Developing your project/activity

The following sections could be included in your project plan

• Defining the problem
• Aims and objectives
• Resources/assets
• Who you are targeting
• The proposition
• The marketing mix
• Monitoring/evaluation and follow up
• Budget
• Implementation plan - including roles, responsibilities and timescales
  

Setting aims and objectives

It is important to set clear and realistic behavioural goals for the target audience (S.M.A.R.T) – Specific, Measurable, Achievable, Realistic and Time bound e.g. If you’ve had a cough for over three weeks, get symptoms checked out by a doctor

Consideration needs to be given to the known insight when setting goals: where is our audience now?; what are they doing?; why are they doing it?; how can we encourage them to behave differently?

Realistic targets should be set based on your budget and resources in terms of staff and time.

An integrated solution

It is well known that a public-facing campaign cannot work in isolation and often ‘push’ and ‘pull’ strategies will be required: ‘pushing’ people towards services and then working with services to ‘pull’ them through as quickly as possible.

Plan for a range of interventions/activities to meet the needs of different audiences e.g.

• The public - raising awareness and promoting earlier presentation for potential cancer signs and symptoms
• Professional stakeholder intervention
• Health trainers/community team engagement

You might decide to use an agency to deliver one or more elements of your project. Here is some guidance from the COI (Central Office of Information) on how to get the best from your agency (PDF).

Fundamentally you need to consider

Will the proposed interventions meet the objectives?

Understanding the ‘exchange process’ for each audience including professional stakeholders will help you develop a ‘proposition’ which meets the needs of each target group and fulfils your original objectives.

The key questions that should be asked

• What's in it for the audience to engage with what we are offering?
• What are the perceived benefits?
• What is the effort or 'cost' involved in engaging with the offering? i.e. what are the barriers?

Planning monitoring and evaluating

It is important to have clear plans in place for how you intend to evaluate the intervention. During the development phase you should agree what indicators you want to measure (see the evaluation section for useful links) and agree who will be responsible for collecting data.

You want to establish what has worked well within your intervention and what hasn’t been so effective.

Pre-testing

Pre-testing new intervention ideas, how to localise a campaign/intervention, methods of communication and engagement with the target audience, for example, finding out about preferred channels or gauging reactions and/or potential engagement with planned activities, is important. Remember that the perceptions of the target group are often different from your own.

This pre-testing doesn’t necessary need to be conducted through formal focus groups. It could be a more informal ‘sense check’ to get the views of your target audience on how best to reach them.

Key areas for pre-testing

• Explore local knowledge about areas and communities
• Find out about territorial issues in terms of where events are held, where the local 'hot spots' are - both positive and negative
• Find out about people's views on whether community-based teams are the right people to introduce the subject of cancer
• Attitude towards roadshows in various communities as an appropriate channel to promote early detection
• Find out about the extent of peer influence/pressure in terms of whether or not the target audience will engage with the 'offer'
• Find out views about benefits and barriers of participating in the proposed activities
• Exploration of whether proposed channels of communication are appropriate. Find out where the target group go, what they do, what they read, listen to and watch. eg. if they never go near a proposed outdoor site, this should be reviewed. If they don’t have access to a computer, then on-line communications are likely to be wasted
• Knowledge and perceptions about the issue being addressed by the intervention
• How engaging is the proposition? Indication of whether behaviour or attitudes may change (and in what direction) as a result of the intervention. The proposed intervention may ‘turn people off’ the intended action you may wish them to pursue e.g. go and see your doctor with signs and symptoms if the approach, message, tone of voice or image is inappropriate
• Pre-testing of a professional training programme may want to explore whether the content is appropriate, who will be delivering the training – are they credible? Views on where and when the training take place? Would they attend and why?

Translating materials into different languages

As part of exploring how best to reach your target audience, you may consider translating materials. Here is some guidance on things to consider before translating materials into different languages (PDF, 20KB).

Media Planning

Once you have decided on the channels for your campaign you may want to include purchased media. Here is some guidance from the COI (Central Office of Information) on developing an effective media plan (PDF).

Budgets- potential costs

It is crucial for project objectives to be realistic compared to the budget available. It's also important to allocate proportions of your budget appropriately to enable you to deliver and evaluate your project effectively. The costs (PDF) associated with Doncaster PCT lung campaigns gives a good example of what allocation of budget to different elements of the project is required to achieve significant results. 

Communicating with professional stakeholders is fundamental to the overall success of any project. The ‘who, what, why, when and how’ of communication is critical to ensure that all relevant stakeholders are informed about plans, have the opportunity to feedback and ultimately take some ownership of the intervention.

Equally important, communication with health professionals plays an important part in building confidence in and preserving the reputation of the organisation responsible for delivering the intervention.

‘Pull’ strategies need to be implemented before ‘push’ strategies begin so that staff in primary and secondary care are prepared to respond to people motivated to attend as a result of the public awareness element of the intervention. ‘Pull’ strategies, especially work in primary care, need careful planning and adequate time to engage, meet and deliver any training required.

