Stakeholder Analysis & Community Readiness

Stakeholder Analysis & Community Readiness
PPOR Stakeholder Analysis & Community Readiness Whether you have long-standing collaboratives or new collaborative efforts, there are usually periods of time when stakeholders are new to the process, collaboratives seek to expand or broaden their membership, and collaboratives experience ‘growing pains’. When PPOR was first adapted for use in urban areas in the US, there were few tools available to communities to help identify stakeholders and ensure readiness, elements of participation and leadership, as well as sustainability. But now, there are a number of tools available – almost all of these are free and widely available. So today I’m going to talk about the tools that are available to you. Stakeholder Analysis & Community Readiness 1

Engaging and creating a sustainable community partnership Creating opportunities for the community to Take a role and “own” the PPOR process Share their stories, and Take a part in helping determine appropriate Communication strategies and methods Interventions Prevention Leadership Community readiness is about engaging and creating sustainable partnerships within your community. It’s also about creating opportunities for all of the stakeholders – those in public health, clinical settings, education, and the community members who experience fetal and infant loss – to Take a role in the collaborative and ‘own’ the PPOR process, Share their stories / experiences, and Take a part in helping determine appropriate Communication strategies / methods Interventions Prevention Leadership Stakeholder Analysis & Community Readiness

Who are “stakeholders”?
“. . . key individuals (or groups of individuals) who have an influence over either decision-making or implementation (or both) either directly or indirectly, overtly or covertly” [T Grundy, Strategic Change, 1997] This influence can assist, hinder or alter the course of change When you hear the word ‘stakeholder’ who or what comes to mind? Stakeholder Analysis & Community Readiness

Who are the community stakeholders? Who owns, drives the PPOR process?
Cultural groups Healthy Start coalitions Schools, colleges Parent groups Businesses Faith-based groups Health care providers, clinics Mental health care providers Local health departments Insurance companies Law enforcement Coroner, medical examiner Others… “Everyone holds a piece of the puzzle” Who are stakeholders in your community? Stakeholder Analysis & Community Readiness 4

Utilize existing resources
If a group of community stakeholders already exists, Healthy Start Coalition FIMR Community Action Team Title V stakeholders population workgroup it may be able to serve the function of the PPOR stakeholders group PPOR is designed to be integrated with existing efforts, not to compete with them! Remember, if a community stakeholders group already exists, another group not need be formed to do PPOR. The group can collaborate throughout the stages of PPOR, including the analysis stage . . . Also, a community stakeholders group for PPOR needs: Adequately trained analytic staff Adequately trained communication staff Analysis team including program staff Sufficient staff hours Strong leadership agreement & support Stakeholder Analysis & Community Readiness 5 5

PPOR Community Challenges
Explaining value to stakeholders Overcoming community inertia -- ‘already know this’ Mistrust of (quantitative) data Seeing PPOR as more than ‘research’ Competing priorities Securing resources for unmet needs, interventions identified through PPOR This slide describes some of the challenges facing community collaboratives. This is hard work and can take a toll on a collaborative. Some of the tools that we will talk about can help collaborative groups keep a finger on the pulse of group and individual dynamics that can ‘make’ or ‘break’ a collaborative. Sometimes community stakeholders may not see value in conducting an analysis about infant mortality. They may believe that they are aware of the nature of the problem, the extent of the problem, and ‘know’ the population most affected. And, they may believe that they have the data they need After all, almost every community, county, state, nation calculates and reports infant mortality rates But PPOR offers a different approach for looking at the data and thinking about the most appropriate preventive strategies and interventions. Sometimes, communities are shocked at the disparities uncovered by PPOR analysis; others feel they already knew there was a problem – and that the IM rate didn’t quite seem right, but they needed “the data” to back them up. Everyone will need to hear a message of opportunity, not just a list of problems, and PPOR can provide this message. There are many problems for communities to work on, and community leaders may be stretched thin. But interventions that reduce infant mortality tend to improve the community in other ways as well, and the deaths of infants can stimulate communities to act when other events or statistics only produce discouragement. In this sense, the collaborative needs to have a common understanding, goals, purpose, and message. Stakeholder Analysis & Community Readiness 6

Tools for Engaging, Measuring, and Sustaining Community Readiness
Stakeholder Analysis Community Readiness Tent Wilder Collaboration Factors Inventory Partnership Self-Assessment Tool Community Participation: A Self Assessment Toolkit for Partnerships Collaboration: Yield, Stop, Go! PARTNER AHRQ Sustainability Toolkit Stakeholder Analysis & Community Readiness

