The National Collaborating Centre for Methods and Tools is excited to present a two-part webinar featuring the Policy Readiness Tool In Part 2, you will hear the stories of how public health practitioners have used the Policy Readiness Tool in practice and discuss challenges and successes when applying the Policy Readiness Tool. ALSO AVAILABLE ON YOUTUBE: https://www.youtube.com/watch?v=cHtFaVCpvhE Part 1 slides are available here: http://www.slideshare.net/NCCMT/nccmt-webinar-policyreadinesstoolpt19172015en A summary statement of this tool developed by NCCMT is available here: http://www.nccmt.ca/registry/view/eng/144.html NCCMT is one of six NCCs for Public Health in Canada. More on the NCCs at www.nccph.ca. Production of this webinar has been made possible through a financial contribution from the Public Health Agency of Canada. The views expressed herein do not necessarily represent the views of the Public Health Agency of Canada.

1. Follow us @nccmt Suivez-nous @ccnmo
Funded by the Public Health Agency of Canada | Affiliated with McMaster University
Production of this presentation has been made possible through a financial contribution from the Public Health Agency of Canada. The
views expressed here do not necessarily reflect the views of the Public Health Agency of Canada..
NCCMT Spotlight on KT Methods & Tools:
Using the Policy Readiness Tool
in Public Health
Advisors on Tap:
Candace Nykiforuk, PhD, CE
Shandy Reed, MSc
Cathy Gladwin, MSc
Sherry Jarvis, MEd
Kayla Atkey, MSc
October 1, 2015 1:00 – 2:30 PM ET

2. Poll Question #1
Where are you from?
1. BC
2. AB
3. SK
4. MB
5. ON
6. QC
7. NB
8. NS
9. PEI
10. NL
11. YK
11. NWT
12. NU
13. Outside
Canada
2

3. Follow us @nccmt Suivez-nous @ccnmo
Your profession?
Put a √ on your answer (or RSVP via email)
/
Epidemiologist Management (director,
supervisor, etc.)
Allied health
professionals (nurse,
dietician, dental
hygenist, etc.)
Librarian Physician / Dentist Other
3

4. Follow us @nccmt Suivez-nous @ccnmo
Using the Policy Readiness Tool
in Public Health
http://www.nccmt.ca/registry/view/eng/144.html
Episode 19
4

5. NCC
Infectious
Diseases
Winnipeg, MB NCC
Methods
and Tools
Hamilton, ON
NCC Healthy
Public Policy
Montreal, QC
NCC
Determinants
of Health
Antigonish, NS
NCC
Aboriginal
Health
Prince George, BC
NCC
Environmental
Health
Vancouver, BC
5

6. Follow us @nccmt Suivez-nous @ccnmo
National Collaborating Centre for
Methods and Tools
• dedicated to improving access to, and use of,
methods and tools that support moving
research evidence into decisions related to
public health practice, programs, and policy in
Canada.
6

7. Registry of Methods and Tools
Online Learning
Opportunities
WorkshopsMultimedia
Public Health+
Networking and
Outreach
NCCMT Products and Services
7

8. Poll Question #2
What sector are you from?
1. Public Health Practitioner
2. Health Practitioner (Other)
3. Education
4. Research
5. Provincial/Territorial/Government/Ministry
6. Municipality
7. Policy Analyst (NGO, etc.)
8. Other
8

9. Follow us @nccmt Suivez-nous @ccnmo
Candace Nykiforuk, PhD, CE is
an Associate Professor in the
School of Public Health,
University of Alberta and
CIHR/PHAC/AIHS Applied Public
Health Chair
Advisor on Tap
9

10. Using the Policy Readiness Tool
in Public Health
Presented by:
Dr. Candace Nykiforuk
CIHR/PHAC/AI-HS Applied Public Health Chair
Associate Professor, School of Public Health
Kayla Atkey, MSc
Policy Analyst, Alberta Policy Coalition for Chronic Disease Prevention (APCCP)
Cathy Gladwin
Policy Analyst, Injury Prevention Centre, University of Alberta
Sherry Jarvis, Med
Project Coordinator, Applied Research Collaborations for Health (ARCH), Dalhousie University
Shandy Reed, MSc
Alberta School Employee Benefit Plan (ASEBP)

11. Poll Question #3
In what ways is policy part of your work
or setting?
1. I participate in policy advocacy (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 setting.
8. Other.
11

13. Overview: Policy Readiness Tool
• An evidence-based tool to help foster the
development of 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

14. Overview: Policy Readiness Tool
• 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 community or organization’s relative
readiness for a policy
- Based on level of readiness provides evidence-based strategies
known to work with 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

15. So What is the Policy Readiness Tool?
• 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
Readiness = relative tolerance for risk for a new policy
It is NOT static & can be different from issue to issue

16. “Readiness” Categories
Use of 3 categories eases applicability for practitioners:
• 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
Readiness = relative tolerance for risk for a new policy
It is NOT static & can be different from issue to issue

17. “Readiness” Categories - Caveats
• Not a value judgment about a community or organization
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!

