HS 2250 Unit 4 Readings

what does literature include (step 1)

scientific articles books government publications documents that explain the past and current knowledge of a particular topic

change talk

statements by the client revealing consideration of, motivation for, or commitment to change

what does change talk involve

statements or non-verbal communications indicating the client may be considering the possibility of change.

what does objective types of evidence include

systematic reviews

before making an appeal to decision makers, planners need to what?

to have a sound rationale for creating a program that is supported by evidence that the proposed program will benefit those for whom it is planned

what is the productivity losses due to premature death and exposure to secondhand smoke

$156 billion

what is the total economic cost burden of tobacco use in the U.S.

$300 billion annually

what is the annual medical and lost productivity costs associated with diabetes

$327 billion

how much is spent on direct medical care

($170 billion

advantages to using several strategies at multiple levels of influence

(1) "hitting" the priority population with a message in a variety of ways from multiple levels of influence (2) appealing to the variety of learning styles within any priority population (3) keeping the health message constantly before the priority population (4) hoping that at least one strategy appeals enough to the priority population to help bring about the expected outcome (5) appealing to the various senses (such as sight, hearing, or touch) of each individual in the priority population (6) increasing the chances that the combined strategies would help reach the goals and objectives of the program (e.g., communication used to publicize a policy change)

intervention strategies were categorized into what groups

(1) Health communication strategies (2) Health education strategies (3) Health policy/enforcement strategies (4) Environmental change strategies (5) Health-related community service strategies (6) Health advocacy and community mobilization strategies

program rationale can be written using what following four steps:

(1) Identify appropriate background information (2) title the rationale (3) write the content of the rationale 4) list the references used to create the rationale.

what questions must planners answer yes to for them to adopt an intervention for use in their program

(1) Is there sufficient evidence to show that the intervention has been successful in dealing with the problem in question? (2) Is there sufficient evidence to show that the intervention has been successful in dealing with the problem in question in a population with similar characteristics (e.g., age, sex, culture, racial/ethnic make-up, social circumstances) to the population in the new setting? (3) Is there evidence to show that the intervention was successful in more than one setting? (4) Are there similar resources available in the new setting to ensure the fidelity of the intervention? and (5) Is the new environment setting similar to the environmental setting identified in the evidence?

major Considerations for Creating New Health Promotion Intervention

(1) What needs to change? And, where is the change needed? -Knowing what must be changed is critical to creating an intervention, but understanding the context in which the change will take place is just as critical. -Therefore, when creating an intervention, planners need to analyze the setting—"who is there; how they think or operate; implicit social norms, hierarchies of power; accountability mechanisms; local moral, political, and organizational culture; physical and psychosocial environment; broader sociopolitical and economic context, etc. to make sure the intervention is a good "fit" for those in the priority population (2) At what level of prevention will the program be aimed? -Because of the needs and wants of those in the priority population, planners need to consider at which level or levels of prevention—primary, secondary, and tertiary—the program will be aimed -Similarly, some fields of health promotion consider whether the intervention should be universal (e.g., interventions that focused on the general public or the whole population), selective (e.g., interventions focused on subpopulations deemed to be at higher risk for the health issue), or indicated (e.g., interventions focused on individuals deemed to be vulnerable based on the health issue). Most primary prevention interventions use universal and selective strategies while secondary and tertiary interventions often have a more indicated approach (3) At what level(s) of influence will the intervention be focused? -Program planners must recognize that those in the priority population "live in social, political, and economic systems that shape behaviors and access to the resources they need to maintain good health" -planners need to decide at what level or levels of influence they can best obtain the goals and objectives of the program -Although an intervention can be aimed at a single level of influence, the evidence is mounting that there is a greater chance of changing and maintaining health behaviors if interventions are aimed at multiple levels of influence -planners need to ask and answer the question, "What levels of influence should be addressed to provide the best chances of achieving the program goal and objectives?" (4) What types of intervention strategies are known to be effective (i.e., have been successfully used in previous programs) in dealing with the program focus? -what does the evidence show about the effectiveness of various interventions to deal with the problem that the program is to address? -To assist planners in identifying the best available evidence colleagues (2015) have put forth typologies for classifying interventions based on the level of scientific evidence (5) is the intervention an appropriate fit for the priority population? -Intervention strategies need to be designed to "fit" the priority population. Each priority population has certain characteristics that impact how it will receive an intervention. -The feedback loops that are integral to design thinking are important steps for ensuring fit. When considering fit for the priority population, it is important to consider tailoring, segmenting, and cultural sensitivity. -ask if there is any chance that the strategy could cause any unintended effects in the priority population (6) Are the necessary resources available to implement the intervention selected? -Some intervention strategies require more money, time, personnel, or space to implement than others (7) Would it be better to use an intervention that consists of a single strategy or one that is made up of multiple strategies? -At this point, it is important to consider the multiplicity and dose of the intervention -intervention activities are more likely to be effective if they are aimed at multiple levels of influence that affect individuals' and populations' behaviors and health status *have a greater chance of being successful if they use a socioecological approach (systems approach)

what are some things planners should consider when looking for partners or collaborators

(1) Who is also interested in meeting the needs of the priority population? (2) Who also sees the unmet need of a priority population as a problem? (3) Who has available resources that could help solve a problem?, and (4) Who would benefit from being your partner?

what common characteristics do health promo programs have? what do there characteristics do?

(1) addressing one or more risk factors of the priority population (2) being theory-driven, (3) being based on the best possible evidence (see the discussion of scientific evidence later in the chapter) (4) adhering to professional ethical standards (5) being culturally appropriate (6) being consistent with professional criteria, guidelines, or codes of practice (e.g., United States Department of Health and Human Services guidelines for physical activity (7) using resources efficiently (8) including an evaluation component (9) supporting community initiative and buyin in the design help standardize and ensure the quality of the program, give credibility to a program, help with program accountability, provide a legal defense if a liability situation might arise, and identify ethical concerns that need to be addressed as a part of planning, implementing, and evaluating programs

what three areas does social media play a role in health advocacy

(1) building critical awareness so that supporters who joined your social media page gain more information that drives their desire to contribute more actively to the cause (2) relationship-building can be enhanced through dialogue that takes place between stakeholders via social media platforms (3) mobilizing action through social media activities. Social media consumers tend to be more politically active compared with nonconsumers, and social media can be used to raise awareness about online and offline forums for political engagement

at a community forum participants may be asked to of what

(1) by answering specific questions (2) by completing some type of instrument.

what are the steps in in conducting a needs assessment

(1) determining purpose and defining the scope of the needs assessment (2) gathering data (3) analyzing the data, (4) identifying the risk factors linked to the health problem (5) identifying the program focus, (6) validating the need before continuing with the planning process

in general, useful information and data in writing a program rationale include what (step 1)

(1) express the needs and wants of the priority population, commonly referred to as consumer research data (2) describe the status of the health problem(s) within a given population (3) show how the potential outcomes of the proposed program align with what decision makers feel is important (4) show compatibility with the health plan of a state or the nation (5) provide evidence that the proposed program will make a difference (6) show how the proposed program will protect and preserve the single biggest asset of organizations and communities—their people.

A program complies with the reasonably designed provision if what?

(1) has a reasonable chance of improving the health of, or preventing disease in, participating individuals; (2) is not overly burdensome (3) is not a subterfuge for discrimination based on a health factor; and (4) is not highly suspect in the method chosen to promote health or prevent disease

what does the process of mapping involve

(1) identifying the geographic area that the map will cover (2) collecting the necessary data (3) importing the data into GIS software so that the data can be placed on maps (4) analyzing what is found in the maps

10 general principles of learning

(1) if several of the senses (e.g., seeing, hearing, speaking) are used (2) if the learner is actively involved in the process, rather than a passive participant (3) if the learner is not distracted by discomfort or extraneous events (4) if the learner is ready to learn (5) if that which is to be learned is relevant to the learner and that relevance is perceived by the learner (6) if repetition is used (7) if the learning encountered is pleasant, if progress occurs that is recognizable by the learner, and if that learning is recognized and encouraged (8) if the material to be learned starts with what is known and proceeds to the unknown, while concurrently moving from simple to complex concepts (9) if the application of concepts to several settings occurs, which generalizes the material (10) if it is paced appropriately for the learner

what are the different ways of advocating for health and health education (pg.81)

