nccmt webinar - policy readiness tool (part 2)

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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:

Using the Policy Readiness Tool

in Public Health

Advisors on Tap:

Candace Nykiforuk, PhD, CE

Shandy Reed, MSc

Cathy Gladwin, MSc

Sherry Jarvis, MEd

Kayla Atkey, MSc

October 1, 2015 1:00 – 2:30 PM ET

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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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

3



in Public Health

http://www.nccmt.ca/registry/view/eng/144.html

Episode 19

4



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

5

http://www.nccid.ca/en/home

http://www.nccmt.ca/

http://www.healthypublicpolicy.ca/2/Home.htm

http://www.nccdh.ca/

http://www.nccah-ccnsa.ca/

http://www.ncceh.ca/


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.

6

Registry of Methods and Tools

Online Learning Opportunities

Workshops Multimedia

Public Health+

Networking and Outreach

NCCMT Products and Services

7

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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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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in Public Health Presented by:

Dr. Candace Nykiforuk

CIHR/PHAC/AI-HS Applied Public Health Chair

Associate Professor, School of Public Health

Kayla Atkey, MSc

Policy Analyst, Alberta Policy Coalition for Chronic Disease Prevention (APCCP)

Cathy Gladwin

Policy Analyst, Injury Prevention Centre, University of Alberta

Sherry Jarvis, Med

Project Coordinator, Applied Research Collaborations for Health (ARCH), Dalhousie University

Shandy Reed, MSc

Alberta School Employee Benefit Plan (ASEBP)

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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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

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

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

“Readiness” Categories

Use of 3 categories eases applicability for practitioners:

• 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

Readiness = relative tolerance for risk for a new policy

It is NOT static & can be different from issue to issue

“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!

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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Practice Example:

How can the Policy Readiness Tool be

used to inform action?

Presented by:

Shandy Reed, MSc

Alberta School Employee Benefit Plan (ASEBP)

Centre for Health Promotion Studies

http://www.sherwoodparknews.com/2011/07/28/follow-the-footsteps

The Initial Letter from the APCCP:







http://www.sherwoodparknews.com/2011/08/01/how-far-will-anti-smoking-laws-go

The Response from the Editor:















http://www.sherwoodparknews.com/2011/08/08/keep-fighting-the-good-recycling-fight

This somewhat related, follow-up column by the same writer that also references their need/value to be seen as an innovator and the risk of falling behind…













New Opportunities for Applying the PRT:

• Organizational readiness for new strategic

focuses

• Adapting the tool for ‘ideas’ in new settings

Practice Example:

Use of PRT for ATV Safety

Presented by:

Cathy Gladwin, MSc

Policy Analyst, Injury Prevention Centre,

University of Alberta

The Problem

• Provincial government inactive

• No political will for legislation

But

• Evidence that Municipal Bylaws can

influence provincial legislation

Municipalities in Alberta

• Urban municipalities

– Cities, towns, villages, summer villages

– No or little ATV use

• Rural municipalities

– Municipal districts and counties

– Specialized Municipalities

– 69 in total

Review of ATV Bylaws

• In 2013 reviewed bylaws of 69

municipalities

• Most bylaws on website, emailed others

• Created spreadsheet showing elements of

bylaws

• Compared elements with best practices for

ATV safety

ATV Safety Elements

• Use of a helmet

• No under 16 year-old users on adult ATVs

• # Passengers = # specified by maker

• Speed limits

• Use only in daylight hours

• Rider training required

Findings of Review

• 28 of 69 muni’s have ATV bylaws

• Parkland has best bylaw

– 5 of 6 safety elements

• No muni’s require training

• 4 muni’s have bylaws with 4 of 6 elements:

Beaver, Leduc, Thorhild, Wetaskiwin

• 8 mandate helmets

• 10 limit passengers

Review to PRT

• Labelled muni’s with 4 or more elements

as “Innovators”

• Looked for similarities:

– Clustered near Edmonton

– All in northern half of province

– Contain larger city or town

– Are an ATV Destination

Interviews to PRT

Informal interviews found that:

• Believe muni’s have duty to protect

• Will make decision with broad knowledge

• Didn’t demand specific, local data

• Not worried about enforcement

• Believe bylaw itself will change behaviour

Review to PRT

Majority or Late Adopters= less than 4

elements:

• Fewer bylaws overall

• Narrower scope of services for citizens

• Not an ATV destination

• More distant from Edmonton

IPC 2014 Awareness Activities

• Awareness of Municipal Bylaws

• Shared results of review

• Congratulated Parkland County for Best

Bylaw

• Held media event with Parkland County

• Aimed to raise interest in bylaws with other

municipalities

The Unthinkable Happened!

