Author Archives: Kelly Stevens

CREATE Research Reflection: Caring

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This month’s blog post is a research reflection penned by Shuks Esmene, our doctoral research fellow.

HAIRE’s CREATE workshops (held June 2021) brought together the partnership to discuss our initial ideas for innovations to improve the wellbeing of local older adults in our pilot sites. The research tools being used in HAIRE are a key part of the
project’s learning. Notably, the experiences and ideas of all project partners,
including volunteers and participants, are as important as these tools in
identifying person-centred and place-based actions that are locally relevant.

Our poetry workshop demonstrated that HAIRE’s delivery partners and
research teams have been able to build a comfortable environment for
discussion – even in these challenging times! Memories of older adults that we
hold special connections to, including parents, grandparents, other family
members and friends, filled the session with emotion. One of our partners
simply remarked, “These are not sad tears!”

Some of the poetry about ageing shared at our CREATE session

The remark above related to a late grandparent and sums up how connections to
people that we value go beyond being in their physical presence. Although a
small moment in HAIRE’s activities, reflections from such experiences can help
HAIRE start conversations around embedding care into communities. A deeper
care. Care that surpasses the functional needs of people. These needs are, of
course, extremely important. However, wellbeing is much more than the sum of
someone’s functional needs.

HAIRE’s Guided Conversations showed how valued activities and passions (walking, knitting, reading and going to local markets, to name a few) provided participants with joy and, unfortunately, sadness due to missing these activities and passions during the pandemic. These findings are in no way unique to HAIRE, but they do present the project with opportunities. The close-knit, caring network of people that HAIRE has engaged can help us to think differently about how we can act on these findings. A record of valued activities and passions in an area, and trying to ensure these activities are offered to locals is important, but opportunities to develop new interests and passions can be seen as a way of adding capacity to a place. Variety and extracurricular activities are regarded as a fundamental part of development in children (1).

I often reflect on why we try to find and measure a set of specific activities that show
benefit when adults are considered – rather than addressing how we can best
understand wellbeing priorities at an individual level. As stated during our
discussions about innovation on the second day of our CREATE workshops,
“…being willing to start small” to achieve innovations that stay open to input
from locals can make a difference – particularly if voices and perspectives are
responded to and not lost in bureaucratic processes. As such, digital solutions
are important in improving outreach, but it was encouraging to see ideas
develop around face-to-face activities and “going to people”.

A French Guided Conversation in action

Face-to-face interactions and events that bring people together were certainly
valued in responses to HAIRE’s Guided Conversations. Additionally, even if
revealed through anecdotes, we cannot overlook how local shop owners and
doctors used to be more deeply embedded in rural neighbourhoods. Services
were more face-to-face and such experiences need to be considered when
bringing older adults together.

Importantly, concerns around the participant profiles engaged by HAIRE so far
were raised at CREATE. Outreach that engages and is inclusive of vulnerable and marginalised groups is often referred to as challenging (2). Inclusive
communities ensure that everyone can feel part of where they live and, through
being able to voice and discuss their opinions, individuals can contribute to
shaping the future of a place. How we achieve more inclusive understandings of
wellbeing will be an important challenge for HAIRE and “…being willing to
start small” can benefit the project here too. Research can tend to focus on
numbers and achieving outcomes that are generated by large, so-called
representative groups. However, if we ask critical questions of the differing
perspectives that we have been able to gather through HAIRE’s Guided
Conversation, we can start small. Questions such as: why can someone that has
cared for others and worked hard in a sector that is not economically
generous end up in a financially precarious position in later life?, and, what
can we do to involve someone locally that has not been able to develop and/or
pursue interests due to a turbulent childhood and early adult life?

Finally, the question that stands out for me the most from our CREATE sessions
was: “Why, as a society, are we so rubbish at this?” The answer may lie in re-thinking care, where care is received and given by individuals in communities and not simply a service that aims to meet the functional needs of older adults. Encouragingly, we have examples in HAIRE where this has been achieved – whether it be between the researchers and delivery teams, between the delivery teams and the volunteers and/or between the volunteers and participants. Our next challenge is to find ways to engage the caring people on the project, across all sites, more closely. I look forward to
working on that challenge.

