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The Fife Regeneration, Health and Wellbeing Study

Finding out more about the health and wellbeing of the people of Fife

Evaluation of the 2006 pilot phase

In recent months we have been talking more about the work, we have been sharing findings, and in particular the posters which are produced have brought an increasing amount of interest amongst professionals across Fife.

This is our report on our evaluation of the 2006 pilot phase, based on facilitated sessions with our participants. Learning from the evaluation will influence the 2007 work.

A big thank you to all our participants for their contributions through 2006.

What local people said

This is a pictorial representation of what people told us. You can right click and save this A4 poster to your desktop.

Poster

What local workers said

This is a pictorial representation of what people told us. You can right click and save this A4 poster to your desktop.

Poster2

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For our final session of the 2006 pilot phase work we asked participants, both local people and local workers to think about the following 6 questions. This is in 7 sections:

WHAT LOCAL PEOPLE SAID

The posters:

“What a great idea.”

“I like to share them with my son.”

“It’s been good, things are there in black and white if you want to read it.”

Links between the props for sessions and the posters:

“The props and the posters are a really clever idea, they work together. The feedback you get is great.”

It’s good to be heard:

“You feel you are able to tell someone your views, someone who listens.”

It’s good to reflect, remember and think about things now:

“It was good to remember what we have lost in family life. It’s made me aware of how things have changed, and how difficult it is for children now, their life isn’t as simple anymore.”

Feedback and a sense of it being worthwhile:

“This has been excellent for me. You get feedback and it makes it feel like it’s worthwhile.”

“I like the feedback, it’s interesting what people say.”

A distraction and way to think about things beyond immediate day to day stresses:

“It’s been a challenge but it’s distracted me from other things in a good way.”

“It’s just the talking; you know good chats, good laughs. It’s good to have time out on your own.”

Good to hear what other people think:

“I like to know that other people are thinking the same things.” 

“I like to read other people’s words and it helps to see it in a poster.”

“It gives you a chance to explore and think things through; it brings things to your attention. I liked finding out there’s a community out there that’s got these views.”

Actual face to face sessions are relaxed:

“It can be stressful to find the time if it’s a stressful time, but taking part isn’t stressful.”

Good to work closely with worker:

“We enjoy each other’s company.”

“Working as a team brought us closer together. We’ve had our laughs and our cries.”

Good to know that what you think matters and it makes you think about things differently:

“You just use your own language and experience and as time goes on you have to think more open minded and the posters make you see what other people have said. I feel a freedom to speak the way I want.”

Being able to identify things you have said:

“It’s good to see things that I’ve said.”

Good that views are written down:

“Usually professional people talk to you and don’t write anything down, so how do they remember?”

The positive tone:

“It was good to look at things positively, that fits the way I look at the world.”

WHAT LOCAL WORKERS SAID

The posters:

“It’s good to see direct quotes. The posters really capture stuff. They’re brilliant, hand drawn. You can relate to them because they’re not from a computer. It makes them more personal rather than professional. It feels like a community thing.”

“There’s something about these posters. They just hit you!”

Good to work closely with local partner on this – got to know each other better and differently – it was an opportunity for time out from pressing matters that lead a professional/client relationship:

“I liked being able to dedicate time to talk and listen. It’s what you want to do normally but don’t have the time. Its sparked different thinking and ideas about what we can do.”

“It was good for me to get to know my local partner better. Like how she sees things and what’s going on for her.”

“We’ve got to know each other in a different way.”

“I liked hearing a young person’s perspective on living here. It reinforced my local partner’s individuality. It moved our relationship from young person and adult to adult and adult.”

“It was good to share our positive childhood experiences.”

“It was good to hear my partner’s stories, to understand the pain and the loneliness. I have got to know her differently; it’s not the same as our professional relationship.”

Good to feel part of something – for both worker and local person:

“I felt good at being asked as I’m an unqualified member of the team here. It’s been very relevant, I have knowledge of the area too and of services so it’s been good for me. It makes me feel like I’m playing my part, belonging to something. It’s not that it changes your way of thinking but who better to comment on things, on solutions, than the people that have experience and their workers?”

“Local people often don’t think their experiences and opinions matter. This helps them understand that it does.”

“I like being part of the bigger picture, something bigger, I get a buzz from that.”

It’s interesting:

“It’s been interesting, my local person has great memories to share, a good perspective on what it’s been like to live in this community.”

