Category Archives: Research Design

Supporting Anticipatory Care and Ageing Well: The Anchor Project

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“In the world of social innovation research it is more pertinent than ever to be attentive to change and adapt accordingly to emerging ideas and practices when presented. This has been the experience of the Social innovation Group and our current work on the ANCHOR project.” – Tom Bailey

The University of Exeter’s Social Innovation group (SIG) has now been working on place-based, person-centred issues within the health and social care sector to promote positive change for over 10 years. The primary focus of this multi-disciplinary research group in recent years has been the HAIRE project: Healthy Ageing through Innovation in Rural Europe, which is funded by the Interreg 2Seas European Regional Development Fund. Through the use of a co-designed Guided Conversation (GC) toolkit, HAIRE aimed to reduce loneliness, isolation and improve general wellbeing in the over 60 age group across rural communities in England, Belgium, France and The Netherlands. In terms of practical objectives, the project aimed to develop and test methods that empower and enable participants to:

  • Define what support is needed;
  • Participate in the design and delivery of services;
  • Develop solutions for the individual to reduce loneliness and improve quality of life, health and wellbeing, supported by the voluntary, private and public sectors.

HAIRE’s approach to achieving these objectives included the HAIRE toolkit, which was developed by the University of Exeter with support and consultation from the project partners in adapting the materials to cater to each location site. The toolkit is person-centred and allows for people to reflect on their own needs, interests, and aspirations in order for individualised care and support to be provided. The GC encourages a wide-ranging informal conversation that takes place between volunteers and participants. With the aid of visual and conversational prompts (see Figure 1), the GC fosters an honest and open dialogue between volunteer and participant to identify how the local area, community and the person themselves influence their wellbeing.

No alt text provided for this image
Figure 1; A place-based visual prompt developed for Carnon Downs, Cornwall.

Due to the success of the HAIRE project across its eight pilot sites in Northern Europe, a new opportunity to use the same methodology in a wider area arose in Cornwall, England. This was named the ANCHOR project: Supporting Anticipatory Care and Ageing Well in Cornwall. This was funded by the NHS Cornwall Partnership Ageing Well/Urgent Care Response Programme Board as well as the Duchy Health Charity and a UKRI ESRC Impact Accelerator Award.

The aim of this project was to design and develop GCs to be implemented across the Coastal Primary Care Network (PCN) to support communities and anticipate undesired health outcomes. The ‘test and learn’ approach of the project was supported by the assumption that the toolkit would fit into existing work practices without adding to health practitioners’ workloads.

However, during the lifetime of the project there have been two significant innovations to service design and delivery in Cornwall which led the team to re-think how best the GC could fulfil the desired anticipatory care outcomes. These innovations were the emergence of the Community Hub model and a pilot scheme involving Community Health Workers (CHWs). These developments are part of the rapidly changing landscape of service design and delivery involving Cornwall’s voluntary sector (which we will deal with in another article). Understanding and adapting to these changes has been an important part of our work in ANCHOR.

While working in a practical capacity with both organisations and individuals to aid in the delivery of anticipatory care within the new innovation pathways we have also worked in a conceptual capacity to understand anticipatory care as both a philosophy and process of care. As a philosophy, anticipatory care speaks to the working assumption that care (provided by individuals, the community or health services) should enable people to maintain good health and wellbeing for longer. However, for those with chronic conditions, an Anticipatory Care Plan is necessary to precisely identify how an individual should be supported to prevent a deterioration in their condition and unwarranted health outcomes.

The ANCHOR project’s original aims – such as improving the management of long-term conditions, reducing loneliness and isolation, improving general wellbeing and reducing the demand on GP surgeries – are still important but can now be considered long term goals to be achieved while working in the emerging ecosystem of care including through Community Hubs and the CHW programme. Data will continue to be collected on these impacts, but the results will likely be published after the lifetime of the project.

The project is now essentially working to build capacity and skills in the sector that both supports the philosophy and process of anticipatory care. The ANCHOR project’s timeline serves to illustrate that flexibility, resilience and persistence required in the voluntary care sector and in research generally in order to succeed.

