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Funded by the Public Health Agency of Canada | Affiliated with McMaster University Production of this presentation has been made possible through a financial contribution from the Public Health Agency of Canada. The views expressed here do not necessarily reflect the views of the Public Health Agency of Canada..

NCCMT Spotlight on KT Methods & Tools: Overview of the Policy Readiness Tool Advisors on Tap:

Candace Nykiforuk, PhD, CE

September 17, 2015 1:00 – 2:30 PM ET

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• ‘Send’ questions to All (not privately to ‘Host’)

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Internet connection (vs. wireless),

• WebEx 24/7 help line • 1-866-229-3239

Q&A

Part icipant Side Panel in WebEx Housekeeping

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Poll Question #1 Where are you from?

1. BC 2. AB 3. SK 4. MB 5. ON 6. QC

7. NB 8. NS 9. PEI 10. NL 11. YK 11. NWT

12. NU 13. Outside

Canada

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Poll Question #2 What sector are you from?

1. Public Health Practitioner 2. Health Practitioner (Other) 3. Education 4. Research 5. Provincial/Territorial/Government/Ministry 6. Municipality 7. Policy Analyst (NGO, etc.) 8. Other

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Your profession? Put a √ on your answer (or RSVP via email)

/

Epidemiologist Management (director, supervisor, etc.)

Allied health professionals (nurse, dietician, dental hygenist, etc.)

Librarian

Physician / Dentist Other

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Overview of the Policy Readiness Tool

Episode 18

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NCC Infectious Diseases Winnipeg, MB NCC

Methods and Tools Hamilton, ON

NCC Healthy Public Policy Montreal, QC

NCC Determinants of Health Antigonish, NS

NCC Aboriginal Health Prince George, BC

NCC Environmental Health Vancouver, BC

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National Collaborating Centre for Methods and Tools • dedicated to improving access to, and use of,

methods and tools that support moving research evidence into decisions related to public health practice, programs, and policy in Canada.

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Registry of Methods and Tools

Online Learning Opportunities

Workshops Multimedia

Public Health+

Networking and Outreach

NCCMT Products and Services

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Candace Nykiforuk, PhD, CE is an Associate Professor in the School of Public Health, University of Alberta and CIHR/PHAC/AIHS Applied Public Health Chair

Advisor on Tap

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Overview of the Policy Readiness Tool

Presented by: Dr. Candace Nykiforuk

CIHR/PHAC/AI-HS Applied Public Health Chair Associate Professor, School of Public Health

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Poll Question #3 In what ways is policy part of your work

or setting?

1. I participate in policy advocacy (formally or informally). 2. I help to find evidence / build the case for new policies. 3. I contribute to policy development. 4. I am responsible for policy implementation. 5. I monitor or evaluate policy effectiveness. 6. I am interested in policy, but do not have an active role. 7. Policy is not part of my work / applicable to my setting. 8. Other.

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Poll Question #4 How would you rate your capacity to

support or influence the policy process in your community or setting?

A. High B. Medium C. Low D. Not Sure

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Overview: Policy Readiness Tool • An evidence-based tool to help foster the

development of healthy public policy • Intent is to make participating in policy change more

accessible to non-experts and experts - E.g., Policy Developers, Advocates, Community Organizations,

Non-profit Sector Staff and Volunteers, Government Employees, Community Members

- Simple to use and not restricted to health policies - Available in English and French

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Overview: Policy Readiness Tool • The policy process is dynamic and can be intimidating,

especially if dealing with a new issue or a new setting - Tool offers a “place to start” - Helps the user identify a community or organization’s relative

readiness for a policy - Based on level of readiness provides evidence-based strategies

known to work with different levels of readiness

• Provides targeted strategies to help navigate what can be a convoluted policy process - Especially for those new to advocacy or policy development, or

who are working with an unfamiliar issue

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So What is the Policy Readiness Tool? • A simple self-administered tool that:

1. Assesses readiness for policy change using a simple, self-administered checklist

2. Provides targeted, evidence-based policy change strategies for taking action (based on level of readiness)

3. Recommends general evidence-based resources to foster healthy public policy

Readiness = relative tolerance for risk for a new policy It is NOT static & can be different from issue to issue

