The Barking and Dagenham Women`s Wheel Evaluation

Barking and Dagenham
Women’s Wheel
An Evaluation
B
D
D
B
B
B
B
D
D
B
B
D
B
D
B
B
D
D
B
Prepared by:
Anna Gaudion, Cathy Godfrey,
Claire Homeyard, Heidi Cutts
B
Summary
The Women’s Wheel was developed by The Polyanna Project for Barking and Dagenham
PCT Health Improvement Team as a measure to engage local women and help them
access Services. It is CD sized card with eye-catching images of women on a rotating
cover and shows phone numbers for a range of services that local women chose in the
development stage.Between November 08 and January 09, 7,000 Wheels were distributed
to 331 locations where women could access them, including services and community
groups where staff and advocates could use them. hey were also launched at the
Phenomenal Women’s Day and an interactive version is available on both the Polyanna
Project and Barking and Dagenham websites.
In this evaluation, feedback was gained from over 30 local service staff and community
advocates (mostly via semi-structured phone interviews) up to 6 months after they had
received Wheels. The aim was to find out how much Wheels were being used and to
what effect and to gauge people’s opinion of their usefulness and potential. From their
perspective, the evaluation looked at whether women like them and at any evidence that
they are using them and accessing services.
The findings are extremely positive and reveal some changes to the knowledge, attitude
and behaviour of staff, advocates and women. All staff and advocates in the sample
like the Wheels and so do the women they give them to. There is also some anecdotal
evidence that women are calling services as a result.
Results indicate that the Wheel is sustainable because people are still very much using it
and intend to continue doing so. They will all want more Wheels. It is replicable and people
are already thinking about updates, other groups or other topics. It has potential, as people
are finding new roles for the Wheel in everyday practice. It is acting as a springboard for
discussion and helping community advocates feel more confident in signposting people to
services. It helps staff signpost more often and efficiently: working as a handy, time saving
reference point, as a prompt for discussion and as an object they can give to people.
This may be given preventatively (opportunistically) or in order to discreetly hand women
information they really need but do not want to be seen to have (e.g. domestic violence).
People are identifying the reasons why the Wheel seems to work – because it is discrete,
non-stigmatizing, user friendly, and is an object to keep. It may therefore overcome the
barriers to access we know about; including stigma and fear, lack of awareness and
discussion about topics and inaccessible information that results in poor knowledge
of services. Importantly, the Wheel is seen as addressing the fact that women need to
gradually tune in to information; to refer back to it, think about it and make the decision (at
some point) to make a call.
This report shows some of the many positive comments that were made and the
considerations for future updates and potential use.
“We want people to call helplines. Making the first call is like going through a gateway to
access”
Staff and advocates work in partnership and demands on them are high, but comments
display how much everyone wants to help women access the services they need. This
evaluation shows that the Wheel can help play a small part in that.
Claire Homeyard
Consultant Midwife and
Supervisor of midwives
Barking, Havering and
Redbridge NHS Hospitals
Trust
Cathy Godfrey
Health
Psychologist
Ruba Sivagnanam
Policy Advisor
Heidi Cutts
Artist and
Designer
Anna Gaudion
Researcher
Designer
Tim Jacques
Administrator
The Polyanna Project
The Polyanna Project is a non-profit making organisation that develops
resources with and for communities around health and social need. The name
Polyanna reflects the ethos of the group...optimism.
www.thepolyannaproject.org.uk
e-mail: info@thepolyannaproject.org.uk
Contents
Summary
1
Aims
1
Distribution and Sample
5
Method
6
Results
6
Main Outcomes
6
Have More Women Called More Services Because of the Wheel?
8
How Much is the Wheel Being Used?
10
Views on The Wheel
12
Ways The Wheel Makes a Difference
17
Helping Discussion of Sensitive Topics such as Domestic Violence
20
Other Ways The Wheel Helps for Sensitive Topics
21
Sustainability and Future Needs
24
Conclusion - Partnership Working
i
iii
iv
Appendices
Interview guide – community / stage 1, stage 2
Interview guide – services
Email questionnaire for children centre managers
Aims
To find out from service staff and community advocates:
•
•
•
•
Their opinions of the Wheel
Their actual use of them over 6 months and intended use for the future
Any perceived effects and improvements to ways of working
Any perceived effects on women
From these results, to identify any important ways the Wheel helps to improve access to
services and may do so in the future.
Distribution and Sample
Distributing the Wheel
The initial print run for the Wheel was 7,000 and these were distributed between
November 08 and January 09 to 331 local settings.
