Transcript http://www.nt.gov.au/health/healthdev/health_promotion

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It is useful to think of research as a
search for answers to questions.
Project planning and evaluation
have different sets of questions to
be answered. Effective planning
and evaluation depend on using
research processes and tools to
collect information, in order to:
decide which issue or problem the
project will address (by
conducting a needs assessment)
find out what things cause the
issue or problem (by analysing the
chosen problem and conducting
a literature search)
determine how the project is
going and how effective it is in
meeting its goal and objectives
(by collecting baseline data and
planning the evaluation)
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Research tools have technical names for
activities which people often do naturally to
find something out. The difference is that
people 'doing research' are generally more
systematic in the way they go about these
activities. Some ways of gathering information
include:
observation: watching and listening to people
as they go about the activities of a project or
their daily lives; looking for any changes in
the community over time
participant observation: a special kind of
observation where you participate in the
project activities with the people you are
observing ·
surveys: using a questionnaire, which is a
written list of questions, used to collect the
data you need from people. Questionnaires
can be used either in interviews or can be
self-completed
interviews: talking to people, either
individually or in groups, usually using some
form of questionnaire. Interviews can be done
face-to-face or by telephone
analysing routinely kept records: finding
specific data in health centre records such as
the number of people with diabetes or who
smoke tobacco; analysing store turnover
records for the amount of tobacco being sold
over a year looking at other documents, such
as: community profiles, reports written on
previous projects or work in the community,
records kept during a project that give
information about participants (number
attending and so on)
doing a literature search to find out what
people have written about a problem or issue
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Quantitative data are collected as
numbers and amounts. These data can
be counted, analysed statistically and
used to compare with other
quantitative data.
Examples:
the number of people attending the
education sessions: 40 people
attended this week and 25 attended
last week
the number of people with diabetes: 20
people with diabetes in community X
this year compared with five people
ten years ago - an increase of 300 per
cent (assuming the population has not
changed)
Qualitative data are collected as
words. These data are descriptions that
can include observations, beliefs,
ideas, opinions, feelings, perceptions,
experiences, and so on. The way the
data are collected, recorded, and
analysed (sorted, grouped and
summarised) should be logical and
systematic. Mathematical calculations
cannot be done on qualitative
information.
Examples:
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what people thought about an
education session. 'People used the
following words to describe the
education session: well organised,
good information, new information,
well presented'
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what people believe about diabetes.
'People reported the following beliefs
about diabetes: caused by bad food,
caused by too much alcohol, caused
by sitting down too much'
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Both quantitative and
qualitative data are
valuable and complement
each other. When used
together, they give a more
complete picture of the
situation and provide
valuable information for
planning and evaluating a
health promotion project.
The following Information
Pyramid may be helpful for
thinking about how data,
information and knowledge
are related.
Action
Knowledge
Information
Data
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One important type of
research is reading about the
work that others have done
and the ideas that other
people have had, by
reviewing the published
literature (books, journals, and
reports) which relates to the
issue or problem that the
project is addressing. It is
likely that work has already
been done in Australia and
elsewhere on the issue or
problem of interest.
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Why do a literature search
Finding journal articles, books and
reports on the issue or problem will
help you to:
save time by learning about what
others have done about the issue
or problem
learn more about the underlying
causes of the issue or problem
discover more about the people
most affected by the issue or
problem
find strategies which have been
successfully used in the past to
address the issue or problem
learn how successful strategies
might be applied to the local issue
or problem
locate research tools (for
example, questionnaires) which
have been used to collect
baseline data or to evaluate
similar projects
be able to set a realistic goal and
objectives for the project based
on what is learnt about the
success levels of similar projects
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Each time health professionals interact
with a client in the course of their work
they have an opportunity to find out
more about that person and share
information. Interacting with individuals
on a one-to-one basis "allows better
possibilities for success than perhaps
any other communication medium"
(Egger et al 1990:31).
Remember it is possible to assist
individuals to make healthier choices
by making the healthier choices the
easy choices (Egger et al 1990:98). For
example, providing quality fresh fruit
and vegetables at prices which
compare favourably with less healthy
food choices means that people are
more likely to buy fresh fruit and
vegetables - the choice becomes
easier. These wider influences are
looked at in the section 'Changing the
Wider Environment'.
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All strategies are potentially useful but
combinations of strategies are likely to
produce the best results
The strategy has to match the
objective. The strategy selected will
depend on what the project is trying to
achieve and with whom
Some knowledge about current health
issues (content) and knowledge about
the best ways to approach them
(process) are both important. Libraries
and other health professionals are
valuable resources
An understanding of team members'
potential and limitations should be
considered when choosing strategies.
