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The blog of the National Network of Libraries of Medicine Evaluation Office

Archive for March, 2016

Inspirational Annual Reporting with Appreciative Inquiry

Friday, March 25th, 2016

Hiker enjoying the view along the Iceberg Lake trail in Glacier National Park

Do you have to file annual reports? How much do you love doing them?

Did I hear someone say “no comment?”

In January, I challenged the outreach librarians of the National Network of Libraries of Medicine Greater Midwest Region (NN/LM GMR) to experiment with a reflective exercise designed to add some inspiration to their annual reporting. The setting was a monthly webinar attended by librarians who led outreach activities at their libraries to promote health information access and use. Because their libraries received funding from the NN/LM GMR, they were required to submit annual reports for their funded activities.

My charge was to teach this group something about evaluation. In response, I presented them with this short (about 15 minute) exercise to be used when they began preparing their annual reports.

When preparing your report, answer these questions. Then write a short paragraph based on your answers and add it to your annual report:

  1. Describe one of the best experiences you had this year conducting outreach for the NN/LM.
  2. What do you value most about that experience?
  3. What do you wish could happen so that you had more experiences like this?

You may recognize these as the three signature questions of the basic Appreciative Inquiry (AI) interview. Appreciative Inquiry is a practice of influencing organizational change by identifying peak experiences and discovering ways to build on them. The book Reframing Evaluation through Appreciative Inquiry (Preskill and Catsambas, Sage, 2006) provides descriptions and examples of how to apply AI to every part of the evaluation process.

My partners for this webinar were host Jacqueline Leskovec, Outreach, Planning and Evaluation Coordinator, and presenter Carmen Howard, who is the Regional Health Sciences Librarian and Visiting Assistant Professor from UIC Library of the Health Sciences Peoria. Carmen headlined the webinar with her presentation about the Nursing Experts: Translating the Evidence (NExT) Guide, which provides resources on evidence-based practice to nurses. Good sport that she was, Carmen helped me demonstrate the exercise to our audience by participating in an AI interview about her outreach project. The outreach librarians then brainstormed ways to use the three questions to prepare their own NN/LM reports. We also talked about how to add their reflective statements to their annual reports, which are entered into an online system.

Soon after that webinar, Carmen wrote an entry about her experience using the three questions that appeared in the NN/LM GMR’s blog The Cornflower. Here is my favorite quote from her entry:

“These three simple questions which only take about 10-15 minutes to answer forced me to stop and reflect on the NExT project. Rather than just being focused on what was next on the to-do list, I was looking back on what had already been accomplished, and better yet, I was thinking about the good stuff.”

The NN/LM GMR outreach librarians have not yet filed their 2016 annual reports, so I can’t tell you how many rose to my challenge. (This exercise was a suggestion, not a requirement.) One other outreach librarian did send an email to say she was using the three questions to have a reflective group discussion with other librarians who participate in NN/LM outreach activities.

I would like to extend the challenge to our readers who may be facing annual reports. Try this exercise and see if you don’t start thinking and writing differently about your efforts over the past year.

If you want to know more about Appreciative Inquiry, we highly recommend this source:

  • Preskill H, Catsambas TT. Reframing Evaluation through Appreciative Inquiry. Thousand Oaks, CA: Sage, 2006.

You also might be interested in the OERC’s other blog posts about Appreciative Inquiry:

If you are interested in earning some continuing education credits from the Medical Library Association while trying your hand at an Appreciative Inquiry project, reach this post: Appreciative Inquiry of Oz: Building on the Best in the Emerald City 

 

Diversity in Evaluation – It’s About All of Us

Friday, March 18th, 2016

Picture of children running through different colors with text "Diversity is about all of us, and about us having to figure out how to walk through this world together.

Unless you’ve been living under a rock, you know that culture permeates everything we do, and that we live in a diverse society with lots of different cultures. Odds are good that no matter what your job is, you take into consideration issues of culture, diversity and inclusion. This applies to evaluation as it does everywhere else.

At the 2015 Summer Evaluation Institute, each attendee was given a copy of The American Evaluation Association’s Statement on Cultural Competence in Evaluation.  I was impressed that the document was frequently mentioned, because it was clear that the AEA felt that cultural competence was central to quality evaluation. As it says in the Statement, “evaluations cannot be culture free… culture shapes the way the evaluation questions are conceptualized which in turn influences what data are collected, how the data will be collected and analyzed, and how the data are interpreted.”

The Statement describes the importance of cultural competence in terms of ethics, validity of results, and theory.

  • Ethics – quality evaluation has an ethical responsibility to ensure fair, just and equitable treatment of all persons.
  • Validity – evaluation results that are considered valid require trust from the diverse perspectives of the people providing the data and trust that the data will be honestly and fairly represented.
  • Theory – theories underlie all of evaluation, but theories are not created in a cultural vacuum. Assumptions behind theories must be carefully examined to ensure that they apply in the cultural context of the evaluation.

