Community Planning: Principles Accept different agendasPeople will want to be involved for a variety of reasons, for instance: academic enquiry, altruism, curiosity, fear of change, financial gain, neighbourliness, professional duty, protection of interests, socialising. This need not be a problem but it helps to be aware of people’s different agendas.

Accept limitationsNo community planning activity can solve all the world’s problems. But that is not a reason for holding back. Limited practical improvements will almost always result, and community planning activity can often act as a catalyst for more fundamental change.

Accept varied commitmentFar too much energy is wasted complaining that certain people do not participate when the opportunity is provided. All of us could spend our lives many times over working to improve the local environment. Everyone has their own priorities in life and these should be respected. If people do not participate it is likely to be because they are happy to let others get on with it, they are busy with things which are more important to them or the process has not been made sufficiently interesting.

Agree rules and boundariesThere should be a common understanding by all main interest groups of the approach adopted. Particularly in communities where there is fear – for instance that others may be trying to gain territorial advantage – it is vital that the rules and boundaries are clearly understood and agreed. In particular it is important to be clear about what can and cannot be changed as a result of any community involvement.

Avoid jargonUse plain language. Jargon prevents people from engaging and is usually a smokescreen to hide incompetence, ignorance or arrogance.

Be honestBe open and straightforward about the nature of any activity. People will generally participate more enthusiastically if they know that something can be achieved through their participation (eg if there is a budget for a capital project). But they may be quite prepared to participate ‘at risk’ providing they know the odds. If there is only a small chance of positive change as a result of people participating, say so. Avoid hidden agendas.

Be transparentThe objectives and people’s roles should be clear and transparent at events. For instance, it may seem trivial but the importance of name badges to prevent events being the preserve of the ‘in-crowd’ can never be stressed enough.

Be visionary yet realisticNothing much is likely to be achieved without raising expectations. Yet dwelling entirely on the utopian can be frustrating. Strike a balance between setting visionary utopian goals and being realistic about the practical options available.

Build local capacityLong-term community sustainability depends on developing human and social capital. Take every opportunity to develop local skills and capacity. Involve local people in surveying their own situation, running their own programmes and managing local assets. Help people to understand how planning processes work and how they can be influenced. Communications and cultural activities are particularly effective at building capacity.

Communicate Use all available media to let people know what you are doing and how they can get involved. Community newspapers or broadsheets in particular are invaluable. Community newspapers and, increasingly, websites are invaluable. Information provision is a vital element of all participatory activities

Encourage collaborationCreate partnerships wherever possible between the various interest groups involved and with potential contributors such as financial institutions.

FlexibilityBe prepared to modify processes as circumstances dictate. Avoid inflexible methods and strategies.

Focus on attitudesBehaviour and attitude are just as, if not more, important than methods. Encourage self-critical awareness, handing over control, personal responsibility and sharing.

Focus on existing interestsStart participatory working with a focus on the existing interests and motivations of local people. They will then see the relevance of being involved.

Follow upLack of follow-up is the most common failing, usually due to a failure to plan and budget for it. Make sure you set aside time and resources for documenting, publicising and acting on the results of any community planning initiative.

Go at the right paceRushing can lead to problems. On the other hand, without deadlines things can drift. Using experienced external advisors may speed up the process but often at the expense of developing local capacity. Get the balance right.

Go for itThis is the phrase used most by people who have experienced community planning when asked what their advice would be to others. You are bound to have doubts, it is usually a leap in the dark. But you are unlikely to regret taking the plunge.

Have funGetting involved in creating and managing the environment should not be a chore. It can be a great opportunity to meet people and have fun. The most interesting and sustainable environments have been produced where people have enjoyed creating them. Community planning requires humour. Use cartoons, jokes and games whenever possible.

Human scaleWork in communities of a manageable scale. This is usually where people at least recognise each other. Where possible, break up larger areas into a series of smaller ones and translate regional issues to a local scale. Working on regional planning issues requires a high level of coordination between community and interest groups and the use of specific methods.

Integrate with decision-makingCommunity planning activity needs to be integrated with government decision-making processes. Participatory processes are undermined if there is no clear link to decision-making.

