One Year On: What Have We Achieved?

A year ago on 10th February, 2020, the fledgling HAIRE team sat down to eat together in a little bistro in Lille to celebrate the launch of the project, Healthy Ageing through Innovation in Rural Europe. It almost seems decadent in retrospect. No-one could have predicted the year that was to follow and the difficulties the world would face in the throes of a global pandemic.

Covid-19 struck at the heart of our target group, exacerbating the very problems HAIRE had been designed to address. Not only was access to health and wellbeing services made more difficult, our already vulnerable target suffered increased loneliness and isolation in many cases. Face to face interviews (HAIRE’s Guided Conversations) could not go ahead as originally planned. As Europe-wide lockdowns took hold, alternative methods to talk to older people had to be found, and fast.

Our first challenge was to secure a remote simultaneous interpretation platform so that we could easily talk to all of our European partners online. Thanks to everyone working together to find solutions, the Guided Conversations – the technique used to establish older people’s needs and desires – were adapted to take place virtually or by telephone according to participant and volunteer comfort. Crucially, they evolved with the unique situation in every locality. HAIRE’s place-based, person-centred approach was (and continues to be) carefully managed at every step of the toolkit adaptation, from content planning to execution. One of the features of the toolkit is the use of a site-specific image to help participants articulate their needs and desires in relation to both interior and exterior spaces. This co-design work involved all partners and brought about a deeper understanding of each others’ localities.

It is a testament to their commitment that throughout 2020 each partner continued to be fully engaged in the project despite Covid-19 obligations in their country. East Sussex County Council and Rother Voluntary Action hosted several online HAIRE-branded community talks for an Ageing Well festival, which other partners attended as well.

The level of every partner’s commitment has not waned even though each partner has had to flex their approach to other HAIRE activities and information gathering, such as the Neighbourhood Analysis and community reports. (These elements of the toolkit establish the extent and nature of individual social networks and connections, and what opportunities, such as activities and services, are available to participants in each community.) There too, partners have helped each other find workarounds and helped problem solve for each other in order to gather the data.

In our most recent partnership meeting, we used Sli.Do to ask partners for one word that describes the work of HAIRE. As the word bubble took shape, three words stood out: Empowering Community Together. So it is perhaps not surprising that, despite Covid-19 lockdowns and limited face to face contact with older people, we have overachieved on Enabler recruitment. Enablers are the volunteers and health professionals who are trained to use the HAIRE toolkit and conduct interviews with older people. We had an original recruitment target of 80 Enablers – and we now have 147, with 115 of them trained so far. And despite delays, we are on track to achieve 600 participants for the Guided Conversations: we have 282 recruited participants, with 126 having already started their conversations.

HAIRE is being designed with future users and sustainability in mind. Partners are already presenting the project to potential future users of the toolkit. In the UK, Devon Mind has introduced HAIRE and the team to CoLab Exeter, a cross-sector, multi-agency co-working hub that is home to some 35 different projects and services that work collaboratively. Other conversations have taken place between Sussex County Council, Rother Voluntary Action and Hastings Borough Council.

Across the 2Seas region, our partners have been talking to local governments’ social services departments; in Belgium, conversations have taken place with the Province of Antwerp and LiCalab (Living and Care Lab). In France, the University of Artois has developed a partnership with 30+ organisations in their area, called ‘Cluster Senior’; our French partners have also connected with the Interreg Project Buurtzorg. Pilot sites in all countries have been in regular contact with their Observer Partners. In total, the HAIRE partnership has engaged over 350 local groups, voluntary groups and a variety of organisations.

The transferability of HAIRE is not just geographic but also crosses sector boundaries to unexpected targets: we are seeing opportunities for its person-centred approach to be applied widely, e.g. tackling homelessness and drug addiction. 2021 and beyond may be a tough road for many communities. We are confident that HAIRE will not only rise to the challenge, but will also offer solutions and tools for communities to thrive beyond this pandemic.

 

What is Social Network Analysis?

The post this month comes from Sebastian Stevens and Rebecca Baines from the University of Plymouth, who have developed the Social Network Analysis component of the HAIRE toolkit.

What is a social network?

The term ‘social network’ is often used to describe online and offline connections between people. For this project, we use the term social network to mean the connections people have with one another in their local community. This could be people you enjoy spending time with, call upon for help and support, or share hobbies with.

What is social network analysis (SNA)?

Social network analysis (SNA) is a method often used in social research to measure, understand and visualise connections between people and organisations. It has many applications including mapping friendships, exploring health advice seeking behaviours and tracing contact patterns during disease outbreaks such as COVID-19.

Why are we interested in social networks?