Article by Tom Bailey, Research Assistant on the Anchor Project

Extending the HAIRE toolkit: Guided Conversations with In The Mix Project

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Over the past couple of months, a small team from the University of Exeter’s Social Innovation Group has been working on adapting HAIRE’s Guided Conversation tool for use in youth work. Two interns, Matilda Ferguson and Lewi Connor, have been involved in this process, and Matilda very kindly agreed to write a blog about it. Read on…

The HAIRE project aims to support older people in rural areas. One of the systems tested by the HAIRE project is Guided Conversations. These take the shape of a semi-structured discussion, prompted by images, general themes and talking points such as the local area, relationships, interests and community. Using the Guided Conversation tool, the HAIRE project has been able to explore the isolated situation of older people in rural areas, and identify their needs and desires. The Guided Conversations became not only part of a study into the rural isolation experienced by older people, but a tool for combatting it.

We have been working alongside In The Mix to explore implementing the Guided Conversations tool into youth work in rural areas. The In The Mix Project (ITMP) is based in the small town of Wiveliscombe, Taunton Deane. However, the charity provides youth and community services across Somerset. ITMP offers informal educational, activities and positive opportunities programmes to provide learning, skills and experiences, which supports young people’s personal, social, emotional and professional development, as well as boosting self-esteem and confidence. Their approach to youth work is flexible and based on issues and values prevalent to young people, their communities and their environment.

Image taken from In the Mix Project website

Working alongside the charity’s project manager John Hellier, we have tailored the prompts and structure of the HAIRE Guided Conversation to fit the focus of ITMP and context of youth work. Our version of the Guided Conversation covers three themes: place-based’, ‘people-centred’ and ‘empowerment’. We have also adapted the tool into a new format: an app. The app shows participants these themes, as well as some sub-topics, image prompts and radars which shows how positively they rate the topics discussed.

We hope that the Guided Conversations will help us to understand the situation of young people living in rural places in terms of the issues and relationships they have with their areas. This research will help youth work in rural areas to be responsive to young people’s needs. As well as this, we hope that like we have found in the HAIRE project, the Guided Conversations themselves will not just be research tools. The discussion provides opportunity for people to open up, share, connect and be heard. This itself will combat isolation and prompt discussion about solutions. The app also provides the opportunity for action through its ‘signposting’ feature, which will allow young people to find existing services to support them.

Over the last week, Lewi and Matilda went up to Exeter to meet with John to try it out. Our practice guided conversation lasted almost three hours and was a great way to understand how the tool would work in practice. After a few adjustments, the app is ready to be tested and we look forward to trying it out at ITMP sessions over the next couple of weeks.

Matilda Ferguson

Image taken from In The Mix Project website

 

 

 

 

Talking Deck to help people with life and health issues

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The Talking Deck is a new resource that has been co-designed by researchers from the University of Exeter, staff and volunteers at CoLab Exeter’s wellbeing hub, people with lived experience of homelessness, and artist Hugh McCann. The project is aligned with Project HAIRE and is based on the Guided Conversation model, showing how the HAIRE toolkit can be customised for different target groups.

The Talking Deck aims to facilitate conversations that are led and shaped by individuals seeking support. Sometimes the purpose of a conversation is simply to allow individuals to share their experiences with staff and volunteers at CoLab Exeter. As seen below, the cards in the deck include a collection of symbols, words and place-based images. They are carefully curated to help people speak about the issues that are important to them.

A variety of Talking Deck cards are in the photo, e.g. a key, a heart, trainers, animals, pictures of Exeter and words such as 'yesterday', 'future' and 'fear'.

Over a series of workshops, staff, volunteers, researchers and people with lived experiences came together to co-design the Talking Deck pack.

“Listening and co-production has been at the heart of this project. We’ve created these together with people from all sectors and walks of life. The cards are a way to facilitate conversations and help people find a way forward without getting to crisis point. People want to be listened to, first and foremost. To be seen and be validated.”  — CoLab Joint CEO Fiona Carden

The project was a partnership between researchers from the University of Exeter (Catherine Leyshon and Shukru Esmene from the Social Innovation Group‘s HAIRE team and Lorraine Hansford from the Wellcome Centre for Cultures and Environments of Health), CoLab Exeter and Devon Mind, funded through HAIRE and an ESRC Impact Accelerator Account (IAA) award. The IAA helped to translate the main principle of HAIRE’s Guided Conversation tool into a resource that suited CoLab Exeter’s working culture and the individuals who use their wellbeing hub. The principle here being the use of meaningfully co-designed visuals to facilitate wellbeing-related conversations.

