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In the IDM best practices model, three domains exist in the context of the broader environment. They are interactive, that is, each influences and is influenced by the others. Click on the following topics for an introduction to the Model's domains. (The information below is excerpted from the IDM Manual for Best Practices in Health Promotion by Barbara Kahan and Michael Goodstadt, April 2002.)
Underpinnings (or "foundations"), although often not visible, are at the very heart of practice. If we consciously identify, define and prioritize our health promotion underpinnings and make our practice decisions consistent with them, we are more likely to achieve health promotion goals than if our underpinnings remain unexamined. If we do not consciously examine our underpinnings, two things are likely to happen. One is that we will be unaware of what our underpinnings are and how they may be influencing our practice. The second is that our practice may be inconsistent with our underpinnings; in other words, we may make practice decisions that are likely to achieve results either incompatible with or non-reflective of our underpinnings.
Click on the following topics for an introduction to the subdomains of underpinnings.
brief description of values, goals, ethical principles
Values are those things that are most important to us. Our values affect which issues we choose to address and the strategies we choose to address these issues. For example, valuing social justice over individualism has obvious practice implications, such as a focus on reducing inequities and an inclusive participatory approach.
Goals are a translation of our values into concrete terms. For example, one goal associated with the value social justice could be to increase the extent of social justice in our community.
Our ethical principles provide guidelines for appropriate values-based conduct.Back to top
example of guiding principles for values, goals and ethical principles
Values, goals and ethical principles should:
example of concrete criteria for values, goals and ethical principles
Our practice reflects the values of:
Our practice attempts to reach the goal of increasing overall levels of:
Our practice reflects these ethical principles:
brief description of theories and concepts, underlying beliefs and assumptions
Theories and concepts range from the formal transtheoretical model of change to the informal explanations we give ourselves concerning life and work issues. Theories/concepts explain how and why things happen, and predict how things might happen; they can be simple or complex. The specific theories/concepts we adopt affect our practice choices. For example, if our "theory" is that health education is more likely to stop people from smoking than public policy, we will take more of a lifestyles approach to health promotion than a structural approach.
Our underlying beliefs and assumptions include what we believe about human nature, how society works and change happens, what kind of change is needed, where our self-interest lies, and how we learn and know. The nature of our beliefs and assumptions, like our other underpinnings, has strong implications for practice decisions. If we believe that people often do not know what is best for them and need to be assisted by "experts" or professionals, we will act quite differently than if we believe that people can solve their own problems if adequate supports or resources are available. Underlying beliefs and assumptions do not necessarily refer to external/objective evidence.Back to top
example of guiding principles for theories/concepts, underlying beliefs/assumptions
Theories and concepts, underlying beliefs and assumptions should:
in addition, theories and concepts should:
and, in addition, underlying beliefs/assumptions should:
example of concrete criteria for theories/concepts, underlying beliefs/assumptions
Some of the major theories used in our practice include (extracted from Theory in a Nutshell, Nutbeam & Harris):
The explanations of key concepts which we apply to our practice are (excerpted from the IDM Manual, Kahan & Goodstadt):
The explanations of key underlying beliefs and assumptions which we apply to our practice are (excerpted from the IDM Manual, Kahan & Goodstadt):
brief description of evidence
Evidence is information which we deem high quality and appropriate enough to use in making our decisions. Questions which guide us in gathering this information may range from "How can we maximize the likelihood that we will achieve our desired results?" to "What capacities exist in our community to provide a supportive environment for healthy living?" Our formal and informal research methods to answer our questions may range from a few phone calls, if the question is simple enough, to a full scale study.Back to top
example of guiding principles for evidence
Re. the foundations of evidence, evidence should be:
Re. the sources of evidence, evidence should:
Re. the nature of evidence, evidence should:
The environment strongly affects what we do, what we think, and how we interpret things. This makes it extremely important to step back and have a very close look at our environment, in terms of how it affects us and how we in turn affect it. Our environments include social, political and economic structures and systems, and physical and psychological conditions, at group, organizational, community, regional, national, and international levels. To truly understand our environments in all their dimensions we need to have both a vision and an analysis of them.
Our organizational environment involves the environmental factors that affect our work. A major contributing factor to the degree of effectiveness of our daily work is the general supportiveness of the organizations with which we are associated. Our health environment involves the environmental factors that affect individual, community and societal health.
Having a vision of our organizational environment answers this question: What would our organizational environment look like if it were truly supportive of our health promotion practice initiatives? Having a vision of our health environment answers this question: What would our general environment look like if it were truly health enhancing for all? In both cases, developing a vision involves considering structures/systems and psychological/physical conditions (at group, organizational, community, regional, national, and international levels).
A complete analysis of organizational and health environments requires that we look not just at our local environments but at our regional, national and international environments as well, because structures/systems and conditions determined at all levels will have an effect on organizational and health issues in our specific situations.Back to top
Vision of the organization- and health-related environments should:
Analysis of organization- and health-related issues should identify:
Analysis of the organization- and health-related environments should be:
Selection of issue should:
The selected issue should:
Our practice reflects the following points in our vision of our environments:
The practice domain is the application of our vision and analysis of the environment; it is also a reflection of our underpinnings. Its subdomains include our responses to health-related and organization/work-related issues, and research (including evaluation).
Responding to our selected issues, whether related to health or work, involves activities, strategies and processes. Strategies are a planned set of actions or activities for achieving specific ends, while processes are the ongoing actions undertaken to support or facilitate our strategies and activities. Strategies may range from health education and communication to healthy public policy and advocacy. Processes may range from planning and evaluation to decision making and skill sharing. To be consistent with and reflect our underpinnings and understanding of the environment it is important to consider not just what we do in our practice, but how we do it (e.g. are our chosen processes and strategies as empowering and capacity building as we would like them to be).
The degree of consistency of our research and evaluation processes and activities with underpinnings and understanding of the environment helps determine what kind of impact we have in our chosen health promotion areas. Ongoing research and evaluation increases the effectiveness of our responses to health- and organization-related issues by allowing us to (a) reflect on the work we have been doing and (b) try out new ways of doing things to see if they might work better. Research and evaluation involves the identification of: issues of concern (i.e. research and evaluation questions), measurable or observable objectives and indicators, data sources, and methods for obtaining data. It also involves collecting and analyzing data, summarizing or synthesizing results, making suggestion, and disseminating and applying findings.Back to top
Processes and activities/strategies responding to organization/work- and health-related issues should:
Activities should be designed to respond to:
Our processes and activities/strategies (at both individual and collective levels):
Our practice includes processes designed to assist:
Our practice includes combinations of the following strategies:
Our research/evaluation activities include:
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