There is increasing evidence to suggest that the size and make-up of a person’s network plays a vital role in their health and well-being. For example:

“Existing research has demonstrated the significance of social networks in relation to physical and emotional wellbeing” (Heenan: 2011)

However, creating and sustaining these networks in a rural and ageing environment can be particularly difficult:

“Aging adults living in rural communities have less access to and lower utilization of health care services; they rely heavily on available peer and family networks. Although social networks have been linked to positive mental and physical health outcomes, there is a lack of understanding about social networks in rural-dwellings” (Gannon et al: 2016)

Working together to map people’s networks, identifying potential gaps and finding ways to build new connections can therefore be incredibly important in supporting peoples health and wellbeing in a rural setting.

What role does SNA play within the HAIRE toolkit?

As part of the HAIRE toolkit, we have developed a SNA ‘tool’ in collaboration with community members and project partners that will:

  • Empower individual community members to review, reflect and discuss their own social networks and consider ways of growing and/or strengthening their connections with other people
  • Allows community organisations to understand how connected people feel to one another
  • Explore how social networks may differ between settings, countries and cultures.

Combined with the neighbourhood analysis and guided conversation tools, the social network tool will help provide a holistic understanding of an individual’s social connections, loneliness and isolation.

How will we capture the social networks of community members and what will we do with this information?

We will capture peoples networks through a series of short questions. These questions will be asked by a HAIRE enabler during each guided conversation with community members. Responses to these questions may then be used to inform the action plan that is created in partnership between the HAIRE enabler and community member.

In time, community members will be able to see a visualisation of their social network. This visualisation may help individuals to identify and reflect on the strength, gaps and opportunities within their social network.

We look forward to sharing insights about social networks in rural communities across Europe with you all very soon!

Seb and Rebecca work on the HAIRE project in collaboration with project partners and pilot sites. Led by Dr Arunangsu Chatterjee, Associate Professor of Digital Health & Education and Head of Digital Education at the University of Plymouth, Seb and Rebecca are providing academic support to the HAIRE project to help explore and understand the impact of social networks on health and wellbeing. To find out more about their research or The Centre for Health Technology, please click here.  

Kindness and Coronavirus: Building Relationships using HAIRE

This article was first published on the University of Exeter’s Research and Innovation blog on 20th October, 2020. 

HAIRE (Healthy Aging through Innovation in Rural Europe) is an Interreg 2Seas funded project, which commenced on 1st Jan 2020.  The project is a partnership of 14 Local Authorities, academic institutions and voluntary and community service organisations. Partners are located in the United Kingdom (UK), France, Belgium and the Netherlands, and the University of Exeter’s Social Innovation Group (SIG), based at its Penryn Campus, UK, is the project’s lead partner. Overall, the HAIRE partnership is collaborating, co-designing and testing a person-centred, place-based toolkit, recruiting volunteers to join service providers in supporting people over 60 in rural and often isolated communities.

Before Covid-19 hit, there were already global concerns about rising levels of loneliness, particularly among older people, which is what HAIRE was designed to tackle. With increased levels of isolation, fear, local lockdowns and a second wave of the virus well underway in Europe, HAIRE’s plan to harness the power of volunteers and community kindness has become more relevant than ever. The project is all about building connections and relationships so that communities are empowered to make change.

One of our partners, East Sussex County Council, led a series of online talks with the public through September and October as part of a digital Healthy Ageing Festival. These talks provided a platform for people to share their thoughts on aspects of healthy ageing and community action at a time when the awareness of what communities can do is at its height. In all our partner countries, we have seen a significant rise in voluntary, local authority and community action. The HAIRE project’s toolkit has been developing alongside the Covid-19 response in our eight pilot sites, and its use has been started early in some locations because of its relational approach.

Our colleagues in Le Nord, France, telephoned every person over 60 living in their region during the lockdown period to check on their wellbeing and to track their needs. The parish of Feock, Cornwall, UK, saw 150 volunteers come forward to help their fellow villagers. According to the Carnegie Trust, 20% of the UK population were giving between two to four hours a week helping people cope with the pandemic during the emergency phase – going shopping and picking up prescriptions, or talking to older people over the phone so they had some human contact during months of isolation.

The levels of voluntary participation have naturally subsided as people have gone back to work, reverted to old or taken up new responsibilities, but Covid has reminded many of what’s important. We’ve had no difficulties recruiting “HAIRE Enablers” – these are the volunteers who will go out and have Guided Conversations with older people to understand their needs and service desires. Our colleagues in Feock have had a 50% over-recruitment of volunteer HAIRE Enablers, exceeding expectations. East Sussex is also ready to go forward with its brand new team of HAIRE Enablers. As the project relies a great deal on the goodwill of volunteers, this is good news.

