Image of a pre-school age girl helps her dad pick out veggies in the produce section at the grocery store. He is holding her next to the produce and she is picking out eggplant.

Some questions to ask

  • Why are we taking action, and how will we do so?
  • How much, of what, do we hope to accomplish, and by when?
  • How will we address factors that contribute to the problem or goal, and how can we reach those most affected?
  • What particular strategies will we use to achieve success?
  • Who is best positioned to implement the strategies to achieve results and to reach those most affected?

 

Some recommended actions

  1. __ State the mission (the what and why) for your project.
  2. __ State the measurable objectives (how much of what you hope to accomplish by when).
    • In developing objectives, clearly describe (as appropriate):
      • Benchmarks that would help assess and show progress toward success with the mission (e.g., By 2020, change policies in the local food system to improve access to healthy fruits and vegetables)
      • Behavioral objectives: the changes in behaviors we would see if the group’s efforts were successful (What would people be doing differently?) (e.g., “By 2022, to increase by 30% the reported/observed level of safe sleep among babies from high risk families.”)
      • Population-level objectives: the changes in community-level indicators we would see if the group’s objectives were met (How would changes in individuals’ behaviors add up to outcomes for all those in the community?) (e.g., “By 2025, infant mortality among Black babies will decrease by 50%)
  3. __ Target strategies to particular groups and relevant factors, including to:
    • Reach and engage particular groups experiencing health inequities (i.e., related to race/ethnicity, income/poverty, gender, and/or where people live)
    • Address relevant factors and determinants affecting the problem/goal, including:
      • Personal factors [These may include: knowledge, beliefs, skills, education and training, education and training, experience, cultural norms and practices, social status, cognitive or physical abilities, gender, age, genetic predisposition]
      • Environmental factors [These may include: social support, available resources and services, barriers (including financial, physical, and communication), social approval, incentives and disincentives, time costs and delays, policies, environmental hazards, living conditions, poverty, and disparity in status]
      • Social determinants that produce inequities [These may include: a) Differential exposures and opportunities for particular groups (e.g., stress, support networks); a) Differential vulnerabilities and capabilities (e.g., education); and c) Differential consequences (e.g., access to quality services, discrimination)]
  4. __ Identity potential strategies to be used in the initiative, including:
    • Evidence-based and practice-based approaches for this issue [See resources below]
    • Specific changes in communities and systems to be implemented that:
      • Provide Information and Enhancing Skills (e.g., provide media messages for screening and well visits targeted to low-income families)
      • Modify Access, Barriers, and Opportunities (e.g., reduce wait times for prenatal care from local clinics)
      • Change the Consequences (incentives and disincentives) (e.g., provide sleep sacks and baby products as incentives for low-income mothers participating in birth preparation classes)
      • Enhance Services and Support (e.g., provide smoking cessation classes for women of reproductive age)
      • Modify Policies and Broader Systems (e.g., change local ordinances to increase fines for sales of tobacco products to minors)
  5. __ Identify those who can best implement strategies, and how they can be engaged in the effort, including:
    • Targets of change: those from groups most affected by health inequities (e.g., low-income families) and those whose actions are critical for success (e.g., mothers; service providers)
    • Agents of change: those who may be in a position to change factors and determinants that affect the problem/goal, including those with power and influence (e.g., agency administrators, elected or appointed officials)
    • Community sectors: those channels through which targets and agents of change can be reached and engaged (e.g., child care, schools, health organizations)

 

Planning example

Wyandotte County conducted a comprehensive and resident-engaged community health assessment and community health improvement plan. The 2018-2023 community health improvement plan identified priority areas including access to medical, dental and mental health care services; safe and affordable housing; violence prevention; and education and jobs.  Community workgroups that include non-traditional partners are engaged in the implementation of this plan to reduce inequities in Wyandotte County.

 

Resources to help with planning

Tools from the Community Tool Box

Toolkit: Developing Strategic and Action Plans

Chapter 8: Developing a Strategic Plan

Developing and Communicating a Vision

Tools from KDHE and other sources

What Works for Health

CDC Community Guide

MCH HRSA

Healthy People 2020/MCH

Heath Equity Zones (HEZ) Initiative

Thrive Allen County

Minnesota Department of Health Community Health Improvement Plan