Of these 7,000 wheels, over 1,200 (around 19%) were specifically requested by services
and groups after publicity or word of mouth.
The method of distribution was:
1
a)
Small samples of Wheels plus ordering information sent to all 22 services on the
Wheel and the 14 community groups involved in the project. Of these, 9 services
and 7 community groups requested and were sent, larger volumes.
b)
20 Wheels plus ordering information sent to approx 200 locations.
c)
Wheels sent to 14 other locations on request.
Table 1. Types of Location to Receive Wheels
Distributed to (Type of Location)
Number of Locations
Individual GPs
GP Surgeries
Pharmacies
Social Care Establishments
Dentists
Opticians
Children’s Centres
Clinics
Local Services on the Wheel
Leisure Centres
Community Housing Partnerships
Hospitals
111
46
36
34
21
15
14
13
10
10
6
3
Local Circulation of:
331 Locations
Other (National) Services on Wheel
Individuals in Health Service
10
12
Total Circulation of:
353 Locations
2
Sample of the Overall Distribution
In total, 36 service staff and community advocates were included in the sample.
This represents a good spread across the entire pattern of Wheel distribution, i.e.:
•
•
•
•
All 11 local services on the Wheel
5 other local community groups involved in the project
4 settings requesting the largest volumes of Wheels after publicity or word of mouth
A small sample (5 out of 111) of the most numerous type of setting receiving
Wheels i.e. GP surgeries / Health Centres
The list below shows the exact sample:
Services on the Wheel
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
Domestic Violence Advocacy Service
Barking and Dagenham Direct
Health Information Centre
Axe Street (Drugs)
Community Alcohol Team
Quit Local (Smoking)
YWCA Young Women’s Centre
Teenage Pregnancy Midwives (x 3)
Maternity Services “Need to book with a midwife?”
Children’s Centres x 7 ( i.e. 50% of centres in the district)
The Sydenham Centre (Sexual Health)
Positively Women (HIV)
Others to support the above
1.
2.
3.
Integrated Family Services
Mind (National)
Strategic Implementation Lead Domestic Violence
Other Community Groups involved in developing the Wheel
1.
2.
3.
4.
5.
3
African and Caribbean Mental Health Project
Zimbabwe Women’s Network
B&D Somali Women’s Association
Eave’s Women’s Aid
Women’s Empowerment Network
Other settings requesting Wheels (x100 each)
1.
2.
3.
4.
Homeless Persons Unit (John Smith House)
Community Educational Psychology (Seabrook House)
Probation Services (Olympic House)
Advice and Brief Intervention Team (Hedgecock Centre)
GPs / Practice Nurses (x 20 each)
1.
2.
3.
4.
5.
White House Surgery
John Smith House
Victoria
Orchard
Faircross
A Note about Sample Size
331 localities received the Wheel and so the proportion sampled of this overall distribution
is acceptable at just over 10%. However, many of these settings e.g. pharmacies, dentists,
libraries, leisure centres, may be places where the Wheels are left for people to pick
up. The aims of the evaluation were to look at perceptions and behaviours of people
giving (and receiving) the Wheel; how much it effects their work and how much it may
influences women to call services. If the scope of distribution is narrowed to places where
practitioners and advocates might actively use the Wheels, the sample proportion rises to
over 30%.
The sample size therefore gives a reliable indication of any effects and this helps to
discuss the results of the evaluation with confidence.
4
Method
Stages of Evaluation
This evaluation was conducted within 6 months of initial distribution of the Wheel. It was
set up as part of the original work, when community advocates and service staff were
asked if they would take part in the evaluation phase and in some cases, if they would
collect data on call volumes for pre and post Wheel comparisons.
The main body of data was collected via informal telephone interviews and for most of the
sample, this was done in 2 stages: just after they first had the Wheels delivered, in order to
gauge initial reactions and expectations, and again after 5-6 months of using the Wheels,
for a realistic impression of their use and effectiveness.
Interview Approach
All interviews were pleasant and informal and asked about preference, use, and
any perceived effects of the Wheel. At both stages, interview guides were used (see
appendices) although questions were tuned according to each setting. Respndents
who were interested in reading the final evaluation report were informed that it would be
available on the Polyanna Project website. The URL was provided for this.
Variations in Data Capture
Because interviews were informal and tuned to each setting, not every topic was covered
by each respondent. Furthermore, some of the sample were only interviewed once:
•
•
•
Those who requested Wheels following publicity
GPs / Practice Nurses
4 who were unavailable at stage 2 (Mind, Quit Local, Positively Women, Women’s
Empowerment Network).
