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

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?

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?

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.  

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.