Chapter 4 - Plan the initiative: How will you reach the goal/objective?
Culture Counts: A Guide to Best Practices for Developing Health Promotion Initiatives in Mental Health and Substance Use with
Ethnocultural Communities
In chapter 4 - Plan the initiative:
On this page:
To reach your goal or objective, you need to choose an initiative that is going to engage the attention of the intended audience.
You are more likely to end up with a useful and appropriate initiative if community members and members of the intended audience
take part in creating a new initiative or adapting an existing one. They'll let you know if the initiative or parts of it
aren't going to work.
As you and your partners start developing your health promotion initiative, remember to:
- involve interested community members/members of intended audience in creating the initiative
- make sure you have or can get the resources to run the initiative
- try out initiative activities with members of the intended audience before launching them
- make sure the initiative reflects the ideas in the Ottawa Charter for Health Promotion.
According to the Ottawa Charter, health promotion is “the process of enabling people to increase control over, and to improve, their health.” The following
strategies, which are often combined, are commonly used:
Create supportive environments
“Activities aimed at establishing policies that support healthy physical, social and economic environments” (WHO, 1998).
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Initiative example: Consumer Voices Are Born, a drop-in centre run by consumers of mental health services in Washington State, trained peer volunteers
to operate a multilingual telephone “warm-line” which people could call just to talk or get information about mental health
services in their own language.
National Consumer Supporter Technical Assistance Center. “Implementing a Multilingual Warm-Line.” (PDF) Cultural Competence Toolkit, Chapter 10.
Health education
“Consciously constructed opportunities for learning designed to facilitate changes in behaviour towards a predetermined goal,
and involving some form of communication designed to improve health literacy, knowledge, and life skills conducive to individual
and community health” (PAHO, 1996; WHO, 1998).
Initiative example: The Montreal Children’s Hospital, in partnership with schools, developed and ran creative expression workshops in schools
to help newcomer children adapt to their new environment.
C. Rousseau, et al.: “Creative Expression Workshops in School: Prevention Programs for Immigrant and Refugee Children.”
Health communication
“A strategy to inform the public about health concerns and place important health issues on the public agenda achieved through
the use of the mass and multimedia, and other technological innovations that disseminate useful health information to the
public, increase awareness of specific aspects of individual and collective health, as well as increase awareness of the importance
of health in development” (WHO, 1998).
Initiative example: working with the community to develop public service announcements (PSAs) in the community language about the risks of alcohol
use and to arrange to have them aired on community radio stations.
Self-help
“Actions taken by lay persons to mobilize the necessary resources to promote, maintain or restore the health of individuals
or communities through self-care activities such as self-medication, self-treatment and first aid in the normal social context
of people's everyday lives” (WHO, 1998).
Initiative example:Alone in Canada: 21 Ways to Make it Better -- a self-help guide for single newcomers in 18 languages published by the Centre for Addiction and Mental Health.
Organizational development
“A process typically used in industry although applicable to other settings such as communities, to improve performance, productivity
and morale issues, and attain an optimally functioning organization, with a high level of cohesion, well-being and satisfaction
on the part of all those involved” (Raeburn & Rootman, 1998).
Initiative example:“Capacity Building and Strengthening for Ethnocultural Communities—A Toolkit for Trainers.” Published by the Canadian Ethnocultural Council, this guide aims at improving organizational and administrative processes
in ethnocultural community organizations.
Strengthen community development / action
“A process of collective community efforts directed towards increasing community control over the determinants of health,
improving health and becoming empowered to apply individual and collective skills to address health priorities and meet respective
health needs” (WHO, 1998).
Initiative examples: supporting the development of an action plan and grant application for a culturally and linguistic appropriate day program
at the community centre for people with dementia.
Build healthy public policy
“Formal statements that demonstrate concern for heath and equity and which make healthy choices possible or easier for citizens,
through creating supportive social and physical environments that enable people to lead healthy lives” (PAHO, 1996; WHO, 1998).