18. Poll Question #4
How would you rate your capacity to
support or influence the policy process
in your community or setting?
A. High
B. Medium
C. Low
D. Not Sure
18

19. Practice Example:
How can the Policy Readiness Tool be
used to inform action?
Presented by:
Shandy Reed, MSc
Alberta School Employee Benefit Plan (ASEBP)

20. Centre for Health Promotion Studies
http://www.sherwoodparknews.c
om/2011/07/28/follow-the-
footsteps
The Initial Letter
from the APCCP:

21. http://www.sherwoodparknews.c
om/2011/08/01/how-far-will-anti-
smoking-laws-go
The Response
from the Editor:

22. http://www.sherwoodparknews.c
om/2011/08/08/keep-fighting-
the-good-recycling-fight
This somewhat
related, follow-up
column by the
same writer that
also references
their need/value
to be seen as an
innovator and the
risk of falling
behind…

23. New Opportunities for Applying the PRT:
• Organizational readiness for new strategic
focuses
• Adapting the tool for ‘ideas’ in new settings

24. Practice Example:
Use of PRT for ATV Safety
Presented by:
Cathy Gladwin, MSc
Policy Analyst, Injury Prevention Centre,
University of Alberta

25. The Problem
• Provincial government inactive
• No political will for legislation
But
• Evidence that Municipal Bylaws can
influence provincial legislation

26. Municipalities in Alberta
• Urban municipalities
– Cities, towns, villages, summer villages
– No or little ATV use
• Rural municipalities
– Municipal districts and counties
– Specialized Municipalities
– 69 in total

27. Review of ATV Bylaws
• In 2013 reviewed bylaws of 69
municipalities
• Most bylaws on website, emailed others
• Created spreadsheet showing elements of
bylaws
• Compared elements with best practices for
ATV safety

28. ATV Safety Elements
• Use of a helmet
• No under 16 year-old users on adult ATVs
• # Passengers = # specified by maker
• Speed limits
• Use only in daylight hours
• Rider training required

29. Findings of Review
• 28 of 69 muni’s have ATV bylaws
• Parkland has best bylaw
– 5 of 6 safety elements
• No muni’s require training
• 4 muni’s have bylaws with 4 of 6 elements:
Beaver, Leduc, Thorhild, Wetaskiwin
• 8 mandate helmets
• 10 limit passengers

30. Review to PRT
• Labelled muni’s with 4 or more elements
as “Innovators”
• Looked for similarities:
– Clustered near Edmonton
– All in northern half of province
– Contain larger city or town
– Are an ATV Destination

31. Interviews to PRT
Informal interviews found that:
• Believe muni’s have duty to protect
• Will make decision with broad knowledge
• Didn’t demand specific, local data
• Not worried about enforcement
• Believe bylaw itself will change behaviour

32. Review to PRT
Majority or Late Adopters= less than 4
elements:
• Fewer bylaws overall
• Narrower scope of services for citizens
• Not an ATV destination
• More distant from Edmonton

33. IPC 2014 Awareness Activities
• Awareness of Municipal Bylaws
• Shared results of review
• Congratulated Parkland County for Best
Bylaw
• Held media event with Parkland County
• Aimed to raise interest in bylaws with other
municipalities

34. The Unthinkable Happened!
• May 2015 election of NDP Government
• Soon hearing that ATV Legislation is being
reviewed by Alberta Transportation
• IPC suspended ATV activities awaiting
government action
• If no ATV legislation is passed or elements
are missing IPC will return to municipal
bylaw plans

35. Issues in ATV Advocacy
• Alberta surveillance system does not
capture ATV Injury and Death data very
well
• Can’t break it down to municipal level
• Therefore, difficult to make case to
municipality.
• IPC too small to reach individual muni’s so
possible strategies are limited

36. Possible Strategies for IPC
• Create model ATV safety bylaw
• Highlight bylaws in use by muni’s
• Show benefits of regional bylaw similarity
• Bring muni’s together in regional workshop
• Promote model bylaw through AAMDC
• Continue public awareness of safety
behaviours

37. Practice Example:
Health Eating in Recreation and Sport
Settings
Presented by:
Sherry Jarvis, MEd
Project Coordinator
Applied Research Collaborations for Health (ARCH)
Dalhousie University

