Working Towards a Public Health Tool Kit for Planning, Implementing and Assessing Multiple Intervention Programs Lynne MacLean 1, Nancy Edwards 1, Alma Estable 1, Mechthild Meyer 1, Sonia Semenic 1, Tyler Watt 2, Barb Riley 3 1 University of Ottawa, 2 City of Ottawa Public Health, 3 University of Waterloo Key Elements of MIP Programs  Based on a set of integrated theories that reflect the types of interventions and levels of action & built on evidence of other effective and cost-effective MIPs.  Coordinate and stage interventions to capitalize on synergy.  Build consistent and supportive programs across sectors and jurisdictions.  Consider resources for intensity and reach, and program sustainability from the outset.  Target evaluation activities at individual levels and combinations of levels; use process data; track spin-offs.  Target local priorities, needs, resources, and existing structures for implementation & tailor to community context and to target group.  Engage community members in planning and implementation. What is a Multiple Intervention Program (MIP)? More encouragement by Ontario MOH-LTC on need for Multiple Intervention Programming in Mandatory Health Programs and Services Recognition of complexity of public health intervention context Recognition of benefits & reality of programs working with more than one intervention at a time Increase in need for collaboration among different sectors and across system levels CHRU developed recommendations on MIPs considerations for MOHLTC technical review Public Health practitioners feedback: develop practical tool : ?? How to do complex programming and evaluation in a coordinated and staged way that maximizes synergy among interventions?? To develop an interactive tool that public health staff and managers can use to strengthen multiple intervention program design and evaluation. Purpose of Tool Kit Projected End Users Public health program planners, managers, and evaluators. A health program that is composed of two or more interventions aimed at two or more system levels (Edwards, Mill, & Kothari, 2004). Background to Tool Kit Development Tool Kit to be organized around 4 activity sections of MIP Framework:  Socio-ecological Assessment  Identification of Intervention Options  Optimizing Potential Impact  Monitoring and Evaluation Each section of Tool Kit to have: Guidelines: Content to explain elements of each activity, including vertical and horizontal integrity, and resource implications (dose, intensity, reach, cost) Case examples of Multiple Intervention Programs (see below, Mujer Sana Communidad Sana program) Exercises to apply to your own programs Links to: o Other sections within tool kit, o Background articles o Other websites and resources Case Example: The Mujer Sana, Comunidad Sana- Healthy Women, Health Communities Project This program was envisioned as MIP from the outset, aiming to improve the health of minority women on several levels, ranging from individual health behavior, to community empowerment, to impacting the health system’s capacity to work effectively with them. Next Steps: Tool Kit Organization Tool Kit Organization: To further develop tool content and format To pilot test the tool with potential users Questions Remaining: Is this the kind of tool you would find useful? Is this the kind of tool you would find useful? How interactive should this be? How interactive should this be? Input from Public Health program planners: Less: - links within and outside tool kit; - exercises for own use, not evaluated, order not enforced Disadvantage : Disadvantage : no feedback on use or misunderstandingMore: - links within and outside tool kit - exercises sent in using own actual programs, evaluated - cannot complete one section until previous one finished Disadvantage : Disadvantage : possible confidentiality concerns regarding programs Want to give us some anonymous feedback now? On the sheet below, please check the box corresponding to your answers to the above questions. Thanks! Would you be willing to be contacted later by us, when the tool kit is more developed, to give us feedback? If so, Please leave contact information on sheet below. Thanks! How much background theory is useful? ?? Very little, just enough to give some context. Just give links to other sources.. ?? Some, but emphasis should be on the practical… ?? Lots, it helps make things clearer..