Centre for Health Promotion Studies The Policy Readiness Tool Laura Nieuwendyk, MSc Project Coordinator Policy, Location and Access in Community Environments (PLACE) Research Lab

In what ways is policy part of your work? 1. I participate in promoting policy (formally or informally). 2. I help to find evidence / build the case for new policies. 3. I contribute to policy development. 4. I am responsible for policy implementation. 5. I monitor or evaluate policy effectiveness. 6. I am interested in policy, but do not have an active role. 7. Policy is not part of my work / applicable to my job. 8. Other 2

How would you rate your capacity to support or influence the policy process in your school or school district? High Low 3 Not sure Medium

Centre for Health Promotion Studies The Policy Readiness Tool is an evidence-based tool to help foster healthy public policy Intent is to make participating in policy change more accessible to non-experts and experts -e.g., Policy Developers, Advocates, Community Organizations, Non- profit Sector Staff and Volunteers, Government Employees, Community Members -Simple to use and not restricted to health policies -Available in English and French Overview: Policy Readiness Tool

Centre for Health Promotion Studies The policy process is dynamic and can be intimidating, especially if dealing with a new issue or a new setting -Tool offers a “place to start” -Helps the user identify a municipality’s (or organization’s) relative readiness for a policy -Then links that to evidence-based strategies known to work with those different levels of readiness Provides targeted strategies to help navigate what can be a convoluted policy process - Especially for those new to advocacy or policy development, or who are working with an unfamiliar issue Overview: Policy Readiness Tool

Centre for Health Promotion Studies A simple self-administered tool that: 1.Assesses readiness for policy change using a simple, self- administered checklist 2.Provides targeted, evidence-based policy change strategies for taking action (based on level of readiness) 3.Recommends general evidence-based resources to foster healthy public policy So What is the Policy Readiness Tool? Readiness = relative tolerance for risk for a new policy It is NOT static & can be different from issue to issue

Centre for Health Promotion Studies To build healthier communities… …local organizations, skilled and lay advocates, and others must be involved in the process of policy change To support this, we need to: ‐ address barriers to local participation in public policy ‐ increase local capacity for policy change

Centre for Health Promotion Studies Emerged out of research program on municipal policy development & diffusion in tobacco control Background on Tool Development

Centre for Health Promotion Studies Emerged out of research program on municipal policy development & diffusion in tobacco control The Policy Readiness Tool employs Rogers’ “diffusion of innovations theory” to make participating in policy change more accessible Background on Tool Development

Centre for Health Promotion Studies Diffusion: the spread of something across time and place Innovation: something new to solve a problem or improve a situation Diffusion of Innovations = a theory that is used to examine how something new spreads from place to place over time

Centre for Health Promotion Studies Emerged out of research program on municipal policy development & diffusion in tobacco control The Policy Readiness Tool employs diffusion of innovations theory to make participating in policy change more accessible Level of innovation: the degree to which an adopter is relatively earlier or later in taking up new ideas than other members of a system Background on Tool Development

Centre for Health Promotion Studies Understanding Level of Innovation Past work on smoke-free spaces bylaws revealed common patterns of municipal policy behaviour Key findings: Initial adopters were often the first to amend or strengthen bylaws over time - “Initiators” reprise their roles as issue evolved Municipal decision-makers followed familiar patterns of policy making within their network Different types of “adopter characteristics” were suggestive of a municipality’s bylaw readiness relative to others in the same policy context

Centre for Health Promotion Studies Phase 1: Development of a pilot tool Phase 2: Tested the tool with municipal representatives across Alberta (24 communities) Phase 3: Lit review, environmental scan, and key informant interviews with experts working in policy  To collect evidence-based and best practice strategies on development / implementation of healthy public policy Development of the Tool (2011)

Centre for Health Promotion Studies Expert advice provided by the Provincial Advisory Group of the Alberta Policy Coalition for Chronic Disease Prevention (APCCP) - Included policy developers and advocates, practitioners, community organizations, and researchers representing 15 different organizations across Alberta The APCCP works together to coordinate efforts, generate evidence and advocate for policy change in order to reduce chronic disease in Alberta. Policy Readiness Tool – Key Partners

Centre for Health Promotion Studies A simple self-administered tool that: 1.Assesses readiness for policy change using a simple, self- administered checklist So What is the Policy Readiness Tool?

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Use of 3 categories eases applicability for practitioners: Innovators Majority Late Adopters Enables users to apply the tool in a variety of contexts “Readiness” Categories Readiness = relative tolerance for risk for a new policy It is NOT static & can be different from issue to issue

Centre for Health Promotion Studies Not a value judgment about a municipality There is no good or bad adopter category! Instead, the Tool offers an efficient way to select appropriate strategies to support policy development in a particular context Not a one-size-fits-all solution, but a place to start! “Readiness” Categories – Caveats

Centre for Health Promotion Studies A simple self-administered tool that: 1.Assesses readiness for policy change using a simple, self- administered checklist 2.Provides targeted, evidence-based policy change strategies for taking action (based on level of readiness) So What is the Policy Readiness Tool? We’re coming back to this!

Centre for Health Promotion Studies A simple self-administered tool that: 1.Assesses readiness for policy change using a simple, self- administered checklist 2.Provides targeted, evidence-based policy change strategies for taking action (based on level of readiness) 3.Recommends general evidence-based resources to foster healthy public policy So What is the Policy Readiness Tool?