• May 2015 election of NDP Government

• Soon hearing that ATV Legislation is being

reviewed by Alberta Transportation

• IPC suspended ATV activities awaiting

government action

• If no ATV legislation is passed or elements

are missing IPC will return to municipal

bylaw plans

Issues in ATV Advocacy

• Alberta surveillance system does not

capture ATV Injury and Death data very

well

• Can’t break it down to municipal level

• Therefore, difficult to make case to

municipality.

• IPC too small to reach individual muni’s so

possible strategies are limited

Possible Strategies for IPC

• Create model ATV safety bylaw

• Highlight bylaws in use by muni’s

• Show benefits of regional bylaw similarity

• Bring muni’s together in regional workshop

• Promote model bylaw through AAMDC

• Continue public awareness of safety

behaviours

Practice Example:

Health Eating in Recreation and Sport

Settings

Presented by:

Sherry Jarvis, MEd

Project Coordinator

Applied Research Collaborations for Health (ARCH)

Dalhousie University

Background Information

• Department of Health & Wellness in NS

recently released Healthy Eating in

Recreation and Sports Settings (HERSS)

voluntary guidelines

• Prior to the release of the provincial

guidelines, we gathered HERSS baseline

data: environmental scans and

stakeholder interviews

HERSS Research Study (Phase 2)

Objectives

(1) Understand the structures and processes required to

optimize healthy eating guideline implementation in

recreation and sport settings (RSS)

(2) Describe changes to food environments in RSS as a

result of the uptake and implementation of healthy eating

guidelines

(3) Define the level of implementation that is required to

produce desired outcomes in the food environments of

RSS

Policy Readiness for Change

Survey • To help us achieve objective one, we will collect detailed data

from RSS facilities to help us understand the barriers and

facilitators of guideline implementation as well as how these

barriers and facilitators may be worsened or moderated

depending on a facility’s readiness for change.

• Case studies: interviews, observations and document reviews

• Recruitment for case studies: distributed the policy readiness

for change survey which included adding a short section that

asked introductory questions (e.g. type of facility, location,

etc.)

Results

• 15 surveys completed

– 7 Innovators

– 6 Majority

– 2 Late adopters

• Survey follow-up:

– The facility’s readiness category

– Invitation to participate in case study

• To date, after following up with the survey respondents,

we have recruited facilities for the innovator and majority

categories, but not for the late adopters

Practice Example:

Alberta Policy Coalition for Chronic Disease

Prevention – Applying the Policy Readiness Tool

Presented by:

Kayla Atkey, MSc

Policy Analyst

Alberta Policy Coalition for Chronic Disease

Prevention (APCCP)

The APCCP: Who We Are

Working to coordinate efforts, generate evidence, and advocate for

policy change to reduce chronic disease risk in AB.

Funded by the Heart and Stroke Foundation of Alberta for 2015.

17 member organizations.

Objective and Focus

Facilitating evidence-based policies to address chronic disease risk

in 4 key areas:

• Unhealthy eating

• Physical inactivity

• Alcohol-related harm

• Tobacco use

Building capacity to use policy as a tool and enhancing public

acceptance of policy-related activities.

Applying the Policy Readiness

Tool: A key tool for your policy

toolkit Examples

Collaborative advocacy with Alberta Food Matters and the Growing

Food Security in Alberta Network (GFSA).

Creating Healthier Food Environments in Edmonton Recreational

Facilities through Policy Change.

Facilitating Evidence-based Policy: The Policy Opportunity

Windows, Engaging Research Uptake in Practice (POWER UP!)

Project

Collaborative Advocacy

From 2012-2013, the APCCP supported Alberta Food Matters (AFM) in

moving through a collaborative advocacy process.

Resulted in the beginning stages of an advocacy campaign calling for

the development of a Universal School Food Strategy.