Also, 3 GPs had not seen the Wheel and so did not give any feedback.
We also broadened the reach of the interviews in two ways:
5
•
For Children’s Centres (14 in the district), we spoke to two managers, but five more
gave responses via a brief emailed questionnaire (see appendices), helpfully
forwarded to them by the Strategic Lead.
•
The evaluation targeted key staff and wherever possible, we asked managers and
team leaders to collect comments informally from their staff too.
Results
Main Outcomes
The main outcomes we looked for were things about the ways we hoped the Wheel would
work. Overwhelmingly, these expected outcomes are met and there is evidence of change.
1.
There are some indications that women are using the Wheel
2.
Service staff and community advocates like the Wheel. They are using it and want
to continue doing so. They also feel that women like it, understand it and may keep
it (thereby increasing awareness for themselves or for other women).
3.
Staff and advocates think it is extremely useful. It increases their knowledge and
helps them to signpost women more often, more effectively and in new ways.
4.
With the Wheel, health issues and sensitive topics, such as domestic violence are
addressed more.
As outcomes, these are all very important and we can look at the results for each in more
detail.
Have More Women Called More Services Because of the
Wheel?
We would like the answer to this as an ultimate outcome. The evaluation suggests,
anecdotally, that they have. While we could not collect data from call records as a way to
detect an increase, the following comments indicate that it is happening.
•
Advocates from 3 community groups say that many more women tell them they
have called and are making comments and asking questions about their experience
of services.
•
Staff from 3 services think that more women are calling:
DVAS (Domestic Violence Advocacy Service):
1.
There has been a significant increase in the number of self referrals since the
Wheel was launched. As a ball park figure - around 40%. There has been lots of
targeted campaigning to high risk groups recently, so the effect of the Wheel
will only be a part of this, but seen as being significant.
2.
There has been an increase in the number of practitioners calling to ask about
referrals.
6
Sydenham Centre:
•
Some women who want to call services from home but can’t, can call from the
centre (they often see women more than once). After the Wheel, they have come
back and asked if they could call a service.
Homeless Person’s Unit:
•
Indicating that Wheels are increasing calls to services, they have noticed a drop
in enquiry calls about domestic violence and teenage pregnancy and some other
Issues covered by the Wheel. They think women are calling services appropriately
instead (“This is brilliant!”)
“Phenomenal Women Day”, Barking.
7
How Much is The Wheel Being Used?
•
Overwhelmingly, staff are positive and keen to be using it. If not everyone at a site
uses it yet (i.e at a Children’s Centre) they all know of it.
•
Everyone asked (100%) is still using the Wheel. Use has not dropped off since
distribution and, in fact has increased as more staff are aware of it.
•
The way it is being used varies appropriately between settings, with the only barrier
being too few Wheels, for example in Children’s Centres.
•
Everyone wants to carry on using it as part of everyday practice and everyone will
want more Wheels at some point.
8
“Phenomenal Women Day”
extracts from book of comments
about The Wheel
*-*-2008 Phenomenal Women Day
9
Views on The Wheel
Do People Like it?
1.
We asked people “what they thought” and the response was extremely positive for
100% of the sample. Community advocates, front line key staff, managers and
strategic leads have all given positive descriptions and their opinions of the Wheel’s
value.
2.
Because we spoke to most people twice (just after getting the Wheels and again, 6
months later), we can note that responses are just as good after 6 months as when
they first saw the Wheels. The positive reaction has not worn off.
3.
People clearly like the Wheel and find it attractive, but people also immediately
stressed that they actually find it useful and helpful in their work.
4.
Finally and crucially, everyone who gives the Wheel to women, said that women
seem to like it. Many gave more specific comments on women’s reaction to the
Wheel.
What People Say about it
We want to use it
•
Everyone who sees it enthuses about it and are very positive
•
We have really welcomed it
•
We are pleased to have it
•
Really, really love it
•
•
We use routinely / regularly
We definitely want to continue using them
What we like about it
•
It’s surprising
•
It’s non threatening
•
Not stigmatizing
•
It feels different
•
It’s a different way to keep information and pass it on
•
Its tactile, engages the brain, you can play with it.
•
They can keep it on the fridge
•
Creative and colourful, simple
•
It looks great.