(1) influencing voting behavior (2) electioneering (3) direct lobbying (4) integrating grassroots lobbying into direct lobbying efforts (5) using the Internet, (6) media advocacy—newspaper letters to the editor and opinion-editorial (op-ed) articles (7) media advocacy—acting as a resource person

what are the unique characteristics of social media

(1) it is user or consumer-generated, organized, and distributed; information can be revised or updated almost immediately; (2) it is typically low cost in terms of creation and maintenance (3) it can reach broader, more diverse audiences (4) it is generally entertaining to use. Many different forms of social media allow for content management (collaborative writing, e.g., wikis), content sharing (e.g., podcasts, Webinars, widgets, eCards), social bookmarking (i.e., tagging, saving, searching, and rating websites, e.g., Digg), social gaming, social journaling (e.g., blogs), social networking (e.g., Instagram, Facebook, LinkedIn, Twitter, Reddit), social news (i.e., tagging, voting for, and commenting on news articles, e.g., Newsvine), social video and photo sharing (e.g., YouTube, Flickr), and syndication (e.g., real simple syndication [RSS] feeds)

what are some reasons to partner

(1) meeting the needs of a priority population, which could not be met by the capacities of a single individual or organization (2) sharing of financial and other resources (3) solving a problem or achieving a goal that is a priority to several partners (4) bringing more stakeholders to the process (5) bringing more credibility to the program (6) working with others who have the same values (7) seeing and solving a problem from multiple perspectives and thus creating different effects (8) creating a greater response to a need because there is strength in numbers.

what are some validation or double checking means

(1) rechecking the steps followed in the needs assessment to eliminate any bias (2) conducting focus groups with individuals from the priority population to determine their reaction to the identified need (3) getting a "second opinion" from other health professionals (4) Another way to validate the prioritized needs is to ensure they compare favourably with the social norms of the priority population. *In other words, do the priorities identified in the needs assessment match up with what planners know about the values, beliefs, and interests that tend to guide and motivate people in the priority population

cell phones and social media can be used for what

(1) recruiting people to join the cause (2) organizing collective action (3) raising awareness and shaping attitudes, (4) raising funds to support the cause, and (5) communicating with decision makers

greatest potential of social media use in health promotion interventions

(1) the Internet as a platform to deliver behavior change interventions (e.g., weight-loss programs) (2) the Internet to promote health promotion programs (e.g., viral marketing); (3) the Internet and mobile devices for community mobilization or advocacy (e.g., organizing youth to get involved in civic affairs)

what are some other things that logic models can contain?

(1) the purpose or mission of the program (2) the context, conditions, or situations under which the program will be offered (3) assumptions associated with the planned program (4) external factors that could influence the success of the program (5) a description of the evaluation of the proposed program. There is no one right way to create a logic Model

what are three main goals of photo voice

(1) to enable people to record and reflect their community's strengths and concerns (2) to promote critical dialogue and enhance knowledge about issues through group discussions of the photographs (3) to inform policy makers

what are some benefits to effective priority setting

(a) building consensus among the stakeholders for the allocation of resources in areas most likely to yield positive and sustainable outcomes (b) clarifying expectations for the use of resources in a constrained environment (c) helping to establish focus on issues based on objective criteria, and helping establish a chain of accountability for the stakeholders

what are some obstacles in priority setting

(a) lack of quality data (b) conflicting political dynamics and agendas (c) stakeholder fatigue with the assessment process (d) poorly developed and/ or understood criteria (e) lack of equity in stake-holder participation and processes

effective interventions

-2nd level -have been peer-reviewed but are not part of a systematic or narrative review -these interventions may be very good but have less evidence backing them example: article that appears in the scientific literature

observation - Advantages and Disadvantages

-Accurate behavioral data -Can be obtrusive -Moderate cost -Requires trained observers -May bias behavior -Possible observer bias -May be time-consuming

example of social math

-Break the numbers down by time -Break the numbers down by place -Provide comparisons with familiar things -Provide ironic comparisons -Localize the numbers

Collaboration (vs. Confrontation)

-Collaboration is a partnership between the therapist and the client -grounded in the point of view and experiences of the client -This contrasts with some other approaches to substance use disorders treatment, which are based on the therapist assuming an "expert" role, at times confronting the client and imposing their perspective on the client's substance use behavior and the appropriate course of treatment and outcome.

self assesment- Advantages and Disadvantages

-Convenient -No interviewer bias -Moderate cost -Minimum staff time required -Easy to administer -Flexibility -Possible low response rate -Possible problem of representativeness -Self-selection

nominal group process - Advantages and Disadvantages

-Direct involvement of priority groups Planned interactivity -Diverse opinions -Full participation -Creative atmosphere -Recognition of common ground -Time commitment -Competing issues -Participant bias -Segmented planning involvement

Express Empathy

-Empathy involves seeing the world through the client's eyes, thinking about things as the client thinks about them, feeling things as the client feels them, sharing in the client's experiences -This approach provides the basis for clients to be heard and understood, and in turn, clients are more likely to honestly share their experiences in depth -process of expressing empathy relies on the client's experiencing the counselor as able to see the world as they (the client) sees it

what are the two primary purposes in reflections (OARS)

-First is to bring to life the principle of Expressing Empathy -By careful listening and reflective responses, the client comes to feel that the counselor understands the issues from their perspective. -Second, strategic use reflective listening is a core intervention toward guiding the client toward change, supporting the goal-directed aspect of MI -In this use of reflections, the therapist guides the client towards resolving ambivalence by a focus on the negative aspects of the status quo and the positives of making change

meetings - Advantages and Disadvantages

-Good for formative evaluation -Low cost -Flexible -Possible result bias -Limited input from some individuals

group interviews- Advantages and Disadvantages

-High response rate -Efficient and economical -Can stimulate productivity of others -May intimidate and suppress individual differences -Fosters conformity Group pressure

face to face interviews - Advantages and Disadvantages

-High response rate -Flexibility -Gain in-depth data -Develop rapport -Can observe nonverbal behavior -Expensive -Requires trained interviewers -Possible interviewer bias -Limits sample size -Time-consuming

Considerations When Developing a Planning Committee (7)

-If the planning committee will be in place for a long time, new individuals should be added periodically to generate new ideas and energy. It may be helpful to set term limits for committee members -If terms of office are used, it is advisable to stagger the length of terms so that there is always a combination of new and experienced members on the committee.

why is The Community Guide an essential planning tool

-It uses a science-based approach to determine the effectiveness of an intervention and whether it is cost-effective. -It helps identify appropriate interventions for behaviour change, disease prevention, and environmental change. -It identifies where there is sufficient evidence and where more research is needed related to effective interventions. -It complements the science and rationale associated with Healthy People 2030 and the Guide to Clinical Preventive Services (Community Preventive Services Task Force, 2021b)

mail surveys - Advantages and Disadvantages

-Large outreach -No interviewer bias -Convenient -Lower costs -Minimum staff time required -Easy to administer Standardized -Possible low response rate -Possible problem of representation -No clarification of questions -Need homogenous group if response is low -No assurance that addressee was the respondent

focus groups - Advantages and Disadvantages

-Low cost -Convenient -Creative atmosphere -Ease of clarification -Flexibility -Groupthink -Limited representativeness -Dependence on moderator skill -Preliminary insights -Participant involvement

Online Surveys - Advantages and Disadvantages

-Low to moderate costs -Ease and convenience -Almost instantaneous -Commercial companies' services -Wide geographic coverage -Must have Internet access -Self-selection -May lack anonymity -Email addresses may be difficult to acquire

Delphi technique- Advantages and Disadvantages

-Pooled responses -Spans time and distance -High motivation and commitment -Reduced influence of others -Enhanced response quality and quantity -Equal representation -Consistent participant involvement -High cost and time commitment -Reduced clarification opportunities -Reduced immediate reinforcement

what does primary data have the advantage of? what are some cons of primary data?

-Primary data have the advantage of directly answering the questions planners want answered about the priority population -can be expensive and when done correctly -take a great deal of time and effort

original definition of Motivational Interviewing (MI)

-R. Miller in 1983 -developed from his experience in the treatment of problem drinkers. Through clinical experience and empirical research

telephone interviews- Advantages and Disadvantages

-Relatively easy to administer -Permits unlimited callbacks -Can cover wide geographic areas -Immediate data collection (as soon as respondent agrees to participate) -moderate to higher costs -Respondent can hang up -Telemarketers and robocalls can create hesitancy among potential respondents -Possible problem of representation -Possible interviewer bias -Requires trained interviewers -Wireless-only households -Unlisted number of households

community forum (town hall meeting)- Advantages and Disadvantages

-Relatively straightforward to conduct -Relatively inexpensive -Access to a broad cross-section of the community -People participate on their own terms -Can identify most interested -Often difficult to achieve good attendance -Participants may tend to represent special interests -Forum could degenerate into complaint session -Data analysis can be time consuming

what are some major steps that are in guides/ frameworks used to conduct a HIA

-Screening (identify plans, projects, or policies for which an HIA would be useful) Scoping (identify which health effects to consider) -Assessing risks and benefits (identify which people may be affected and how they may be affected) -Developing recommendations (suggesting changes to proposals to promote positive health effects or minimize adverse health effects) -Reporting (present the results to decision makers) -Monitoring and evaluating (determining the effect of the HIA on the decision)

