HAMMERSMITH AND FULHAM PCT - Community Championscommunitychampionsuk.org/development/.../uploads/2013/01/lungc… · HAMMERSMITH AND FULHAM PCT: Lung Cancer Social Marketing Campaign

Date 18.7.11

HAMMERSMITH AND FULHAM PCT EVALUATION OF COMMUNITY ACTIVITY TO IMPROVE EARLY AWARENESS AND DETECTION OF LUNG CANCER

DRAFT REPORT

HAMMERSMITH AND FULHAM PCT: Lung Cancer Social Marketing Campaign Evaluation 18.7.11

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CONTENTS

1. About the campaign – objectives, activity and KPIs 2. Evaluation methodology 3. Evaluation Results:

a. Inputs evaluation b. Outputs evaluation c. Outtakes evaluation d. Outcomes evaluation e. Process evaluation

4. Appendices


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1. ABOUT THE CAMPAIGN – OBJECTIVES, ACTIVITY AND KPIS 1.1. OBJECTIVES

Overarching strategic objective

• To improve awareness of the signs and symptoms of lung cancer • To encourage earlier presentation in primary care settings • To increase early diagnosis • To reduce cancer inequalities in the most deprived areas

Campaign objectives

• To raise awareness of the key signs and symptoms of lung cancer among the target audiences already identified in the target areas

• Increase presentations to GPs with relevant signs and symptoms by target audiences • Engage, equip and mobilise stakeholders (being undertaken by H&F PCT)

Social marketing objectives

• To engage priority audiences in priority communities • To encourage and support dialogue about the issues within communities • To create a framework for partners to support ongoing sustainable community ownership of the solution • To produce materials to support HCP engagement being undertaken by H&F PCT

1.2. ACTIVITY Targeting the campaign Three wards were identified based on deprivation and smoking prevalence:

• College Park and Old Oak • Wormholt and White City • Shepherds Bush Green

As a result of data analysis which overlaid smoking prevalence for different ethnicities (split by gender) onto the ethnicity profile for each of the three wards followed by analysis of audience penetration, the following audiences were selected as target audiences for the campaign:

Males, C2DE, aged 50+ Females, C2DE, aged 50+ White

Black Caribbean Black African (to include

Somali) Mixed race (white / black

African or Caribbean)

White Black Caribbean

Mixed race (white / black Caribbean)

Summary of campaign activity The campaign activity undertaken by The Hub consisted of three main strands:

1. Community engagement: identifying, recruiting, training and equipping a team of volunteers to undertake face to face engagement with the target audiences.

2. Direct audience engagement: half page adverts in local paper; lamp post banner ads, 4 sheets in tube stations, door drop in target wards

3. Equipping stakeholders: producing some materials for use by pharmacists, smoking cessation advisers and GPs


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1.3. KEY PERFORMANCE INDICATORS

OBJECTIVE METRICS

COMMUNITY ENGAGEMENT STRAND Recruit at least 40 champions from within the priority communities across the three target wards to conduct face to face engagement (mix of existing assets and ‘new’ resources – we envisage this will consist of 20 existing assets and 20 new recruits)

95% of champions engaged clearly understood the purpose of the campaign

95% of champions engaged clearly understood their role in supporting the delivery of the campaign 95% of champions engaged to feel they had the necessary information and materials to communicate the key campaign messages effectively with public Champions to engage between 900-1200 people during their activity (20-30 people each) 90% of people engaged by community champions recall one or more key messages 90% of people engaged by community champions recall one or more signs/symptoms 90% of people engaged by community champions to feel comfortable talking to people about the signs and symptoms of lung cancer

Encourage and support dialogue about the issues within communities

90% of people engaged by community champions to understand the call to action Create a framework for partners to support ongoing sustainable community ownership of the solution

Creation of succession plan and successful hand over to at least one partner working in the area

DIRECT ENGAGEMENT STRAND (MEDIA) Reach of campaign Recall of channels Recall of messages Understanding call to action Think campaign is for ‘someone like them’ Symptom recognition Understanding the benefits of early presentation

Engage priority audiences in priority communities

Intention to take action / change behaviour (claimed)

STAKEHOLDER MATERIALS

Producing materials to support HCP engagement being undertaken by client

Hub provides materials on time and to budget


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2. EVALUATION METHODOLOGY The Hub was commissioned to undertake an evaluation of the community engagement strand of the project in addition to an inputs and process evaluation. The below table clarifies the full scale of the evaluation activities (mapped against the DH’s evaluation metrics) and the roles and responsibilities of individual parties within this.

METRIC SOURCE BASELINE DH METRIC

INPUTS (description of activity, volume, spend, duration and location) Description of activity Hub to provide details of

inputs – public and stakeholder. Client to provide details of HCP activity

Not relevant 3 & 4

Recruit at least 40 champions from within the priority communities across the three target wards to conduct face to face engagement (mix of existing assets and ‘new’ resources)

Hub to provide details Not relevant 3 & 4

95% of champions engaged clearly understood the purpose of the campaign

Hub to undertake research with champions

Not relevant 3 & 4

95% of champions engaged clearly understood their role in supporting the delivery of the campaign


Not relevant 3 & 4

Communication and engagement channels Advertising Community engagement activity HCP engagement activity

95% of champions engaged to feel they had the necessary information and materials to communicate the key campaign messages effectively with public


Not relevant 3 & 4

OUTPUTS (cumulative reach of activity against specific audience) Planned reach, frequency, number of events, number of attendees, number of leaflets etc

Hub to provide details of inputs H&F PCT to provide details of HCP activity

Not relevant 3 & 4 Communication and engagement channels Advertising Community engagement activity HCP engagement activity

Champions to engage between 900-1200 people during their activity (20-30 people each)


Not relevant 3 & 4

OUTTAKES (levels of campaign awareness/understanding/engagement/likely action) % of target audience aware of signs and symptoms of cancer

DH Tracking study Yes – pre-wave survey

5 & 6 Awareness of signs and symptoms of cancer

90% of people engaged by community champions recall one or more signs / symptoms

Hub to undertake exit interviews at engagement event

Not relevant 5 & 6

Campaign awareness recall

% of target audience aware of campaign activity (via which channel)


