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									                              Policy Development
                                Putting Knowledge into
                              Practice: OSNPPH Nutrition

                                     June 14, 2002
100 College Street
                                    Larry Hershfield
Room 213

The Banting Institute
University of Toronto
Toronto, Ontario
M5G 1L5
Tel (416) 978-0522
Fax (416) 971-2443
E-mail: hc.unit@utoronto.ca
    Adapted from:

“Making a Difference
In Your Community:
 A Guide for Policy

     Ontario Public
   Health Association

 Housed at the Centre for Health Promotion,
  University of Toronto
 Funded as one of Ontario‟s 14 resource centres
  by the Ministry of Health and Long-term Care
 Consultation, training, information, networking
  & referral services to health promoters at no
 Web site (www.thcu.ca), workbooks,
  workshops, consultants
Workshop Objectives
 To understand the purpose of policy as a health promotion strategy;
 To apply a practical model of policy development based on
  identified community health needs and stakeholder involvement to a
  specific relevant issue (school vending machine policies);
 To explore several steps on the policy journey, including Identifying
  the problem, Setting policy goals and objectives, Assessing
  policy makers, Developing an action plan and Drafting a policy
 To work on an individual project as we move along;
 To consider collective action;
 To have fun
What is Policy ?
 Can specify expectations, regulations & guides to action
 Can be informal or formal
 Can facilitate healthy choices & promote healthier lifestyles
 At macro level, can provide more equitable access to
  determinants of health (income, housing, etc.)
 Should be part of a comprehensive health promotion
 Has a consequence for non-compliance & some method of
Aspects of a “Good” Policy

 economically feasible to its supporters & those it
 politically acceptable to the more powerful
  groups affected by it
 socially acceptable within the milieu in which it is
  to operate
 administratively & technologically possible.
5 Parts to a Formal Policy

 Rationale/preamble (why the policy is
 Definitions
 Components (ie. How the policy is
 Communication, enforcement and
Policy is part of a comprehensive
approach to health promotion
           Ottawa Charter for
           Health Promotion
   Build healthy public policy
   Create supportive environments
   Strengthen community action
   Develop personal skills
   Re-orient health services
Settings for
Policy Development

   Workplaces
   Schools
   Homes
   Point-of-purchase
   Community
    • local, regional, provincial, national, international
 Others?
Why Take a Policy Approach?

 Addresses organizational and socio-environmental forces
  (beyond intra-personal and interpersonal forces)
 Widespread, lasting change
 Impact of awareness & educational programs is limited and
 Policies are a way of addressing the broader social,
  economic and environmental determinants of health.
 Policies are part of a comprehensive approach to health
  promotion (e.g., Ottawa Charter, planning cube, etc)
 Empowering
Why Take a Policy Approach?

 “ If we rely solely on a strategy of providing
      information, we not only abandon our
   communities by not providing real support
  for change but lose our voice in shaping the
    social, political and economic contexts in
         which the information is given.”

       Wallach, Dorfman, Jernigan & Themba, 1993: 26-27
Why Take a Policy Approach?

        “Those who take no interest
                  in policies
        are destined to be governed
             by those who do.
         That is the price they pay
             for their apathy.”

                              Source Unknown
Impact of Policy

 A 10% increase in the price of
cigarettes decreases consumption
about 4% among adults, and up to
       14% among youth.

          Health Canada
Sample rationale: resolution format

WHEREAS it has been determined that the presence of second-
hand smoke in public places is a health hazard and

WHEREAS children are particularly susceptible to the negative
respiratory health effects of second-hand smoke; and

WHEREAS subsection 213(2) of the Municipal Act authorizes
local municipalities to pass by-laws regulating smoking in public
places; and

WHEREAS municipal by-laws will decrease exposure to second-
hand smoke; and

NOW THEREFORE the Council of (name of municipality)
enacts as follows the (name of by-law)
Sample of Public Health Unit‟s
Nutrition Policy
1. Nutritious and safe food and beverage choices shall be provided at all
   work-related meetings, workshops and other events where food and/or
   beverages are served.
2. The Health Unit is committed to five principles:
    • Healthy eating - Healthy eating incorporates the concepts outlined in Canada's Food
       Guide to Healthy Eating. It also includes the belief that all foods can be part of a healthy
    • Safe food handling practices - High standards of food preparation and service
       ensure access to safe food.
    • Being environmentally friendly - Environmentally friendly means recycling and
       minimizing waste from food, food packaging and disposable dishes.
    • Promoting Ontario products - By choosing Ontario products we support Ontario's
       food and agriculture industries.
    • Being fiscally accountable - Fiscal accountability means the best responsible price to
       support healthy eating.
Sample of Public Health Unit‟s
Nutrition Policy (2)

