UNIVERSITY OF CAPE COAST

COLLEGE OF HEALTH &ALLIED SCIENCES

SCHOOL OF NURSING AND MIDWIFERY

DEPARTMENT OF ADULT HEALTH

BSc. NURSING

2021/2022 ACADEMIC YEAR

LEVEL 200 SECOND SEMESTER

NUR 228: INTRODUCTION TO COMMUNITY HEALTH 3 CREDITS

GROUP WORK

TOPIC: HEALH PROMOTION

a. The use of the Using the mass media in health promotion

b. Planning a health promotion programme

Group members Index numbers

AYIM ADDAE AKWASI SN/NUS/19/0026
AMPONSAH YAW SN/NUS/19/0027
ASARE DARKWAH HILDA SN/NUS/19/0028
BADU KESSEH DANIEL SN/NUS/19/0029
BELINDA FRIMPONG SN/NUS/19/0030
KORKOR RHODA ASIGBESE SN/NUS/19/0031
ADAMS JACOBINA SN/NUS/19/0032
MOHAMMAD FAUZIA MOLLA SN/NUS/19/0033
QUANSAH PRINCE SN/NUS/19/0147
 HEALTH PROMOTION USING THE MASS MEDIA
The mass media helps in communicating with people on a large scale and can have a great impact on the
public’s knowledge, beliefs, perceptions, attitudes and behaviours. The mass media can influence all aspects
of people’s lives, including health and well-being, and can be directed to promote health by informing,
motivating and empowering people to change behaviour and by providing a platform for advocating healthier
policies.
The mass media are those avenues of communication designed to reach large numbers of people. They include;
broadcast media (e.g., television (TV) and radio), print media (e.g., newspapers, magazines, posters and
leaflets), recorded media (e.g., films, videos, compact discs and digital versatile discs), Internet media (e.g.,
emails, websites, podcasts and blogs), social media (e.g., text messages, phone apps, twitter and Facebook).
The Mass Media and The Nurses’ Role
Nurse mostly work directly with the individual patient, family or perhaps groups of patients. Health promotion
messages focus mainly on lifestyle advice, prevention and self-care. In so doing, nurses build a relationship
of with their patient. The one-on-one interaction with patient helps convey health promotion messages, with
opportunities for dialogue, reinforcement, goal-setting, motivational counselling and feedback. For example,
national campaigns promoting healthy lifestyles are most effective if supported by one-to-one advice by health
practitioners.
Nurses should be aware of the range of health promotion messages being aimed at their patient. They should
also have at least a basic understanding of the main ways in which the media can be used to promote health,
especially those nurses involved in planning and commissioning health services or working with public health
colleagues in community-wide health initiatives. The local media can provide a useful vehicle not only for
promoting healthy behaviours but also for letting people know about services available and where to go for
help.
Nurses can take their involvement with the media a step further and actively contribute by, for example,
writing articles for their local paper, appearing on local radio or creating content for their practice web pages.
Extending their role beyond the hospital setting is a useful way of using their knowledge and skills to benefit
a larger number of people.