Footnotes

1. Metsäpelto, R., & Pulkkinen, L. (2012). Socioemotional Behavior and School Achievement in Relation to Extracurricular Activity Participation in Middle Childhood. Scandinavian Journal
 Of Educational Research, 56(2), 167-182. doi: 10.1080/00313831.2011.581681

2. Meyer, C., Evans, D., Soucat, A., Dkhimi, F., Akweongo, P., & Kessy, F. et al. (2018). Leaving no one behind? Reaching the informal sector, poor people and marginalised groups with
 Social Health Protection. Journal Of Poverty And Social Justice. doi: 10.1332/175982718x1536143686739

Shukru Esmene, s.esmene@exeter.ac.uk, University of Exeter

What Does a Guided Conversation Look Like?

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A recent article published by the Département du Nord, one of our project partners in France, brings the interview process to life for those new to HAIRE and the Guided Conversation technique. The article appears below in its original language, and is followed by a translation into English by our French intern, Valentine Naude. 

Conversations guidées pour séniors isolés

25 Mai 2021

Le Département participe au projet européen HAIRE qui vise à identifier les besoins et envies des personnes âgées isolées grâce à des conversations guidées. À Arnèke, Jocelyne et Guy Deroo ont pu y participer. Rencontre.

Pour arriver chez Jocelyne et Guy Deroo, mieux vaut avoir un bon GPS. L’ancien corps de ferme qu’ils habitent est situé aux confins du village d’Arnèke, tout au bout d’un long chemin de terre.

Une fois sur place, plus que la cloche un peu fatiguée par les années, c’est “Nounours” qui se charge de prévenir de votre arrivée. L’impressionnant chien de montagne des Pyrénées (65 kg !) est l’un des nombreux animaux à tenir compagnie au couple, très isolé.

Nous sommes ici depuis 20 ans mais nous ne connaissons personne, explique Guy. Nous n’avons presque pas de famille non plus, et au fil des années, les liens se sont distendus. Et puis notre boîte aux lettres est là-bas, au bord de la route, alors je ne vois même pas le facteur. 

Jocelyne, son épouse, souffre d’importants problèmes de santé qui entravent grandement sa mobilité. Coincé dans sa maison isolée au beau milieu de la plaine flamande, le couple ne voit plus que l’auxiliaire de vie qui passe quotidiennement.

Identifier les besoins des séniors isolés

C’est dans le cadre du projet européen HAIRE (Healthy Aging Innovation in Rural Europe) que Jocelyne et Guy ont fait la connaissance d’Isabelle Poiret, évaluatrice médico-sociale au Département.

Le projet, qui s’intitule en français “Vieillir en bonne santé grâce à l’innovation dans l’Europe rurale”, consiste à mener une étude sur la situation d’isolement des personnes âgées. Il est notamment basé sur le principe de la conversation guidée.

La conversation guidée est un entretien semi-directif qui dure généralement entre deux et trois heures. À partir de thématiques larges (la vie personnelle et professionnelle, l’environnement de vie, les centres d’intérêt, etc.) et de quelques images, nous invitons les personnes à nous parler d’elles-mêmes, explique Isabelle Poiret.

Les entretiens sont ensuite retranscrits et analysés par l’université d’Artois, l’un des partenaires français du Département dans le projet HAIRE.  Avec l’aide de l’association Unis-cités, le Département a prévu de mener 150 conversations guidées. Des conversations loin d’être anodines et dans lesquelles, de l’avis même de la professionnelle du Département, il y a un investissement réciproque.

Pour Guy et Jocelyne Deroo, Isabelle Poiret a une vraie qualité d’écoute qui nous a mis en confiance. Le contact est bien passé et après sa venue, on était contents. Ce projet recrée du lien et donne envie de reprendre des activités.

Les deux séniors ne demandent pas grand chose : trouver des gens pour jouer au tarot, réapprendre à jouer aux échecs, aller au musée de Flandre à Cassel, partir quelques jours en Normandie avec leur camping-car, …  Et surtout, ne plus être esseulés.

Beaucoup de séniors se résignent et ne s’autorisent plus à dire “j’ai envie de”. Pourtant, ils ne demandent généralement que de petites choses qui nous semblent anodines mais améliorent vraiment leur quotidien. Isabelle Poiret

 Ce qui ressort le plus, c’est l’envie de sortir et de revoir ses proches. L’autre jour, j’ai juste accompagné une dame jusqu’à sa boite aux lettres : c’était son bonheur de la journée, ajoute-t-elle.

En pleine crise sanitaire, la conversation guidée a dépassé ses objectifs : elle s’est transformée en outil de lutte contre l’isolement. Pour Isabelle Poiret, c’est donc bien plus qu’une étude. C’est une action à part entière et une véritable expérience humaine.

