Study Group - Planning Flashcards
3 Dimensions of health behavior
Complexity, Frequency, Volitionality
Complexity
higher levels of knowledge, skill, or resources to perform simple behaviors
- more complicated behavior less likely to be performed correctly
Volitionality
Degree of personal control over behavior
High Volitionality
person has complete control performing behavior & does not require external resources/support
Low Volitionality
requires external resources
What are the 6 types/approaches to planning?
- Incremental
- Apolitical
- Advocacy
- Communicative Action
- Comprehensive Rational
- Strategic Planning
Public Health Pyramid (from bottom to top)
Infrastructure - designed to enhance personal, resources, capacity, technology, & information
Population Services - Designed to be received by entire population to address health concern
Enabling Services - Designed to provide services to subpopulation with specific needs
Direct Services - Designed to provide care to individuals
Target Audience
Entire population in need of program
Intended Audience
Segment of population who program is intended to reach
Recipients
Individuals who receive or participate in program
Who are stakeholders?
- Those involved in program operations
- People in community being served
- People affected by program
- Participants (primary users) of program
What should HES be able to tell stakeholders?
- Explain why program is necessary
- Explain philosophy behind program being developed
How can HES ensure program is effectively implemented & maintained (sustainability)?
- Have formalized roles, rules, & procedures
- Include volunteers & compensated leaders
What are important factors during planning process?
- Transparent & frequent communication
- Mutual & formalized decision-making processes
- Strategies to resolve conflicts
- Positive perception that value participation
Why is it important to engage populations, partners, & stakeholders throughout the planning process?
- Strong member engagement
- Sharing of resources
- Effective assessment & planning
Coalitions
Diverse group from organizations & the community that work together toward a common goal
What are the general steps in building coalitions?
- Prepare groundwork
- Create action plan & organize partnership(s)
- Implement action plan
- Evaluate action plan
- Sustain collaboration
What is included in ‘preparing the groundwork’ when building coalitions?
- Identify problem, need for partnership(s), potential partners
- Draft goals & objectives
What is included in ‘creating action plan’ when building coalitions?
- Set & solidify vision & goals
- Identify SMART action plan
What are critical components when considering who to partner with when program planning?
- Research potential partners/organizations
- Ensure they are knowledgeable & committed to the effort
- Establish clear goals, tasks, & communication methods
- Continually monitor effectiveness
How can HES increase likelihood of gaining & maintaining program support?
- Working with community to identify and/or validate issues that are important to them
- Establish clear relationships between program goals & assets, capacities, & values of community
Who may want to serve on program planning committee?
- Individuals who represent various groups within priority population
- Representatives of stakeholders not represented by priority population
- Individuals who have key roles within organization sponsoring program
How can HES ensure widespread input about program plan?
- Use mixed methods for obtaining input (global & specific)
- Use various modes of communication (email, face-to-face, newsletter, etc)
What are some obstacles to obtaining input from priority population, partners, & stakeholders?
- Lack of time
- Lack of awareness
- Communication barriers
- Interest/apathy
- Convenient locations/times
Why is rationale important?
- Helps HES gain support by stakeholders & agencies
- Helps to ensure essential resources are obtained
- Helps with development & implementation of program run smoothly
What are the key components of a good rationale?
- Shows how benefits of program goes with decision makers’ values (demonstrates potential return of investment)
- Showcases best evidence available
What are the 4 important (basic) steps when writing program rationale?
- Identify appropriate background information
- Title
- Write content
- List references used
What should HES include in program plan?
- Summary of program goals & objectives
- Specific tasks required to meet each objective
- Summary of required resources & funding
- Summary of data to be used to measure progress toward objectives
3 Fs of Program Planning
Fluidity, Flexibility, Functionality
Fluidity of Program Planning
Steps in program planning process are sequential
Flexibility of Program Planning
- Planning is adapted to needs of stakeholders
- Responsive to current & emerging health problems
Functionality of Program Planning
Outcome of planning is improved health conditions (not just planning the program)
Vision Statement
Brief description of where program will be in approx. 3-5 years
Mission Statement
Program purpose & unique ‘reason for being’
- Used to reveal purpose/focus of organization or program
Why are vision & mission statements (as well as goals & objectives) important during program planning?
- Provides program direction
- Lays foundation for program evaluation
Program Goals
general, long-term statements of intent & direction of program & desired results
Program Objectives
Precise, measurable statements of intended program outcomes
How are goals & objectives used in program planning?
GOALS used to measure program’s processes & outcomes
OBJECTIVES guide program development & assesses program effectiveness
Indicators of Objectives
- “What” portion of objective
- Variables used to measure “what” of objective
- Performance benchmarks used to determine failure/success of program
Performance Measures
Indicators of process, output, or outcomes that have been developed for use as standardized indicators by health programs, initiatives, practitioners, or organizations
- Should align objectives with performance measures that need to be reported
What types of changes should be included when writing objectives?