Centre for Health Promotion Studies Who Can Use the Tool? Anyone interested in encouraging healthy public policy development: Policy developers Advocates Community organizations Non-profit sector staff and volunteers Government employees Community members / general public Researchers Available in English and French (~900 downloads to date)

Centre for Health Promotion Studies What Kinds of Policies Can the Tool be Used With? Designed to encourage and support healthy public policies in general, for example: Smoke-free public spaces regulations Injury prevention (e.g., helmet bylaws) Nutrition policies (e.g., in schools or recreation facilities) Social planning policies Location/implementation of new green spaces or facilities etc, etc Created with municipalities in mind, but can be used with other types of governing bodies (e.g., school boards)

Centre for Health Promotion Studies Complete the short checklist (found on page 5 of the tool) Choose the ‘closest’ description (A, B, or C) in each row that describes a characteristic (there are 11 rows) Tally up the total number of As, Bs, and Cs Select the category (A, B, or C) that has the most responses Let’s try it together… Using the Policy Readiness Tool

Take a moment and think about the school or school district that you work with and consider the questions from the Policy Readiness Tool Complete the tool individually and tally your score. 25

Based on your responses to the questions Mostly As Mostly Bs 26 Mostly Cs

Centre for Health Promotion Studies Using the Policy Readiness Tool: “Adopter Categories” Mostly Bs: The Majority Mostly As: Innovators Mostly Cs: Late Adopters

Centre for Health Promotion Studies Talk about experiences getting a new policy or idea put forward within your school or school district Can be related to things that you have already experience or anticipate experiencing Small Group Discussion

Centre for Health Promotion Studies What surprised you the most? What were some of the commonalities/differences amongst your group? What were your overall experiences? Large Group Sharing

Centre for Health Promotion Studies Mostly As: Innovators are described as “adventurous” and often serve as initiators or role models within their social networks Mostly Bs: The Majority are described as “deliberate” because they require time to consider the evidence and determine whether to adopt a new policy Mostly Cs: Late Adopters are described as “traditional” and may be skeptical of new ideas (without substantial evidence) or eager to maintain the status quo Adopter Category Descriptors

Centre for Health Promotion Studies Are described as “adventurous” and often serve as initiators or role models within their social networks -Attracted by high-reward initiatives and are “risk-takers” -Can cope with elevated levels of uncertainty associated with the new policy -Typically willing to cope with initial problems & able to identify solutions to these problems Mostly As: Innovators

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Are described as “deliberate” because they require time to consider the evidence and determine whether to adopt a new policy -Seldom leads the pack -Is often of the philosophy that it is better to change as a group than to be one of the first to change -Tends to adopt policies at about the same time as the average adopter Mostly Bs: The Majority

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Are described as “traditional” and may be skeptical of new ideas (without substantial evidence) or eager to maintain the status quo -Usually wait until the majority of others have adopted a policy -May need to be pressured into policy adoption -May never adopt the policy unless required to Mostly Cs: Late Adopters

Centre for Health Promotion Studies

Not a value judgment about a municipality, organization, school or school district There is no good or bad adopter category! Instead, the Policy Readiness Tool offers an efficient way to select appropriate strategies to support policy development in a particular context Not a one-size-fits-all solution, but a place to start! Reminder: Category Caveats

Centre for Health Promotion Studies Successful diffusion depends on interaction between the adopter groups over time and place -e.g., A critical mass of bylaws can lead to provincial policy Supports action and advocacy: -Find sound innovations & support innovators -Make innovator activity observable (visible!) Understanding policy adoption trends is useful for: -Refining policy strategies -Responding to changes in policy context -Informing new policies or policy development in other jurisdictions Lessons from Practice So Far…

Centre for Health Promotion Studies Increasing Local Capacity for Policy Change 1)Builds personal and community level capacity Increase knowledge, skills & leadership 2)Addresses the resource capacity issues of advocates and organizations Focus on effective use of limited resources via tailored strategies 3)Builds knowledge through intersectoral collaboration Encourage those from different sectors to consider new policy change strategies Applying the Tool: Strengths

Centre for Health Promotion Studies Applying the Tool: Limitations Diffusion theory is uni-directional, time-specific, and linear - Static instrument explaining a dynamic process, which may still be ongoing at time of “readiness” assessment Most applicable to simple (single issue) and straight- forward cases of policy change Caveat - users must remain flexible and leave room to act on the unexpected!

Centre for Health Promotion Studies The team would like to thank members of the Alberta Policy Coalition for Chronic Disease Prevention (APCCP) for their expertise and feedback in the development of the Policy Readiness Tool. Financial Support: * Diffusion work was funded by a CIHR Strategic Training Program in Tobacco Research Fellowship ( ). * PRT development supported by the APCCP ( ), which was funded by Alberta Cancer Prevention Legacy Fund (Alberta Health Services). * PRT pilot evaluation funded by Killam Trusts, University of Alberta (2012). Acknowledgements

Centre for Health Promotion Studies Laura Nieuwendyk PLACE Project Coordinator School of Public Health, University of Alberta Phone: For more information on the Policy Readiness Tool: If you have specific comments or feedback about the Policy Readiness Tool send them to: For further information or follow-up conversation: