
• balanced - appropriate mix of process and outcome
  indicators
• measurable - should be 'evaluable
• continuous - contribute to comprehensive
  understanding of program
• compatible - identical or comparable with those
  adopted in similar programs
• linked to available data - sources of data needed
  to apply indicator are accessible

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Steps 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?

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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.

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Sources of Health Promotion Indicators

• Health Canada website (search indicators)
  www.hc-sc.gc.ca
• U.S Healthy People 2010 Local Health Indicators
  www.healthypeople.gov/LHI
• Canadian Council on Social Development
  www.ccsd.ca
• Federation of Canadian Municipalities quality of
  life reporting system www.fcm.ca

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More Sources of Health Promotion Indicators

• Indicators that Count Measuring Population
  Health at the Community Level http//www.phac-asp
  c.gc.ca/ph-sp/phdd/resources/subject_determinants.
  html
• APHEO http//www.apheo.ca/
• Health Evidence Network
• http//www.euro.who.int/HEN/Syntheses/20030820_1
• Empowerment Paper http//www.euro.who.int/Docum
  ent/E88086.pdf

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The Great Indicators Challenge

• Identify a potential indicator
• Volunteers will work with facilitators and the
  whole group in Find that Indicator Online

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Step 6

• Review the Program Plan

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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.

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Review of Planning process

• In table groups
• Review the case study provided.
• Highlight strengths, weaknesses, recommended
  changes
• Be prepared to share a few highlights with the
  large group.

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Check-in

• Revisit the expectations you had at the beginning
  of the workshop
• Reflections on what we have learned
• Identify unmet needs, things we still want to
  learn
• Suggest best learning methods

127
Create your Own Planning Model

• Consider your next planning project.
• Based on learning to date, complete the
  worksheet.
• Be prepared to share learnings, challenges, plans
  to implement in the field.

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Useful Tools

• Generating Ideas Making Decisions

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Useful Tools

• For generating ideas
• Affinity diagrams, cards
• Narratives, stories
• Others
• For making decisions
• Logic Models
• Debates
• Decision rules, tables, grids
• Polling, voting
• Others

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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

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Logic models contribute to effective planning by

•  clarifying connections between key facets of a
  program (e.g., demonstrating how activities help
  achieve objectives)
• identifying gaps and inconsistencies within a
  program (e.g., activities that are not
  contributing to specific objectives)
• 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.

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Issues in Application

• How do you intend to apply what you have learned
  over the last two days?
• What barriers might arise to prevent you from
  applying your learnings from this workshop?
• What promising practices and successful
  experiences can we offer as solutions?

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Ongoing Learning

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

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A big thank you to

• Ontario Ministry of Health Promotion
• Jodi Thesenvitz, Cathy Duerden and Cam White
• Staff of Oakham House, Ryerson University
• Our workshop participants.