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SLIDE 1

E L DE RS’ ST ORYT E L L I NG PROJE CT

I

NN-04

F I NAL E VAL UAT I ON RE PORT F E BRUARY 2, 2016 F I NDI NGS OF PROCE SS AND OUT COME QUE ST I ONS

F inal Re por t pr e par e d by: Sadhna Diwan, PhD Pr

je c t E

valuator Pr

fe ssor

, Sc hool of Soc ial Wor k Dir e c tor , Ce nte r

n He althy Aging in Multic ultur

al Populations (CHAMP)

SLIDE 2

PROCE SS QUE ST I ONS

1. Ho w do e s the utiliza tio n o f a c o mmunity wo rke r with c ultura l c o mpe te nc e

c o ntrib ute to the se nio r's c o mfo rt le ve l in e xpre ssing his pe rso na l me mo rie s?

2. Ho w do e s the inc lusio n o f a fa mily me mb e r thro ug ho ut the a c tivity a ffe c t the

re la tio nship b e twe e n the se nio r a nd the fa mily me mb e r a t the c o nc lusio n o f the a c tivity?

3. Ho w do e s the e xe rc ise o f c a pturing the se nio rs’ life sto rie s thro ug h so me

e xpre ssive a rts me dium a nd pre se nting the m to the la rg e r c o mmunity c o ntrib ute to pre se rving pe rso na l a nd c o lle c tive histo ry?

4. Wha t a re the se nio rs’ pe rc e ptio ns o f the Sto ryte lling pro g ra m? (T

his q ue stio n wa s a dde d in c o nsulta tio n with se rvic e pro vide rs a nd the Pro je c t L e a d sta ff).

SLIDE 3

PROCE SS QUE ST ION 1: HOW DOE S T HE UT IL IZAT ION OF A COMMUNIT Y WORKE R WIT H CUL T URAL COMPE T E NCE CONT RIBUT E T O T HE SE NIOR'S COMF ORT L E VE L IN E XPRE SSING HIS PE RSONAL ME MORIE S?

Ha ving a c ommunity wor

ke r with c ultur a l c ompe te nc e c ontr ibute d to the se nior s’ c omfor t in e xpr e ssing the ir pe r sona l me mor ie s.

Clie nts we re ove r

whe lming ly positive in the ir r e sponse s on fe e ling like the ir c ultur a l tr a ditions we r e unde r stood a nd tha t the ir wor ke r c ommunic a te d we ll with the m.

While the ma jo rity c o nc urre d tha t ha ving a wo rke r o f a simila r c ultura l b a c kg ro und wa s he lpful

fo r b uilding ra ppo rt a nd fa c ilita ting the sto ry te lling pro c e ss, the r

e sponse s we r e some wha t mixe d whe n a ske d if the y would be just a s c omfor ta ble sha r ing the ir stor ie s with a wor ke r fr

m

a nothe r c ultur a l ba c kg r

und, sug g e sting tha t pe rha ps mo re a c c ultura te d c lie nts, o r tho se

mo re flue nt in E ng lish c o uld fe e l c o mfo rta b le with wo rke rs o f o the r c ultura l b a c kg ro unds.

F

urthe rmo re , the se finding s ma y a lso re fle c t the e xpa nsio n o f the ta rg e t po pula tio n to inc lude no n-Hispa nic a nd no n-Vie tna me se c lie nts, thus re duc ing the “c ultura l fit” b e twe e n pe e r spe c ia lists a nd c lie nts.

Qua lita tive da ta indic a te tha t spe c ific c ounse lor

c ha r a c te r istic s suc h a s the c ounse lor ’s c ha r a c te r , pr

fe ssiona l c ompe te nc e , a nd r

e la tiona l skills he lpe d e nha nc e the stor yte lling e xpe r ie nc e . Ho we ve r, it is a lso impo rta nt to no te tha t the se re sults o n the c ultura l c o mpe te nc e

pro c e ss q ue stio ns a re b a se d o n re spo nse s o f fe we r tha n 50% o f c lie nts who c o mple te d the inte rve ntio n.

SLIDE 4

PROCE SS QUE ST ION 2: HOW DOE S T HE INCL USION OF A F AMIL Y ME MBE R T HROUGHOUT T HE ACT IVIT Y AF F E CT T HE RE L AT IONSHIP BE T WE E N T HE SE NIOR AND T HE F AMIL Y ME MBE R AT T HE CONCL USION OF T HE ACT IVIT Y?

Inc luding a fa mily me mbe r

in the Stor yte lling pr

c e ss positive ly influe nc e d the r

e la tionship

b e twe e n the se nio r a nd the fa mily me mb e r(s).

Pro vide r a g e nc ie s indic a te d tha t slig htly le ss tha n ha lf of a ll pa r

tic ipa nts ha d one or mor e fa mily me mbe r s pa r tic ipa te in the Sto ryte lling inte rve ntio n.

