Guidebook: Guardian Engagement

2012

Welcome to the Guardian Engagement Learning Community!

We are comprised of graduate students at the George Washington University School of Public

Health and Health Services and School of Medicine. We meet to discuss and present public

health topics of interest that are important to guardians and their children at Southeast

Children’s Center and Marie Reed Elementary School. The guardians in these communities care

about their health and the health of their children. They ask great questions and seek accurate,

timely, and helpful information to better support their families. Time spent in these

communities is very valuable, as most of the guardians are single mothers who have low

socioeconomic status. While the communities we serve share similarities, Marie Reed is very

ethnically diverse with a large Hispanic population and Southeast Children’s Fund is mostly

African American. As the Guardian Engagement Learning Community it is our mission to

increase the engagement of parents and guardians in the health of their children.

ii. Background: There were over 70,000 students enrolled in DC public schools

during FY12 and all of these children are required to have a Universal Health

Certificate filled out each year. With the complexity of the US health care system,

this leaves uninsured and underinsured families with difficulties in accessing

quality and timely health care and health information.

iii. Methodology and Results: Weekly planning on presenting relevant health

information to families. Implementation occurs on a monthly basis at each site

or as needed if the timing permits. Implementation usually occurs at meetings

that are already scheduled by the communities for the guardians. The results are

immediately tangible, as parents are usually vocal and provide useful feedback

to our community coaches or directly to us, so we can meet their needs.

iv. Key Recommendations:

• Implementation dates should be scheduled at the start of the year

• Children should be included in the implementation

• Schedule a weekly meeting

• Understand and utilize best methods of communication with sites and coaches

• Projects should be started even if the dates are not decided at the moment

Our service project focused on increasing/ improving…

The following topics… (You can

pick more than one)

Among Which Ages?

Among people who

partially or fully identify as which races/ ethniticies?

Among people who identify with which

immigration status?

Among people operating with what English proficiency?

Knowledge/ Awareness about

Immunizations, Child development, Over the counter

medications, prescription medications, communicating

with healthcare providers, Literacy

Adults/Parents/Guar

dians

White, African American,

Other

N/A

People with Limited English Proficiency (LEP), People who read between a 5th and 8th grade reading level, People who read at a high school

reading level or above

Attitudes/ Beliefs/ Perceptions/ Values about…

Immunizations

Adults/Parents/Guar

dians

White, African American,

Other

N/A

People with Limited English Proficiency (LEP), People who read between a 5th and 8th grade reading level, People who read at a high school

reading level or above

Behaviors/Skills Related to

Over the counter medications, prescription medications,

individualized health plans, Nutrition

Adults/Parents/Guar

dians

White, African American,

Other

N/A

People with Limited English Proficiency (LEP), People who read between a 5th and 8th grade reading level, People who read at a high school

reading level or above

Participation only (did not intentionally focus on knowledge,

attitudes, beliefs, or behaviors)

Exercise (what it is/consists of/how to do it)

Elementary Youth (Ages 5 – 8)

Diverse group

N/A

N/A- unable to tell reading ability from this activity

Participation only (did not

intentionally focus on knowledge, attitudes, beliefs, or behaviors)

Participated in South East Children's Fund Halloween

parade and party

Toddlers-PreK (1-4)

African American, Other

N/A

childern

Among people who identify with which

gender(s)?

Among people who financially live…

Among people who fulfill the following

family role…

Among youth in…

Among people

living with

Among a community

partner site's…

Among Other People not listed here (Optional

Comments)

All Guardians were female by chance

N/A

Mom/Guardian, Single parent

N/A

N/A

Consumers/ Clients/ Patients/ Residents

All Guardians were female by chance

N/A

Mom/Guardian, Single parent

N/A

N/A

Consumers/ Clients/ Patients/ Residents

All Guardians were female by chance

N/A

Mom/Guardian, Single parent

N/A

N/A

Consumers/ Clients/ Patients/ Residents

female, male, maybe other as well

N/A- not disclosed

Child/Student

N/A no other information

provided Elementary School

N/A

students

Fun run

female, male, maybe other as well

People living at or below the poverty line ($23,050 for a

family of 4; +/- $3960/person)

Child/Student

N/A

N/A

Consumers/ Clients/ Patients/ Residents

Halloween Party

Starter Project Details

Instead of starting with the starter project outlined in the binder, we began with meet and greet type events at the South East Children’s Fund and Marie Reed. We began by visiting the SECF site in Anacostia, talking to the coaches (Robert, Hazel and Tanetta), and meeting the children and a couple parents. Most of our communication and feedback for SECF came from Robert. While Robert provided important insights and shared central concerns, it would have been more helpful if we also got direct feedback from parents or the coaches on site. Our initial plan was to create or utilize the listserv to collect demographic data and to communicate with the parents better. We never got to it or had an opportunity to communicate with the parents after a couple meet and greet events. Utilizing the listserv or creating another communication channel would be a great way to reach out to them, provide information, and get feedback. We created handouts for parents, but we were not sure if or how they were distributed.

The most difficult part in implementing projects at SECF was setting up a time and communicating with Hazel and Tanetta. Although we had one meeting at the site in the beginning of the year, Hazel and Tanetta were not present. Either inviting them to the meetings or communicating with them on a regular basis would help with scheduling. One challenge was that they preferred events in the afternoon, while most of us had classes in the afternoon and could only meet in the mornings. It would be extremely helpful to check the calendar in the beginning of the year and book dates early. Even if the parents would not have as much time in the morning, it would be a good idea to hold brief meetings in the morning so we could get started. This can also allow the opportunity to receive feedback and help planning the future implementations.