Un rapport intermédiaire a déjà été produit afin que les partenaires puissent commencer à se mobiliser sur le territoire. À partir des envies exprimées par les séniors isolés, deux axes de travail sont envisagés : mieux faire connaître aux personnes âgées ce qui existe déjà pour elles et proposer des solutions innovantes.

Dans six mois, quand je retournerai voir Jocelyne et Guy Deroo, et tous les autres, j’espère bien pouvoir leur proposer des choses !, conclut Isabelle Poiret.

Crédits photo : C. Arnould

English Translation

Guided Conversations for isolated older people

The Département du Nord is part of the European project HAIRE, aiming to identify the needs and desires of isolated older people through Guided Conversations. In Arnèke, Jocelyne and Guy Deroo were able to participate.

If you are on your way to the Deroo’s, you’d better have a good Sat Nav. The old farm buildings they live in stand at the edge of the village of Arnèke, at the very end of a long dirt track.

Once you get there, “Nounours” (“Teddy Bear”) takes it upon himself to warn the couple of your arrival (more so than the bell, a little weathered by time). The imposing Pyrenean Mountain Dog (65 kg!) is one of the many animals that keep them company in their isolation.

“We’ve been here for 20 years now, but we don’t know anyone”, Guy explained. “We barely have any family; the bonds have stretched thin. And our letterbox is all the way over there, by the road, so I don’t even get to see the postman.”

His wife Jocelyne suffers from serious health problems that greatly hinder her mobility. The couple, being stuck in a secluded house in the middle of the Flemish region, only ever see their carer who comes by every day.

Identifying the needs of isolated older people

Jocelyne and Guy met Isabelle Poiret, the Département’s medico-social evaluator, through the European project HAIRE (Healthy Ageing through Innovation in Rural Europe).

The project involves carrying out a study on the isolated situation of older people. It notably makes use of the Guided Conversation tool.

“A Guided Conversation is a semi-structured discussion that generally lasts from two to three hours. Starting off with general themes (personal and professional life, living environment, main interests, etc) and a few images, we encourage people to tell us more about themselves”, explained Isabelle Poiret.

The discussions are then transcribed and analysed by the University of Artois, one of the Département’s French partners within the HAIRE project. With the support of the organisation Unis-cité, the Département is planning on carrying out 150 Guided Conversations. “Far from being trivial”, these conversations show there is “a mutual commitment”, said the Département’s evaluator.

According to Guy and Jocelyne Deroo, “Isabelle Poiret has a great ability to listen which got us to open up to her. There was a real connection there and we were happy after she came to see us. This project is creating bonds and is making us want to pick up activities.”

Caption: Guy Deroo and Isabelle Poiret, the Département’s medico-social evaluator, discussing in front of the farm. “Nounours” never strays far from his owner.

The two older people are not asking for much: finding people to play tarot with, learning how to play chess again, going to the Flandre museum in Cassel, going to Normandy in their camper van for a few days… But mostly, not to be lonely anymore.

“Many older people resign themselves to this and don’t allow themselves to say “I want to”. And yet, they usually only ask for small things that seem trivial to us but truly improve their everyday life.” Isabelle Poiret

“What stands out the most is the desire to go outside and see their loved ones again. The other day, all I did was walk an old lady to her letterbox, and it was the highlight of her day”, she added.

During this health crisis, the Guided Conversations have exceeded their objectives, changing into a tool for combatting isolation. Therefore, for Isabelle Poiret, this is way more than a study. “This is a fully-fledged action and a real human experience.”

An initial report has already been drafted so our partners can start going into action on the field. From the desires expressed by isolated older people, two areas of work are being considered: helping older people know what already exists, and offering innovating solutions.

“Six months from now, when I come back to see Jocelyne and Guy Deroo and all the others, I sure hope that I’ll be able to offer new things!” concluded Isabelle Poiret.

Photo credit: C. Arnould

Q-Sorting: A Participatory Method for Innovation Development

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In preparation for the CREATE phase of our project – the cross border development of social innovations for older people – our Research Fellow, Shuks Esmene, produced some guidance for partners around alternative methods of approaching idea generation and prioritisation. Below is an explanation of how the Q-Sort approach can be used and adapted in relation to HAIRE and its tools.

An adapted Q-Sort

The Q-Sort approach is part of a larger methodology (Q-Methodology1). Q-Sorts involve participants arranging a set of statements into a grid based on how much they agree and disagree with the statements. Therefore, the approach is more suited for situations where stakeholders can be presented with a set of statements. This approach may be useful for collating stakeholder opinions on what types of innovations would benefit the local area the most.

