2250 Ch 9, 10, 11, 12
Fifth step in the process of community organizing: DETERMINING PRIORITIES AND SETTING GOALS
- 2 phases of goal setting: 1) identifying priorities of the group (determined through consensus, not formal voting) 2) using priority list to write the goals - stakeholders are the ones to establish priorities and set goals - challenge - turf struggles (disagreements over the control of resources and responsibilities) Solution = subgoals worked on by subcommittees.
Recruiting and managing volunteers
- Create a job description outlining tasks - recruit volunteers (typically though mass media, social media) - interview volunteers - train the volunteers - supervise and periodically evaluate - include them in staff meetings when appropriate, show appreciation etc. to keep them doing a good job - if they resign hold an exit interview
Sixth step in the process of community organizing: ARRIVING AT A SOLUTION AND SELECTING INTERVENTION STRATEGIES
- Group should identify alternative solutions and choose course of action (through consensus) - done by subcommittees; write and present a formal report
External personnel
- Individuals from outside the planning agency/organization or PP who would conduct all or part of the program - usually brought in when there's a gap between what can be provided internally and what ultimately must be provided - speakers bureaus = inexpensive, effective (individuals who can speak on health topics)
How does competition play a role in social marketing?
- People have choices for what behaviours they will participate in and products they will use to fulfill their needs (ie. to lose weight a) eat less or b) exercise more) - competition can come from other programs or services that are offering similar programs/products OR are sending messages that are in conflict with the behaviours the program planner is trying to promote (ie. weight loss -> competitive messages come from fast food restaurant ads)
Internal personnel
- Using individuals from the planning agency/organization or people from within the PP to supply labour - Peer education
When does financial management begin?
- after funds have been obtained and budget created - program manager responsible for ensuring funds are spent appropriately - each org. has accounting process -> generate financial statement at the end of fiscal year; compare to program budget - internal audit -> frequent/ongoing; conducted by employee not responsible for accounting - external audit -> done by an accountant once a year
Phase 4: Putting the plan into action -> PHASING IN
- after the program has been piloted and revised - 4 ways: by different program offerings (ie. offer stress mgmt classes first 6 months, next 6 month program add smoking cessation programs), limit on the # of participants (ie. 1st month -> 25 participants, 2nd month -> 50 etc.), choice of location, participant ability (ie. beginning exercisers, intermediate, then advanced)
Early majority & late majority
- between minus 1 SD and mean, between mean and plus 1 SD - 34% of the PP - may be interested in the health promo program but they will need external motivation to become involved - takes more work to get late majority involved bc they're skeptical and will not adopt an innovation until most ppl in social system have done so (planners try peer mentoring or constant exposure about the innovation)
Early adopters
- between minus 2 and minus 1 SD (14% of PP) - very interested in the innovation but not the first to sign up - wait until the innovators are already involved to make sure the innovation is useful - respected by others in the social system and looked upon as opinion leaders
Why should planners identify competition during the formative research phase?
- can help them make strategic decisions about products to offer that will provide greater benefit at a lower cost than competitors - helps planners price products/frame messages in promotional campaign
Cost sharing
- combination of participant fee and third-party support (ie. employer pays 60%, participant pays 40% or employer has reimbursement policy for participation)
Direct marketing
- communicating directly with consumers about a product with the purpose of getting them to purchase the product/service - ie. direct mail (pamphlets, flyers), direct selling, telemarketing
How to prepare for the first day of implementation
- decide on a day when the program is to be rolled out (consider launching on special days that can promote the program (ie. starting weight-loss program on Jan 1) - kick off the program in style (ie. ribbon cutting, celeb appearance ie. famous person, mayor, affected individual) - seek news coverage (use "news hook")
When considering PLACE (where the PP has access to the product), what should planners ensure?
- easy for the customer to obtain the product/service - avoid areas people don't go or where they'd feel uncomfortable or unsafe - optimum time of day
Innovators
- fall to the left of the curve, minus 2 standard deviations from the mean (between 2-3% of PP) - become involved in the program because they heard about it and wanted to be first - venturesome, independent, daring, may not be respected by others in the social system - use MASS COMMUNICATION to reach them
To ensure that a program is implemented as planned, the program facilitators must be familiar with the intervention
- familiarity may come from planning the intervention or through training session - if multiple facilitators are going to be used, implementation training would be useful to ensure standardized delivery - qualified instructor is important (internal to the org. or hire a vendor/consultant, or send facilitators to classes) - if you need a certified or licensed person to facilitate the intervention, don't assume some knowledgeable person who is not formally qualified can do so bc that increases your liability
Why might participant's manuals be useful/needed?
