Week 9- program planning Flashcards
Health Promotion in Community Health Nursing
CHN embraces health promotion through the concept of social justice
HP strategies and interventions seek to enable individuals, families and entire communities to prevent, enhance, maintain or restore health across the lifespan (Canadian Nurses Association, 2012)
Health Promotion
“process of enabling people to increase control over, and to improve their health” (WHO, 2009, p 1).
This is much, much more than simply health education
Health Education
About providing health information and knowledge to individuals and communities
Helps enable individuals to adopt healthy behaviours voluntarily
Helps influence attitudes
Health Promotion
More comprehensive approach
Involves multi-sectoral key stakeholders
Addresses: advocacy, economics, capacity building, legislative changes, research and building partnerships….to name a few
What is health promotion?
Health promotion is any combination of health, education, economic, political, spiritual or organizational initiative designed to bring about positive attitudinal, behavioural, social or environmental changes conducive to improving the health of populations.
Health Promotion
- Mediating strategy between people & their environments.
- Based in the socio-environmental approach to health.
- A holistic view of health.
- Participation.
- DOH must be considered.
- Build on existing strengths and assets.
- Use multiple strategies.
Foundational Concepts in Health Promotion
Injury prevention Disease Illness Disease prevention Health protection Healthy public policy Risk avoidance Risk reduction Health enhancement Resiliency Risk factors Protective factors Health literacy Advocacy
Ottawa Charter for Health Promotion 1986
5 major strategies to promote health. Build healthy public policy. Create supportive environments. Strengthen community action. Develop personal skills. Reorient health services.
Population Health Approach
1- focus on the health of populations
2- address the DOH and their interactions
3- base decisions on evidence
4- increase upstream investments
5- apply multiple interventions and strategies
6- collaborate across sectors and levels
7- employ mechanisms for public involvement
8-demonstrate accountability for health outcomes
Population Health
is an approach to health that aims to improve the health of the entire population and to reduce health inequities among population groups.
Community Mobilization
A process of activating a community to achieve public policy and/or enhance the capacity of a community to sustain a positive change.
This is what you want to achieve with your community.
Community Engagement
Social, economic and environmental causes of health and illness
• Assets and strengths of individuals and communities
• Participatory approaches that build the capacity of individuals and communities to address their health concerns
Community Health Program Planning
Health program planning is a sequence of decisions ranging from broad strategies such as goals, to specific objectives that depend on the gathering and analysis of various types of information collected from a variety of ways
Health Program Planning
Can also be referred to as health program management
Addresses issues of populations; applied to programs rather than clients
Consists of four steps
Assessing
Planning
Implementing
Evaluating
Community Health Program Planning
Consists of rational decision making system to help CHN’s know:
When to make a decision to develop a health program
Where they want to be at the end of the health program
What to do to have a successful health program
How to develop a plan to go from where they are to where they want to be
How to know that they are getting to their destination
How to implement the program plan
What to measure to know whether what they are doing is appropriate
Health program
“Consists of a variety of planned activities to address the assessed health concerns of clients over time and builds on client strengths in order to meet specific goals and objectives”
PATCH model
Planning Approach to Community Health; increases capacity of members of the community and empowers them to participate; applicable to addressing specific health issues of a community
Program Logic Model (PLM)
Use in health care as a communication tool to depict the community health program planning process and components in diagrammatic form
Health program..
An organized approach to meet the assessed concerns of individuals, families, groups, or communities by reducing or eliminating one or more health concerns and building on client strengths
Simply: a collection of activities intended to produce particular results
Remember that communities are partners in programming, not just recipients!!!
Community Health Program Planning: Assessment
Community health assessment is often used to identify specific health concerns of the community
Assessment is “defined as a systematic appraisal of the type, depth and scope of health concerns and strengths a perceived by clients, health providers or both.”
What are some of the data sources for this assessment????
Community forums Focus groups Key informants Indicators approach –census Survey of existing agencies Surveys
Assessment
Identify target population and involve them in designing the program.
The interdisciplinary planning team must verify that a health concern exists.
Health education may be necessary to alert the population to the health concern
Determine the size and location of the population.
Determine boundaries (to stipulate who is included or excluded).
Identify available resources.
