Doula Seminar - A Civic Conversation event March 8, 2010
Posted by pmclaren in : Civic conversation, Health & Early Years Network, Research & Evaluation, Service Champions , add a commentPosted on behalf of Shauna Powers
Support from the Start: - Civic Conversation
“A Volunteer Doula Project: Could it work here?”
Liz Cregan the chief nurse for East & Midlothian opened a ‘Civic conversation’, event at The Quay on February 22 to discuss the work of a successful Volunteer Doula project in Hull. The event was to raise awareness of a new initiative developing in England that appears to show promise in tackling early health inequalities. The participant discussed how these benefits could be extended to women in East and Mid Lothian.
A Doula is a trained and experienced partner who accompanies a woman through pregnancy and childbirth and the first few weeks of family life. Traditionally hired privately, training volunteer doulas who then offer their services free of charge to pregnant women is a growing trend. The Goodwin volunteer doula project trains women as doulas who then volunteer their services to women in the community. The project works closely with pregnant women from the asylum seeker community, teenage mothers, and women in sex work.
Heather Barnes, the current project manager in Hull (http://www.goodwindoulas.org/) was the keynote speaker at this event.
Through presentations and panel discussions, the morning session brought together mothers, doulas, midwives, members of the voluntary sector, NHS Lothian health professionals and a member of the Scottish Government. The session brought up many topics from how constant labour support can help improve outcomes for both mum, baby and their family to the importance of peer support and advocacy for women during this important time.
It proved to be a very interesting session which brought together a wide range of experiences and stories. We have attached the PowerPoint presentations for the day. Any comments or questions can also be directed to Shauna.
From this event, a mailing list was created to keep delegates informed about the progress of this idea. To be included on this mailing list, please contact Shauna.Powers@nhslothian.scot.nhs.uk
Volunteer Doula Project
Goodwin Replica Volunteer Doula Service
Volunteer Doula Programme Canadian Presentation
Volunteer Doula Project Report
Volunteer Doula Project Executive Summary
Music and emotional literacy February 5, 2010
Posted by wrays2 in : Research & Evaluation , 1 comment so farDavid had been working with Ross High School and the council’s arts service on a pilot project that showed significant promise.
The evaluation of this pilot can now be accessed on the councils website at:-
http://www.eastlothian.gov.uk/site/scripts/documents_info.php?documentID=895&pageNumber=4
What is emotional literacy?
“Emotional literacy is the ability to understand ourselves and others and to be aware of, understand and to use information about the emotional states of others with competence” (Elizaeth Weare 2004)
The health promoting school website say the following about emotional literacy:-
The environments that encourage emotional and social competence are:
- an enriched physical environment
- an enriched emotional environment.
We now understand that by providing these environments, together with specific training and coaching in personal and social skills, we can enable children and young people to develop emotional maturity far more effectively than we could before. Many schools believe that emotional intelligence can and must be developed because it leads to so many benefits. They are therefore finding ways to explicitly place emotional literacy at the heart of their approach to learning, teaching, achieving, behaviour change and well-being.
Aspects of emotional literacy
The various aspects of emotional literacy as described by Katherine Weare in her book ‘Developing the Emotionally Literate School’ are outlined here.
Self-understanding:
- having an accurate and positive view of ourselves
- having a sense of optimism about the world and ourselves
- having a coherent and continuous life story.
Understanding and managing emotions:
- experiencing the whole range of emotions
- understanding the causes of our emotions
- expressing our emotions appropriately
- managing our responses to our emotions effectively: for example, managing our anger, controlling our impulses
- knowing how to feel good more often and for longer
- using information about emotions to plan and solve problems
- resilience: processing, and bouncing back from, difficult experiences.
Understanding social situations and making relationships:
- forming attachments to other people
- experiencing empathy for others
- communicating with others and responding effectively
- managing our relationships effectively
- being autonomous, independent and self-reliant.