38. Background Information
• Department of Health & Wellness in NS
recently released Healthy Eating in
Recreation and Sports Settings (HERSS)
voluntary guidelines
• Prior to the release of the provincial
guidelines, we gathered HERSS baseline
data: environmental scans and
stakeholder interviews

39. HERSS Research Study (Phase 2)
Objectives
(1) Understand the structures and processes required to
optimize healthy eating guideline implementation in
recreation and sport settings (RSS)
(2) Describe changes to food environments in RSS as a
result of the uptake and implementation of healthy eating
guidelines
(3) Define the level of implementation that is required to
produce desired outcomes in the food environments of
RSS

40. Policy Readiness for Change
Survey
• To help us achieve objective one, we will collect detailed data
from RSS facilities to help us understand the barriers and
facilitators of guideline implementation as well as how these
barriers and facilitators may be worsened or moderated
depending on a facility’s readiness for change.
• Case studies: interviews, observations and document reviews
• Recruitment for case studies: distributed the policy readiness
for change survey which included adding a short section that
asked introductory questions (e.g. type of facility, location,
etc.)

41. Results
• 15 surveys completed
– 7 Innovators
– 6 Majority
– 2 Late adopters
• Survey follow-up:
– The facility’s readiness category
– Invitation to participate in case study
• To date, after following up with the survey respondents,
we have recruited facilities for the innovator and majority
categories, but not for the late adopters

42. Practice Example:
Alberta Policy Coalition for Chronic Disease
Prevention – Applying the Policy Readiness Tool
Presented by:
Kayla Atkey, MSc
Policy Analyst
Alberta Policy Coalition for Chronic Disease
Prevention (APCCP)

43. The APCCP: Who We Are
 Working to coordinate efforts, generate evidence, and advocate for
policy change to reduce chronic disease risk in AB.
 Funded by the Heart and Stroke Foundation of Alberta for 2015.
 17 member organizations.

44. Objective and Focus
 Facilitating evidence-based policies to address chronic disease risk
in 4 key areas:
• Unhealthy eating
• Physical inactivity
• Alcohol-related harm
• Tobacco use
 Building capacity to use policy as a tool and enhancing public
acceptance of policy-related activities.

45. Applying the Policy Readiness
Tool: A key tool for your policy
toolkit
Examples
 Collaborative advocacy with Alberta Food Matters and the Growing
Food Security in Alberta Network (GFSA).
 Creating Healthier Food Environments in Edmonton Recreational
Facilities through Policy Change.
 Facilitating Evidence-based Policy: The Policy Opportunity
Windows, Engaging Research Uptake in Practice (POWER UP!)
Project

46. Collaborative Advocacy
 From 2012-2013, the APCCP supported Alberta Food Matters (AFM) in
moving through a collaborative advocacy process.
 Resulted in the beginning stages of an advocacy campaign calling for
the development of a Universal School Food Strategy.
 The project was informed by Themba-Nixon’s seven steps in the
development of an advocacy initiative.1
 Testing the Waters
 Defining the Initiative
 Strategy and Analysis
 Direct Issue Organizing
 Steering Through Appropriate Channels
 Victory and Defense
 Implementation and Enforcement
1. Themba-Nixon M. The power of local communities to foster policy. In: Cohen L, Chavez V, Chehimi S, editors.
Prevention is Primary: Strategies for Community Well-being. San Fransisco Jossey-Bass; 2010. p. 137-56.

47. Collaborative Advocacy
 Advocating at the provincial level is complex. Multiple strategies and
tools are needed.
 The PRT provided a reference point and evidence-based strategies
throughout the collaborative process:
 Testing the Waters
 Defining the Initiative
 Strategy and Analysis
 Direct Issue Organizing
 Questionnaire and adopter categories could apply at the provincial
level & to organizations you are seeking buy-in from (i.e. school
board).

48. Creating Healthy Food Environments in
Recreational Facilities
 Building capacity to promote healthy food environments in
recreational facilities through policy change at the municipal level.
 Using the tool to develop policy resources suitable to different levels
of readiness.
 Working with recreational facilities to apply the tool at the
organizational level.

49. Partner on
The APCCP is a partner on the POWER UP! project for 2013-2016,
which is funded by the Coalitions Linking Action and Science for
Prevention (CLASP) initiative.
Power Up! Activities:
 Summarize evidence on the impact of obesity-prevention policy
activities.
 Promote information sharing through annual consensus conferences.
 Develop evidence-based tools and resources to support adoption and
implementation of obesity prevention policies.
 Development of www.powerupforhealth.ca, a one-stop-shop for policy
tools and resources to promote heathy weights.