- get all the program material into participants hands at once - help them organize their materials/keep them in one place - serve as reference/resource for participants - may be more inclined to refer to it outside of program sessions
Laggards (call them late majority)
- greater than plus 1 SD - 16% - not very interested in innovation and would be the last to become involved in new health promo programs - traditional, suspicious, limited communication networks
In-house materials
- having someone else develop custom materials - the more "unique" the priority population, the more important this approach may be - esp. with cultural differences - drawback = time, money, effort (it's all original) - may not be necessary (ie. health agencies give away up-to-date health pamphlets for free)
Phase 2 of program implementation: IDENTIFYING AND PRIORITIZING THE TASKS TO BE COMPLETED
- identify and prioritize a number of smaller tasks (ie. reserving space where program is to be held, ordering correct # of manuals) - use planning table or timeline
Phase 5: Ending or sustaining a program
- if the program met its goals and objectives and the PP has been served to the fullest extent, you can end the program - challenge is when goals/objectives haven't been met and you must sustain the program: 1. work to institutionalize the program 2. seek feedback from participants and evaluate the program to generate evidence to show its worth 3. advocate for the program 4. partner with other organizations/agencies with similar missions to share resources, expenses, and responsibilities 5. revisit/revise rationale used to initially create the program
Sales promotions
- incentives that entice customers to try a product - ie. coupon for half off a mammogram
Personnel
- individuals needed to carry out the program - sometimes program participants themselves are a program resource (ie. workplace health promo program -> will employees participate during work time or their own time) - flex time = during the work day, working regular work hours - typically ask employees to participate on their own time (fosters sense of program ownership)
Public relations (aka publicity)
- internal and external marketing communications - ie. press conferences, news media coverage (not paid for)
Advantages to segmentation
- narrowing focus of marketing strategy - increases likelihood of developing the right product to meet needs/desires of PP (increases chances of exchange) (ie. women who knew you were supposed to get a yearly mammogram vs. women who didn't know received a different program)
Third step in the process of community organizing: ORGANIZING THE PEOPLE
- obtaining support of community members to deal with the concern - start with individuals who are already interested (people most affected by the cause/want to see change occur) -> "executive participants" - leader should be chosen (leadership skills, knowledge, community member) -> first goal: build group cohesion - next step is to expand the group (sometimes become task force or coalition)
Fourth step in process of community organizing: ASSESSING THE COMMUNITY
- one of the major differences between community organization and community building is the type of assessment used to determine where to focus the community's efforts - community organization = needs of community - community building = assets/capabilities of community (building on good work already done) - assessment should identify needs, assets, and involve those living in the community to be strong
Participant fee
- participants pay for the cost of the program - may be equal to expenses or may include profit margin - motivate participants to stay involved (ownership) - often those most in need of health programs are unable to pay - may charge based on ability to pay instead (ie sliding-scale fee = lower the income, lower the participation fee)
Personal selling
- person-to-person interaction - used regularly in health care marketing ie. pharma reps - lay health workers (aka promotoras) would go door-to-door
canned program
- program that has been developed by an outside group and includes the basic components/materials necessary to implement a program - cost ranges from $0-thousands (for profit or non profit) - most have 5 major components: participant's manual, instructor's manual, AV materials, training for instructors, marketing - no time spent on development but program may not fit the needs of PP
First step in process of community organizing: RECOGNIZING THE ISSUE
- recognize issue exists in community and something needs to be done about it - person who recognized issue = "initial organizer" even though he/she may not be primary organizer later on - recognition can occur from outside or inside community (most successful = inside)
Phase 4: Putting the plan into action -> TOTAL IMPLEMENTATION
- should do piloting and phasing in first (except maybe programs where the PP is relatively small and you can possibly skip phasing in) - only exception is "one-shot programs" ie. screening or single lecture but even then piloting would help
Third party-support (in financing a program)
- someone other than participants (first-party) or planners (second-party) is paying for the program - ie. employers, agencies, professional association
Second step in the process of community organizing: GAINING ENTRY INTO THE COMMUNITY
- this step is likely not needed if issue is recognize from someone inside community (unless person is new to community or s/t) - have to get in with "gatekeepers" of the community (individuals with influence ie. business leaders, teachers etc.) - organizers must first be familiar with the community before approaching gatekeepers (cultural competence, sensitivity, humility)
Cooperative agreement
- two parties (ie. groups, organizations, individuals) share resources and work together to offer a program or service (usually don't involve transfer of money) - ie. an agency provides educational literature in exchange for a space to present a program - usually written up and signed (memorandum)
Phase 4: Putting the plan into action -> PILOT TESTING
- work out bugs and validate work that's already been done - should be piloted in a similar setting and with people as much like those who will eventually use the program as possible - planners should ensure: intervention strategies were implemented as planned, they worked as planned, adequate resources were available to carry it out, participants in the pilot group had an opportunity to evaluate the program
In record keeping, what are the two techniques used to protect the privacy of participants?