“It gives an interesting slant on the work I do with clients being able to look at health in more depth.”

Participation requires minimum preparation:

“I like the fact that it didn’t require too much preparation from me, I just opened the pack, had a bit of a think, and we got on with it.”

Questions, props and posters are being used in other work:

“This is all really visual, its putting things we’re trying to do too in a more accessible format so we’re using it too.”

“I was at a meeting and someone produced a poster that was part of the study!”

WHAT LOCAL PEOPLE SAID

Personal Journey:

“It made me think about stuff that’s going on now.”

“I think the personal journey question brought up lots in our conversation, and the visual prop, the poster was great and easy to use.”

Where we live question:

“It was good to remember what things were like and why they’ve changed.”

“I liked that question because I could be positive, there’s no hassle, I live in a good street.”

WHAT LOCAL WORKERS SAID

Personal Journey:

“I’ve used the prop and the approach successfully with other clients!”

“The poster feedback was really good.”

Where we live question:

“There was a lot to talk about”

“It was good to have some positive things to talk about.”

“This question really lent itself to some good reminiscence for the older person.”

Helping professional question:

“It was really good because I’m really interested in mental health and there’s lots of help out there that you can get but some people just don’t get it, they don’t know how to ask for help. People still see the stigma of being ill or asking for help.”

WHAT LOCAL PEOPLE SAID

Keeping to agreed meeting times:

“Things can come up in life that can be an issue on the days we’d planned to meet.”

Some questions can feel a bit harder to engage with than others:

“The personal journey question was hardest for me, it didn’t feel so relevant.”

“Sometimes the instructions felt a bit baffling but (worker) helped me think it through.”

Finding it hard to say what you want:

“Sometimes it’s hard to find the words that explain what you want to say. It can be hard.”

Being a bit anxious about having something to offer:

“It’s not hard but I was a bit worried that she’d get something from what I was saying.”

The personal journey question:

“That question was harder. It was hard to identify what support there was, but we did eventually do it.”

What local workers said

Finding time and making sure the meetings happen as planned:

“It could have taken an hour, but it did take longer, that’s not a problem but needs to be planned.”

“Time is an issue, not that it’s a huge commitment but just in reality it can sometimes be hard to keep the time free for this.”

Deadlines:

“Timescales can be difficult; sometimes we were late with submissions.”

Capturing the story:

“It can be hard to listen and capture the essence of what you’re being told. I want to get it right, I didn’t want to miss anything.”

Engaging the local person at the outset:

“I had quite a disappointment at the outset with my first choice of local person who didn’t stay involved, but then I feel we’ve got it right now and it’s been great.”

The props and posters have a strong visual style that isn’t accessible for everyone:

“The props and posters have proved difficult for our local person, the style of work and reporting back is a problem because they have a visual impairment. This needs to be thought through more.” 

The being connected question:

“It just didn’t look straightforward enough.”

The helping professional question:

“It was good for us to focus on the role of the GP but my local partner did have a poor understanding of what other professional people and services there are out there.”

Helping the local person to be positive:

“It can be hard to be positive when there are lots of things going on that are difficult.”

Helping the local person engage:

“My local person sometimes found it hard to look at the ‘bigger’ picture and the answers depended on how she felt at the time.”

“My local partner, being older, feels a bit detached from services and the community and so sometimes found it hard to talk about things are now. But they did like reminiscing, remembering how things were.” 

Some questions have an emotional impact:

“It can be hard at an emotional level to reflect on some if the issues that came up, but we did want to.”

“Its not that it’s hard but it is least comfortable when issues were raised that were more personal to my local person.”

The local partner withdrawing:

“It was hard for her and me as well, but health issues just meant she had to withdraw.”

WHAT LOCAL PEOPLE SAID

Get to the right people:

“Make sure you get local people that have got ideas and experiences to share. You’ve got to get to people through groups like Gingerbread, to get to people that feel stigmatised.”

Keep the language used in the questions straightforward and clear:

“Some of the questions felt a bit more round about, the questions need to be straightforward.”

About covering the same issues for people that are staying involved:

“It will be inevitable that we’ll cover some of the same ground.”

Always stress that participation is confidential:

“You know we’re a suspicious lot. It’s always good to remind people this is safe and confidential.”

Share more information amongst the group about who is taking part. Make the initial information sheet shorter:

“You should do a short version of the information about the project, like one page, and then you can go back to this for a reminder.”