Involve all those affectedCommunity planning works best if all parties are committed to it. Involve all the main interested parties as early as possible, preferably in the planning of the process. Activities in which key players (such as landowners or planners) sit on the sidelines are all too common and rarely achieve their objectives completely. Time spent winning over cynics before you start is well worthwhile. If there are people or groups who cannot be convinced at the outset, keep them informed and give them the option of joining in later on.

Involve all sections of the communityPeople of different ages, gender, backgrounds and cultures almost invariably have different perspectives. Ensure that a full spectrum of the community is involved. This is usually far more important than involving large numbers.

Learn from othersThere is no need to re-invent the wheel. One of the best sources of information is people who have done it before. Don’t think you know it all. No one does. Be open to new approaches. Get in touch with people from elsewhere who have relevant experience. Go and visit them and see their projects; seeing is believing. Do not be afraid of experienced ‘consultants’ but choose and brief them carefully.

Local ownership of the process

The community planning process should be ‘owned’ by local people. Even though consultants or national organisations may be providing advice and taking responsibility for certain activities, the local community should take responsibility for the overall process.

Maintain momentumRegularly monitor progress to ensure that initiatives are built on and objectives achieved. Development processes are invariably lengthy, the participation process needs to stay the course. If there has to be a break, start again from where you left off, not from the beginning. Periodic review sessions can be very valuable to maintain momentum and community involvement.

Mixture of methodsUse a variety of involvement methods as different people will want to take part in different ways. For instance, some will be happy to write letters, others will prefer to make comments at an exhibition or take part in workshop sessions.

Now is the right timeThe best time to start involving people is at the beginning of any programme. The earlier the better. But if programmes have already begun, participation should be introduced as soon as possible. Start now.

Ongoing involvementCommunity involvement in planning issues needs to be an ongoing and continuous activity and be supported accordingly. One-off consultations with tight deadlines only have limited value. (Source: APaNGO project)

Personal initiativeVirtually all community planning initiatives have happened only because an individual has taken the initiative. Don’t wait for others. That individual could be you!

Plan your own process carefullyCareful planning of the process is vital. Avoid rushing into any one approach. Look at alternatives. Design a process to suit the circumstances. This may well involve combining a range of methods or devising new ones.

Plan for the local contextDevelop unique strategies for each neighbourhood. Understand local characteristics and vernacular traditions and use them as a starting point for planning. Encourage regional and local diversity.

Prepare properlyThe most successful activities are invariably those on which sufficient time and effort have been given to preliminary organisation and engaging those who may be interested.

Process as important as productThe way that things are done is often as important as the end result. But remember that the aim is implementation. Participation is important but is not an end in itself.

Professional enablersProfessionals and administrators should see themselves as enablers, helping local people achieve their goals, rather than as providers of services and solutions.

Quality not quantityThere is no such thing as a perfect participation process. The search for one is healthy only if this fact is accepted. Generally, the maximum participation by the maximum number of people is worth aiming at. But any participation is better than none and the quality of participation is more important than the numbers involved. A well organised event for a small number of people can often be more fruitful than a less well organised event for larger numbers.

Reach all sectorsUse methods to reach all sectors of the community – for example young people, minority ethnic communities, small businesses, the ‘silent majority’, the ‘hard to reach’. But take care to avoid further alienation of disadvantaged groups by creating separate processes.

Record and documentMake sure participation activities are properly recorded and documented so that it can be clearly seen who has been involved and how. Easily forgotten, such records can be invaluable at a later stage.

Respect cultural contextMake sure that your approach is suitable for the cultural context in which you are working. Consider local attitudes to gender, informal livelihoods, social groupings, speaking out in public and so on.

Respect local knowledgeAll people, whether literate or not, whether rich or poor, whether children, women or men, have a remarkable understanding of their surroundings and are capable of analysing and assessing their situation, often better than trained professionals. Respect local perceptions, choices and abilities and involve local people in setting goals and strategies.

Shared controlThe extent of public participation in any activity can vary from very little to a great deal. Different levels are appropriate at different stages of the planning process but shared control at the planning and design stage is the crucial ingredient.

Special interest groupsimportant Groups representing different special interests have a vital role to play in shaping the environment because of its complexity. Decision-makers need to consider evidence which represents best the variety of interests of current and future communities, including taking into account views of specific interest groups with particular knowledge.