When deciding on how best to intervene to reach the program goals and objectives, program planners have what three avenues available to them

-adapt an existing intervention that is supported by evidence showing it was effective elsewhere but the circumstances or setting in which it was used were different from the proposed setting -design a new intervention

who is the leader

-aka chairperson -should be knowledgeable about the health problem being addressed, familiar with the community, have the respect of partners, and be capable of leading a group through the planning process

single step surveys

-aka cross-sectional (point-in-time) surveys -means of gathering primary data from individuals or groups with a single contact example: -online surveys -mail surveys -face-to-face interviews -telephone interviews

proxy measure

-aka indirect measure -involves an outcome measure that provides evidence that a behaviour has occurred example: (1) lower blood pressure for taking medication (2) body weight for exercise and dieting (3) cotinine in the blood for tobacco use (4) empty alcoholic beverages in the trash for consumption of alcohol (5) another person reporting on the compliance of their partner

Reflections

-aka reflective listening -most crucial skill in Motivational Interviewing. -several levels of reflection ranging from simple to more complex -Different types of reflections are skillfully used as clients demonstrate different levels of readiness for change example: some types of reflections are more helpful when the client seems resistant and others more appropriate when the client offers statements more indicative of commitment to change.

problem statement

-aka statement of the problem -declaration of the health problem

logic model

-aka theory of change -systematic and visual way for planners to share and present their understanding of the relationship among the resources they have to operate a program, the activities they plan to implement, and the outputs and outcomes they hope to achieve basically: road map showing the connections among the key components of a program

community forum

-aka town hall meetig brings together people from the priority population to discuss what they see as their group's problems/needs

windshield tour

-aka waling survey -person(s) doing the observation "walks or drives slowly through a neighborhood, ideally on different days of the week and at different times of the day, "on the lookout" for a whole variety of potentially useful indicators of community health and well-being

what are some examples of environmental factors

-applies to more than just the physical environment (e.g., clean air and water, proximity to facilities) -economic environment (e.g., affordability, incentives, disincentives) -service environment (e.g., access to health care, equity in health care, barriers to health care) -social environment (e.g., social support, peer pressure); -psychological environment (e.g., emotional learning environment) -political environment (e.g., health policy)

Support Self-Efficacy

-client's belief that change is possible (self-efficacy) is needed to instill hope about making those difficult changes -Clients often have previously tried and been unable to achieve or maintain the desired change, creating doubt about their ability to succeed -Motivational Interviewing, counselors support self-efficacy by focusing on previous successes and highlighting skills and strengths that the client already has

what should the problem statement begin with? what should it contain?

-concise explanation of the issue that needs to be considered -why it is a problem and why it should be addressed -supporting data for the problem, including what could possibly happen if the problem is not corrected

what are some sources of secondary needs assessment data

-data collected by government agencies at multiple levels (federal, state, or local) -data available from nongovernment agencies and organizations -data from existing records (e.g., medical records) -data or other evidence that are presented in the literature

what was the Collaboration Multiplier designed for

-designed to guide an organization to a better understanding of which partners it needs and how to engage them -for organizations that already work together, so they may identify activities to achieve a common goal, identify missing sectors that can contribute to a solution, delineate partner perspectives and contributions, and leverage expertise and resources

outputs

-direct results of the activities and include things such as products (e.g., curricula, educational DVDs, new software, data collection tools), -services (e.g., in-service trainings, screenings, counseling, events) -new components of infrastructure (e.g., structure, capacity, process, and relationships)

how is MI different

-does not impose change (that may be inconsistent with the person's own values, beliefs or wishes) -supports change in a manner congruent with the person's own values and concerns

Basic Priority Rating (BPR) Model

-first known as priority rating process -introduced more than 65 years ago in an attempt to prioritize health problems in developing countries

emerging interventions

-fourth level -ongoing works, practice-based summaries, or evaluation works in progress example: pilot studies -Often, emerging interventions are created by the planners based on their knowledge and skills of good planning processes including the involvement of those in the priority population

nominal group process

-highly structured process in which a few knowledgeable representatives of the priority population (5 to 7 people) are asked to qualify and quantify specific needs -Those invited to participate are asked to record their responses to a question without discussing it among themselves -Once all have recorded a response, participants share their responses in a round-robin fashion -While this is occurring, the facilitator is recording the responses on a computer screen, whiteboard, or flipchart, etc., for all to see -responses are clarified through a discussion. -After the discussion, the participants are asked to rank-order the responses by importance to the priority population -ranking may be considered either a preliminary or a final vote -If it is preliminary, it is followed with more discussion and a final vote.

What do inputs include?

-human resources (and related items like training, technical assistance, volunteers), -partnerships -funding sources -equipment -supplies -materials -community resources (e.g., space, gifts)

Steps for Conducting a Literature Search

-identifying the need of the priority population or topic to be searched. -->At this point, planners can search either by subject/title or by author. -->if planners know of an author who has done work on their topic, they can search the database using the author's last name -->If they do not have information on authors, they will need to match their topic with the keywords presented in the thesaurus -Once they have a list of keywords, they need to search the database for possible matches. -This search should identify possible sources and citations -Once sources are identified, planners may review abstracts online or locate a hard copy of the document -Then, planners must determine the quality and usefulness of the publication in the needs assessment process. -->planners can judge the quality of the literature by examining the references at the end of the publications. -->First, this reference list may lead planners to other sources not identified in the original search -->Second, if the sources found in the database include all those commonly cited in the literature, this can verify the exhaustiveness of the search

when should a needs assessment not be used

-if another needs assessment had been conducted recently, possibly for another related program, and the funding or other resources to conduct a second needs assessment in such a short period of time were not available. -program planners are employed by an agency that only deals with a specific need that is already known or the agency for which they work has received categorical funds, which are earmarked for or dedicated to a specific disease, health determinant, or program

community

-includes geographic distinctions (e.g., communities in general, schools, healthcare settings, worksites, other organizations). -represents any collective body within the broader community that shares commonalities such as interests, experiences, concerns, values, race, ethnicity, or culture, etc.

why do we have to conduct a needs assessment before any other steps

-logical place to start *Planners must identify and measure a need before they can address or meet it -needs assessment can help planners allocate resources to programs and activities with the greatest likelihood of providing maximum health benefit *Without determining and prioritizing needs, planners can waste scarce resources on unsubstantiated programming -needs assessment allows planners to "apply the principles of equity and social justice in practice" by focusing on those with the greatest need -failure to perform a needs assessment may lead to a program focus that prevents or delays adequate attention directed to a more critical health problem -needs assessment can determine a community's capacity to address specific needs -helps develop interventions to meet the needs of the priority population -knowing the needs of a priority population offers a reference point for comparisons to future assessments.

why are Health policy/enforcement strategies controversial

-mandates a particular response from those governed by it -It takes away individual freedoms and sometimes plays on a person's pride, pocketbook, and psyche. -runs counter to a fundamental emphasis on property rights, economic individualism, and competition in American political culture -americans more concerns about what government will do to control them then what they will do to benefit them

cons of secondary data

-may not identify the true needs of the priority population based on how the data were collected and interpreted

policy implementation

-necessary human and financial resources must be assembled to make the policy work. -those who are implementing the new policy must use good judgment and show respect for others when doing so.

drawbacks of using internet for interviewing

-not everyone has access -obtaining email addresses of potential respondents can be difficult -some people are still uncomfortable for various reasons with using a computer or other personal device

Education Resource Information Center (ERIC)

-online digital library of education literature sponsored by the Institute of Education Sciences (IES) of the U.S. Department of Education -provides free access to educational journal articles and other education-related materials

how can we sell program to those at top

-planners need to develop a rationale that shows how the new program will help decision makers meet the organization's goals and, in turn, carry out its mission -planners need to position their program rationale politically and culturally, in line with the organization

how can we stop the decline of mail response rates

-pre-notice in the form of a letter that has advantages over a postcard (e.g., use of stationery and personalized address), thus tailoring the request -nominal financial incentive ($1-$5) included with the survey

PsycINFO

-produced by the American Psychological Association (APA) -an abstracting (not full-text) and indexing database of peer-reviewed literature in the behavioral and social sciences

Cumulative Index to Nursing & Allied Health Literature (CINAHL)

-provides indexing of journals from the fields of nursing and other allied health disciplines -also provides indexing for healthcare books, dissertations from the field of nursing, selected conference proceedings, and standards of practice. -Subject headings follow the NLM's MeSH® structure.