•
Brilliant, really well done
•
It’s a very good piece of work, looks excellent and all the information is correct
10
It is useful and effective
•
•
•
•
•
•
•
•
•
It’s handy to have the information all together
Very useful and easy to use
Very useful for colleagues
Liked very much, incredibly helpful
It really, really helps
Just the sort of thing useful in (Mind) settings
It’s a way to give women what they need
Good to have emotional needs on there
Clients don’t know these services. They are not aware, but the range of topics is
just right.
Why it Works
“I tell them to keep it in their house because even if they don’t need it, the information is
there for other women who come into their house”
•
•
.
•
•
•
•
•
We can target people who don’t speak English
The pictures are child friendly
We do a lot of work with young families and outreach in schools. This is just right.
They don’t want to read a lot of media. They need it to be picture based, succinct,
a snapshot.
We want them to start using helplines... it’s like a gateway to the possibility of help
and a network of support
People in general are less inclined to read things in hard copy unless it’s a bit
different
You can’t expect them to keep it unless it is an object in itself
They will want to keep this. The drip effect is really important
What Women Seem to Think of it
•
•
•
•
•
•
•
•
•
11
People like them and have the confidence to call
They are very popular
Women like it
Women come back and ask about a service
They turn it and play with it and think it’s pretty and nice.
Really good for women, girly, they love it
Creative and colourful, simple, women are telling me they like it
Women like them. They feel reassured
Women are happy to have the numbers and want to keep it. They appreciate
having it
Ways The Wheel Makes a Difference
Increased Awareness
•
Staff and advocates are using it efficiently as their own handy guide to services,
when on the phone or to answer queries.
•
Nearly everyone asked (just under 90%) said they knew most / knew broadly of the
range of services, but only a few (e.g. Eaves, ABIT, Sydenham Centre) knew all of
them and no-one of course, had all the numbers to hand before the Wheel.
•
There were some gaps in people’s knowledge. Sometimes relating to particular
areas (e.g. pregnancy and breastfeeding) or relating to specific services. The
“Health Information Centre” “National Breastfeeding Helpline” and “Booking a
Midwife” numbers were newly set up and so the Wheel was useful for promoting
these.
•
For some, it was just helpful to see an “overview of the range of services available”
Time Saving
Nearly everyone giving help by phone said staff now have the Wheel handy. The majority
(66%) say it is “pinned up” on notice boards. This is a good indication that people do, as
hoped, like to keep the Wheel.
A few said staff knew of the services anyway; but even so, thought it was useful to have
everything in one place. Several people commented that it replaced voluminous, or
numerous leaflets.
93% agreed that it has made their jobs / giving information much easier, with everyone
agreeing that it has helped at least a bit.
Some comments were:
•
It is making our job easier
•
We knew a lot of services already but still find it helps. We signpost to a very high
% of people.
•
Mangers are finding it really useful as a note of services
•
We do a lot of work on the phone. Staff have them pinned up
•
We refer all the time, nearly everyone we see will need this range of services
•
Were not based in Barking and Dagenham and so don’t know all these
•
We didn’t know about some areas on the Wheel
12
Increased Confidence
•
“The information is helping staff to refer more efficiently. Today, we saw a woman
with a history of domestic violence, but the child protection practitioner was on
holiday and we were unsure who to contact. We used the Wheel to call DVAS and
ask them what to do.”
•
“It’s a struggle for us to find numbers for an appropriate service and maybe we
would call and the number would be wrong or unanswered”. (advocate)
•
“It’s difficult. We need to signpost people every day. The Wheel is very handy and
much more useful than leaflets for us” (advocate).
Increased Signposting
•
From both service staff and community group perspectives, most (90%) women
need signposting to other services and they are relieved / pleased to have all these
service numbers in one place as a reference for this.
In order to identify any change, we asked staff about their signposting before and after the
Wheel. Results strongly indicate that change has happened because staff are using the
Wheel.
•
In general, services signpost women regularly, with perhaps up to 90% of women
needing other services.
•
For several settings, there is an increase in perceived levels of signposting (up
to 50%) and more specifically, in effective signposting, as staff say they are now
able to target groups and individuals and create more opportunities to get across
more information.
Preferred to Leaflets
Firstly, staff use the Wheel in place of, or alongside, other leaflets. At the very
least, everyone sees the Wheel as a useful addition here, because of its simplicity,
comprehensiveness and attractiveness etc. For the Sydenham Centre, it replaces staff
having to write things out by hand, or to print things out.
More importantly, for many the Wheel fulfils a new role in signposting, as an addition to
previous practice, which helps them give more information more often.
13
New Roles for the Wheel and Their Outcomes
Role
Probation services use it as a springboard for discussion with female
offenders.
