Home Visiting in Tribal Communities: Using the OPRE Review One Sky Center R. Dale Walker, MD Douglas A. Bigelow, PhD 19 February 2011.

Home Visiting in Tribal Communities: Home Visiting in Tribal Communities: Using the OPRE ReviewUsing the OPRE Review

One Sky CenterR. Dale Walker, MD

Douglas A. Bigelow, PhD19 February 2011

Outline

• Frameworks for use in planning

• Logic model details

• Cultural appropriateness criteria

• Intervention details

• Creating, operating a planning coalition

04/20/23 2Using the OPRE Review

Developing a Community-Driven Best Practice

Goal: An Goal: An evidence-informedevidence-informed, , community-drivencommunity-driven program program

1. Community Assessment & Planning Process:

2.2. CulturalCultural Validity

3. Evidence-informed program design

CoalitionCoalition

CriteriaCriteria

Logic ModelLogic Model

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Best Practice includes Culture


Practice Practice (Service)(Service)

CultureCulturePhilosophies

Belief about causes of problems and solutions

Local innovation, trial and error

Medicinal use of wild plants and minerals

Healing procedures

Oral transmission of knowledge

Community evaluation and acceptance

Best PracticeBest Practice

Science & Science & ScholarshipScholarship








Logic ModelLogic Model


4. Theory of Change

5. Operations Manual

3. Strategy

8. Long term (Impact)

7. Medium term

6. Short term

1. Causes

Problem

• Injury

• Lack of development

• Not ready for school

Causes

• Parenting role performance

• Family strength/dysfunction

• External factors


1. Causes Goals

Parent• Delivery (birth)• Parenting knowledge

– (of child development)

• Parenting skills• Non-abuse• Non-neglect

Child• Cognitive & emotional

development• Health• School readiness• (ameliorated

developmental delays, if any)


2. Target Population

• Kids are the TP

• Abused kids

• Neglected kids

• Developmental deficiency (re school)

– Physical– Cognitive– Emotional


3. Intervention Strategy

• In home (“place-based”)

• Trained Peer-parents• Professional staff – (RNs; MSWs)

• Links to resources– Navigate and access

• Parent needs– Counseling– Problem-solving– Access to resources

• Income; education; employment; treatment

• Context-specific needs– Culture– Family dynamics– Employment– Neighborhood


3. Strategy: Visits

• Content (visit)

• Frequency/intensity– One per week

• Duration– 3 months to 2 years


4. Theory of Change

• Place-based

• Staff characteristics

• Local context and culture


Intervention: Criteria for CulturalCultural Validity

• Longevity• Teachings (based on)• Values (based on; incorporated)• Principles (based on; incorporated)• Elder’s approval• Community feedback/evaluation/acceptance• Contribution to advancement of the people

Using the OPRE Review 1904/20/23

Intervention: ActivitiesActivities

• Experience, observation, listening, participating

• Traditions, ceremonies, daily observances

• Stories, songs, artwork

• Oral, modeling, practice, animation

• Language, worldview, teachings, experience

Using the OPRE Review 2004/20/23

Intervention: MaterialsMaterials

• Settings

• Dress; Regalia

• Symbols; Graphics; Pictures

• Sensory Substances

• FoodFood

• FunFun


Intervention:PersonnelPersonnel

• Enthusiasm

• Confidence

• Caring, compassion

• Vision, knowledge

• Charisma

• Credibility

• Community statusCommunity status

• Peer group statusPeer group status


5. Program Manual

• Intervention activities

• Materials

• Personnel characteristics

• Training and supervision

• Detailed procedures

• Process milestones

• Short-term outcomes

• Long-term outcomes


6. Short-term Outcomes

• Parents’ knowledge

• Parents’ attitudes (incl. bonding)

• Parents’ skills/performance

• Child health


7. Medium-term Outcomes

• Child development

• Child school readiness

• Child school performance

• Child health and thriving

• Family strength and function


8. Long-term Outcomes

• Parental health and thriving• School enrollment, retention, achievement,

and graduation rates

• Non-delinquency

• Child-as-adult Employment


Create a Coalition

Agreed-upon goalsVision & mission statements Action plan Structure for the coalition Identify need for specialists Resources

(coalition ideas from the University of Kansas Community Tool Box http://ctb.ku.edu)


http://ctb.ku.edu/

Coalition Rules

Open communication Inclusive & participatory Constant networking Achievable goalsCreative meetings Keep promisesAcknowledge and use the diversity of the

group


Coalition Train leaders in all sectors that have the vision, commitment, and respect necessary to lead a

collaborative. Identify a facilitator to bring the different groups together. Find the information necessary to understand issues and possible solutions. Promote community empowerment. Identify the stakeholders. Make a commitment to collaborate. Establish procedural ground rules. Teach potential participants process skills. Build trust, learned process skills, and explored beliefs. Identify problems. Clarify a vision and develop a mission statement. Keep the process open and get input from community members. Create options for solving problems. Formulate goals, objectives, and an action plan. Implement the action plan. Evaluate the results. Celebrate every success, large and small


Action Plan (Coalition)

• Who, what, when action plan • Resource plan • Communication plan– (who should know what?)

• Ensure follow through on plan• Keep track of progress• Keep everyone informed• Celebrate


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Contact us at

Contact us at

503-494-3703

E-mail

Dale Walker, MD

[email protected]

u

Or visit Contact

us at

503-494-3703

04/20/23

Home Visiting in Tribal Communities: Using the OPRE Review One Sky Center R. Dale Walker, MD Douglas A. Bigelow, PhD 19 February 2011.

Documents

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opre reviewintervention

opre reviewdeveloping

opre review1

opre review3

opre review4

opre reviewlogic model

opre reviewbest practice