The above strikes a strong resonance with Dr Harry Burns recent summary of what creates the conditions for positive health outcomes in human beings, particularly in the early years of life. (based on the work of social researcher Aaron Antonovsky and the body of biological research that has identified how the body and brain responds to chronic stress)
To be healthy he argues we need to have an environment that is :
- comprehensible
- manageable
- meaningful.
In other words we need to be able to make sense of our personal worlds, have some sense that we are in control and to be able to value our experience of the world.
We are social animals and have to be able to make sense of (comprehend) those that are in our lives. We also need to be able to deal with disputes, negotiate help when we need it and generally get on with other people (manageable). Finally we need to be loved or at least valued by the people in our lives (meaningful). If we don’t learn the skills need for this we can literally be lost in a world that has little meaning, seems beyond our ability to influence and is difficult to understand. In other words a place that is either frightening, dangerous or both.
Reflecting on my own childhood experiences understanding, managing and valuing emotions and relationships was not something that was addressed verbally and I can’t recall emotions or relationship being talked about in a classroom context. Having said that I always felt loved (if not understood) by my family, valued by my friends and their was a lot of emotional expression (not all of it very literate) So no doubt whatever degree of emotional literacy I developed I learnt, in large part, experientially and through role models.
I understand that I was lucky to be in a relatively stable and loving family situation, and I am sure I absorbed a lot of emotional awareness if not literacy from that environment. However, I think other strands of my learning were less dependant on family and these were stories, music and sport. For a boy growing up mostly in the north east of England participation in football (mostly in the street - that how old I am) was both an experience that allowed me to feel a wide range of emotion but it provided a medium and language to talk about those experiences to my peers. The experience of Success/ failure - elation / disapointment - rage/pride were daily occurrences and you can’t be emotionally aware / literate if you are not in an environment that offers you emotional experience. So for me learning about emotions had a lot to do with the physical environment that I could access. In the present its not unknown for my wife to accuse me of being selfish, and for me the emotional content and understanding of that word is still tied up with the feelings that went along with boys that refused to pass the ball.
I come from a large family and dealing with strong emotions often meant not being in the same physical space as annoying brothers, which meant being outside. Today being outside preferably amongst or close to trees has a pretty much instantaneous effect of calming me.
Exposure to reading and stories was probably another way that I learnt about emotions - when we put ourselves in the place of a character in a novel we learn about their feelings and our reaction to them. My first independent reading experience was the Victor comic book - even that which is not known for its emotional range gave me a vicarious access to the emotions of others and the words that describe them. Television was another way that I accessed stories - and stories where the emotional nuances were accented and defined by music. My environment was not music rich (apart from a couple of Elvis Presley LPs) and television was really how I experienced music. Some words / stories for me have emotional connotations that are intimately connected to the music of television programmes. If I hear the word holocaust the theme music of a t.v. programme called The World at War leaps straight into my mind followed by the mixture of horror, disbelief and anger that that I felt as I was first exposed to the image of a bulldozer pushing skeletal human bodies into a mass grave.
The experiences available to us in our in our physical environment have emotional contexts and therefore learning opportunities - its not all about words. Too much emphasis on words and intellectual understanding of emotions for me easily slides into therapy, and that can be dangerous if you don’t know what your doing. ( Carol Craig of the centre for confidence and well being I think has made a similar point).
Thats what I like about the use of music for developing emotional literacy - it connects the internal to the external world as does sport and being in a natural environment. For children that don’t have the benefit of stable or perhaps even caring families maybe the learning value of the emotional environments outwith the home become even more valuable. That would make access to those environments and the right learning experiences a powerful tool. - Do we use music to learn about emotion, do we use sport to learn about emotions, do we use the outdoor environment to learn about emotion?
Curricullum for excellence - perhaps it start with the question - What does that feel like?
Doula January 15, 2010
Posted by pmclaren in : Civic conversation, Research & Evaluation , 1 comment so farA Doula” (pronounced “doola”) is a Greek word meaning “woman servant or caregiver”. It now refers to a trained and experienced person who accompanies a woman through pregnancy and childbirth and the first few weeks of family life.