5 & 6

% of target audience understanding the key campaign messages


5 & 6 Awareness/ understanding of messages

90% of people engaged by community champions recall one or more key messages


Not relevant 5 & 6


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90% of people engaged by community champions to understand the call to action


Not relevant 5 & 6

Symptom recognition

% of target audience confident to recognise sign/symptom of cancer


5 & 6

Intention to act % of target audience likely to present to GP if they found sign/symptom


5, 6 & 7

Understanding of benefits of early presentation

% of target audience understanding the benefits of early presentation


5 & 6

Discussions within community

90% of people engaged by community champions to feel comfortable talking to people about the signs and symptoms of lung cancer


Not relevant 5 & 6

OUTCOMES Presentation to Pharmacies

Number of people asking for advice at pharmacies

Pharmacists 7

Referral to secondary care

Number of referrals to secondary care via 2WW

GP Practice Profiles 1

Requests for investigation

E.g. number of requests for lung X ray Primary / Secondary Care 8

Positive diagnosis Number of positive cancer diagnoses through 2WW


Suspected cases of cancer

Number of 2WW referrals with suspected cancer by tumour site


Emergency presentations

Number of emergency presentations with / without cancer


Managed referral presentations

Number of managed referrals i.e. not via 2WW pathway


Staging data Number of diagnosed cases by stage of disease

Secondary care 10

Radical treatment Number of surgical procedures Patients undergoing radiotherapy/chemotherapy

Secondary Care

H&F PCT managing

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PROCESS (description of process, assessment of success and identification of lessons and improvements) Evaluate whether the campaign was delivered as intended

Assessment of reality against agreed proposal / strategy Assessment of the impact of any changes

Assess the strengths in implementation

Assessment of what worked well

Assess the barriers and challenges in implementation

Assessment of what worked less well

Identify lessons learnt that would result in improvements in future campaign activity

Identify learnings and transferable knowledge / resources

Hub to provide process evaluation

Not relevant Not relevant


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2.1. METHOD IN DETAIL: RESEARCH WITH COMMUNITY CHAMPIONS

Following the initial briefing of Champions a self-completion questionnaire was distributed and collected by The Hub. This consisted of a range of questions that assessed clarity of purpose of the campaign, clarity over their role in supporting the delivery of the campaign, and confidence in the materials.

During regular update sessions with the champions, a slight variation of the self-completion questionnaire was re-administered, along with additional questions to assess the reach and nature of the engagement activity undertaken by each individual to date (n.b. this was self-reported). The latter part of the questionnaire sought to understand:

o Numbers engaged o Demographic profile of those engaged o Locations o Nature of discussions / activity undertaken o Reaction to messages o Any barriers / issues that need addressing

At the end of the campaign, The Hub conducted a short face-face evaluation session attended by 14 champions. In addition to this, semi-structured telephone interviews were conducted with a further 10 champions in return for a £10 high street voucher as a thank you for their time and effort. This interview sought to understand the numbers and profile of those engaged since the last feedback session, and included reflection on the whole process undertaken.

Feedback from all stages of activity is analysed in section 3.3 and conclusions have been drawn about how engaged and well equipped the community champions were, and about the reach of their activity.

2.2. METHOD IN DETAIL: RESEARCH WITH THOSE ENGAGED BY CHAMPIONS

The Hub developed a short questionnaire (see Appendix 4.4) incorporating relevant questions from the DH tracking survey to enable results from this strand of activity to be compared and contrasted with results from other strands of activity (i.e. stakeholder engagement and direct engagement via media)

The questionnaire was piloted at one community event prior to wider delivery A Hub researcher attended five events attended by community champions to administer the questionnaire

by intercepting people once engaged. The researcher targeted a mixture of primary audience and influencers. These events were: West 12 shopping centre (16th & 23rd June), Shepherd’s Bush library (16th June), Shepherd’s Bush Market (23rd June) and a White City Community Engagement Day (7th July)

By way of incentive the name of participants was be entered into a prize draw (value £100). In addition, community members were asked to complete a self-completion version of the questionnaire

after a Champion gave a group talk on Monday 27th June at White City Residents Association Meeting. Again, a prize draw was offered as an incentive to complete the survey.

In total, 44 community members were interviewed or completed a self-completion questionnaire. Following the pilot, a change to the questionnaire was subsequently made. This means that for the question: “How comfortable do you feel talking to someone about lung cancer?” 25 responses are included for analysis.

Data has been analysed and conclusions about the outtakes from this strand of campaign activity have been drawn in section 3.3.


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3. EVALUATION RESULTS

3.1. INPUTS - DH METRICS 3 &4 KPIs (for evaluation by The Hub)

• Recruit at least 40 champions from within the priority communities across the three target wards to conduct face to face engagement (mix of existing assets and ‘new’ resources)

• 95% of champions engaged clearly understood the purpose of the campaign • 95% of champions engaged clearly understood their role in supporting the delivery of the campaign • 95% of champions engaged to feel they had the necessary information and materials to communicate the

key campaign messages effectively with public RESULTS

DIRECT ENGAGEMENT STRAND VOLUME SPEND DURATION LOCATION

Door drop Letter and leaflet in NHS branded envelope inserted into local paper for distribution

28,030 £5,206 Distributed on 14th June

Whole of Borough

Lamppost banner ads Used creative execution 1

15 £3,000 30th May – 20th June (4 weeks)

Uxbridge Road (5) Du Cane Road (5) Bloemfontein Road (5)

4 Sheets in tube stations Creative executions 1 used

2 £1,624 30th May – 13th June (2 weeks)

Shepherd’s Bush and East Acton tube stations

Newspaper adverts Half page adverts in the Fulham and Hammersmith Chronicle (free paper) - used creative execution 1

4 £1,800 1 per week from 23rd May until 13th June

Whole of Borough

Electronic advertising board An electronic version of the Lung Cancer poster was displayed on the large stadium board during half-time (this was organised and implemented by H&F PCT)

1 £300 1 match on 5th March 2011

Queen Park Rangers Stadium, White City

STAKEHOLDER MATERIALS VOLUME SPEND DURATION LOCATION

Pharmacy bags

110,000 distributed across 40 pharmacies – between 1,000-3,000 per pharmacy depending on demand

