PH

20
1

2
1

Developing a Health
Promotion Program
dr. Harun Al Rasyid, MPH

Objectives
2

Students are able to:

Determine health issue

Determine target group
Make appropriate program goal and
objectives
Select appropriate method of health
promotion program

What we have
learned last
semester
Definition of
health promotion
Behavioral
theories used in
health promotion

Health Promotion
health education
- behavioural
- structural
------------------------organisational
actions
------------------------economic
actions
------------------------political actions
Including advocacy

attitudinal
behavioural
environmental
and
social
changes
conducive
to health

Improved
Health
status

Developing Health Promotion

Program
5

Plannin
g

Method
s

Evaluati
on

9/9/15

Planning A Health Promotion

Program

What do you want to achieve?

Why do you want to achieve
it?
How will you achieve it?

Who is the program aimed at?

How will it happen?
Where will it happen?
When will it happen, or when will
it stop?

How will you know if you

achieved what you wanted?

Why develop a plan?

To ensure the program is appropriate to

the:

health problem
identified target group
available resources

To apply accepted theory and experience

To maximise the opportunity for
achieving the desired change
To enable the program to be
implemented by others
To enable the program to be evaluated
and possibly duplicated

Why Might Health Promotion

Programs Fail?

Inadequate needs assessment

Inadequate planning
Inadequate applied research
Underestimation of diffusion
and adoption barriers

Planning Questions
1.

2.

3.

4.

5.

How serious is the health issue,

concern or problem?
Which behavioural and
environmental risk factor are
involved?
What contributes to those risk
factors?
Which combination of
interventions might change
these factors
How can these interventions be

Evaluation questions
1.

2.

3.

4.
5.

Has the implementation carried

out as intended?
Have the interventions been
executed as planned?
Have the causes of behavioural
or environmental risks
changed?
Has the risk itself changed?
Has the problem lessened?

Planning A Health Promotion

Program

Determine the health issue

Determine the target group

Building a rationale
Needs assessment
High risk group
Primary, secondary, tertiary target group

Determine goal and objectives

Determine the methods and
strategies
Evaluation planning

Needs Assessment
Should provide answers for the
following questions:
What does the community
REALLY need?
What are the most relevant
issues?
Is the need for directional change
indicated?
How much time, money, and
other resources required?

Steps in needs assessment:

Part one

Identifying the health

problem

Consultation
Data collection and
preliminary review of
literature
Interim presentation of
findings to stakeholders
Collaboratively determine
priorities

Steps in needs
assessment: Part two
Analysis of the health
problem

More specific literature

review
Describe target group
Exploring the health problem
Analyzing the contributing
factors
Assessing community
resources

Defining Target
Group

The nature of the target group will

influence the style of the planned
intervention
Include demographic characteristics,
such as: age, sex, ethnic composition
May be appropriate to include other
factors, eg: education, employment
profiles, area of residence
You may need to re-define your target
group as you progress through the
planning stage and before finalizing
goals and objectives
You may want to use a

Analysis of the factors

contributing to the health
problem

Risk markers: factors that identify where the

problem is occurring
Risk Factors: account for why the problem is
occurring
Contributing Risk Factors: contribute to,
or account for the risk factor
predisposing: predispose a person into
behaving in a certain way (knowledge, attitudes
and beliefs)
enabling: enable a behaviour, or situation to
occur (usually focus on skills)
reinforcing: reward of punish the carrying out
of a behaviour or the maintenance of the
situation

DETERMINING
GOALS
what do you ultimately
want to achieve with
the program

corresponds to health
problem
Usually a health indicator /
diagnosis, but may be a
behaviour or environmental
concern if that is defined as
the health issue

DETERMINING
OBJECTIVES
the changes to be
brought about by
the target group

corresponds to risk
factor
Generally a
behavioural/
environmental focus

DETERMINING
SUB-OBJECTIVES
what has to happen
to achieve an
objective

corresponds to
contributing risk factor skills, knowledge,
awareness etc
generally only separated
out from general objectives
for large projects or where
helpful

corresponds to

GOAL
OBJECTIVE

SUB-OBJECTIVE

Health Problem
Risk Factor
Contributi
ng Risk
Factor

Example
Health Problem

Excessive exposure of school

children to ultraviolet light

Risk Factor

Goal

Children do not
wear hats

To reduce exposure of school

children to ultraviolet light

Objective

To increase the
proportion of
children who wear
hats

Example
Contributing Risk
Factor

Sub-Objective

Children do not like

wearing hats
(predisposing)

Hats are not supplied

by the school
(enabling)
Hats are not a
compulsory part of
uniform (reinforcing)

To increase the
proportion of
children who like
wearing hats
To make hats free
for school children
To make wearing
hats compulsory
for school children

Example 2
Health Problem

Excessive exposure of school

children to ultraviolet light

Risk Factor

Goal

Not enough shade

in school
playgrounds

To reduce exposure of school

children to ultraviolet light

Objective

To increase the
amount of shade
in school
playgrounds

Example
Contributing
Risk
Parents and teachers
Factor
not sufficiently aware

To increase
Sub-Objective

teachers and
parents
knowledge of risk
of sun exposure

of risk of sun
exposure
(predisposing)

Insufficient funds to
build shelters
(enabling)
Education
Department has no
policy on shade areas
(reinforcing)

To acquire Rp 5
million for shade
shelter
To have shade
protection
incorporated into
Education

Writing GOAL and

OBJECTIVES

Should be

SMART:

Specific
Measurable
Achievable
Relevant
Time

Specific

Example
Untuk meningkatkan proporsi anak
sekolah sebesar 40% yang suka
memakai topi sampai akhir Januari
2009
Untuk meningkatkan tingkat
pengetahuan para guru dan orang
tua sebesar 25% tentang resiko
paparan sinar matahari sampai akhir
program

HEALTH PROMOTION
METHODS
Choice of Methods

Four factors determine the choice

of methods:

Time
Audience
Environment
Outcome

FOCUS ON THE
INDIVIDUAL

Patient Education

Hospital inpatient program

General

health education materials

Education for specific ailments (e.g. Diabetes,
asthma, etc.)

