Community Readiness: A Handbook for Successful Change

1. Community Readiness: A Handbook for Successful Change By: Annie Holtkamp

2. RSC works with each coalition: Conduct the assessment Distribute and collect 2 worksheets Score the assessment Explain the score to the coalition Getting Started1. Call or meet in person with each coalition for group interviews. There should be 4-6 coalition members present.2. There are 36 questions. The questions are located on pages 12-14.3. Conduct the Community Readiness Assessment every year. The first assessment will take anywhere from 1 hour to 3 hours. 4. Start conducting the assessments early. There is a lot that goes into the assessment. Recommendations: Set-up the assessment with the coalition leader a month ahead of time. This way they may be able to conduct the assessment before, during, or after a regularly scheduled coalition meeting. The coalition leader should participate in the assessment. I recommend typing the questions before conducting the interview. This will allow enough space for you to write the coalition’s answers. Allow enough time to conduct your first assessment. The first assessment will take anywhere from 1 – 3 hours. You may want to time each question, example 2 minutes per question. This will keep the assessment under 2 hours. Next year the assessment will take an hour or less, since you can use the previous assessment to add and subtract comments. Have each coalition complete the 2 worksheets and return them to you.

3. Assessment Questions are found on page 12-14 Community Readiness Assessment Interview Questions • Coalition Name: • Coalition Leader: • Number of People Present: • Counties Served: • Specific Issue: I recommend you send out the assessment questions to the coalition leader a week or 2 before the assessment. This will allow them to be prepared and have an idea of what specific issue the coalition wants to focus on or already focuses on. Throughout the assessment it refers to “this issue”, so I would try and have the coalition decide on 1 specific issue they work on already. If the coalition chooses more than one issue, you want to make sure they answer the question with all of the issues in mind. For example, if a coalition chooses alcohol, marijuana, and prescription medication, when there is a question stating “this issue”, the coalition needs to have an answer for alcohol, marijuana, and prescription medication for that question. It is recommend when you read the questions to the coalition members and they respond, read the answers back to the coalition members. This will ensure you have accurate information and it may prompt someone to think of something to add to the question.

4. Completing the Assessment Once you have completed the assessment give the coalition a packet and go over it with them: • How the assessment will be scored – on page 15 or you may use my document on slide 8. • Anchored Rating Scales For Scoring Each Dimension – on page 19-24 • Stages of Community Readiness and the definitions –on page 34-35 • Record of Community Strengths, Concerns, and Resources Worksheet – page 44 • Sample of Record of Community Strengths, Concerns, and Resources Worksheet – page 45 • Record of Community Interventions and Strategies: Action Plan – page 46 • Sample of Record of Community Interventions and Strategies: Action Plan – page 47-48 By providing this information to the coalition now, you will save yourself time later. The assessment and the 2 worksheets listed above will be used in the Strategic Work Plan. If any coalition has questions on how to fill out the worksheets, a lot of their answers will be found in the actual assessment. We try and type the assessments as soon as possible, so we may send the assessment out to the coalition leader. This allows the coalition to use the assessment to complete the worksheets.

5. Scoring the Assessment • Instructions are on pages 15-16. • The Community Readiness Assessment Scoring Sheet are on pages 17-18 • Anchored Rating Scales For Scoring Each Dimension are found on pages 19-24 • You will use pages 17-24. • Try to have at least 2 staff members score each assessment, which it doesn’t have to be the same scorers for each assessment. If you only have one staff member, see if you can have someone at your agency score the assessments with you. If only one person scores the assessment it is very subjective, which you can’t have the coalition score it’s own assessment. How to score: • Read through the assessment independently in its entirety before scoring any of the dimensions in order to get a general feeling and impression from the interview. Although questions are arranged in the interview to pertain to specific dimensions, other interview sections may have some responses that will help provide richer information and insights that may be helpful in scoring other dimensions. • Staff then scored each dimension individually using the Anchored Rating Scale. On each dimension, you will notice your score could range from a 1 to a 9. • In order to receive a score at a certain level, all previous levels must have been met up to and including the statement which the scorer believes best reflects what is stated in the interview. In other words, a community cannot be at a 7 and not have achieved what is reflected in the statements for 1 through 6. *Do keep in mind some coalitions may be upset they did not receive the top score.