£2,225 24th May – 1st July (earliest complete date – some pharmacies have enough bags for 12 week supply)

All 40 pharmacies in target wards (see Appendix 4.1 for details)


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Symptom cards for pharmacies A7 symptom cards for insertion into pharmacy bags

10,000 – distributed between pharmacies depending on demand

£485 24th May – 1st July (earliest complete date)


Posters for display in pharmacies 1 x A4 and 1 x A3 poster per pharmacy

40 x A4 40 x A3

£409 24th May – 1st July (earliest complete date)


Posters for display in GP surgeries 3 x A4 and 1 x a A3 poster per surgery

30 x A4 10 x A3

As above 20th May – 1st July (earliest complete date)

All 10 GPs in target wards (see Appendix 4.2 for details)

Symptom cards for smoking cessation advisors To be distributed to clients as fit

2,000 As above 24th May – 1st July (earliest complete date)

Distributed by H&F PCT to advisors in target wards

COMMUNITY ENGAGEMENT STRAND QUANTITY TOTAL SPEND

FOR STRAND Physical inputs

Training event details Fatima Community Centre, 23/05/11 White City Community Centre, 23/05/11 Fatima Community Centre, 24/05/11 Fatima Community Centre, 01/06/11 Fatima Community Centre, 10/05/11 Elgin Close Resource Centre, 15/06/11 Total

Attendance 3 2 21 6 4 6 42

£363 total venue hire for meetings £3,000 for volunteer expenses £300 for community engagement day

Campaign meetings Fatima Community Centre, 01/06/11 (Facilitated by PCT staff. Staff also briefed additional community champions who couldn’t attend previous training sessions) Fatima Community Centre, 15/06/11 Fatima Community Centre, 22/06/11 Fatima Community Centre, 01/07/11 (Campaign and evaluation meeting) Total

Attendance 15 8 12 14 49

Breakdown of champion recruitment Community Champions (original assets) Health Trainers (original assets) Other Champions (new assets) | where they were recruited from

- LINks - Community groups - Local charity staff - Elgin Close residential centre staff

Total

Numbers 21 5 5 3 2 6 42

Campaign material Community Champion Handbooks Banner stands T-Shirts A3 Posters A4 Posters A5 Leaflets Symptom Cards

100 6 30 160 160 3,000 3,000

£1,070 £554 £145 as above as above as above as above


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Measure of success of inputs – results from research activity with champions

After Champions had attended training they were asked to complete a brief evaluation form on how confident they felt delivering the campaign activities. The same evaluation form was completed after attending mid-campaign meetings and finally after the campaign had been completed. 20 Champions who attended the training sessions completed the mid-point evaluation form and 24 Champions completed the post-campaign evaluation form. All pre-campaign evaluation forms were completed face-face. What do you think the aim of the campaign is?

This question was designed as an open response. All the respondents were able to identify the campaign as either raising awareness of lung cancer or saving lives. Slightly fewer Champions also identified the need to encourage people to see their GP and also made particular reference to raising awareness of the signs and symptoms of lung cancer. Some Champions also mentioned the importance of providing community members with correct information for them to share this information with their friends and family. How well equipped do you feel to talk to people about Lung Cancer?

Post training and pre campaign launch Post campaign

Of those people completing evaluation forms (20) following the training events the majority (90%) of participants felt that they were well equipped to deliver the campaign.

100% of those completing the evaluation felt well equipped to talk to people about lung cancer and over half of these (54%) felt fully equipped to deliver the campaign.

How confident do you feel talking to people about Lung Cancer?



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100% of respondents said they felt confident in talking to members of the public about lung cancer following the training sessions

100% still feel confident talking to people about lung cancer. However more than (62%) feel very confident in talking to people about lung cancer. This increase is significant as a number of volunteers initially lacked confidence when it came to engaging with members of the public.

How confident do you feel about undertaking your role in delivering the campaign?


100% of respondents were also confident in undertaking their role in the campaign following training. Qualitatively, those who felt fairly confident were mostly concerned about engaging with members of the public about lung cancer. Concerns included fear of upsetting people, worrying that they weren’t medically trained, concerned about reactions.

100% of respondents were confident in delivering the campaign with an even bigger increase in the number of respondents stating that they were very confident.

How confident do you feel using the campaign materials that have been given to you?


All respondents were confident using the campaign materials with half of respondents stating they were very confident in using the campaign materials, including leaflets and posters, following the training sessions

100% of respondents were confident in using the campaign materials with an even bigger increase in the number of respondents stating that they were very confident. This is a positive sign in terms of legacy activity as Champions can continue to deliver and discuss campaign materials with local residents


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3.2. OUTPUTS – DH METRICS 3 & 4 KPIs (for evaluation by The Hub)

• Provide details of reach, frequency, number of events, number of attendees etc • Champions to engage between 900-1200 people during their activity (20-30 people each)

RESULTS

COMMUNITY ENGAGEMENT ACTIVITIES NUMBERS OF CHAMPIONS ATTENDING

Shepherds Bush Library x 2 2 Shepherds Bush Market x 3 6 Irish Support and Advice pensioners meeting 3 King’s Mall Shopping Centre 2 Gibbs Green event 2 Care for Carers 2 West 12 Shopping Centre x 7 20 Masbro Community Centre 1 Irish Cultural Centre Tea Dance 2 Holy Innocents Church 1 Friends of Wormholt Park fun day 1 K&C LINks event 2 Cancer Awareness Talk 1 Nubian Life Community Talk 1 White City Residents Association 2 Community Engagement Day 13

TOTAL CHAMPIONS ATTENDING 61

CHAMPION IMPACT REACH (PEOPLE SPOKEN TO DURING THE 6 WEEKS)

Zahra A Farah 81 Hellen Atim 30 Onyeka Ezenagu 65 Oola Balam 65 Suzanne Iwai 10 Hodon Abdi 21 Haula Dalmar 14 Andreene Eaton 35 Koss Mohammed 30 Hoodo Yusut 50 Leslie Jackson 151 Betty Goode 29 Kissu Denton Savage 168 Cecilia Williams 80 Givovanny Garcia 14 Yolande Nyack 112 Mikal Yohannes 58 Catherine El-Houdaigui 14 Faith Ndirangu 7