Initiative example: helping the community to develop a local policy on alcohol availability.
To learn more about effecting policy change:
Advocacy
“A combination of individual and social actions designed to gain political commitment, policy support, social acceptance and
systems support for a particular health goal or program” (PAHO, 1996; WHO, 1998).
Initiative examples: working with the community to set up workshops for medical and social work professionals to learn about the community’s mental
health needs.
Research
“Information that links theory and practice through the investigation of the real world and that is informed by values about
the issue under investigation, follows agreed practices, is sensitive to ethical implications, asks meaningful questions and
is systematic and rigorous (Naidoo & Wills, 1998). Evaluation research is formal or systematic activity, where assessment
is linked to original intentions and is fed back into the planning process (Naidoo & Wills, 2000).”
Initiative example: helping community members gather statistics to support the community’s submission for alcohol policy reform to the liquor
control board.
Combining several strategies in an initiative
Initiative example:“Healthy Women – Healthy Communities/Mujer Sana – Communidad Sana.” A partnership of four organizations in Ottawa worked together to improve local Hispanic women’s access to information and
services for breast and cervical cancer screening, in hopes of developing a model that can be used in other ethnocultural
communities in Canada.
To learn more about health promotion strategies:
You will probably want to use more than one activity in your initiative in order to reach its goal or objective. Using different
media and methods to communicate your message will help you reach a broader range of community members. You can use communication
strategies to both promote the message of your initiative and encourage community members to get interested and involved.
Identify credible communicators in the community
Within ethnocultural communities, institutions such as churches, temples or mosques, local businesses, schools and local political
bodies play important roles in addressing health and substance use problems. Identify prominent leaders within these institutions
and see if they are willing to speak up in support of your health promotion message. If so, they can be an important part
of your communication strategy. They already have the trust and “ear” of the community and their support will add credibility
to your initiative. They could speak to their community directly about the message. Some may also be willing to be interviewed
by the media about the problem your initiative is trying to address.
Use different methods to communicate your initiative’s message
There are many different ways to communicate your message but, as your resources are limited, you'll want to focus on those
that are most likely to reach your intended audience. Here are some examples of communication methods you might use.
Audio presentations
What: any presentation of information in audible form, usually recorded on audio tape/CD.
Types:
- dramas
- documentaries
- interviews with community leaders and key informants
- public service announcements
- songs
- self-help programs, e.g., smoking cessation
- advertisements
- readings of print materials for non-readers or the visually impaired.
How:
- consumer recording equipment can be used but recording studios will likely yield better results
- partner with local college/university/public radio stations to make recordings and air results
- programs can be distributed through broadcast on ethnic/local radio; on tape or CD; through web site podcast that can be downloaded
to digital audio players; over the telephone.
Pros:
- multiple methods of distribution
- can reach people who cannot or do not read or prefer oral presentation of information
- useful for busy people—can be listened to in the car, on public transit, while doing household work
- can be used by the visually impaired
- recorded formats can be listened to repeatedly if needed
Cons:
- requires recording knowledge and equipment
- can be costly depending on recording and distribution methods
- may need professional actors/speakers to get best results.
To learn more about audio presentations:
Video presentations
What: any presentation of information in audiovideo form, usually recorded on video tape/DVD.
Use for:
- dramas
- documentaries
- interviews with community leaders and key informants
- public service announcements
- advertisements
- demonstrations (e.g., what a standard alcoholic drink looks like; ways to prepare healthier versions of ethnic dishes)
How:
- show in clinic waiting rooms; to groups to promote discussion
- webcasts; Youtube; ethnic TV stations, television programs
- provide copies to public libraries to be borrowed.
Pros:
- multiple methods of distribution
- more appealing to people who prefer oral presentation of information
- in tape/DVD/online form, can be used at audience’s convenience
- with subtitles, can be used by the hearing impaired
- recorded formats can be listened to repeatedly if needed
- narration can be done in different languages, dialects.