3. All caterers shall be booked in consultation with the Infectious Disease

4. When planning meetings, workshops or other events where food
   and/or beverages are going to be served, staff are encouraged to use
   the Practical Suggestions for Applying Healthy Eating Guidelines.
   Inquiries about special dietary requirements or restrictions should be
   made in advance when possible so appropriate arrangements can be
   made for participants. For large groups, a vegetarian choice should be
   automatically provided. As well, the choices should include fruit as an
   alternative dessert and fruit juice and decaffeinated coffee as an
   alternative to coffee.

5. Nutrition staff and inspectors will assist with food arrangement when
Position Paper: Rationale for policy

  Informs stakeholders (the public, the Board of
   Directors, the media, other peer organizations)
   where you stand on a particular issue.
  Involves having researched the topic and come to
   a statement that will be shared.
  Usually includes a clear statement of the issue,
   the evidence, the position of the organization, the
   rationale for this stance and what they are
   prepared to do.
The Policy
Larry's tips for planning
1. Use "right brain" methods
2. Use small groups to generate drafts, lists of
   possibilities & large group to revise, prioritize,
3. Use your time to create end documents from the
   outset e.g. creative briefs, policy statements,
   strategic plans
4. Use brief minutes and other project
   management tools to track key decisions,
   milestones, action steps, reminders.
                              1. Identify, describe
                                 and analyze the

100 College Street
Room 213
The Banting Institute
University of Toronto
Toronto, Ontario
M5G 1L5
Tel (416) 978-0522
Fax (416) 971-2443
E-mail: hc.unit@utoronto.ca
Identifying the Problem
 “Something is wrong. Something needs to change.
  We want to do something. Our current approach is
  causing problems!”
 May mean a “flip” on the healthy lifestyles
  approach - heart disease not heart health
 Work begins when people see a problem and want
  to resolve it

          Problem-solving Framework
Problem - Solving Framework
Describing the Problem
 What is the extent of the problem? How big a
  problem is it? What and who is involved? What
  are the costs (social, economic and other
  burdens)? What are the limits of the problem?
 What is the origin of the problem? Is there a
  starting point to your problem? When did it first
  become apparent? What would happen if nothing
  was done?
 How is the problem viewed by others? Who else
  thinks it is a problem? Has the media been
  covering the situation? Is it seen as a crisis?
Describing the Problem

   Be as specific as you can when describing the
  Could also be called Issue Analysis or Situational

 A position paper might capture it, or
 What EXACTLY is the problem - try to state it in
  one sentence.
Analyzing the Problem

 What factors in the community affect the problem
  (e.g. community attitudes, traditional values,
  conflicting agendas, economic difficulties, cultural
 Are you looking at the real problem or a
 What has been done to try and resolve it? What
  else could be considered?
It‟s as simple as ABC

 Antecedents (analyze)

 Behaviors (identify)

 Consequences (describe)
Analyze the Problem

Gathering Data
 What related / relevant policies already exist in
  this setting? Elsewhere?
 Surveys, stats, media coverage, studies, literature
  review, interviews with key individuals or groups.
 Aim for as much local data as possible - perhaps
  undertake a sound survey.
 Looking to “make the case” for recognizing and
  addressing the problem.
             Sources of Audience Analysis Information
             Qualitative                          Quantitative
  Existing                  New            Existing              New
Low     High         Low          High   Low     High     Low          High
Cost    Cost         Cost         Cost   Cost    Cost     Cost         Cost
When do we have enough?

