Using BARHII's Organizational Self Assessment Toolkit to initiate LHD action on health inequity <br />Tuesday, March 8, 20...
Objectives<br />At the end of today’s webinar participants will: <br />Understand the prerequisites to implementing the BA...
Agenda<br />I.   Webcast and Speaker Introductions<br />II.  Introduction and background to Self Assessment Toolkit      E...
Introduction and background<br />Edith Cabuslay<br />Chronic Disease and Injury Prevention Manager, San Mateo County Healt...
Berkeley’s experience using the Toolkit<br />Kate Clayton<br />Chief of the Health Promotion<br />Berkeley Public Health D...
Alameda<br />City of Berkeley<br />Contra Costa<br />Marin<br />Napa<br />San Francisco<br />San Mateo<br />Santa Clara<br...
BARHII Mission Statement<br />“. . . To transform public health practice for the purpose of eliminating health inequities ...
Organizational Approach<br /><ul><li> Identify Social Justice as a core Public Health value
 Build alliances with key institutions that influence the health of communities
 Inform policy makers and the general public about the underlying social causes of  Health Inequities
 Build the capacity of Public Health workforce and agencies</li></li></ul><li>BARHII Framework<br />
BARHII Framework<br />
BARHII FRAMEWORK<br />
Bay Area Regional Health Inequities Initiative<br />Built environment<br />Community<br />Data<br />Internal capacity<br /...
Organizational Self-Assessment Toolkit<br />
Mission of Internal Capacity Committee<br />Enhance the capacityand collaborationof multiple health departments to effecti...
Key Questions addressed by ICC<br />What are the skills and abilities needed by public health department staff to effectiv...
Workforce Attributes<br /><ul><li>Specific personal attributes
Knowledge of public health framework
Understand the social, environmental and structural determinants of health
Community knowledge
Leadership skills
Collaboration skills
Community organizing skills
Problem solving ability
Cultural competency/ cultural humility </li></li></ul><li>Organizational Attributes<br /><ul><li>Institutional commitment ...
Hiring to address health inequities
Structure that supports true community partnerships
Supporting staff to address health inequities
Transparent & inclusive communication
Institutional support for innovation
Creative use of categorical funds
Community accessible data & planning
Streamlined administrative process</li></li></ul><li>Tool Development Process<br />Matrix: <br />Develop <br />Compe-<br /...
Org. Development Literature
Org. and Cultural Competency Tools</li></li></ul><li>Organizational Self-Assessment for Addressing Health Inequities<br />...
 Inventories a set of research-based organizational and individual traits;
 Informs strategic planning and organizational development activities;
 Ongoing tool to assess progress</li></li></ul><li>What’s in the Toolkit:  Before<br />Before the Self-Assessment:<br /><u...
 Time Estimates & Materials Budget
 Bibliography
 Lessons Learned</li></li></ul><li>What’s in the Toolkit:  During<br />During the Self-Assessment:<br /><ul><li> Implement...
 Roadmap: Tailoring the Self-Assessment
 Tips
 Online Survey Guide
 Sample Communications
 Glossary of Key Terms
 Self-Assessment Instruments</li></li></ul><li>Tips from the Berkeley Pilot<br />
What’s in the Toolkit:  After<br />After the Self-Assessment:<br /><ul><li> Analysis Guidelines
 Sample Tables & Reporting Guidelines
 Action Planning Tool</li></li></ul><li>Action Planning Worksheet<br />
Overview of Self-Assessment Tools<br />Web-based Surveys:<br /><ul><li>Health Department staff
Collaborating partners</li></ul>Focus Groups:<br />Cross-section of Health Department staff<br />Interviews:<br />Manageme...
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Barhii self assessmenttoolkitwebinar mar2011 final

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  • We developed a framework to guide our work. We recognized that much of our funding and consequently our programs are in TPHP.
  • We realized that if we were going to make a dent we needed to start focusing some of our work on the things on the other side of this framework. The PH work that we’re all now trying to create. Go over it quickly.
  • So this is what guides our work. Many of you are familiar with this already. Recently adopted by the CDPH.
