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Centretown Community Health Centre. Improving Group Programs Through Feedback and Reflection. 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 ….
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Centretown Community Health Centre Improving Group Programs Through Feedback and Reflection
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 …. Women of All Cultures Living with Stress Children’s Self Esteem Challenge of How to assess these groups and implement change in a consistent manner Walking Group Breastfeeding Drop-in Senior’s Tea
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
3. Study – Feedback Forms • 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 • 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 • In what ways, specifically, have you changed? • Specific question to your program • Specific question for your program • Specific question for your program • 10. What suggestions do you have for improving the group program?
3. Study – Feedback Forms Review feedback and observations Reflect Write up summary 100% were very satisfied " I have to take care of my self esteem in order to help my children" Immigrant Seniors are not being well served
4. Act • Recommend changes to group structure Refocus attention on immigrant's adaptation needs Remove the word "stress" in the group name Minimize disruptions from children by moving rooms
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
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.
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
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