Effective communication between primary, secondary care and the team responsible for developing the intervention/activities, appropriate training for staff (professional and health trainers/peer educators), can make the difference between success and failure.

Tips

• Set up the right communication structures. Spend time identifying who needs to know what, what are the best methods to reach them and how often they need to be consulted or communicated with. Find 'champions' in primary and secondary care who will help you to get access to the decision makers. Many Cancer Networks have clinical cancer leads - public health, general practice and secondary care
• Share common goals and agree an action plan and timescale for the project with professionals
• Never underestimate the importance of face-to-face contact with key stakeholders. It can help increase their confidence in your plans and your own credibility
• Be inclusive and communicate with a wide range of internal and external stakeholders
• Develop joint plans about referral pathways, training and timing of the intervention. Primary and secondary care teams will be the 'front line' staff required to address any increase in demand. It is therefore important to plan for various levels of response to the intervention (low, medium, high). Have contingency plans in place to cover all eventualities 
• Changes to services must be agreed with key stakeholders and built into delivery plans
• Developing appropriate and timely methods of two way communication and encourage feedback and comments on your plans
• Use a variety of methods to communicate - e.g. email, letter, newsletter, face-to-face meetings, presentations, training events, but of all of these methods the most valuable is likely to be direct personal contact with key stakeholders
• Develop a '10 frequently asked questions' about the project

Prepare the ground

Pressures being faced by the service providers have to be acknowledged and addressed as well as providing support in the local community by developing an appropriate communication and training strategy.

Key issues that may be raised by health professionals

• A fear that the public awareness element of the intervention will attract the 'worried well'
• Concern that patients cannot be referred quickly or appropriately
• Having time to deal with complex issues during brief consultation
• Concern about staffing levels and recruitment issues
• Worried about secondary care services ability to cope with any extra demand
• Concern from secondary care about receiving inappropriate referrals
  

What the public want from health professionals

• Reassurance
• To be taken seriously
• Quick diagnosis
• The best possible treatment
• Support - someone to talk to who has time and knowledge - not a 'counselor'
• To be treated personally - not as a number or a statistic
• Communication and coordination between primary and secondary care
• To know what will happen, when, how long it will take and who is involved. Some, but not all, will want to know why

Examples of good practice

The Doncaster lung campaign and the West of Scotland Cancer Awareness Project have very good experience in developing links.

The West of Scotland Cancer Awareness Project bowel cancer initiative developed an award winning communication strategy to engage with professional stakeholders.

There's information about the 'pull' strategy used in the Doncaster lung campaign in the How to Guide. For links to the workbooks for health professionals used in Doncaster, visit the lung cancer projects page.

NEW Clare De Normanville and Angela Tod, part of the team behind the Doncaster workbooks, have developed 10 top tips for engaging with health professionals as part of a behaviour change campaign - download the tips.

Read more about engaging with public health and primary care in the clinical leadership section.

The 2010/11 centrally funded local projects were asked for examples of resources they are using and some of these can be found here.

To find out about training being developed for front line professionals and GP registrars, visit our 'getting results' section.

Community pharmacy

A range of projects have engaged with community pharmacy, as a channel for health messages or to pilot new pathways.

South East London Cancer Network conducted a pilot study with two community pharmacies in 2006. Download their evaluation report.

The project undertaken by North West London Cancer Network is another example. Their report includes some useful advice for pharmacists and pharmacy staff, in talking to customers about cancer (appendix 11).

Key lessons from the project were:

• Use education events as a way of engaging and informing staff, and making clear any data requirements that will help you to evaluate the impact of the activity
• Include all pharmacy staff in any education events, including medicines counter assistants
• Visits by Network or PCT staff engaged in the project are highly valued by the pharmacy team
• Pharmacy staff can be concerned about 'launching' into a conversation about cancer, and value tips and support on how to do this
• Essex Cancer Network have recently completed a pilot study engaging community pharmacy in tackling bowel and skin cancer. Download their evaluation report from July 2010.

Cancer charities and other relevant organisations can be great sources of information, insight and expertise as you develop and implement your project. To help you identify what could be available, a number of charities have provided details of the support and information they have to offer. The charities are all members of the NAEDI forum, a forum for cancer charities with interest and activity in early diagnosis to share learning and feed into NAEDI. These charities represent the less, as well as the more common types of cancer, as well as overarching areas, such as Men's Health. For details see our relevant charities and organisations page.

Linking with community networks can make a huge difference to the impact of an intervention as personal contact and ‘local ownership’ is a very powerful method of communication especially when supported by other activities such as a media campaign, PR and events in the community. You will know your local communities best but think carefully about who the target audience for your intervention is and what groups and networks they may have a connection with.

The North East Lincs cancer awareness programme was led by volunteers who drove ideas and activity forward. 

The Healthy Communities Collaboratives also worked in partnership with local people to promote awareness and encourage early presentation in breast, bowel and lung cancers. Read more in the BJC supplement paper and in the East Lancs article.