1. Anonymity - no one, including planners, can relate a participant's identity to any information pertaining to the program (make sure data collected from participants has no identifying info attached to them ie. name, SSN etc.) 2. Confidentiality - planners are aware of the participant's identities and have promised not to reveal those identities to others
Three characteristics of a good organizer
1. Change vision attributes - see a need for change and committed to seeing it occur 2. Technical skills - efficacy issues and organizational health & effectiveness 3. Experience skills - ie. respond with empathy, assess/intervene with individuals and groups
When it comes to selecting the curriculum and other instructional materials that will be used to present the content of the program, planners can proceed in what 4 ways?
1. Develop their own materials (in-house) or have someone else develop custom materials 2. Purchase/obtain various instructional materials from outside sources 3. Purchasing/obtain entire "canned" programs from outside vendors 4. Using any combination of the first 3
As part of obtaining informed consent from participants, program facilitators should take what steps?
1. Explain nature/purpose of the program 2. Inform program participants of any inherent risks or dangers associated with participation and any discomfort they may experience 3. Explain expected benefits of participation 4. Inform participants of alternative programs that will accomplish the same thing 5. Indicate to participants that they're free to discontinue participation at any time * also ask if they have questions. Informed consent should be signed by participants before they enter the program.
5 stages of team development
1. Forming - orientation, introducing each other, establish ground rules - 2 things: members must feel welcome/included, develop consensus about goal 2. Storming - different opinions will cause conflict. Good teams will work through it, others will disband. 3. Norming - team members understand their roles, est. closer relationships/interdependence, cohesion 4. Performing - teams work towards team goals -> "constructive action" 5. Adjourning/mourning - reached goal, disband * some go to reforming where they refocus efforts on other tasks/problems
Steps in working with creative teams to help execute the promotional strategy (as opposed to planners developing/executing it)
1. Identify PR or marketing agency 2. Discovery meeting - met members of program planning team and creative team to discuss what needs to be accomplished 3. Creative team comes back to agency with recommendations 4. Sign an estimate agreement
Four primary purposes of promotion (IPRD)
1. Inform - increase product awareness or inform consumers 2. Persuade - convince people to purchase the product 3. Reinforce - remind them that the product exists 4. Differentiate - position the product as being different from the competition
3 basic components of a logic model
1. Inputs - resources used to plan, implement, evaluate a program - ie. human resources, partnerships, funding sources, equipment etc. 2. Outputs - activities or interventions in a program - ie. products, services, infrastructure 3. Outcomes - intended results - broken into short-term (ie. changes in awareness, attitudes), mid-term (ie. changes in behaviour, environment), and long-term (ie. risk reduction, change in health status)
Once planners have identified potential segments, they have to choose one segment to focus on (weigh data against organization's abilities/goals). To do this, planners consider the extent to which segments exhibit what 5 criteria? (MAADS)
1. Measurable - how many people are in the segment and whether important characteristics can be measured 2. Substantial - size and profitability of the segment (will enough people be reached with the intervention to make a difference) 3. Accessible - will the planners be able to reach the segment/deliver the services 4. Differentiable - are the segments unique/different enough that each responds in its own way to the marketing strategy 5. Actionable - decide whether programs can be developed that will attract and serve segments
Five criteria that community organizers need to consider when determining priorities and setting goals. The concern/issue/problem:
1. Must be winnable 2. Must be simple and specific (can be explained in a sentence or two by any member of organizing group) 3. Must unite members of organizing group/involve them in meaningful way 4. Should affect many people and build up the community 5. Should be part of larger plan/strategy to enhance the community
In order to map community assets (mapping community capacity) assets are grouped into: primary building blocks, secondary building blocks, and potential building blocks.