how can observe bias be reduced

-providing training -by determining rater reliability

summary of chapter 1

-rationale should show how the benefits of the program align with the values of the decision makers, address the potential return on investment, and be backed by the best evidence available. -A planning committee can be most useful in helping with some of the planning activities and in helping to communicate the value and benefits of the program to the priority population -When the planning committee is being formed, consider potential collaborating partners -Planning committee members should include program stakeholders including interested individuals, doers and influencers, and others who are representative of the priority population -If the planning committee is to be effective, it will need to work efficiently and to know the planning parameters set for the program by the decision makers

what are some advantages of online surveys

-reduced response time -ease of data collection -flexibility in the design and format of the questionnaire -control over the administration such as distribution to the recipients all at the same time on the same day, -recipient familiarity with the format and technology -responses received can be formatted to enter directly into a program or spreadsheet/ statistical package eliminating manual data entry or scanning

MEDLINE PLUS and MEDLINE PubMed

-service of the National Library of Medicine (NLM), which is part of the National Institutes of Health (NIH) -authoritative health information website for the public on a broad range of health topics -MEDLINE is the main part of PubMed, an online, searchable, database of research literature in the biomedical and life sciences. PubMed includes links to many full-text journal articles via PubMed Central

what is the primary output of health impact assessment (HIA)

-set of evidence-based recommendations geared to informing the decision-making process -hese recommendations aim to highlight practical ways to enhance the positive aspects of a proposal, and to remove or minimise [sic] any negative impacts on health, well-being and health inequalities that may arise or exist

policy adoption or approval

-takes place when the authoritative individual or group "approves" the formulated policy -depending on the policy being considered, politics can impact the outcome.

Considerations When Developing a Planning Committee (1)

-the committee should be composed of individuals who represent a variety of subgroups within the priority population -To the extent possible, the committee should have representation from all segments of the priority population -The greater the number of individuals who are represented by committee members, the greater the chance of the priority population developing a feeling of program ownership -With program ownership, there will be better planned programs, greater support for the programs, and people who will be willing to help sell the program to others because they feel it is theirs

Considerations When Developing a Planning Committee (3)

-the committee should include willing individuals who are interested in seeing the program succeed. -Select a combination of doers and influencers. -Doers are people who will be willing to "roll up their sleeves" and do the necessary work to plan and implement the program. -Influencers are those who, with a single phone call, email, or text, will enlist other people to participate or will help provide the resources to facilitate the program -Both doers and influencers are important to the planning process

promising interventions

-third level -deemed effective via a program evaluation but without formal peer review example: state or federal government reports that have not gone through peer review

how does Delhi process begin?

-those collecting the data asking the priority population to respond to one or two broad questions -responses are analyzed, and a second questionnaire with more specific questions based on responses to the first questionnaire, is developed and sent to the priority population. -answers to these more specific questions are analyzed again, and another new questionnaire is created and sent out, requesting additional information

what are some things that built environment include

-transportation systems (e.g., mass transit) -urban design features (e.g., bike paths, sidewalks, adequate lighting) -parks and recreational facilities -land use (e.g., community gardens, location of schools, trail development) -building with health-enhancing features (e.g., green roofs, stairs) -road systems -housing free from environmental hazards

adult learning principles

1) Adults need to know why they are learning. 2) Adults are motivated to learn by the need to solve problems. 3) Adults' previous experience must be respected and built upon. 4) Adults need learning approaches that match their background and diversity. 5) Adults need to be actively involved in the learning process

opinion leaders are...

1) Discriminating users of media, data, and activity that are community-related 2) Demographically similar to the priority group 3) Knowledgeable about community issues and concerns 4) Early adopters of innovative behavior 5) Active in persuading others to become involved in innovative behaviour

what are the six health strategies

1) Health communication 2) Health education 3) Health policy/enforcement 4) Environmental change 5) Health-related community service 6) Health advocacy and community mobilization

Motivational Interviewing include three essential elements

1) MI is a particular kind of conversation about change (counseling, therapy, consultation, method of communication) 2) MI is collaborative (person-centered, partnership, honors autonomy, not expert- recipient) 3) MI is evocative (seeks to call forth the person's own motivation and commitment)

what are some ways to overcome limitations and maximize the usefulness of self reported data

1) Select measures that clearly reflect program outcomes 2) Select measures that have been designed to anticipate the response problems and that have been validated 3) Conduct a pilot study with the priority population. 4)Anticipate and correct any major sources of unreliability. 5) Employ quality-control procedures to detect other sources of error. 6) Employ multiple methods. 7) Use multiple measures. 8) Use experimental and control groups with random assignment to control for biases in self-report.

what are the four components in BPR 2

1) Size of the problem (0 to 10) 2) Seriousness of the problem (0 to 20) 3) Effectiveness of the possible interventions (0 to 10) 4) Propriety, economics, acceptability, resources, and legality (PEARL) (0 or 1)

what are some things planners should consider before conducting a needs assessment

1) What are the values and principles driving the interest in the needs assessment? Are these values and principles broadly understood and appreciated? Is there a shared vision? 2) What is the purpose of the needs assessment? Does an external agency require it? If so, the parameters of the process are likely already identified. If the interest in performing a needs assessment originates within a community, what parameters will guide this type of needs assessment? Is the purpose of the needs assessment to identify health problems and their determinants, to identify forces or other elements in the community that lead to health problems, or to assess the capacity and resources of a community, etc. 4) If there is a predetermined need in the community, how is the community already addressing the problem? Who are the existing partners? Has a priority population been identified? If so, what is known about this population? What types of programs or approaches will be most effective in addressing needs within this population? 5) Have broad or narrow needs assessments been previously conducted within the community? What can be learned from what is already known? 6) Who will conduct the needs assessment? Is there adequate organizational and individual diversity and representation to ensure that the right methods and questions are being asked and the appropriate data are being collected?

When setting priorities, the planners should seek answers to what questions

1) What is the most pressing need? Why? 2) Are there adequate resources to deal with the problem? 3) Can the problem best be solved by a health promotion intervention, or could it be handled better through another means? 4) Are effective intervention strategies available to address the problem? 5) Can the problem be solved in a reasonable amount of time?

program planners should seek to determine the status of existing health promotion programs by trying to answer as many of what questions possible

1) Which health promotion programs are presently available to the priority population? 2) Are the programs being utilized? If not, why not? 3) How effective are the programs? Are they meeting their stated goals and objectives? 4) How were the needs for these programs determined? 5) Are the programs accessible to the priority population? Where are they located? When are they offered? Are there any qualifying criteria that people must meet to enroll? Can the priority population get to the program? Can the priority population afford the programs 6) Are the needs of the priority population being met? If not, why not?

the first domain has four key standards what are they?

1) a collaborative process that results in a comprehensive assessment (2) collecting and maintaining reliable, comparable, and valid data for decision making (3) analyzing data for trends (4) using results to develop recommendations that become the basis for program development and implementation

what four values are HIAs based on

1) democracy (i.e., all who are impacted by the proposed change get to participate in the assessment) (2) equity (i.e., all who will be impacted by the proposed change are treated fairly in the assessment) (3) sustainable development (i.e., both short- and long-term impacts of the proposed change are considered as part of the assessment) (4) ethical use of evidence (i.e., evidence used in the assessment includes both qualitative and quantitative evidence and is collected using best practices)

five Events of Instruction (look at page 76)

1) gain attention (convey health threats and benefits) (2) present stimulus material(target or tailor the message to audience knowledge and values, demonstrate observable effectiveness, make behaviors easy to understand and do) (3) provide guidance (use trustworthy models to demonstrate) (4) elicit performance and provide feedback (to develop proficiency and self-efficacy) (5) enhance retention and transfer (provide social support and deliver behavioral cues)

why is mapping a good tool

1) it makes patterns based on place much easier to identify and analyze, and 2) it provides a visual way of communicating those patterns to a broad audience, quickly and dramatically

Makeup of a Solid Planning/Steering Committee

1.represnetatives of all segments of priority pop. 2.doers 3.influencers 4.representative of sponsoring agency 5.other stakeholders 6.good leadership =solid committee

what percents of those 18+ in the US smoke

14%

how much higher are medical expidentures for people with diabetes

2.3x

what is the acceptable industry response rates for online surveys

20-30%

when was PHAB created

2007

labour costs represent typically re[resent a total annual operating costs for most organizations of how much

60-70%

how much have response rates gone down for mailed surveys

77% in the 1970s to 43% in the 2010s and a projected average of 21% in the 2030s

how many people do focus groups contain

8-12 people

what are some potentially useful indicators in windshield tours

A) Housing types and conditions (B) Recreational and commercial facilities (C) Private and public sector services (D) Social and civic activitie (E) Identifiable neighborhoods or residential clusters (F) Conditions of roads and distances most traveled (G) Maintenance of buildings, grounds and yards

what are some strategies for evoking change talk

Ask Evocative Question Explore Decisional Balance Good Things/Not-So-Good Things Ask for Elaboration/Examples Look Back Look Forward Query Extremes Use Change Rulers Explore Goals and Value Come Alongside

Look Back

Ask about a time before the target behavior emerged. How were things better, different?