Note: If you wish to engage stakeholders in a more ‘open’ activity to generate ideas, a different spotlight method (to be released in the coming weeks) may be more appropriate.

i. The participants

Traditionally, individuals carry out Q-Sorts. However, for HAIRE, it may be more appropriate to arrange small groups (around 4 people in each group) to take part in and agree on a Q-Sort. For consistency, you may choose to group stakeholders with common characteristics or those that are working in a similar field to carry out Q-Sorts together.

ii. The statements

Q-Sorts are usually carried out using around 20 to 60 statements. Based on HAIRE’s timeframes and the highly likely remote delivery of the CREATE sessions, it may be best to lead a Q-Sort with around 15-20 statements!

The statements should be easy to understand and, where possible, structured similarly. We recommend using no more than two sentences per statement. See below the examples from our imaginary pilot site, HAIREbridge:

 

The statements chosen for a Q-Sort can be led by the findings of a pilot site’s draft Community Report (these were released at the end of April 2021). However, feasibility is important, e.g., if it is unlikely that you will be able to implement a transport-related innovation / change, we recommend that a transport-related statement is not included for your Q-Sort.

iii. The grid

The grid that is used to help participants sort the statements they are presented with is usually structured as shown below:

The grid shown above may be adapted to reflect the number of statements that are presented to the participants. However, the ‘bell-shaped’ structure (i.e., where there are fewer options at the extremes of the grid compared to the middle) is important. This structure enables participants to make a judgement call (usually through discussion) as to which statements they agree and disagree with the most.

Generally, statements grouped in the categories ranging from -4 to -2 in the example show above are classed as ‘disagree’. The statements placed under -1, 0 and 1 are classed as neutral, and the statements placed under 2, 3 and 4 are classed as ‘agree’. Once more, this is not a strict rule. You may wish to adapt the numbering in your grid to make the Q-Sort easier to conduct with the specific stakeholders you wish to engage.

Note: The section at the bottom right of the image included above, listing the ‘Agree’, ‘Neutral’ and ‘Disagree’ classifications, is used to collate the statement numbers that were assigned to the respective classifications. Remember to label / number the statements you present to participants clearly!

iv. Remote delivery

A remote delivery adaptation of a Q-sort can be relatively easy to implement. A facilitator can run a Q-sort with a small group (up to 4 participants) in a break-out session. A Q-sort grid can be shared on screen and statements (referred to by their numbers) can be collectively assigned to the appropriate places on the grid through discussion. The facilitator can write the relevant statement numbers into the relevant squares of the grid as the participants agree on their position. In such a circumstance, the statements can be sent to participants prior to the session.

1 Further Notes

The Q-Sort approach is part of a larger method known as Q-Methodology. The full method involves collating all scoring grids compiled by all participants. A statistical analysis of the results is then conducted to generate a ‘best-fit’ grid for groups of participants that share certain characteristics. Further, the full method dictates that individual participants produce their own scoring grids.

Given the purpose and timeframes of HAIRE, using only the Q-Sort component of the method can help facilitate group discussions and still generate an understanding of what types of innovations would be most valued in a pilot site. Overall, we hope to build CREATE approaches that are best suited to each pilot site. Each pilot site may choose to use a combination of different participatory tasks in their CREATE activities.

CREATE: New Models of Service Delivery for Older People

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(This blog is written in English and French – please scroll to the end for the French language version.)

It’s been a cold and reluctant spring for us all in the HAIRE community: the UK saw the lowest April temperature since 1922. The sun is shining today, however, and we are feeling more hopeful as we get ready for summer and the opening up of our communities. By the end of April, HAIRE partners had compiled the initial Community Report drafts for our pilot areas, which combines information gleaned from Guided Conversations, Action Plans and Neighbourhood Analysis. Our partners are now preparing for our next major challenge: co-creating innovative service delivery in the pilot sites and beyond that respond to the challenges identified in their areas. Some challenges are unique to the pilot sites and some stem from issues that are commonplace in rural Europe.

For the past several weeks, the University of Exeter has been hosting drop-in Teams sessions for all partners to discuss progress and to share participatory methods for innovation and idea generation. We’ve looked at such techniques as mind-mapping and Q-sorting. We’ve discussed key practical considerations, such as tailoring sessions to different audiences and sizes and making sure all the exercises are inclusive. Our colleague Femke Verthé at iDROPS – a Belgian organisation skilled in social innovation development – led sessions on Human Centred Design Thinking, a participatory tool for inspiration, ideation, focusing and prototyping.