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Tawio Okubanjo 31 Sagal Osman 80 Dan Ware 25 Martha Romeo 15 Media Zahamy 20 George Osore 12

TOTAL REACH 1,246 PROJECTED REACH based on 42 Champions 1,932

DIRECT ENGAGEMENT ACTIVITIES NUMBERS ANTICIPATED REACH

Door drop 28,030 households. Approx 2 adults per household = 56,060

people

Approx 2 adults per household = 56,060

people

Newspaper advertising Weekly readership = 141,957

Not possible to calculate reach

4 sheets in tube stations 2 week footfall at Shepherds Bush =

945,385. 2 week footfall at East Acton = 131,154


Lamppost banner ads Footfall numbers available for 5 lamppost

banners on Uxbridge Road. Peak Hourly rate:

5,500. Approx daily rate = 44,000 (5,500 x 8 hours).

Daily rate x 4 weeks = 1,232,000


Electronic Advertisement Board Maximum stadium capacity = 19,100


TOTAL NUMBERS/ REACH Minimum: 2,525,656 56,060

STAKEHOLDER MATERIALS NUMBERS

Pharmacy bags 110,000 x 1 person only = 110,000 Symptom cards for pharmacies Included in 110,000 above Posters for display in pharmacies 40 pharmacies – not possible to calculate Posters for display in GP surgeries 10 GPs – not possible to calculate Symptom cards for smoking cessation advisors 2,000 x 1 person only = 2000

TOTAL REACH 112,000


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3.3. OUTTAKES – DH METRICS 5 & 6 KPIs (for evaluation by The Hub)

• 90% of people engaged by community champions recall one or more signs / symptoms • 90% of people engaged by community champions recall one or more key messages • 90% of people engaged by community champions to understand the call to action • 90% of people engaged by community champions to feel comfortable talking to people about the signs

and symptoms of lung cancer RESULTS % OF PEOPLE ENGAGED BY COMMUNITY CHAMPIONS…

DESCRIPTION OF OUTTAKE RESULTS

Recall one or more signs/symptoms

8 signs and symptoms as outlined in the leaflet given by volunteers

77%

Conclusions:

Of those who could not recall the signs and symptoms to the researcher, most had not very much time to spend with the volunteer (who therefore kept their talk brief) and promised to read the leaflet, whilst a small minority said that they did know the signs and symptoms but refused to explain what they are. Of those who recalled at least one symptom, 74% recall more than one, suggesting that the majority who were engaged took a lot from the talk.

% OF PEOPLE ENGAGED BY COMMUNITY CHAMPIONS…


Recall one or more key messages

Key messages are: 1. The earlier lung cancer is

diagnosed the better 2. There are 3 key symptoms that

should be checked by a GP • Persistent cough • Out of breath • Flecks of blood in phlegm

73%

Conclusions:

Few members of the public repeated the “earlier, the better” message to the researcher. Volunteers struggled to separate this message from the message explaining what to do if the early signs and symptoms are spotted.



Understand the call to action The call to action is to persuade someone to see their GP if they display signs/ symptoms

91%


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Conclusions:

Only those members of the public who had very little time to speak with a volunteer gave an answer other than “see your GP”. These respondents suggested that the person should go to hospital.

The findings show that around 15% are unclear about the signs and symptoms but would still recommend going to see their GP. This suggests that even if people are unclear what the symptoms are they are confident to tell someone to see their GP.



Feel comfortable talking to people about the signs/ symptoms of lung cancer

Represented by percentage of people who feel very/fairly comfortable talking to someone about lung cancer

85%

Conclusions:

This demonstrates that through engagement people are happy to talk to others about lung cancer, thus expanding the reach from community champions to the wider population. Those who didn’t feel comfortable talking to others about the issue were not fully engaged with by the community champion, opting to just take the leaflet and read it later.

Other findings from the survey of those engaged by champions:


DESCRIPTION OF QUESTION RESULTS

Cite words to describe their experience of being engaged

People were asked to describe their experience with the following words:

• Interesting • Boring • Relevant • Helpful • Confusing • Irrelevant

The most commonly selected words were:

• Interesting (57%)

• Helpful (36%)

In contrast, no-one described it as “boring”, “irrelevant”, or “confusing”

Feel more comfortable talking about lung cancer than before the engagement

People were offered the choice of “more comfortable” or “no more comfortable”

38% feel more comfortable. The remaining 62% already felt comfortable talking about Lung Cancer before being engagement by the Champion

Are confident knowing what to do if someone displays a sign or symptom of lung cancer

People were given 4 options: • Very confident • Fairly confident • Not very confident • Not at all confident

86% describe themselves as very/ fairly confident


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3.4. OUTCOMES – DH METRICS 1,7,8,10,11 KPIs (for evaluation by The Hub)

• None – outcomes being evaluated by H&F PCT 3.5. PROCESS OBJECTIVES

• To provide The Hub’s perspective on the process undertaken and to provide a framework for H&F PCT to use in order to provide their perspective on the process

• Specifically: o To evaluate whether the campaign was delivered as intended o To report any gaps between campaign design and delivery and understand the impact of these o To assess the strengths in implementation o To assess the barriers or challenges in implementation o To identify lessons learnt that would result in improvements in future campaign delivery

SUMMARY

SUMMARY: Was the campaign delivered as intended from the original brief?

KEY QUESTIONS RESPONSES

Did the campaign reach the intended audience*? *If audiences were provided in the original brief evaluate against this. If data analysis to prioritise audiences was part of the brief, evaluate against the outcomes of this stage.

Yes. The community engagement strand engaged people aged 50+, while the media channels were selected for their ability to reach into the communities where our target audience live.

Was the activity mix delivered as intended?

Yes. The activity delivered was exactly as planned with some additions made part way through the project. These were:

- A door drop (which included a letter and a leaflet) targeting relevant postcode

sectors was included as more budget became available. - Posters were sent out to GPs for display to increase the reach within the

community. While the outputs from the community engagement strand were delivered as planned, the way in which we worked with the community champions differed to the proposal. See below for more details.