Good Things/Not-So-Good Things

Ask about the positives and negatives of the target behavior

Ask evocative questions

Ask an open question, the answer to which is likely to be change talk

Explore Decisional Balance

Ask for the pros and cons of both changing and staying the same.

Look Forward

Ask what may happen if things continue as they are (status quo). Try the miracle question: If you were 100% successful in making the changes you want, what would be different? How would you like your life to be five years from now?

formula of BPR

BPR= (A+B)C/ 3 X D

Considerations When Developing a Planning Committee (8)

Be aware of the "politics" that are always present in an organization or priority population. It is common for people to bring their private agendas and biases to committee work

Cost-Benefit Analysis (CBA)

CBA of a health promotion program will yield the dollar benefit received from the dollars invested in the program

wht is a helpful tool to calculate the financial burden of chronic disease

Chronic Disease Cost Calculator Version 2 created by the Centers for Disease Control and Prevention and RTI International

implementing change talk

Commitment (I will make changes) Activation (I am ready, prepared, willing to change) Taking Steps (I am taking specific actions to change)

Considerations When Developing a Planning Committee (6)

Committee membership should be reevaluated regularly to ensure that the composition lends itself to fulfilling program goals and objectives

prepretory change talk

Desire (I want to change) Ability (I can change) Reason (It's important to change) Need (I should change)

step 1 of conducting a needs assessment

Determining the Purpose and Scope of the Needs Assessment -what is the goal of the needs assessment?

what is the value/ benefit for a community

Establishing good health as a norm; improved quality of life; improved economic well-being of the community; providing a model for other communities

what type of source of evidence is substance Abuse and Mental Health Services Administration

Evidence Based Practices Resource Center Type of Evidence: Searchable online registry of substance abuse and mental health interventions to incorporate evidence-based practices into communities or clinical settings.

Come Alongside

Explicitly side with the negative (status quo) side of ambivalence. "Perhaps _______is so important to you that you won't give it up, no matter what the cost."

four Principles of Motivational Interviewing

Express Empathy Support Self-Efficacy Roll with Resistance Develop Discrepancy

step 2 of conducting a needs assessment

Gathering Data -Once relevant secondary data have been identified, planners need to turn their attention to gathering the appropriate primary data in order to fill in the "data gaps" to better understand the needs of the priority population

what type of source of evidence is Task Force on Community Preventive Services

Guide to Community Preventive Services Type of evidence: Programs and policies to improve health and prevent disease in communities.

Strategies Li and Bernoff

How do you want relationships to change (e.g., customers to carry your messages; customers to become engaged)?

Strategies Thackeray & Bennion

How will you use the marketing mix (i.e., product, price, place, promotion)?

step 4 of conducting a needs assessment

Identifying the Risk Factors Linked to the Health Problem -planners need to identify the determinants of the health problem identified in the previous step -That is, what genetic, behavioral, and environmental risk factors are associated with the health problem? -identify and prioritize the behavioral and environmental factors that, if changed, could lessen the health problem in the priority population

Considerations When Developing a Planning Committee (2)

If the program that is being planned deals with a specific health risk or problem, it is important that someone with that health risk (e.g., smoker) or problem (e.g., diabetes) be included on the planning committee

what is the value/ benefit for a employee/ individual

Improved health status; reduction in health risks; improved health behavior; improved job satisfaction; lower out-of-pocket costs for health care; increased well-being, self-image, and self-esteem

what is the value/ benefit for an employer

Increased worker morale; enhanced worker performance/productivity; recruitment and retention tool; reduced absenteeism; reduced disability days/claims, reduced health care costs; enhanced corporate image

what are focus groups used to obtain

Information about the feelings, opinions, perceptions, insights, beliefs, misconceptions, attitudes, and receptivity of the priority population concerning an idea or issue

when did PHAB create Accreditation Standards and Measures

July 2011

The "Spirit" of Motivational Interviewing

MI is more than the use of a set of technical interventions. It is characterized by a particular "spirit" or clinical "way of being" which is the context or interpersonal relationship within which the techniques are employed.

Considerations When Developing a Planning Committee (9)

Make sure the committee is large enough to accomplish the work, but small enough to be able to make decisions and reach consensus -If necessary, subcommittees can be formed to handle specific tasks.

OARS

Often called micro counseling skills, OARS is a brief way to remember the basic approach used in Motivational Interviewing

what is one systematic way to analyze data? what are some questions to be asking

PRECEDE-PROCEED model for guidance 1) What is the quality of life of those in the priority population? 2) What are social conditions and perceptions shared by those in the priority population? 3) What are the social indicators (e.g., absenteeism, crime, discrimination, performance, welfare, etc.) in the priority population that reflect the social conditions and perceptions? 4) Can the social conditions and perceptions be linked to health promotion? If so, how? 5) What are the health problems associated with the social problems? 6) Which health problem is most important to change?

what does POST stand for?

People Objectives Strategy Technology

health education

Planned learning experiences that provide knowledge and skills to the learners in a more formal educational setting example: Course classes trainings workshops seminars

what type of source of evidence is Canadian Task Force on Preventive Health Care

Practice guidelines that support primary care providers in delivering preventive health care. Also, has information for the general public

what type of source of evidence is Campbell Collaboration

Produces systematic reviews on the effects of governmental and other social interventions including crime and justice, education, international development, and social welfare

what should be at the core of any health promotion program

Promoting, maintaining, and, in some cases restoring human health

If the planner is using multistrategy interventions, review of what is recommended

RE-AIM framework developed by Glasgow et al.

what are the three categories of findings based on systematic reviews of peer reviewed literature

Recommended Insufficient Recommended against

what type of source of evidence is National Cancer Institute

Research-tested Intervention Programs Type of evidence: A searchable database of cancer control interventions and program materials that are designed to provide program planners and public health practitioners with easy and immediate access to program materials.

Health-related Community Service

Services, tests, treatments, or care to improve the health of those in the priority population examples Health-risk assessments immunizations screenings checkups examinations

what are some sources of primary data

Single-Step or Cross-Sectional Surveys -From priority population—self-report *Online surveys Mail surveys *Face-to-face interviews *Telephone interviews *Proxy measures *From significant others *From opinion leaders *From key informants -Multistep Survey: Delphi Technique -Community Forum (Town Hall Meeting) Meetings -Focus Group -Nominal Group Process -Observation *Direct observation *Indirect observation (proxy measures) *"Windshield" or walk-through *(walking tours) Photo voice and video voice -Self-Assessments

Steps in Creating a Program Rationale

Step 1: Identify Appropriate Background Information Step 2: Title the Rationale Step 3: Writing the Content of the Rationale Step 4: Listing the References Used to Create the Rationale

Health Policy/Enforcement

Strategies that are mandated or regulated, such as executive orders, laws, ordinances, judicial decisions, policies, regulations, rules, and position statements examples: Laws ordinances judicial decisions policies regulations rules position statements

Environmental Change

Strategies that help remove barriers in the environment and add health-enhancing features. Environments include physical, economic, service, social, cultural, psychological, and political environments example: Smoke-free workplaces seat belts airbags car seats speed bumps signage social support peer pressure access to services

Health Advocacy and Community Mobilization

Strategies to help communities identify and take action on shared concerns using participatory decision making and include such methods as empowerment examples: coalitions photovoice

what type of source of evidence is Cochrane

Synthesized research evidence on health and health care. Can be searched using various terms including health education and health promotion

what type of source of evidence is Centre for Reviews and Dissemination; The University of York

Systematic reviews and economic evaluations covering a wide variety of healthcare topics, many of which impact national policy.

who made The Community Guide and how often is it updated

Task Force on Community Preventive Services

what type of source of evidence is U.S. Preventive Services Task Force

The Guide to Clinical Preventive Services Type of evidence: Recommendations on the use of clinical preventive services such as screening tests, counseling services, and preventive medications.

Considerations When Developing a Planning Committee (4)

The committee should include an individual who has a key role within the organization sponsoring the program—someone whose support would be most important to ensure success

Heath Communication

Using communication methods to inform and influence community understanding and decisions relating to health issues example: Mass media entertainment education print materials social media

step 6 of conducting a needs assessment

Validating the Prioritized Needs

Query Extremes

What are the worst things that might happen if you don't make this change? What are the best things that might happen if you do make this change?

Post Li and Bernoff

What are they ready for?

Objectives Thackeray & Bennion

What do you want to happen (i.e., a change in attitudes, knowledge, and/or behavior)?

People Thackeray & Bennion

What technology do they use? Why?

Technology Li and Bernoff

What technology to use?