 When our picture is relatively complete.
 When our picture is valid (triangulate)
 When our picture is compelling
                              2. Assess Community
                                  capacity and

100 College Street
Room 213
The Banting Institute
University of Toronto
Toronto, Ontario
M5G 1L5
Tel (416) 978-0522
Fax (416) 971-2443
E-mail: hc.unit@utoronto.ca
The Policy
Assessing community
Identifying & Understanding Stakeholders
 Who will be positively or negatively affected if the
  problem were resolved?
 Who else sees this as a problem?
 What exactly do some stakeholders stand to gain
  from resolving the problem? How important is this
  to them?
 What are they doing already?
 Are the stakeholders‟ reasons for wanting the
  problem solved the same as yours? If not, what
  are they?
Assessing community
 Are there others who you might bring on side if
  the matter were brought to their attention?
 What exactly do other stakeholders stand to lose
  from resolving the problem? How important is it
  to them? How strong is their opposition likely to
  be? What counter-arguments can be anticipated?
 What would be the impact of these changes, on
  the community-at-large, on certain segments, on
  certain individuals?
An Example of Stakeholders
Assessing Community Capacity

 Are there programs in your community whose
  focus is “your” problem? For how long? Success?
 What kinds of environmental supports exist for the
 If similar issues have arisen in the past, what was
  the response?
 What general capacities, assets, social capital
  might be available, and when?
                              3. Determine “Is policy
                                 an appropriate

100 College Street
Room 213
The Banting Institute
University of Toronto
Toronto, Ontario
M5G 1L5
Tel (416) 978-0522
Fax (416) 971-2443
E-mail: hc.unit@utoronto.ca
Is your strategy “strategic”

 Having considered the external environment
  (opportunities, threats, trends,
 Consider internal strengths and
  weaknesses/limitations, and
 Mandate(s)
The Four Levels
 Consider, for a moment, the following…

  • Do you believe that an individual can change his/her
  • Do you believe that an individual‟s behaviours are
    influenced by the social, workplace, and community
    networks to which they belong?
  • Do you believe that the environments in which people
    eat, play, work and worship influence their behaviour?
  • Do you believe that the laws and regulations of a
    society/community influence individual behaviour?
The Four Levels (con‟t)

  If you believe these to be true, then
    you agree that there are multiple
   levels which influence health, all of
          which are important.

Level Interactions
 As individuals become concerned about an issue,
  they will likely discuss it in their social networks
  (e.g. friends and family),
 Which may eventually lead to changes in
  organizations such as worksites,
 And then to changes in public opinion and laws at
  the societal level.
 Laws and the physical environment of
  communities and societies can also influence
  individual, network and organization actions.
Working with the
four levels
   Level       What is   Who is to   Amount of   Related to   Conclusions
                 the      blame?      change     mandate?
               cause?                possible?




Developing a Multi-Level
Health Promotion Strategy
Level        Bottom line target    Relevant        Factors affecting           Principle audiences
             for change            theories        bottom line

Individual   Maintaining a         Stages of       An individual‟s:            Segments most in need of change
             personal behavior     Change.         -knowledge                  (based on demographics,
             change.               Health Belief   -beliefs                    psychographics, etc.) Such as:
                                   Model           -attitudes                  -men
                                                   -skills                     -children
                                                   -self efficacy              -low income groups
                                                                               -homeless people

Network      State of the social   Diffusion of    -Views of network opinion   Opinion leaders of networks such
             environment.          Innovations     leaders                     as:
                                   Theory          -Frequency and content of   -families
                                                   conversations about a       -groups of friends
                                                   heath issue within a        -colleagues
                                                                               -team mates
Developing a Multi-Level
Health Promotion
Strategy (2)
Level          Bottom line target   Relevant         Factors               Principle audiences
               for change           theories         affecting
               (objective)                           bottom line

Organization   Policies.            Organizational   -cost/benefits to     Decision makers (primary) or employees,
                                    Theory           industry.             unions, customers (secondary) of
                                                     -general industry     organizations such as:
                                                     trends.               -Schools,
                                                                           -Places of worship
                                                                           -Primary health care settings

Society        Formal Laws.         Social Change    -Actions of special   Elected officials (primary) or the public,
                                    Theory           interest groups       special interest groups, media (secondary)
                                                     -Media coverage       of a:
                                                     -Public opinion
Chicken or the Egg
      Do we begin with a policy outcome in mind and
      build our awareness, education & environmental
      strategies in order to get there?

      Do we generate awareness, share education,
      build skills and supportive environments and
      see what policies are needed to complement
      this work?
New Nutrition Label
          Build on
          Existing Work
 Awareness campaigns to sensitize people to the
  problem (e.g. Nutrition Month)
 Education & skill development programs that
  address individual‟s needs (e.g. School Curricula
  on nutrition & health)
 Environmental supports that address the system &
  need to be in place (e.g. school nourishment
  program), to complement a policy (school food
The Problem:
Decide what to do
 Is a policy approach the best way to
  proceed, at this time, given the problem you
  have identified?
 Are there complementary approaches that
  should be pursued in addition to the policy
Possible Directions
 Adaptations to existing approaches.
 Ceasing current approaches.
 A new approach or program to address the critical
  issues within the situational context.