  • Ashley’s slide
  • Ashley’s slide
  • Barhii self assessmenttoolkitwebinar mar2011 final

    1. 1. Using BARHII's Organizational Self Assessment Toolkit to initiate LHD action on health inequity <br />Tuesday, March 8, 2011<br />
    2. 2. Objectives<br />At the end of today’s webinar participants will: <br />Understand the prerequisites to implementing the BARHII Self Assessment Tool.<br />Be familiar with the measures and capacities BARHII’s tool emphasizes.<br />Understand the benefits to implementing an equity-oriented self assessment and using that assessment to plan future efforts.<br />
    3. 3. Agenda<br />I. Webcast and Speaker Introductions<br />II. Introduction and background to Self Assessment Toolkit Edith Cabuslay & Sandi Galvez<br />III. Berkeley’s experience using the Toolkit Kate Clayton & Abraxas Seale <br />IV. Q&A<br />V. Closing and evaluation<br />
    4. 4. Introduction and background<br />Edith Cabuslay<br />Chronic Disease and Injury Prevention Manager, San Mateo County Health System<br />Co-chair of BARHII<br />Sandi Galvez<br />Senior Policy Associate<br />Bay Area Regional Health Inequities Initiative (BARHII)<br />
    5. 5. Berkeley’s experience using the Toolkit<br />Kate Clayton<br />Chief of the Health Promotion<br />Berkeley Public Health Division<br />Abraxas SealeBerkeley Public Health Division<br />
    6. 6. Alameda<br />City of Berkeley<br />Contra Costa<br />Marin<br />Napa<br />San Francisco<br />San Mateo<br />Santa Clara<br />Santa Cruz<br />Solano<br />Sonoma<br />
    7. 7. BARHII Mission Statement<br />“. . . To transform public health practice for the purpose of eliminating health inequities using a broad spectrum of approaches that create healthy communities.”<br />
    8. 8. Organizational Approach<br /><ul><li> Identify Social Justice as a core Public Health value
    9. 9. Build alliances with key institutions that influence the health of communities
    10. 10. Inform policy makers and the general public about the underlying social causes of Health Inequities
    11. 11. Build the capacity of Public Health workforce and agencies</li></li></ul><li>BARHII Framework<br />
    12. 12. BARHII Framework<br />
    13. 13. BARHII FRAMEWORK<br />
    14. 14. Bay Area Regional Health Inequities Initiative<br />Built environment<br />Community<br />Data<br />Internal capacity<br />Social determinants of health<br />Policy/ advocacy<br />BARHII Structure<br />
    15. 15. Organizational Self-Assessment Toolkit<br />
    16. 16. Mission of Internal Capacity Committee<br />Enhance the capacityand collaborationof multiple health departments to effectively eliminate health inequities. <br />
    17. 17. Key Questions addressed by ICC<br />What are the skills and abilities needed by public health department staff to effectively address health inequities?<br />What are the characteristics of a public health department that can effectively address health inequities?<br />
    18. 18. Workforce Attributes<br /><ul><li>Specific personal attributes
    19. 19. Knowledge of public health framework
    20. 20. Understand the social, environmental and structural determinants of health
    21. 21. Community knowledge
    22. 22. Leadership skills
    23. 23. Collaboration skills
    24. 24. Community organizing skills
    25. 25. Problem solving ability
    26. 26. Cultural competency/ cultural humility </li></li></ul><li>Organizational Attributes<br /><ul><li>Institutional commitment to address health inequities
    27. 27. Hiring to address health inequities
    28. 28. Structure that supports true community partnerships
    29. 29. Supporting staff to address health inequities
    30. 30. Transparent & inclusive communication
    31. 31. Institutional support for innovation
    32. 32. Creative use of categorical funds
    33. 33. Community accessible data & planning
    34. 34. Streamlined administrative process</li></li></ul><li>Tool Development Process<br />Matrix: <br />Develop <br />Compe-<br />tencies<br />Literature <br /> Review &<br /> Validation<br />Indicators<br /> Toolkit<br />Revisions <br />Dissemi-<br /> nation<br />Peer <br /> Review<br />Further<br />Revisions<br />Self-<br /> Assessment<br />Pilot Test<br />Sources Included:<br /><ul><li>Public Health Literature
    35. 35. Org. Development Literature
    36. 36. Org. and Cultural Competency Tools</li></li></ul><li>Organizational Self-Assessment for Addressing Health Inequities<br /><ul><li> Baseline measure of capacity, skills and areas for improvement;
    37. 37. Inventories a set of research-based organizational and individual traits;
    38. 38. Informs strategic planning and organizational development activities;
    39. 39. Ongoing tool to assess progress</li></li></ul><li>What’s in the Toolkit: Before<br />Before the Self-Assessment:<br /><ul><li> Readiness Checklist
    40. 40. Time Estimates & Materials Budget
    41. 41. Bibliography
    42. 42. Lessons Learned</li></li></ul><li>What’s in the Toolkit: During<br />During the Self-Assessment:<br /><ul><li> Implementation Guide