Early action was taken in the Netherlands too. During lockdown, social workers were enthusiastic about trying one of HAIRE’s tools, the Guided Conversation, ahead of schedule. The Social Work and Welfare Foundation Eastern Scheldt Region (SMWO) is a broad welfare institution in the Netherlands that provides services in the fields of social work, welfare and sports and exercise. Their social workers went out to talk to people using the Guided Conversation tool predominantly via telephone and, where possible, in person. They felt that doing the conversations strengthened their network in the community and made their position stronger. The project has helped SMWO and the social workers to renew their connections in the community. Their activities have over the years moved away from establishing individual contact to overseeing general service delivery, meaning less interpersonal contact. With the Guided Conversations they renewed relations with individuals and gained new insights into the community. This has been an important impact of HAIRE.

The Guided Conversation’s key strength is that it is a social tool. For example, one of our partners in France, Unis-Cité, works to link younger and older people through a variety of intergenerational programmes. The HAIRE project team has linked up young people with over-60s to begin a social relationship and build trust. This trust will be key in completing Guided Conversations where older adults can openly talk about what is important to them. In order to reach these objectives, the volunteers visit older people who feel lonely every week. They do whatever the elderly participant feels able to: chatting, going out, taking part in “allowed” activities and even meeting new people. They also help elderly people who have difficulties with the internet or their computer – an increasingly important means of connection in Covid times.

Most importantly, HAIRE’s Guided Conversation is not a finished tool – it is evolving, organic, responsive to individuals and their places and uses a variety of techniques to elicit responses. We are learning as we go, but in every instance, nurturing an individual relationship is key to its success. In Laakdal, Belgium, one of our partners tested the Guided Conversation outdoors with two elderly participants who were good friends. With a Duvel in hand (a typical Belgian beer), they were encouraged to talk about themselves. Both participants agreed they learnt things about each other as a result. They reflected on life’s strains during the pandemic. All activities for elderly people have been taken away and the Guided Conversation was “the most fun they’d had in months.” Indeed, the tool itself not only helps to unpick unmet needs and identify potential solutions, it is a means of connection in and of itself – an antidote to the isolation that Covid-19 can bring.

What’s in a Place?

This month we are showcasing our place illustrations, which will be used during Guided Conversations in individual pilot sites during the research…

Depiction of the Parish of Feock, Cornwall, UK

Parish of Feock, Cornwall (UK)

A cow peers over a wooden picket fence close to a Celtic cross, one of the waymarkers in Cornwall that still stands on ancient rights of way. A ship drifts in the sky, which is punctuated with trees and cliffs, farm buildings and a Spar shop. A lone dog walker stands on the quayside, looking out across the water towards the village hall. A village signpost nudges a fairylike stone tower that sits on the edge of a National Trust garden. The Docks, an icon of Falmouth’s modern shipping industry, melds past and present, overlooking the third deepest natural harbour in the world…or is it? Maybe, to you, it’s the ferry chugging across the river; perhaps the fairytale tower brings to mind your local church and community, or the dog walker is actually not on a quayside at all, but in your local park (and just out of sight is the dog walking group you have been longing to join).

The images have all been created to bring to mind local elements in each of our project pilot sites. This image was designed for participants living in the Parish of Feock in Cornwall, which spans several villages. Some depictions, such as specific landmarks, are unmistakable; others are more malleable – in fact, the story changes depending on who is doing the viewing. That’s exactly what we want. These images are able to elicit unique responses that are beyond top of mind thoughts and feelings as participants are asked what it’s like to live in their community. They may trigger ideas and experiences that give a deeper insight into what life is like in the community in which they live – and what might be changed or added to make it better for them as they age.

Image depicting Le Nord

Le Nord (France)

As one resident puts it: “The days of “grey” skies has arrived in the Hauts-de-France region. It may be a bit “challenging” sometimes but it is part of the cycle of nature. And, it’s a beautiful region, especially in the spring…” In this image are the ubiquitous Tabac and La Poste, familiar signage to all inhabitants, with some hints to urban life, such as the Merville town hall and the station at Hazebrouck. The more rural traditions are also visible: the dresses of Flanders, for example, which are well known, and the sight of a Bailleul windmill in the distance, a feature of countryside walks.

Depiction of East Sussex, UK

East Sussex (UK)

Historic landmarks that will be familiar to residents are here: a walker crosses the moat to visit Bodiam Castle; a street sign for Playden, a village first recorded in the 1086 Domesday Book, is at the centre; transport links are evident: the bus and the train station, with links into London, suggest its position out of the city. There is evidence of the water: a playground near Camber Sands, a famous stretch of beach, is alluded to – perhaps an opportunity here to recall trips with children and grandchildren. The oast houses are a familiar sight on the horizon.