The Statement makes some recommendations for essential practices for cultural competence. I highly recommend reading all of the essential practices, but here are a few examples:

  • Acknowledge the complexity of cultural identity. Cultural groups are not static, and people belong to multiple cultural groups. Attempts to categorize people often collapse them into cultural groupings that may not accurately represent the true diversity that exists.
  • Recognize the dynamics of power. Cultural privilege can create and perpetuate inequities in power. Work to avoid reinforcing cultural stereotypes and prejudice in evaluation. Evaluators often work with data organized by cultural categories. The choices you make in working with these data can affect prejudice and discrimination attached to such categories.
  • Recognize and eliminate bias in language: Language is often used as the code for a certain treatment of groups. Thoughtful use of language can reduce bias when conducting evaluations.

This may sound good, but how can it apply to the evaluation of your outreach project?

Recently, the EvergreenData Blog had two entries on data visualizations and how they can show cultural bias. In the first one, How Dataviz Can Unintentionally Perpetuate Inequality: The Bleeding Infestation Example, she shows how using red to represent individual participants on a map made the actual participants feel like they were perceived as a threat. The more recent blog post, How Dataviz Can Unintentionally Perpetuate Inequality Part 2, shows how the categories used in a chart on median household income contribute to stereotyping certain cultures and skew the data to show something that does not accurately represent income levels of the different groups.

Does it sometimes feel like cultural competence is too much to add to your already full plate of required competencies? This quote from the AEA Statement on Cultural Competence in Evaluation may be reassuring: “Cultural competence is not a state at which one arrives; rather, it is a process of learning, unlearning, and relearning.”

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Get to Know a Community though Diffusion of Innovation (Part 2)

Friday, March 11th, 2016

two granddaughter whispering some news to their grandmother

It’s really simple. You sell to the people who are listening, and just maybe, those people tell their friends.“ — Seth Godin, marketer.

Diffusion of Innovation changed my approach to community assessment. I now focus primarily on identifying the following three things: the key problem that the program or product (the innovation) offers the target community; key community members who will benefit both from the innovation and promoting it; and the best channels for capturing the attention of the majority and laggard segments of the group.

I now purposely use the term “community” rather than “needs” assessment because you have to assess much more needs. You must learn the key components of an entire social system. A community could be faculty or students in a particular department, staff in a given organization, or an online support group of people with a challenging health condition. All of these groups fit my definition of “community” by virtue of their connectedness and ability to influence each other.

Key Evaluation Questions

No matter what type of evaluation I do, I always start with guiding evaluation questions. These questions lead my investigation and help me design data collection methods. Here are my most typical community assessment questions:

  • What problems can the innovation solve for the target audience?
  • What are their beliefs, lifestyles, and values; and will the innovation fit all three? (Marketers call these characteristics “psychographics.”)
  • Who in the group is most likely to want to use the innovation and talk about it to their friends? (These are the early adopters who fit a second category: opinion leaders.)
  • Who among the early adopters will want to work with the project team and how can we work with them?
  • Where are the best places to connect with community members?
  • What are the best ways to communicate with the larger majority?

Answering Evaluation Question

 I also have a series of steps that I usually take to gather information about my key evaluation questions.  This is my typical process:

  1. Talk to “advisors” about their ideas and their contacts. Start talking with people you know who are part of or had experience with a community. I call this group my “advisors.” They don’t have to be high-level officials, but they do need to have solid social connections. It helps if they are well liked within the target community. They will know about the daily lives of target community members, as well as the influential voices in the community. They also can help you gain access.
  2. Look at publically available data: Local media provides clues to the concerns and interests of your target community. In a town or neighborhood, newspapers and websites for television stations are good sources.  Inside an organization, you should look at public and employee relation publications to see what is on the minds of leaders and employees.
  3. Interviews with key informants: Get your advisors to recommend people they think would be early adopters and opinion leaders for your innovation. But don’t stop there. Early adopters are different from those in the “later adopter” segments. You need to talk with people from the other segments to understand how to get their attention and participation. The best way to find community members in the other segments is to ask for recommendations and introductions from the early adopters. This is called “snowball sampling.”
  4. Visit the community: More specifically, visit locations where you are most likely to connect with members of your target audience. Visit the venue of a health fair where you could exhibit.  Stop by the computer lab in an academic department where you might teach students. Check out the parking and building access at the public library or community-based organization that could host a consumer health information workshop. If your community is virtual, see if you can visit and participate with group members through their favored social media channels.
  5. Put ideas together, then present them to early adopters for feedback: If at all possible, bring together a group of early adopters and potential partners to listen to and respond to your ideas. Early adopters are the people that companies use for beta testing, so you can do the same. It may be the same people you interviewed or a different crowd (or a mix).