In this part of the presentation, I am going to give you an overview of The steps in conducting a stakeholder analysis, Key elements to include in a stakeholder profile, Steps in a ‘Ladder of Participation’, and The types of categories and methods of participation for each stakeholder For those of you interested in stakeholder analyses, there is a workbook available. Stakeholder Analysis Stakeholder Analysis & Community Readiness 8

What is a stakeholder analysis?
Designed to provide an organization with information to evaluate and understand stakeholders in terms of their relevance to a policy or specific activity Can produce a broad understanding or focused understanding Ideally, a systematic process rather than a singular tool Stakeholders can greatly influence the intended outcome and success of a public health intervention or project. Their involvement can take place during any stage of the project; however, performing a stakeholder analysis during the planning stage can greatly influence the development of an effective project strategy. Many organizations express support of stakeholder involvement by promising participation, but gaining stakeholder involvement is not always easy. Careful and thorough planning is essential to identify the right stakeholders and to ensure stakeholders participate in appropriate and effective ways. So a stakeholder analysis is [read slide] Stakeholder Analysis & Community Readiness

Why involve stakeholders?
Provide valuable information Needs, resources, realistic objectives, practical considerations Recognize hidden factors that might not be obvious in the planning stage Identify points of opposition / prevent problems during implementation Encourage a sense of ownership / involvement Ensure that the project focus remains on the population it is meant to support / serve [read slide] Stakeholder Analysis & Community Readiness

Step 1: Identify the stakeholders
Beneficiaries Supporters Opponents Resource providers Vulnerable groups Others Stakeholders are individuals, groups, or institutions likely to be affected by a proposed project (either negatively or positively), or those who can affect the outcome of the project. They are persons who might be involved or be impacted by the project. The stakeholder population can be broad, so narrowing the field to key stakeholders is a main objective of conducting a stakeholder analysis. Beneficiaries -- Who are the potential beneficiaries? Supporters -- Who are the supporters? Opponents -- Who are the opponents? Resource Providers -- Who can provide resources to ensure the implementation of the project? Vulnerable Groups -- Who are the vulnerable groups that might be affected by the project? Stakeholder Analysis & Community Readiness

Step 2: Create a stakeholder profile
Role Motivation for being in project Perceived expectations / goals Level of importance for project success Potential negative impact on project Level of influence over decision-making for the project Intention to participate in accordance with project design Intended use of project / project results Role as a stakeholder? Be clear and specific . . . Motivation for including a stakeholder in a project – is there mutual benefit? Do stakeholder’s expectations / goals conflict with or support the purpose of the project? Level of Importance for the Success of Project What resources might the stakeholder bring to the project? What is the stakeholder willing to organize for the project? Potential Negative Impact on the Project What can the stakeholder prevent from happening? Are there any stakeholder interests that conflict with project goals? Level of Influence over the Project for Decision-Making What is the stakeholder’s power and status in relation to the project? Does the stakeholder control key resources? Does the stakeholder have informal influence or personal connections that will affect the project? What power does the stakeholder have over implementation of the project or over other stakeholders? Intention to Participate According to the Project Design Does the stakeholder want to be involved or merely need to be informed about the project and its process? How much does the stakeholder need to participate to make the project a success? Intended Use of the Project or the Project Results How will the stakeholder directly benefit from the project and how will this affect the stakeholder’s motivation? Stakeholder Analysis & Community Readiness

Step 3: Determine a ladder of participation
Information Sharing Stakeholders are provided information about a project but do not have the opportunity to influence the project because the information is shared with them after decisions have been made. Participation by Consultation Stakeholders participate by being consulted for their views, which are then incorporated into the project at the discretion of the project planner. The project planner defines both problems and solutions, and may modify these after considering the stakeholders’ responses but is under no obligation to agree with or incorporate the stakeholders’ views. Participation through Material Incentives Stakeholders participate by conducting an activity or providing labor in return for food, cash, or other material incentives. Functional Participation: Group Formation Stakeholders participate by forming groups to meet predetermined objectives related to a project. Their involvement usually occurs after major decisions have been made. These groups tend to be dependent on external factors (e.g., donor funding) but may become independent. Interactive Participation/Collaboration Stakeholders participate in joint analysis with the project planner. Typically, this leads to joint goal and objective setting, action planning, and the formation and strengthening of groups. This level involves multiple perspectives between all members of the group and the planner. Groups can take control over project planning decisions, thus allowing stakeholders to influence the implementation and structure of a project. Self- Actualization/Empowerment Stakeholders have control over decisions and resources and participate in lead roles for the project. Stakeholders are the original designers of project ideas and may take control at a given point in the project. Stakeholder Analysis & Community Readiness

