Starting the Planning Process

• Gaining Support of Decision Makers

• Creating a Rationale

• Identifying he a Planning Committee

• Parameters for Planning

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

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

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

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

Assessing Needs

• What Is a Needs Assessment?

• Acquiring Needs Assessment Data

• Conducting a Needs Assessment

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).

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)

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

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

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

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

Measurement, Measures, Data Collection, and Sampling

• Methods of Data Collection

– Self-Report

– Observation

– Existing Records

– Meetings

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

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

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)

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

Relationship of Mission Statement, Goals, and Objectives

Mission Statement

Goals Objectives

Theories and Models Commonly Used for Health Promotion Interventions

• Social Cognitive Theory

• Theory of Planned Behavior

• Health Belief Model

• Stage Theories

Theories and Models Commonly Used for Health Promotion Interventions

• Social Cognitive Theory (Bandura 1977)

Person Behavior Outcome

Efficacy expectations

Outcomeexpectations

Theories and Models Commonly Used for Health Promotion Interventions

• Theory of Planned Behavior (Fishbein & Ajze, 1975;

Ajzen, 1998)

AttitudeToward the behavior

Subjectivenorm

Perceivedbehaviorcontrol

Intention Behavior

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.

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 Threat of Disease

Perceived susceptibility to diseasePerceived seriousness of disease

Likelihood of TakingRecommended PreventiveHealth Action

Perceived benefits of Preventive action

Minus

Perceived barriersTo preventive action

Cues to actionMass media campaignsAdvice from othersReminder from physician/dentistFamily illness/illness of friendNewspaper or magazine article

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)

Precontemplation

Contemplation

Relapse

Maintenance

Termination

Preparation

Action

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

Interventions

• Types of Intervention Strategies

• Creating Health promotion Interventions

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

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.

Creating Health Promotion Interventions

• Designing Appropriate Interventions– Consider several major components

Figure of Intervention Model