Use all relevant assessment data
Health program planning process:
The organized approach to identifying and choosing interventions to meet specific goals and objectives that address client health concerns
Goal is to ensure that health care services are acceptable, equitable, efficient, and effective
Health program implementation process:
Putting the health program planned activities into action
Community Health Program Planning: Evaluation
“the systematic process of appraising all aspects of a program to determine its impact” (Stanhope et al., 2012)
Needs to start early in the process
Ideally should be designed at the same time as the health program planning process
This is the method used to determine whether a program or service is required and likely to be used, whether it is conducted as planned, and whether it had the desired effect
An ongoing process of reflecting on plans, action and results to programs can be improved along the way and at the conclusion
Societal Influences on Health Programs
Health programs are experiencing greater public scrutiny because:
Limited resources
Increased demand for accountability
Growing emphasis on individual rights
Advocacy groups
Increased access to information
Funders want to feel confident that their precious dollars are well spent and the desired outcomes of the program are achieved
Sustainability of the program once funding has ended is a significant factor in today’s funding environment
CHN Role in Community Health Program Planning
CHN’s promote health in environmental, political and social contexts
CHN’s use the community health nursing process to assess/plan/intervene/evaluate on a micro and macro level
According to the Canadian Community Health Nursing Standards of Practice
“Community health nursing process refers to the processes on which CHN’s base community health nursing decisions”
Planning is more difficult than implementation within the CHN process
According to the Canadian Community Health Nursing Standards of Practice, planning encompasses:
Traditional terms such as ‘nursing process’, ‘problem solving’, clinical judgement’, ‘critical thinking’, and ‘decision making’
Goal- to build a caring community by keeping people healthy and connected to each other
Create strong communities to reduce problems
Don’t only look at what needs to be fixed…..must recognize what factors makes the community strong and healthy
Application of DOH to Program Planning
DOH Our well-being is affected by the DOH….but communities can influence many of these DOH
Determinants can be grouped into 3 categories (social world, physical world and DOH within the individual).
Social world
Income and Social Status Social Support Networks Education Employment and Working Conditions Social Environments Healthy Child Development Health Services
Physical
air and water quality
safe communities
adequate housing
Individual
Personal health practices and coping skills Biology and genetic endowment Gender Culture
Community Strength Everyone has strengths, as does every member.
Strength in people
Strength in the way people work together
Strength in community facilities
Strength in community services
Strategic planning
Involves matching client health needs, client and provider strengths and competencies with available resources
Most likely to be used when a general open ended question needs to be answered
Operational planning
Used on a smaller scale and starts with a specific objective in relation to program planning
Planning Process
Define the health concern
Identify target population and involve in designing the program
The interdisciplinary planning team must verify that a health concern exists
Health education may be necessary to alert the population to the health concern
Key factors in managing the planning process
Participation-critical-plan WITH not FOR; must involve stakeholders at every step
Time-participatory planning takes longer; and may conflict with existing political and cost issues
Money and resources-allocated funds, staff, volunteers, space, equipment, in kind donations
Data gathering-look at a broad definition of health, best practices
Decision making-timely decisions in process, proceed or not, allocation of resources, political contexts
Goal:
broad statements of desired outcomes
Objectives:
precise statements indicating the mans of achieving the desired outcomes; specific, measurable statements; usually have several; can be short or long term-usually have both; must be written in SMART format
Well written outcome objectives
Target (how much)
Priority population (who)
Outcome (What)
Conditions (When)
Planning process
Identify activities for alternatives
Working with the client, consider the possibility of solving a health concern using the various solutions identified
For each alternative, list the resources required to implement each activity (can use GANTT chart for this)
PATCH:
goal of this model is to give clients control of their health based on health education and to enhance the capacity of communities to plan, implement and evaluate all-inclusive, community-based health promotion programs
Planning Approach to Community Health
Program Logic Model:
PLM is used in health care as a planning and evaluation framework, and depicts the components in diagrammatic form. It describes and defines the parts of a program, but is not an evaluation model, therefore other tools need to be used for evaluation of the parts
5 steps to PATCH Model
Mobilize community Collect and organize data Choose health priorities Develop a comprehensive intervention plan evaluation
PATCH Model: Mobilizing Community
The identified community is organized with community representatives, and working as steering groups providing program information
PATCH Model: Collecting and organizing data
Working and steering groups analyse quantitative and qualitative data to identify community health concerns
PATCH Model: Choosing health priorities
Further data are collected, such as the determinants of health, to assist in stating and selecting health priorities
PATCH Model: Developing a comprehensive intervention plan
A plan is developed based on the available resources that includes strategies, timelines, and a task list for various activities such as publicizing, recruitment, and program evaluation
PATCH Model: Evaluation
The should be ongoing to assess the progress of the program at each stage as well as the program activities, with feedback of the results directed to the community
Program Logic Model
Useful because is clarifies the logical linkages of program inputs (resources and activities), outputs (products, program deliverables, and audiences or targets), and program outcomes related to a specific health concern
Depict a cause and effect sequence towards a stated outcome
