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Chapter 2

Chapter 2

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Western University
Health Sciences
Health Sciences 2200A/B
Bill Irwin

Chapter 2 Notes • health educator is associated with planning, implementing, and evaluating health programs. • models : means by which structure and organization are given to the planning process. • The Generalized Model for Program Planning: (basic steps in a model in order to plan a health program) • assessing needs • setting goals and objectives • developing an intervention • implementing the intervention • evaluating the results • knowing the Generalized Model for Program Planning with help you better understand all planning models, prepare you to adapt to any planning situation in professional practice, and help you better understand related processes such as grant writing • models change over time, and come and go frequently • what doesnʼt change over time are the things outlined in the Generalized Model for Program Planning. • all the things outlined in the generalized model may seem one step to another, but they are actually all related to each other. • generalized model is like the “North Star” for planning. • building blocks for all other models • generalized model is also important as a professional when looking at applications of other colleagues. • when selecting a planning model, one must take into account: • the preferences of the stakeholders (e.g. who will be funding the program) • how much time and funding • how many resources available for data analysis and collection • consumer-oriented • three Fʼs of Program Planning: • fluidity - steps are in sequence and they build up on one another • flexibility - adaptive to the needs of the stakeholders. • functionality - being able to improve health conditions, reach goals, etc. • planners also must consider the ecological framework, that families, communities, schools, peers, etc influence oneʼs health behaviour • FOUR models focused in this chapter: • PRECEDE- PROCEED • MATCH • CDCynergy • SMART • PRECEDE - PROCEED Model • developed over the course of 20 years • PROCEED is an elaborated version of PRECEDE • has 8 phases / steps • goal of the model is to identify the desired outcome, what causes it, and to design an intervention • Phase 1: Social Assessment and Situational Analysis • define quality of life • involves individuals to assess their own needs and ambition • Phase 2: Epidemiological Assessment • planners use data (mortality, morbidity, etc) to rank their health goals and problems • also take into account genetic, behavioural, and environmental factors • Phase 3: Educational and Ecological Assessment • classifies factors that affect behaviour into 3 classes: •predisposing - knowledge, personality, values •enabling - access to health care, resources available •reinforcing - feedback and rewards • Phase 4: a) Intervention Alignment and b) Administrative and Policy Assessment • a) Intervention Alignment •match appropriate strategies with projected changes and outcomes • b) Administrative and Policy Assessment •determines if the capabilities and resources for the program to work are present. • ****PROCEED BEGINS**** • Phase 5: Implementation • select methods and strategies of the intervention and implementation begins • Phase 6: Process Evaluation • Phase 7: Impact Evaluation • Phase 8: Outcome Evaluation • MATCH Model • acronym for Multilevel Approach to Community Health. • developed in the late 1980s • an ecological planning perspective that recognizes that intervention approaches can and should be aimed at a variety of objectives and individuals. • compromised of 5 phases • Phase 1: Goals Selection • take into account relative significance of the problem, changeability of the problem, and environmental factors • Phase 2: Intervention Planning • matches intervention objectives with the intervention targets and intervention actions • begins with identifying the targets of the intervention actions (TIAs) • TIAs are individuals who influence personal or environmental conditions that are related to health. • identify which level of harm is made (personal, family, society, etc) • intervention action is used (teaching, counseling, etc) • Phase 3: Program Development • creation of program units • includes the development of individual sessions and lesson plans • Phase 4: Implementation Preparations •prepare for implementation and interventions are made. •effective implementation must include: • specific proposal for the adoption of change • develop the need, readiness, and environmental supports for change • provide evidence that the intervention works • identify and select change agents and opinion leaders and convince them of the need for change. • establish good working relationships with the decision makers • Phase 5: Evaluation •also includes process, impact, and outcome components. •process - quality of implementation and direct learning outcomes •impact - measuring the targeted mediators (knowledge, attitudes, etc), health behaviours and environmental factors •outcome - typically focus on health behaviours and monitors long-term maintenance of changes in behaviour or environmental factors • Consumer-Based Planning • The two models listed above have been used by many planners successfully in the past • consumer-based planning: most decisions are based on consumer input and made with consumers in mind • includes consumers throughout the whole planning process • Health Communication: the use of strategies to informs and influence individual and community decisions to enhance health. •can be in the form of a brochure, a website, etc •private sector - very successful at relaying health information by using new innovative technology • these people need to understand how to work the new technology in order to properly communicate •planners must avoid unrealistic expectations •health communication alone is not sufficient enough to change behaviour and reduce the risk for disease. •not only on an individual basis must they communicate, but they should also communicate with health care providers, health promotion partners, the media, and policymakers •in the next 10 years, application of new technologies in HC will provide cost- effected applications that can be more easily tailored to large populations. • Social Marketing •audience centered program development •promotion of voluntary behaviour change •audience segmentation and profiling. •“the application of commercial marketing technologies to the analysis, planning, execution, and evaluation of programs designed to influence the voluntary behaviour of target audiences in order to improve their personal welfare and that of their society.” • primitive social marketing focused on family planning, nutrition, immunizations, and agricultural reforms. • now, North American social marketing focuses on bigger global issues such as HIV/AIDS, cardiovascular disease, low-fat eating, prevention and treatment of drug use, and breast cancer screening. • two models that capture health communication and social marketing are CDCynergy and SMART. • CDCynergy (CD-Rom) • developed in the mid-1990s by the Centre for Disease Control Prevention (CDC) • developed primarily for public health professionals at the CDC with responsibilities regarding to health communication • basic edition of CDCynergy (3.0) includes: general methodology for health communication planning, step-by-step guide, reference library, links to templates that allow personalization. • now more editions are made, targeted to specific health problems including cardiovascular disease, diabetes, and tobacco prevention and control • Phases of CDCynergy: • Phase 1: Describe Problem • using epidemiologic data, identify the health problem that merits attention and that the organization has the means to address. • a short written statement describing terms such as who is affected, to what extent, where it is geographically, and as to what the trends are. • also examines whether an organization is ʻfitʼ enough to address the issue. Thus, Cynergy analyzes whether an organization has enough human resources, technology resources, and the political climate in general. • also need a rationale as to why the organization is addressing the problem, and a list of factors that justify the organizationʼs involvement with the problem. • Phase 2: Analyze Problem • describes problem more in detail such as factors that directly and indirectly contribute to the problem. • prioritize the importance of subproblems by the complexity or difficulty of the direct and indirect causes leading to the health problem. • **better to do a few things well - planning avoids overcommitting scarce resources and addressing too many problems • once subproblems are selected, goals are developed for each to identify outcomes and time frames • SWOT (strengths, weaknesses, opportunities, and threats) are discussed for each intervention, then one is chosen for each subproblem.
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