“Seeing the Guided Conversation transform into the Talking Deck has been an incredibly exciting and rewarding process. Transferring our tools into new settings to help different groups and organisations always depends on successful co-design. We have worked alongside staff from CoLab and people with lived experience to produce something that can genuinely help people to have more in-depth, productive conversations about their needs, aspirations, hopes and fears.” — University of Exeter researcher Professor Catherine Leyshon

CoLab Exeter’s wellbeing hub hosts around 30 voluntary sector and statutory organisations who support people in Exeter with experiences of homelessness, addiction, the criminal justice system, the care system and domestic abuse. Over a series of workshops, staff, volunteers, researchers and people with lived experiences came together to co-design the Talking Deck pack. The packs are currently being trialled by staff and volunteers at CoLab and in other organisations, for example Julian House have experimented with using the Talking Deck in key worker support sessions with young adults in supported accommodation. So far, feedback from users of the Talking Deck has focused on how the cards help facilitate conversations that are led by the individual, rather than the staff member.

“It’s been really exciting to hear people’s reactions to the new cards. Support workers who have tried them out reported back that they were surprised how well such a simple tool opened up conversations, and helped people to talk about things that were important to them that they hadn’t raised before.” — University of Exeter researcher Lorraine Hansford

Workers commented that using the cards had given them more insight into people’s interests and concerns, and ‘opened different doors’ for people to talk about what is important to them, with issues sometimes emerging that would not necessarily come up in standard assessments used by the organisations:

“I was sceptical at first… I was quite surprised at how it was more powerful than I thought.”

“It’s another way of communicating with people, pictures have a connection to memories. For people who are vulnerable, talking can be intimidating, and it can bypass that in a gentle way.”

There is still work to be done, as the project does not intend to be prescriptive about how the resource is used. Ways of using the cards need to consider how some individuals may find engaging with the entire Talking Deck overwhelming and/or feel unsure about where to start. Continued exchanges between organisations that use the cards will be valuable in promoting the flexibility of the resource and in sharing new practices. Importantly, a Mental Health Alliance, including CoLab Exeter and Devon Mind, can potentially provide a platform for practice-led exchanges and skills sharing to take place. The Talking Deck’s launch will engage members of the Mental Health Alliance in scoping the coordination of such a platform.

Overall, the Talking Deck can be used informally in different settings to help guide conversations. The cards predominantly intend to give people choice about the topics that they wish to discuss, whilst helping to start conversations that may be difficult for people to raise.

After collating a last round of feedback, the finalised Talking Deck was launched at an event at CoLab Exeter on 3rd May 2022.

For more information, contact: Professor Catherine Leyshon (c.brace@exeter.ac.uk) or Lorraine Hansford ().

Picture of collaborators from MIND, CoLab and the University of Exeter

Left to Right: Tom Cox (Devon MIND), Fiona Carden (CoLab), Lorraine Hansford and Catherine Leyshon (University of Exeter)

 

 

A systematic review on the impact of social networks on loneliness among older people in rural areas

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As part of the HAIRE project, the University of Plymouth is undertaking a systematic review on the impact of social networks on loneliness among older people living in rural areas. In this month’s blog, Basharat Hussain and Mahrukh Mirza, from the University of Plymouth, explain the process and findings to date.

Healthcare related decisions are critical and therefore need to be based on high quality scientific evidence. The scientific evidence on a topic is generated through individual studies. However, evidence from a single study may not offer confidence to policy makers and practitioners to change an existing practice or adopt a new intervention. This requires an acceptable method to pool all the relevant evidence on a topic and to make the information accessible to busy policy makers and practitioners.

Systematic review is a well-recognised method of identifying, evaluating and summarising evidence from all relevant individual studies, thereby making the available evidence readily accessible to decisionmakers. In a systematic review, all studies published on a topic (in our case, healthy ageing) are searched through online bibliographic databases (e.g., MEDLINE). The online searching of databases is undertaken using a comprehensive, reproducible, and predefined search strategy. This search can result in few hundreds to thousands of studies published on the topic globally or a geographical region of interest (e.g., Europe). The searched studies are screened using strict and narrow inclusion and exclusion criteria. These criteria can consist of research participants (e.g., age over 60 years), setting (e.g., rural areas) and phenomenon of interest (e.g., impact of social network on loneliness). All studies meeting the inclusion criteria are thoroughly read, quality assessed, and their findings synthesised. The final product is a summary of findings on a topic of interest and identification of any gaps for further research in that area.