Technology Thackeray & Bennion

What technology will you use, given what you are trying to accomplish?

complex interventions

When interventions include multiple strategies offered at multiple levels of influence to multiple groups, they often include several interacting components or "active ingredients."

Objectives Li and Bernoff

Why do you want to pursue the groundswell?

Motivational Interviewing (2009)

a collaborative, person-centered form of guiding to elicit and strengthen motivation for change

what can Information and data that express the needs and wants of the priority population can be generated through

a needs assessment

advantage of mail surveys

ability to reach mass geographic area so they can get a large number of respondents in a small period of time

literacy

ability to use printed and written information to function in society, to achieve one's goals, and to develop one's knowledge and potential

Capacity building

activities that enhance the resources of individuals, organizations, and communities to improve their effectiveness to act.

three avenues for designing health promotion interventions

adopting, adapting, or creating a new intervention

six phases of policymaking

agenda-setting policy formulation policy adoption policy implementation policy assessment policy modification

Secondary data

already collected by somebody else and available for your use

What is MI now established as

an evidence-based practice in the treatment of individuals with substance use disorders

Community building

an orientation to practice focused on community, rather than a strategic framework or approach, and on building capacities, not fixing problems

design thinking

analytic and creative process to help people and agencies understand a community's needs, experiment with possible solutions, and create solution prototypes, such as a health promotion intervention

step 3 of conducting a needs assessment

analyzing the data

tailoring

any combination of information or change strategies intended to reach one specific person, based upon characteristics that are unique to that person, related to the outcome of interest, and have been derived from an individual assessment

Health Impact Assessment (HIA)

approach that can help to identify and consider the potential—or actual—health impacts of a proposal on a population.

what is at the base of the health impact pyramid? what do they require?

areas of intervening that have a large population impact but require less individual effort to achieve change policy changes and the efforts of multiple agencies and services in the health system

partnering

association of two or more entities (i.e., individuals, groups, agencies, organizations) working together on a project of common interest

what does effectiveness of interventions relate to? (bpr)

availability of proven prevention programs and medical care. For a more detailed explanation of BPR Model 2.0 scoring

For legislative and enforcement interventions to prevent injuries, the laws must

be widely known to the people; be fair and acceptable to the people; ensure that the probability of being caught for not obeying is high; and outline punishment that is swift and certain if the law is broken

designing an appropriate intervention begins with what?

by going back to the early steps in the program planning process and examining the results of the needs assessment and reviewing the goals and objectives of the proposed program

health literacy

capacity to obtain, process, and understand basic health information and services to make appropriate health decisions

community capacity

characteristics of communities that affect their ability to identify, mobilize, and address social and public health problems

Motivational interviewing (MI)

collaborative, person-centered form of guiding to elicit and strengthen motivation for change

multistep survey

collecting the data contact respondents who will provide the data on more than one occasion

Considerations When Developing a Planning Committee (5)

committee should include representatives of other stakeholders not represented in the priority population

networking

communicating with others who may know about existing programs

health advocacy

community advocacy that deals with health issues

what are some other terms used to describe needs assessment

community health assessment community analysis community diagnosis

what is a key subcategory of community mobilization

community organization community building

what is one of the requirements the ACA requires non profit organizations to meet?>

conduct a community health needs assessment and adopt an implementation strategy (also called community benefit) for addressing identified needs at least once every 3 years

validity

data measure what they intend to measure

primary data

data you collect yourself example: -survey -focus group -in-depth interviews

agenda setting

deals with determining what the health problem is, analyzing whether the cause of the problem can best be solved with a policy/ enforcement strategy, and identifying evidence to show that such a strategy will work

what does having a reference list show?

decision makers that you studied the available information before presenting your idea

health numeracy

degree to which individuals have the capacity to access, process, interpret, communicate, and act on numerical, quantitative, graphical, biostatistical, and probabilistic health information needed to make effective health decisions

what is the first challenge associated with conducting a needs assessment

determining whether an assessment should even be performed, and if so, what type of needs assessment is appropriate

what is a challenge of priority setting

differences of opinion exist and there might be conflict among stakeholders

biggest drawback of using complex interventions

difficulty of separating the effects of one strategy from the effects of others in evaluating the impact of the total program and individual components.

observation can be what?

direct or indirect

cons of BPR model

does not represent the broad array of data available to decision makers today

in general what does ROI compare

dollars invested in something to the dollars in benefits produced by that investment (benefits of investment - amount invested/ amount invested

who was MI first used with

drinkers

what are the five stages in deign thinking

empathize: get to know your community and seek to develop a deep understanding of the health issue define: articulate the priority health issues that need to be improved ideate: brainstorm and review the literature for potential strategies to address the public health problem. solicit feedback from the community prototype: select a potential solution and develop the intervention. pilot test the intervention test: work with the community to do further piloting and design improvement to develop the best intervention

what was the initial intent of health risk appraisals

engage family physicians and their patients in conversation about risks of premature death and preventive health behaviors

to plan is to what

engage in a process or a procedure to develop a method of achieving an end

Recommended

evidence exists that the intervention is effective

Rrecommended against

evidence exists that the intervention is harmful or ineffective

Insufficient

evidence means that available studies do not provide sufficient evidence to determine intervention effectiveness

what does MI focus on

exploring and resolving ambivalence and centers on motivational processes within the individual that facilitate change

ambivalence

feeling two ways about behavior change

what is pohotovoice

form of participatory data collection in which those in the priority population take pictures or video and then use these images to help convey and communicate community problems and strengths

focus group

form of qualitative research that grew out of group therapy

strategy

general plan of action for affecting a health problem

built environment

generally refers to an interdisciplinary area of focus that describes the design, construction, management, and land use of human-made surroundings as an interrelated whole, as well as their relationship to human activities over time

meetings

good source of information for a preliminary needs assessment or various aspects of evaluation

when can planners begin identifying an appropriate intervention

have completed a needs assessment, written program goals and objectives, and developed a logic model

what type of source of evidence is World Health Organization

health Evidence Network (HEN) Type of evidence: Summarized evidence for public health, health care, and health systems policymakers

what has been the. most helpful in the needs assessment process

health assessments

health communication vs health education

health communication: strategies as those that inform people example: a brochure on skin cancer or a mass media campaign on preventing HIV health education: strategies are those that are planned learning experiences that provide knowledge and skills to the learners in a more formal educational setting. usually associated with settings such as classes, seminars, workshops, and courses, both face-to-face and online. examples: include prenatal classes for expectant parents, a workshop for parents on how to better communicate with their teenager, or a first aid and CPR course for potential babysitters.

what are the two types of health assessment

health impact assessment and organizational health assessment

geographic information systems (GIS)

helps us analyze spatially referenced data and make well-informed decisions based on the association between data and the geography

what is a central concept of MI

identification, examination, and resolution of ambivalence about changing behavior

what should be in the first paragraph or two of the program rationale

identify the health problem from a global or macro perspective, whether it be international, national, regional, state, or local -begin the rationale by presenting the problem at the most macro level for which supporting data are available

Considerations When Developing a Planning Committee (10)

if the priority population is highly dispersed geographically and/or broken into decentralized subgroups (e.g., various offices of the same corporation, or several different local groups within the same state, or different buildings within a school corporation), these various subgroups may need their own local planning committee that operates with some latitude but maintains and complements the core planning committee as the base of the program

what is MI grounded on?

in a respectful stance with a focus on building rapport in the initial stages of the counseling relationship

disadvantage of mail survey

inability to clarify any questions or confusion on the part of the respondent

Listing the References Used to Create the Rationale

include a list of the references used in preparing the rationale

Significant others

include family members and friends

health assessments

include instruments known as health risk appraisals or health risk assessments, health status assessments, various lifestyle-specific assessment instruments, wellness and behavioral/ habit inventories

what does The Community Guide summarize

indings from systematic reviews of public health interventions covering a variety of topic

capacity

individual, organizational, and community resources, such as leadership, relationships, operations, structures, infrastructure, politics, and systems, to name a few, that can enable a community to take action

levels of evidence intervention focus (circle thing)

individual: develop social and personal skills family: family bonding; parenting skills school: school policies peer led interventions community: integrated community strategies coalitions societal: mass media and policy

self report data

individuals or groups (also called respondents or participants) are answering questions about themselves, the information that is provided is this

opinion leaders

individuals who are well-respected in a community and who can accurately represent the views of the priority population