6. Continuation of Scoring Filling in Page 17 by using the Anchored Rating Scales page 19-24 Using the top table • #1 can be you, #2 staff, and #3 staff • Each person scores each dimension (A-F) individually. Example: #1 #2 #3 Dimension A: 9 8 9 Dimension B: 6 7 7 Dimension C: 9 8 9 Dimension D: 555 Dimension E: 566 Dimension F: 787 Using the middle table “Combined Scores” • Agree on a single score • For us, having 3 people worked out best. Example: Total Dimension A: 9 9 Dimension B: 7 7 Dimension C: 9 9 Dimension D: 5 5 Dimension E: 6 6 Dimension F: 7 7

7. Scoring Continued Bottom of Page 17 Example: TOTAL Dimension A 9 / # of interviews 1 = 9 TOTAL Dimension B 7 / # of interviews 1 = 7 TOTAL Dimension C 9 / # of interviews 1 = 9 TOTAL Dimension D 5 / # of interviews 1 = 5 TOTAL Dimension E 6 / # of interviews 1 = 6 TOTAL Dimension F 7 / # of interviews 1 = 7 Average Overall Community Readiness Score: 43 Top of Page 18 Take the TOTAL calculated score and divide by 6 (the number of dimensions). Use the list of stages below to match the result with a stage of readiness. REMEMBER, ROUND DOWN INSTEAD OF UP. TOTAL Calculated Score 43 (number from page 17) / 6 = 7.16667 The coalition’s score is a 7 and the Stage of Readiness is Stabilization.

8. Anchored Rating Scales for Scoring Each Dimension The Regional Support Center staff read through the interview independently in its entirety before scoring any of the dimensions in order to get a general feeling and impression from the interview. Although questions are arranged in the interview to pertain to specific dimensions, other interview sections may have some responses that will help provide richer information and insights that may be helpful in scoring other dimensions. Staff then scored each dimension individually using the Anchored Rating Scale. On each dimension, you will notice your score could range from a 1 to a 9. In order to receive a score at a certain level, all previous levels must have been met up to and including the statement which the scorer believes best reflects what is stated in the interview. In other words, a community cannot be at a 7 and not have achieved what is reflected in the statements for 1 through 6. After each staff member scored the assessment individually, we took the combined score for each dimension. Your combined score for each dimension is located on your Community Readiness Assessment under Comments (first page). Please remember this assessment is looking at the community and if it is ready to address your community’s specific issue. *We give this to the coalition leader as well.

9. One of Our Coalition Assessments Community Readiness Assessment Interview Questions Coalition: Coalition Leader: Number of People Present: 7 Counties Served: Specific Issue: Prescription Medication Score: 7.17. The Stage of Readiness is Stabilization with a score of 7. Comments: Overall, the coalition is accomplishing great outcomes in the community. The coalition scored a 9 on Dimension A, which states, “Evaluation plans are routinely used to test effectiveness of many different efforts, and the results are being used to make changes and improvements”. On Dimension B, the coalition scored a 7, which says, “There is evidence that the community has specific knowledge of local efforts including contact persons, training of staff, clients involved, etc”. On Dimension C, the coalition scored another 9, which states, “Leaders are continually reviewing evaluation results of the efforts and are modifying support accordingly”. The coalition scored a 5 on Dimension D, which reads, “The attitude in the community is “we are concerned about this,” and community members are beginning to reflect modest support for efforts”. On Dimension E, the coalition scored a 6, which says, “A majority of community members know the signs and symptoms of the issue and that is occurs locally, and local data are available”. On the last dimension, Dimension F, the coalition scored a 7, which states, “A considerable part of support of on-going efforts are from local sources that are expected to provide continuous support. Community members and leaders are beginning to look at continuing efforts by accessing additional resources”. *This explains what they scored on each Dimension and gives them their overall score. Again, you may find the Anchored Rating Scales for Scoring Each Dimension on page 19-24 **This is page one of the assessment I send to the coalition.

10. Continuation of Our Coalition Assessment EXPLANATION: There are 9 Stages of Readiness and they are as follows: No Awareness, Denial/Resistance, Vague Awareness, Preplanning, Preparation, Initiation, Stabilization, Confirmation/Expansion, and High Level of Community Ownership. Using the Community Readiness Assessment, your coalition now knows your overall community readiness is at a 7, and the coalition can start to develop strategies appropriate for the community. The Stabilization Stage is described briefly as “One or two efforts or activities are underway and stable. Staff are trained and experienced, but there is no in-depth evaluation of effectiveness. There is little perceived need for change or expansion. Community climate generally supports what is occurring”. The next step for the coalition is to complete 2 worksheets. NEXT STEP: The first worksheet is the “Record of Community Strengths, Concerns, and Resources”. This worksheet allows the coalition to discuss and evaluate the community in which it serves. After completing the community worksheet, the coalition then needs to complete the “Record of Community Interventions and Strategies: Action Plan” worksheet. This worksheet allows the coalition to create intervention/strategies with a timeline. On the following page, there are generic strategies appropriate for the Stabilization Stage listed. Please contact the Southeast Regional Support Center at (573) 651-5081, if you have any questions please let us know. If your coalition has an Action Plan already, please use it for the action plan worksheet. The overall goal in completing the worksheets is to analyze your community and put the coalition’s strategies into action, so next year when completing the Community Readiness Assessment your community may possibly be at the next Stage of Readiness. COMPLETION: Once your coalition has completed the 2 worksheets, please send them to the Southeast Regional Support Center either by email, fax, or mail. My email address is aholtkamp@semo.edu. Our fax number is (573) 651-2856. The mailing address is as follows: Southeast Regional Support Center Southeast Missouri State University One University Plaza, Mail Stop 7650 Cape Girardeau, MO 63701 *The coalition will want to know the Next Step. **This is page two of the assessment.

