Post on 11-Jan-2016
description
Improving Group Programs
Through Feedback and
Reflection
Centretown Community Health Centre
Quality Improvement
QI is based on understanding:
• The current system/environment • The complexity working with people
• How the environment and complexity creates variations
AND HOW to ….
• Use knowledge/information to influence outcomes.
Quality Improvement – With Group Programs
The system/environment • Many different health education groups, • Each with different specific objectives
Complexity of working with people• Different populations (age, gender, culture, socio-economic status)• Different modes of delivery• Different levels of literacy/knowledge of English
Lots of Different Groups ….
Children’s Self Esteem
Women of All Cultures
Living with Stress
Walking Group
Senior’s Tea
Breastfeeding Drop-in
Challenge of How to assess these
groups and implement change
in a consistent manner
Not your typical health careQI setting …
• Non-clinical
• “soft” interventions/outcomes – i.e. improve self esteem
• Difficult to measure change/impact with limited resources
Evaluation And QI Issues
in Health Promotion and Community Development Unit of Focus Individual OR
Group, community, system
Type of evaluation
Outcome OR
Include process and context
Indicators Biomedical OR
Community capacity; social health
Evidence Rational & “scientific”; valid/reliable OR
Theory-based, practice-based
How to evaluate
Standardized tools; quantitative OR
Participatory & capacity building; qualitative
Quality Improvement
1. Plan – Group Logic ModelsInputs Staffing, supplies etc.
Activities Sessions, activities etc.
Target Groups Who the group is being targeted for
Outputs # of sessions, # of participants
Outcomes (short term)
What is hoped to happen by the time the group is complete
Outcomes (long term)
What is hoped to happen if the impact/knowledge/skills are maintained
Goal Macro level – (e.g.. decrease in chronic conditions) (but not full influence)
2. Do – Carry Out Group
3. Study – Feedback FormsGroup Feedback Form
Name of the Group: Date: (Day/Month/Year)
Number of sessions attended:
1. How satisfied were you with the group program? (Circle the number that best expresses your opinion.)1 2 3 4 5
Not at all Somewhat Very satisfied satisfied satisfied
2. What have you found useful about the group program?
3. How much have you learned as a result of participating in the group program? 1 2 3 4 5
Little or A moderate A great nothing amount deal
4. What, specifically, have you learned?
5. How much change have you made as a result of participating in the group program? 1 2 3 4 5
Little or A moderate A great none amount deal
6. In what ways, specifically, have you changed?
1. Specific question to your program2. Specific question for your program3. Specific question for your program
10. What suggestions do you have for improving the group program?
Group Feedback Form
Name of the Group: Date: (Day/Month/Year)
Number of sessions attended:
1. How satisfied were you with the group program? (Circle the number that best expresses your opinion.)1 2 3 4 5
Not at all Somewhat Very satisfied satisfied satisfied
2. What have you found useful about the group program?
3. How much have you learned as a result of participating in the group program? 1 2 3 4 5
Little or A moderate A great nothing amount deal
4. What, specifically, have you learned?
5. How much change have you made as a result of participating in the group program? 1 2 3 4 5
Little or A moderate A great none amount deal
6. In what ways, specifically, have you changed?
1. Specific question to your program2. Specific question for your program3. Specific question for your program
10. What suggestions do you have for improving the group program?
Review feedback and observations
Reflect
Write up summary
3. Study – Feedback Forms
4. Act Recommend changes to group structure
Children’s Self Esteem
Teaching participants about the importance of both children’s and their own “emotional tank” and how to “fill it up” to have high self esteem.
9 participants, from catchment area (6 new immigrants)
2 sessions. Childcare provided
Children’s Self Esteem Group
What was trying to be accomplished?
Importance of Self Esteem
Skills and techniques to develop self esteem.
How did we know if intervention was an improvement?
Participants listed techniques they were now using “physical touch/positive talking”
What changes can we make that will result in an improvement?
Moving location of parent’s session so they will have fewer interruptions from the children
Women of All Cultures Program designed to decrease isolation and increase knowledge of
Canadian system and services
Intended population: newcomer women 8 sessions average 14 participants/session
Intended short term outcomes (from logic model):– Participants have increased knowledge of topics.– Participants are more aware of Canadian systems.– Participants are more aware of community services.
Women of All CulturesWhat was trying to be accomplished?
More awareness of Canadian systems and community resources
Decreased isolation
How did we know if intervention was an improvement?
Participants listed “information, knowledge and friendship” and change in “nutrition habits and knowledge about health”
What changes can we make that will result in an improvement?
Develop a program specifically for immigrant seniors.
Focus on informal reciprocity
Limit amount of printed material
Living With Stress Stress reduction workshop designed for use in
community with marginalized populations Intended population: women on low income,
homeless or at risk of homelessness, unemployed or underemployed, social isolation.
5 sessions, 9 unique participants Intended short term outcomes (from logic model):
– Increased knowledge/awareness of: what our stressors are; how we react to stress (in the body, behaving, thoughts); healthy ways to respond to stress; link between stress and chronic diseases
– Gain skills in relaxation/stress reduction skills & techniques to calm the body/mind/breath
Living with StressWhat was trying to be accomplished?
Stress reduction training for marginalized populations
How did we know if intervention was an improvement?
“exploratory” group – what did we learn?
What changes can we make that will result in an improvement?
Less focus on the body
Focus on specific stressors – not generalized
Improve general poverty advocacy within the Centre
Factors for Success
• Commitment from staff to complete the summaries
• Investment in evaluation resources within the Community Health Promotion/Early Years Programs
• Increased interest in results when there are similar comparisons between groups.
• Centre philosophy of group service delivery
How we could do this better?
•Repeat for similar groups
•Working database developed for input and automated summaries of feedback form data.
•Reports back in a timely manner so that facilitators can use the results in planning and evaluation
•Ensuring each group has specific questions linked directly to the group’s logic model
Thank you – Questions?