Throughout May, partners have been gathering ideas and meeting with their volunteers, stakeholders and communities in unique ways. For example, in East Sussex, the HAIRE enablers have been going on walks with their community, and this act of getting volunteers to talk to the community members really engages them in the idea generation process and makes for powerful, insightful input.

Drawing on their experience of piloting actions locally, the partners, older people, local partners, volunteers and agencies will come together in June in a joint CREATE workshop (Crossborder European Activity Testing Exercise) to share their experiences and support and mentor each other. Partners will organise themselves into Action Learning Sets, cross-border groups that want to work on shared innovations together. Action Learning is one of the methods effective programmes use to help participants apply learning in a support group. This approach encourages partners to make meaning from direct experience and supports genuine cross-border idea exchange.

We are also taking the time during the June CREATE workshops to “get to know each other” more personally. All the Covid restrictions have meant we haven’t been able to travel or meet with our counterparts in different countries. The socialising will have to wait a little longer, but we’ve integrated a creative writing workshop into the sessions, in which we’ll look at poems about ageing in all our languages, listen to each other speak in our native tongues, and write and share our own personal and cultural experiences of ageing. The atmosphere of mutual support, shared experience and cultural learning will provide another layer of depth and understanding in our cross-border exchange as we drive towards positive change for our older people.

Here’s one of our chosen poems.

Long Life, by Elaine Feinstein

Late Summer. Sunshine. The eucalyptus tree.
It is a fortune beyond any deserving
to be still here, with no more than everyday worries,
placidly arranging lines of poetry.

I consider a stick of cinammon
bound in raffia, finches
in the grass, and a stubby bush
which this year mothered a lemon.

These days I speak less of death
than the mysteries of survival. I am
no longer lonely, not yet frail, and
after surgery, recognise each breath

as a miracle. My generation may not be
nimble but, forgive us,
we’d like to hold on, stubbornly
content – even while ageing.

French Translation follows:

Ce fut un printemps frileux pour la communauté HAIRE, le Royaume-Uni ayant connu ses températures les plus basses depuis 1922 pour un mois d’avril. Aujourd’hui cependant, le soleil brille, et l’optimisme est lui aussi au rendez-vous alors que nous nous préparons en vue de l’été et de la réouverture de nos communautés. D’ici la fin du mois d’avril, les partenaires du projet HAIRE auront compilé les versions préliminaires des premiers rapports communautaires de nos sites pilotes, qui cumulent les informations récoltées lors des Conversations Guidées, des Plans d’Actions et des Analyses de Voisinage. Nos partenaires se préparent désormais à affronter notre prochain grand défi : non seulement cocréer une prestation des services innovante au sein de chaque site pilote, mais aussi résoudre les problèmes qu’ils ont distingués dans leur région respective. Certains problèmes sont propres à leur site pilote tandis que d’autres découlent de problèmes répandus en Europe rurale.

Ces dernières semaines, l’Université d’Exeter a animé des séances de discussion ouvertes sur Microsoft Teams, afin que tous les partenaires puissent discuter de l’avancée du projet et partager des méthodes participatives d’innovation et de conception de nouvelles idées. Nous avons testé des techniques comme la carte heuristique ou le Q-sort. Nous avons débattu de sujets clefs d’ordre pratique, par exemple comment adapter les séances à des publics différents et des groupes de tailles différentes, et comment s’assurer que tous les exercices sont inclusifs. Notre collègue Femke Verthé, de la société belge iDROPS – spécialisée dans le développement de l’innovation sociale –, a animé des séances sur le Design Centré sur l’Humain, un outil participatif d’inspiration, d’idéation, de concentration et de prototypage.

Au cours du mois de mai, nos partenaires ont recueilli les idées des uns et des autres et ont rencontré bénévoles, intervenants et communautés par le biais de méthodes uniques. Par exemple, dans le Sussex de l’Est, les Aidants HAIRE font régulièrement des promenades avec les membres de leur communauté. Cette démarche d’échange entre les bénévoles et la communauté les implique réellement dans le processus de conception de nouvelles idées, apportant au projet une contribution percutante et instructive.

