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Presented by: Office of Minority Health & Public Health Policy  (OMHPHP) Advancing Health Equity for All Virginians http:/...
Health Equity Pre-test
<ul><li>Vision:  Advancing health equity for all Virginians </li></ul><ul><li>Mission:   Our mission is to identify health...
<ul><li>Minority Health   </li></ul><ul><li>http:// www.vdh.state.va.us/healthpolicy / </li></ul><ul><li>CLAS Act </li></u...
<ul><li>SOCIAL JUSTICE   </li></ul><ul><li>Social justice is the equitable distribution of  social, economic  and  politic...
<ul><li>Social Determinants of Health   are   those inter-related social and economic factors that influence health.  </li...
<ul><li>Health Disparities   are “Differences in health status among distinct segments of the population including differe...
<ul><li>Health Inequities   are   disparities in health that are a result of systemic, avoidable and unjust social and eco...
Office of Minority Health &  Public Health Policy  (OMHPHP) <ul><li>Addresses Health Inequities through Collaborative Appr...
OMHPHP Linking to the Network
OMHPHP is utilizing a national initiative as a tool to address  Health Inequities...
Unnatural Causes Documentary  Series Structure  UNNATURAL CAUSES  is a  pioneering 4-hour PBS documentary series with an a...
Unnatural Causes – Is Inequality Making Us Sick? <ul><ul><ul><ul><li>Health is more than healthcare </li></ul></ul></ul></...
Unnatural Causes Is Inequality Making Us Sick? <ul><li>Selected Clips </li></ul>
Discussion Objective -- Reflective -- Interpretive <ul><li>O:  What scenes and/or sound grabbed your attention the most?  ...
Become Involved
Searching within your organization <ul><li>What activities can you do? </li></ul><ul><ul><li>Make Unnatural Causes Toolkit...
Action Steps for Addressing Health Equities...  <ul><li>Join the  UNNATURAL CAUSES  Public Impact Campaign at  www.unnatur...
  Ways to address health inequities <ul><li>Examples: </li></ul><ul><li>Education  impacts health:   </li></ul><ul><ul><li...
<ul><li>Examples: </li></ul><ul><li>Environment  impacts health:   </li></ul><ul><ul><li>Create neighborhood gardens to pr...
<ul><li>Examples: </li></ul><ul><li>English proficiency  impacts health:   </li></ul><ul><ul><li>Provide tutoring to limit...
<ul><li>Examples: </li></ul><ul><li>Use your knowledge about the needs and health problems in the community to advocate fo...
Who can help create Health Equity ? <ul><li>Individuals </li></ul><ul><li>Groups </li></ul><ul><li>Organizations </li></ul...
Health Equity Post-test
Presented by: Office of Minority Health & Public Health Policy  (OMHPHP) Advancing Health Equity for All Virginians http:/...
Pre & Post Test Overview
Before your presentation…
<ul><li>It is important that your organization as a whole  – leadership and staff –  is committed to health equity and has...
<ul><li>Take a minute to ask yourself: </li></ul><ul><li>How do health equity and social justice fit into the mission of m...
<ul><li>Take a minute to ask yourself: </li></ul><ul><li>Does everyone know how to move the conversation beyond disparitie...
<ul><li>Each goal and objective should be specific to your organization’s vision and existing scope of work and outline ho...
<ul><li>Once you are able to define your audience, you can tailor your event to your participants and foster appropriate l...
Logistics <ul><li>What must be done to prepare for the presentation? </li></ul>
During your presentation…
<ul><li>Reflect on your facilitator style.  </li></ul><ul><li>Are you a Leader? </li></ul><ul><li>Do you prefer to manage ...
<ul><li>Plan </li></ul><ul><li>Materials </li></ul><ul><li>Audience Management </li></ul>Foundation of a Good Presentation
<ul><li>Introduction  </li></ul><ul><li>Support </li></ul><ul><li>Discussion </li></ul><ul><li>Conclusion </li></ul>Presen...
<ul><li>Create group agreements </li></ul><ul><li>Explore ideas rather than debate positions </li></ul><ul><li>Encourage a...
Audience Management Pitfalls <ul><li>Letting a member run away with the meeting </li></ul><ul><li>Not starting/ending on t...
Audience Management Facilitating a Group <ul><li>More than showing up </li></ul><ul><li>Carries increased responsibility a...
Audience Management Facilitator’s Role <ul><li>Facilitate Meetings </li></ul><ul><li>Mediate conflicts </li></ul><ul><li>K...
Audience Management Resources for Facilitators <ul><li>Leadership “job descriptions” </li></ul><ul><li>Website with free g...