Take photographs of where we live:

“We should take photos of where we live so we can see the physical changes that are happening.”

Stay positive but allow people to be critical:

“The emphasis is on being positive which is great but local people should be able to make observations which are critical without feeling they are being negative, they’re just useful observations of the reality of the problems we face.”

Remember that life can be difficult:

“Its good you just remember that life is difficult for people, you have worries about your children. But we have talked about this.”

WHAT LOCAL WORKERS SAID

Keep it real:

“You’ve got to continue to make this about human experience, not abstract.”

Share more information amongst the group about who is taking part.

“Maybe you could think about getting people together once the project is established?”

“If you could create opportunities for some people to get together would that make it less abstract?”

Use people who have been involved to recruit others and share achievements form the pilot phase:

“Make sure people see what we’ve done!”

Ensure time and commitment to exploration:

“You need to make sure that workers have the time and that they need to explore things, not just expect answers.”

Encourage more connection amongst participants with the web site.

Keep up the commitment to having a timetable and expecting people to follow it.

Offer more advice on how to approach a question:

“It might be useful for some questions to have a b it more on the prompt sheet that helps you to structure discussion.”

Continue with the posters as a way of reporting back to people.

Represent the less happy feelings and emotions people have in the drawings

Help workers think through the impact of getting involved:

“You need to encourage partnerships where people know each other, or want to get to know each other. I can imagine some people might think it will be difficult to do this and have a worker:client relationship, especially if the local person has personal stuff they might not want to share.”

WHAT LOCAL PEOPLE SAID

Get involved!

“Get involved, why not? It’s given me insight into the way things are. I think a lot of people would be interested.”

The first step is the hardest:

“Once you’ve done the first question you just get involved.”

Be confident:

“Use your own language, tell the story the way you want to tell it. Don’t feel you can’t say what you want.”

Be honest:

“Just be open and honest. Do it with somebody like I have, they can help you spark up different conversations. You never know where it goes.”

Remember it’s about things you know:

“Remember it’s just about everyday issues.”

Work with someone you already know and respect:

“It’s good to do it with someone you know and see anyway.”

It’s important to feel safe with your partner:

“It’s important to feel safe with your local worker. It’s okay to check out and be reassured that what you’re doing is safe, so you need to know your local worker.”

“You need to feel comfortable with your worker, and know them.”  

“It’s okay it won’t pry into your business.”

Give the time, it’s worth it:

“Because I’m interested in my community I’ll make the time and effort. It’s not too time consuming, you should think about doing it.”

“It’ll help you to talk, especially if you’re lonely or someone who doesn’t normally talk.”

“Come along and you’ll enjoy it because you could make a difference.”

What local workers said

Get involved:

“It can be positive for workers, especially if you know the local person, I would say this was important.”

“Get involved. It helps build relationships with your local person.”

It’s straightforward:

“At first I thought it was more complex than it was, maybe I look for complexity, I thought there was something I was missing, but I wasn’t.”

Be realistic about the commitment and put it in the diary:

“Working with one local person is enough, that’s realistic.” 

“Get the dates in your diary, remember it can work within the hour but sometimes it can lead to good conversations.” 

Be conscious about what your partner will get out of it:

“They will enjoy it. Choose a local person you know will get something out of it.” 

Integrate the work into what you do:

“Build it into your existing relationship.”

Remember engagement will bring up a range of issues:

“The questions do evoke other issues, that’s a good thing. The questions aren’t provocative in a negative sense, but they do encourage discussion.” 

Develop your own skills and confidence:

“You do need to remember to talk and record at the same time; you’ll build confidence and skill to do this, to pull people back to the task when you need to.”

Meet in the right place:

“Make sure you meet in a nice relaxing setting, wherever that might be.”

Give feedback:

“It’s okay to feedback to Colin what you think of the question or the prop, including if it isn’t good enough.”

WHAT LOCAL PEOPLE SAID

Impact:

“For me this has always been about more than a survey. They shouldn’t find this in 20 years and say ‘oh, they did that’. It should be used to make a difference now.”

“You need to make something come out of this, not just questions but make something happen.” “We need to know how this will make a difference. People need to know they’re being heard. I know change can be a slow process but I still want to be part of it.”

What local workers said

Promote the work/the site:

“Use local media and in house communications in Council and NHS to promote people’s knowledge of the work.”