Spend moneyEffective participation processes take time and energy. There are methods to suit a range of budgets and much can be achieved using only people’s time and energy. But over-tight budgets usually lead to cutting corners and poor results. Remember that community planning is an important activity, the success or failure of which may have dramatic implications for future generations as well as your own resources. The costs of building the wrong thing in the wrong place can be astronomical and make the cost of proper community planning pale into insignificance. Budget generously.

Think on your feetOnce the basic principles and language of participatory planning are understood, experienced practitioners will find it easy to improvise. Avoid feeling constrained by rules or guidance (such as this handbook)!

TrainTraining is invaluable at all levels. Encourage visits to other projects and attendance on courses. Build in training to all your activities.

Trust in others’ honestyStart from a position of trusting others and generally this will be reciprocated. Lack of trust is usually due to lack of information.

Use experts appropriatelyThe best results emerge when local people work closely and intensively with experts from all the necessary disciplines. Creating and managing the environment is very complicated and requires a variety of expertise and experience to do it well. Do not be afraid of expertise, embrace it. But avoid dependency on, or hijacking by, professionals. Keep control local. Use experts ‘little and often’ to allow local participants time to develop capability, even if it means they sometimes make mistakes.

Use facilitatorsOrchestrating group activities is a real skill. Without good facilitation the most articulate and powerful may dominate. Particularly if large numbers of people are involved, ensure that the person (or people) directing events has good facilitation skills. If not, hire someone who has.

Use local talentMake use of local skills and professionalism within the community before supplementing them with outside assistance. This will help develop capability within the community and help achieve long-term sustainability.

Use outsiders, but carefullyA central principle of community planning is that local people know best. But outsiders, if well briefed, can provide a fresh perspective which can be invigorating. Getting the right balance between locals and outsiders is important; avoid locals feeling swamped or intimidated by ‘foreigners’.

VisualisePeople can participate far more effectively if information is presented visually rather than in words, A great deal of poor development, and hostility to good development, is due to people not understanding what it will look like. Use graphics, maps, illustrations, cartoons, drawings, photomontages and models wherever possible. And make the process itself visible by using flipcharts, Post-it notes, coloured dots and banners.

Walk before you runDeveloping a participatory culture takes time. Start by using simple participation methods and work up to using more complex ones as experience and confidence grow.

Work on locationWherever possible, base community planning activities physically in the area being planned. This makes it much easier for everyone to bridge the gap from concept to reality.

HEALTH PROMOTION MODEL--------------------------------------------------------------------------------------------------------INTRODUCTIONThe health promotion model (HPM) proposed by Nola J Pender (1982; revised, 1996) was designed to be a “complementary counterpart to models of health protection.” It defines health as a positive dynamic state not merely the absence of disease. Health promotion is directed at increasing a client’s level of wellbeing. The health promotion model describes the multi dimensional nature of persons as they interact within their environment to pursue health. The model focuses on following three areas:· Individual characteristics and experiences · Behavior-specific cognitions and affect · Behavioral outcomes The health promotion model notes that each person has unique personal characteristics and experiences that affect subsequent actions. The set of variables for behavioral specific knowledge and affect have important motivational significance. These variables can be modified through nursing actions. Health promoting behavior is the desired behavioral outcome and is the end point in the HPM. Health promoting behaviors should result in improved health, enhanced functional ability and better quality of life at all stages of development. The final behavioral demand is also influenced by the immediate competing demand and preferences, which can derail an intended health promoting actions.