With Marie Reed Elementary School we were able to be a little bit more actively involved. Again, with that site we began with meet and greet type events. These were tied into events already occurring at the school, specifically, their monthly “Fun Run.” We adapted the initial project by hosting a semi-informal workshop to introduce the binder. While each team member because an expert on one resource in the binder and gave a presentation on it, the presentation created room for guardian feedback. Note that feedback works best by asking specific questions of the audience. Avoid “Do you have any questions?” and replace it with something more specific such as, “What has been your experience with getting your child vaccinated?” A quick note of caution: We spent a lot of time getting set up to do the implementations. Our advice would be to jump in a little bit sooner than 2nd semester.

Lastly, with regard to quality control, the only methods used were a mid-year continuous quality improvement exercise and informal verbal feedback from the coaches and guardians. There was no robust, repeatable survey or feedback mechanism established. It can sound a little bit cheesy, but feedback is an important part of any team process. Through ISCOPES you will be working with both your

specific team, as well as partnering with community sites in teamwork. An idea that would help you guys get started early is to have a feedback sheet at the end of every trip to the site. Regarding your specific ISCOPES team, perhaps take 5 minutes at the end of each meeting to assess what the group is doing well and where it could improve. Don’t feel badly about offering suggestions to improve! As interdisciplinary colleagues, professional honesty about the quality and methods of doing work is valuable feedback to all involved.

To conclude, here is a list of bullet points to summarize the major points. As you begin your starter project and continue throughout the year, please return to this list. It will help you avoid some of the mistakes we made as well as build upon our successes.

1. Establish a protocol for working with your team (monthly meetings, weekly meetings, conference calls, etc.).

2. Set the calendar. Establish specific dates with the site for all activities at the beginning, and then you will have less administrative work for each time you visit.

3. Establish a protocol for feedback with the group and with the site.

4. Jump into the starter project and going to your site soon! Do this within the 1st month of starting ISCOPES. We remember that this can feel daunting, because we are all in school since none of us are experts in the field. Yet remember the wisdom of Dr. Seuss, “Unless someone like you cares a whole awful lot, nothing is going to get better. It's not.” Your care and willingness to be involved in the guardian’s lives means a lot and will allow the team to grow along with the parents.

It took us a very long time before we were actually able to implement at Marie Reed and at the time this document was created, we still hadn’t implemented at Southeast Children’s. Therefore, the impact of our actions has been limited. Furthermore, we didn’t do a formal survey before implementing to establish any sort of baseline information and we didn’t do a formal survey of knowledge after our implementation so we lack any quantitative data relating to the impact of our projects. However, we do have anecdotal evidence that our time spent at Marie Reed was worthwhile. Feedback from parents after our meetings was positive and we did seem to have a lasting effect on their familiarity with health issues and nutrition.

Some tangible outcomes of our projects relate more to recommendations for future work. We learned that it was very beneficial to work with the mental health team at Marie Reed to utilize pre-planned parents’ meetings. We also saw that there is not much continuity in parents that attend those meetings which has a couple of implications for future work: 1) in additional implementations you should not assume that parents present will have received information presented in previous implementations and 2) there is no need to worry about repeating information.

Our learning community worked super well together as a group. We have a few key recommendations to help your team get started and continue the excellent work that ISCOPES puts forth:

1. We found it was critical to meet every week. This way we were on the same page and could constantly re-evaluate our methods in order to figure out what was and was not working. We recommend you set up a weekly meeting time at the beginning of the year.

2. Taking notes in a google doc for all to contribute to and see was an effective way to keep up communication between team members, especially when someone couldn’t make it to a meeting.

3. Always look to Angie and Donna for advice. They are great resources and can assist with team conflict or any other difficulties your team may face.

4. Scheduling with our sites was definitely a challenge. We recommend you set up implementation dates at each site at the start of the year. This will help you to be more organized and ensure accomplishment.

5. Communication with our site was another challenge. We recommend you work out the best modes of communication with your site and coaches at the beginning of the year. Make sure you stay connected throughout the year as well. Invite coaches to your meetings and keep them in the loop.

6. Continue to develop the binders. We found the binders to be very useful and the parents really appreciate them. It would be great to continue to work with the binders and encourage parents to refer to them and keep their children’s health records in them.

7. Be creative. We took ideas from our starter project but really created our own implementation workshops.

8. Find out what is important to your audience and what they want to learn about. After our first implementation (presentation of the binders and going over the inside

materials) we got a lot of questions about nutrition from parents. We therefore, decided to do a nutrition workshop to answer their questions. This will make your implementations easier because your audience will be interested and engaged.

9. A good tactic we discovered when implementing was to - rather than stand in front of the room as if you are lecturing - mix within the crowd, sit down, make people feel more comfortable.

10. A lot of times people will have questions but they are too intimidated to ask in front of everyone. It is important to make time for casual discussion after the implementation. Go up to people afterwards and ask them what they think. Allow time for people to come up to you and ask any additional questions they may have.

Good luck!! ISCOPES is a wonderful learning experience. Make sure to take full advantage of all it has to offer!

Note to ISCOPES Office: Our team felt it was too much to have two different sites. We feel we would have been able to accomplish much more if we had been able to focus on just one site.