Awareness        Env‟l           Policy
& Education      Support /
Assessing the situation

 Force Field Analysis
  • positive or driving / negative or restraining
  • undertake this with your “collective”
  • part of change management process
  • could plot people who are on different sides of
    the fence or factors
                              4. Develop policy goals
                                  and objectives

100 College Street
Room 213
The Banting Institute
University of Toronto
Toronto, Ontario
M5G 1L5
Tel (416) 978-0522
Fax (416) 971-2443
E-mail: hc.unit@utoronto.ca
Develop Policy Goals and Objectives

 Goal: A brief statement summarizing the
  ultimate direction or desired achievement of
  your policy (e.g., to promote food security
  among low-income families, or to reduce
  the incidence of alcohol-related harm
  among young people)
Develop Policy Goals and Objectives

When setting policy goals, consider:

• What aspect of the health issue/problem
  you want to address
• What your policy can achieve over the short
• What your policy can achieve over the long-
Develop Policy Goals and Objectives


• Brief statement specifying desired impact or effect
  of your policy (ie., how much of what should
  happen (to whom) by when)
• Most policies have one (at most 2-3) goals, and
  multiple objectives
• Think of objectives as the „directions‟ for the
  achievement of goals
Examples of objectives for
school alcohol policy

 To reduce the incidence of alcohol-related injuries
  on campus by 2004
 To promote low-risk drinking while supporting
  those who choose not to drink
 To implement an intervention and counselling
  protocol for students at risk of drug and alcohol-
  related problems by December 2002
 To promote responsible alcohol service at licensed
  establishments on campus
Tips for Setting Objectives

 Consider the specific policy components and time
  frame needed to meet your goals
 Each objective should focus on one desired policy
  change or result
 Remember that a comprehensive policy will entail
  multiple objectives (both short and long-term)
 Objectives must be measurable, so they can be
                              5. Identify decision-
                                  makers and

100 College Street
Room 213
The Banting Institute
University of Toronto
Toronto, Ontario
M5G 1L5
Tel (416) 978-0522
Fax (416) 971-2443
E-mail: hc.unit@utoronto.ca
Identify Decision-Makers &

 Whose decision is it to say “yay” or “nay” to
  the proposed policy?
 Who influences these people?
  • Constituents - those affected by the policy
  • Other partners
  • Opinion leaders
 What do you know about these people that
  will aid in your approach?
Types of Decision-Makers

 Status-oriented decision-makers are highly
  concerned about generating positive media
  coverage and/or avoiding unfavourable coverage.
 Mission-oriented decision-makers hold strong
  views about what their department should be
 Process-oriented decision-makers are most
  concerned with serving their “clientele” or
Types of Decision Makers
   Delayed decision - weigh the evidence.
   Decisions to please someone.
   Unavoidable decisions.
   Reactionary decisions - in a corner.
   Personal preference decisions.
   Results-oriented decisions.
   Popular decisions.
   Safe decisions.
   Power-based decisions.
   Decisions based on vision.
                              6. Assess Decision-

                                Is support for policy
100 College Street
Room 213
The Banting Institute
University of Toronto
Toronto, Ontario
M5G 1L5
Tel (416) 978-0522
Fax (416) 971-2443
E-mail: hc.unit@utoronto.ca
Ways to Assess Stakeholders

   Look at their “walk” not their “talk”
   Poll
   Ask them
   Ask people close to them
   Others….
                              7. Develop an action
                                  plan to build
                                  support for your

100 College Street
Room 213
The Banting Institute
University of Toronto
Toronto, Ontario
M5G 1L5
Tel (416) 978-0522
Fax (416) 971-2443
E-mail: hc.unit@utoronto.ca
Develop an
Action Plan
to Build

 In the „real world‟, the process of reaching
  consensus on a policy often involves „trade-
  offs‟ between the competing agendas and
  interests of key stakeholder groups
Policy Development:
the art of the „possible‟

