The Development of a Set of Pan-Canadian Health Promoter Competencies Version 1 (December 2014)   The Pan-Canadian Committee on Health Promoter Competencies gratefully acknowledges the funding support provided by the Public Health Agency of Canada.

Purpose of this Slidedeck This slidedeck has been prepared as a resource for the health promotion community to explain the development and use of the health promoter competencies. The number of provided slides is likely greater than any one presentation – feel free to edit and tailor the slides for your particular use. Only request is to acknowledge the source.

Outline Introduction and rationale Understanding health promotion Development of health promoter competencies Consultations Toolkit Project next steps

Introduction & Rationale

What are the Health Promoter Competencies? Building on the Core Competencies for Public Health in Canada, the Pan-Canadian Health Promoter Competencies describe the expectations for the knowledge and skills for health promotion practice. The competency set (v5) is comprised of 36 competency statements grouped in 9 domains.

Why Were the Health Promoter Competencies Developed? Relative importance of health promotion increasing: Burden of chronic diseases Recognition of importance of supportive environments and need for policy-based approaches to improve health Concern for inequalities/inequities Misunderstanding of the role and best use of health promoter positions Diversity of potential training paths A lack of consistency in health-promotion position descriptions – in particular: Defining ‘the work’ of health promoters Identifying required knowledge and skills Aligning training programs and continuing education with workforce needs

What Are the Potential Uses of the Health Promoter Competencies? To increase understanding of the range of knowledge and skills required by health promoters to effectively plan, deliver and evaluate health promotion initiatives To assist in the development of competency-based job descriptions for health promoters To inform the development of health promotion training needs and assessment tools To inform the content of health promotion training programs To inform curriculum development of continuing education for health promoters.

Who are the Target Audiences for the Health Promoter Competencies The Health Promoter Competencies are envisioned to be of interest to multiple audiences. For practitioners: Promotes the understanding of a common set of expectations to effectively plan, deliver and evaluate health promotion initiatives. Support individuals’ health promotion skills enhancement and professional development.  For managers: Supports the recruitment, development and retention of health promotion practitioners. Supports a common set of expectations for what skills and knowledge are required by health promoters in the workforce. Informs the development of competency-based job descriptions and the assists in assessing performance. For academic institutions: Informs the content of health promotion training programs and continuing education. Supports health promoters in acquiring the necessary skills and training to be effective in the workforce.

Understanding Health Promotion

Health Promotion? The policies and processes that enable people to increase control over and improve their health: These address the needs of the population as a whole in the context of their daily lives, rather than focusing on people at risk for specific diseases; and, Are directed toward action on the determinants of health. Health promotion is action oriented and based on public policies to enable, support and protect health.

The Work of Health Promoters Includes: Organisational Development – developing organisations to be more health promoting; e.g., in schools, workplaces and hospitals.   Community Development – developing communities to be more health promoting; e.g., neighbourhoods, cultural communities and communities of interest. Strategy Development – developing a strategic approach to improving health and ensuring that local, regional and national policies that can affect public health do so in a health promoting way.  Personal Development – developing the personal, emotional, and social skills and abilities of lay and professional people in order for them to maximise their own health and build a health promoting capacity for those around them Partnership development – developing partnerships with key people, communities and organisations who can affect or influence public health, and to enable these partnerships to be better able to promote health Health Information – developing ways of providing appropriate and accurate information about people’s health, what social and behavioural factors can affect their health, and what can be done to improve health.   Project Management – managing specific health promoting projects in order to ensure they are ethical, effective and efficiently delivered. 

Health Promoters Need to be Able to… Develop advanced knowledge of health and its determinants Analyse complex issues regarding how health is created and how health behaviours are brought about Think strategically and work for strategic change, which often calls for a level of influence and leadership beyond the authority and status of many health promotion posts Champion ways of working based on evidence of effectiveness, theory and clear ethical principles Commit to working with rigour and in ways which involve people and encourage participation. Rather than becoming the expert on which others come to depend, the health promoter is committed to building capacity and skills in others to do health promotion themselves.

The Health Impact Pyramid Counselling and Education Clinical Interventions Long-Lasting Protective Changing the Context to Make Individuals’ Default Decisions Healthy Socioeconomic Factors Increasing Population Impact Increasing Individual Effort Needed The focus of health promotion work is on increasing the impact of interventions at a population level. As shown in this diagram from the director of the U.S. Centers for Disease Control and Prevention, this requires a focus on changing the context to make healthy choices the easy choice and addressing social determinants of health. Source: Frieden TR. A framework for public health action: The health impact pyramid. Am J Public Health 2010; 100(4): 590-595 (Reproduced with permission from author and journal, USA).

Level of Action Ottawa Charter Actions Determinants of Health Health promoters apply the population health promotion model applying Ottawa Charter for Health Promotion strategic actions considering the determinants of health and the appropriate levels for action for a particular issue.