Additional training may be necessary
Strategies for lessening individual risk
are important. Use them to
complement strategies which lower
average risk in a whole community
(Egger et al 1990:113)
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some questions to ask
When considering which strategy or
combination of strategies to use, think
about the following questions:
who is the project for?
what are the objectives of the project?
What does it want to achieve?
what does the community think the
best strategies would be?
how ready and willing are people to
become involved?
how long have you got to do the
project? · what skills and knowledge do
project team members have
individually and collectively?
what resources (human, financial and
material) are needed? What is
available?
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Research shows that a brief intervention can help people decide to change their health behaviours.
Brief interventions have been shown to be effective in reducing alcohol consumption by over 20% in
people with hazardous or harmful drinking levels (Anderson 1996:16). Research has shown that just a
few words from a medical practitioner can result in a 5% quit smoking rate and that a little more effort
can lead to long term smoking cessation rates of over 10% (Owen 1985:177). It has also been found
that the intervention is more effective with follow-up and additional interventions from other health
staff (Richmond 1993:209).
More brief interventions are needed at the primary care level. Most interventions in the western health
system are either very early, to prevent the beginning of a problem, or very late. There is a need for
more attention on interventions which focus on people with risky behaviours which affect health, or
with early signs of illness.
Brief interventions are acknowledged to be cheap, easy and effective. Brief interventions are
accepted and used as an effective tool for a range of health issues. For example, interventions
involving counselling and education for new mothers are part of regular infant health consultations in
community health centres.
In summary, what health professionals say and do can make a difference. It can help to motivate and
support people to make the decisions that are best for them.
Who can do brief interventions
Brief intervention is part of the health team's everyday work. Good reasons why health professionals
are suitable people to do interventions:
people expect health professionals to give advice
their advice is personal, directed to each individual's health
the advice of the health professional provides a legitimate excuse to change
they often have knowledge of the client, the family, living conditions and what is happening in the
community (Brady 1995a:12-17)
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Service providers have a responsibility to
raise health related behaviours with people,
and to give clear, factual information. Do
not assume that people already know
about health risks, or that they cannot
change a behaviour. People decide for
themselves, but what service providers say
and do can make a difference. It can help
to motivate and support people to make
the decisions that are best for them.
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The Stages of Behaviour Change model
was developed in the alcohol and other
drugs field by Prochaska and DiClemente
(1986). It is used for matching interventions
with a person's readiness to take on
information and make changes. The model
can be used for interventions in areas such
as alcohol, smoking, using other drugs,
changing diet, weight loss, exercise and
personal hygiene - for any behaviour
change.
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There are numerous opportunities to work with naturally
occurring groups in Aboriginal communities. Groups can be
composed of two or three people or many. These include
families and groups based on: gender, age, language, a
particular disability or condition. Clubs or special interests
groups, such as sporting clubs or art and craft cooperatives, also
provide opportunities for group work.
Group strategies can take place in a range of settings:
where the focus is on prevention: in schools, in the workplace,
out bush, at the women's centre, at the community store
where strategies may have more of an intervention orientation:
in the health centre or old people's home
Useful strategies for working with groups range from providing
information through presentations to school or community group,
to working alongside special interest or lobby groups to facilitate
community action. The skills required for giving presentations
differ from those skills required for working in partnership using a
community development approach.
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People are social beings and generally like
working with others
All the resources, abilities and energy of the
group are pooled
There is less chance that mistakes will be made
- it is easier to see other people's mistakes than
to see our own
Group discussion stimulates ideas that might
not occur to an individual working alone
Group members support each other and
provide security, especially for problem solving
(Alcohol and Drug Programs Unit 1988
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There are a number of things to think about when choosing or making health education and health promotion resources.
The following checklist may be a useful evaluation tool.
Is the information accurate and up to date?
Is the resource suitable for the target group?
Does it give information that people have asked for?
Is it culturally acceptable? Will it upset or offend anyone?
Can the target group understand the message?
Will anyone outside the target group be upset or offended by it?
Does it make the person feel like it's 'talking' to them personally?
Is the resource eye catching and interesting to look at?
Are the diagrams/photos/images clear in what they are trying to say?
Are the photos or images acceptable to people in the community?
Is information well presented?
Are written words large enough to read easily?
Does the resource use language, words and images people can understand?
What is the language? Can people read/understand it?
Does it use straightforward words and sentences?
Does it use many technical words?
Are the ideas explained clearly?
Are pictures, diagrams or images suitable and clear?
Is the message or purpose clear?
Does it give clear directions to the reader or viewer?
Is the message put in a positive way?
Are there any conflicting or hidden messages that might confuse people?
Does it seem to persuade the person to do something?
Is it worth the money you spend on it?
Can you afford to buy it or make it?
Do you need extra funds for it?
Can you share the cost with anyone else in the community or anyone else in THS?
How many copies are needed, or how many times will you be able to use it?
How long will it last?