Program Planning

Hi guys. Welcome to the program planning lesson. At this point we’ve talked about improving health of a community and most of the things that come with that but we haven’t talked about how those wellness programs keep popping up. So in this lesson, we’re going to talk about what the process looks like to get a community health program started and why the community is such an important factor in planning. Let’s get started.

So here we have the planning process. It looks complex but it’s really very basic once you think about it. At this point you’ve heard about the nursing process and it actually looks pretty similar. Why am I showing you this? Because I want you guys to understand that even though the goals of a plan can be different, the process is always the same. You can put the nursing process to just about anything. What you’re looking at here is your assess and diagnose, your plan and your implementation and evaluation.

So now you understand the process, let’s put it into a little perspective. So for the planning process to work in the community, you need community involvement. You want the input of members of a community because how else can you be sure what your goals are? So the reason we create community programs is to reduce or eliminate health problems, ensure community members have access to efficient services, and most of all, that we are meeting the needs of the community or specific members. So you see why involvement would be a big deal because we can’t expect to make changes to a community without understanding the problems from their lenses. Their input is imperative to the success of the program. Remember, we want to focus on patient centered care and empower and encourage people to take control. Including them on plans is a great start.

So let’s talk planning models for a second. Now remember I said the process may have different goals but the process is still the same. When we are talking about community nursing, the goals are the same, but the plans all look different. There are several different process models out there and when you strip them all down they all amount to ADPIE. So we’re going to talk about three of the more popular models. We have the MAP-IT model, the PATCH model and the PRECEDE-PROCEED model. MAP-IT is actually backed by Healthy People 2020 and is also known as MAPP. The mnemonic changes, but it’s still the same model focusing on community partnerships for better wellness. PATCH was developed by the CDC and is used to increase the community’s ability to create and evaluate health programs. PRECEDE-PROCEED was developed from PATCH and focuses on behaviors to change outcomes. Different focuses, same process. I’ll show you how.

So the MAP-IT model is the easiest to see. It stands for Mobilize, Assess, Plan, Implement, Track. So the mobilize phase is the phase where your mission and target population is determined. It’s also where we determine who will be involved in the process. Who do you want sitting at the table? And what will they be doing? Remember, I said it focuses on partnerships so this can be anything from community members to organizations. Either way, everyone will have a role. The assess phase is where we determine the issues we want to work on. We collect data during this phase to determine the priorities of the program. Are we focusing on the hows and whys of childhood obesity or hypertension in older adults? You are searching for available resources as well to help you meet your goal during this phase. Think of it as your needs assessment phase. Next is the planning phase. We are setting goals here. How do we implement the plan and what will it look like? What do we do in the implementation phase? We put the plan to action. And the tracking phase is our evaluation. Did it work or not? What can we change?

So the PATCH model is a little more difficult. It’s the Planned Approach to Community Health. This model has 5 phases. Community participation, data collection, collaboration, develop the plan and evaluate or enhance the plan. I want to talk about the community participation phase. Remember I said earlier, this model wants to enhance the community’s ability right? Don’t we need them to be active in the planning for that to happen? How mad would you be if your boss came in and made changes to your job without your input? Works the same with community. This entire model focuses on encouraging the community to collaborate with agencies for better health. And that’s how it became the basis for the PRECEDE-PROCEED model.

So the PRECEDE-PROCEED model is probably the most intricate of the three. Like I said earlier, it focuses on behavior changes for positive health outcomes. Now, the phases here are a little different because of how they are broken up. PRECEDE includes your assessment and planning phases. So social, environmental, behavioral and policy are all the assessments we make in the precede phase. You can kind of see why it’s labeled this way. Precede means first. So in the planning process we assess and plan first. We can’t do anything without knowing the needs. Now PROCEED means what, carry on. So we’ve assessed and figured out what we want to improve on, we’ve created a plan, now let’s move forward and implement the plan and evaluate its success. For this we look at how well it works, what’s the impact it’s had on the community and what were the outcomes. Did we meet our goals?

Now, just like everything else planning community health programs don’t come without its barriers. Social and cultural barriers we talked about in the access to care lesson. But then there’s lack of available resources and community participation. Why are these so important? Because remember what we said at the beginning of this lesson, creating new community health programs can’t be very successful without input from the community. The social and cultural barriers can be linked to the participation point. Being able to access resources is equally important because we plan around what’s available and what’s not and how to make it available so we can layout and meet the goals of the program.

Let’s review. Program planning needs to include everyone. We can’t expect to promote changes to health outcomes without the main ingredient. Planning models may all look different, but they all do the same thing! Remember the nursing process throughout. And finally, we can’t make plans for a community without their input and understanding the resources available to make those plans become a reality. So be sure to address those barriers when you see them.

That’s all for the program planning lesson. Make sure you check out all of the resources attached to this lesson. Now, go out and be your best self today! And, as always, happy nursing!