Development of Discipline-Specific Competencies for Health Promotion

Why Discipline-Specific Competencies? Following the development of the Core Competencies for Public Health in Canada, several groups have produced sets of discipline-specific competencies in order to provide additional guidance regarding the package of competencies needed for practice.

What is the Difference Between Core & Discipline-Specific Competencies? Essential knowledge, skills and attitudes necessary for public health practice Transcend the boundaries of specific disciplines and are independent of program and topic Discipline-Specific: Augment the core competencies by providing additional guidance regarding the package of competencies for practice

History of Initiative With support from the Public Health Agency of Canada (PHAC), Health Promotion Ontario produced a series of foundational documents to prepare for the development of an initial set of draft health promoter competencies in 2007. These were the subject of initial consultations with health promoters in 2008. With renewed funding by PHAC in 2013, the current project has been updating the competencies based on consultations in 4 provinces. A toolkit has also been developed to support application of the competencies, and a national network is being developed to share information on the competencies, the toolkit and other issues of interest to health promoters. Additional details are available on the project website: http://www.healthpromotercanada.com/

Pan-Canadian Health Promoter Competencies (v5) 36 competency statements in 9 domains: Health Promotion Knowledge and Skills Situational Assessments Plan and Implement Health Promotion Programs Policy Development and Advocacy Community Mobilization and Building Community Capacity Partnership and Collaboration Communication Diversity and Inclusiveness Leadership and Building Organizational Capacity

Example: Situational Assessments Partner with communities to conduct a situational assessment for a specific issue: 2.1 Conduct population assessment using existing or collected health data for a specific health issue. 2.2 Access and critically appraise evidence (i.e. published and grey literature, systematic reviews, and promising practices) on the health issue and effective interventions. 2.3 Conduct an environmental scan to identify community assets, resources, challenges and gaps. 2.4 Analyze all data, evidence, and environmental scan findings to develop effective program and policy interventions.

Competency Sets as a Package Competency sets should be viewed as an inter-dependent set of expectations For any practice task, a practitioner typically needs to draw upon and integrate competencies from multiple domains.

How Do the Health Promoter Competencies Compare with the Public Health Core Competencies? Development of the health promoter competencies builds on the public health core competencies. The health promoter competencies are more detailed and have greater expectations in a number of areas e.g., application of health promotion theories and principles; analysis and communication of policy options; development of strategic partnerships and intersectoral collaboration; etc. A direct comparison of the two competency sets is available on the health promoter competencies’ toolkit website.

Consultations

Provincial Consultations The current project committed to conducting consultations on the health promoter competency set in 4 provinces. As of April 2015, consultations will have been completed in Manitoba, Nova Scotia, British Columbia and Alberta.

Consultation Themes To-Date High levels of agreement have been expressed for the vast majority of the competencies Lower levels of agreement on selected items have been mainly due to: Uncertainty of the meaning of terms Concerns regarding level of expectations Distinctions between current practice and desired future practice

Response to Feedback Uncertainty of meaning of terms: Added a glossary Toolkit provides examples of outputs identified in the competencies (e.g., situational assessment, policy brief, etc.) Concerns regarding levels of expectations: Toolkit’s Job Profile describes two levels of proficiency (junior and senior) and provides examples for these levels for each competency statement Toolkit provides sample job descriptions for junior and senior levels with side-by-side comparison of expectations. Distinctions between current practice and desired future practice Explanation that competency set is forward-looking; it is intended to capture desired practice and not be limited to current practice

Toolkit

Competency-Based Toolkit Purpose is to support use of the competency set Anticipated to be of interest to practitioners, their managers, and academic institutions Content available for browsing and use (www.healthpromotercanada.com/toolkit/) Feedback received by June 30, 2015 will be used to make improvements to the Toolkit  with updates appearing in fall 2015.

Toolkit Contents Overview Roadmap: provides links to specific tools based on desired use Position profile: central resource providing supporting rationale and role summary, as well as proficiency-level examples Practitioner tools: Self-assessment Examples of specific outputs (e.g., policy brief, situational assessment) Manager tools: Job description examples Sample interview questions (and other recruitment tools) Performance appraisal template Additional resources: Comparison with public health core competencies Slidedeck describing development of competencies Feedback form (responses needed by June 30, 2015)

Project Next Steps

Project Completion The current project ends December 2015 In the fall 2015, final revisions will be made to: The competency set and glossary The toolkit (Note: these products will continue to be available online) The Pan-Canadian Network for Health Promoter Competencies will also consider post-project potential next steps to support application of the health promoter competencies.

Summary To support workforce development of health promoters, the Pan-Canadian Network for Health Promoter Competencies has: Updated the health promoter competencies and prepared an accompanying glossary Developed a toolkit to support application of the competencies Been developing a national network to share information on the competencies, the toolkit and other issues of interest to health promoters For more information, go to: www.healthpromotercanada.com