Outcome
Where nothing was given previously, they now say there is a big increase in
discussion of health topics and issues and that this is important.
Role
DVAS use it for training staff and raising awareness when going to schools
etc.
Outcome
They feel strongly that it is helping staff feel more confident to address
domestic violence. They also note an increase in phone enquiries
and referrals from service staff (although we cannot attribute this directly to
the Wheel).
Role
Midwives use it: Routinely – at antenatal “booking” interviews and regularly
at post natal appointments (midwives may spin through it and flag things up)
as an opportunity to raise awareness.
Opportunistically - e.g. they may give to mothers of pregnant teenagers
too, if present, as a preventative measure.
Outcome
They are reaching a large number of women at an appropriate time and feel
it helps women feel reassured “that they’re not just left in at the deep end”.
Role
Occasionally - As a back up “Sometimes, unfortunately, you don’t have time
to deal with everyone properly. When a pregnant teenager came in saying
they didn’t know what to do, I was able to give them the Wheel, ask if they
read English enough to understand it and I was happy that they had a good
starting point”.
Outcome
If time is short, it has been used to give information where otherwise none
would have been given.
Role
Children’s Centres use it as a picture base for outreach in schools and
with families. Because it is child friendly, they feel it is “great” and
“very helpful” to use in this context.
Outcome
Previously, it would have been hard / unsuitable to give information about
services.
14
Role
One manager intended to give it “as a gift” in outreach work, creating an
opportunity for discussion and inviting contact, but has not yet had a
sufficient supply of wheels.
Role
Health information staff give it as an introduction when women are new to
the area and asking about GPs.
Outcome
Staff feel it increases their role in signposting and it is good PR for the PCT.
Role
Somali Women’s Network display Wheels at their new premises at the
Women’s Advisory Centre and are now reaching Turkish and African
communities as well as Somali.
Outcome
As a conversation piece, they feel the Wheels have been really useful for
helping them reach this widening community.
Role
YWCA: Domestic violence is part of their “Women’s Group” programme and
they use the Wheel as a focus for discussion
Outcome
Increased discussion, targeted signposting and uptake of services (see page
17)
Overview of the Way Wheels are Used
Wheels are more often used in consultations and groups rather than being on display.
The table below gives a overview, but the uses are dynamic and changing, and influenced
by enough Wheels being available and the nature of the service. Where not listed below,
services are using Wheels for staff reference only.
15
Table 2. Overview of Way wheels are Used
On display
+ given out
Homeless Unit
Centre
GP / H. Centres
Health Information
YWCA
Somali Women’s
Network
Axe St
Child Centres
CAT
School Outreach
Midwives
TP midwives
Probation
DVAS
Sydenham
Af & Caribbean
Zimb Network
Ed psych
1:1 Based Helps Group
on need
discussion
X
X
X
X
X
X
X
X
X
X
X
X/O
X
X
X
X
?
X
X
X
X
X
X
Given
New Role
Routinely
X
X
X
X
X
NOT
ENOUGH
X
X
X
X
X
X
X
X
X
X
X
X
X
X
Wheels Are Used for Particular Groups
•
Most people agree that the Wheel helps with sensitive topics and for discussing
domestic violence.
Children Centres said:
All groups
Young adults / teenagers
Family support, home visits
Young families
2
2
2
1
DVAS said:
Young teen mothers
Schools / social service context
Sydenham Centre said:
Africans with multiple issues (domestic violence and partner binge drinking, not
aware of rights).
16
Helping Discussion of Sensitive Topics such as
Domestic Violence
Does it Help?
•
6 out of 7 Children centres said yes, it particularly helps for raising and discussing
domestic violence.
•
3 other services (Homeless persons unit, CAT, Axe street) said it helped discussion
on various topics, especially teenage pregnancy and domestic violence
•
3 services (probation, sexual health, domestic violence) already find it easy to raise
sensitive topics. But the Wheel still helps, as a focus and a way of leading onto
other topics women may need help with.
•
3 settings (Sydenham Centre, YWCA and Somali Network) find also acts as prompt
for a women to come back and ask more questions about; or even, as at the
Sydenham Centre, to ask if they can call one of the services from there!
Community Advocate Examples
Here are 2 summaries of experiences described by Community Advocates:
The YWCA*
On receiving the Wheels, advocates hoped to use them to open up discussion on
domestic violence, drugs, alcohol, smoking and teenage pregnancies. Crucially, in their
experience, a lot of women did not ask about domestic violence and only revealed later
that it was an issue / even the main issue.