Cons:
- requires skills, good equipment to yield good results.
- can be expensive depending on the level of production quality desired
Arts projects
What: using visual arts, theatre, dance, music to present health promotion message.
Types:
- displays and presentations in public spaces—parks, community centres, during community street festivals, schools, other public
buildings
- competitions to create songs, poems, short stories, essays, etc., with the initiative’s message as the theme
- theatre and dance performances by community groups or professional troupes.
How:
- use volunteer or professional artists and arts facilitators to work with community members and/or intended audience to produce
art works.
- can be created by intended audience as a way of exploring health issue.
- may be used as content for audio/video presentations and web sites.
Pros:
- provides opportunity for skills development
- effective for different learning styles
- encourages community members to work together
Cons:
- requires skilled organizers and facilitators
- requires materials, equipment, workspace
- may need longer-term commitment from participants
- may require special funding if professional artists are used.
Example:
FOCUS is a province-wide health promotion program aimed at vulnerable communities. In Regent Park, a public housing development
in downtown Toronto, the Regent Park Youth Media Arts Center provides community youth with a variety of ways to express themselves
and address health issues through the arts. The centre’s web site the results of many arts projects that creatively provoke
thought and discussion about community concerns, particularly substance use.
ESL/LINC classes
What: ESL (English as a Second Language) or LINC (Language Instruction for Newcomers to Canada) classes can be used to present
and teach about community health issues. Students can also produce materials based on their own experiences with the issues.
How:
- prepare class plans and materials that could be used by teachers and tutors in these classes
- have bilingual workers and volunteers make presentations to the classes, e.g., about how to use health services in Canada.
- encourage students to develop their reading and writing skills by writing articles or other text pieces about community health
issues that can be published in community newspapers, newsletters, on web sites or be posted in public displays, such as bulletin
boards in community centres or public libraries.
Pros:
- can reach community members who may be too busy to get involved in other activities
- inexpensive
Cons:
- needs people skilled in ESL/LINC education methods.
- requires cooperation with ESL/LINC programs and instructors.
Examples:
Printed materials
What: a health promotion message can be printed on just about anything.
Types:
- brochures, posters, pamphlets, newsletters, postcards, comics, place mats, coasters, T-shirts, hats, buttons, bookmarks, temporary
tattoos
How:
- materials and format depends on budget
- can use professional writers and designers and offset printing services (high cost)
- can present content created by staff, community members and print using office laser or ink jet printers along with specialized
papers, such as card stock, pre-printed papers, transfers for use on fabrics.
Pros:
- using office equipment, can be produced quickly
- different options for different budgets
- many distribution possibilities.
Cons:
- professional-looking materials usually require professional artists, copywriters, designers
- can be expensive
- difficult or costly to fix errors or to revise print materials if content becomes dated
- products need to be stored
- can be costly to distribute.
Examples of different printed document types:
To learn more about developing print materials:
Where possible, use more than one type of method to deliver your message so that the widest audience can be reached. Where
literacy levels vary, having both a text-based product or resource and a non-verbal or oral delivery mode will increase the
numbers of people reached.
Non-verbal and visual approaches may work best
Flyers, brochures, advertisements and other text-based media are frequently the main products used in health promotion campaigns.
Language is often a major challenge when developing health promotion campaigns with ethnocultural communities, however. The
intended audience may have little or no literacy in English; they may also have limited literacy in their first language.
Delivery methods that rely heavily on text and the users’ reading skills may not be the best choice for ethnocultural communities.
Unfortunately, many of the non-text or low-text communication methods, such as photonovellas, videos/DVDs, audiotapes/CDs,
and radio and TV ads are expensive to produce and distribute. Community activities, such as parades, plays, and arts festivals,
may be less expensive ways of engaging the community in thinking about and discussing a particular issue.
To learn more about non-text approaches:
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