Printable View : Steps to Developing an Action Plan

It can be tempting to jump straight into action. Kids are overweight? Let's offer lower-fat school lunches! Organize soccer games after school! Tell parents to offer more fruits and vegetables! But if your action doesn't address the root causes of the problem, your intervention is likely to have little effect, particularly in the long term. The ecological approach that you have been practicing in this course helps you identify the underlying causes of the problem and the actions you need to take to change them. Now that you have done this groundwork, you're ready to develop your action plan.

The steps presented here will help guide you and your collaboration partners as you develop an action plan.

Before You Start

At this stage of the ecological approach to preventing childhood obesity, so far you (and, in real-life practice, you and your collaborators) have:

• Identified the problem: Excessive weight gain in children
• Assessed child and adult behaviors related to excessive weight gain in children, selected the ones you want to change, and set objectives for changing these behaviors
• Assessed what built, social, economic, and/or policy environmental factors influence these prioritized behaviors, selected which you want to change, and set objectives
• Assessed what predisposing, enabling, and reinforcing (P.E.R.) factors influence these prioritized behaviors and/or environmental factors, selected which ones you want to change, and set change objectives.

Now that your team has set change objectives, you may need to expand your group to include other community members who can help you achieve them. With your team, you're now ready to develop an action plan for refining and meeting your objectives. Taking the steps that follow will help.

Step 1: Select Appropriate Intervention Methods

The first step is deciding what intervention methods your team will use. In other words, what general technique or process will you use to promote change in the P.E.R. determinants of the behaviors or environmental conditions you have prioritized for change?

The methods you select should be matched to the P.E.R. factors you have identified as priorities. We'll come back to this.

Step 2: Select Intervention Strategies

Strategies are the specific techniques for applying the method. For example, imagine an assistant principal who believes he can't influence the availability of sweetened beverages in school vending machines. You diagnose this as low self-efficacy (a predisposing factor) and decide that the most appropriate methods to address it are communication methods such as verbal persuasion, modeling, and guided practice.

You then have to select your strategies for implementing these methods. For example, a modeling strategy would be to invite an administrator from a school that has made vending machine changes to give a presentation. A guided practice strategy would be to "buddy" the assistant principal with another administrator who is more experienced in facilitating change.

The table on the next slide summarizes which kinds of methods tend to work best for changing which P.E.R. factors, with examples of related strategies. A more detailed list can be found under Resources for Planning Action in Tools for You for this course at the Cornell NutritionWorks website, www.nutritionworks.cornell.edu.

Intervention Methods and Sample Strategies Matched to P.E.R. Factors¹

Step 2: Select Intervention Strategies (continued)

In choosing intervention strategies, in addition to the research evidence, also consider the following:

• What the community will broadly support
• What the community has the capacity to implement
• What can be done in a reasonable length of time
• The likelihood of reaching and affecting your priority audiences.

Also, interventions aimed at changing enabling factors in the environment, while very important, are especially dependent on community resources such as time, money, and goodwill. Start with one environmental change at a time—too many changes will confuse community members and cloud your ability to determine what works.

Step 3: Identify and Delegate the Required Actions

Actions are the specific tasks that each of the people involved in the action planning are going to do to implement the strategy. For example, in a plan to support that assistant principal mentioned earlier (the one who thinks he can't impact vending machine policy), you might have the task of contacting the principal for permission to have a speaker on this topic at the next staff meeting. One of your partners might identify a speaker and also work with the parent/teacher organization to sponsor and promote a similar information session for parents and children.

Putting the actions into an organizing framework, such as a list of who will do what and by when, is important. Samples of action plan worksheets are provided in this course and in the Tools for You for this course on the Cornell NutritionWorks website, www.nutritionworks.cornell.edu.

Step 4: Plan the Evaluation

Before you implement your plan, you need to decide how you will evaluate your intervention. Your assessment should include the following:

• Process evaluation: Was your intervention implemented in the way it was intended? How was it adjusted/changed along the way? What were the experiences/responses of those who were implementing the intervention? How did the collaboration function?
• Outcome evaluation: Did you achieve your specific objectives?

Your evaluation plan should answer the following questions:

• What will be assessed?
• How will it be assessed?
• When will it be assessed?
• Who is the audience for your results?
• How will you know that you have been successful?

The process evaluation helps you know if and when you need to change strategies or even methods. The outcome evaluation will add to the evidence about what works (and doesn't work); this will help guide not just your future efforts but also those of your colleagues.

Step 5: Be Flexible

As you monitor your progress, be flexible about changing intervention strategies if needed. For example, if an aerobics class does not catch on, try salsa dancing in the after-school program. If you have tried multiple strategies for implementing a method and are not feeling successful, then it is time to go back and reconsider both the P.E.R. factor you are focusing on and your overall mix of methods.

Here is a summary of the steps to help you and your team develop an action plan.

• Select intervention methods that are evidence-based and matched to the priority P.E.R. factors
• Select intervention strategies to apply the method
• Identify and delegate the required actions
• Plan and implement both process and outcome evaluations
• Be flexible and adjust your process and action plan as needed

Because you and your team have taken the time to ensure your plan gets at the root causes of the problem, your intervention should be a great success. When it succeeds, it is time for step six: Celebrate!

¹Bartholomew LK, Parcel GS, Kok G, Gottlieb NH. Intervention Mapping. Designing Theory-and Evidence-Based Health Promotion Programs. Mountain View, CA: Mayfield Publishing Company, 2001:171- 227.