After 6 months of using the Wheel, the effect had been beyond their expectations.
Advocates routinely refer to them in conversation and give them out to individuals and in
group discussions.
In groups, particularly, they can raise the topic of domestic violence as part of the
spectrum of women’s health, and find that informally, discussion increases and any stigma
lessens. They stress that it allows them to “get information across at the right opportunity”
Sexual health and domestic violence are now the main focus of their work.
As a measure of the Wheels’ success, there has been a big increase in discussion of all
health topics.
A new area of importance coming to the fore, partly resulting from the Wheel, is mental
health. For their clients, “mental health” is a stigmatic label, associated with psychopathy,
but feeling “worried, stressed or depressed” are things they identify with. The wheels are
helping with this.
17
To YWCA advocates, the Wheel has been “extremely impressive and useful”.
•
Although they deal with these things a lot anyway there has been a significant
increase (“by 50%”) in:
1.
2.
3.
Conversation and “normalising” of sensitive topics
Passing information and answering queries about services
Actual uptake of services – indicated by many more women coming back to them
with questions and comments having accessed services and also wanting to talk
about more / other services. This has included sexual health and domestic
violence.
* The YWCA, working with young women, were part of the project to develop the Wheel
and their number appears on it.
Somali Women’s Association*
“The Wheel has enlivened discussion of health topics hugely and has already made a
huge difference. Women now talk about domestic violence and sexual health in particular
and before had thought their problems were just theirs. Now, with the Wheel they talk
about things in groups and share experiences”.
Women had not realised
1.
That they shared circumstances with others
2.
That there are services to help them.
After using the Wheel, there has been increase in
3.
Women using services
4.
Talking about their experience of services and needs met / unmet.
This has led to
5.
Discussion about need for interpreters or Somali / female doctors
6.
A new onus on advocate to provide more information about services (as much
more discussion).
* This group was part of the project to develop the Wheel. FGM is one issue being
addressed by this group. The Wheel has helped. After the Wheel, they said they needed
more support / information from the PCT (with 6 below). After 6 months they say they have
an excellent relationship with the Health Improvement Team at the PCT.
18
“Phenomenal Women Day”
extracts from book of comments
about The Wheel
19
Other Ways The Wheel Helps with Sensitive Topics
The Wheel helps by passing the information discretely to women.
•
Everyone we asked thought this was a very useful part of the Wheel and they were
happy and confident to give women a Wheel for this reason.
There are several important examples of this:
•
Training Staff: When services want to ask about domestic violence, but find it
difficult, the Wheel may help. A consultation in February 09 with midwives and the
domestic violence strategic lead revealed that whilst midwives should ask routinely
about domestic violence, in reality it often wasn’t asked or recorded adequately
because of time, locality, partner being present (which happens “a lot”), training
needs and confidence.
The Wheel was seen as part of a solution (along with training) to help midwives become
confident and to routinely make effective and early referrals to domestic violence services.
•
Midwives in the sample do ask about domestic violence routinely at booking
interviews, but even so, find that women very rarely say they need / want
any help. They found the Wheel useful for giving out the number without them
requesting it.
•
You can give it out in front of a partner, at clinic or at a home visit, or give for a
women to take home where the partner is and they won’t know the DV number is
there. The partners wouldn’t search the Wheel (2 Midwives)
•
In school context. As it is child-friendly (not alarming) could give it to a mother in
need (community psychologist)
•
In a group, when you think someone needs DV information, you can flag it up on
the Wheel without targeting them (YWCA)
•
When victims of DV identify themselves. It is non stigmatizing, which must help
the woman actually have courage to make the call (Children’s Centre)
•
DV doesn’t come up much and even if it does, people don’t want advice.
•
Give to mums, who want numbers hidden from families (Axe St)
•
DV seen as private and not brought up. The Wheel is private and non threatening
(CAT)
•
Many topics can be seen as “sensitive”. African women with multiple problems
feeling isolated and unaware of service or their rights. They can take it home. It
is not obvious to their partners. It works over time, once they know the services
exist. (Sexual Health Clinic)
20
Sustainability and Future Needs
The Wheel is a simple, sustainable measure towards increasing access that the Trust can
build on. The fact that it is already incorporated into daily practice so readily and so widely
means that it is likely to be easily sustainable. Simple steps can support this: a few people
commented that confidence in the Wheel could remain high, if it is kept up to date and
easily available. These points and ideas for future Wheels are outlined below:
Supply
Some places had never received enough Wheels to use them as they would like (e.g.