Approaches to Using the Media

There are three broad approaches to using the media to promote health. They are; Public information, social
marketing and Media advocacy.
Public Information
Also referred to as public education, this approach is geared towards providing health information to the
public. For example, a health expert commenting on a news story, appearing in a radio phone-in or writing a
column in a local paper; health advice features in newspaper and magazines or programmes on radio and TV;
information available on the internet. The main problem for the public is to know which information is credible
or not. There is no universal approach to quality assurance for this information and much depends on the
reputation of the organisation or individual responsible.
Social Marketing
It involves engaging and motivating the public to adopt healthy behaviours. The use of commercial marketing
techniques combined with an understanding of people’s perceived aspirations, motivations and barriers with
regard to whatever behaviour is being targeted.
Media Advocacy
This approach aims to put pressure on policymakers at national or local level to regulate for health -media
advocacy. It raises broad awareness of an issue to advocate for changes in policy or practice to facilitate or
enhance health and well-being. For great impact, a media advocacy campaign needs to target three main
audiences: the public; the relevant professionals; and the key policymakers at local or national level.
Using the Media in Practice
How the media is used in health promotion depends on the key messages being conveyed, the main targeted
group or audience and the appropriate media that will be used to reach them.
Messages should be direct and easy to understand, and the language accessible to the intended audience. It
can raise awareness of an issue, provide very basic information and offer a cue to action where further
information and support is available.
It appropriate to channel messages to the intended audience through the right mix of media. The mix of media
to reach a youth audience is likely to be very different from the mix aimed at older people—for example, there
is likely to be greater use of music channels, digital media and social networking sites in the former group.
The media are heterogeneous, comprising newspapers, magazines, radio and television programmes, websites
and blogs, newsfeeds and podcasts, phone apps, texts and tweets, all competing for readers, listeners, viewers,
hits, downloads, followers and usually advertisers.
Radio/TV interviews, discussions and phone-ins
Some of the best opportunities for health promotion come in the form of one-to-one interviews, studio
discussions or phone-ins. These are usually ‘live’ and thus have the advantage of being unedited, giving
participants more control over their messages than if their words are pre-recorded. The disadvantages are not
knowing exactly what questions will be asked or not having enough time or the relevant knowledge to answer
them adequately.
News stories are a method by which health professionals and organisations can convey health messages in
two main ways:
● by providing a reactive comment or quote to a journalist
●by proactively generating a news story by,
for example, issuing a press release (e.g., announcing the launch of an initiative or publication of a report or
survey results) or press statement (e.g., offering an unsolicited comment on an issue of current interest). This
can often gain widespread coverage for the story, but the health professional or organization will usually have
little control over how their contribution is dealt with or how the tone or balance of the total piece will come
across. Thus, there is a risk not only of being misrepresented but also of health messages being misconstrued.
Media training for health professionals can help to minimize the risk of such mishaps

PLANNING A HEALTH PROMOTION PROGRAMME

WHAT IS PLANNING?
Strategic, program, and operational planning all entail a sequence of decisions based on the collection and
analysis of a wide range of data.
There are six steps involved in planning a health promotion program:
1. Pre-planning and project management
 2. Conduct a situational Assessment
3. Set goals, audiences and outcome objectives
4. Choose strategies and activities and assign resources
5. Develop indicators
6. Review the plan
OVERVIEW OF THE PLANNING PROCESS
The model begins with step 1, managing the planning process. That means addressing how key stakeholders
will work together to make decisions, based on good data-gathering and analysis, within the constraints of
time, budget and other resources.
Step 2, involves conducting a situational assessment, a multifaceted process that basically addresses this
question:
“Should we proceed, and if so, how?”
Steps 3–5 are planning decisions relating to setting goals, populations of interest and objectives (step 3),
strategies and activities (step 4), and indicators (step 5).
Step 6 is a review of the proposed program to see if it is feasible and evaluable. We suggest using a logic
model to do this.
Evaluation is a concurrent process within program planning and development. Consider it
at each of the planning steps.
STEP ONE: PRE PLANNING AND PROJECT MANAGEMENT