Key informants

individuals with unique knowledge about a particular topic

Lobbying

individuals/ organizations attempt to influence a specific piece of pending legislation by contacting elected officials or their representatives

what four components does a logic model contain

inputs (or resources) activities (or interventions or strategies) outputs (or evidence of activities) outcomes (or results or effects)puts (or resources)

outcomes

intended results and are broken into: short-term (e.g., changes in awareness, attitudes, knowledge, skills) mid-term (or medium or intermediate) (e.g., changes in behavior or the environment) long-term (e.g., risk reduction, change in health status, or quality of life)

systems approach

interaction and interconnectedness of people and agencies who may help to solve the health issue

where so most health promo problems result from

interaction of complicated social dynamics that must be accommodated

what is social media also referred to as

interactive media web 2.0

what does segmentation all planners to create?

intervention to fit the needs and characteristics of a priority population

activities

interventions or strategies used in a program to bring about change

what are the four communication channels

intrapersonal (one-on-one communication) interpersonal (small group communication) organization and community mass media (hierarchal with intrapersonal reaching the least)

subjective data

involve personal experience and observations as well as anecdotes

Step 2: Title the Rationale

just like name the rationale

what does design thinking help planners do?

keep the community's needs and priorities in mind at all times and reminds planners to be attentive to gathering feedback throughout the process

what are some shapes logic models can take

linear circular lists

what is one of the most often-used methods of collecting self-reported data

mail

what does PEARL do

make a final assessment of how advisable it is for an organization to address a health problem

what is the greatest concern associated with proxy measure

making sure that the measure is both valid and reliable

policy assessment

making sure that the policy is being carried out as written and that it is indeed working to solve the problem it was intended to solve

settings approach

means addressing the contexts (physical, organizational, and social) within which people live, work, and play and making these the object of inquiry and intervention as well as the needs and capacities of the people found in the different settings

cost-effectiveness analysis

measures the cost of a program based on health outcomes achieved

return on investment (ROI)

measures the costs of a program (i.e., the investment) versus the financial return realized by that program

what should the solution include?

name and purpose of the proposed health promotion program, and a general overview of what the program may include

what is the first domain required for a health department to be accredited

needs assessment Conduct and Disseminate Assessments Focused on Population Health Status and Public Health Issues facing the Community

where can evidence come from

needs assessments knowledge about the causes of a health problem research that has tested the effectiveness of an intervention evaluations conducted on other health promotion programs

example of mass media

news coverage, public affairs coverage, talk shows, public service roundtables, entertainment, public service announcements (PSAs), paid advertisements, editorials, letters to the editor, comic strips, and columnists' commentaries

how many in interventions were in Gagne's framework? how many are there now?

nine five

observation

notice taken of an indicator

penetration rate

number in the priority population exposed or reached

dose

number of program units delivered

evidence p yramid what's at top and what's at bottom

objective evidence at the top of the pyramid and subjective evidence at the base of the pyramid

analyzing epidemiologic data does what

obtains Information and data that describe the status of a health problem within a population

environmental change strategies have useful in what

opportunities, support, and cues to help people develop healthier behaviors

what is more important than our genetic code when it comes to health

our zip code

unobtrusive observation

persons being studied are not aware that they are being measured, assessed, or tested

what was photovoice formally called

photo novella

intervention

planned actions that are designed to prevent disease or injury or promote health in the priority population

what does POST do

planners need to focus on the relationship among themselves and those in the priority population, and the ways people connect because social media is all about developing relationship

what do planners to think about when using technology

planners need to focus on the relationship among themselves and those in the priority population, and the ways people connect because social media is all about developing relationships

step 5 of conducting a needs assessment

planners need to identify those predisposing, enabling, and reinforcing factors that seem to have a direct impact on the risk factors *Study of the predisposing, enabling, and reinforcing factors automatically helps the planner decide exactly which of the factors making up the three classes deserve the highest priority as the focus of the intervention

when do planners know step 3 (analyzing the data) is completed?

planners should be able to list in rank order the problems/needs of the priority population

policy formulation

policy or mandated action is developed

examples of opinion leaders

political figures, chief executive officers (CEOs) of companies, other organizational heads such as union leaders, administrators of local school districts, church leaders, and other highly visible and respected individuals

social math

practice of translating statistics and other data so they become interesting to the journalist and meaningful to the audience

what are the two types of data associated with a needs assessment

primary data and secondary data

health coaching

process by which a trained health coach, using the results from some type of personal health assessment (e.g., health-risk appraisal), assists a client/consumer in identifying health-enhancing goals and uses behavioral psychology principles to help motivate the client to work toward the goals

Community advocacy

process in which the people of the community become involved in the institutions and decisions that will have an impact on their lives

segmenting

process of dividing a broader population into smaller groups with similar characteristics that are likely to exhibit similar behavior/ reaction to an intervention

needs assessment (ch.2)

process of identifying, analyzing, and prioritizing the needs of a priority population

Delphi Technique

process that generates consensus through a series of questionnaires, which are usually administered online or via mail

reliability

produces the same or similar data or results over time, thus representing stability and consistency

what happens when ROI equals to zero

program pays for itself.

evidence-based practice

program planners systematically find, appraise, and use evidence as the basis for decision making when planning a health promotion program

what do propriety, acceptability, resources, and legality ask? (bpr)

propriety asks if the organization is best positioned to address the problem Economics asks if benefits outweigh costs Acceptability asks if the community will support a focus on a particular health problem Resources asks whether the organization has the funding to address the problem adequately Legality asks whether the organization has the legal right to address the problem

why may conducting a needs assessment be the most critical step in the planning process

provides objective data to define important health problems, sets priorities for program implementation, and establishes a baseline for evaluating program impact

what is the task force composed of

public health experts who are appointed by the CDC director, is charged with reviewing and assessing the quality of available evidence and developing appropriate recommendations

Multiplicity

refers to the number of components or activities that make up the intervention

public health 3.0

represents a new era of public health practice for the 21st century that focuses on collaboration across sectors and engaging communities to lead the charge in public health interventions

Basic Priority Rating (BPR) Model 2.0.

requires planners to rate four different components of the identified needs and insert the ratings into a formula to determine a priority rating

rationale for tailoring an intervention activity is based on what?

research that shows people pay more attention to information that is personally relevant to them

inputs

resources (or infrastructure) that are used to plan, implement, and evaluate a program

what is the number of people involved in a planning process determined by?

resources and circumstances

which way are logic models generally read

right to let

communication channel

route through which a message is disseminated to the priority population

In the case of an investment in a prevention program, ROI compares what

savings produced by the intervention, net cost of the program, to how much the program cost net savings/ cost of intervention

direct observation

seeing a situation or behavior

Health-related community service strategies include...

services, tests, treatments, or care to improve the health of those in the priority population

Health Impact Pyramid

shows different levels of intervening in which health education specialists may be involved

policy modification

some judgment and possible action must be made to determine whether the policy should be maintained, modified, or eliminated

stakeholder

stakeholder is any person or organization with a vested interest in a program

participatory action research

systematic inquiry, with the collaboration of those affected by the issue being studied, for the purposes of education and of taking action or affecting change

When considering fit for the priority population, it is important to consider what?

tailoring segmenting cultural sensitivity

culturally sensitive

that are relevant and acceptable within the cultural framework of the population to be reached

need

the difference between the present situation and a more desirable one

Health promotion issues are "wicked" problems because...?

the issues are typically intertwined with other problems such as poverty, racism, and other social determinants of health

what happens is PEARL score is 0

the problem drops from consideration since PEARL, or any score of 0, becomes a multiplier in the formula

Community organization

the process by which community groups are helped to identify common problems or change targets, mobilize resources, and develop and implement strategies to reach their collective goals

what happens when ROI greater than zero

the program is producing savings that exceed the cost of the program

Step 4 of the needs assessment process is parallel to what part of the PRECEDE-PROCEED model

the second part of Phase 2 epidemiological assessment

what has understanding the context been referred to as

the settings approach

what does MI involve

the skillful use of certain techniques for bringing to life the "MI spirit", demonstrating the MI principles, and guiding the process toward eliciting client change talk and commitment for change

Health communication

the study and use of communication strategies to inform and influence individual and community decisions that enhance health form it takes in health promotion programs (e.g., mass media, media advocacy, risk communication, public relations, entertainment education, print material, social media, and other electronic communication)

epidemiology

the study of the distribution and determinants of health-related states or events in specific populations, and the application of this study to control health problems

the fifth step of the needs assessment process is similar what phase of the PRECEDE-PROCEED model

the third phase: educational and ecological assessment.

what does assessing community capacity helps us what?