<ul><li>ORID </li></ul><ul><li>Tailor facilitation questions to your audience and refer to ORID: a “four-stage process tha...
<ul><li>ORID: Objective Level </li></ul><ul><ul><li>O bjective  level: questions about facts and external reality that peo...
<ul><li>ORID: Reflective Level </li></ul><ul><ul><li>O bjective   </li></ul></ul><ul><ul><li>R eflective  level: questions...
<ul><li>ORID: Interpretive Level </li></ul><ul><ul><li>O bjective   </li></ul></ul><ul><ul><li>R eflective </li></ul></ul>...
<ul><li>ORID: Decisional Level </li></ul><ul><ul><li>O bjective   </li></ul></ul><ul><ul><li>R eflective   </li></ul></ul>...
<ul><li>Prepare more than you need.  </li></ul><ul><li>Note in advance which components you can sacrifice.  </li></ul><ul>...
Concluding your presentation…
<ul><li>At the end of your presentation, it is important to do a </li></ul><ul><li>general summary of the discussion and p...
Questions?
Presentation Materials Resources <ul><li>OMHPHP Health Equity PowerPoint can be accessed at  http://www.vdh.state.va.us/he...
Contact OMHPHP <ul><li>Virginia Department of Health </li></ul><ul><li>Office of Minority Health and Public Health Policy ...
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Training of the Trainer: Health Equity 101

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Presentation by Susan Triggs, RN, MPH at the 2009 Virginia Health Equity Conference - Learn to use the “Unnatural Causes: Is inequality making us sick?” (UC) series to lead community discussions and action planning to promote health equity by targeting the social determinants of health. Provides facilitation tips, background, sample agendas, and guidelines for planning effective screenings of Unnatural Causes that not only deepen the understanding of issues but serve as a step towards commitment to becoming involved and staying engaged.

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Training of the Trainer: Health Equity 101

  1. 1. Presented by: Office of Minority Health & Public Health Policy (OMHPHP) Advancing Health Equity for All Virginians http:// www.vdh.state.va.us/healthpolicy/index.htm Training of the Trainer - Module I: Health Equity 101
  2. 2. Health Equity Pre-test
  3. 3. <ul><li>Vision: Advancing health equity for all Virginians </li></ul><ul><li>Mission: Our mission is to identify health inequities, assess their root causes and address them by promoting social justice, influencing policy, establishing partnerships, providing resources and educating the public. </li></ul>VISION AND MISSION
  4. 4. <ul><li>Minority Health </li></ul><ul><li>http:// www.vdh.state.va.us/healthpolicy / </li></ul><ul><li>CLAS Act </li></ul><ul><ul><li>www.CLASActVirginia.org </li></ul></ul><ul><li>Division of Health Equity Website: http:// www.vdh.state.va.us/healthpolicy/healthequity/index.htm </li></ul><ul><li>Unnatural Causes Partnership Web Site: www.unnaturalcauses.org </li></ul>OMHPHP Division of Health Equity Initiatives
  5. 5. <ul><li>SOCIAL JUSTICE </li></ul><ul><li>Social justice is the equitable distribution of social, economic and political resources, opportunities , and burdens and their consequences. </li></ul>Advancing Health Equity for All Virginians
  6. 6. <ul><li>Social Determinants of Health are those inter-related social and economic factors that influence health. </li></ul><ul><li>Including, but not limited to: </li></ul><ul><ul><li>Socioeconomic Status </li></ul></ul><ul><ul><li>Discrimination </li></ul></ul><ul><ul><li>Housing </li></ul></ul><ul><ul><li>Physical Environment </li></ul></ul><ul><ul><li>Food Security </li></ul></ul><ul><ul><li>Child Development </li></ul></ul><ul><ul><li>Culture </li></ul></ul><ul><ul><li>Social Support </li></ul></ul><ul><ul><li>Healthcare Services </li></ul></ul><ul><ul><li>Transportation </li></ul></ul><ul><ul><li>Working Conditions </li></ul></ul><ul><ul><li>Democratic Participation </li></ul></ul>
  7. 7. <ul><li>Health Disparities are “Differences in health status among distinct segments of the population including differences that occur by gender, race or ethnicity, education or income, disability, or living in various geographic localities.” </li></ul><ul><li>Source : The Office of Healthy Carolinians, 2007. Available at www.healthycarolinians.org. </li></ul>
  8. 8. <ul><li>Health Inequities are disparities in health that are a result of systemic, avoidable and unjust social and economic policies and practices that create barriers to opportunity. </li></ul><ul><li>Health Equity is the absence of differences in health between groups with differential exposure to those social and economic policies and practices that create barriers to opportunity. </li></ul>
  9. 9. Office of Minority Health & Public Health Policy (OMHPHP) <ul><li>Addresses Health Inequities through Collaborative Approaches with partners in the Public Health System . </li></ul>
  10. 10. OMHPHP Linking to the Network
  11. 11. OMHPHP is utilizing a national initiative as a tool to address Health Inequities...