    43. 43. Roadmap: Tailoring the Self-Assessment
    44. 44. Tips
    45. 45. Online Survey Guide
    46. 46. Sample Communications
    47. 47. Glossary of Key Terms
    48. 48. Self-Assessment Instruments</li></li></ul><li>Tips from the Berkeley Pilot<br />
    49. 49. What’s in the Toolkit: After<br />After the Self-Assessment:<br /><ul><li> Analysis Guidelines
    50. 50. Sample Tables & Reporting Guidelines
    51. 51. Action Planning Tool</li></li></ul><li>Action Planning Worksheet<br />
    52. 52. Overview of Self-Assessment Tools<br />Web-based Surveys:<br /><ul><li>Health Department staff
    53. 53. Collaborating partners</li></ul>Focus Groups:<br />Cross-section of Health Department staff<br />Interviews:<br />Management staff and leadership<br />Internal documents review and HR Worksheet<br />
    54. 54. Roadmap: Tailoring the Assessment<br /><ul><li> Each matrix element has corresponding questions within each instrument
    55. 55. Prioritized questions are highlighted
    56. 56. Guides selection of instruments and/or questions within each instrument</li></li></ul><li>Sample Roadmap<br />
    57. 57. Glossary of Key Terms<br /><ul><li> Health Disparities
    58. 58. Health Inequities
    59. 59. Social Determinants of Health
    60. 60. Root Causes of Health Inequities:
    61. 61. Institutionalized or Structural Racism
    62. 62. Class Inequality
    63. 63. Social Justice</li></li></ul><li> Sample Key Term<br />Health Inequities are differences in health status and death rates across population groups that are systematic, avoidable, unfair, and unjust. These differences are sustained over time and generations, and are beyond the control of individuals. These differences follow the larger patterns of inequality that exist in society. This is different from the term health disparities, which emphasizes that differences exist but does not consider the relationship to patterns of social inequalities.<br />
    64. 64. Key Term Examples<br />A local health department addressing health inequities targets the health issues facing the community it serves, while at the same time working to address the inequalities in the social and environmental conditions that contribute to the differences in illness and injury. For example, in addition to providing individuals with WIC vouchers, a local health department also works to advocate for improved access to sustainable, affordable, healthy food in neighborhoods with few resources.<br />
    65. 65. Staff Survey<br /><ul><li>Administered online
    66. 66. Administered to all staff
    67. 67. Content spans five broad areas:
    68. 68. Health department planning and policies
    69. 69. Collaboration within public health agency
    70. 70. Collaboration with external partners & policy-makers
    71. 71. Working with communities to address health inequities
    72. 72. Supporting staff to address health inequities</li></li></ul><li>Staff Survey Sample Question<br />17. I think we have strategies in place in [LHD] to advocate for public policies that address environmental, social and/or economic conditions that impact health inequities.<br /> □ No □ Moving in that Direction <br /> □ Yes □ I don’t know<br />Matrix element:<br />Institutional Commitment to Address Health Inequities<br />
    73. 73. Collaborating Partners Survey<br /><ul><li>Administered online or by paper
    74. 74. Select group of partners is asked to participate
    75. 75. Content spans five broad areas:
    76. 76. LHD's role and commitment to addressing health inequities
    77. 77. Staff members' commitment to and understanding of health inequities
    78. 78. Collaboration with LHD: administrative processes and decision-making
    79. 79. Community input and communication
    80. 80. Efforts to build community capacity </li></li></ul><li>Collaborating Partners Survey Sample Question<br />50. [LHD] builds the leadership capacity of community members to advocate on issues affecting the root causes of health inequities.<br /> □ Yes □ Moving in that Direction <br /> □ No □ I don’t know<br />Matrix element:<br />Community Organizing Skills<br />
    81. 81. Staff Focus Groups<br /><ul><li>Administered by external facilitator
    82. 82. All levels of the organization participate
    83. 83. Explores:
    84. 84. LHD culture and support for staff
    85. 85. Skills and practices critical for understanding health inequities
    86. 86. Diversity and cultural competency
    87. 87. Working with the community
    88. 88. Staff members’ input to organizational plan to address health inequities</li></li></ul><li>Staff Focus Group Sample Question<br />4. What has [LHD] done to help you learn about and develop skills to address root causes of health inequities?<br />Matrix element:<br />Supporting staff to address health inequities<br />
    89. 89. Management Interviews<br /><ul><li>Lead staff participate
    90. 90. External interviewer recommended
    91. 91. Explores:
    92. 92. Mission, vision, and values of LHD
    93. 93. Planning
    94. 94. LHD culture regarding organizational and workforce development