Step 4: Establish participation categories & methods
Link stakeholders, based on the stakeholder profile, with the categories on the ‘ladder of participation’ Identify practical strategies or methods for stakeholder involvement The first step in this process is to link each stakeholder with a level of participation. It is important to keep in mind that stakeholders may participate in multiple categories and varying levels of participation. When the varied levels of participation have been identified, add the strategies or methods you will use to encourage stakeholder participation. Some examples of methods that have been used to encourage stakeholder participation include:  Workshops  Questionnaires  Interviews  Dramas, role plays  Brainstorming discussions  Open-ended discussions  Round robin discussions (i.e., everyone in the group shares one or more ideas)  Small group discussions  Surveys Stakeholder Analysis & Community Readiness

Acknowledgements Denise Traicoff CDC, Center for Global Health, Sustainable Management Development Project Requires careful interpretation Joyce Stanley, Consultant United National Development Program, United Nations Capital Development Fund, US Agency for International Development Stakeholder Analysis & Community Readiness

Tools for Assessing Community Readiness,
We have made all of these tools available to you on-line or provided a link! Tools for Assessing Community Readiness, Participation, Leadership & Sustainability Stakeholder Analysis & Community Readiness 16

Assessing Readiness for Change
Are the key players prepared for their roles? Is the case for change compelling? How will changes mesh with current culture and values? Are there sufficient resources and adequate systems to sustain change? What are the opportunity costs? From: C Aschenbrener,AAMC, July 2000 What is needed for change? It’s hard to effectuate change in community norms and behaviors unless the community is involved and prepared for change / willing to change! This slide shows some of the questions that a collaborative should consider before embarking . . . 4 key players: Sponsor – sanctions, supports, and/or legitimizes change Agent – responsible for making the change happen Target – people who must change Advocate – wants to achieve change but lacks power to sanction it Some considerations include: Is there demand for change? Is the organization or community in crisis? What is the current change load? Will another change overload people? Are leaders personally engaged in the change process? Are the leaders / community prepared for the consequences? Stakeholder Analysis & Community Readiness 17

What do all of these tools / methods have in common?
TALKING! Most important features Talking / communicating Having a respected leader Having a common vision Having a plan – how will you move from vision to action Ensuring that everyone has a “role” Ensuring that everyone feels appreciated Periodically assessing gains and satisfaction As we move through the tools, you will begin to see some common themes. But what we have found is that there are some core keys to effective collaboratives . . . Stakeholder Analysis & Community Readiness

Community Readiness Tent
Many of you may be familiar with the tool used by Magda Peck . . . Community Readiness Tent Stakeholder Analysis & Community Readiness 19

Community Readiness Tent
Provides a framework for starting the PPOR process Helps engage partners, reach consensus, identify assets, reveal gaps, develop strategies [read slide and then go through each of the 5 Rs . . .] Reasoning: partners can communicate a clear, compelling case for PPOR based on its value-add Results: partners can articulate what measurable results are expected from doing PPOR, and by when Roles: partners are willing and able to champion PPOR over time in their various roles in community Risks/Rewards: sufficient strategic balance exists between benefits and consequences for essential stakeholders to support PPOR implementation Resources: sufficient systems and resources to support full implementation Stakeholder Analysis & Community Readiness

Readiness Tent Process Review the 5 essential elements questions Assess the current status of each Reach consensus on a “score” for each readiness element Plot each score on the “tent” by marking the number on each corresponding axis Connect the 5 points between the axes to form the roof, then shade the tent Identify the tent pattern most like yours: what does this mean for PPOR readiness? Tool for discussion!!! Stakeholder Analysis & Community Readiness 21 21

What’s the shape of your community’s tent?
Obviously, there are a lot of shape’s this tent could take, the point is that a very small tent or a tent lacking in one or more ‘tent poles’ is an indication that the community may need to ensure that additional infrastructure is in place or that the collaborative partners are sufficiently prepared for the process to move forward smoothly . . . Stakeholder Analysis & Community Readiness