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Why is Healthy Public Policy Important? • Healthy Public Policy: any policy that improves

overall health and seeks to increase individual and community control over the determinants of health

• Building healthy public policy is a key health

promotion strategy (Ottawa Charter) - Clearest evidence of effective health interventions is consistently

linked to policy

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To build healthier communities… …local organizations, skilled and lay advocates, and others must be involved in the process of policy change

To support this, we need to: - address barriers to local

participation in public policy - increase local capacity for policy

change

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The Evidence Tells Us… • Municipalities (and organizations) learn policy

responses from the experiences of similar communities (and organizations)

• Despite practice-based knowledge on how municipalities learn from one another, there is limited best practice research on municipal policy diffusion

• Practitioners value tools and best practices that help them influence the policy process in their own setting

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Development of the Tool • Emerged out of a research program on municipal policy

development & diffusion in tobacco control

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Municipal Tobacco Bylaws & Community Characteristics (Nykiforuk, NCIC: 2001-2002) Diffusion of Municipal Tobacco Policy in Two Provinces (Nykiforuk, CIHR-STPTR: 2004-2005)

National Survey of School Smoking Policies & Tobacco Use (PI: Lovato, CTCRI: 2005-06)

Smoke-free Spaces Knowledge Synthesis (PI: Nykiforuk, CTCRI: 2005-06)

Ecological Policy Environment of Smoke-free Spaces (PI: Nykiforuk, OTRU: 2007-08)

Alberta Policy Coalition for Chronic Disease Prevention (PIs: Raine,Nykiforuk, ACB-PHII: 2009-11; HSFC 2011-present; CPAC 2013-2016) - KAB of Policy Influencers re: Healthy Public

Policy for Prevention - Policy Readiness Tool Development

Pilot Evaluation of Policy Readiness Tool (PI: Nykiforuk, UA-Killam 2012-2013)

Policy Readiness Tool Dissemination Grant (PI: Nykiforuk, CIHR 2014-2016)

Development of the Tool • Emerged out of research program on municipal policy

development & diffusion in tobacco control • The Policy Readiness Tool employs Rogers’ “diffusion of

innovations theory” to make participating in policy change more accessible

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Diffusion of Innovations = a theory that is used to examine how

something new spreads from place to place over time 24

Development of the Tool • Emerged out of research program on municipal policy

development & diffusion in tobacco control • The Policy Readiness Tool employs Rogers’ “diffusion of

innovations theory” to make participating in policy change more accessible

• Level of innovation: the degree to which an adopter is relatively earlier or later in taking up new ideas than other members of a system

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Understanding Level of Innovation • Past work on smoke-free spaces bylaws revealed

common patterns of municipal policy behaviour • Key findings:

– Initial adopters were often the first to amend or strengthen bylaws over time - “Initiators” reprise their roles as issue evolved

– Municipal decision-makers followed familiar patterns of policy making within their network

– Different types of “adopter characteristics” were suggestive of a municipality’s bylaw readiness relative to others in the same policy context

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Development of the Tool (2011) • Phase 1: Development of a pilot tool

• Phase 2: Tested the tool with municipal representatives across Alberta (24 communities)

• Phase 3: Lit review, environmental scan, and key informant interviews with experts working in policy

– To collect evidence-based and best practice strategies on development / implementation of healthy public policy

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Policy Readiness Tool – Key Partners • Expert advice provided by the Provincial Advisory

Group of the Alberta Policy Coalition for Chronic Disease Prevention (APCCP)

- Included policy developers and advocates, practitioners, community organizations, and researchers representing 15 different organizations across Alberta

The APCCP works together to coordinate efforts, generate evidence and advocate for policy change in order to reduce

chronic disease in Alberta.

http://www.abpolicycoalitionforprevention.ca/

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So What is the Policy Readiness Tool? A simple self-administered tool that:

1. Assesses readiness for policy change using a simple, self-administered checklist

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“Readiness” Categories • Use of 3 categories eases applicability for

practitioners: – Innovators

– Majority

– Late Adopters

• Enables users to apply the tool in a variety of contexts

Readiness = relative tolerance for risk for a new policy It is NOT static & can be different from issue to issue 31

“Readiness” Categories - Caveats • Not a value judgment about a community or organization

There is no good or bad adopter category!

