Health PromotionKaipara Care Incorporated Health Promotion Proposal Te Kopuru – A Health Promoting Community1. Profile Linking Te Kopuru With The Wider Northern Wairoa District. Te Kopuru is situated 12 km from Dargaville on the Pouto Peninsula. In its ‘hay day' Te Kopuru was the main centre for the Northern Wairoa. The surrounding area is rolling farm land, dairying predominates with beef and sheep and forestry further down the peninsula. Dargaville has a population of some 5,000 but services the surrounding
area which has an overall population of some 15,000. Within Northern
Wairoa, there are primary Schools and both Dargaville and Ruawai
have secondary schools. The shopping centre is good with a wide selection
of shops. There are two marae, Oturei and Ripia. The community is kind, caring and friendly and there are ample opportunities to become involved with the many clubs.
2. Te Kopuru Population and Deprivation Data Te Kopuru stands out from all other towns in the Kaipara because of its population mix. It has the highest proportion of Maori of all towns in the Kaipara, and almost every street in Te Kopuru is Quintile 5 (Decile 9 & 10) or the most highly deprived. Of KCI’s enrolled population who are also known to be Quintile 5, Te Kopuru makes up 21%. The KCI register is almost 60% complete in geocodable addresses. This means that the known deprivation level of Te Kopuru will rise as the register becomes more complete. The high level of deprivation and the well known health inequalities of Maori, along with a geographically defined town, make Te Kopuru the leading focus for our health promotion project.
3. Initial Approach An approach was received from senior men’s grade rugby coach, Allen Dennis, who felt that more could be done to encourage his team members, their families, and other grade teams at the (Te Kopuru) Southern Rugby Club to adopt healthier lifestyles, from their food and recreational choices, their health and safety on and off the field, their choices to smoke or be smoke-free, and their general levels of fitness. This approach led to an initial proposal framed for the KCI board to consider further, which focused on the Southern Rugby Club – The Health Promoting Rugby Club. The KCI board agreed that the concept had promise, and that a Te Kopuru base for early health promotion activity was well justified. The board nominated a Health Promotion sub-committee to develop this proposal further.
4. The KCI Health Promotion Sub-Committee This sub-committee is made up of 3 KCI Board members, KCI Project Manager, Te Ha Health Promotion Co-ordinator, Health Promoting Schools Regional Co-ordinator (Public Health Promotion, Northland DHB), Public Health Nurse (Northland DHB). It met on three occasions. In establishing priorities and developing this proposal it became clear that the committee’s establishment, and ongoing activities were essential to the success of the Te Kopuru and any other health promotion projects which would be supported, implemented, evaluated and reviewed. It is the committee’s view that a stable group of members with governance and health promotion expertise should meet regularly (quarterly once projects are established) to oversee their development. The committee can make recommendations on expenditure to the full KCI board, and present progress reports as required. Choosing Te Kopuru as an initial focus should be viewed as strategically justifiable. Lessons learned here about consultation, leadership choices, successes and failures would be important when applying these principles to other projects.
KCI Health Promotion Sub-Committee, developed this Health Promoting Community approach targeting a ‘health action group’ from two initial behaviour change proposals (a) a health promoting rugby club; (b) smoking cessation; and statistical data highlighting Te Kopuru as a high deprivation area (as outlined above), tabled at their first meeting. The committee recognised the need to investigate what health promotion
activities were already taking place in Te Kopuru and support a plan
that fostered collaboration, cooperation and coordination The following goal statement was developed to assist us to adhere to proven health promotion principles: “To develop a model that will promote collaboration between participating agencies in developing a health promoting community in Te Kopuru by: • Consultation with people of Te Kopuru KCI recognises the need to know the role of other agencies, and play a lead role as co-ordinating body to assist communities in the Kaipara to prioritise and make the changes that will promote, improve and protect their health.” 6. Intersectoral Activities Because of the potential overlap of agencies working within the Te Kopuru boundaries, regular intersectoral meetings will be a priority, their aims being: • To canvass the agencies to ascertain their current involvement
and future interest in collaborative approaches. Special mention should be made of the intention of this group to consult with and align itself with the Kaipara District Council, Niho Taniwha model in engaging the Physical (Mana Whenua), Intellectual (Mana Tupuna), and Spiritual (Mana Atua) aspects of this community to make its own decisions. Our group will approach the Kaipara District Council to make use of existing research to supplement our own information. The first intersectoral hui will extend invitations to representatives
from the following groups, based on their current and future interest
for working within the Te Kopuru community.
7. Identifying Gaps in Services and Key Health Needs No meeting will occur without attention to this activity, but previous intersectoral meetings have sometimes resulted in attendance of some but not all agencies, often the most urgent of issues go un-represented. Careful stocktaking of activities and the amount of resource spent within Te Kopuru is required to allow more in-depth analysis of health issues or gaps. In addition these services and perceived gaps need to be matched with some population health outcomes gained from admission and health service data, and disease based data within KCI’s existing databases. In working with this community to prioritise health promotion strategies we must have the best information available to support their decisions. It is also expected within the identified priorities a community decides to action, some priorities will be outside of the scope of activity of a PHO but may be supported in order to achieve some priorities which are more closely aligned. 8. Using Existing Community Assets The founding proposal involving the Southern Rugby Club is one area for assessing the level of further interest, as is either marae mentioned. Schools are already involved as health promoting schools. a. Example of a local Te Kopuru strategy: The Southern Rugby Club provides an early focus for this project, but like any sustainable project it must endure full consultation with people making up its membership before any health initiatives should commence. The lessons learned in Health Promoting Schools in the Kaipara have been important in our planning this project so far, as well as using a community development approach to gradually develop trust, participation, and the initial focus on issues most important to the club members. A health promoting environment approach to such issues as: (These issues are loosely prioritised as the community consultation is still to occur) 1. Injury prevention Sports Injury prevention Each of these recognised health issues has people with expertise and resources accessible to KCI within Northland. KCI's role will be to facilitate the consultation process, allocate appropriate resources, appoint or contract providers as necessary, establish linkages with organisations such as ACC, and to access existing resources and expertise. The above example can only be that until sufficient community consultation can take place, and issues prioritised. 9. Planning and Resourcing A health promotion programme plan is included. Specific Project resource allocation can only be estimated until a thorough assessment of stakeholders and issues in the Te Kopuru community can be made.
a. Year One All the activities listed above can be achieved in the first year. Initial contact with community agencies and key community leaders (potentially) is important, requires the use of local knowledge and will encompass more than the key stakeholders. The key stakeholders will emerge as meetings become more focused and issues begin to be prioritised. Strategy meetings may require agencies previously not engaged. Specific project resource allocation may involve contracting a person or agency to coordinate the project(s) or may be put toward facilitating the commencement of programmes into the Te Kopuru community. For example, if Hep B/Meningitis prevention is signalled as a priority activity for this community, an awareness campaign tackled through marae, schools, rugby club, radio, competitions can be resourced appropriately from this fund. Evaluation occurs at each stage, looking at effectiveness of consultation processes, how differences in priorities are resolved, measures of outputs put in place for each sub-project, use of existing agencies, quality of collaboration, and final gathering of outcomes from a range of sources, including interviews of Te Kopuru consumers, and agency providers. b. Continuation Beyond Year One Critical evaluation of the overall effectiveness of this project
will be reported on by KCI. Decisions to continue part or all projects
will follow this process. Other questions will need to be asked such
as: |