Castle Green and William Bellamy Children’s Centres, Axe St, CAT) and several people
said they were nearly running out. Everyone would like to reorder them for continued use.
On a practical note, one Children’s Centre suggested larger stocks could be left there as a
resource for various professionals (e.g. Teenage Pregnancy midwives) coming to the site.
One person suggested supplies for display could come with a dispenser (like one for
straws where a new one comes down whenever you take one from the bottom) because
the shape made them messy / difficult to display
Updates
Although not asked about in the phone interviews, 3 people stressed that for the future,
the Wheel must be checked and kept up to date, so as to maintain confidence for staff and
women. Perhaps a date on the Wheel would help this.
Training
It may be a useful resource alongside training (e.g. for midwives on domestic violence).
Checking Quality of Phone Lines
Axe Street
This service has changed its name to Gateway Services (to be launched in June). The
number remains the same though.
The Sydenham Centre
Demands on the phone line have increased, with changes to the service (known before the
Wheel was made). However, there has been a lag in implementing the “call centre” to cope
with this. At the moment, calls may be unanswered for periods and go to answer phone.
The service staff are working hard to cope with these calls and plans are due to be
complete “within the next couple of months” to have more staff and train them to handle
calls. For this, they need to find space for phone set ups with screens.
A quality check on this issue in the near future could help ensure the number on the Wheel
is working well enough.
Maternity Booking Line
This new service has received a huge number of calls – a good indication perhaps, that
women want this service. We anticipated that women could book directly with a midwife
21
by calling, but due to a high call volume, women were being asked to go to their GP, or to
come in to complete forms instead. This may now have been resolved, but again, follow
up checks on the numbers are important if people are to have confidence in the Wheel
Future Wheels?
•
Another Wheel is being commissioned for Maternity Services to use across
boroughs. It is a similar tool with an emphasis on issues highlighted in Maternity
Matters (DH 2007) Saving Mother’s Lives, CEMACH (Lewis, 2007) and local
need. It will therefore include sections on access, breastfeeding, parenting
and domestic violence.
Other ideas were put forward:
•
Family Information Service stress that efforts to reach people with disabilities
(current targets for many providers, such as the Catch Project for LBBD) would
benefit from a similar Wheel.
•
Probation services say it would be very helpful to have a Wheel for men (age 2535). It would work in the same format and with the same feel. Drugs and alcohol
are issues for their clients, but general health, diet and wellbeing would also
be extremely useful, because the men they see are just not aware of these things.
•
A Children Centre manager suggests a Wheel to target young women for
preventative messages / info e.g. where to get condoms etc, (“because they are not
aware of what’s available where they can access things and because there are so
many partners, they need information all in one place - a pocket guide”).
•
A Children’s Centre manager suggests the Wheel should be available in 2 sizes,
the current size and pocket / purse size.
•
Community Psychology think a Wheel for 16 – 19 year olds would help, to include
information about how to access things online
•
Health information Centre suggested Wheels for mental health services, or around
drugs and alcohol
•
Eaves Women’s Aid: Felt they should be on the Wheel
•
Somali Women’s Network said that FGM (female genital mutilation) should be on
any future Wheel
•
Women’s Empowerment Network said that more details about services, e.g. a
booklet from the woman’s perspective, would be useful.
22
“Phenomenal Women Day”, Barking.
23
Conclusion - Partnership Working
A final, important point is that the Wheel gives value as a way of underlining “Partnership
Working”.
•
A few service staff commented that the Wheel actually made them feel more
reassured that this was strong and that measures were in place to help this
i.e. everyone using the same information on the Wheel.
This outcome should be noted because it contributes to staff satisfaction and behaviour to
incorporate the Wheel into practice.
Actual change from people using the Wheel also reflects partnership.
•
There are examples of staff calling other services for information. Everyone says
they know of more service numbers (or have them more to hand). Ideas are being
put forward to use Wheels as one part of meeting joint targets.
Community Advocates clearly have similar feelings.
•
They feel reassured that everything is in one place and “it is all there”. Three said
they feel more confident and now play a stronger role in helping people access
services.
Finally, the Wheel is a banner for the way the PCT works to engage people. The specific
pictures on the Wheel, the way it was developed and the fact that a couple of community
group numbers appear on it along with other services, of course, goes a long way to
strengthen this message.
One advocate enthusiastically says they have an “excellent relationship” with the Health
Improvement Team at the PCT – perhaps the Wheel has helped this along.