Depiction of Laakdal, Belgium

Laakdal (Belgium)

There are four small parishes conjured up in this image: Eindhout, Veerle, Groot-Vorst and Klein Vorst in the municipality of Laakdal, Flanders. Laakdal was named after the valley (dal) of the river Laak. Key landmarks include the old town hall, in the upper left, in Eindhout; the water tower (bottom right) in Veerle; dotted about the image are figurines from the garden of a building housing adults with disabilities. A man leans against a tractor, similar to those found in Groot-Vorst.

Depiction of Goes, Zeeland, in the Netherlands

Goes, Zeeland (The Netherlands)

Goes is a city within the rural municipality, criss-crossed with waterways; you can see a typical boat, train and of course, someone riding their bicycle – in this case, commuting. There is distinctive street art on the sides of buildings, evidence of the new merging with the historic architecture. Many of the graffiti murals include geese as a symbol of the area (Goes is pronounced almost like goose or “ghoosh”, with a distinctively soft ‘g’.) Two towers are included as points of reference; the water tower south of Goes, and the TV tower in the North.

Depiction of Poperinge, Belgium

Poperinge (Belgium)

Last, but not least, residents will recognise the statue of Warme William, the local mascot, seated on a park bench in the town of Poperinge (he is usually blue). He is a symbol of community connection and resilience. Other familiar features of the town include the town hall and the library, (Letterbeek). There are public art installations in the local area; a monument to the Paardenmarkt, the old horse market, is alluded to in the bottom right of the image. The rural life surrounding the town is depicted by the tractor and foliage at the top of the image, and the Vleterbeek is a waterway, with trails along streams and grassy landscapes.

We worked with design company MAP Digital to create unique stimulus materials for each location. The images are supplementary tools in our Guided Conversations to help explore people’s experiences, needs and desires for healthy ageing. The response from participants will help shape the final toolkit (including visual designs) which is due for completion in March 2022.

 

Neighbourhood Analysis: Research in a Tea Garden

The Neighbourhood Analysis is one of the three tools being used in HAIRE to help us understand healthy ageing in rural places. The University of Exeter research team were able to visit a local pilot site in Feock parish and listen to what people had to say.

Feock’s neighbourhood analysis took place outdoors in Linden Hey Garden Tea Room in August. Linden Hey has been an important meeting place for people in the Feock parish, and for that reason might well provide a future site for other activities and meet ups. We were able to safely social distance, with three round tables at which community members were seated.

It’s a beautiful setting, and during the session we were joined by small birds, mostly robins, flying in and out of the garden. In one session, a vole even peeped out at us. We talked about the neighbourhood as we drank tea from red and gold floral china cups and ate lemon drizzle cake made by the owner of the tea garden (there may or may not have been scones with cream and jam. Local tip: jam first in Cornwall!)

Feock’s HAIRE Project Co-ordinator and Administration Assistant, Bex and Esther, put the session together. Bex put a flip chart on the glass windows of the cafe and the analysis began. This is a tool developed by our Dutch partners at Solidarity University and will be used by all the pilot sites in the HAIRE project. It involves the creation of a “rich picture” in words through brainstorming and mapping the neighbourhood. People were asked to talk about:

  • Local people who share knowledge, skills, experiences, offerings and expertise with others in the parish,
  • Physical elements of the community such as community buildings and meeting rooms where activities take place and where people organise gatherings and meetings,
  • Networks in which people can communicate in a less formal manner and the physical places where people can meet to discuss local problems and challenges,
  • Collaborative forms of organisation and local partnerships connecting the community and its members – for example, connections promoting and supporting positive change,
  • Associations, community groups, recreational groups, clubs, tenant organisations, and other services run by institutions, such as schools, health centres, general practitioners and emergency services,
  • Economic connections in the community, including local companies, business leaders and entrepreneurs, such as supermarkets, local shops and tourism related companies,
  • Identifying important places, traditions, and activities that are of cultural meaning to the community, and
  • History and heritage, including places and stories of particular local interest as well as past processes, plans, and efforts in community development.

There are many individuals who support others in the parish of Feock already. The trust and relationships within the community are important to recognise. This exercise helped us gain an understanding into these relationships as well. Questions and comments flowed, and during a break, people asked more questions about the project and chatted about local planning, who was moving into the area and other local issues.

The resources collated during the sessions will be used and and built on during the rest of the project. The information collated will provide a useful starting point to link and support, wherever possible, individuals to activities, groups and organisations they may not have been aware of and identify venues or spaces that may be appropriate for new activities, groups and organisations.

We continue to learn so much about our pilot sites from the communities themselves. It is an integral part of making sure that any innovation, new product or service is relevant, because it will come from the very people it is designed to serve.