Building a Case for Your Project

1. Building a Case for Your Project Center for Health Equity | Minnesota Department of Health October 17, 2018

2. Agenda

3. Introductions-------------------------------------------------------------------NameOrganizationPronounsIntroductions-------------------------------------------------------------------NameOrganizationPronouns

4. MDH and CHE Mission MDH’s mission is protecting, maintaining and improving the health of all Minnesotans. MDH’s vision is for health equity in Minnesota, where all communities are thriving and all people have what they need to be healthy. The Center for Health Equity’s mission is to CONNECT, STRENGTHEN & AMPLIFY health equity efforts within MDH and across the state of MN.

5. CHE Mission The Center for Health Equity’s mission is to CONNECT, STRENGTHEN & AMPLIFY health equity efforts within MDH and across the state of MN.

6. CHE Tree PDF available on our website

7. Priority Populations Communities Most Impacted

8. Intersectionality

9. Intersectionality Leading w/ Race Race/ Ethnicity

10. Purpose of the Workshop Learning Objectives Understand the different ways models or practices are classified Learn about different ways to tell your story in your application

11. Application Context Where this may be helpful in the application: Project Narrative Questions 8, 9, and 10 8. Describe your strategies for reducing the disparities described in Question 6. (2,000 character limit) 9. Provide a brief overview of the activities you will undertake to address the identified priority health area(s) in the population(s) served. (2,500 character limit) 10. Describe how your proposed activities value cultural knowledge and wisdom and build on community resilience, including why you believe the activities will be effective in the population(s) served (may include lived experiences, organizational experience, research, etc.). (2,500 character limit) mainly this question

12. EHDI Evidence Framework Adapted from: Puddy, R. W. & Wilkins, N. (2011). Understanding Evidence Part 1: Best Available Research Evidence. A Guide to the Continuum of Evidence of Effectiveness. Atlanta, GA: Centers for Disease Control and Prevention.

13. Evidence • MDH sees evidence as consisting of: • Experience & Expertise – collective experience and expertise of those who have practiced or lived in a particular setting • Context – community factors likely to influence implementation of strategies • Research – published results, mostly quantitative but can also be qualitative

14. Types of Models and/or Practices • Evidence-Based • Evidence-Informed • Promising • Emerging • Practice-Based

15. Types of Models and Practices (handout) Research-Based Practices Promising Practices

16. Model and/or Practice Selection (handout) • Community/Organization match • Quality • Resource requirements The Checklist handout is a tool you can use to compare or contrast the models and practices you are developing or considering and select the one that is the best fit. This optional tool is for your own use only; do not submit it with your application.

17. Model and/or Practice Selection 1 • Community/Organization match • Goals & objectives are what organization and participants value • Culturally appropriate – community strengths & needs • Of sufficient length and intensity to be effective with this group of participants • Participants can make time commitment • Demonstrated effectiveness with population & setting similar to yours • Can implement as is, or adaptations needed (are they allowed) • Complements current programming in organization and community

18. Model and/or Practice Selection 2 • Quality • Has been shown to be effective; level and quality of evidence are sufficient for your organization • Populations it has been shown to be effective • Experience of others who have used it • Amount and quality of training and TA offered by developer • Available info on acceptable adaptations and adaptation assistance

19. Model and/or Practice Selection 3 • Resource requirements • Cost of training, curriculum and implementation • Can be implemented within time frame (e.g., grant period) • Can afford to implement it long-term (sustainability) • Have staff qualified to implement it • Staff shows enthusiasm and commitment • Community partners & stakeholders support its implementation

20. Cultural Adaptations of Models and Practices • Why adapt? • What can you adapt? • Cite original model or practice • What if you can’t adapt? • e.g., adaptations you want to make are not allowable (will compromise effectiveness of model or practice) • Build your own! • Still acknowledge

21. Adaptation Examples Participant Issues (cultural norms, demographics, etc.) “We were able to recruit fewer youth than anticipated because many of them have after-school activities, and some parents did not approve of some of the topics.” Staff Issues (staff recruitment/retention issues, costs, etc.) “We didn’t have the required number of mentors for the number of youth, so we shortened the minimum time that each mentor would spend with their youth mentee.” Community Issues (political climate, traumatic incident, community norms, etc.) “We had to eliminate two sessions because the community did not think the health issue was a priority when there are so many more urgent issues going on.” Optional Tagline Goes Here | mn.gov/websiteurl

22. Adaptation Examples (continued) Setting Issues (policies, scheduling, facilities, etc.) “The location of the program was changed from a school to a community center because we have a very strong relationship with the center, and would have better luck recruiting participants there.” Evaluation Issues (sample size requirements, resources, reporting schedule, etc.) “The principal at the school would not allow us to collect data on students’ sexual behaviors so we eliminated some questions from the model program survey.” Sustainability Issues (funding, community buy-in, etc.) “Two key community stakeholders who are respected elders said they could fully support the program only if the content of two sessions was modified.” (Based on: Adaptation Toolkit by Education Development Center, Inc.) Optional Tagline Goes Here | mn.gov/websiteurl

23. Evaluating Models and Practices • Evidence-based models come with manuals and tools, including evaluation tools • Usually quantitative, e.g., pre-post tests or surveys • Note: they also specify outcome measures (valid and reliable) which must be administered consistently and accurately across all participants. Make sure these are in line with what you want for your target population • Some evidence-based and promising models that have been adapted by the developer also come with these documents • More leeway in models or practices that you or others have developed • Refer to RFP Appendices for examples of evaluation measures

24. Telling Your Story in Your Proposal Example of scenario: • 1) We learned about this evidence-based approach at a conference session and it will fit our objectives for this project well. We plan to use this approach in our grant and with our population.