  12. 12. Unnatural Causes Documentary Series Structure UNNATURAL CAUSES is a pioneering 4-hour PBS documentary series with an ambitious outreach and public health impact campaign to help reframe the nation’s debate over health and what we as a society can—and should—do to reduce our socio-economic and racial health disparities.  
  13. 13. Unnatural Causes – Is Inequality Making Us Sick? <ul><ul><ul><ul><li>Health is more than healthcare </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Health is tied to the distribution of resources </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Racism imposes an added health burden. </li></ul></ul></ul></ul><ul><ul><ul><ul><li>The choices we make are shaped by the choices we have. </li></ul></ul></ul></ul><ul><ul><ul><ul><li>High demand + low control = chronic stress. </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Chronic stress can be deadly. </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Inequality – economic and political – is bad for our health. </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Social policy is health policy. </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Health inequalities are not natural. </li></ul></ul></ul></ul><ul><ul><ul><ul><li>We all pay the price for poor health. </li></ul></ul></ul></ul>
  14. 14. Unnatural Causes Is Inequality Making Us Sick? <ul><li>Selected Clips </li></ul>
  15. 15. Discussion Objective -- Reflective -- Interpretive <ul><li>O: What scenes and/or sound grabbed your attention the most? </li></ul><ul><li>O: What words or phrases still linger in your mind? </li></ul><ul><li>R: Where did the video excite or frustrate you the most? </li></ul><ul><li>R: What past experience did you associate with these scenarios? </li></ul><ul><li>R : What was your first reaction? How did you feel when that happened? </li></ul><ul><li>I: What were some of the key points made in the video? </li></ul><ul><li>I: How does the video relate to your community/community you serve? </li></ul><ul><li>I: Does the video reflect the reality of your community? </li></ul><ul><li>I: What are some of the social determinants that influence health in your community or the community you serve? </li></ul>
  16. 16. Become Involved
  17. 17. Searching within your organization <ul><li>What activities can you do? </li></ul><ul><ul><li>Make Unnatural Causes Toolkit Available </li></ul></ul><ul><ul><li>Coordinate Screenings of Series </li></ul></ul><ul><ul><li>Facilitate Discussions Action Plans </li></ul></ul><ul><ul><li>Develop Health Equity Ambassador Programs </li></ul></ul>
  18. 18. Action Steps for Addressing Health Equities... <ul><li>Join the UNNATURAL CAUSES Public Impact Campaign at www.unnaturalcauses.org </li></ul><ul><li>Organize a screening to raise awareness for Leadership - May chose to link screening to an event that is already scheduled, i.e. meetings, leadership forums, and other activities. </li></ul><ul><li>Assemble a Planning Committee to create opportunities to develop comprehensive plans to address health inequities. </li></ul>
  19. 19. Ways to address health inequities <ul><li>Examples: </li></ul><ul><li>Education impacts health: </li></ul><ul><ul><li>Set up a reading room, where tutors can help people with low-literacy enhance their reading skills </li></ul></ul><ul><li>Social Support impacts health: </li></ul><ul><ul><li>Adopt a senior member of the community to provide basic living skills. </li></ul></ul>
  20. 20. <ul><li>Examples: </li></ul><ul><li>Environment impacts health: </li></ul><ul><ul><li>Create neighborhood gardens to promote healthy eating, social support, and social capital. </li></ul></ul><ul><li>Physical activity & social support impact health: </li></ul><ul><ul><li>Start an ongoing year-round sports league. </li></ul></ul> Ways to address health inequities
  21. 21. <ul><li>Examples: </li></ul><ul><li>English proficiency impacts health: </li></ul><ul><ul><li>Provide tutoring to limited English proficient individuals. </li></ul></ul><ul><li>Transportation impacts health: </li></ul><ul><ul><li>Coordinate a ride board so people without transportation can go where they need. </li></ul></ul> Ways to address health inequities