50. Website Link:
www.powerupforhealth.ca

51. Evidence & Tools to Complement
PRT Strategies
 Innovator - Provide Supportive Evidence

52. Evidence & Tools to Complement
PRT Strategies
 Majority – Outline Public Opinion

53. Evidence & Tools to Complement
PRT Strategies
 Late Adopter - Illustrate how communities or organizations with similar
characteristics have successfully adopted and implemented the
proposed policy.

54. Evidence & Tools to Complement
PRT Strategies
 Late Adopter - Illustrate how communities or organizations with similar
characteristics have successfully adopted and implemented the
proposed policy.

55. Thank you!
 To learn more about Alberta Food Matter’s advocacy efforts to
promote a Universal School Food Strategy, visit:
http://www.foodsecurityalberta.org/node/1887
 To learn more about POWER UP!, visit www.powerupforhealth.ca.
Check back often for new tools and resources.
 Subscribe to the POWER UP! e-newsletter:
http://powerupforhealth.ca/power-up/subscribe/

56. Lessons from Practice so Far…
• 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

57. Applying the Tool: Strengths
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

58. 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!

59. What’s Happening Now
• New website:
• Online completion of the questionnaire component
• Resources and strategies always being updated
• Evaluation of the new website (online survey and
interviews)
• Working to adopt the Tool specifically for use in
school settings
• Connecting people interested in healthy public policy
change

60. Join us in the conversation!

61. Acknowledgements
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 (2004-2005).
* PRT development supported by the APCCP (2009-2011), which was
funded by Alberta Cancer Prevention Legacy Fund (Alberta Health
Services).
* PRT pilot evaluation funded by Killam Trust Fund, University of Alberta
(2012).
* PRT dissemination grant funded by CIHR (2014-2015)

63. Dr. Candace Nykiforuk
Associate Professor, School of Public Health, University of Alberta
CIHR/PHAC/AI-HS Applied Public Health Chair
E: candace.nykiforuk@ualberta.ca
E: prt.info@ualberta.ca
www.policyreadinesstool.com
For more information or conversation:
Kayla Atkey, MSc
Policy Analyst
Alberta Policy Coalition for Chronic Disease Prevention
E: kayla.atkey@ualberta.ca
Cathy Gladwin
Policy Analyst
Injury Prevention Centre, University of Alberta
E: cathy.gladwin@ualberta.ca
Sherry Jarvis, Med
Project Coordinator
Applied Research Collaborations for Health, Dalhousie University
E: sjarvis@dal.ca
Shandy Reed, MSc
Alberta School Employee Benefit Plan
E: shandyr@asebp.ab.ca

64. Poll Question #5
What are your next steps? I plan to …
A. access the Policy Readiness Tool.
B. read the NCCMT summary of the Policy
Readiness Tool.
C. consider using the Policy Readiness Tool.
D. tell a colleague about the Policy Readiness
Tool.
64

65. Follow us @nccmt Suivez-nous @ccnmo
• Use Q&A to post comments
and/or questions
• ‘Send’ questions to All (not
privately to ‘Host’)
OR
• Ask questions or add comments
via the teleconference line
• ‘Unmute’ your phone
Q&A
Participant Side
Panel in WebEx
Your Comments/Questions
65

66. Your Feedback is Important
Please take a few minutes to share your thoughts
on today’s webinar.
Your comments and suggestions help to improve
the resources we offer and plan future webinars.
The short survey is available at:
https://nccmt.co1.qualtrics.com/SE/?SID=SV_2
codTY9uxgN9KM5
66

67. After Today
The PowerPoint presentation (in English and French)
and English audio recording will be made available.
These resources are available at:
PowerPoint: http://www.slideshare.net/NCCMT/
Audio Recording:
https://www.youtube.com/user/nccmt/videos
67

68. Join us for our next webinar
The Consolidated Framework for
Implementation Research (CFIR)
November 12, 2015 from 1:00 – 2:30pm EST
Learn about how this resource can be used to guide
the adaptation of public health interventions and to
develop implementation plans by considering factors
that are likely to influence implementation success.
Register at: https://health-evidence.webex.com
68

69. Follow us @nccmt Suivez-nous @ccnmo
Funded by the Public Health Agency of Canada | Affiliated with McMaster University
The views expressed here do not necessarily reflect the views of the Public Health Agency of Canada.
For more information about the
National Collaborating Centre
for Methods and Tools:
NCCMT website www.nccmt.ca
Contact: nccmt@mcmaster.ca