Wilder Collaboration Factors Inventory
Stakeholder Analysis & Community Readiness 23

Wilder Collaboration Factors Inventory
Developed by the Amherst H Wilder Foundation (Wilder Research Center) Consists of 20 factors that influence the success of collaborations Factors are grouped into 6 domains Environment Membership Characteristics Process and Structure Communication Purpose Resources This tool focuses on the factors that most impact the collaborative group as a whole . . . It is a easy, short instrument of about 40 questions – including instructions Domains Environment History of collaboration or cooperation in the community Collaborative group seen as a legitimate leader in the community Favorable political and social climate Membership Characteristics Mutual respect, understanding, and trust Appropriate cross-section of members Members see collaboration as in their self-interest Ability to compromise Process and Structure Members share a stake in both process and outcome Multiple layers of participation Flexibility Development of clear roles and policy guidelines Adaptability Appropriate pace of development Communication Open and frequent communication Established informal relationships and communication links Purpose Concrete, attainable goals and objectives Shared vision Unique purpose Resources Sufficient funds, staff, materials, and time Skilled leadership Stakeholder Analysis & Community Readiness

A Word about Inventory Scoring & Interpretation
No normative standards for a definitive interpretation of the numerical scores Look at overall scores and score patterns within the statements that comprise the factor and the factors that comprise the domain Consider . . . What are the collaborative group’s strengths? Weaknesses? Do representatives from the team tend to rate the factors in the same way? If not, what are the implications? For low-rated factors, are there particular items that are especially problematic? How strong are the scores overall? General rule of thumb for scoring = Indicates a strength, probably no special attention is needed = Indicates a borderline score, probably should be discussed to see if there is an issue deserving attention = Indicates a concern, should be addressed Team / group scores for each factor are calculated by Adding together all the ratings for each of the statements of a factor, then Dividing the total number of ratings for those items. Stakeholder Analysis & Community Readiness

Partnership Self-Assessment Tool

Partnership Self-Assessment Tool
Developed by the Center for the Advancement of Collaborative Strategies in Health Designed to help partnerships: Understand how collaboration works Understand what it means to create a successful collaborative process Assess how well the collaborative process is working Identify specific areas they can focus on to make the collaborative process work better While Wilder provides an assessment of a collaborative group, the PSAT provides an assessment at a more individual level Assessing the individual’s perceptions and feelings of the collaborative process Collaborative teams that we have worked with find the tool useful – particularly for identifying weaknesses in leadership and level of satisfaction of individual collaboration members Warning – it is a lengthy instrument of 15 pages – it doesn’t take that long to complete – but looks daunting / overwhelming [read slide] Stakeholder Analysis & Community Readiness

Self-Assessment Toolkit for Partnerships

Community Participation: A Self Assessment Toolkit for Partnerships
Developed by the East Midlands Development Agency, Nottingham, UK Designed to enable more effective voluntary and community sector participation in partnerships Point out this ‘Racial Equity Tools . org’ site because there are a number of interesting and informative tools for community assessment , but they also have a number of tools for evaluating racial equity . . . We haven’t had any groups use these tools at this point, but I anticipate that we will have groups in the future use them. Stakeholder Analysis & Community Readiness

Self Assessment Toolkit Contents
Getting community participation right Reasons for the partnership Benefits and barriers to community participation The ‘lifecycle’ of partnerships Evidence that things might be going wrong Self-assessment tools for all phases of partnerships Start up Planning Implementation Evaluation Renewal ‘Getting Community Participation Right’, gives an introduction to the issues involved and provides a framework of principles, but the toolkit was not intended to be read through at one sitting in an academic kind of way. Nor was it a benchmarking or auditing tool which asks partnership players to tick boxes and score their performance against an external standard. Its main purpose is as a tool for group use. The questions and exercises in this publication were designed to help users to clarify what they want to achieve, what current good practice says they ‘ought’ to achieve, and how they can move on from their present situation towards their goals by understanding the size and nature of the gap between the two, and devising their own plans of action to cross that gap. The intention is that after using this set of self assessment tools, partnerships will know in very practical terms what they could do to increase the quality and effectiveness of their community participation practices. Stakeholder Analysis & Community Readiness

Collaboration: Yield, Stop, Go!