• Instead, the Tool offers an efficient way to select appropriate strategies to support policy development in a particular context

Not a one-size-fits-all solution, but a place to start!

32

So What is the Policy Readiness Tool? A simple self-administered tool that:

1. Assesses readiness for policy change using a simple, self-administered checklist

2. Provides targeted, evidence-based policy change strategies for taking action (based on level of readiness)

We’re

coming back to

this! 33

34

So What is the Policy Readiness Tool?

A simple self-administered tool that:

1. Assesses readiness for policy change using a simple, self-administered checklist

2. Provides targeted, evidence-based policy change strategies for taking action (based on level of readiness)

3. Recommends general evidence-based resources to foster healthy public policy

35

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Who Can Use the Tool? Anyone interested in encouraging healthy public policy development:

Policy developers

Advocates

Community organizations

Non-profit sector staff and volunteers

Government employees

Community members / general public

Researchers

Available in English and French 37

What Kinds of Policies Can the Tool be Used With? • Designed to encourage and support healthy public policies in

general, for example: Smoke-free public spaces regulations

Injury prevention (e.g., helmet bylaws)

Nutrition policies (e.g., in schools or recreation facilities)

Social planning policies

Location/implementation of new green spaces or facilities

Etc., etc.

• Created with municipalities in mind, but can be used with other types of governing bodies (e.g., organizations, schools, school boards) 38

Using the Policy Readiness Tool

• Complete the short checklist found online http://policyreadinesstool.com/the-tool/start-the-tool/

• Choose the ‘closest’ description (A, B, or C) in each row that describes a characteristic (there are 11 rows)

• Your result will be provided when you click ‘finish’ and link you to strategies for the adopter category most appropriate

Let’s try it together…

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Take a moment and think about a community you are familiar with, and consider the 5 questions below:

Choose the closest response, then tally your total As, Bs, and Cs (at your desk)… …We will ask for your response on the next slide.

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Poll Question #5 Based on your responses to the 5

questions on the last slide: 1. Mostly A’s 2. Mostly B’s 3. Mostly C’s

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Using the Policy Readiness Tool: “Adopter Categories”

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Adopter Category Descriptions • Mostly As: Innovators are described as

“adventurous” and often serve as initiators or role models within their social networks

• Mostly Bs: The Majority are described as “deliberate” because they require time to consider the evidence and determine whether to adopt a new policy

• Mostly Cs: Late Adopters are described as “traditional” and may be skeptical of new ideas (without substantial evidence) or eager to maintain the status quo

Mostly As: Innovators • Are described as “adventurous” and often serve as

initiators or role models within their social networks

- Attracted by high-reward initiatives and are “risk-takers”

- Can cope with elevated levels of uncertainty associated with the new policy

- Typically willing to cope with initial problems & able to identify solutions to these problems

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Mostly Bs: The Majority • Are described as “deliberate” because they require

time to consider the evidence and determine whether to adopt a new policy

- Seldom lead the pack - Is often of the philosophy that it is better to change as a

group than to be one of the first to change - Tends to adopt policies at about the same time as the

average adopter

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Mostly Cs: Late Adopters • Are described as “traditional” and may be skeptical

of new ideas (without substantial evidence) or eager to maintain the status quo

- Usually wait until the majority of others have adopted a policy

- May need to be pressured into policy adoption - May never adopt the policy unless required to

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Reminder: Category Caveats • Not a value judgment about a community or organization

There is no good or bad adopter category!

• Instead, the Tool offers an efficient way to select appropriate strategies to support policy development in a particular context

Not a one-size-fits-all solution, but a place to start!

50

Lessons from Practice so Far… • Successful diffusion depends on interaction between the

adopter groups over time and place - e.g., A critical mass of bylaws can lead to provincial policy

• Supports action and advocacy: - Find sound innovations & support innovators - Make innovator activity observable (visible!)

