HEIA Community of Interest Webinar Recap
From Brainstorming to Action: Implementing mitigation strategies for HEIA
HEIA was developed by the Ministry of Health and Long Term Care as a way for organizations to address health inequities by considering the needs of specific populations. There are 5 steps in an HEIA: scoping, impacts, mitigation, monitoring and dissemination. Today I presented a webinar that focusses on step three, where we identify mitigation strategies to maximize the positive and minimize the negative potential impacts.
I’ve noticed that step three is the one that people tend to jump in with- it’s action orientated and we get to identify what we can actually DO to address inequities. I’ve also found that it’s the step that poeple struggle with the most. The main challenges that I’ve observed from the people that I work with are that:
- People aren’t sure how to identify mitigation strategies, or that
- Too many mitigation strategies are identified, and there is a struggle to implement the identified strategies
At Health Nexus, we encourage people conducting HEIAs to consider three steps to guide Step 3.
1. Identify potential strategies
Collaborate and consult: ask fellow staff/team members for insights. Consider collaborating with members of the population groups identified in step 1.Conduct key information interviews, focus groups and surveys to gain insights.
Think simple: mitigation strategies don’t have to be complex or difficult in order to be effective. Keeping changes small-scale or incremental may be the most effective way to see impact.
Use evidence-based approaches: At Health Nexus, the definition of evidence that we use considers not only published research but also our years of experience in supporting communities, as well as the lived experience of people and communities. I recommend considering all of those sources of evidence.
2. Select strategies
Focus your efforts on what can be realistically implemented AND will have impact. I’m borrowing here from a body of work on priority setting – which will help you to rank potential strategies in order to select ones to move forward with.
Firstly, identify criteria to compare the various mitigation strategies you’ve identified. For example:
- Alignment with the objective of your HEIA and the data you’ve identified in steps 1 & 2
- Resources required (human, time, money)
- Potential impact
- Needs of the population group
This step allows us to identify how we’ll know what’s important. Otherwise we risk using the “ooooh sparkly thing!” method of prioritizing, which means we drop whatever we’re doing in favour of the new, shiny thing.
Once you’ve identified the criteria that’s important, you can select a process to analyze the criteria for each potential mitigation strategy. For example in the Tip Sheet on Step 3, we talk about a quadrant analysis where potential mitigation strategies are ranked according to effort and impact. This article by the former Health Communications Unit that explores several other priority setting processes- many intended for group decision making, such as Grid Analysis.
3. Develop an implementation plan
I’m a planner by nature, so my tendency is to develop a workplan for everything that I do. The level of detail required in your implementation plan will depend on your organizational context and the mitigation strategies you’ve selected. Something jotted down on a piece of paper might be sufficient, or you might require a full workplan with timelines, roles and responsibilities and budget. The important step here is to ensure that you have a plan to actually implement the mitigation strategies that you’ve identified.
A few parting words:
I’ve already written about some of these but I believe they bear repeating!
- Be firmly grounded in the objective of the HEIA and the data you’ve identified in step 1 & 2: the populations you have identified, and enhancing the positive and minimizing the negative potential impacts.
- Find the balance between blue sky thinking and thinking realistically. In the beginning of Step 3 of HEIA, brainstorming can be helpful, in particular with the populations you’re working with. However it is important to move to strategies that can be realistically implemented and will have the intended impact.
- Engage partners, stakeholders, and the populations and communities identified in Step 1.
- Actually implement the strategies you’ve identified! You can then move on to steps 4 and 5 in the HEIA: monitor you implementation strategies to see what impact they’ve had, and then disseminate your findings.
Sources for this webinar:
The HEIA tool developed by the Ministry of Health and Long Term Care
Health Nexus has published a tip sheet on Navigating Step 3: Identifying and Selecting Mitigation Strategies.
This blog post, Setting Priorities: How do we decide what to do? by Andrea Bodkin of Health Nexus, outlines why and how we can select priorities.
In this article, Priority Setting- Four Methods for Getting to What’s Important!, The Health Communication Unit discusses priority-setting group processes.