 “There are two things you never want to
  see: sausage making and policy

                 Source unknown.
Building Support

    For your policy outcome:
    • Who makes the decisions on your proposed
       policy? Who influences them?
    • How will you appeal to them?
    • How will you reach them?
       Format (letter, conversation, formal presentation)
       Messenger (peer, expert, human interest)
       Content (main point, counter-arguments)
Tips on Setting the Agenda
with Policy-Makers
 Solutions need to be clearly linked to a compelling
 Build as many plausible links between problems and
  solutions as you can.
 Proposed solutions need to be clearly explained,
  straightforward and not overly complex.
 Solutions must be technically accurate, but remember
  that decision-makers must be able to translate
  solutions into explanations, accounts and arguments
  that make sense to their own constituents.
 Build coalitions and stimulate debate in various
Influencing Decision Makers

Demonstrate that …

   progress is possible
   collective action cannot be avoided
   participation is beneficial to all parties
   proven tools & methods are readily available
   short-term successes will be apparent
   the credibility & influence of various sources are
    well established

 The proposed change is too costly.
 Increased legislation/regulations restrict
  individual freedoms to an inordinate degree.
 There is an alternative (non-legislative)
  means of addressing the issue.
 There is a philosophical difference about the
  origin or the the needed response to the
Understanding the
Tactics of the Opposition
 Deflect - they could divert the issue to a lesser, side issue; or could
  "pass the buck" to a lower official who has no real power.
 Delay - your opponent could make you think they are addressing the
  issue, when nothing is really being done. For example, forming a
  "study commission" that has no real power.
 Deny - your opponent may say your claims and your proposed
  solutions, or both, are invalid.
 Discount - your opponent may try to minimize the importance of the
  problem or question your legitimacy as an agent of change.
 Deceive - your opponent may deliberately try to make you and your
  group feel like they are taking meaningful action, when they in fact
  have not; they may never have had any real intention to consider your
Understanding the
Tactics of the Opposition (2)

 Divide - your opponent may sow the seeds of dissent into your
  group's ranks, and use a "Divide and Conquer" strategy.
 Dulcify - your opponent may try to appease or pacify your group
  through offers of jobs, services, and other benefits .
 Discredit - your opponent may try to cast doubt on your group's
  motives and methods.
 Destroy - your opponents may try to de-stabilize or eliminate your
  group through legal, economic, or scare tactics.
 Deal - your opponent may decide to avoid conflict by offering a deal,
  working towards a mutually acceptable solution.
 Surrender - the opposition may agree to your demands. If this is the
  case, you should remember that the victory is not complete
  until the opposition follows through with its promises.
University of Kansas Community Tool Box http://ctb.lsi.ukans.edu/
Possible Persuasion Strategies

  MEDIA                INTERPERSONAL                   EVENTS

* letter writing       *   telephone campaign          *   public forum
* press conference     *   debriefing sessions         *   marches
* mass media           *   deposition / presentation   *   demonstration
(billboards, radio)    *   one-on-one meetings         *   elections
* petition             *   others?                     *   others?
* posters, pamphlets
* others?
Effective Policy Strategies

 lobbying legislators directly, through influential
  partners, or through their constituents
 election of sympathetic political leaders
 litigation
 community group mobilization
 private debriefing meetings
 press conferences as part of a wider media
Direct Tactics:
Letter Writing
 Benefits:
    • considered by some authors to be more effective than phoning
      because of its tangibility
    • can expedite by sending your letter through the fax or via email.
      Because e-mail may be novel to some decision-makers, it may get
      more attention in the short term.

 Drawbacks:
    • A passive form of communication. It is hard to predict exactly how
      your letter will be interpreted.

-Working toward Heart Health Public Policy at the Local Level, page 20
Direct Tactics:
Letter Writing (con‟t)
 Tips:
  • Always send personalized letters - never send a form or
    generic letter. Use the coalition letterhead as a way to
    demonstrate that there is support for the cause. Keep
    the letter to one or two, typed pages.
  • Ask for a response to your letter.
  • When writing about a specific by-law, indicate the name
    or topic.
  • Enclose relevant news clippings.
  • Close with “I am looking forward to your response.”
  • Follow up with a phone call or letter to determine the
    progress being made and reaffirm their commitment to
Direct Tactics:
Phone Calls
 Benefits:
  • a very quick way to express your concerns about an issue