Mettant à profit leur expérience pour mener des actions à l’échelle locale, les partenaires, les personnes âgées, les partenaires locaux, les bénévoles et les organismes se réuniront en juin lors d’un atelier CREATE (« Crossborder European Activity Testing Exercise ») commun, afin de partager leurs expériences ainsi que se soutenir et se guider mutuellement. Les partenaires se répartiront dans des « Sets de formation-action », des groupes transnationaux désirant travailler ensemble sur des innovations communes. La formation-action est l’une des méthodes que les programmes efficaces utilisent pour aider les participants à appliquer les notions apprises dans un groupe de soutien. Cette approche encourage les partenaires à trouver du sens dans leurs expériences directes et promeut un véritable échange d’idées à travers les frontières.

Pendant les ateliers CREATE de juin, nous prenons également le temps « d’apprendre à se connaître » de façon plus personnelle. Toutes les restrictions relatives au COVID19 nous ont empêchés de voyager ou de rencontrer nos homologues d’autres pays. Le retour de la vie sociale devra attendre encore un peu, mais nous avons mis en place un atelier de création littéraire parmi les différentes sessions. Cet atelier nous donnera l’occasion de découvrir des poèmes sur le vieillissement dans toutes nos langues, d’écouter les uns et les autres parler dans leur langue maternelle, et d’écrire et de partager notre propre expérience personnelle et culturelle du vieillissement. Cette atmosphère de soutien mutuel, de partage d’expérience et d’apprentissage culturel apportera une nouvelle dimension de profondeur et de compréhension à notre échange transnational, alors que nous avançons vers un changement positif pour nos personnes âgées.

Voici l’un des poèmes que nous avons choisis:

Longue vie, par Elaine Feinstein

 

Fin d’été. Soleil. L’eucalyptus.

C’est une chance que nul ne mérite

d’être encore ici, avec des soucis de tous les jours et rien de plus,

à placidement accorder des vers de poésie.

 

J’examine un bâton de cannelle

enroulé de raphia, des pinsons

sur l’herbe, et le buisson râblé

qui cette année a donné naissance à un citron.

 

Ces temps-ci je parle moins de la mort

que des mystères de la survie. Je ne suis

plus seul, pas encore chétif, et

depuis l’opération, je réalise que chaque souffle

 

Est un miracle. Ma génération n’est peut-être pas

preste mais, pardonnez-nous,

nous voulons tenir bon, obstinément

satisfaits – même en vieillissant.

 

Senior Cluster University

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This month’s blog comes from our HAIRE colleagues at the University of Artois, who have innovated a new research institute dedicated to the study of healthy ageing.

Thanks to Julie Varlet at the University of Artois for this contribution to our team blog, and thanks to our intrepid intern Valentine for the excellent translation (which you will find if you scroll down.) Contact details for the team at the University of Artois are included at the end of the English translation. 

Permettre aux personnes âgées de rester à domicile tout en favorisant le lien social est un défi pour notre société et nécessite une gamme de services adaptés et un savoir-faire innovant. L’université d’Artois, entend y contribuer grâce au Cluster Senior University, un institut de formation et de recherche, dont la formation « Management Sectoriel – Parcours Cadres de direction des établissements du secteur social et médico-social ».

La formation se donne pour objectif de former les futurs directeurs et cadres de direction du secteur social et médico-social en assurant une montée en compétences et en qualification dans un secteur qui ne cesse d’évoluer. Elle vise à assurer une prise en charge de qualité des publics vulnérables. L’objectif de la formation est de former les professionnels de demain capables de répondre aux nouveaux besoins et aux nouvelles attentes des seniors. L’enjeu de la recherche est de permettre des innovations au service de la qualité de vie des seniors. Cependant, avant d’entreprendre toutes actions visant à favoriser leur maintien à domicile tout en luttant contre leur isolement en milieu rural, il était nécessaire de comprendre l’environnement dans lequel ces personnes évoluaient. Ce fut le challenge pour l’année 2021 pour les 22 étudiants issus du Master 1 « Management sectoriel ». Ceux-ci ont travaillé en collaboration avec les partenaires des Flandres Intérieures afin de produire un diagnostic démographique, de l’accessibilité et des services du territoire par le biais de la boite à outils HAIRE. Tout l’enjeu de ce travail repose maintenant sur les actions à mettre en œuvre afin de lutter contre cet isolement rural en Flandre Intérieure.