  22. 22. <ul><li>Examples: </li></ul><ul><li>Use your knowledge about the needs and health problems in the community to advocate for changes in the underlying social and economic policies. </li></ul> Ways to address health inequities
  23. 23. Who can help create Health Equity ? <ul><li>Individuals </li></ul><ul><li>Groups </li></ul><ul><li>Organizations </li></ul><ul><li>Initiatives </li></ul><ul><li>Partnerships </li></ul>
  24. 24. Health Equity Post-test
  25. 25. Presented by: Office of Minority Health & Public Health Policy (OMHPHP) Advancing Health Equity for All Virginians http:// www.vdh.state.va.us/healthpolicy/index.htm Training of the Trainer - Module II: Facilitator Training
  26. 26. Pre & Post Test Overview
  27. 27. Before your presentation…
  28. 28. <ul><li>It is important that your organization as a whole – leadership and staff – is committed to health equity and has the proper knowledge and training to be an effective advocate. </li></ul>Build internal consensus and capacity
  29. 29. <ul><li>Take a minute to ask yourself: </li></ul><ul><li>How do health equity and social justice fit into the mission of my organization(s)? </li></ul><ul><li>How do these translate into practice? </li></ul><ul><li>How knowledgeable, skillful and committed to health equity are leadership, staff, or my constituents? </li></ul>Build internal consensus and capacity
  30. 30. <ul><li>Take a minute to ask yourself: </li></ul><ul><li>Does everyone know how to move the conversation beyond disparities in care to the ways in which social conditions impact wellbeing? </li></ul><ul><li>Where are the areas of resistance? </li></ul>Build internal consensus and capacity
  31. 31. <ul><li>Each goal and objective should be specific to your organization’s vision and existing scope of work and outline how you will use Unnatural Causes. </li></ul>Develop Clear Goals and Objectives
  32. 32. <ul><li>Once you are able to define your audience, you can tailor your event to your participants and foster appropriate levels of involvement. </li></ul>Define Your Audience & Opportunities for Action
  33. 33. Logistics <ul><li>What must be done to prepare for the presentation? </li></ul>
  34. 34. During your presentation…
  35. 35. <ul><li>Reflect on your facilitator style. </li></ul><ul><li>Are you a Leader? </li></ul><ul><li>Do you prefer to manage or facilitate? </li></ul><ul><li>Are you most comfortable when you take a backseat? </li></ul>Facilitator Style
  36. 36. <ul><li>Plan </li></ul><ul><li>Materials </li></ul><ul><li>Audience Management </li></ul>Foundation of a Good Presentation
  37. 37. <ul><li>Introduction </li></ul><ul><li>Support </li></ul><ul><li>Discussion </li></ul><ul><li>Conclusion </li></ul>Presentation Plan
  38. 38. <ul><li>Create group agreements </li></ul><ul><li>Explore ideas rather than debate positions </li></ul><ul><li>Encourage active listening </li></ul><ul><li>Invite quiet, thoughtful people to participate </li></ul>Audience Management
  39. 39. Audience Management Pitfalls <ul><li>Letting a member run away with the meeting </li></ul><ul><li>Not starting/ending on time </li></ul><ul><li>Too passive/dominating </li></ul><ul><li>Avoids addressing “bad habits” </li></ul><ul><li>Has bad habits & sets bad example </li></ul><ul><li>Isn’t prepared for meeting </li></ul>
  40. 40. Audience Management Facilitating a Group <ul><li>More than showing up </li></ul><ul><li>Carries increased responsibility as member in terms of attendance, task assignment, & setting examples </li></ul>
  41. 41. Audience Management Facilitator’s Role <ul><li>Facilitate Meetings </li></ul><ul><li>Mediate conflicts </li></ul><ul><li>Keep group on task </li></ul><ul><li>Identify big picture issues and next steps </li></ul><ul><li>Summarize LONG discussion and verbal agreements for decisions </li></ul>
  42. 42. Audience Management Resources for Facilitators <ul><li>Leadership “job descriptions” </li></ul><ul><li>Website with free guide to successful facilitation: http://www.thiagi.com/tips.html </li></ul><ul><li>Website with free leadership development tools, materials, & guides http://www.managementhelp.org/grp_skll/resource.htm </li></ul>