Managing and planning process is a way of developing a “plan to plan” in which steps and tasks are
described, people are assigned to various roles, deadlines and milestones are set and shows resource
allocation. At the beginning of planning process, projecting management starts and it is taken into account
any assumptions, expectations and other contextual issues. Project management does not end until the
program plan is completed and approved. In planning management process, the planner must manage the
following are:
• Stakeholders’ roles and expectation: Internal and external stakeholders are included in the
project team. Therefore, their roles and expectations are known to them to prevent them questioning,
challenging, delaying or overruling decisions. Their participation is critical in achieving the best
results.
• Decision making process: Each planning steps requires a decision. People who are supposed
to be involved, consulted or informed must be taken into consideration.
• Time: how many hours or days to be allocated to each planning step should be important in
the planning management. It is important to also know when all he planning and the individual steps
should start and end.
• Resources for planning: resources that are supposed to be managed such as money space
equipment and personnel are to be listed and defined before developing the work plan
• Data gathering and analysis process: best planning decisions requires good data about the
stakeholders’ opinions, possible programs and other factors. Data being gathered and analyzed is a
matter of where stakeholders expectations and practical consideration meet. Good process for
collating, sorting, prioritizing and interpreting the data are also critical.
HOW TO CARRY OUT STEP ONE
There are sub-steps involved in pre-preplanning and project management.
1. Understanding the context: Planning must take place in the context of one’s particular
condition.
• Why you are going through a planning process now?
• Are you modifying an existing plan, or starting a new one?
• What if anything, has already been decided (audiences, issues, strategies)?
• What kind of content do you have to include in your plan (e.g., a template or form from your
potential funder or your organization)?
• Might any other circumstances or expectations affect how you carry out your planning
process or your final program?
• What time will be available to implement the program that you plan?
• What financial resources are available to implement the program that you plan?
2. Identify stakeholder roles and expectations: At the outset of the project, you should:
• identify the key stakeholders;
• determine their overall degree of involvement (peripheral, supportive, involved or core)
• determine the roles for each stakeholder in the planning process, engaging them in a
meaningful way; and
• ensure you understand why each stakeholder is interested or involved with the program
and/or planning process.
3. Choose a decision-making process: Establish a clear decision-making process for the core
planning group early on and outline any other decision-making processes that will be used, specific
to the context. Ensure effectiveness by revisiting decision-making process regularly.
4. Determine the planning start and date: When planning should begin and end must be
considered as well as the rationale behind it.
5. Assess resources for planning: Financial, material, and human resources must be allocated
in the work plan which should include allocated budget, staff time, space, equipment, expertise, and
in-kind contributions from volunteers and partners.
6. Determine complexity of data-gathering and analysis process: general guidelines must be
set for: how much data to collect; how much, if any, original research to conduct; the balance
between qualitative and quantitative research; and the type of evidence to incorporate into the
planning process.
7. Develop the work plan for the planning process.

STEP TWO: CONDUCT A SITUATIONAL ASSESSMENT

A situational assessment influences planning in significant ways—by examining the legal and political
environment, the stakeholders, the health needs of the population, the literature and previous evaluations,
and the overall vision for the project. The purpose is to inform planning decisions about goals, objectives,
audiences, promising strategies and activities. This step includes examining the trends and factors that may
help or hinder your potential program.

In line with the definition of health promotion principles in the 1986 Ottawa Charter,7 situational assessment
results should also:

• show the positive (strengths and issues, rather than needs or deficits);
• result from ongoing, meaningful input from the intended audience(s);
• look broadly and deeply at health issues; and
• be complete, convincing, credible and compelling

Situational assessments are used to:

 • choose goals, intended audiences and outcome objectives (step 3); and
• select the most promising strategies and activities for your program (step 4)