 Drawbacks:
  • You may not have an opportunity to speak to the decision-maker

 Tips:
  •   The eight minute mark
  •   Give your name and indicate who you are
  •   Do not call form a cell phone if the connection will not be clear
  •   Ensure your call will not be interrupted
  •   Follow up with a letter to reaffirm your message and their
      commitment to follow through.
                Working toward Heart Health Public Policy at the Local Level, page 20
Direct Tactics:
 Benefits:
  • Personalizes issues
  • Helps to establish relationships

 Drawbacks
  • You may not get a meeting for as long as you
    have requested.
Direct Tactics:
Meetings (con‟t)
 Tips
  • Call to set up an appointment. Follow-up to confirm.
  • Select two people to attend the meeting.
  • Prepare a summary of the issue (max 2 pages) to take with you.
  • Rehearse responses.
  • Dress appropriately.
  • Arrive on time.
  • Thank them for the meeting.
  • Don‟t fake answers to questions you don‟t know.
  • At the end of the meeting, briefly summarize.
  • Leave a background report or fact sheet.
  • Debrief back at your office.
  • Follow-up with thank-you letter.
  • Say in touch.
Direct Tactics:
 Benefits:
  • A good way to get known by decision-makers
    and enhance the credibility of your coalition.
  • Can generate enthusiasm within your coalition
    when the presentation is well received.
 Drawbacks:
  • Unexpected things can happen and these can
    derail the presentation.
  • Knowing as much as possible about the physical
    setting and your audience will help you to
    prepare and cope.
Direct Tactics:
Presentations (con‟t)
  • Carefully consider what your objective is for the presentation.
  • Find out what the protocol is for such presentations.
  • Select a suitable spokesperson – someone who has credibility, good
    speaking skills & commitment & enthusiasm for the cause.
  • Avoid jargon, abbreviations, acronyms & sophisticated language.
  • Use audio-visual aids to retain interest & to communicate complex
  • Provide a handout of your presentation for members of audience.
  • Have your supporters present and readily identifiable.
Social Judgment Theory:
Five Principles
 We have categories of judgment by which we evaluate
  persuasive positions - latitudes.
 When we receive persuasive information, we locate it on
  our categories of judgment.
 Our level of ego-involvement (how important the issue is
  to our self-identity) affect the size of our latitudes.
 We tend to distort incoming information to fit our
  categories of judgment.
 Small to moderate discrepancies between our anchor
  positions and the one advocated will cause us to change,
  large discrepancies will not.

Implications for
 Work in the latitude of acceptance (zone of
  positions we accept), and avoid the latitude of
  rejection (zone of positions we reject).
 Expect change to happen in many small steps
  over a long time period.
 Watch out for ego-involvement (how important
  the issue is to our self-identity).

When stating your case…
 Keep it short.
 Identify the benefits of or the need for the policy
 Substantiate your position with local data,
  scientific facts, the experiences of other
 Link to the strategic direction/overall mission of
  the decision-makers jurisdiction.
 Counter opposing arguments (see next slide).
 Make an emotional appeal.
Look for ways to:

 Hit them in the head.
 Hit them in the heart (with something warm
  and appealing).
 Hit them in the gut (with something
 Hit them in the pocketbook.

     Light       Heavy

    Humourous     Angry

    Whimsical    Outrage

        Ironic   Injustice

     Cheery      Dramatic
Typical Categories of
 Celebrity (famous athlete or entertainer)
 Public official (government leader or agency director)
 Expert specialist (doctor or researcher)
 Organization leader (hospital administrator or executive),
 Professional performer (standard spokesperson,
  attractive model, or character actor)
 Ordinary real person (blue-collar man or a middle-class
 Specially experienced person (victim, survivor, or
  successful role model)
 Unique character (animated, anthropomorphic, or
  Above information presented by Dr. Chuck Atkin at 2000 Special
                     Topics, THCU workshop).
Selection of Messengers
 In selecting the appropriate messenger, the crucial factor is which
  component of influence model needs a boost. For example,
   • celebrities help draw attention to a dull topic,
   • experts enhance response efficacy,
   • ordinary people heighten self-efficacy,
   • victims convey the severity of harmful outcomes, and
   • victims who share similar characteristics of the audience
     should augment susceptibility claims.
 Atkin (1994) provides an elaborate discussion of strengths and
  weaknesses of various types of messengers
  Above information presented by Dr. Chuck Atkin at 2000 Special
                     Topics, THCU workshop).
                              8. Draft policy