1. Primary building blocks - most accessible assets - located in neighbourhood and are largely under the control of those who live in the neighbourhood - organized into assets of individuals and those of organizations and associations 2. Secondary building blocks - assets located in the neighbourhood but largely controlled by people outside 3. Potential building blocks - least accessible assets - resources originating outside the neighbourhood and controlled by people outside * good examples on pg 272!
Most of the ethical issues that program planners will face revolve around what 3 fundamental principles?
1. Respect for persons - acknowledges dignity and autonomy (freedom) of individuals and requires that people with diminished autonomy (ie. children, mentally disabled) require special protection 2. Beneficence -> "doing good" - requires program planners to protect participants by maximizing anticipated benefits and minimizing harms - benefit-harm ratio 3. Justice - treat participants fairly
Steps in segmentation
1. Review the formative research data to identify behaviours that influence whether people experience morbidity or mortality associated with the health topic 2. Identify which segmentation factors (box 11.2) are associated with and influence whether people participate in that particular behaviour 3. Group people together who share similar characteristics as it relates to the behaviour - choose factors that distinguish how the PP will respond to marketing strategy (group ppl by 1 or 2 variables that most influence or are associated with the behaviour)
Planners can segment groups of people using information gathered from what two types of data?
1. Secondary data ie. literature, epidemiological data (a priori) 2. Primary data ie. focus groups, interviews (a posteriori)
Diffusion theory provides an explanation for the spread of innovations (something new, such as a product) in populations. If one thinks of a health promotion program as an innovation, what does the theory describe?
A pattern the PP will follow in adopting the program - pattern of adoption represented by normal bell-shaped curve
Advantages and disadvantage of phasing in
A: Easier to cope with workload, gradual investment D: fewer people involved
Advantages and disadvantages of total implementation
A: more people involved, evaluation more meaningful with larger group D: big commitment, no chance to test the program
Advantages and disadvantages of pilot testing
A: opportunity to test program, close control of program D: very few involved, not meeting all needs, hard to generalize about results
Active vs. occasional vs. supporting participants
Active - take part in most group activities and do the work that needs to be done (may also be executive participants) Occasional - involved on an irregular basis and usually only when major decisions are made Supporting - seldom involved; may contribute in non-active ways or through financial contributions
Phase 1 of program implementation
Adoption of the program
Phase 3 of program implementation: Establishing a system of management
Assembling and using human, financial, and technical resources in a goal-directed manner to accomplish tasks
"A name, term, design or symbol or any other feature that identifies one seller's good or service as distinct from those of other sellers"
Brand - can be image, reputation, or how the organization wants people to think/feel when they hear about/see the brand - can increase competitive advantage - name is important -> first impression (interested or not?) - acronyms as names can be used too
What factors must be considered when deciding which promotional tool/channel to use?
Communication objectives (ie. increasing awareness of a product vs. demonstrating how to use a product) and communication preferences (ie. radio, TV, internet)
"a process by which community groups are helped to identify common problems or goals they have collectively set"
Community organizing
The process of knowing and understanding a PP (consumer orientation) is part of the formative research process. How does formative research for marketing differ from that of needs assessment?
Data they try to uncover is related to consumer analysis (wants, needs, preferences), market analysis (identifying competing behaviours, messages, and programs), and channel analyses (communication preferences)
Price also refers to charging the appropriate amount for the product being provided. What factors influence price?
Demand, location, psychological mindset of people in PP (ie. some wouldn't participate in a free program, others will only participate if it's free etc.)
Planners want rapid diffusion of innovations so they have to target which category of adopters (most influential)?
Early adopters (they're the opinion leaders)
Good management programs are needed to ensure that programs are both effective and efficient. When is a program effective and efficient?