Outpatient settings

Counseling, brief interventions, and

motivational interviewing
Programmed learning, self-help
materials, and the internet

FOCUS ON GROUP
Group Methods

Didactic approach
The

goal is transmission of knowledge or information

Directed at group of individuals to bring about
individual behaviour change
Examples: lectures, seminar

Experiential group learning

Best

performed when the behavioural outcome

required is a complex one and requires detailed
development of components that have been
identified in HBM (intentions, attitudes, barriers, and
beliefs)

FOCUS ON GROUP
Didactic
group
method

Description

Lecture discussion

Best for knowledge transmission or motivation

in large groups. Requires dynamic, effective
speaker with more knowledge than the
audience

Seminar

Smaller number (2-20). Leader-group

feedback. Leader most knowledgeable in the
group. Best for trainer learning.

Conference

Can combine lecture or seminar techniques.

Best for professional development.

Video
Opportunity for group learning with
conferencing professionals, such as rural and remote
doctors, nurses, and so on.

FOCUS ON GROUP
Experienti
al group
method

Description

Skills training Requires motivated individuals. Includes

explanation, demonstration and practice; for
example relaxation, childbirth, exercise
Behaviour
modification

Learning and unlearning of specific habits.

Stimulus-response learning. Generally
behaviour-specific; for example smoking
cessation, phobia desensitisation

Inquiry
learning

Used mainly in school settings. Requires

formulating and problem solving through group
cooperation

Peer group
discussion

Useful where shared experiences, support and

awareness are important. Participants
homogenous in at least one factor; for example

FOCUS ON GROUP
Experienti
al group
method

Description

Simulation

Useful for influencing attitudes in individuals

with varying abilities. Generally in schoolsetting but relevant to tother group

Role-play

Acting of roles by group of participants. Can be

useful where communication difficulties exist
between individuals in a setting; for example
families, professional practice. Require skilled
facilitator.

Self-help

Requires motivation and independent attitude.

Valuable for ongoing peer support and value
clarification. Can be therapy or a forum for
social action.

USING THE MEDIA

Mass media methods

Advertising
Publicity
Edutainment
Civic journalism
Websites and
interactive information
technology

Mass media methods

Advertising

the paid placement of messages in

various media vehicles by an
identified source.
Disadvantage: Cost | Advantage:
large exposure

Publicity

The unpaid placement of messages

in the media, usually in news or
current affairs program, but also in
feature article or documentaries

Edutainment

Use the combination of education and

entertainment
Deliberate inclusion of socially
desirable messages in entertainment
vehicles, such as TV soap opera
(sinetron).

Civic journalism

Attempts to build community

consensus and cooperation
Emphasizes similarities and seeks to
emphasize more moderate views

Websites and interactive

information technology

For health promoters, the web

provides a relatively efficient
and inexpensive forum for the
dissemination of information
and materials
Dietary

habit questionnaire
online immediate diagnosis
and prognosis about dietary
changes

Choosing media methods

Factors:

Goals and objectives (outcomes)

Cost
Effectiveness
Complexity of messages delivered
Time
Relationship with the media
Type of media available

A framework for using media in social

marketing
Advertisi
ng

Publicity

Edutainm Web
ent
sites

Civic
journalis
m

Educate

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Motivate

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Objectives
:

Advocate ***

A summary of media method

Limited reach media
Type

Characteristics

Pamphlets

Information transmission. Best where cognition rather

than emotion is desired outcome.

Information
sheets

Quick convenient information. Use as series with

storage folder. Not for complex behavior change.

Newsletter

Continuity. Personalized. Labor-intensive, requires

detailed commitment and needs assessment before
commencing.

Posters

Agenda-setting function. Visual message. Creative

input required. Possibility of graffiti might be
considered.

T-shirts

Emotive. Personal. Useful for cementing attitudes and

commitment to program/idea.

Stickers

Short message to identify/motivate the user and

cement commitment. Cheap, persuasive.

Videos

Instructional. Motivational. Useful for personal viewing

with adults as back-up to other programs.

DVDs and

Provides the opportunity for portable, attractive, easy

A summary of media method

Mass reach media
Type

Characteristics

Television

Awareness, arousal, modeling, and image creation

role. May be increasingly useful in information and
skills training as awareness and interest in health
increases.

Radio

Informative, interactive (talkback). Cost-effective and

useful in creating awareness, providing information.

Newspaper

Long and short copy information. Material dependent

on type of paper and day of week.

Magazines

Wide readership and influence. Useful as supportive

role and to inform and provide social proof.

Internet

Can serve wide role from personal information

transmission ato group sessions to blogging

Components of successful media

campaigns

Carry out informative research

Base the campaign on a model of

attitude-behaviour change

Fully understand the topic being

communicated

Use skilled creative personnel

Understand the audience

Components of successful media

campaigns

Target the message

Take account of interpersonal and peer

influences

Optimize contact with the message

Use multiple channel

Use a credible source or spokeperson

Components of successful media

campaigns

Set realistic goals and a realistic duration

of the study

Provide environmental support for

change

Ensure that input from a behavioral

scientist guides the communication
agency