The development of Doula’s has been associated with people who could afford to pay for a private service - but services have developed in England that provide volunteer Doula’s to women from a variety of backgrounds. The results sound impressive
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84% breastfeeding initiation rate
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55% breastfeeding rate at 6 weeks
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18% caesarean section rate
A Volunteer Doula Project this link will give you details of a Civic Conversation event being held in Musselburgh in February, entitled ‘A Volunteer Doula Project: Could it work here?’ You will here the manager of the Goodwin volunteer Doula project based in Hull talk about her experience, and have an opportunity for discussion following the presentation.
Some research links
Continuous support for women during childbirth (review)
Social support by doulas during labour and the early postpartnum period
A chicago based young mother project
Evaluation - why, what for and who for? December 12, 2009
Posted by wrays2 in : Research & Evaluation, evaluation , add a commentTo evaluate is to measure or estimate the nature, quality, ability, extent, significance of or to form a critical opinion of
Synonoms: weigh up, rank, assess, estimate, appraise
The most valuable piece of advice about ‘evaluation’ that I have ever had was from a New Zealand based researcher who gave a presentation at an evaluation summer school I attended in 2006 (apologies but her name has gone from my memory). The advice was that the first question one should always ask is, ‘Why am I doing this evaluation?’; and this should be followed by what and who is it for before you get anywhere near the how question.
I think the why, what for and who for questions are particularly important because so often evaluation is an externally imposed condition: ‘Thou shalt evaluate’ has been one of the commandments of health improvement (particularly for community based work) at least since the 1990s. Funding for project work became increasingly dependant on the ‘How will you evaluate?’ question.
I believe many of us are tempted to skip past the why am I, or we, doing this evaluation, straight to how am I / we going to evaluate this work because it became a given, a must do. When the why question is not asked, (and why bother asking if it is a given) evaluation can easily become degraded to a process of self justification, or a sometimes pointless counting of outputs. There’s nothing wrong with self justification - its vital in a world of limited resources - but its not the process of open, honest, and organised critical reflection which creates the learning of the evaluation process. Maybe the real importance of the questions - ’why am I doing this’, ‘who is it for’, and ‘what does it aim to achieve’ - is that they lay bare our motivations as evaluators.
When funders project commissioners don’t make explicit why they want want evaluation, who its for, and what they are going to do with it, it can have significant consequences. Countless thousands of ‘evaluation’ reports or products have been produced on initiatives and projects the length and breadth of the country that have simply disappeared. If nobody is asking why do we want evaluation, what we will we do with it once we have got it, and who is intended for then it should be no surprise that much of the product of evaluation is unused and neglected, nor that those that are tasked with ’evaluating’ their own work become cynical and disillusioned with ‘evaluation’.
I think many professonal evaluators also make the mistake of focusing on method without asking why and what for. It can seem that some evaluators are trained to look down their noses at less formal methods of appraising, weighing up, estimating the worth or forming opinions on a programme or project.
So why do we want to evaluate Support from the Start, the East Lothian Equally Well test site.
My answer has two parts, firstly, because we want to be able to understand and explain with the most confidence we can manage, what we have done, why we we did it that way and what we think have have been the positives and negatives of what we have done. Secondly we want to be able to monitor progress towards the outcomes we have established for the test site. What we want from the evaluation is reliable means of explaining / understanding what we have done and what the impact of that has been. Who is it for - in no particular order the ministerial taskforce, the community planning partnership and partners agencies and the communities that are the target for the test site. So what we want to do is assess the change process within the test site and use that as evidence to a range of local and national audiences that the approach we have taken has produced service change.
Note that i have not mentioned anything about measuring change in health inequalities, although we may well try to do this for specific initiatives. I have said from the start that the timescale of the test site is far to short to measure changes in health inequalities. Also I have grave doubts that quantitative methods can be applied across a complex and dynamic service environment with any confidence that you can attribute change to one service change or another.