In order to gain meaningful participation and long-term support for your program, involvement of
stakeholders in data gathering and interpretation must be employed.
HOW TO CARRY OUT STEP TWO
Below are six sub-steps in conducting a situational assessment.
1. Identify key questions to answer through the assessment: in situational assessment you
start with what you want to know by asking major questions such as:
• What is the situation? E.g. How do local stakeholders and the public perceive the
situation?
• What is making the situation better or worse?
• What possible solutions, interventions and actions can you take to deal with the
situation?
2. Develop a data-gathering plan: a plan that is realistic and has clear list of specific tasks.
Every good plan must cover he five main areas of project management: Stakeholder roles and
involvement; resources; time; decisionmaking; and data collection.
3. Gather the data with the help of the plan drawn from the previous step.
4. Organize, synthesize and summarize the data: by sorting key lessons gathered and
organizing them around the three broad situational assessment questions stated in the first step.
Information is synthesized and summarized into key findings which indicates the results of your
situational assessment which cannot be ignored
5. Communicate the information taking into consideration the key audience, communication
objectives, communication channels and communication vehicles.
6. Consider how to proceed with planning: After collecting and organizing your data, it is
time to evaluate the situational assessment results and decide how to proceed. Base this decision on
the quality and quantity of data, and your understanding about how to improve the situation with
your resources.
STEP THREE: SETTINGS GOALS, AUDIENCE AND OUTCOME OBJECTIVES
Track of findings that suggest directions or conclusions related to goals, audience and objectives are kept.
Here the information is applied. Stakeholders are involved in a meaning way to generate possibilities and
make decisions. It creates a large part of a logic model that usually summarizes one’s program.
SET GOALS
A goal is a broad statement that provides overall direction for all aspects of a program over a long period.
Most health promotion programs have a single goal, although more complex programs may have several.
Goals don't have a time limit. They're also difficult to quantify precisely because they frequently involve
subjective phrases like evaluate, know, improve, and comprehend. What goals do is act as a compass and
framework for program development. They provide a set of unambiguous end points around which
various tactics or activities can be organized. Your techniques and efforts may vary as the circumstance
changes, but well-stated goals are rarely affected. This is especially critical when there are competing
goals among stakeholders or when you require creativity or a new method.
CHOOSE AUDIENCES
The audience of interest requires special attention to achieve your goals. There are generally two kinds of
audiences: primary and secondary. The primary audience, often mentioned in the goal, is the group
whose health you are concerned with. Secondary audiences influence the primary audience.
WRITE OUTCOME OBJECTIVE
An outcome objective is a brief statement specifying the desired changes caused by a health promotion
program. Depending on the accepted terms of your organization, changes may also be called results,
impacts, or effects. Good objectives include four components:
• who you want to change (audience);
• what you want to change in the audience (outcome);
• by how much; and
• by when.
Setting goals is an important part of planning any program, and it's also when stakeholders become invested
and motivated. Knowing your audience is crucial because it proposes alternative techniques and actions.
Objectives that are clear, concise, and well-written can help you focus your planning efforts and clarify next
actions for stakeholders, especially those interested in evaluation or research. In addition, objectives serve as
the foundation for choosing indicators (step 5), which is an important part of the evaluation process.

HOW TO CARRY OUT STEP THREE

1. Set goals: Create a simple statement that captures the broad direction of the program.
Examples include:
• “to increase [a positive quality or state of affairs]”; or
• “to decrease [problems]”
2. Choose audience: Look at your situational assessment data result and know the group that:
• must change because they have significant bearing on the situation (something that
should be done);
• may change given the resources at hand, e.g., pregnant or breastfeeding women living
in high-risk circumstances, children in low-income families (something that could be done);
and
• are unlikely to change, as they are aligned with the mandates, expectations and
interests of key stakeholders, or aligned with something your organization is expected to do
3. Write outcome objectives: this is done in a four-step process:
• Begin with stating the primary or secondary audience (who)
• Consider what precise change you want to see. Changes should be significant,
attainable, and within your authority.
• Consider how much progress may be made. Use the information from your
situational assessment once again. In this area, stakeholders, surveys, or benchmarks
discussed in the literature may provide guidance.
• Finally, establish a schedule for achieving the goal (when).

STEP FOUR: CHOOSE STRATEGIES AND ACTIVIIES AND ASSIGN RESOURCES

Where the previous two steps meet to answer this question: “Which strategies and activities will best
advance our goals and objectives within the limits of our resources?” Step 4 is the planning phase in which
you identify strategies, choose activities, assign resources and write process objectives. In step 2, you
tracked findings that suggested directions or conclusions related to your program.