Re a so ns fo r la c k of fa mily pa r

tic ipa tion inc lude d not ha ving a ny fa mily a r

und, o r fa mily

me mbe r s be ing a t wor k a ll da y whic h pre c lude d the ir pa rtic ipa tio n in the Sto ryte lling

inte rve ntio n.

Ho we ve r, whe n c lie nts we re a ske d if the inte r

ve ntion r e sulte d in impr

ve me nt is re la tio nships

with fa mily/ frie nds, 76% of AACI’s c lie nts a nd 44% of Ga r

dne r ’s c lie nts r e sponde d a ffir ma tive ly.

T

he qua lita tive da ta pro vide so me c o nte xt to the se finding s. T ha t is, the sto ryte lling inte rve ntio n le a d to impr

ve me nt in fa mily r

e la tionships thr

ug h impr
ve d c ommunic a tion

a nd sha r e d unde r sta nding of the c lie nt’s life stor y.

Whe n no c ha ng e s in fa mily r

e la tionships we re no te d it wa s be c a use the r e la tionships we r e a lr e a dy positive or no fa mily me mbe r s we r e a va ila ble , or just simply tha t the r e ha d be e n no c ha ng e .

SLIDE 5

PROCE SS QUE ST ION 3: HOW DOE S T HE E XE RCISE OF CAPT URING T HE SE NIORS’ L IF E ST ORIE S T HROUGH SOME E XPRE SSIVE ART S ME DIUM AND PRE SE NT ING T HE M T O T HE L ARGE R COMMUNIT Y CONT RIBUT E T O PRE SE RVING PE RSONAL AND COL L E CT IVE HIST ORY?

Ab o ut 50% of a ll c lie nts pr

e se nte d the ir stor ie s or a r twor k a t one of 6 c ommunity e ve nts

he ld b y e a c h pro vide r a g e nc y, a nd se ve r

a l c lie nts a tte nde d subse que nt c ommunity e ve nts to suppor t the ir pe e r s.

F
r AACI, ma ny c lie nts pr

e se nte d the ir stor y a t se ve r a l c ommunity e ve nts, whic h ma y

ha ve e nha nc e d the ir

e xpe r ie nc e of fe e ling mor e c onne c te d with the c o mmunity.

Simila rly, fo r Ga r

dne r , the r e we r e six stor ie s tha t we r e use d a g a in for the T e a tr

Vision

c ommunity e ve nt.

T

he ma jor

ity of c lie nts who a tte nde d a c ommunity e ve nt or pr e se nte d the ir stor y or a r twor k spoke ve r y positive ly a b o ut the e xpe rie nc e , e spe c ia lly fo c using o n the impr

ve d

c onne c tion with the ir c ommunity, liste ning to othe r s’ life e xpe r ie nc e s, a nd sha r ing the ir

wn.
T

he str

uc tur e a nd for ma t o f the c o mmunity e ve nts (c lie nt pre se nta tio ns a nd inviting the

la rg e r c o mmunity to a tte nd) g r

e a tly e nha nc e d the pr e se r va tion of pe r sona l a nd c olle c tive histor ie s a s c lie nts e njoye d sha r ing the ir stor ie s a nd liste ning to othe r s’ e xpe r ie nc e s, a s did the a tte nde e s (fa mily me mbe r s a nd the g e ne r a l public ).

SLIDE 6

PROCE SS QUE ST ION 4: WHAT ARE T HE SE NIORS’ PE RCE PT IONS OF T HE ST ORYT E L L ING PROGRAM? (T HIS QUE ST ION WAS ADDE D IN CONSUL T AT ION WIT H SE RVICE PROVIDE RS AND T HE PROJE CT L E AD ST AF F ).

T

he Sto ryte lling pro g ra m wa s we ll r

e c e ive d b y the se nio rs a nd the ir fa milie s.

Sixty- e ig ht pe r

c e nt of the sa mple ha d a sc or e of 6 on the T r e a tme nt Sa tisfa c tion Sc a le indic a ting the g r e a te st sa tisfa c tion with tr e a tme nt.

Qua lita tive c o mme nts o n re a so ns fo r r

e c omme nding the pr

g r

a m to othe r s r e fle c te d a ppr e c ia tion of the r e minisc e nc e a c tivity, r e duc tion in isola tion, a nd impr

ve me nt in mood for

c lie nts.

SLIDE 7

OUT COME QUE ST I ONS

1. Ho w ma ny se nio rs e ng a g e in this pro g ra m?
2. Ho w do e s the pro g ra m a ffe c t the se nio rs’ q ua lity o f life a nd da ily func tio ning ?

SLIDE 8

OUT COME QUE ST ION 1: HOW MANY SE NIORS E NGAGE D IN T HIS PROGRAM?

T

he pro vide rs we re suc c e ssful in e ng a g ing e thnic minor

ity se nior s of Vie tna me se or Me xic a n

r

ig in tha t we re the ta rg e t po pula tio n fo r this pro je c t.

Clie nt r

e c r uitme nt wa s do ne thro ug h outr e a c h in non- me nta l he a lth se tting s suc h a s se nio r

c e nte rs, we llne ss fa irs a nd o the r c o mmunity e ve nts, a nd se nio r ho using .