- Changes in health status, behavior, attitude, or knowledge
- When/under what circumstances or conditions change will occur’
- What will change (outcome)
- Who will change
What are the different types of program objectives?
- Process
- Impact (learning, behavioral, environmental)
- Outcome
What are process objectives?
- Activities & tasks that lead to accomplishing all other levels of objective
- Assessments that lay foundation for process evaluation
What are Impact Objectives?
- Immediate & observable effects of program
- Lay groundwork for impact evaluation
What are Learning Objectives?
Short-term, specific descriptions of awareness, knowledge, attitudes, & skills
What are behavioral objectives?
Describe behaviors or actions that population will engage in to resolve problem
- Leads to attainment of program goal
- Statements of desired outcomes
What do behavioral objectives indicate?
Who will change, how much change by when, & what action will take place
What are environmental objectives?
Environmental or non-behavioral influences on health problem
What do environmental objectives include?
Social, physical, psychological, service, & economic environments
What are outcome objectives?
Specific, measurable statements that are related to ultimate goal(s)
Change in health status = desired result of program/intervention
Strategies for Meeting Objectives
1.Health-related community service
2. Health Communication
3. Community Mobilization
4. Health Engineering
5. Educational
Health Policy or enforcement
What is required in planning timeline during program planning process?
- Make list of all tasks & steps involved in sequential order
- Estimate time needed & necessary resources
- Should be monitored throughout planning & implementation and adjusted as necessary
What is health-related community service strategy for meeting objectives?
Free or low cost services or screenings
What is health communication strategy for meeting objectives?
Promotion & dissemination of health issues through media
What is community mobilization strategy for meeting objectives?
Efforts to involve target community through advocacy & building of coalitions
What is health engineering strategy for meeting objectives?
Efforts to positively alter elements of physical environment that affects health
What is an educational strategy for meeting objectives?
Efforts to inform target population about specific health issue
What is healthy policy or enforcement strategy for meeting objectives?
Efforts to influence behavior through changes in gov’t or organizational policy
TAAPS
Time frame, Amount, Activities, Participants, Staff
Impacts of successful programs
- Personnel expertise
- Characteristics of intended audience
- Degree of attention to acquiring & managing resources
What issues need to be considered to ensure sustainability of health program?
- Need
- Resources
- Support
- Currency
Theory of Cause/Determinants
Explains relationship among existing factors, main causal factors, moderating/mediating factors, & health outcome of health problem
Theory of Intervention
Specifies how intervention changes main determinant factors & moderating/mediating factors of health problem
Theory of Outcome
Explains how immediate health outcomes become long-term health impacts
What does organizational plan include?
- Program inputs
- Resources
- Way in which resources are organized & used
Outputs of Organizational plan
- Timeline
- Organizational charts
- Information system
Operations Manual
What is a business plan for health program?
Document that summarizes analyses behind development of product, service, or program
Types of Resources
- Human resources
- Physical resources
- Information resources
- Time
- Managerial resources
- Fiscal resources
What are human resources?
Quantity & quality of personnel needed to cary out program (expertise, experience, capabilities)
What are physical resources?
Materials, facilities, supplies, & equipment
What are information resources?
- Knowledge & expertise of staff
- Professional networks & “street smarts” that affect program implementation
What are Managerial resources?
Qualities & characteristics of managers of program (leadership, communication, organization)
What are fiscal resources?
Money, investments, & income
Universal public health approach
When an entire population or subgroup of population are targeted regardless of whether individuals have specific risk factors
Selective public health approach
Targeted at those in the population who are at heightened risk
Indicated public health approach
Individuals who have a risk factor that puts them at very high risk
Primary Prevention
- efforts made to intercept onset or occurrence of disease, injury, or behavior
- focuses on protecting individuals from disease or injury
- Intervening BEFORE onset of disease
Secondary Prevention
- Focused on early diagnosis
- Disease/injury already present in early stage
- Focus is to minimize consequences through early detection & intervention
Tertiary Prevention
- Rehab after diagnosis of disease/injury
- GOAL: prevent further deterioration & maximize QOL
- Involves mitigating consequences of disease/injury AFTER the fact
What are theories?
Set of interrelated concepts, definitions, & propositions that present systematic view of events or situations by specifying relations among variables to explain/predict events of situations
- Refers to “Chain of Causation”
Chain of Causation
How health program is expected to cause change leading to desired health benefits & avoid unintended consequences
What are models?
Composite, mixture of ideas or concepts taken from theories used together
What are general components of models?
