Listening To Our Communities: Leveraging Qualitative Data for Strategic Expansion of Evidence-Based Programs

NCOA Center for Healthy Aging Annual Meeting

May 22-24th, 2018

Carolyn Ham

Older Adult Falls Prevention Specialist

Injury and Violence Prevention

Washington State Department of Health

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Presentation Overview

❖What Kind of Data?

❖Falls Prevention in Washington

❖Development of State Plan

❖Expected Highlights and Features of Plan

❖Next Steps

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Qualitative Data vs Quantitative Data

The CDC on effective program evaluation:

“The integration of qualitative and quantitative information can increase the chances that the evidence base will be balanced, helping to meet the needs and expectations of diverse users.”

https://www.cdc.gov/healthcommunication/cdcynergy/Evaluation.html

Qualitative Data is narrative (not numbers) and includes:

➢ Focus Groups

➢ Observations

➢ Key Informant Interviews

➢ Open-ended survey responses

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Why Is This Helpful?

We all want to have programs that reach the people who need them, but don’t always know what the end user really wants and needs to be successful

Qualitative data allows us to LISTEN to the end user instead of just counting how many there are

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Falls Prevention in Washington

• Started in early 2000’s with CDC Grant

• Report on best practices

• Developed SAIL (Stay Active and Independent of Life)

• Added more evidence-based programs

• Statewide Coalition

• Quarterly meetings and monthly newsletter

• Member of NCOA Coalition

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Missing Pieces

• Problem: Washington has great programs and strong partnerships, but our falls-related death and hospitalization rates are still rising

➢ How can we reach the highest risk age group (85+)?

➢ Why aren’t more people participating?

• Next Step: We have to reach outside our known circles to find the answers from community members

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State Action Plan

• Advisory Group of 86 members

• Focus Groups (3)

• Survey (800 responses)

• Key informant interviews

• Workgroups for Goal Development

➢ Supported by Aging and Long Term Support Washington

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What We Learned: Program Location

• 29% of older adult survey respondents said: main barrier to participation was not knowing of any falls prevention programs in their community.

“Have fall prevention exercise programs that are easily accessible within a certain mile radius of the city/town.

Some places are rural and difficult for folks to travel 30 some miles or more to get to a exercise class.”

Focus Group Participants:

“Close to home, that is very important”

“Effectiveness would be interesting, but location is most important.”

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What We Learned: Screening for Risk Factors

• 68% of older adult survey respondents said: They have never had their medications checked to see if they increase their risk of falling

• Only 14% said: They had spoken with their doctor about falls prevention in the previous six months

Focus Group Participants:

“Most family doctors, it doesn’t occur to them to ask about falls, and even if they do give you a referral for PT they

don’t call to follow up on you.”

“I think most of us assume that our primary care MD’s are not knowledgeable about falls.”

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What We Learned: Family and Caregiver Needs

• Of those who responded to the survey, 52% indicated they were both a family member and caregiver

• 51% said: “Resources for Home Safety” was a top need

“Individual assessments of a person's home to provide affordable, reasonable modifications.”

“Outreach & educate family members about ways to prevent falls early on and make the resources available to

a wide variety of abilities.”

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What We Learned: Community Programs Barriers

• 62% of respondents who work in the community said: Lack of resources is one of the most significant barriers to helping older adults prevent falls.

“Lack of space” “Lack of transportation”

“Lack of programs being Community/Home based”

• 76% said: They encouraged an older adult to start or continue an exercise program in the past year

“Encouragement to continue classes”

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What We Learned: Medical Professionals Perspective

• 89% of survey respondents said: Falls prevention was “extremely important” for their older adult patients

“Educate them. (and let them know, that by getting education, they are not giving up their independence or telling the world that they cannot handle being at home

alone.)”

“Education of resources and balance exercise programs for older adults and no cost. List of resources for primary care

offices to follow-through when they do fall risk assessment.”

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What We Learned: Outreach Insights

“Until I fell I thought I was invincible, I thought about balance but not about falls.” – Focus Group Participant

“Make it a family/community event. If it is something that "everyone" can get involved in, then it may not seem so

isolated.” –Survey Respondent

“Teach them how to fall and how to get up after a fall.” –Survey Respondent

“(Tell them)You are young at heart and you can do it!” –Focus Group Participant

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Insight Into Action (Plan)

• Action Plan with approximately 46 Goals

• Examples of goals directly drawn from focus groups and survey:

➢ Expand existing statewide website for evidence based programs and home safety resources

➢ Develop a seminar to teach older adults how to safely stop a fall and get up after a fall

➢ Outreach to family caregivers on EBP for falls prevention

➢ Partner with clinicians to actively promote Otago

➢ Increase the number of instructor trainings for falls prevention EBP in rural and underserved areas

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Steps for Planning Your Data Collection

1. What questions you need to answer

2. Who can answer them (older adults, healthcare providers, family members?)

3. How can you reach them to ask the questions?

➢ Surveys – online and/or paper

➢ Focus Groups

➢ Key Informant Interviews

➢ Observations

4. Where and When will you reach them? (Online, phone, in person, a mix?)

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Who Can Do It?

➢ Anyone!

➢ Internally (this is what we did in 2017)

➢ Hire outside firm (this is what we did in 2002)

➢ Work with partners

➢ Do what fits your resources and needs

➢ It’s not research!

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Lessons Learned

❖ Open-ended process worked well

❖ Need additional time for partners to review questions before distributing survey/doing focus groups

The best question we asked:

“If you were inviting a friend to participate in a fall prevention program, what would you say to them?”

Least effective question:

“What would motivate you to participate in a falls prevention program?”

Questions?

handle: WADeptHealth

Older Adult Falls Prevention Specialist

Injury and Violence Prevention

Thank You!

Carolyn Ham

Using Data to Tell Your Story

Overview

• What is data visualization?

• Why is it important?

• What tools can I use to create graphics?

• How will it help me manage grant activities?

What is Data Visualization?

• Data Visualization

• Information Visualization

https://www.neoncrm.com/nonprofit-data-visualization-and-infographics-the-definitive-guide/

This Photo by Unknown Author is licensed under CC BY-NC

Why is this important?

• “Big Picture” of large amounts of data

• Tells a story

• Making a case to potential payors

• Helps to guide problem solving and strategic thinking

https://www.neoncrm.com/nonprofit-data-visualization-and-infographics-the-definitive-guide/

This Photo by Unknown Author is licensed under CC BY-NC

What tools to use?

Workshop Materials

Topic: Statistics and Descriptions

Tools:PowerPoint

• Assess usefulness of resources and provide recommendations for change

Topic: Tools:Program Implementation PowerPoint

How to use: Provide information

Topic: Tools:

Process Improvement Visio and PowerPoint

How to use:

Evaluate current process and assess waste

Topic:

Evaluation

How to use:

Measure data (quantitative and qualitative) from groups

Workshop Materials

Topic: Sustainability Planning

Tools: Canva

How to use:Outline process or timeline

Topic:Mapping

Tools: Google Maps & Salesforce• Survey Gizmo

How to use:• Evaluate capacity and

reach • Program planning

usefulness of re

Topic:

Network Model

Tools:

Adobe InDesign• Survey Gizmo

How to use:

• Make a case for network model

Thank You!

Cassandra Manfre, MSWProject ManagerHealth Self-Management ServicesPartners in Care Foundationcmanfre@picf.org

Karol Matson, RD, CDEDirector of Diabetes and Self-ManagementHealth Self-Management ServicesPartners in Care Foundationkmatson@picf.org