The project was informed by Themba-Nixon’s seven steps in the

development of an advocacy initiative.1

Testing the Waters

Defining the Initiative

Strategy and Analysis

Direct Issue Organizing

Steering Through Appropriate Channels

Victory and Defense

Implementation and Enforcement

1. Themba-Nixon M. The power of local communities to foster policy. In: Cohen L, Chavez V, Chehimi S, editors.

Prevention is Primary: Strategies for Community Well-being. San Fransisco Jossey-Bass; 2010. p. 137-56.

Collaborative Advocacy Advocating at the provincial level is complex. Multiple strategies and

tools are needed.

The PRT provided a reference point and evidence-based strategies

throughout the collaborative process:

Testing the Waters

Defining the Initiative

Strategy and Analysis

Direct Issue Organizing

Questionnaire and adopter categories could apply at the provincial

level & to organizations you are seeking buy-in from (i.e. school

board).

Creating Healthy Food Environments in

Recreational Facilities

Building capacity to promote healthy food environments in

recreational facilities through policy change at the municipal level.

Using the tool to develop policy resources suitable to different levels

of readiness.

Working with recreational facilities to apply the tool at the

organizational level.

Partner on

The APCCP is a partner on the POWER UP! project for 2013-2016,

which is funded by the Coalitions Linking Action and Science for

Prevention (CLASP) initiative.

Power Up! Activities:

Summarize evidence on the impact of obesity-prevention policy

activities.

Promote information sharing through annual consensus conferences.

Develop evidence-based tools and resources to support adoption and

implementation of obesity prevention policies.

Development of www.powerupforhealth.ca, a one-stop-shop for policy

tools and resources to promote heathy weights.

http://www.powerupforhealth.ca/

Website Link: www.powerupforhealth.ca

Evidence & Tools to Complement

PRT Strategies Innovator - Provide Supportive Evidence


PRT Strategies

Majority – Outline Public Opinion


PRT Strategies Late Adopter - Illustrate how communities or organizations with similar

characteristics have successfully adopted and implemented the

proposed policy.


PRT Strategies

Late Adopter - Illustrate how communities or organizations with similar

characteristics have successfully adopted and implemented the

proposed policy.

Thank you!

To learn more about Alberta Food Matter’s advocacy efforts to

promote a Universal School Food Strategy, visit:

http://www.foodsecurityalberta.org/node/1887

To learn more about POWER UP!, visit www.powerupforhealth.ca.

Check back often for new tools and resources.

Subscribe to the POWER UP! e-newsletter:

http://powerupforhealth.ca/power-up/subscribe/



http://www.powerupforhealth.ca/





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

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

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!

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

Join us in the conversation!

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)

Dr. Candace Nykiforuk

Associate Professor, School of Public Health, University of Alberta

CIHR/PHAC/AI-HS Applied Public Health Chair

E: [email protected]


www.policyreadinesstool.com

For more information or conversation:

Kayla Atkey, MSc

Policy Analyst

Alberta Policy Coalition for Chronic Disease Prevention


Cathy Gladwin

Policy Analyst

Injury Prevention Centre, University of Alberta


Sherry Jarvis, Med

Project Coordinator

Applied Research Collaborations for Health, Dalhousie University


Shandy Reed, MSc

Alberta School Employee Benefit Plan


mailto:[email protected]


http://www.policyreadinesstool.com/





Poll Question #5

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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• Use Q&A to post comments and/or questions

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

OR

• Ask questions or add comments via the teleconference line

• ‘Unmute’ your phone

Q&A

Participant Side

Panel in WebEx Your Comments/Questions

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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.

The short survey is available at:

https://nccmt.co1.qualtrics.com/SE/?SID=SV_2codTY9uxgN9KM5

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After Today

The PowerPoint presentation (in English and French)

and English audio recording will be made available.

These resources are available at:

PowerPoint: http://www.slideshare.net/NCCMT/

Audio Recording:

https://www.youtube.com/user/nccmt/videos

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http://www.slideshare.net/NCCMT/






Join us for our next webinar

The Consolidated Framework for Implementation Research (CFIR)

November 12, 2015 from 1:00 – 2:30pm EST

Learn about how this resource can be used to guide

the adaptation of public health interventions and to

develop implementation plans by considering factors

that are likely to influence implementation success.

Register at: https://health-evidence.webex.com

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https://health-evidence.webex.com/





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: [email protected]

http://www.nccmt.ca/


nccmt webinar - policy readiness tool (part 2)

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