100 College Street
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The Banting Institute
University of Toronto
Toronto, Ontario
M5G 1L5
Tel (416) 978-0522
Fax (416) 971-2443
E-mail: hc.unit@utoronto.ca
Draft a
Draft Policy Checklist

All policies should include:
• A preface or preamble describing the purpose of the policy;

• Policy goals and objectives

• A description of the policy components (ie., the associated activities,
  regulations, sanctions, etc. that constitute the „meat‟ of the policy)

• Procedures for dealing with failure to comply with the regulations
  specified in the policy

• A plan for promoting and disseminating the policy

• A plan for monitoring and evaluation.
The Writing Process

   Ideally done by a small subcommittee (2-3
    persons) with a designated lead writer

 Committee will assume responsibility for:
a) Writing drafts of the policy
b) Obtaining feedback from other stakeholders (as
   deemed appropriate)
c) Undertaking revisions
Draft a policy

 Consider
  •   using a collective process of many stakeholders
  •   implications for all affected
  •   enforcement issues
  •   loop-holes
  •   existing examples
  •   history with this issue (has it been tried
Supports Available
 The Ontario Health Promotion Resource
  System: (www.ohprs.ca)
  •   THCU
  •   Heart Health Resource Centre
  •   Program Training & Consultation Centre
  •   Nutrition Resource Centre
  •   Ontario Healthy Communities Coalition
  •   Best Start
  •   FOCUS Resource Centre

 Ontario Health Promotion Email Bulletin -
100 College Street
Room 213
The Banting Institute
University of Toronto
Toronto, Ontario
M5G 1L5
Tel (416) 978-0522
Fax (416) 971-2443
E-mail: hc.unit@utoronto.ca
The Health Communication Unit and its resources and

  services are funded by the Community Health Promotion

  Branch, Ontario Ministry of Health and Long-term Care.

  The opinions and conclusions expressed in this paper are

  those of the author(s) and no official endorsement by the

  Ministry of Health and Long-term Care, Community Health

  Promotion Branch is intended or should be inferred.
Characteristics of Effective Policies

Effective policies:
• Are developed using a „bottom-up‟ approach
  (consult with stakeholders to determine needs and
  appropriate solutions
• Have realistic goals and objectives
• Do not rely exclusively on punitive measures
• Are enforced fairly and consistently
• Are responsive to changing circumstances and
  unintended consequences
Policy Implementation Checklist

• Have you identified and analyzed the issues your
  policy needs to address?
• Do you have sufficient information about these
  issues to support and justify the implementation of
  your policy?
• Are your policy goals reasonable, and your policy
  objectives measurable?
• Do you have the required support and approval of
  key decision makers? If not, how will this be
Policy Implementation Checklist

 Have you selected your policy components and
  prepared a written policy that describes these
  components and a strategy for implementation?
 Do you have an accurate estimate of the
  resources (time, money, person power and
  expertise) needed to implement and monitor your
 Is the time-line for implementation realistic?
 Does your policy specify who is responsible for
  doing what?
Policy Implementation Checklist

 Have you identified the barriers to implementation
  you are likely to encounter?
 Do you have a plan for dealing with these
 Have you shared your draft policy with other key
  stakeholders who will be responsible for
 Is this the appropriate time to start implementing
  your policy?
Tips for Successful Implemenation

 Time management is critical, as you will need to
  juggle multiple activities

 Need to be flexible in order to respond quickly
  when things don‟t go according to plan

 Remember that no policy will be completely
  flawless, esp. when it is being implemented for the
  first time
Evaluating Policy:Looking Back

 Have you moved ahead? By how much?
 Is the situation better than before?
 How have your efforts changed the big picture? Have you
  reached your goal?
 Did it go as planned? What caught you off-guard?
 What would you do differently another time?
 Did you exceed your expectations? What does this mean
  for future plans?
 What have you learned about the issue? What have you
  learned about the policy change process?
 Are the people who were involved in the process happy
  with the results of their actions?
Evaluating Policy: Looking Ahead

 Does more need to be done? If so, what
  and when and by whom?
 Do people in your group want to do more?
  Are they highly motivated?
 What will happen to the coalition? Has it
  served its purpose? Is there a reason to
  stay together?

Closing Remarks

 Reflections on the day
  • Process
  • Outcome
 Evaluation Forms

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