A to ta l o f 206 c lie nts we r

e e nr

lle d in the inte r

ve ntion with 165 c lie nts c omple ting the inte r ve ntion a nd the post- te st me a sur e me nts.

T

he ove r

a ll a ttr ition r a te wa s 12% a nd c o uld b e a ttrib ute d to a va rie ty o f re a so ns suc h a s:

c lie nts we re no lo ng e r inte re ste d in pa rtic ipa ting ; did no t like a nswe ring the e lig ib ility a nd e va lua tio n q ue stio ns; se rio us illne ss in c lie nt o r fa mily; a nd ne e ding a hig he r le ve l o f me nta l he a lth c a re . T he re we re 16 c a se s tha t we re still o pe n a t the time o f this re po rt.

T

he c o mb ine d de mog r

a phic da ta o n c lie nts indic a te s tha t the c lie nts we re olde r (me a n a g e = 75 ye a r s), fe ma le (62% ), the ma jor ity of c lie nts a r e Vie tna me se or Hispa nic (Me xic a n), who ha d limite d E ng lish pr

fic ie nc y, se lf-de sc rib e d a s ha ving po o r to fa ir a b ility to spe a k, re a d, o r

write in E ng lish. Altho ug h a fe w c lie nts we re na tive b o rn the ma jor

ity ha ve live d in the US for va r ying le ng ths of time. Ab o ut a qua r te r

f the c lie nts live d a lone , a nd the ma jor

ity fr

m

both a g e nc ie s live d with e ithe r a spouse or with a spouse a nd a dult c hildr e n.

Pro g ra m imple me nta tio n da ta indic a te s tha t, o n a ve r

a g e , c lie nts we r e se e n for 11 to 12 se ssions a nd the a ve r a g e time spe nt on e a c h c omple te d c a se wa s 25 to 27 hour s.

SLIDE 9

OUT COME QUE ST ION 2: HOW DOE S T HE PROGRAM AF F E CT T HE SE NIORS’ QUAL IT Y OF L IF E AND DAIL Y F UNCT IONING?

T

he Stor yte lling pr

gr

am was suc c e ssful in impr

ving the se nior

s’ quality of life and daily func tioning as asse sse d thr

ugh statistic ally signific ant impr
ve me nt in

post- te st sc or e s on de pr e ssive symptoms, lone line ss, and life satisfac tion.

Whe n the re sults a re e xa mine d se pa ra te ly b y pro vide r a g e nc y, fo r AACI the post

inte r ve ntion sc or e s on all four

utc ome var

iable s show statistic ally signific ant impr

ve me nt. I

nte re sting ly, a ltho ug h no t a fo c us o f the inte rve ntio n, the SPMSQ sc o re s a ppe a r to sho w sta tistic a lly sig nific a nt impro ve me nt (p <.05) a t po st –te st, whic h ma y po ssib ly b e re la te d to re duc tio n in de pre ssive sympto ms, o r simply a n a no ma ly in the da ta .

F
r

Gar dne r , the two de pr e ssion me asur e s (PHQ- 9 and the GDS- 15) as we ll as the lone line ss and life satisfac tion me asur e s show statistic ally signific ant impr

ve me nt. T

he re wa s no c ha ng e in the SPMSQ sc o re s. Ho we ve r, Ga rdne r a lso ha d c lie nts who e nde d the inte rve ntio n sho wing hig he r de pre ssio n sc o re s. Po ssib le re a so ns fo r this finding we re e xplo re d with pro vide rs a nd inc lude : c ritic a l inc ide nts suc h a s the de pa rture o f a visiting fa mily me mb e r, the de a th o f a fa mily me mb e r, e xa c e rb a tio n o f illne ss in the c lie nt o r fa mily me mb e r.

SLIDE 10

OUT COME QUE ST ION 2: HOW DOE S T HE PROGRAM AF F E CT T HE SE NIORS’ QUAL IT Y OF L IF E AND DAIL Y F UNCT IONING? (CONT

INUE )

Clie nt r

e sponse s indic ate d that the two ar e as with the most pe r c e ive d impr

ve me nt we r

e mood, and r e lationships with family and fr ie nds –whic h a re

the two do ma ins spe c ific a lly ta rg e te d b y the pro g ra m.

F

ina lly, the inte r

ve ntion, was suc c e ssful in pr

duc ing c linic ally signific ant c hange

sc or e s in de pr e ssion (5 o r mo re po ints) a s me a sure d b y the PHQ-9 fo r

a ppro xima te ly a third o f a ll c lie nts in the pro g ra m (32%) a nd suc c e ssful in pro duc ing sma lle r c ha ng e in de pre ssio n sc o re s (1 – 4 po ints) fo r o ve r ha lf o f a ll c lie nts (54%). A sma ll numb e r o f c lie nts e ithe r e xpe rie nc e d no c ha ng e o r ha d wo rse sc o re s o n the PHQ-9 a t po st-te st.