Needs and strengths assessment Hughes & Margetts 2011, Chp 3 ? ? ? (Hughes & margetts 2011; SACHRU Program Planning 1994; Goldberg et al 1999; Wass 2000 Hughes & Margetts 2011, Chp 4 Analysing structure and attributes of community; understanding community context; social and environmental determinants Involving community from the ?outset; utilising community capacity (knowledge, connections, leadership); building community capacity A description of the Salisbury community socio-demographic profile of the community, and, historical, geographical and cultural facts about the area, for example, the mix of residential, commercial, industrial and agricultural development Hughes & Margetts 2011, Chp 4 Embedded within phc participatory, collaborative, sharing of knowledge and resources empowerment & action for health improvement ? McCashen 2005 Hughes & Margetts 2011, Chp 5 To answer questions: What is the problem/issue? Who does it affect and how many are affected (prevalence) What are the effects eg. burden of disease, costs? (significance) What are the Consequences of doing nothing? Are the issues important to community members? Is there community support for action? Are there resources to support addressing the issue? (p54) epidemiological data, views of experts, current services, community resources, theory community perceptions of problem/issue, barriers and enablers, interest in participating The nature of the problem obesity and burden of disease; prevalence of childhood obesity; diet and physical activity patterns of children; high risk sub-groups; obesogenic environment. You should compare national, state and local data, where possible. The purpose is to demonstrate the magnitude and significance of the childhood obesity problem in Salisbury. (Talbot & Verrinder 2005) Similar ideas to Step 1:Community analysis and engagement Understanding stakeholder agendas to build capacity for intervention determine capacity (interest, influence & resources) Assess sources of opposition & support Build partnerships and alliances Hughes & Margetts 2011 Important principles for effective partnerships with stakeholders: Shared vision and agreed upon values Shared decision-making management committee, working party, steering group Consensus on intervention governance deliverable, accountability, reporting, risk management, Terms of reference (p67) Resources and relationships within the community (a) what services, organisations, structures or programs that can contribute to a nutrition intervention, and (b) stakeholders and potential partners who can contribute to and participate in the intervention who they are; what information you need from them; how you will engage them; and what may be their likely role. Hughes & Margetts 2011, Chp 7 Analysing individual, social, economic and environmental determinants of problem/issue Determining causal association restricting junk food marketing (protective); Increasing access to healthy foods (promoting) Hazards or risks threat to health eg. cheap pricing of EDNP foods Hughes & Margetts 2011, p 75 directly impacts problem/issue eg. f&v protective of obesity, diabetes access, knowledge, attitudes influence f&v consumption downstream behavioural or biomedical Socio-environmental upstream Hughes & Margetts 2011, p 75 Hughes & Margetts 2011, Chp 8 Capacity building approach to working with communities aims for sustainable interventions; Using and developing skills, networks and resources of community Capacity analysis involves identifying and respecting existing skills, structures, partnerships, resources Builds trust, engages community, empowers community (p 84) Hughes & Margetts 2011, Chp 9 drivers and levers for interventions; national, state, organisational policies Communicate evaluation results of local interventions to policy-makers (to provide evidence for policy development) Hughes & Margetts 2011, Chp10 in similar situations strategy mix, and evaluation Avoid re-inventing the wheel! Strategy mix refer to Ottawa Charter framework (WHO 1986) , p116 changing community norms/attitudes social marketing Go for 2 &5 changing environments healthy school canteens changing knowledge, skills, beliefs individual or group education p115 Hughes & Margetts 2011, Chp 11 Assess risks associated with doing nothing And risks associated with intervention strategies Strategy prioritisation is always a compromise between ideal strategy mix and available (limited) resources, capacity & mandate for action ?best buys(eg. ACE Obesity: assessing cost effectiveness of obesity interventions in children and adolescents 2006) Clear, concise presentation of information gained to all people who contributed, stakeholders and decision-makers Maintain community/stakeholder engagement The format needs to be appropriate (eg. ?report format for the organisation, ?newsletter or ?letter format with key issues identified for community members, presentation at public meeting etc Literature review of Australian data highlighting the barriers to fruit and vegetable consumption; Audit of local businesses selling fresh fruit and vegetables in the OPAL catchment area; Development of localised survey tool (including quality audit, how we can support promotion of f&v, what they need support with, education re storage The Intelligence phase is crucial to successful program development planning the right intervention All steps in the cycle describe a comprehensive approach to Intelligence gathering Community engagement and building capacity yield benefits in intervention development, health impacts and sustainability It is important to distinguish between deficit and strengths-based orientations Hughes R & Margetts BM, 2011, Practical Public Health Nutrition, Wiley-Blackwell Owen JM, 2006, Program evaluation. Forms and approaches, 3rd edition, Allen & Unwin Green L & Kreuter M (eds), 1991, Health promotion planning: an educational and environmental approach, Mayfield, Mountain View. Talbot L & Verrinder G. 2005. 3rd Edition. Elsevier. Sydney. DHS Vic, 2006, ACE Obesity: assessing cost effectiveness of obesity interventions in children and adolescents, Victorian government Department of Human Services Hawe, P., Degeling, D. & Hall, J. 1990, MacLennan and Petty, Sydney. McCashen W, 2005, A philosophy for practice, Chp 1 St Lukes Innovative Resources. Vic Health. 2004. Hawe P, King L, Noort M, Jordens C, Lloyd B. 1997. , NSW Health Department. www.health.nsw.gov.au Centre for Primary Health Care, University of QLD. 2002. ÿ
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