cppw everyone swlims needs assessment focus groups
DESCRIPTION
kTRANSCRIPT
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Sarah Stempski, MPHcElizabeth Bennett, MPH, CHES
CPPW Everyone Swims! Phase 2: Focus Groups
November 29, 2010
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Everyone Swims! Goal
Increase widespread access to pools and water recreation throughout King County among low income and culturally/ethnically diverse populations
Phase 2 goal: Examine current policies and systems, and identify barriers and opportunities from the perspectives of families
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Why we are here
II. Compare themes from partners and focus groups
I. Share themes: What have families said?
Linking to CPPW overall goals:
• increase physical activity
• decrease smoking rates
• reduce health inequities
Policy and Systems Opportunities and Barriers
What we’ll focus on
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In the Media
More recent news headlines
‘Blacks don’t swim’ November 1, 2010; U.S. Masters Swimming
‘Swimming lessons do not increase drowning risk in younger children: Study allays concern the lessons could increase risk by reducing parental vigilance’ March 2, 2009; NIH News
‘Kids, adults need to get into the swim of things: Data show two key barriers prevent children from learning to swim—fear of drowning, and lack of parental encouragement’ August 28, 2010; Walla Walla Union Bulletin
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Methods• Design focus group questionnaire based on precede-proceed
behavior theory identifying the predisposing, enabling and
reinforcing factors associated with swimming1
• Predisposing factors are antecedents to behavioral
change that provide the rational or motivation for the
behavior.
• Enabling factors are antecedents to behavioral or
environmental change that allow a motivation to be
realized.
• Reinforcing factors are factors following a behavior that
provide the continuing reward or incentive for the
persistence of the behavior.
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Methods
• Children’s IRB approval for project exempt status
• Work with partners to recruit families representing
populations of focus in grant
• Incentives: Focus group participants were given a grocery gift
card, child care to attend the meeting, and light snacks
• Meetings conducted by culturally appropriate moderator
throughout November in clinics and community centers
• Groups are convenience sample and not fully representative
• Notes transcribed during focus group discussions
• Develop themes for review with partners to identify key
opportunities and barriers
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Demographics of Focus Groups
Scheduled meetings: 5
•Seattle Children’s: Spanish Speaking parents from Renton and Federal Way
•Odessa Brown Community Clinic: African American Families who participate in a special swim program at Medgar Evers from south and central Seattle
•Columbia Health Center (2): Somali and Vietnamese families who come to the clinic
•George Pocock Rowing Foundation: Group of people who participate in boating programs
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Behavior Theory
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Predisposing Factors
• Knowing about scholarships• Information about registration process• Beliefs about swimming as a life skill• Access to current information• Language, time and money constraints• Adult water phobias• Water cleanliness
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Enabling Factors
• Knowing what to expect at the pool• Flexible swimwear policies• Ease and transparency of scholarship process• Ease of registration process• Programming offered at multiple times• Programming offered for special groups• Information about importance of swimming from a
trusted source • Having the proper equipment
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Reinforcing Factors
• Being involved in a special group program• Swim teachers and pool staff that are attentive and kind• Reminder phone calls• Learning new skills/making progress• Ease of re-enrollment• Benefits (learning new skill, exercise, etc) are perceived
to outweigh the costs (time, money, effort, etc)
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Themes (preliminary)
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Scholarships for swim programming
Focus Group Themes
• Applying requires multiple tries and is embarrassing
• Qualification requirements should be listed so they know if they qualify before they apply
• Families don’t know about scholarship opportunities
Recap: Partner Themes
• Ensuring that swimmers value programming
• Need for a more efficient approval process
• Restrictions by age, programming, residency vary
• Availability of funds not always advertised
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Screening for Swim Ability
Themes
• Doctors are viewed as a trusted source of information about the importance swimming
• Some families do not think of swimming as an activity or skill
• They should have something to give to the families about swimming
Recap: Partner Themes
• Some providers are champions
• Screening based on guidelines or other standardized tools
• Time perceived as a barrier for some clinics
• Need to have resources to provide if bring up question
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Referrals to Pools and Water Rec Programs
Focus Group Themes
• It would help lessen the confusion of finding a pool
• Special programs or partnerships are appreciated by those involved in programs
• Clinic staff are trusted, but need to give parents options
Recap: Partner Themes
• Informal referrals (web-based searching)
• Personal knowledge
• Water partners unaware of referrals from clinics
• Clinics need updated resources on hand
• Some clinics have formalized referrals for pools
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Programming for special populations
Themes
• Parent-child swim lessons wanted, should allow multiple children with parent
• Adult water phobias
• Children will be less embarrassed if there are other kids like them
• Gender only swims viewed as pools making effort to include all cultures
Recap: Partner Themes
• Parent-child swim lessons not common
• Adult water phobias
• Water exercise class is attended by older populations
• Partnering to provide programming for certain populations
• Working hard to meet gender only swimming needs
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Additional Barriers for these groups
Themes
• Acceptable swimwear is really important to feel included
• Concern about water being clean
• Finding out about swimming opportunities in places common to culture
• Discrimination at pools is a concern
Recap: Partner Themes
• Acceptable swimwear
• Great value placed on provider advice
• Assumption that people know what to do at pools
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Next steps
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Next Steps: Immediate Action Plan
I. Follow-up with lessons learned from today’s meeting
II. Add to themes from remaining focus groups and be thinking about prioritizing model policies based on opportunities and barriers
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Next Steps: Communication Plan
• Develop profile of different audiences based on focus groups
• Families
• Physicians
• Clinic staff
• Pool staff
• Others who influence families’ decisions related to water recreation
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Next Steps: Communication Plan
• Develop key messages for providers
• Develop key messages for families
• Decide what kinds of materials or communication are most likely to be effective
• Test messages and materials with the audiences
• Finalize materials
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Next Steps: Action Plan
Narrow focus to the key elements of policies and
systems to increase access
Prioritize policy and system components
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CPPW Everyone Swims!
Thank you for your time, dedication, and insight!
November 29, 2010