Image Source: https://libguides.library.curtin.edu.au/systematic-reviews

The review started in January 2022 and will be completed by April 2022. A comprehensive search strategy has been developed to search five main healthcare related databases on the topic. The search has identified over 38,000 published studies on the topic globally, starting from 1954 to January 2022. Screening of the published studies is underway. An interesting finding struck during the screening process is an acute lack of research on social networks and loneliness among older people in rural areas of Europe.

The findings from this review will be helpful not only for the HAIRE project, but also for policy makers, practitioners and researchers who have an interest in the topic. If you are interested in knowing more about this systematic review or would like to have copy once the findings are published, please get in touch with Dr Basharat Hussain, Research Fellow in Health Innovation, University of Plymouth (Basharat.hussain@plymouth.ac.uk), OR Dr Mahrukh Mirza, Lecturer in Clinical Education, University of Plymouth (Mahrukh.mirza@plymouth.ac.uk).

CREATE: New Models of Service Delivery (Spanish Translation)

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One of the aims of HAIRE is to develop new models of service delivery for older people. In April and May of this year, we began our CREATE process, a participatory journey for stakeholders to develop social innovations. We wrote about this here in English and French (courtesy of Valentine Naude, our French intern). The university runs a Masters degree in Translation Studies, and as a result we now have this blog in a third language – Spanish! – thanks to student Amanda Ferguson.

CREATE: Nuevos modelos de prestación de servicios para personas mayores

 Ha sido una primavera fría y recia para todos los miembros de la comunidad HAIRE: el Reino Unido registró la temperatura más baja en abril desde 1922. Sin embargo, hoy brilla el sol y nos sentimos más esperanzados mientras nos preparamos para el verano y la apertura de nuestras comunidades. A finales de abril, los colaboradores de HAIRE habían elaborado los primeros borradores de los informes comunitarios de nuestras zonas piloto, que combinan la información obtenida en las conversaciones guiadas, los planes de acción y el análisis de los barrios. Nuestros colaboradores se preparan ahora para nuestro próximo gran reto: crear conjuntamente una prestación de servicios innovadora en los lugares piloto y fuera de ellos que responda a los retos identificados en sus zonas. Algunos retos son exclusivos de los centros piloto y otros se derivan de problemas comunes en la Europa rural.

A lo largo del mes de mayo, los colaboradores han recogido ideas y se han reunido con sus voluntarios, partes interesadas y comunidades de una manera extraordinaria. Por ejemplo, en East Sussex, los facilitadores de HAIRE han salido a pasear con su comunidad, y este acto de hacer que los voluntarios hablen con los miembros de la comunidad realmente los involucra en el proceso de generación de ideas y hace una aportación poderosa y profunda.

Aprovechando su experiencia en el pilotaje de acciones a nivel local, los colaboradores, las personas mayores, los colaboradores locales, los voluntarios y las agencias se reunirán en junio en un taller conjunto CREATE – Crossborder European Activity Testing Exercise (en español: Ejercicio Transfronterizo de Comprobación de la Actividad Europea) para compartir sus experiencias y apoyarse y asesorarse mutuamente. Los colaboradores se organizarán en Grupos de Aprendizaje en Acción, grupos transfronterizos que quieren trabajar juntos en innovaciones compartidas. El aprendizaje en acción es uno de los métodos que utilizan los programas eficaces para ayudar a los participantes a aplicar el aprendizaje en un grupo de apoyo. Este enfoque anima a los colaboradores a darle sentido desde la propia experiencia y apoya un auténtico intercambio transfronterizo de ideas.

También estamos aprovechando los talleres CREATE de junio para “conocernos” más personalmente. Todas las restricciones por el coronavirus han hecho que no hayamos podido viajar ni reunirnos con nuestros homólogos de los distintos países. La interacción con otros tendrá que esperar un poco más, pero hemos integrado un taller de escritura creativa en las sesiones, en el que veremos poemas sobre el envejecimiento en todos nuestros idiomas, nos escucharemos hablar en nuestras lenguas maternas y escribiremos y compartiremos nuestras propias experiencias personales y culturales sobre el envejecimiento. El ambiente de apoyo mutuo, la experiencia compartida y el aprendizaje cultural proporcionarán otra capa de profundidad y comprensión en nuestro intercambio transfronterizo mientras nos dirigimos hacia un cambio positivo para nuestras personas mayores.

