Harkness2e chap09 ppt

Copyright © 2016 Wolters Kluwer • All Rights Reserved

Chapter 9: Planning for Community

Change

2Copyright © 2016 Wolters Kluwer • All Rights Reserved

Chapter Highlights• Health planning at the state, national,

and global levels• Social and environmental

determinants of health • Social ecological model and multilevel

interventions• Community coalitions


Chapter Highlights (cont.)• Health impact pyramid• Health equity and social justice• Lewin’s change theory, force field

analysis, and levers of change• Logic models • Role of the community health worker


Chapter Highlights (cont.)

• Funding community health interventions

• Evaluating community health interventions

• Nurse-managed health centers


Question

Is the following statement true or false?Health planning occurs on both an ongoing and an episodic basis.


Answer

TrueRationale: The timing of health planning depends on the responsibilities of the planning agency, the type of assessment data, and the nature of the health problem.


Health Planning

Organized and systematic process in which problems are identified, priorities selected, and objectives set for the development of community health programs based on the findings of community health assessments and health surveillance data.


Common Themes• Common themes of current national

and international health plans include providing health promotion and disease prevention at the population level, addressing social determinants of health, and achieving health equity.


Levels of Health Planning• Global• National and state levels

• Healthy People 2020• National Prevention Strategy• State Departments of Public Health


Community Health Improvement Planning Process

Systematic process that involves all sectors of a community to conduct a comprehensive community health assessment (CHA), identify priorities for action, develop and implement a community health improvement plan (CHIP), and guide future community decisions and resource allocations.


Community Assessment

Systematic process that may use several approaches including key informant interviews, analysis of data on health status and health behavior indicators, observation, and community surveys.


Systems Theory

Social systems engage in reciprocal exchange or flows of information, energy, resources, and goods or services. Systems within the community are interdependent and interconnected.


Working With the Community• Defining the population of interest• Coalitions• Stakeholders and opinion leaders


Social Ecological Model• Based on general systems theory and

health promotion theory• Multiple determinants of health

interact at different levels to affect the health status of individual people, population aggregates, or communities.


Question

Is the following statement true or false?The purpose of using levers of change is to decrease driving forces and/or to increase restraining forces.


Answer

FalseRationale: The purpose of using levers of change is to increase driving forces and/or to decrease restraining forces.


Health Impact Pyramid• Useful framework for community

health nurses when planning health promotion interventions at multiple levels


Multilevel Interventions• Multilevel interventions are needed to

achieve change in complex community health conditions that have multiple determinants.


Social Determinants of Health• Obesogenic and salutogenic

environments• Health impact assessment• Health disparities, health equity, and

social justice


Change Theory• Lewin’s Model of Change– Unfreezing– Changing– Refreezing


Force Field Analysis• Force field analysis is a tool used to

identify the forces driving or restraining change.


Levers of Change• The purpose of using levers of change

is to increase driving forces and/or to decrease restraining forces.

• Public policies such as tax increases on tobacco, alcohol, or soft drinks can serve as policy levers to bring about change in community health status.


Community Involvement in Change• Planning programs or interventions to

change community health status include an assessment of the community’s readiness to undertake the change process related to a specific health issue.


Planning Community-Level Interventions

• Guide to community preventive services

• Logic model• SMART objectives


Collaboration and Teamwork• Community health workers can help bridge

the gap between the community health nurse and the community, especially when there are cultural and language differences.

• Nurses can play an important role in their professional and personal lives as advocates and champions for health improvement, social justice, and health equity at the local, regional, national, and global levels.


Evaluating Community-Level Interventions

• Develop evaluation questions.• Determine indicators or measures you will use

to answer your evaluation questions.• Identify where you will find the data you need to

measure your indicators and answer your questions.

• Decide what method you will use to collect data.• Specify the time frame for when you will collect

data.• Plan how you will analyze your data based on

the type of data you are using.• Decide how you will communicate your results.


Funding Community-Level Intervention Programs

• Accountability• Sustainability• Program replication• Project funding

• Government• Private• Local


Community Benefit Programs• Community benefit programs of local

or regional hospitals and HMOs may be valuable partners to the public health department or community health nurse in planning, implementing, and funding programs to improve population health.


Social Marketing• Use of marketing principles and

practices to change health behaviors or beliefs, social or cultural norms, or community standards to improve health or benefit society


Nurse-Managed Health Centers• Nurse-managed health centers

provide health promotion and primary care services to vulnerable and underserved population aggregates.

Education

Harkness2e chap09 ppt