Effective - meet goals and objectives Efficient - best possible use is made of program resources
Final steps in the community organizing/building process
Evaluation (before implementation, maintaining or sustaining the outcomes (may be most difficult), and looping back to a previous step to rethink or rework before proceeding.
Negligence
Failing to act in a prudent (reasonable) manner - Omission -> not doing something when you should - Commission -> doing something you should not be doing
What are the two most common pretesting methods?
Focus groups and central location intercept (grab sampling)
A term used to quantify the number of people working on a program
Full-time equivalent - avg. # hours a person works per week/avg. # hours worked by a full-time employee per week - ie. 20/40 = 0.5 FTE
Seventh step in the process of community organizing: IMPLEMENTING THE PLAN
Identifying/collecting necessary resources for carrying out the solution and creating timeline for implementation - oftentimes resources can be found within a community, thus horizontal relationships are needed - other times resources must be obtained from units located outside the community and vertical relationships are needed
When is there a need to create a program procedural manual (aka training manual)?
If program is very involved (ie. several interventions or very detailed curriculum) and/or has a number of different people facilitating the program
Category of community development: seeks community change through broad self-help participation from the local community
Locality development
Equipment and supplies
May be defined differently (ie. supply = consumable, less than $499; equipment = non-consumable, over $500) -> doesn't matter how it's defined just know how it is as the planner - determine necessary E/S, sources to obtain them, how you'll pay for them
"What it costs the PP to obtain the product and its associated benefits; what they have to 'give up' aka sum of the costs the consumer must accept to engage in the exchange process"
PRICE - may be financial, but often non-financial (ie. social, mental, emotional, behavioural, or psychological costs) - make sure that the benefits the PP receives are greater than what it costs them to obtain the product; or at least make them appear less
"What planners are offering that will meet the consumers' needs, make it easy and convenient to do the behaviour, and provide a benefit that consumers value"
PRODUCT - can be tangible items or services (aka augmented products) - benefits of using a product or service are called "core products" or "bundle of benefits" bc people choose to buy certain products for the value or benefit it provides (ie. you buy a hotel room for a restful night's sleep)
"The communication strategy, including the message and associated visuals or graphics as well as the channels, use to let the PP know about the product, how to obtain or purchase it, and the benefits they will receive"
PROMOTION - aka marketing communications
Pretesting can be completed in what two phases (both occur during the developmental process when products and promotional materials are in draft form, before ideas finalized/promo materials produced)
Phase 1: Testing the product concepts - Get feedback on design of the product + product-related benefits Phase 2: Testing promotional strategy messages/materials - test separately * pretesting allows planners to identify red-flags in the strategy that may reduce chances of success
Four fundamental functions associated with human resources management (PADS)
Planning - personnel (determining what positions are needed to carry out a program and how to fill them) Acquisition - recruiting and selecting personnel - usually advertise on job postings (ie. online) - screen, interview, hire Development - orientation, training, performance appraisal, and professional growth opportunities Sanction - maintaining the expectations and obligations program personnel and their program manager have (through compensation, health and safety, etc.)
Positive feedback from priority population vs. inability to generate feedback
Positive feedback -> cannot indicate the degree to which consumers will like the product/service Inability to generate feedback -> due to small sample size and selection methods
No matter how small the risk of injury to participants (physical or mental), all personnel connected with the planned health promo program should be adequately covered by liability insurance. What is the real key to avoiding liability?
Reduce risk by planning ahead (pg. 362 if you wanna look over them idk)
What measure is used to ensure that materials are suitable for the priority population?
SAM (suitability assessment of materials instrument)
Category of community development: task and process oriented; increases community's problem solving ability to redress imbalances of power and privilege between the oppressed or disadvantaged group and the larger society
Social action
Hard money vs. soft money
Soft money = grants and gifts (bc usually only given for a specific period of time) Hard money - ongoing source of funds
Task development time line (TDTL) vs Gantt chart
TDTL - identifies tasks that need to be completed and the time frame in which the tasks will be completed Gantt chart - same thing but provides an indication of the progress made toward completing the task by using different sized lines to distinguish between the projected time frame for a task and the progress toward completing it. Marks the date at the top. pg. 348 for visual
A relationship in which individuals with specific knowledge and skills share their expertise, via advice or training, with those who need it.
Technical assistance (aka capacity-building assistance) - comes from consultants or funding agencies - typically provided after needs assessment (delivery can be through phone call, written material, face-to-face training etc.)