Aquí está uno de nuestros poemas elegidos.

Larga vida, escrita por Elaine Feinstein

Finales de verano. El sol brilla. El eucalipto.
Es una fortuna más allá de cualquier merecedor
estar todavía aquí, sin más preocupaciones que las cotidianas,
ordenando plácidamente versos.
Contemplo un palo de canela
atado con rafia, los pinzones
en la hierba, y un arbusto rechoncho
que este año engendró un limón.
Estos días hablo menos de la muerte
que de los misterios de la supervivencia. Ya no
me siento sola, aún no soy frágil, y
después de la operación, reconozco cada respiración
como un milagro. Puede que mi generación no sea
ágil, pero perdónanos,
nos gustaría aguantar, tercamente
satisfechos – incluso mientras envejecemos.

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.

 

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.  

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.

 

Cross-border cooperation in action: early use of the HAIRE tool in the Netherlands

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This month our research partner Kim Boes of Solidarity University describes the adaptation of the HAIRE tool in the Netherlands in the context of COVID-19.

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. Due to the COVID-19 crisis, SMWO social workers in Goes, a HAIRE pilot site, felt the urgent need to stay in contact with elderly and vulnerable people using our Guided Conversation technique. A vital component of the HAIRE toolkit, the Guided Conversation is a person-centred tool using a variety of different prompts and imagery that allows people to reflect on their own needs, desires, interests and aspirations, so it is ideally suited to getting to the heart of what matters to people at this extraordinary time.

Training in how to use the HAIRE toolkit is planned across the partnership for autumn, but the team decided to move this process forward and let social workers in Goes use the Guided Conversation tool for the contact moments they already had planned with elderly and vulnerable people. An English-language version of the Guided Conversation had been developed with the input of all partners, but it was vital to ensure it was adapted for the current Dutch context, so we worked in close collaboration with the social workers at SMWO, since they know their community best.

By the end of May, we decided to start testing the Guided Conversation. Three social workers from SMWO were going to interview three people each in June. In early July we planned a feedback session to discuss their experiences. We were very pleased with the results. We decided the social workers would continue using the Guided Conversation over the summer since they felt these conversations really support the work they are doing. The social workers felt the Guided Conversation tool helped them get to know the participants’ needs very well, and both interviewer and participant were enthusiastic about using it:

“It was very nice and interesting to do the interviews.” (Social worker)

“It’s amazing how open people are in those conversations. Lovely conversations arise!” (Social worker)

We discussed the social workers’ first experiences and reviewed where things needed to change in the Guided Conversation as well as what aspects should be covered in the autumn training sessions. One important thing to consider further is the dependency relationship between social workers and the participant, meaning that as they get to know each other more, there is a risk that they will worry personally about each other. There is a need to make sure all volunteers have appropriate support and have clear boundaries – this is something that social work organisations have built into their practice, and we will need to ensure the volunteers are protected throughout the HAIRE network as the study moves forward.

Other partners are hoping to start working with Guided Conversations as early as they can. Our Belgian partners in Poperinge and Laakdal expressed their wish to start using the Guided Conversation tool in their communities and asked us to share our experiences with them. We have been knowledge-sharing with them as well as with our lead partner, the University of Exeter. As a result, Poperinge and Laakdal are looking into using our test version, which will need mildly adjusting to the Belgian context. We decided to have another experience-sharing session once they have conducted some Guided Conversations. This is also important for us since their experience could again help us in developing our toolkit.

The conversation is always open between all the partners as we develop and refine HAIRE’s Guided Conversation. The more they are tested and used, the more we discover how to really make the tool work best for the participants. The head start to the programme means that the learning can be incorporated into the Train the Trainers programme planned for September, and the stories of how the Guided Conversation has worked so far will be invaluable for all HAIRE partners. They can feel comfortable going out into the field.

Kim Boes is a researcher at the Solidarity University. She is involved in setting up the pilot sites in The Netherlands and works on developing the HAIRE toolbox together with all partners. Kim is also a PhD researcher at the University of Antwerp, focusing her dissertation on the micro dynamics of social innovation in rural areas.