ASSUMPTIONS OF THE HEALTH PROMOTION MODEL The HPM is based on the following assumptions, which reflect both nursing and behavioral science perspectives: Individuals seek to actively regulate their own behavior. Individuals in all their biopsychosocial complexity interact with the environment, progressively transforming the environment and being transformed over time. Health professionals constitute a part of the interpersonal environment, which exerts influence on persons throughout their lifespan. Self-initiated reconfiguration of person-environment interactive patterns is essential to behavior change THEORETICAL PROPOSITIONS OF THE HEALTH PROMOTION MODEL Theoretical statements derived from the model provide a basis for investigative work on health behaviors. The HPM is based on the following theoretical propositions: Prior behavior and inherited and acquired characteristics influence beliefs, affect, and enactment of health-promoting behavior. Persons commit to engaging in behaviors from which they anticipate deriving personally valued benefits. Perceived barriers can constrain commitment to action, a mediator of behavior as well as actual behavior. Perceived competence or self-efficacy to execute a given behavior increases the likelihood of commitment to action and actual performance of the behavior. Greater perceived self-efficacy results in fewer perceived barriers to a specific health behavior. Positive affect toward a behavior results in greater perceived self-efficacy, which can in turn, result in increased positive affect. When positive emotions or affect are associated with a behavior, the probability of commitment and action is increased. Persons are more likely to commit to and engage in health-promoting behaviors when significant others model the behavior, expect the behavior to occur, and provide assistance and support to enable the behavior. Families, peers, and health care providers are important sources of interpersonal influence that can increase or decrease commitment to and engagement in health-promoting behavior. Situational influences in the external environment can increase or decrease commitment to or participation in health-promoting behavior. The greater the commitments to a specific plan of action, the more likely health-promoting behaviors are to be maintained over time. Commitment to a plan of action is less likely to result in the desired behavior when competing demands over which persons have little control require immediate attention. 13. Commitment to a plan of action is less likely to result in the desired behavior when other actions are more attractive and thus preferred over the target behavior. Persons can modify cognitions, affect, and the interpersonal and physical environment to create incentives for health actions.

THE MAJOR CONCEPTS AND DEFINITIONS OF THE HEALTH PROMOTION MODELIndividual Characteristics and ExperiencePrior related behaviourFrequency of the similar behaviour in the past. Direct and indirect effects on the likelihood of engaging in health promoting behaviors. PERSONAL FACTORS Personal factors categorized as biological, psychological and socio-cultural. These factors are predictive of a given behavior and shaped by the nature of the target behaviour being considered.Personal biological factors Include variable such as age gender body mass index pubertal status, aerobic capacity, strength, agility, or balance. Personal psychological factorsInclude variables such as self esteem self motivation personal competence perceived health status and definition of health. Personal socio-cultural factorsInclude variables such as race ethnicity, accuculturation, education and socioeconomic status. Behavioural Specific Cognition and Affect PERCEIVED BENEFITS OF ACTION Anticipated positive out comes that will occur from health behaviour. PERCEIVED BARRIERS TO ACTION Anticipated, imagined or real blocks and personal costs of understanding a given behaviour PERCEIVED SELF EFFICACYJudgment of personal capability to organise and execute a health-promoting behaviour. Perceived self efficacy influences perceived barriers to action so higher efficacy result in lowered perceptions of barriers to the performance of the behavior. ACTIVITY RELATED AFFECTSubjective positive or negative feeling that occur before, during and following behavior based on the stimulus properties of the behaviour itself. Activity-related affect influences perceived self-efficacy, which means the more positive the subjective feeling, the greater the feeling of efficacy. In turn, increased feelings of efficacy can generate further positive affect.INTERPERSONAL INFLUENCES Cognition concerning behaviours, beliefs, or attitudes of the others. Interpersonal influences include: norms (expectations of significant others), social support (instrumental and emotional encouragement) and modelling (vicarious learning through observing others engaged in a particular behaviour). Primary sources of interpersonal influences are families, peers, and healthcare providers.SITUATIONAL INFLUENCESPersonal perceptions and cognitions of any given situation or context that can facilitate or impede behaviour. Include perceptions of options available, demand characteristics and aesthetic features of the environment in which given health promoting is proposed to take place. Situational influences may have direct or indirect influences on health behaviour.Behavioural Outcome COMMITMENT TO PLAN OF ACTIONThe concept of intention and identification of a planned strategy leads to implementation of health behaviour. IMMEDIATE COMPETING DEMANDS AND PREFERENCES Competing demands are those alternative behaviour over which individuals have low control because there are environmental contingencies such as work or family care responsibilities. Competing preferences are alternative behaviour over which individuals exert relatively high control, such as choice of ice cream or apple for a snackHEALTH PROMOTING BEHAVIOUREndpoint or action outcome directed toward attaining positive health outcome such as optimal well-being, personal fulfilment, and productive living.