Social marketing
Uses marketing principles to design programs that facilitate voluntary behaviour change for improved personal or societal well-being
Reporting and documenting needs to be attended to. Planners should keep stakeholders informed about the progress of the program for several different reasons
accountability, PR, motivation of present participants, recruitment of new participants
How do barriers differ from price?
barriers are what keep people from responding to an intervention or doing a behaviour (ie. won't go to a nutrition class bc you can't find a babysitter) - you're not giving anything up
Segmentation categories and variables
box 11.2 pg 318
"a formal alliance of organizations that come together to work for a common goal, often to compensate for deficits in power, resources, or expertise"
coalition
Are internal or external personnel most used/most effective
combination of both is most common and most successful
Marketing, as it relates to health promotion programs, is really a ________-based approach
consumer-based
Continuous monitoring
continually integrating feedback from priority population
What is the goal of segmentation (dividing PP into smaller, more homogenous groups)?
create groups of people who share similar characteristics or qualities that are associated with being at risk for certain health problems and who will respond in a similar way to the intervention
"a developmental process defined as a set of values, principles, behaviours, attitudes, and policies that enable health professionals to work effectively across racial, ethnic, and linguistically diverse populations"
cultural competence * if planners aren't familiar with the culture of those in the PP, it's recommended they work the indigenous health workers and/or those who are well trained bilingual/bicultural
"The seller's goal is to make it possible for consumers to get the product and the associated benefits at a reasonable cost and with minimal effort"
exchange
It is better for the planner to come from within the community (community is often defined by something other than geographical boundaries) and the role they should take is that of a _______ or assistant rather than leader
facilitator
Internal recognition of the issue or concern
grassroots, citizen-initiated, or bottom-up organizing
For exchange to occur between buyers and sellers, the benefits offered by the product must be _______ than what it costs consumers to obtain the product.
greater * benefits must be outcomes that are important and of value to the priority population
The processes selected and used to plan programs are in part predicated on the level of the ________ and that is often predicated on the ___ of the PP.
influence (intrapersonal, interpersonal, and/or community) size
"A ____ model attempts to convey visually the connection between program activities and the program's desired outcomes; that is, the ____ of the program" aka a road map
logic x2
If participating in a program puts anyone at medical risk, these individuals need to obtain what before participating?
medical clearance (signed by physician)
Who should pretesting be completed with?
members of the PP + subject matter experts or gatekeepers
A community is defined as a "group of people who have common characteristics". They characterized by what 6 elements?
membership, common symbol systems, shared values and norms, mutual influence, shared needs and commitment to meeting them, shared emotional connection
In-kind contributions
nonmonetary gifts (ie. equipment, supplies, vehicles, food, services)
Advantages/disadvantages of internal/external personnel
pg 286
Those who assist communities with organizing must make what assumptions?
pg. 258
Greatest limitation of the three community organizing methods proposed by Rothman?
problem-based and organizer centred, rather than strengths-based and community-centred
The first day of implementation (aka program launch) is an extension of the P of marketing called ________.
promotion - creating/sustaining demand for a product -> leads to program initiation
In designing the product or intervention, planners have to make sure they ______ barriers and ______ cost to make it easy for people to obtain the product or service or engage in the desired behaviour.
reduce x2
"human, fiscal, and technical assets available to plan implement and evaluate a program"
resources
Category of community development: heavily task oriented, focused on rational-empirical problem solving, usually by an outside expert
social planning
"a self-contained group of doers that is not ongoing but rather brought together due to strong interest in an issue and for a specific purpose. Sometimes convened at request of an overseeing body or committee."
task force
What three skills does a manager need to be successful?
technical, interpersonal, conceptual
What is the real advantage of using diffusion theory when trying to market a health promo program?
the distinguishing characteristics of people who fall into each category of adopters tend to be consistent across a wide range of innovations (different marketing techniques can be used depending on the type of ppl planners are trying to reach)
Planners most often start the segmentation process by using secondary data including demographic variables (ie. age, gender, income) but what variables are the strongest in social marketing?
variables related to consumers' motives, personality attributes, and lifestyles
Many companies (ie. YMCAS, hospitals) offer or sell programs, services or consulting to groups wanting health promotion programs
vendors