Collaboration: Yield, Stop, Go!
Developed by a Great Plains Public Health Leadership Institute team as a leadership resource Consists of 4 questions and the resources to help a collaborative . . . Does the group work together as a collaborative? Is there a common understanding of why the group is together? Is the collaborative going where the group members want it to go? Is the collaborative effective? [read slide] Very simple 3-4 page document, nice way to start . . . Stakeholder Analysis & Community Readiness

PARTNER Stakeholder Analysis & Community Readiness 33

PARTNER (RAND Corporation)
Program to Analyze, Record, and Track Networks to Enhance Relationships (hence, “PARTNER”) Type of data collected: Identification of collaboration partners Record of the frequency of interactions Elements of the strength and quality of the interactions Measures of trust and value within the collaboration Network scores to report and illustrate changes to collaboration activity over time Analysis possibilities: Visualizations to show who is connected to whom, including the strength of links and characteristics of the collaboration members Network scores representing the density, centralization, and trust of the collaborative are provided Purpose: PARTNER is a tool that allows public health departments (and their partners) to measure and monitor collaborative activity over time. Using social network analysis, network measures indicate progress of collaboration by assessing which partners are involved, the ways that partners exchange resources, and provide a better understanding of the amount of effort required to sustain a collaborative. By using the tool, you will be able to demonstrate to stakeholders, collaborative members, and funders how your collaborative activity has changed over time and progress made in regard to how community members and organizations participate. Stakeholder Analysis & Community Readiness

Collaborative Leadership & Sustainability
AHRQ Tools for Collaborative Leadership & Sustainability Stakeholder Analysis & Community Readiness 35

AHRQ Community Quality Collaboratives
Agency for Healthcare Research & Quality (AHRQ) Multiple tools and resources available Tools for Collaborative Leadership and Sustainability Sustainability Toolkit for Community Quality Collaboratives Multi-stakeholder Community Inventory Modules Community quality collaboratives are community-based organizations of multiple stakeholders, including health care providers, purchasers (employers, employer coalitions, Medicaid and others), health plans, and consumer advocacy organizations, that are working together to transform health care at the local level. Tools for Collaborative Leadership and Sustainability Sustainability Toolkit for Community Quality Collaboratives: An Overview of the Art & Science of Building Staying Power Tools to help collaboratives build, maintain, and refine an infrastructure that supports and advances the mission of the organization as market and stakeholder expectations change Go to: Multi-stakeholder Community Inventory Modules Tools to assess strengths and goals of Community Quality Collaboratives along 8 areas: collaborative leadership, public at-large engagement, quality and efficiency measurement, public reporting, provider incentives, consumer incentives, strategy for improving quality, health information technology/health information exchange. Go to: Regional Coalition Collaboration Guide Assists community leaders in creating and sustaining a regional coalition based on lessons and tips from six pilot quality initiatives Go to: Tools to Engage Consumers The Community Quality Collaborative Leader's Guide to Engaging Consumer Advocates Guide for including consumer advocates in Community Quality Collaboratives Go to: Talking to Consumers about Health Care Quality Site designed for people and organizations trying to educate consumers about health care quality Go to: AHRQ Publications for Consumers Easy-to-understand publications for health care consumers Go to: Tools on Measures, Data, and Reports on Quality and Efficiency Consumer Assessment of Healthcare Providers and Systems (CAHPS®) Public-private initiative to develop standardized surveys of patients' experiences with ambulatory and facility-level care Go to: HCUPnet Online query system that provides access to health statistics and information on hospital inpatient utilization and quality — at the national and state levels — and thereby can inform local quality agendas… Go to: National Healthcare Quality Report and National Healthcare Disparities Report Annual, comprehensive overviews of the state of quality and disparities in health care in the United States Go to: AHRQ Preventable Hospitalization Costs, a County-Level Mapping Tool Downloadable software that can be used with administrative data on hospital admissions to assess the number and cost of "preventable admissions" in State or communities. Go to: Identifying, Categorizing, and Evaluating Health Care Efficiency Measures Rand report that identifies, analyzes, and classifies current definitions of efficiency, lays out a roadmap to help illuminate discussions, and identifies next steps Go to: AHRQ Quality Indicators Downloadable software that can be used with hospital administrative data to assess quality of care. Software includes four modules: inpatient quality indicators; patient safety quality indicators; prevention quality indicators; and pediatric quality indicators. Go to: Tools for Public Reporting Health Care Report Card Compendium Searchable directory of over 200 sample report cards that show formats and approaches for providing comparative information on the quality of health plans, hospitals, medical groups, individual physicians, nursing homes, and other providers of care Go to: Quality Indicators Draft Model Reports Model reports designed to report comparative information on hospital performance based on the AHRQ Quality Indicators Go to: Tools on Incentives for Quality Pay for Performance: A Decision Guide for Purchasers An evidence summary organized around 20 questions that span four phases of purchaser decisionmaking: contemplation, design, implementation, and evaluation. Go to: Decision Guide on Consumer Financial Incentives An evidence summary organized around 21 questions that span incentive design and implementation decisions identified by user-stakeholders. It reviews the application of incentives to five types of consumer decisions: selecting a high value provider, selecting a high value health plan, deciding among treatment options, reducing health risks by seeking preventive care, and reducing health risks by decreasing or eliminating high-risk behavior. Go to: Tools to Improve Preventive Services U.S. Preventive Services Task Force Expert recommendations for clinical preventive services Go to: A Purchaser's Guide to Clinical Preventive Services: Moving Science into Coverage Information source for employers on clinical preventive service benefit design Stakeholder Analysis & Community Readiness