Was the campaign delivered on time and for the intended duration?

There was some confusion between The Hub, COI and H&F PCT at the outset of the project which led to a delayed launch (see below on ‘Commissioning Process) for more detail. Once the project commenced it was delivered on time, launching less than a month after commencing. All media activity was delivered for the intended duration, however due to the project end


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date being set in stone (The Department of Health and Cancer Research UK require an evaluation report by the end of July and the client is moving on to a new role before this date), the community engagement activity was delivered within a condensed timeframe. In the original proposal the intention was for community engagement work to last for 8 weeks, however, in reality it ran for 5 weeks prior to evaluation activities commencing, but will continue beyond this.

Was the campaign delivered in the locations* intended? *If locations were provided in the original brief evaluate against this. If data analysis to prioritise areas was part of the brief, evaluate against the outcomes of this stage.

Yes. All campaign activity was targeted in the three wards to the North of the Borough. Through engaging with the community via partners, we learnt that many people living within our target wards conduct their daily lives outside of these wards (i.e. in town shopping centres). Therefore, in order to reach people from our target wards, some of the community activity was conducted just outside the wards but in areas where people from the wards were likely to be / to travel to.

Was the campaign delivered to budget?

Yes. The full scope of activity as planned was delivered on budget.

IN DETAIL

COMMISSIONING PROCESS


Was this stage delivered as intended?

The initial chemistry meeting went well and a proposal was produced shortly afterwards. However, the process from the proposal being produced to the project commencing upon a receipt of a PO from COI took much longer than originally anticipated.

If the answer to the above question is ‘no’, answer the following: • How did this differ to the

original campaign design?

• What were the factors that lead to this change?

• What was the impact of this on the project?

As mentioned, the commissioning process was protracted despite approval for the proposal in principle being given shortly after the initial proposal was received. This was because of several rounds of minor amends (i.e. changing quantities for print) prior to sign off. H&F PCT assumed The Hub had booked media and begun production once approval of the proposal in principle was given, however, The Hub did not commence any project activity until a receiving a PO for the work from COI (a delay of 3-4 weeks). Following commission, The Hub sent a timing plan to H&F PCT which took into account the delayed starting date. Having limited experience of working with external agencies, H&F PCT were surprised and disappointed that work had not commenced earlier, despite it being standard practice not to commence work prior to receiving a PO. This confusion could have been avoided if COI had clearly explained the implications of delay to H&F PCT. The impact of this delay on the project was:

• Timings for launch were delayed • Less time to engage, recruit and train community champions • Reduced duration for community activity • Production timelines were squeezed – pharmacy bags were originally supposed to

launch on day 1 of the campaign but did not launch until 1 week later

What worked well? Why? The initial chemistry meeting facilitated by COI provided an opportunity to explore the brief


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in more detail and receive clarity over various points. During the course of this meeting the brief changed as it became clear that evaluation needed to be procured separately, with a separate budget, to the campaign activity. As a result, this meeting enabled The Hub to produce a proposal that met the clients’ expectations and needed limited changes prior to sign off. Had this meeting not been held, and had COI not have facilitated it as well then the procurement process would have taken considerably longer.

What worked less well? Why? What was the impact of this?

Communication between all parties about the impact of delayed sign off – see above.

What has been learnt that could improve the approach taken when delivering future projects?

Clear communication about the procurement process, particularly when clients have limited experience of working with external agencies.

What (if any) legacy has been left by this stage of the project?

N/a

DATA ANALYSIS


Was this stage delivered as intended? If the answer to the above question is ‘no’, answer the following: • How did this differ to the




What worked well? Why? What worked less well? Why? What was the impact of this? What has been learnt that could improve the approach taken when delivering future projects? What (if any) legacy has been left by this stage of the project?

Not relevant – no data analysis was required as part of the brief and none was undertaken.


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PRIMARY RESEARCH


Was this stage delivered as intended? If the answer to the above question is ‘no’, answer the following: • How did this differ to the




What worked well? Why? What worked less well? Why? What was the impact of this? What has been learnt that could improve the approach taken when delivering future projects? What (if any) legacy has been left by this stage of the project?

Not relevant – no primary research was required as part of the brief and none was undertaken.

STRATEGY DEVELOPMENT AND MEDIA PLANNING



Yes. Strategy and media planning were undertaken as part of the proposal process given no primary / secondary research was required in advance.





N/a

What worked well? Why?

H&F PCT had some clear ideas about what media they wanted to include in the campaign given previous experience of running health campaigns. Having worked with COI to book media on other projects, The Hub knew that 4 days lead


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time was required for costings. COI responded quickly to requests, and delivered well within the timeframes outlined.


Nothing.


When working on local projects with a tightly defined geographic focus, spending the time discussing media expectations with clients who know the local area prior to producing a proposal / costings ensures proposals will meet expectations.


N/a

CREATIVE DEVELOPMENT



No. There was a lack of clarity around how Be Clear on Cancer (BCOC) could be used right up until artwork needed producing for this project.





When this (and other) projects were commissioned, The Hub was advised by DH/ CRUK that it would be possible to amend the DH produced BCOC campaign to meet local needs providing national approval is given prior to production. At the outset The Hub intended to produce a suite of branded resources for volunteers / community champions. However, through experience on other projects it became clear that this would not be possible as DH would not approve the use of the BCOC brand in this way. The Hub therefore produced materials for volunteers that were not branded, therefore missing an opportunity to promote the brand / reinforce the brand to a key group of champions. Furthermore, despite being able to create new materials and to amend artwork for BCOC on other projects, The Hub was advised by COI for this project that any changes to BCOC (for example adding the PCT’s logo) needed to be made by an agency contracted via COI at a charge of £45 per item. This cost had not been communicated at any stage until early May, and therefore had not been accounted for in the final costing previously agreed with the client and COI.


COI turned around the artwork quickly.


Lack of clarity around uses of BCOC creative, inconsistent approaches taken on different projects – see above.


Clarity on uses of national creative from the outset to avoid delays to project processes.


All materials (including volunteer handbook) can be used again by H&F PCT and partners when working on other projects.