Favoriser le maintien des personnes âgées au domicile tout en étant en mesure de répondre aux besoins des publics fragiles et dépendants constituera d’ailleurs leur problématique future. Ce pourquoi les étudiants du Master étudient actuellement une gamme d’innovation sociale, en rupture par rapport à l’existant ou se basant sur une solution existante pour significativement l’améliorer. Ces nouvelles solutions, intégrant les besoins repérés dans le discours des personnes âgées, seront proposées aux partenaires français lors des ateliers CREATE, voués à la conception d’innovations locales.

____________________________________________________________________

The Senior Cluster University: a training and research institute

Enabling older people to stay at home while strengthening their social connections constitutes a major challenge for our society, one that requires an array of tailor-made services and innovative skills. The University of Artois figured out a way to rise to the task: we created The Senior Cluster University, a training and research institute that offers the training programme ‘Leadership and Management Course in Health and Social Care’.

This course aims to:

  • train future directors and executives in Health and Social Care by improving their skills and qualifications in a sector that is constantly evolving.
  • ensure that vulnerable groups are properly taken care of.
  • train future professionals so they can tend to the ever-evolving needs and desires of older people.
  • foster innovation for the benefit of the quality of life of older people.

However, before we could undertake actions to combat isolation in rural areas and enable older people to stay at home, it was essential that we first gained a better understanding of the environment these people lived in. This is precisely what the 22 students who completed their ‘Master 1: Leadership and Management’ aimed for in 2021. They worked alongside partners in the Flandres Intérieures [area in the Hauts-de-France region] to make a ‘demographic diagnosis’ of the accessibility and services particular to each locality using the HAIRE toolkit. The study’s significance and practical utility will be brought to bear through the initiatives that are to be put in place to combat rural isolation in Flandre Intérieure.

The next challenge will be to enable older people to stay in their own homes, and to tend to the needs of vulnerable and dependent groups. The Masters students are therefore studying a wide range of innovative social initiatives; some of them are a clean break from existing solutions, while others are based on existing solutions with the aim of improving them significantly. These new solutions, which take into account the needs that older people have expressed in conversation, will be brought forward to the French partners during the “CREATE workshops”, which are all about ideating local innovations.

 

For further information, please contact:

Julie Varlet, Post-doctorante  06 37 62 59 96

Cécile Carra, Professeure des universités, responsable scientifique 

 

 

 

Un an plus tard : Qu’avons-nous accompli ?

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The HAIRE team at Exeter is pleased to have an MA Translation Studies intern, Valentine Naude, on board for a few months. This is the first of our dual language blogs. Welcome, Valentine!

Il y a un an de cela, le 10 février 2020, une toute nouvelle équipe s’est réunie autour d’un repas dans un petit bistrot de Lille pour célébrer le lancement du projet HAIRE, « bien vieillir grâce à l’innovation en Europe rurale » [en anglais « Healthy Aging through Innovation in Rural Europe »]. Voilà qui semble presque décadent, désormais : personne n’aurait pu prédire l’année qui suivrait et les difficultés que nous rencontrerions tous dans les affres d’une pandémie mondiale.

Le Covid-19 a beaucoup affecté notre groupe cible, exacerbant les problèmes que le projet HAIRE était précisément destiné à résoudre. Non seulement l’accès aux soins (santé et bien-être) est devenu plus difficile, mais notre groupe cible, déjà vulnérable, a encore plus souffert de la solitude et de l’isolation dans bien des cas. Les entretiens en face à face (les « Conversations Guidées » du projet HAIRE) n’ont pas pu se dérouler comme prévu. Alors que toute l’Europe s’est confinée, il a fallu trouver en toute urgence des solutions alternatives pour communiquer avec les personnes âgées.

Le premier défi a été de mettre en place une plateforme d’interprétation simultanée à distance, afin de faciliter la communication virtuelle avec nos partenaires européens. Grâce à nos efforts communs, nous avons pu adapter les Conversations Guidées – l’outil qui nous permet d’identifier les besoins et les désirs des personnes âgées – pour qu’elles soient menées en ligne ou par téléphone, selon les préférences du participant et du bénévole. Elles ont aussi et surtout évolué en fonction de la situation propre à chaque localité. Adaptée au milieu et axée sur la personne, l’approche adoptée par le projet HAIRE a été (et continue d’être) modulée avec soin à chaque étape d’adaptation de la « boîte à outils », depuis la planification du contenu jusqu’à son exécution. Une des caractéristiques de la boîte à outils consiste à utiliser une image propre à la localité du participant, de façon à l’aider à formuler ses besoins et ses désirs vis-à-vis d’espaces autant intérieurs qu’extérieurs. Tous les partenaires du projet ont contribué à ce travail de cocréation et ont été amenés à mieux connaître les localités de chacun.