think about existing community strengths that can be mobilized to address social, economic, and environmental conditions affecting health inequities -you should look at the places (e.g., parks, other green spaces, community spaces, shops, libraries) and organizations (e.g., education, health care, faith-based groups, social services, volunteer groups, businesses, local government, law enforcement) in various sectors of the community

bias

those data that have been distorted because of the way they have been collected

participatory data collection

those in the priority population participate in the data collection

Evidence-based interventions

those that are peer-reviewed via a systematic or narrative review

what is some other info and data that are useful in creating a program rationale

those that show how the potential outcomes of the proposed program align with what decision makers feel is important. -Planners can often get a sense of what decision makers value by reviewing the organization's mission statement, annual report, and/or budget for health-related items. -Planners could also interview decision makers directly to determine what is important to them

validate

to confirm that the need that was identified is the need that should be addressed

the size of a problem related to what (bar)

traditional morbidity and mortality indicators (e.g., prevalence and incidence)

what type of process in MI

trained professional helps guide an individual to identify their internal motivation for change

advocacy

trying to affect generalized change (e.g., healthier school lunches) by expressing opinions for or against causes or positions

when does a complete needs assessment take place

until decision makers give permission for the planning to begin

seriousness involves what four components (bpr)

urgency(i.e., how fast is the health problem increasing or spreading) severity (i.e., lethality or likelihood of serious illness) economic loss (i.e., direct and indirect costs) impact on others (e.g., the health problem's potential for communicability, behaviors that impact others, and effects of caregiving)

when using secondary data what should we factor in

validity reliability

mapping

visual representation of data by geography or location, linking information to a place to support social and economic change on a community level

evidence

we mean the body of data that can be used to make decisions when planning a program

when are program rationale made

when health promotion programming has not been successful in the past, or when decision makers want evidence that a program is needed and will be successful, the planning process often begins with planners creating a program rationale or justification to gain the support of decision makers

when does epidemiological data gain additional significance

when it can be shown that the described health problem(s) is(are) the result of modifiable health behaviors and that investing resources to promote healthy lifestyles and prevent health problems makes sense economically

obtrusive observation

when people know they are being observed

impact

which they define as the fundamental intended or unintended change occurring in organizations, communities, or systems as a result of the program

to use a health-risk assessment as part of a needs assessment planners must what

would have those in the priority population complete a questionnaire

Develop Discrepancy

-When clients recognize that their current behaviors place them in conflict with their values or interfere with accomplishment of self-identified goals, they are more likely to experience increased motivation to make important life changes -It is important that the counselor using MI does not use strategies to develop discrepancy at the expense of the other principles, yet gradually help clients to become aware of how current behaviors may lead them away from, rather than toward, their important goals.

Roll with Resistance

-counselors avoid eliciting resistance by not confronting the client and when resistance occurs, they work to de-escalate and avoid a negative interaction, instead "rolling with it." -Actions and statements that demonstrate resistance remain unchallenged especially early in the counseling relationship. By rolling with resistance, it disrupts any "struggle" that may occur and the session does not resemble an argument or the client's playing "devil's advocate" or "yes, but" to the counselor's suggestions. -The MI value on having the client define the problem and develop their own solutions leaves little for the client to resist -frequently used metaphor is "dancing" rather than "wrestling" with the client -In exploring client concerns, counselors invite clients to examine new points of view, and are careful not to impose their own ways of thinking -A key concept is that counselor's avoid the "righting reflex", a tendency born from concern, to ensure that the client understands and agrees with the need to change and to solve the problem for the client

what are some of the reasons proving the economic impact of health promotion programs is not easy

-multiple causes of many health problems -the complex interventions needed to deal with them -the complexity of conducting research studies measuring behavior change and associated cost savings

needs assessment

-process of identifying, analyzing, and prioritizing the needs of a priority population -may also involve collecting consumer research data to determine the "wants" of a priority population

in Collaboration (vs. Confrontation) what does collaboration build

-rapport and facilitates trust in the helping relationship, which can be challenging in a more hierarchical relationship. -does not mean that the therapist automatically agrees with the client about the nature of the problem or the changes that may be most appropriate -Although they may see things differently, the therapeutic process is focused on mutual understanding, not the therapist being right

summaries

-special type of reflection -therapist recaps what has occurred in all or part of a counseling session(s) -Summaries communicate interest, understanding and call attention to important elements of the discussion. -they may be used to shift attention or direction and prepare the client to "move on" -Summaries can highlight both sides of a client's ambivalence about change and promote the development of discrepancy by strategically selecting what information should be included and what can be minimized or excluded.

Affirmations

-statements that recognize client strengths. -assist in building rapport and in helping the client see themselves in a different, more positive light -To be effective they must be congruent and genuine. -The use of affirmations can help clients feel that change is possible even when previous efforts have been unsuccessful -affirmations often involve reframing behaviors or concerns as evidence of positive client qualities -Affirmations are a key element in facilitating the MI principle of Supporting Self-efficacy

what type of approach is MI (Support Self-Efficacy)

-strengths-based approach that believes that clients have within themselves the capabilities to change successfully

Evocation (Drawing Out, Rather Than Imposing Ideas)

-therapist's drawing out the individual's own thoughts and ideas, rather than imposing their opinions as motivation and commitment to change is most powerful and durable when it comes from the client No matter what reasons the therapist might offer to convince the client of the need to change their behavior or how much they might want the person to do so -lasting change is more likely to occur when the client discovers their own reasons and determination to change. The therapist's job is to "draw out" the person's own motivations and skills for change, not to tell them what to do or why they should do it

open ended questions

-those that are not easily answered with a "yes/no" or short answer containing only a specific, limited piece of information -Open-ended questions invite elaboration and thinking more deeply about an issue -Although closed questions have their place and are at times valuable (e.g., when collecting specific information in an assessment) -open-ended questions create forward momentum used to help the client explore the reasons for and possibility of change

Creating the Program Rationale (triangle)

-title the work "a rationale for the development of..." and indicate who is submitting the work -identify the health problem in global terms, backing it up with appropriate (international, national, state) data. if possible also include the economic process -narrow the heath problem by showing its relationship to the proposed priority population. create a problem statement. state why it is a problem and why is should be addressed. again back up the statement with appropriate data -state a proposed solution to the problem (name and purpose of the proposed health promo program0 provide a general overview of the program -state what can be gained form such a program in terms of the values and benefits to the decision. makers -state why the program will be successful -provide the references used in preparing the rationale

Autonomy (vs. Authority)

-true power for change rests within the client. -up to the individual to follow through with making changes happen. This is empowering to the individual, but also gives them responsibility for their actions. -Counselors reinforce that there is no single "right way" to change and that there are multiple ways that change can occur -clients are encouraged to take the lead in developing a "menu of options' as to how to achieve the desired change.

when does resistance in treatment occur? (Roll with Resistance)

-when then the client experiences a conflict between their view of the "problem" or the "solution" and that of the clinician or when the client experiences their freedom or autonomy being impinged upon -These experiences are often based in the client's ambivalence about change.

by how much can weight loss and physical activity reduce onset diabetes? how much of each

58% 5-7% weight loss 150 minutes of physical activity weekly

Explore Goals and Values

Ask what the person's guiding values are. What do they want in life? Using a values card sort activity can be helpful here. Ask how the continuation of target behavior fits in with the person's goals or values. Does it help realize an important goal or value, interfere with it, or is it irrelevant?

Use Change Rulers

Ask: "On a scale from 1 to 10, how important is it to you to change [the specific target behavior] where 1 is not at all important, and a 10 is extremely important? Follow up: "And why are you at ___and not _____ [a lower number than stated]?" "What might happen that could move you from ___ to [a higher number]?" Alternatively, you could also ask "How confident are that you could make the change if you decided to do it?"

what type of source of evidence is Health Evidence, McMaster University, Canad

Effectiveness of public health interventions (and related cost data) in Canada.

Lay person's definition (What's it for?)

Motivational Interviewing is a collaborative conversation to strengthen a person's own motivation for and commitment to change.

A technical therapeutic definition (How does it work?)

Motivational Interviewing is a collaborative, goal-oriented method of communication with particular attention to the language of change. It is designed to strengthen an individual's motivation for and movement toward a specific goal by eliciting and exploring the person's own arguments for change

A pragmatic practitioner's definition (Why would I use it?)

Motivational Interviewing is a person-centered counseling method for addressing the common problem of ambivalence about change.

what does OARS stand for?

Open Ended Questions Affirmations Reflection Summaries

Ask for Elaboration/Examples

When a change talk theme emerges, ask for more details. "In what ways?" "Tell me more?" "What does that look like?" "When was the last time that happened?"

what are the three elements MI is based on

collaboration between the therapist and the client evoking or drawing out the client's ideas about change emphasizing the autonomy of the client

what is the place to begin the process of identifying appropriate sources of info and data (step 1)

conduct a search of existing literature

What are OARS used for?

core counselor behaviors employed to move the process forward by establishing a therapeutic alliance and eliciting discussion about change

when does the motivation for change occur (Develop Discrepancy)

when people perceive a mismatch between "where they are and where they want to be", and a counselor practicing Motivational Interviewing works to develop this by helping clients examine the discrepancies between their current circumstances/behavior and their values and future goals.