Using storytelling as one of the hows or methods for evaluation has lots of attractions for me, but I acknowledge that it is looked upon as being unscientific, unreliable too simplistic.
What can storytelling offer us as an evaluation tool :-
- tapping into knowledge that practitioners gain through reflection on their own experiences;
- providing an environment that enables people to tell their stories;
- helping practitioners to share their practice knowledge with one another more effectively;
- creating more generalised knowledge about practice, from practice, for practice;
- incorporating practice knowledge in project evaluation.
And reading the output might be far more interesting and engaging than tables describing enumerated outputs.
Storytelling could help us evaluate at the same time as involving service providers and community member in the process of change that we are trying to generate. If we can get people to trust that we want to hear their stories and are systematic in listening and recording their stories then as an evaluation process it will have as much validity as ‘focus groups’ or questionnaires. Combined with identifying appropriate indicators linked to service pathways for the medium term outcomes for the test site I think this is the best we can both assess / evaluate change and the change process.
Untold damage November 18, 2009
Posted by wrays2 in : Research & Evaluation , add a commentNew research highlights the negative impacts of harmful parental drinking on the lives of children in Scotland
Read the research from SHAAPlinked below, that details the high number of calls to childline which center on the effect of alcohol abuse in a family and then ask yourself what should the minimum price of a unit of alcohol be?
I like a drink and don’t what to pay through the nose for it, but its unbearable that cheap drink is taking childhood away for many Scottish children.
“What is particularly sad, is that many children experience a loss of childhood because they often take on caring responsibilities such as looking after brothers or sisters and this can prevent children doing normal childhood activities.”
Dr Evelyn Gillan, Director of Scottish Health Action on Alcohol Problems
Scottish Health Action on Alcohol Problems (SHAAP) news release: http://www.shaap.org.uk/news/131,Untold_Damage%3A_Children%27s_accounts_of_living_with_harmful_parental_drinking.htmlDownload report:
http://www.work-interactive-test.co.uk/UserFiles/File/Reports%20and%20Briefings/Untold%20Damage%20full%20report.pdf (1Mb)Media coverage:
http://thescotsman.scotsman.com/health/Scots-twice-as-likely-to.5805728.jp
Using the outdoors to promote emotional wellbeing November 6, 2009
Posted by wrays2 in : Civic conversation, Health & Early Years Network, Research & Evaluation , add a comment
Juliet Robertson
Juliet Robertson gave a workshop on ‘Using the outdoors to promote emotional wellbeing’ at the in service session on Learning, Emotions and well being’ held at Preston Lodge High school on the 26th Ocober.
Juliet is a former head teacher. Prior to entering the education sector, Juliet undertook a wide variety jobs in outdoor and environmental work. As a teacher, Juliet maintained her passion for being outdoors. Juliet now runs her own consultancy - Creative Star Learning company
Juliet’s workshop took the participants through some of the many ways that the outdoor environment can be used to enhance approaches to developing well-being, emotional literacy and learning.
The slides from the workshop can be viewed here el-emotional-wellbeing-outdoors
A helpful questionnaire October 16, 2009
Posted by Ginnie Moreton, Health Promotion Team Manager in : Research & Evaluation, Service Champions, Steering Group , add a commentThe public health team had a useful debate about how best to evaluate and record the effectivenss of our work. The result is the following - hopefully - very user friendly questionnaire. Use it if you like and think it helps - and not if you don’t! Right click on the link below to find it. Any comments or problems let me know!
Long-Term Monitoring of Health Inequalities October 9, 2009
Posted by wrays2 in : Health & Early Years Network, Research & Evaluation, Service Champions, Steering Group , add a commentThe following is a summary of a recent report from Scotland’s chief statistician and is taken from the Community Health Exchange Bulletin - Snippets-
I find this bulletin really useful as a way of keeping up to date on health improvement / health inequalities issues. It is well written with short concise summaries and lots of web links for more detailed information. For more information on CHEX and to register for Snippets visit www.chex.org.uk
Scotland’s Chief Statistician published the report Long-Term Monitoring of Health Inequalities: Headline Indicators, September 2009 last week. This report represents the second of a series of annual updates of headline indicators of inequalities and has been published following a recommendation in the report of the Ministerial Task Force, Equally Well.