- Assessing needs
- Setting goals/objectives
- Developing intervention
- Implementing intervention
- Evaluating results
How does including theories and/or models help HES when program planning?
- Guide implementation
- Identifies needed resources
- Uses logical sequence tools to organize program delivery
- Create & adhere to timeline
- Develop marketing plan
- Select right methods for reaching priority population
- Consider integration with other programs
- Evaluate sustainability of plan
- Pilot test program
Theory of Implementation
Predicts or explains why program is successful or not
What are the 2 parts of theory of implementation?
- Strategy chosen for implementing program
- Whether program strategy is implemented as intended
Logic Model
- Illustration that describes program’s theory of implementation
- Does NOT illustrate mechanisms/pathways of program that may cause expected benefits
What are the basic components of a logic model?
- Resources/Inputs
- Activities
- Outputs
- Outcomes
- Impact
Mediator Variable
Explains process through which 2 variables are related
Moderator Variable
Affects strength & direction of relationship between variables
What does PRECEDE from precede-proceed model mean?
Predisposing, Reinforcing, Enabling Constructs in Educational/Ecological Diagnosis & Evaluation
What does PROCEED from precede-proceed model mean?
Policy, Regulatory, & Organizational Constructs in Educational & Environmental Development
What are the 8 stages of PRECEDE-PROCEED model? Are they under Precede or proceed?
Precede -
1. Social Assessment
2. Epidemiological Assessment
3. Educational & Ecological Assessment
Proceed -
4. Administrative & Policy Assessment
5. Implementation
6. Process Evaluation
7. Impact Evaluation
8. Outcome Evaluation
PRECEDE-PROCEED Model: What is involved in social assessment?
Define QOL of priority population
PRECEDE-PROCEED model: What does epidemiological assessment identify & determine/prioritize?
- Identifies health problems of priority population
- Determines/Prioritizes behavioral & environmental risk factors of health problem
PRECEDE PROCEED model: What does Educational & Ecological Assessment determine?
Predisposing, Reinforcing, & Enabling factors
PRECEDE PROCEED model: What does administrative & policy assessment determine?
Resources available for program
PRECEDE PROCEED model: What is included in implementation stage?
- Select evidence-based strategies & activities
- Begin program
PRECEDE PROCEED model: What is included in process evaluation?
Document program implementation, feasibility, & gather feedback
PRECEDE PROCEED model: What is included in Impact evaluation stage?
Assess immediate effect of intervention
PRECEDE PROCEED model: What is included in outcome evaluation stage?
Determine whether long-term program goals were met
What does MATCH mean?
Multilevel Approach to Community Health
What is MATCH?
- Socio-ecological community planning tool
- Intervention planning aimed at multiple objectives & variety of individuals
What are the 5 stages of MATCH?
- Health goals selection
- Intervention planning
- Program development
- Implementation preparation
- Evaluation
What is CDCynergy Lite?
Community-level model used for health communication & social marketing
How does CDCynergy Lite help HES?
- helps understand priority population
- helps in finding communication strategies to best help priority population change their behavior
- Provides step-by-step guide, reference library, & links to templates that facilitate creation of tailored plans
What are the 6 stages of CDCynergy Lite?
- Describe problem
- Analyze problem
- Plan intervention
- Develop intervention
- Plan evaluation
- Implement plan
MAPP model
Strategic planning tool that helps health departments facilitate community prioritization of public health issues & identify resources for addressing them
What are the phases of MAPP?
- Mobilize community members & organizations under leadership of public health agencies
- Generate shared vision & common values that provide framework for long-range planning
- Conducting 4 assessments: community strengths, local public health system, community health status, & forces of change
- Implementation
PACE-EH model
Community environmental health assessment tool that focuses on evaluation of environmental health conditions
What is PACE-EH used for?
Identify populations at risk & set priorities
What is the emphasis of PACE-EH?
Health equity & social justice
What does PACE-EH focus on?
Building relationships & sharing power & responsibilities with community
What should HES do when considering what materials to use for program implementation?
- Literature review or environmental scan to help identify existing protocols, plans, or other available materials
- Make sure information & resources are developmentally & culturally appropriate
What order should HES use when deciding what materials to use?
- Existing materials that have proven successful
- Adapt/Tailor existing materials for intended audience
- Create new materials ONLY when funds & time are available or nothing has been successfully used with audience
What should HES consider when creating/developing new material for program implementation?
- Scope (how much detail)
- Sequence (logical order of topics)
Fuzzy Aspects of Planning
- Uncertainty
- Ambiguity
- Risk
- Control
What is uncertainty when it comes to planning programs?
- Unknown likelihood of possible outcome
- Doubt of certain course of action
- Results in unknown likelihood of selecting & having effective interventions
What is Ambiguity when it comes to planning programs?
