Forming a Diverse Workgroup: Lessons Learned and Sample “Tools” Presenters: Aiko Allen and Janet Brandes May 2, 2007

Review of Workgroup Goal Identify critical issues and develop strategic plan for tobacco use prevention among populations that experience the greatest health burden from tobacco use and exposure.

Process Taking Stock (Training, Pre-Planning, Data) –Training –Identifying Populations –Reviewing and Analyzing Data Getting Organized (Forming the Workgroup) –Planning –Group Formation Setting Direction (Developing the Plan) –Task Performance Refining and Adopting the Plan Implementing the Plan –Implement –Integrate –Media/Marketing

Taking Stock Training, Pre-Planning, Identifying Populations, and Reviewing Data

Training/Pre-Planning What We Did Built on Lessons Learned Healthy Kansans 2010 Planning Process –Identifying Nominators and Potential Group Members –Building on Strategies and Action Steps from Related HK2010 Action and Workgroups –Group Processing Lessons Learned Attended Three 2-3 Day CDC Trainings –Networked with Other States –Built on Lessons Learned from Other States –Received Specific Direction from CDC Staff –Provided with Many Examples and Resources

Training/Pre-Planning What We Learned Building on similar experiences within our own state (HK2010) and from others (CDC Training, examples & mentors from other states) was invaluable –Especially helpful to have written examples of product and personal resources Both HK2010 results and CDC Training encouraged workgroup membership beyond “usual” suspects Both HK2010 results and CDC Training adopted broad definition of “disparities” beyond racial/ethnic categories

Training/Pre-Planning What We Learned Be flexible! No cookie-cutter approach; used resources and lessons learned from others to help tailor a successful approach for Kansas and for this particular process Advantage to have relatively large planning team & to maintain/expand same team throughout process

Which Populations to Include? Defined populations –Examples: Tribal nations, Hispanic/Latino Strata –Examples: Age groups, income level, level of educational attainment Populations for which disparities are undefined or data is currently unavailable –Examples: Religious affiliations, LGBT, military

List of Populations People with low SES (socioeconomic status; e.g., low income or education, unemployed) Black/African Americans Asian Americans & Pacific Islanders American Indians/Alaskan Natives Hispanic/Latino Lesbian/gay/bisexual/transgender Medically underserved/ uninsured Young people Pregnant women People facing mental or emotional challenges People living with disabilities Groups and affiliations for which tobacco-related disparities may be unidentified, including: migrant, German Mennonites, faith communities, Vietnamese, refugees, Lebanese, rural/frontier, and military.

Identifying Populations What We Learned Many “specific” populations affected by disparities Kansas communities much more diverse than they realize If we don’t address specific populations, it will be difficult (impossible?) to make significant progress decreasing tobacco use rates Specific populations can still be addressed even when data for those populations are not available

Getting Organized Planning, Forming the Workgroup

Terms: What to call our workgroup and populations? In the beginning: Tobacco Disparities CDC advised against using these terms: people of color, special populations, diverse populations, disparate populations, target populations Second project name: Tobacco Prevention for Priority Populations Later…CDC advised against the term “priority populations” Now: Tobacco Prevention for Specific Populations

Membership Recruitment Nomination model Nominations solicited from interested parties such as TUPP grantees; HealthyKansans 2010 participants in Disparities, Cultural Competency, and/or Tobacco workgroups; Center for Health Disparities Advisory Board; and other non-government organizations serving specific populations (not necessarily tobacco- or health- focused) Focused on knowledge of/membership in specific populations versus expertise in tobacco prevention Effort made to recruit “grass roots” members Ended up with diverse workgroup but more “grass tops” than “grass roots”

Nomination Criteria Cultural membership in one of the listed populations. People you commonly contact for advice and information when you are working with one or more of the populations listed above. People who enjoy and are willing to take time to share their knowledge with you, and would be willing to attend and participate in three meetings. People with expertise (e.g., cultural expertise, tobacco use prevention/policy expertise).

Workgroup Selection Criteria Compatible with issue of eliminating tobacco-related disparities Ability to actively participate in workgroup and attend all three meetings Cultural membership in one or more specific populations Expertise (e.g., tobacco prevention, cultural) that will build the capacity of the entire workgroup Able to provide leadership in implementing recommendations for improvements within priority populations Will positively and productively contribute to the decision- making process of the workgroup if all reasonable accommodations are made to accommodate special needs and alleviate cultural barriers

Workgroup Formation What We Learned It is harder to get “grass roots” representatives involved than we thought. Experienced some difficulty recruiting members of specific populations versus those serving specific populations, but the expertise of those serving specific populations is also valuable. Thoughtful time and effort during recruitment and nomination process was helpful. Personal contact makes a difference! Nearly everyone on the final workgroup had a personal contact versus response to a mass distribution or mailing.