• Understanding policy adoption trends is useful for: - Refining policy strategies - Responding to changes in policy context - Informing new policies or policy development in other

jurisdictions 51

Applying the Tool: Strengths Increasing Local Capacity for Policy Change

1) Builds personal and community level capacity Increase knowledge, skills & leadership

2) Addresses the resource capacity issues of advocates and organizations Focus on effective use of limited resources via tailored strategies

3) Builds knowledge through intersectoral collaboration Encourage those from different sectors to consider new policy

change strategies 52

Applying the Tool: Limitations • Diffusion theory is uni-directional, time-specific, and

linear - Static instrument explaining a dynamic process, which may still

be ongoing at time of “readiness” assessment

• Most applicable to simple (single issue) and straight-forward cases of policy change

• Caveat - users must remain flexible and leave room to act on the unexpected!

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Examples of Community Products & Outcomes • Policy Readiness Tool (English and French) (~1200

downloads since early 2012) • General Strategies for Policy Change (English & French) • Profiles is:

• ‘Registry of Methods and Tools’ on National Collaborating Centre for Methods and Tools website

• ‘Prevention Policies Directory’ on the Canadian Partnership Against Cancer’s website

• ‘Practice-based Evidence in Nutrition’ through Dietitians of Canada

• Requests for specific uses all across Canada (e.g., using the Tool to identify municipalities to work with for research around healthy eating policies in recreation facilities)

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What’s Happening Now • New website:

• Online completion of the questionnaire component • Resources and strategies always being updated

• Evaluation of the new website (online survey and interviews)

• Working to adopt the Tool specifically for use in school settings

• Connecting people interested in healthy public policy change

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Join us in the conversation!

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Upcoming Webinar • Thursday, October 1, 2015 (1:00-2:30pm EST) • Using the Policy Readiness Tool in Public Health • Advisors on Tap:

• Kayla Atkey, Alberta Policy Coalition for Chronic Disease Prevention

• Cathy Gladwin, Injury Prevention Centre, University of Alberta • Sherry Jarvis, Applied Research Collaborations, Dalhouise

University • Shandy Reed, Alberta School Employee Benefit Plan

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Acknowledgements The team would like to thank members of the Alberta Policy Coalition for Chronic Disease Prevention (APCCP) for their

expertise and feedback in the development of the Policy Readiness Tool.

Financial Support: * Diffusion work was funded by a CIHR Strategic Training Program in

Tobacco Research Fellowship (2004-2005). * PRT development supported by the APCCP (2009-2011), which was

funded by Alberta Cancer Prevention Legacy Fund (Alberta Health Services).

* PRT pilot evaluation funded by Killam Trust Fund, University of Alberta (2012).

* PRT dissemination grant funded by CIHR (2014-2015) 58

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Dr. Candace Nykiforuk Associate Professor, School of Public Health, University of Alberta CIHR/PHAC/AI-HS Applied Public Health Chair E: candace.nykiforuk@ualberta.ca www.policyreadinesstool.com E: prt.info@ualberta.ca

For more information or conversation:

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Poll Question #6 What are your next steps? I plan to …

A. access the Policy Readiness Tool. B. read the NCCMT summary of the Policy

Readiness Tool. C. consider using the Policy Readiness Tool. D. tell a colleague about the Policy Readiness

Tool.

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• ‘Send’ questions to All (not

privately to ‘Host’)

Q&A

Part icipant Side Panel in WebEx Your Comments/Questions

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Join us for our next webinar Part 2: Using the Policy Readiness Tool in

Public Health

October 1, 2015 from 1:00 – 2:30pm EST Hear the stories of how public health practitioners have used the Policy Readiness Tool in practice and discuss challenges and successes when applying the Policy Readiness Tool. Click here to register: http://ow.ly/Qc50a

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Your Feedback is Important

Please take a few minutes to share your thoughts on today’s webinar. Your comments and suggestions help to improve the resources we offer and plan future webinars. Click here to complete a short survey: https://nccmt.co1.qualtrics.com/SE/?SID=SV_2r7Ri63uZigAlJX.

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Funded by the Public Health Agency of Canada | Affiliated with McMaster University The views expressed here do not necessarily reflect the views of the Public Health Agency of Canada.

For more information about the National Collaborating Centre for Methods and Tools: NCCMT website www.nccmt.ca Contact: nccmt@mcmaster.ca