Other Tips

For the most part, I tend to rely heavily on qualitative methods for community assessment. Diffusion of Innovation describes how ideas spread through a system of relationships and communication channels. You need details to truly understand that system.  You need to talk to people and understand how they live. Interviews, focus groups, and site visits provide the most useful planning information, in my opinion. You may have to include quantitative data, though.  Library usage statistics might indicate the best branches for providing workshops.  Short surveys might confirm broad interest in certain services. In the end, a blend of mixed-methods gives you the best picture of a community.

The downside to mostly qualitative data collection methods is that you get an overwhelming amount of information. I like to use an information sheet that allows me to summarize information as I conduct a community assessment. A version of this worksheet is available in OERC’s Planning and Evaluating Health Information Outreach Projects Booklet 1: Getting Started with Community-Based Outreach (downloadable version available here.). See Worksheet 2 on page 19. You should see how the evaluation questions I posed above are related to this worksheet.

Final Thoughts

Seth Godin said ideas that spread are remarkable, meaning they are “worth making a remark about.” Use community assessment to find out why your innovation is remarkable and how to start the conversation.

Other Resources

If you want to see an example of a community assessment that used this process, check out this article in Public Libraries.

You also might be interested in  Seth Godin’s TEDtalk How to Get Your Ideas to Spread.

A Most Pragmatic Theory: Diffusion of Innovation and User Assessment (Part 1)

Friday, March 4th, 2016

Seven tomatoes in a row, increasing in maturity from left to right

If your work includes teaching or providing products or services to people, you are in the business of influencing behavior change. In that case, behavior change theories should be one of the tools in your evaluation toolbox. These theories are evidence-based descriptions of how people change and the factors that affect the change process. If you have a handle on these influences, you will be much more effective in gathering data and planning programs or services.

Today and next week, I’m going to talk about my go-to behavioral change theory: Diffusion of Innovations. It was introduced in the 1960s by communication professor Everett Rogers to explain how innovations spread (diffuse) through a population over time. The term innovation is broadly defined as anything new: activities, technologies; resources; or beliefs. There are a number of behavioral change theories that guide work in health and human services, but I particularly like Diffusion of Innovations because it emphasizes how social networks and interpersonal relationships may impact your success in getting people to try something new.

I use Diffusion of Innovations for most user or community assessment studies I design. Next week, we’ll talk about using these concepts to frame community or user assessment studies. This week, I want to cover the basic principles I found to be most helpful.

People change in phases

The heart of behavior change is need.  People adopt an innovation if it that solves a problem or improves quality of life. Adoption is not automatic, however. People change in phases. They first become aware and gather information about an innovation. If it is appealing, they decide to employ it and assess its usefulness. Adoption occurs if the innovation lives up to or exceeds their expectation.

Product characteristics influence phase of adoption

Five criteria impact the rate and success of adoption within a group. First, the innovation must be better than the product or idea it is designed to replace. Second, it must fit well with people’s values, needs and experiences. Innovations that are easy to use will catch on faster, as will technologies or resources that can allow experimentation before the user must commit to it. Finally, if people can easily perceive that the innovation will lead to positive results, they are more likely to use it.

Peers’ opinions matter greatly when it comes to innovation adoptions. Marketers will tell you that mass media spreads information, but people choose to adopt innovations based on recommendations from others who are “just like them.” Conversations and social networks are key channels for spreading information about new products and ideas. If you are going to influence change, you have to identify and use how members of your audience communicate with one another.

Migration of flock of birds flying in V-formation at dusk

Riding the Wave

Segments of a population adopt innovations at different rates. In any given target population, there will be people who will try an innovation immediately just for the pleasure of using something new. They are called innovators. The second speediest are the early adopters, who like to be the trendsetters. They will use an innovation if they perceive it will give them a social edge. They value being the “opinion leaders” of their communities.

Sixty-eight percent of a population comprise the majority.  The first half (early majority) will adopt an innovation once its reliability and usefulness have been established. (For example, these are the folks who wait to update software until the “bugs” have been worked out.) The other half (late majority) are more risk adverse and tend to succumb through peer pressure, which builds as an innovation gathers momentum. The last adopters are called the laggards, who are the most fearful of change. They prefer to stick with what they know. Laggards may have a curmudgeonly name, but Les Robinson of Enabling Change pointed out that they also may be prophetic, so ignore them at your own risk.

Next Step: Diffusion of Innovations and User/Community Assessment

Next week, I will show you how I develop my needs assessment methods around Diffusion of Innovation concepts. In the meantime, here are some sources that might interest you. Everett Rogers and Karyn Scott wrote an article specifically for the NN/LM Pacific Northwest Region that you can read here. Les Robinson’s article has an interesting discussion of the specific needs of the different population segments: Finally, If you want the classic text by Ev Rogers himself, here is the full citation.

Rogers EM.  Diffusion of innovations (5th ed). New York, NY: The Free Press, 2003.

Last updated on Monday, June 27, 2016

Funded by the National Library of Medicine under Contract No. UG4LM012343 with the University of Washington.