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IMPLEMENTATION: COMMUNICATIONS (INC. PR)



Yes. The activity delivered was exactly as planned with some additions made part way through the project.





Part way through the project H&F PCT advised that there was some additional budget available for the project. We discussed the options available and decided that spending this budget on communications materials to increase the reach of the campaign within the community would be the best option. We therefore increased the activity mix to include:

- A door drop (which included a letter and a leaflet) targeting relevant postcode

sectors - Posters were sent out to GPs for display to increase the reach within the

community.


H&F PCT went around and visited 13 out of the 40 pharmacies immediately following the distribution of materials. Where pharmacies had not started to use materials they were encouraged to do so immediately. Visits were made to pharmacies in the target areas the remaining received email follow-up and support.


Nothing.


Nothing.


Communications materials designed can be used again on other projects.

IMPLEMENTATION: PARTNERS



Due to the time constraints, resulting from delayed final project approval, partners were predominately engaged with the aim of recruiting local Champions. This meant a reduction in the amount of time spent involving partners as originally planned. The mapping process was very successful with an additional 40 community partners being contacted in addition to the 8 already provided through the set-up meeting. Full list is available in Appendix 4.3




• What was the impact of

Involving the Community Champions and Health Trainers in the project meant that most of them had links in with the relevant local organisations so could provide these partners with updates on the campaign. The Champions were keen to use their links in this way. Other partners remained involved by organising meetings for Champions to attend and distribute campaign material. Due to the immediate requirement to recruit Champions, engagement activity occurred with key partners based on their location and their knowledge of the issue. This took the form of face-face meetings and phone conversations. These partners have a more developed


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this on the project?

understanding of the campaign messages and would be appropriate partners to involve in future campaign activities. These key partners include: • Kick It Stop Smoking Service • White City Community Centre • Fatima Community Centre • Macmillan Cancer Care • Masbro Community Centre • Elgin Residential Centre

This was a more focused approached than originally proposed and was in response to the level of involvement partners wanted, the relationship already developed with these partners by Champions and perceived importance these organisations had within the local communities. This meant that as the project developed a stronger relationship was built with specific community groups therefore allowing them to understand the campaign messages in more detail. In some cases particular partners also became Champions, therefore enhancing the potential for the campaign messages to embed further into day-day activity.


The ability to meet with a number of partners face-face early in the project allowed a greater understanding of the campaign objectives. This was particularly important in developing an approach with the PCT Public Health Team in how best to involve their Community Champions and Health Trainers. Using Council information networks allowed information to be distributed to a number of partners very quickly. Local volunteers also had some good suggestions for locations to arrange meetings and activities


The partner meeting at the start of the campaign was not well attended due to the speed with which it was convened and a number of cancellations on the day. Some partners were concerned that their organisations were not more central to the approach being taken, with some requesting a fee in the delivery of activities, or using their resources. Due to the need to focus work with partners on recruiting Champions some partners were not provided as much of an update on campaign activity as originally planned


Larger partners that have a national remit like Macmillan don’t have the resources to be fully engaged with the implementation. Partners are happy to use their networks groups to pass information on, but they can’t be expected to play an active role in recruiting Champions or persuading current volunteers to participate in campaign activities.


Some staff working for partner organisations have received Champion training so are equipped to deliver campaign messages to service users in the future. A number of events for volunteers to attend have been arranged with partners to occur from July through to September. There has been campaign engagement with relevant health networks in neighbouring PCTs. This helped develop legacy activity due to the future partnership between Hammersmith, Fulham, Kensington, Chelsea and Westminster health authorities.

IMPLEMENTATION: COMMUNITY CHAMPIONS



While the outputs from the community engagement strand were delivered as planned, the way in which we worked with champions differed to the proposal. Community Champion implementation had three stages: map and warm up, train and equip and connect with the community. All stages were delivered as intended. However there was some flexibility in equipping the volunteers and organising community events.


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Additional, shorter training sessions were delivered to smaller groups of Champions who either couldn’t attend the original training session, or were recruited later in the campaign. Many of the organised community events focused around speaking to members of the public as the Champions organised there own meeting with local community groups. There was a clear divide between the level of involvement from Community Health Champions and Health Trainers compared to other local residents who became involved in the campaign. Community Health Champions and Trainers were experienced in delivering health messages within the local community and had the support and flexibility to attend promotional events and campaign meetings. A lot of the engagement stemmed from these volunteers. Other Champions delivered more informal engagement activity, which was not restricted to the target wards. Many of these volunteers took an interest in the project alongside their professional responsibilities and saw the training as contributing towards this. In some cases these Champions commuted into these target wards so their community ties were based on their work activities.


Having a lead member of staff at the PCT that some Champions had previously worked with helped to organise Champions to ensure they attended relevant meetings and helped co-ordinate Champions in attending community events. The community events were researched and organised by The Hub who provided details to the PCT who then contacted Community Health Champions and Health Trainers with further details. The Hub directly communicated with the other Champions recruited to deliver the campaign. Being able to deliver the training in ‘bite-sized’ sessions also worked for members of staff who were only able to attend training for an hour. The handbook was also seen as a clear and a useful referral point for volunteers who could refer back to key campaign messages to refresh their memory. Having launched the wider communications elements prior or in parallel to Champion activity built Champions confidence in engaging with the public: eg, many of the Champions commented on seeing the lamp post banners when they were engaging with people and this motivated them to feel that they were part of a wider campaign.


Despite securing support from the local Volunteer Centre and Macmillan Support who advertised the opportunity to their members, few came forward to get involved. This resulted in a more direct approach to recruitment being adopted via Outreach within the community. Community Outreach was combined with snowballing via existing organisations; The Hub invited staff to attend a shorter training session with the aim of participants delivering campaign messages informally to colleagues and service users where appropriate. The Hub compiled a schedule of existing events that Champions could attend in order to deliver the public message. It was intended that this schedule would include planned activity by partners that would be useful for Champions to attend. This schedule was limited in parts as follows:

• the Public Health Team did not have the staff resources to organise their own health awareness events

• the Council events schedule was limited • some health awareness activities would not allow different campaign activity to run

alongside them. • Diabetes UK were unable to support campaign activity as they themselves had

engagement targets to meet so couldn’t accommodate for additional activities. This meant that the majority of events needed to be organised and arranged by The Hub


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and concentrated on places of high footfall including markets, shopping malls, parks and libraries in the target areas.