- Lack of clarity in single meaning, vision, or pathway
- Lack of clarity in who is leading process, boundaries, or other aspects of planning
- Unclear about what is intended to be accomplished
What is Risk when it comes to planning programs?
- Perceived possibility of adverse outcome
- Unknown possibility of planning touching on politically sensitive issues
What is control when it comes to planning programs?
- Reaction to uncertainty, ambiguity, or risk
- Attempt to mitigate perceived problems
- Directs decisions about program
How does understanding influences on learning help HES?
- Allows HES to make informed decisions & develop appropriate learning experiences
- Knowing barriers to learning helps HES develop methods for individuals or communities to overcome them
Principles to Facilitate Learning
- Use several senses (people learn differently)
- Actively involve participants
- Provide appropriate learning environment
- Assess learner readiness
- Establish information relevance
- Use repetition
- Strive for pleasant learning experience
- Build up to more complex info (start with what is known & move toward new info)
- Generalize information
- Pace delivery of information
What are the categories of Gagne’s Theory of Instruction?
- Verbal Information
- Cognitive Strategies
- Intellectual Skills
- Motor Skills
- Attitudes
Gagne’s Events of Instruction
- Gain attention
- Inform learners of objectives
- Build on prior knowledge
- Present Stimulus
- Provide guidance
- Elicit performance
- Provide feedback
- Assess performance
- Enhance retention & transfer
What can HES do to address unforeseen factors that could impact/influence program?
- Become familiar with community & any potential issues that could impact reaching program goals & objectives
- Find solutions to challenges that may arise during planning process
- Engage stakeholders to increase likelihood of program acceptability & reduce participant/staff related barriers (Plan ahead for overcoming potential barriers)
Theory of Cause & Effect
Underlying causal assumptions or logic explaining why program is expected to cause specific outcomes
Chain of Causation
Pathways/mechanisms program is expected to cause change leading to desired benefits/outcomes & avoids unintended consequences
Guidelines for Theory of Cause & Effect
- Aim for clarity
- Start at both ends
- Revise, revise, revise
- Review literature
- Focus on concepts rather than data
- Cross check for mediators, moderators, & cofounding
- Check for arrows that indicate accurate relationships & contexts
- Perform logic analysis of program theory
What influencing factors need to be considered when segmenting target audience?
- Audience size
- Extent group needs would benefit from behavior change
- How well available resources can reach intended group
- Extent group is likely to respond to program
- Extent secondary audience (if there is one) influence primary audience
What does CBPM stand for?
Community-based Prevention Marketing
What is CBPM?
Program planning framework suited to foster translational research into practice
What is the goal of CBPM?
Achieve feasible & sustainable behavior change
What does CBPM build on?
- Social Marketing
- Strengths & wisdom of community
What are public, community, & population health education programs/interventions designed for?
Inform, elicit, facilitate, & maintain positive health practices
What supports individual’s motivation for positive change?
- Increasing understanding
- Predisposition
- Skills
- Support from others
What are the types of strategies to accomplish health promotion goals?
- Educational
- Automatic Protective
- Coercive
What is Automatic protective strategy directed at controlling?
Environmental variables
How does Coercive strategy control individual behavior?
Employs legal & other formal sanctions
What are factors to deal with complex problems?
Social, environmental, economic, psychological, cultural, Physiological
Implicit Bias
biases we are unconscious of
Explicit Bias
Biases we are conscious of & acknowledge
Individual Bias
Biases that are tied to a person’s own behaviors & interpersonal interactions
Institutional Bias
Biases that influence social norms, political ideologies, & cultural systems
What does formative research provide?
- Information on how problem is defined
- Provides strategies to address health problem
- Aids in creating strategic model
Why is formative research important?
It is essential for understanding wants, needs, & desires of priority population
What is Incremental Planning?
- Does not attempt to address problem
- Focuses on immediate concerns without seeing “big picture”
What is Apolitical Planning?
- Relies on current knowledge
- Does not look at interpersonal dynamics
What does Advocacy Planning require/focus on?
- Focuses on client
- Requires community participation in planning activities
What is Communication Action Planning?
- Empower those with problem via shared information
- Works to shape attention, change beliefs, & understand those involved
- Participants gain knowledge, skills, & confidence in addressing own problems
What is Comprehensive Rational Planning?
- Systems approach to planning
- Analyzes problem via systems theory
- Sets goals, identifies alternatives, implements & monitors program & results
What is Strategic Planning?
- Focuses on organization’s ability to accomplish mission
- Infrastructure level of public health pyramid
- Identifies needed resources
- Considers best option for action
- Takes policy into consideration
- Time/Resource sensitive
- Can affect actions of whole team as it affects program choices