IDENTIFY STRATEGIES:
A strategy refers to a wide approach to change facilitation. Choose strategies based on the outcomes you
want to achieve or the normal tasks you'll be doing. The Ottawa Charter for Health Promotion7 identifies
five types of strategies: 1) build healthy public policy, 2) create supportive environments; 3) strengthen
community action; 4) develop personal skills; and 5) reorient health services. Choose strategies according to
the results they are intended to create, or the typical activities they might include. Many theories or
frameworks list related strategies.

Other terms can be used to describe the five Ottawa Charter strategies and additional strategies. A program
can include one or more strategies. The terms shown are not necessarily identical in meaning, but are often
associated with similar activities.

CHOOSE ACTIVITIES
A specialized product or service is referred to as an activity (something you do or produce). In order to reach
your end objectives, activities are carried out within the context of one or more broad strategies. As an
example, as part of an educational plan, you might distribute brochures, posters, and articles.

ASSIGN RESOURCE

Money, expertise, time, space, and equipment are all resources. Funded budgets, contributed monies or
revenue, and/or goods and services provided in-kind by partners are all possibilities. Allocating resources
now will assist you in developing realistic process goals.

The essence of this step is that it connects strategies and activities to goals and outcome objectives

HOW TO CARRY OUT STEP FOUR

1. Identify strategies: Begin by making a list of potential health-promoting strategies. One

method is to make a list for each of the step 3 result objectives. Another method is to create a list of
actions for each of the outcome objectives, then group them into strategies. Use the results of your
situational assessment to help you figure out which methods will work best in your situation.
2. Choose activities: If you are planning for an existing program, review the activities you
currently offer. Decide whether to continue, stop or adapt the activities by considering:
• What you know, from the available evidence (from step 2), about the expected or
actual effectiveness of this activity for meeting your outcome objectives.
• What you know about the appropriateness of this activity for your intended audiences
(from step 2).
• What you know about the financial and human resources required to implement this
activity properly.
• What resources you have to implement this activity, and how that compares to what
resources are required.
 3. Write process objectives: Write one or more process objectives for each of your activities.
Recall that good process objectives include four components:
• what you want to do or produce (activity/output);
• who you are doing or producing it for (audience); • how much (number and type of
products or services); and
• by when.
4. Assign Resources: It is essential to match chosen activities with sufficient and available
resources. Look at your overall budget and other resources as outlined in step 1 to do the following
steps.
• Allocate what is available to specific activities.
• Examine the gaps between what is needed and what you have.
• Explore ways of obtaining the required resources from other organizations, alternative
funding sources,
• Consider which activities you will keep and which parts will be on hold until new
resources are found (in the next fiscal cycle, for example).

STEP FIVE: DEVELOPING INDICATORS

This step concerns itself with selecting indicators that helps in assessing the extent of your process and
outcome objectives. Indicators enables you know the success and effectiveness of the program. They are
useful in answering questions such as:
• How will you know the strategy has been implemented?
• How will you know if you’ve achieved the objective?
• How will you measure progress toward your desired outcome?
• How will you know what is different after your program?
Indicators should be reliable, valid and accessible by taking into consideration: what will be measured?
where the data are available and any limitation on accessibility.

OUTCOME INDICATORS
Outcome indicators measure progress toward your outcome objectives. Every objective should have at least
one indicator and indicators can also bring a measure of progress for more than one objective. An example
of an outcome objective and its corresponding outcome indicator is shown below:

OUTCOME OBJECTIVE OUTCOME INDICATOR

• Percentage of people who agree that
depression and anxiety are highly treatable
To increase by 10%, within 2 years, the number of disorders
adults between 50- 80 who agree that depression
• Percentage of people who can identify
and anxiety are highly treatable disorders, which
two possible treatments for depression/anxiety
they should discuss with a doctor
• Number of doctor/patient discussions
about depression and anxiety disorders
 PROCESS INDICATORS
Process indicators measure both the quantitative and qualitative aspects of program delivery:
• Quantitative measures focus on numbers (e.g., number of girls registered in fitness
programs).
• Qualitative indicators use words (e.g., what participants liked, barriers or facilitators
to change, lessons learned in working with this audience).