Workgroup Formation What We Learned Difficult to balance “labeling” participants and identifying their expertise and the populations they represent. Difficult to strike a “balance” of specific populations; representing many/all relatively equally while keeping the workgroup an appropriate size. –Many specific populations to include –Several workgroup members represent more than 1 pop. –Attempt to avoid “token representative” scenario Important for members to attend all meetings. Two-tier level of involvement for workgroup members was way to involve those with limited time while keeping workgroup on track and membership balanced.

Logistical Accommodations Tried to identify relatively central location for meetings (Wichita) Provided stipend plus reimbursement for some expenses Attempted to identify and accommodate individual barriers

Logistics & Accommodations What We Learned Build in plenty of processing time for contracts, approvals, scheduling, and other logistical issues Recognize that there will be constraints from grants, contacts, etc., and be flexible! Culturally diverse food choices are typically not available from hotel menus Difficult to choose central and convenient location for all Kansas participants Sessions during normal work hours a barrier to “grass roots” involvement, but Saturdays and evenings were not convenient for representatives from public and professional organizations Distance, time commitment, and schedule still made it unfeasible for some grass-roots participation

Planning What We Did Pre-plan, plan, and plan! (met by conference call biweekly and weekly for several months before first meeting) Completed data analysis before first meeting Considered timeline: worked backwards based on deadline and available meeting times to set dates, agendas, and meeting objectives Team member challenged us to remember diverse populations and accommodate other styles of planning and processing Included dedicated time of support/logistics staff Integrated evaluation into planning process from the beginning

Planning What We Learned All of the planning and pre-planning paid off with an efficient and productive 1 st workgroup meeting Be realistic and flexible with time constraints Logistics and administrative tasks take time but important; support staff helpful Planning team productive, diverse ideas, enjoys working together Incorporating evaluation planning from beginning is paying off; documenting as we go has been invaluable It is difficult for some of us to think beyond “usual” strategic planning tools and group processing methods (thanks to planning team member and Co-Chair Aiko, for stretching us in this direction)

Setting Direction Task Performance by Workgroup 1.Strategic Plan 2.Implementation Plan

Three P’s of Strategic Planning: There must be a balance ProcessPeople Product

Workgroup Process/Task Performance What We’ve Learned So Far Inclusivity does not guarantee active participation Members process information, engage each other differently Developing an environment that facilitates dialog with “grassroots” and “grasstops” (as well as process-, product-, and relationship-oriented members) requires multiple strategies Relationship-building is time-intensive and must be nurtured Ongoing engagement of members is important

Workgroup Process/Task Performance What We’ve Learned So Far Clarity of language is a necessity Clear and effective communication is important Stay focused on workgroup purpose and project goals Acknowledge identified & potential issues –Recognize and correct logistics/accommodation shortfalls –Different types of members: Task versus process versus relationship

Challenging Trade-Offs Still learning… Workgroup size vs. adequate representations Invested vs. overwhelmed Inclusivity vs. continuity Diverse vs. welcoming/safe Expertise vs. “grass roots” representation Labels vs. identified representation Targeting populations vs. cross-cutting strategies Products vs. process vs. people Improving health vs. limited funding

Samples from the “Toolbox” Seating arrangement Evaluation forms focusing on process and involvement rather than only outcomes Photo Album project Opening/closing ceremony

Seating Arrangement

Evaluation Forms Evaluation included participation/processing questions such as… (used Lichert scale – strongly agree, agree, neutral, disagree, strongly disagree) There is adequate representation of specific population groups in Kansas. There has been adequate time for getting to know each other and building an effective team. I felt comfortable expressing my views today. There was adequate time for questions, answers, and discussion. The group made sufficient progress today. The decisions reached today accurately reflected the consensus of the group.

Community Photo Album We would like you to take pictures that document the following themes: –Your community assets –The influence of tobacco in your community –Something important about your culture(s) and traditions A few ideas to get you started: –What is unique about your community and your culture? –Are there tobacco ads that target your community? –What is a common struggle/issue in your community or culture? –Where are the tobacco free areas?

Opening/Closing Cultural aspects to opening and closing work as a group A shift from “doing business in a meeting setting” to “doing work as a community” Appreciation, gratitude, and setting the tone for working together

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