24
“Phenomenal Women Day”
extracts from book of comments
about The Wheel
Appendices
Interview Guide for Community Groups (Stage 1)
Community Group, name,
A
Outline
Receipt of Wheel etc. Looked at Wheel and read visual diary?.
Know they can get more Wheels from Sam?
Thank for input towards it. Intro about this bit of the project. I want to talk to them
now and in 6 months time
B
Preference
What do you think of the Wheel
Do you like it / What do you like about it
C
Relevance and usefulness
Right sort of thing? / For you and your group? Right services?
Do you think it will be useful? How? For whom?
D
Knowledge
They know of the services if worked on the Wheel, but are there some services that
didn’t know about? Which ones?
E
Social Capital / Health culture and sensitive topics
How often do people ask you about services (on the Wheel or others) per week/
month?
Do people talk about health services like ones on Wheel? Some are sensitive
topics. What about domestic violence?
F
Communication preference
Do you use leaflets / other health info resources much? Images?
Images they like? “Trust” and relevance
G
Opportunity for them to add comments
Has it raised anything you want more information about?
I can email you with notes from this conversation...Contact you in 6 months to ask about
how useful it has been
END
i
Community Groups Follow up Questions (Stage 2)
ii
A
Is it still used? How much?
B
Is it talked about?
Do people know about it
Do people share it
Has it helped people find out about services?
Use services they hadn’t before
C
How do you use it?
Advocates:
Have people asked you about services?
Used it in conversation to help someone
Given it out
D
Why / how does it work?
E
Have you referred to it to help /someone Called services for them?
More frequently (how often per week or %)
More / different services?
F
Will you be wanting to order more Wheels?
Interview Guide for Services (Stage 1 and 2 )
Name
Post
Service
A
Outline
Receipt of Wheel etc. Looked at wheel and read visual diary?.
Know they can get more wheels from Sam?
Thank for input towards it. Intro this bit of the project. I want to talk to them now and
in 6 months time
B
Preference
What do you think of the Wheel
Do you like it / What do you like about it
C
Relevance and usefulness
Do you think it will be useful? How?
As a reference for signposting
To give to women in consultation
For women to pick up
D
Knowledge and signposting, sensitive issues
Which ones if any do you signpost women to?
How many women do you currently signpost to other services (% of total women)
What about help for domestic violence? How many (% of total women)
Do you find it difficult sometimes to bring up sensitive topics and signpost women to
services?
Do you think the Wheel would help with this?
Do you know all the services on the Wheel?
Which are unknown?
E
Anything could be improved?
Any other comment?
F
Monitoring - check if applicable
n calls (monitor how they got number?)
END
I can email you with notes from this conversation....
I‘ll contact you in 6 months
iii
Email Questionnaire for Children Centre Managers (at Stage 2)
The Women’s Wheel was produced by the Polyanna Project for B&D PCT (contact Sam
Woodhouse).You can see The Wheel on:
http://www.thepolyannaproject.org.uk/projects.html
Your Feedback on The Women’s Wheel
We don’t need any precise data, just your feelings / views on the following (it doesn’t
matter if you can’t answer them all). It will only take you a couple of minutes.
Please just email this sheet back to me with your comments inserted. (Please send by
Wednesday 22 April at the latest). If you prefer, you can give your feedback by phone - just
call me on 01326 219293.
Thank you very much for your help. I know you are all busy, but this feedback will help
B&D PCT focus on what works.
Best wishes,
Cathy Godfrey
The Polyanna Project
info@thepolyannaproject.org.uk
iv
1.
Approx how many staff are in contact with clients?
2.
Do they all / who uses Wheel?
3.
Approx how often do they use the Wheel i.e.
With what % of clients?
Regularly in practice or more for particular situations?
4.
Is it helpful for any client groups in particular?
5.
Is it helpful for any services (e.g. sensitive topics?) in particular?
6.
Does it help with discussion re domestic violence?
7.
How much has it helped?
Bit only
Quite a lot
Very much
Hugely
8.
Have you noticed people (clients) talking about / referring to the Wheel or the
services on it?
9.
Do you think the appearance / style has hit the right note with clients?
10.
Overall comments:
Anything could be improved?
Any other comment?
Do you want me to email you feedback on the evaluation results?
Thank you
v
©The Polyanna Project May 2009
Copyright of The Polyanna Project, all rights reserved. No part of this
publication may be reproduced or transmitted in any form without
permission of The Polyanna Project
www.thepolyannaproject.org.uk
B
B
B
B