Below is an example of process indicators:

EXAMPLES OF
EXAMPLES OF QUANTITATIVE
PROCESS OBJECTIVE QUALITATIVE
INDICATORS
INDICATORS
2,000 educational pamphlets • Number of pamphlets sent • Recipient comments
on • Percentage (when asked) about what they did and
the most effective treatment who remember receiving the didn’t like about the
options for depression and pamphlet pamphlet
anxiety, sent to adults aged • Percentage (when asked) who
50- remember reading the pamphlet
80
by next January

Establishing indicators is a vital step towards ensuring your program can be evaluated. Step 5 is also
important because it indicates a real commitment to achieving results and measuring achievement.
HOW TO CARRY OUT STEP FIVE
1. Develop a working list of indicators by means of reviewing existing sources of indicators,
checking its reliability and validity, and checking its accessibility.
2. Prioritize your indicators on standards of most reliable, valid and accessible.
3. Review indicators timely to ensure continued relevance of your information needs.

STEP SIX: REVIEW THE PLAN

You can undertake a more thorough assessment once the full plan is in place and given in an overview, such
as a logic model. This will determine whether the strategy is comprehensive, reasonable, and consistent with
the situational evaluation. You may need to revisit one or more planning phases and change your
corresponding worksheet inputs due to errors or omissions.

HOW TO CARRY OUT STEP SIX

1. Assemble a logic model: Logic models exist in a variety of sizes and shapes. Decide on the
overall design of your logic model before beginning to construct it. There are numerous logic model
forms to choose from. A logic model should, in general, include the decisions you made in phases 3
and 4 regarding your:
2. Assess the plan for completeness: Make sure your information in your plan contains all of
the facts you'll need to put it into action. To make sure your strategy is complete, ask yourself the
following questions:
• Does the program include broad goals (step 3)?
• Have you identified audiences, including individuals, social networks, organizations,
communities and/or governments (step 3)?
 • Are your outcome objectives SMART (specific, measurable, appropriate, realistic,
and time-limited (step 3))?
• Have you identified a few major strategies to advance the objectives, and reflect your
overall health promotion theory (step 4)?
• Do the activities fall within clearly defined strategies (step 4)?
• Are the process objectives SMART (step 4)?
• Have you identified the resources (people, funds, materials) required (step 4)?
• Does your plan have at least one indicator for each objective (step 5)?
• Are the indicators reliable, valid and accessible (step 5)?
3. Asses the plan for logic: Consider the following questions to asses your plan for logic:
• Will the short-term objectives contribute to the long-term objectives?
• Will the strategies effectively contribute to the goals and objectives?
• Have you chosen the best activities to advance the strategy?
• Are the activities appropriate to the audiences?
• Are the resources adequate to implement the activities?
4. Check the alignment of your plan with your situational assessment: Return to step 2, the
situational assessment. Examine the plan's compatibility with your data-gathering and decision-
making at that time.
• Is the plan consistent with the key findings of the situational assessment?
• In particular, does your program plan consider the major influences on your situation
(the second key question in your situational assessment analysis)?
• Finally, will stakeholders be satisfied with the proposed program plan?
5. Review Plan presentation: Ensure the logic model (or other plan format) presents the
information in a clear and compelling manner. Consider the following questions:
• Is it user-friendly?
• Is it easy to follow the arrows and/or flow of logic?
• Is there enough white space?
• Is it presented in an order that is useful for you and your stakeholders?
6. Consider how to proceed: Approve your plan using the decision-making procedure you
agreed on. Then, before you start implementing, create a comprehensive evaluation strategy. Use
formative and/or process evaluations to make any necessary changes as you implement your plan.

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