Securing greater attendance from local organisations at the first briefing meeting would have increased understanding amongst a wider audience about the project aims and objectives. Some Champions thought that it would have been beneficial to translate core campaign material. Projects planners could take this into account when budgeting for organisation campaign materials for future campaigns. The symptoms cards were seen as a very useful tool and easy for local residents to place in their pockets instead of a leaflet that they needed to carry around.


As a proportion of the Champions are Community Champions and Health Trainers these local residents will remain active in the community, being able to provide brief interventions when required. Kensington & Chelsea LINks are interested in replicating the campaign approach in their locality. The two LINks grounps: Hammersmith & Fulham and Kensington & Chelsea partner up in a number of their activities. Further Champion activity in July and September has been identified and communicated, these include: • Wormholt Fun Day (12 September) • Old Oak Community Centre Fun Day (19 September) • Time of your life, Hammersmith and Fulham Council (30 September) • Older Residents Meeting, Queen Park Rangers FC (mid-October)

IMPLEMENTATION: STAKEHOLDERS (HCPs)



The materials developed and delivered were as planned, however the timings were delayed.





As a result of the delay in commissioning and pressure to deliver the project within a set timeframe, production timelines were squeezed. This impacted the production of pharmacy bags which were originally supposed to launch on day 1 of the campaign but were not distributed until day 6 of the campaign. This meant that materials distributed along with the pharmacy bags (posters and symptom cards) were also delayed by the same length of time.


H&F PCT clearly communicated with stakeholders prior to the receipt of materials and found out what materials / quantities would be most useful.


There were no problems once the project commenced.


Nothing from The Hub’s perspective given H&F PCT were responsible for this strand of activity.


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The design for these materials can be used again on future campaigns.

EVALUATION (INC. KPI DEVELOPMENT)



The process for evaluating the success of the community activity was as planned. The process for evaluating community champions’ perspective on the campaign varied slightly from the proposal as it was an iterative process – as Champion engagement ensued, the approach was tweaked in line with what would work best for them. Completing impact evaluation forms worked well at face-face meetings with Community Health Champions and Health Trainers. Other Champions completed forms remotely and emailed these in.





Some of the Champions thought they were going to be monitored when evaluation activity was occurring with members of the public. This reduced their confidence in delivering this aspect of the evaluation. We would recommend specifically covering off this concern during the Champion training sessions whilst further stressing the importance of evaluation.


Developing KPIs for this project was relatively straightforward given a framework had already been developed for another project (CSCCN). Champions were happy to complete evaluation documents on their own experiences and the forms that recorded the reach of the campaign. Although this resulted in a high degree of paperwork, once explain Champions were happy to complete forms with a number of them opting to complete the forms electronically. Pilotting the approach to evaluation prior to roll out was useful. After testing the questionnaire in the field an additional question was added to provide further clarity on whether a community member felt more comfortable talking to others about lung cancer after having been engaged by a Champion.


Events that the Hub researcher attended attracted fewer of the target audience than originally anticipated. Effort was made to increase numbers by attending 5 events (as oppsed to the 4 originally planned). Despite this, only 44 community members were available and happy to be interviewed. Numbers were lower than aniticipated due to the following reasons:

• Some events that were organised with external partners had Champions located in lower foot fall areas. Equipping Champions with the tools to be able to identify when locations are not useful and move positions during events may to some extent have overcome this challenge

• The events were attended by the researcher part way through the campaign. At these events, Champions were still building confidence in engaging with the public about lung cancer. This resulted in more people being handed leaflets than


26

engaged face to face when compared with events attended later in the campaign. As the campaign developed Champions felt more confident in approaching people.

• Some larger events yielded greater numbers of responses from the public who could not easily recognise all of the campaign messages. For example, whilst the White City Community Engagement Day was well attended many community members were receiving a variety of messages (both health and community based). Therefore a number of them could not recall specific messages and others could not recall conversations with Champions about the campaign and therefore were not included in the research.

• Events attended attracted members of the public from outside the target areas. They were screened out of the research.


It would be more appropriate to conduct evaluation towards the end of future campaigns where Champions would have had more experience, and therefore more confidence, in delivering the campaign messages. It must be anticipated that events will be attended by community members outside of the target wards therefore the key messages would be more likely to bleed into areas outside of those targeted.


A KPI framework taking into accounts inputs, outputs and outcomes. A process evaluation framework can be used again on other social marketing projects. An approach to evaluation of Champion activity.


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4. APPENDICES 4.1. LIST OF PHARMACIES IN TARGET WARDS PHARMACY NAME LOCATION DELIVERY

QUANTITIES

Oza Chemist Fulham Broadway 3000 Boots The Chemist Fulham Broadway Retail Centre 3000 ABC Drugstores North End Road 3000 Superdrug Pharmacy North End Road 3000 Boots UK Ltd North End Road 3000 ABC Pharmacy Wandsworth Bridge Rd 3000 C.E Harrod Chemist North Kings Road 3000 Fulham Pharmacy Fulham Road 3000 Kanari Pharmacy Fulham Road 3000 Fontain Pharmacy Munster Road 3000 Palace Pharmacy Fulham Palace Road 3000 Lloyds Pharmacy Richford Gate Med Ctr 2000 Tesco Pharmacy Shepherds Bush Road 4000 HealthsidePharmacy Shepherds Bush Road 3000 Barons Pharmacy Margravine Gardens 3000 Boots UK Ltd King Street 3000 Boots UK Ltd Fulham Palace Road 1000 Rite Chem Fulham Palace Road 1000 Boots UK Ltd Broadway Shopping Ctr 3000 Faro Pharmacy SwanscombeRoad 3000 Jay's Pharmacy Uxbridge Road 3000 Westway Pharmacy Westway 3000 Greenlight Pharmacy Uxbridge Road 3000 Hamlins Chemist Bloemfontein Road 3000 Boots UK Ltd Westfield S/Ctr, Ariel Way 3000 Bush Pharmacy Uxbridge Road 3000 Pestle & Mortar Uxbridge Road 3000 Pestle & Mortar South Africa Road 3000 Limegrove Pharmacy Goldhawk Road 3000 Superdrug Pharmacy Uxbridge Road 3000 Babylon Health Ltd Uxbridge Road 3000 Morrisons Pharmacy Concord Centre 3000 Caregrange Pharmacy Goldhawk Road 3000 Globe Chemist Kings Parade 3000 Winwood Chemist Askew Road 3000 Forrest & Co Blythe Road 3000 North End Pharmacy West Kensington 3000 Parmay Pharmacy Fulham 3000