    95. 95. Diversity and cultural competency
    96. 96. LHD decision-making process
    97. 97. Efforts to build community capacity
    98. 98. Administrative processes </li></li></ul><li>Management Interview Sample Question<br />12. Would you say [LHD] has a culture that encourages learning, growth, and change?<br />a. (Probe: How are staff encouraged to challenge assumptions and the status quo? How does [LHD] give positive incentives for feedback? Are there repercussions if staff make a mistake etc.?)<br />b. What types of risk-taking does [LHD] successfully encourage? (i.e. hiring people without traditional qualifications, advocating for public policies that address the determinants of health, etc.)?<br />Matrix element:<br />Institutional Support for Innovation<br />
    99. 99. Internal Document Review<br /><ul><li>Identify priority areas of Inquiry
    100. 100. Systematic review of organization’s documents
    101. 101. Human Resources data and practices
    102. 102. Budget documents
    103. 103. Program materials
    104. 104. Human Resources Worksheet
    105. 105. Explores institutional commitment and capacity to address health inequities</li></li></ul><li>Internal Document Review Sample Question<br />14a. Are County Classifications written so that the educational requirements do not eliminate candidates with the experience, skills and qualities needed to do health equity work in a local health department?<br />Matrix element:<br />Hiring to Address Health Inequities<br />
    106. 106. Human Resources Worksheet<br />
    107. 107. Implementing the Self-Assessment <br />Leadership:<br /><ul><li>Assess readiness
    108. 108. Commitment
    109. 109. Identify resources
    110. 110. Participate in interviews and focus groups
    111. 111. Provide appropriate and timely follow-up</li></li></ul><li>Implementing the Self-Assessment <br />Create an Implementation Team:<br /><ul><li>Assess Identify appropriate personnel
    112. 112. Communicate department-wide and create buy-in
    113. 113. Prepare staff and provide adequate time and support for completion of instruments
    114. 114. Identify appropriate community partners to survey
    115. 115. Review and modify instruments as needed
    116. 116. Coordinate document review and data extraction</li></li></ul><li>Lessons Learned from Pilot Test<br /><ul><li>Strong Implementation Team with designated lead pivotal
    117. 117. Staff Engage on Health Equity through Assessment
    118. 118. Communication between all levels of organization before, during and after process
    119. 119. Allocate staff time to participate in process
    120. 120. Incentivize staff participation</li></li></ul><li>Lessons learned from Pilot Test<br /><ul><li> Ensure confidentiality
    121. 121. Strong and knowledgeable focus group facilitation
    122. 122. Use the assessment results to develop department-wide strategies
    123. 123. Be prepared to receive feedback</li></li></ul><li>Berkeley Assessment Results –Structural Changes Implemented<br /><ul><li> New Public Health 101 Training
    124. 124. New ISMS Workgroup
    125. 125. New Workforce Development
    126. 126. Promotional practices influenced
    127. 127. Division reorganization influenced</li></li></ul><li>Berkeley Assessment Results – ISMS Workgroup Activities<br />Post Self-Assessment activities:<br /><ul><li>Analysis of results
    128. 128. Recommendations for departmental changes informed by findings</li></li></ul><li>Berkeley Assessment Results – ISMS Workgroup Activities<br />Staff-led activities:<br /><ul><li> Ongoing Staff Education on Inequities and Isms
    129. 129. Formal Celebrations of Diversity
    130. 130. Reframing Department Leadership</li></li></ul><li>Question & Answer Session<br />Ask a question via “chat” using the box on the lower left of your screen. <br />If we cannot get to your question today, please consider posting it to the Coalition’s website (http://healthequity.naccho.org) .<br />
    131. 131. Discussion<br /><ul><li> How do you see this being relevant to the work of your LHD?
    132. 132. What resources would you need to be able to carry this out?
    133. 133. Do you think your LHD is ready to to implement the Self-Assessment? If not, what would it take to get there?</li></li></ul><li>Discussion<br /><ul><li>With whom can you work? What role do you see for:
    134. 134. Colleagues in other LHDs?
    135. 135. organizations like NACCHO, etc?
    136. 136. others?
    137. 137. How could we provide assistance?</li></li></ul><li>Additional Information<br />Toolkit available at:<br />www.barhii.org<br />Feel free to contact:<br />Sandi Galvez<br />Senior Associate<br />sgalvez@phi.org<br />(510) 302-3369<br />
    138. 138. Thank you!<br />If you have any questions or additional comments please feel free to contact:<br />Ashley Bowen, MAProgram Associate, Health Equity & Social JusticeNACCHO(202) 507-4282 directabowen@naccho.org<br />Or visit<br />http://healthequity.naccho.org<br />

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