  43. 43. <ul><li>ORID </li></ul><ul><li>Tailor facilitation questions to your audience and refer to ORID: a “four-stage process that enables a group facilitator to ask series of questions to elicit responses that take a group from the surface of a topic to its deeper meaning and implications.” </li></ul><ul><li>The four levels of questioning: </li></ul><ul><ul><li>O bjective </li></ul></ul><ul><ul><li>R eflective </li></ul></ul><ul><ul><li>I nterpretive </li></ul></ul><ul><ul><li>D ecisional </li></ul></ul><ul><ul><li>Source: Wee, Lian Chee. “The ORID in IS Classes.” 4 Nov 2006. < http://isedj.org/isecon/2006/3732/ISECON.2006.Wee.pdf> 26 Feb 2008. </li></ul></ul>Facilitation of Discussion
  44. 44. <ul><li>ORID: Objective Level </li></ul><ul><ul><li>O bjective level: questions about facts and external reality that people take in with their senses </li></ul></ul><ul><ul><li>R eflective </li></ul></ul><ul><ul><li>I nterpretive </li></ul></ul><ul><ul><li>D ecisional </li></ul></ul><ul><ul><li>Source: Wee, Lian Chee. “The ORID in IS Classes.” 4 Nov 2006. < http://isedj.org/isecon/2006/3732/ISECON.2006.Wee.pdf> 26 Feb 2008. </li></ul></ul>Facilitation of Discussion
  45. 45. <ul><li>ORID: Reflective Level </li></ul><ul><ul><li>O bjective </li></ul></ul><ul><ul><li>R eflective level: questions to call forth immediate personal reaction to the data. </li></ul></ul><ul><ul><li>I nterpretive </li></ul></ul><ul><ul><li>D ecisional </li></ul></ul><ul><ul><li>Source: Wee, Lian Chee. “The ORID in IS Classes.” 4 Nov 2006. < http://isedj.org/isecon/2006/3732/ISECON.2006.Wee.pdf> 26 Feb 2008. </li></ul></ul>Facilitation of Discussion
  46. 46. <ul><li>ORID: Interpretive Level </li></ul><ul><ul><li>O bjective </li></ul></ul><ul><ul><li>R eflective </li></ul></ul><ul><ul><li>I nterpretive level: questions to draw out meaning, values, significance and implications for the individual by building on the data from the objective level plus the associations from the reflective level. </li></ul></ul><ul><ul><li>D ecisional </li></ul></ul><ul><ul><li>Source: Wee, Lian Chee. “The ORID in IS Classes.” 4 Nov 2006. < http://isedj.org/isecon/2006/3732/ISECON.2006.Wee.pdf> 26 Feb 2008. </li></ul></ul>Facilitation of Discussion
  47. 47. <ul><li>ORID: Decisional Level </li></ul><ul><ul><li>O bjective </li></ul></ul><ul><ul><li>R eflective </li></ul></ul><ul><ul><li>I nterpretive </li></ul></ul><ul><ul><li>D ecisional level: questions to elicit resolution, enable the individual or group to make a decision in response to the even or about he future. </li></ul></ul><ul><ul><li>Source : Wee, Lian Chee. “The ORID in IS Classes.” 4 Nov 2006. < http://isedj.org/isecon/2006/3732/ISECON.2006.Wee.pdf> 26 Feb 2008. </li></ul></ul>Facilitation of Discussion
  48. 48. <ul><li>Prepare more than you need. </li></ul><ul><li>Note in advance which components you can sacrifice. </li></ul><ul><li>Keep a watch/clock visible </li></ul><ul><li>Give instructions before the activity </li></ul><ul><li>Allocate appropriate time to each activity/discussion </li></ul>Time Management
  49. 49. Concluding your presentation…
  50. 50. <ul><li>At the end of your presentation, it is important to do a </li></ul><ul><li>general summary of the discussion and point out </li></ul><ul><li>next steps that emerged. </li></ul>Presentation Summary and Next Steps
  51. 51. Questions?
  52. 52. Presentation Materials Resources <ul><li>OMHPHP Health Equity PowerPoint can be accessed at http://www.vdh.state.va.us/healthpolicy/healthequity/unnaturalcauses/documents/ToT-Unnatural-Causes.ppt </li></ul><ul><li>“ Unnatural Causes” DVD: Available for purchase from California Newsreel – http://www.newsreel.org/nav/title.asp?tc=UNAT </li></ul><ul><li>Handouts: available at http://www.vdh.virginia.gov/healthpolicy/healthequity/unnaturalcauses/resources.htm </li></ul>
  53. 53. Contact OMHPHP <ul><li>Virginia Department of Health </li></ul><ul><li>Office of Minority Health and Public Health Policy </li></ul><ul><li>109 Governor Street, Suite 1016 East </li></ul><ul><li>Richmond, Virginia 23219 </li></ul><ul><li>www.vdh.state.va.us/healthpolicy </li></ul><ul><li>804-864-7435 </li></ul>Golam Rabbani CLAS Act Coordinator Susan L. Triggs, MPH, RN Health Equity Specialist Karen E. Reed, MA Director, Division of Health Equity Mike Royster, MD, MPH Office Director

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