11. Our Assessment Continued Goals and General Strategies Appropriate for Each Stage - Page 26-28 and pages 38-40 EXAMPLES: Listed below are some generic strategies appropriate for the Stabilization Stage. The generic strategies are as follows:   • Goal: Stabilize efforts or establish programs. • Continue strategies from previous stage. • Maintain business and other support for the project/efforts. • Introduce new programs and identify support. • Increase and further develop media exposure. • Utilize evaluation to improve efforts. • Goal: Stabilize efforts and programs • Plan community events to maintain support for the issue. • Conduct training for community professionals. • Conduct training for community members. • Introduce your program evaluation through training and newspaper articles. • Conduct quarterly meetings to review progress, modify strategies. • Hold recognition events for local supporters or volunteers. • Prepare and submit newspaper articles detailing progress and future plans. • Begin networking among service providers and community systems. **This is page three of the assessment and then it goes into the actual assessment questions. * We provide this information on the 3 page of the assessment.

12. How and Where ALL of This Fits into the Strategic Work Plan Starting at the beginning of the Strategic Work Plan document go to “Resource Assessment”. Under “Resource Assessment”, place the information gathered from the coalition worksheet “Record of Community Strengths, Concerns, and Resources”. This is a list of the Strengths, Gaps, and Resources for the area the coalition serves. For Example: Resource Assessment X County Strengths: Gaps: Resources: *We did ours by county, since each coalition serves individual counties. We do have 1 coalition that serves 2 counties where there are already coalitions. In this circumstance, we combined the one coalition’s worksheet with the 2 counties. This is why it is important for each coalition to complete their own work sheets. For each coalition, there probably be several bullet points for strengths, gaps, and resources.

13. Strategic Work Plan Continue under “Resource Assessment”. We then placed “Community Readiness to Change” next. We stated, “The following is the Service Area 21 Community Readiness Assessment utilizing the Tri-Ethnic Readiness Survey.” We then created a table, such as, this example:

14. Strategic Work Plan Individual Coalition Scores: X Coalition: 43/6 = 7.17 (Stabilization Stage) *Do this for each coalition Overall Stage of Readiness: (use chart from previous page for the total of each dimension) Dimensions: Dimension A: Total for A / 7 (number of coalitions) = Dimension B: Total for B / 7 = Dimension C: Total for C / 7 = Dimension D: Total for D / 7 = Dimension E: Total for E / 7 = Dimension F: Total for F / 7 = Total of All Seven Coalitions: Total Number / 7 coalitions = Total Average Total Average/6 Dimensions = Stage of Readiness The Overall Stage of Readiness is with a score of #. I went on to describe this stage of readiness. I then described the overall score for the overall individual dimension. I ended this paragraph by stating the action plan worksheets of all the coalitions have been compiled into this one worksheet, please see below.

15. Strategic Work Plan This slide follows the previous slide. The headline for this section is “Record of Community Interventions and Strategies: Action Plan” *Insert all of the information from each coalition’s worksheet titled “Record Community Interventions and Strategies: Action Plan”. Also, under Who’s Responsible: put coalition name, not individual name. With the every coalition completing this worksheet, all of your coalitions will have an action plan for the upcoming year.

16. Homework • Conduct a Community Readiness Assessment with your coalition • Give the coalition a packet with worksheets, date of completion, examples, and definitions (Recommended, but not required) • Type the assessment (Recommended, but not required) • Send the assessment to the coalition (They use this to complete the worksheets) • Score the assessment (Recommended 3 people, but 2 people can score the assessment, individually) • Coalition complete the 2 worksheets and send them back to you • Fill in the Strategic Work Plan Resource Assessment Section - Strengths, Gaps, Resources (worksheet), Action Plan (worksheet), and table with individual coalition and individual coalition score below under Community Readiness to Change. We are in the midst of conducting the assessment at this time. It is great to see the improvement with all of the coalitions, comparing this years assessment to last year. Even though the coalitions have made improvements, it does not mean they will move up to the next level of stage of readiness. As stated before, one coalition did have a problem with the score we gave them last year, but overall it was well received. Other coalition members really liked the “outsiders” coming in and doing an assessment. If you have any questions, please feel free to contact me at 573-651-5081 or aholtkamp@semo.eduor ACT Missouri.

17. Questions Does anyone have any questions?