The report includes both absolute and relative measures, which assess the size of the health equalities gap between the most deprived and least deprived groups in Scotland and how steep the inequalities gradient is. The main findings were:
- Healthy Life Expectancy (HLE) at birth: Inequalities in HLE are stable in both absolute and relative terms.
- Premature Mortality from all causes, in adults aged under 75 years: Inequalities are stable in absolute terms but are widening in relative terms.
- Mental Wellbeing in adults aged 16 years and over: The data for Mental Wellbeing measured by Warwick-Edinburgh Mental Wellbeing Scale (WEMWBS) are reported here for the first time. The mean score in the least deprived decile was higher than that of the most deprived decile (a higher score indicates better mental wellbeing).
- Low birthweight: Inequalities are narrowing in both absolute and relative terms.
- Coronary Heart Disease (CHD), first ever hospital admission for heart attack in adults aged under 75 years: Inequalities have decreased in both absolute and relative terms in recent years but increased slightly in the latest year.
- Coronary Heart Disease (CHD), deaths in adults aged 45-74 years: Inequalities have narrowed in absolute terms but are widening in relative terms.
- Cancer incidence rate in adults aged under 75 years: Inequalities are stable in both absolute and relative terms.
- Cancer deaths in adults aged 45-74 years: Inequalities are increasing both in absolute and relative terms.
- Alcohol first ever hospital admission in adults aged under 75 years: Inequalities are stable both in absolute and relative terms.
- Alcohol deaths in adults aged 45-74 years: Inequalities are increasing both in absolute and relative terms.
For more details, visit http://www.scotland.gov.uk/News/Releases/2009/09/29103539. Download the report at http://www.scotland.gov.uk/Publications/2009/09/25112211/0.
Can we learn something from Harlem? September 24, 2009
Posted by wrays2 in : Health & Early Years Network, Research & Evaluation, Steering Group , add a comment
The foillowing is a link to a podcast from an American Radio show which talks about the work of Geoffrey Canada and the Harlem Children’s Zone
http://www.thisamericanlife.org/Radio_Episode.aspx?sched=1311
The radio show is about people who dare to think BIG and Geoffrey Canada has certainly done that.
He had a belief that focusing on Harlems children from pre-birth up was the only way to break the cycle of poverty he saw in Harelm. He had seen years of programs that aimed to break the poverty cycle by focusing on changing parents, or changing their environment through work programs etc. He argued for a shift from trying to change things for parents / adults - to parents and communities changing things for their children. He envisioned a ‘conveyor belt’ that supported children from Harlem to Harvard. He has worked to put a comprehensive program in place that supports parents to make a difference for their children using simple things that can be done by all parents and communities.
The Harlems Children zone is ambitious and appears to be successsful, but is also simple.
As I understand what I have heard and read - thinking big seems to have been a critical part of its success (see the results page at the link on the bottom of this page) becasue it is the seamlessness of the support as well as the engagement of parents that is a large part of its success. For many childen in this challenged community discrete packages of support at different stages is simply not enough. This program aims to provide a ‘conveyor belt’ which children and their parents can join from before birth right through to a college place. But this is not a passive support program that simply does things for parents - it challenges parents to read, sing and play with children as well as to change entrenched attitudes to displine. It is also focused on outcomes - making a difference to how children from Harlem cope with school and education so that they get more benefits (including better attainment).
Much of what Geoffrey Canda has created is already provided by services in East Lothian - but I think we still have a lot to learn from the approach - BIG thinking - simple actions - would this combination helps us to reverse the gap in health and social outcomes evident for children across East Lothian?
Scottish Storytelling Health & Wellbeing September 9, 2009
Posted by dunch in : Health & Early Years Network, Research & Evaluation, Service Champions , add a comment
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