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4.2. LIST OF GPS IN TARGET WARDS GP DETAILS LOCATION

Dr Cordelia Anyiam-Osigwe Old Oak Surgery, Uxbridge Road

Dr A Badat Shepherds Bush Medical Centre, Uxbridge Road

Dr Clare Graley Canberra Centre for Health, White City

Dr R Dandapat White City Health Centre, White City

Dr G Uppal White City Health Centre, White City

Dr R Kukar White City Health Centre, White City

Dr S Dasgupta Medical Centre, Westway

Dr R Kukar The Medical Centre, Uxbridge Road

Dr Faisal Samji The Bush Doctors, West 12 Shopping Centre

Dr Braithwaite Hammersmith Centre for Health, Hammersmith Hospital


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4.3. LIST OF PARTNERS CONTACTED Hammersmith & Fulham Volunteer Centre Nubian Life Sir Oswald Stoll Foundation Help Hammer Cancer MacMillan Cancer Support - West London Division The Forward Project H&F BME Network Fulham Good Neighbours LINks CITAS CaVSA Afican & Caribbean Voices Assoication African Carribbean Women's Development Council Old Oak Community Centre Old Oak Housing Association Shepherd's Bush Community Association Shepherd's Bush Healthy Living Centre Sexual Health Champion Wormholt Residents Association Hammersmith Community Trust Turning Point Village Hall Senior Citizens Club Blythe Good Neighbourhood Queen Park Rangers in the Community Trust Kick It Stop Smoking Service H&F Council Aasha Project for Bengali Women Afghanistan Culture and Art Association Asian Health Agency Association Of Eritrean Jeberti Banooda Aid Foundation British Arab Resources Centre Ltd Eritrean Community Association Ethiopian Advice & Support Centre Urban Studies Centre Horn Of Africa Community GRP Indian Women's Welfare Association Iranian Association Iraqi Community Association Kanga (Kurdish Association) Moroccan Centre Muslim Women's Organisation Somali Caring Education Association Somali Children's Advocacy Somali Women Organisation


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Zimbabwe Women's Network Maggie's Centre Urologist SCN


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4.4. RESEARCH MATERIALS

Hammersmith & Fulham Lung Cancer Campaign

Public Evaluation Questionnaire Please complete this form about the Lung Cancer Awareness Campaign. All your answers are strictly confidential. If you take part then you will be entered into a prize draw where you could win £100 worth of shopping vouchers. Q1: How would you describe the talk you have just been given? Please tick all that apply. Interesting ☐ Helpful ☐ Boring ☐ Confusing ☐ Relevant ☐ Irrelevant ☐ Q2: In your own words, what did you learn today?

Q3: What do you think are signs and symptoms of lung cancer? Please say as many as you can remember. (Unprompted, code responses) Cough that doesn’t go away after 3 weeks ☐ Coughing blood ☐ Unexplained persistent breathlessness ☐ A cough that has got worse or changes ☐ Constant chest infections ☐ Unexplained persistent tiredness or lack of energy ☐ Unexplained persistent weight loss ☐ Persistent pain in the chest and/or shoulder ☐

Any other responses:


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Q4: How comfortable would you feel talking to someone about lung cancer? Very comfortable ☐1 Fairly comfortable ☐2 Not very comfortable ☐3 Not at all comfortable ☐4 Q5: Still thinking about speaking to someone about lung cancer, do you feel more comfortable talking to others than you did before?

More comfortable ☐1

No more comfortable ☐2 Q6: Why did you give your answer in Q5? Please say in the box below:

Q7: How confident are you knowing what to do if someone you know displays the signs and symptoms of lung cancer?

Very confident ☐1

Fairly confident ☐2

Not very confident ☐3 Not at all confident ☐4 Q8: What do you think someone who displays the signs and symptoms of lung cancer should do? Please say in the box below:


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Q9: Would you like to make any other comments? Please say in the box below:

Q10: Please state your gender:

Male ☐1 Female ☐2

Q11: In which age category do you belong? 18-24 ☐1 55-64 ☐5 25-34 ☐2 65-74 ☐6 35-44 ☐3 75+ ☐7 45-54 ☐4 I prefer not to say ☐8 Q12: In which area do you live? College Park and Old Oak ☐1 Wormholt and White City ☐2 Shepherds Bush Green ☐3 Other ☐4 Please state area: _________________________ Q13: To which of these ethnic groups do you belong? White British ☐1 Irish ☐2 Eastern European ☐3 Any other White background ☐4 Mixed White and Black Caribbean ☐5 White and Black African ☐6 White and Asian ☐7 Any other Mixed background ☐8 Asian or Asian British Indian ☐9 Pakistani ☐10 Bangladeshi ☐11 Any other Asian background ☐12 Black or Black British Caribbean ☐13 African ☐14 Any other Black background ☐15 Chinese or other ethnic group Chinese ☐16 Any other ethnic group ☐17 I prefer not to say ☐18


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If you would like to enter the prize draw then please give your name and telephone number below. You could win £100 in shopping vouchers! These details will only be used for the prize draw and for no other purpose. Your details will not be passed on to anyone else and all your responses will remain confidential. Name: ____________________________________ Telephone number: _________________________ Thank you for your time. If you have any questions or would like to make any further comments, then please contact Alex Bone on 0161 235 8455 or email: [email protected]

Documents

HAMMERSMITH AND FULHAM PCT - Community Championscommunitychampionsuk.org/development/.../uploads/2013/01/lungc… · HAMMERSMITH AND FULHAM PCT: Lung Cancer Social Marketing Campaign