Rien ne témoigne plus de leur engagement que l’implication indéfectible dont ils ont tous fait preuve au cours de l’année 2020 en dépit des restrictions relatives au Covid-19 dans leurs pays respectifs. A l’occasion d’un « Festival Bien Vieillir » [en anglais « Ageing Well Festival »], le conseil général du Sussex de l’Est et Rother Voluntary Action [organisme bénévole de la même région] ont animé de multiples dialogues communautaires en ligne pour le projet HAIRE, auxquels d’autres partenaires ont également assisté.

Tous nos partenaires n’ont cessé de donner d’eux-mêmes, et ce malgré la nécessité d’adapter leur approche aux autres actions entreprises par le projet HAIRE et aux collectes de données, par exemple « l’Analyse du Quartier » et les rapports des collectivités. (Ces composants de la boîte à outils permettent de mesurer et d’identifier le réseau social et les connexions de chaque individu, ainsi que de déterminer les opportunités – par exemple les activités ou les services – auxquelles les participants ont accès dans chaque communauté.) Là encore, les partenaires se sont entraidés pour trouver des solutions alternatives et résoudre mutuellement les problèmes intervenus dans la collecte des données.

Lors de notre dernière réunion entre partenaires, nous avons demandé à chacun de décrire le travail réalisé par le projet HAIRE en un mot, par le biais de l’application web Slido. La bulle de mots a peu à peu pris forme et trois mots se sont démarqués : Autonomiser [en anglais « empowering »] Communauté Ensemble. A la lumière de cela, on ne s’étonnera pas de voir que nous avons dépassé notre objectif de recrutement d’Aidants en dépit des confinements et d’un contact présentiel limité avec les personnes âgées. Les Aidants sont les bénévoles et les professionnels de la santé qui ont été formés pour utiliser la boite à outils du projet HAIRE et diriger des entretiens avec les personnes âgées. Au départ, notre objectif de recrutement était de 80 Aidants ; nous en avons maintenant 147, dont 115 qui ont reçu leur formation. Bien que nous ayons été retardés, nous sommes en voie d’atteindre un total de 600 participants aux Conversations Guidées : nous avons recruté 282 participants parmi lesquels 126 ont déjà commencé leurs conversations.

Dans sa conception, le projet HAIRE prend en compte ses futurs utilisateurs ainsi que le souci de la durabilité. Nos partenaires sont déjà en train de présenter le projet à de potentiels futurs utilisateurs de la boite à outils. Au Royaume-Uni, Devon Mind [association caritative axée sur la santé mentale] a présenté le projet HAIRE et son équipe à CoLab Exeter, un centre de cotravail intersectoriel et pluri-institutions sous le toit duquel environ 35 différents projets et services travaillent ensemble. Des échanges ont également eu lieu entre le conseil général du Sussex, Rother Voluntary Action et le conseil d’arrondissement de Hastings. D’un bout à l’autre de la région des 2Mers, nos partenaires sont en conversation avec les services sociaux des autorités locales ; en Belgique, des échanges ont eu lieu avec la Province d’Anvers et LiCalab (« Living and Care Lab »). En France, l’Université d’Artois a mis en place un partenariat – baptisé le « Cluster Senior » – entre plus de 30 organismes de la région; nos partenaires français se sont aussi associés au projet Interreg TICC, dirigé par Buurtzorg. Dans tous les pays, les sites pilotes maintiennent un contact régulier avec leur partenaire observateur. Au total, plus de 350 groupes locaux, groupes de bénévoles et une grande variété d’organismes ont contribué au partenariat HAIRE.

La transférabilité du projet HAIRE n’est pas seulement géographique, mais franchit aussi les frontières de multiples secteurs jusqu’à toucher des cibles inattendues. En effet, nous estimons que notre approche axée sur la personne pourrait être appliquée de manière plus large, par exemple pour résoudre le problème des sans-abris ou de l’addiction à la drogue. Pour de nombreuses communautés, il se pourrait que l’année 2021 et les suivantes représentent un chemin parsemé d’embuches. Nous ne doutons pas que le projet HAIRE relèvera le défi, et, loin de se contenter de cela, qu’il remettra à ces communautés les solutions et les outils qui leur permettront de s’épanouir au-delà de la pandémie.

One Year On: What Have We Achieved?

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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 TICC, led by 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?

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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

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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?

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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.