Impact:

“Workers need to evidence why giving their time is important. My manager needs to know that there’s some outcome, what outputs there are that will influence my work.”

“It’s good that local people’s views get into the system and influence what’s happening, without them having to go to formal consultation meetings.”

“Think about ways to engage the workers and local people in reflection, over time, about what all the information means and how it can influence services.”

What have we learned from participant’s feedback? What are we committed to do as a result?

  • The tools or props we have used to promote discussion between local people and local workers, along with the posters which report back on the findings from each question, are viewed very positively. We will continue this approach through the 2007 phase.

  • Those local partnerships which have successfully maintained engagement throughout the pilot report that relationships between local person and local worker are enhanced by participation. They report that the process has enhanced mutual understanding and respect. There is also a sense of personal and professional growth or development as a result of engagement. We would like to talk more with participants about the impact of participation through 2007.

  • Local people report that they value the experience of seeing their contributions reflected back in the project posters and site. We will continue our commitment to accurately reflecting the voice of participants through the 2007 phase.

  • However, from the evaluation it is clear that some local people lack confidence about the importance of their views and opinions. We will continue to see the 2007 phase as having a role in ensuring participants understand the value we place on their contributions and will increase efforts to explain what we do with the findings and which agencies they reach.

  • The evaluation has identified that participants have enjoyed the poster feedback but have not engaged enough with the project web site. As project managers we are hoping to promote better engagement with the site in 2007, amongst project participants and beyond. We see this as crucial because the site offers more detail on findings, and, from analysis of the findings, poses key questions to the Regeneration partners about how the findings can impact on what they do. We will return to the importance of impact later.

  • The tone of the project is seen as positive, but we also recognise from comments in the evaluation that there needs to be space for criticism and unhappiness with services or Regeneration activity. We will continue to seek this balance throughout the 2007 work.

  • The evaluation has shown that although positive in tone and intention, sessions can on occasion lead to conversations which are personal and sensitive. In recruiting new people to the study we will discuss with them the importance of their relationship. We will explain that we want their participation to be positive, respectful and honest, but that participants should not feel under any pressure to share what they feel is private. We will talk about these issues in training for workers and in initial meetings with local people and local workers.

  • We very much appreciate the time and commitment given by participants. In order to help with finding the time to take part we will do our best to establish and keep to an agreed timetable for the 2007 phase.

  • The importance of clear, concise, jargon free written instructions with each prompt question was identified and we will commit to maintaining this through 2007.

  • Capturing the views of local people requires both partners to have an understanding of the process and the skills and confidence to use the prompts/props provided as best they can. In 2007 we will continue to provide training for workers and support local partnerships in one to one meetings.

  • We recognise that participation may not be for everyone, and that it is okay for people to withdraw. Where we can we will think through why a local person or worker withdraws form the project and change or improve what we do for others where we can.

  • We have identified from feedback from local workers working with older participants - who can be isolated from wider community services and Regeneration activity - that we need to consider how to meaningfully maintain their involvement. We understand this means seeing the value and importance of reminiscence work but as project facilitators we are also interested in seeing older residents as active participants now, with views on current and future Regeneration activity. We are considering these issues further for the 2007 phase.

  • We have identified from feedback from participants with visual impairments that we need to give further consideration to the tools we use to ensure they can effectively engage with the process. We are building this learning into the 2007 phase.

  • In the pilot phase we worked to ensure anonymity and confidentiality for participants. This will continue. The evaluation has also shown that within the group, participants see value in knowing more about who else is involved. We will provide more opportunities to engage amongst participants in 2007.

  • We recognise that the 2007 phase will need to balance the contributions of both new and continuing participants and we will endeavour to ensure that those continuing with us do not feel that they are covering ‘old ground’.

  • The 2007 phase of the project will continue to try to reach and engage participants who might not otherwise contribute views and experiences through more traditional consultation/participation models.

  • A key area of interest for all participants is the impact which their contributions will make to services and Regeneration activity in the target areas. As facilitators of the project we will seek to support agencies – Fife Council, NHS Fife and their partners in regeneration – to hear and understand the messages from the work. We will also work through 2007 to help these agencies identify and state clearly where and how findings can and are being used. Increasingly, this should form part of the feedback to project participants in 2007.

  • In recruiting new participants for 2007 we will continue to provide good information about what participation entails, and will draw people’s attention to the pilot phase evaluation.