HEALTH BELIEF MODELexplaining health behaviorsHistory and OrientationThe Health Belief Model (HBM) is a psychological model that attempts to explain and predict health behaviors. This is done by focusing on the attitudes and beliefs of individuals. The HBM was first developed in the 1950s by social psychologists Hochbaum, Rosenstock and Kegels working in the U.S. Public Health Services. The model was developed in response to the failure of a free tuberculosis (TB) health screening program. Since then, the HBM has been adapted to explore a variety of long- and short-term health behaviors, including sexual risk behaviors and the transmission of HIV/AIDS. Core Assumptions and StatementsThe HBM is based on the understanding that a person will take a health-related action (i.e., use condoms) if that person: 1. feels that a negative health condition (i.e., HIV) can be avoided,2. has a positive expectation that by taking a recommended action, he/she will avoid a

negative health condition (i.e., using condoms will be effective at preventing HIV), and3. believes that he/she can successfully take a recommended health action (i.e., he/she can

use condoms comfortably and with confidence). The HBM was spelled out in terms of four constructs representing the perceived threat and net benefits: perceived susceptibility, perceived severity, perceived benefits, and perceived barriers. These concepts were proposed as accounting for people's "readiness to act." An added concept, cues to action, would activate that readiness and stimulate overt behavior. A recent addition to the HBM is the concept of self-efficacy, or one's confidence in the ability to successfully perform an action. This concept was added by Rosenstock and others in 1988 to help the HBM better fit the challenges of changing habitual unhealthy behaviors, such as being sedentary, smoking, or overeating.Table from “Theory at a Glance: A Guide for Health Promotion Practice" (1997)

Concept Definition Application

Perceived Susceptibility

One's opinion of chances of getting a condition

Define population(s) at risk, risk levels; personalize risk based on a person's features or behavior; heighten perceived susceptibility if too low.

Perceived Severity

One's opinion of how serious a condition and its consequences are

Specify consequences of the risk and the condition

Perceived Benefits

One's belief in the efficacy of the advised action to reduce risk or seriousness of impact

Define action to take; how, where, when; clarify the positive effects to be expected.

Perceived Barriers

One's opinion of the tangible and psychological costs of the advised action

Identify and reduce barriers through reassurance, incentives, assistance.

Cues to Action Strategies to activate "readiness"

Provide how-to information, promote awareness, reminders.

Self-Efficacy Confidence in one's ability to take action

Provide training, guidance in performing action.

Conceptual Model

Source: Glanz et al, 2002, p. 52Favorite MethodsSurveys. Scope and ApplicationThe Health Belief Model has been applied to a broad range of health behaviors and subject populations. Three broad areas can be identified (Conner & Norman, 1996): 1) Preventive health behaviors, which include health-promoting (e.g. diet, exercise) and health-risk (e.g. smoking) behaviors as well as vaccination and contraceptive practices. 2) Sick role behaviors, which refer to compliance with recommended medical regimens, usually following professional diagnosis of illness. 3) Clinic use, which includes physician visits for a variety of reasons. ExampleThis is an example from two sexual health actions. (http://www.etr.org/recapp/theories/hbm/Resources.htm) Concept Condom Use Education Example STI Screening or HIV Testing1. Perceived Susceptibility

Youth believe they can get STIs or HIV or create a pregnancy.

Youth believe they may have been exposed to STIs or HIV.

2. Perceived Severity Youth believe that the consequences of getting STIs or HIV or creating a pregnancy are significant enough to try to avoid.

Youth believe the consequences of having STIs or HIV without knowledge or treatment are significant enough to try to avoid.

3. Perceived Benefits Youth believe that the recommended action of using condoms would protect them from getting STIs or HIV or creating a pregnancy.

Youth believe that the recommended action of getting tested for STIs and HIV would benefit them — possibly by allowing them to get early treatment or preventing them from infecting others.

4. Perceived Barriers Youth identify their personal barriers to using condoms (i.e., condoms limit the feeling or they are too embarrassed to talk to

Youth identify their personal barriers to getting tested (i.e., getting to the clinic or being seen at the clinic by someone they know)

their partner about it) and explore ways to eliminate or reduce these barriers (i.e., teach them to put lubricant inside the condom to increase sensation for the male and have them practice condom communication skills to decrease their embarrassment level).

and explore ways to eliminate or reduce these barriers (i.e., brainstorm transportation and disguise options).