25. Telling Your Story in Your Proposal 2 Example of scenario: • 1) We learned about this evidence-based approach at a conference session and it will fit our objectives for this project well. We plan to use this approach in our grant and with our population. • This explanation is JUST OKAY • Pro: It fits your objectives • Con: It hasn’t been tested with your population • Con: You didn’t describe how it could or would be tailored to your population

26. Telling Your Story in Your Proposal 3 Example of scenario: • 2) This approach has been used by our organization in a different program for a few months, and although it hasn’t been formally evaluated, we have heard from their participants that this helped them take care of their health better.

27. Telling Your Story in Your Proposal 4 Example of scenario: • 2) This approach has been used by our organization in a different program for a few months, and although it hasn’t been formally evaluated, we have heard from their participants that this helped them take care of their health better. • This explanation is SOMEWHAT STRONG • Pro: You have some experience with it • Con: No documented evidence (qualitative or quantitative) and not with the population you’re targeting

28. Telling Your Story in Your Proposal 5 Example of scenario: • 3) This approach was developed with our community elders. Our Diabetes program has been using it for several years now. Over time we have made adjustments so that it fits our clients. Our years of evaluation have showed it is effective based on participant data (pre-post tests, focus groups, case management notes).

29. Telling Your Story in Your Proposal 6 Example of scenario: • 3) This approach was developed with our community elders. Our Diabetes program has been using it for several years now. Over time we have made adjustments so that it fits our clients. Our years of evaluation have showed it is effective based on participant data (pre-post tests, focus groups, case management notes). • This explanation is VERY STRONG • You described how and who (elders) was involved in creating the program/intervention • Several years of experience with it • Efforts have been made to make it fit clients • You know how well it is working (via multiple forms of evaluation)

30. Telling Your Story in Your Proposal 7 Example of scenario: • 4) A longtime organizational partner has been implementing the evidence-based program Diabetes Prevention Program since 2015 and has shown it to be effective with their immigrant patients. We have referred our clients to them in the past. Now that we have expanded our health program to include diabetes prevention, the DPP will fit our program well since we are similar in size to our partner, also serve immigrant populations (East Africans), and very are familiar with the elements of DPP.

31. Telling Your Story in Your Proposal 8 Examples of scenarios: • 4) A longtime organizational partner has been implementing the evidence-based program Diabetes Prevention Program since 2015 and has shown it to be effective with their immigrant patients. We have referred our clients to them in the past. Now that we have expanded our health program to include diabetes prevention, the DPP will fit our program well since we are very familiar with the elements of DPP, are similar in size to our partner, and also serve immigrant populations (East Africans). • This explanation is SOMEWHAT STRONG • Pro: Familiarity with it through longtime relationship • Pro: Effective with immigrant patients • Con: Same size org does not mean same resources (quality and quantity) • Con: East African population might have different needs

32. Tips for Building a Case for your Project 9 • Everything should tie together • See Example Work Plan and examples in Appendices • Complete Work Plan before Project Narrative • Use up character limits – e.g., Q10 has 2500 character limit, our longest scenario has 411 • Demonstrate knowledge of your community or target populations • Health disparities; what has worked/not worked/will work well to address these; cultural knowledge, wisdom, other assets and how your activities build on these

33. Telling Your Story in Your Proposal 1 10 minutes individually reflecting & 10 minutes sharing and receiving feedback with a neighbor How do you know this work is important and impactful? • How do you know that what you are trying to address is important to your community? • How do you know that what you want to work on will change health inequities in your communities? • How do you know that what you are proposing works? Where does that information come from?

34. Telling Your Story in Your Proposal 2 10 minutes individually reflecting & 10 minutes sharing and receiving feedback with a neighbor How do you show what you know? • What is the data that supports that this is important work to do in your communities? • What are the stories that support that this is important work to do in your communities? • Which stories and data points will you prioritize to paint a clear picture of why this is important and how your project will help you reach your goals/outcomes?

35. Telling Your Story in Your Proposal 3 10 minutes individually reflecting & 10 minutes sharing and receiving feedback with a neighbor How will you evaluate what you do? • What are you trying to change? • What are benchmarks or ways that you know that you are getting toward your goals? • Evidence-based and promising models oftentimes already specify evaluation outcomes – Pro: they’ve done it for you! Con: not always the ones you or your stakeholders want to measure • If this is something that you developed on your own, what are the outcomes that you anticipate from your proposed project?

36. Questions?Other RFP questions after today?Please submit them by Nov 28 using the online Question Submission Formon our website.If you need to submit a question through an alternative format, please call 651-201-5813 for assistance.

37. Thank you!