COLLABORATIVE LIFE CYCLE PHASES
Sustainability Toolkit for Community Quality Collaboratives VISION GROWTH COLLABORATIVE LIFE CYCLE PHASES ESTABLISHMENT REBOOTING EXTENSION Stakeholder Analysis & Community Readiness

Building Sustainability in Each Life-Cycle Phase
Common Activities Key Questions Desired Outcomes Vision Defining goals Recruiting leaders What are we trying to accomplish? Clear goals Growth Demonstrating value Leveraging resources How will we get there? Early ‘wins’ Committed membership Establishment Institutionalizing value Are we on track? Recognition as a leader and trusted source Extension Assessing results Delivering What is / isn’t working? Continuity Incorporating new perspectives Rebooting Responding to significant shifts How will we adjust / continue? Renewed vision [Describe slide] Refer to page in Toolkit Stakeholder Analysis & Community Readiness

Key Questions in Building a Sustainability Plan
What is the life-cycle phase of the collaborative? What are the life-cycle phases of participating stakeholders / stakeholder organizations? How do they inform / impact the collaborative? What relevant models and tools can be used to frame and guide collaborative efforts? Even at the beginning of the collaborative, it is a good idea to talk about the potential ‘shelf-life’ of your collaborative. What is the group’s vision for the life of the collaborative? Sometimes, stakeholders can be hesitate to participate if roles are not clearly defined and if there is not end in sight. If a end-point can’t be determined, then when will you check in on members? Do certain types of members have different ‘shelf-lives’? This leads us into the final slides and a reminder about EVALUATION! Everybody’s favorite topic! Stakeholder Analysis & Community Readiness

Evaluation of Community Collaboratives
Wrap-up & Evaluation of Community Collaboratives Stakeholder Analysis & Community Readiness 40

Evaluation of Collaborative Processes
Collaborative work should be evaluated to better understand How is it functioning? How effective is the group work? Are we likely to achieve our desired results? How satisfied are members? Questions about capacities, operations, climate, context Factors influencing success Projected tasks/activities relative to stages of development Milestones and Critical Events (journey) You can use the assessment tools to help evaluate the collaborative and give you a sense of how members perceive the collaborative. Document your journey – use logic models and build a plan for assessing, monitoring and evaluating the work of the collaborative as well as the collaborative process. There is a great but lengthy document from University of Wisconsin-Extension called “Evaluating Collaboratives: Reaching the Potential” – it provides step-by-step guidance. Send us your successes, failures, lessons learned, evaluation results – we want to know!!! Stakeholder Analysis & Community Readiness

Consider Measuring Change in . . . Individuals Attitudes, perceptions, knowledge, competence, skills, abilities, behaviors, actions, lifestyles Groups Families Interactions, behaviors, actions, values, culture Agencies Organizations # / type of services/programs delivered, access, practices, resource generation, resource use, policies Systems Relationships, interaction patterns, linkages, networks, practices, policies, resource use, institutionalization of changes Communities Values, attitudes, relations, support systems, civic action, social norms, policies, laws, practices, conditions And, document, document, document!!! If you need assistance in finding evaluation tools on-line, please give me a call. Stakeholder Analysis & Community Readiness

MANY THANKS!!! If you have any questions or need technical assistance around these areas of PPOR, please give us a call or write! Laurin Kasehagen Carol Gilbert Stakeholder Analysis & Community Readiness

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