5. Cues to Action Youth receive reminder cues for action in the form of incentives (such as pencils with the printed message "no glove, no love") or reminder messages (such as messages in the school newsletter).

Youth receive reminder cues for action in the form of incentives (such as a key chain that says, "Got sex? Get tested!") or reminder messages (such as posters that say, "25% of sexually active teens contract an STI. Are you one of them? Find out now").

6. Self-Efficacy Youth confident in using a condom correctly in all circumstances.

Youth receive guidance (such as information on where to get tested) or training (such as practice in making an appointment).

What Is Self-Efficacy?By Kendra Cherry, About.com Guidealbert bandura

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Psychology Ads Psychology Bandura Theory of Psychology Self Efficacy Social Learning Theory The concept of self-efficacy lies at the center of psychologist Albert Bandura’s social cognitive theory. Bandura’s theory emphasizes the role of observational learning, social experience, and reciprocal determinism in the development of personality.According to Bandura, a person’s attitudes, abilities, and cognitive skills comprise what is known as the self-system. This system plays a major role in how we perceive situations and how we behave in response to different situations. Self-efficacy plays is an essential part of this self-system.What Is Self-Efficacy?According to Albert Bandura, self-efficacy is “the belief in one’s capabilities to organize and execute the courses of action required to manage prospective situations” (1995, p. 2). In other words, self-efficacy is a person’s belief in his or her ability to succeed in a particular situation. Bandura described these beliefs as determinants of how people think, behave, and feel (1994). Since Bandura published his seminal 1977 paper, "Self-Efficacy: Toward a Unifying Theory of Behavioral Change," the subject has become one of the most studied topics in psychology. Why has

self-efficacy become such an important topic among psychologists and educators? As Bandura and other researchers have demonstrated, self-efficacy can have an impact on everything from psychological states to behavior to motivation.The Role of Self-EfficacyVirtually all people can identify goals they want to accomplish, things they would like to change, and things they would like to achieve. However, most people also realize that putting these plans into action is not quite so simple. Bandura and others have found that an individual’s self-efficacy plays a major role in how goals, tasks, and challenges are approached.People with a strong sense of self-efficacy:View challenging problems as tasks to be mastered. Develop deeper interest in the activities in which they participate. Form a stronger sense of commitment to their interests and activities. Recover quickly from setbacks and disappointments.People with a weak sense of self-efficacy:Avoid challenging tasks. Believe that difficult tasks and situations are beyond their capabilities. Focus on personal failings and negative outcomes. Quickly lose confidence in personal abilities (Bandura, 1994).Sources of Self-EfficacyHow does self-efficacy develop? These beliefs begin to form in early childhood as children deal with a wide variety of experiences, tasks, and situations. However, the growth of self-efficacy does not end during youth, but continues to evolve throughout life as people acquire new skills, experiences, and understanding (Bandura, 1992).According to Bandura, there are four major sources of self-efficacy.

1. Mastery Experiences

"The most effective way of developing a strong sense of efficacy is through mastery experiences," Bandura explained (1994). Performing a task successfully strengthens our sense of self-efficacy. However, failing to adequately deal with a task or challenge can undermine and weaken self-efficacy.

2. Social Modeling

Witnessing other people successfully completing a task is another important source of self-efficacy. According to Bandura, “Seeing people similar to oneself succeed by sustained effort raises observers' beliefs that they too possess the capabilities master comparable activities to succeed” (1994).

3. Social Persuasion

Bandura also asserted that people could be persuaded to belief that they have the skills and capabilities to succeed. Consider a time when someone said something positive and encouraging that helped you achieve a goal. Getting verbal encouragement from others helps people overcome self-doubt and instead focus on giving their best effort to the task at hand.

4. Psychological Responses

Our own responses and emotional reactions to situations also play an important role in self-efficacy. Moods, emotional states, physical reactions, and stress levels can all impact how a person feels about their personal abilities in a particular situation. A person who becomes extremely nervous before speaking in public may develop a weak sense of self-efficacy in these situations. However, Bandura also notes "it is not the sheer intensity of emotional and physical reactions that is important but rather how they are perceived and interpreted" (1994). By learning how to minimize stress and elevate mood when facing difficult or challenging tasks, people can improve their sense of self-efficacy.