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Hi!

I am with a group of senior nursing students connected to the La Buena Salud

Wellness project in Idaho, which attempts to bring wellness services to

Hispanic Migrant Farmworkers. We are looking for ways to evaluate client

satisfaction satisfaction with the student's services. One of the

difficulties encountered is that many clients are not literate in their

primary language or english so written surveys are out. Any ideas? Is anyone

using something that is working? We appreciate any leads you can give us!

R. Hulen, RN

_________________________________________________________________

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Hi R. Hulen,

A few years ago I did surveys in rural Niger, West Africa on women's

satisfaction with health care services (and also on adherence to medical advice

and sources of social and financial support).

I used a variety of qualitative and quantitative techniques to elicit

information. I wrote a survey in English and translated it into the local

language. The questions were geared towards the various spheres in which the

local health department had stated quality goals. It asked for responses of the

type " very much, somewhat, average, not much, very little " to which I assigned

values of 1-5 for my own use. I personally interviewed each woman and marked

down her answers.

Another technique I used comes from the field of participatory evaluation (some

expertise in this at the University of Sussex in England). I did it with

individuals but it could also be done with groups. The basic idea is to discuss

something abstract like help or safety or cleanliness, and ask the participants

to make an analogy with something concrete. For example, I had a box of 20

sorghum seeds. I first asked the subject to generate a list of the people who

helped her when her child was ill (husband, mother-in-law, sister, neighbor,

doctor, traveling pill salesman, etc. were typical replies). Then I said, okay,

this box of sorghum seeds represents how helpful these people were to you in

total. I want you to divide the seeds up, some for each person, but not

necesarily equally. I want you to assign more seeds to whoever helps you more,

and fewer to whoever helps you less.

Another way might be to ask them to rate the overall quality of care from

different providers or at different clinics. You could set the value of X

Clinic to 10 seeds (or pebbles, or pennies, or whatever) and ask them to tell

you what value they would assign to Y Clinic and Z Clinic by comparison. Make

sure to take notes on why they give higher or lower ratings. This can be

especially valuable with a group where they need to argue with each other to

arrive at consensus on what value to assign. By what is said in the arguments,

and what people seem to find convincing, you can get a lot of information.

Yet another way of finding out how people think about health care is to ask them

to help you sketch a map of all the places that health care or health promotion

activities happen for them. You could just do that and take notes on the

discussion. Or you could add another layer and have them assign value with

piles of seeds, etc. to the different places. This would give the same

information as in the paragraph above, but with another layer of richness

because of all the conversation around building the map (where should/should not

be included, and why).

With all these methods, people may have a tendency to try to be polite and say

everyone's doing a good job. Two things can help with this. One is to assure

people of confidentiality, and make the investigators/sureyors people who are

not also delivering the care being studied. Another is to use a preliminary

study to find what end of the scale most responses will be and try on the larger

scale study to give more options on that end (e.g. okay, good, very good,

excellent, outstanding, amazing). The numerical analogy activities after some

opportunity for free generation of categories are also helpful in finding out

what issues are important to the clients.

Good luck!

Alix

alix@...

andra Barstow, Resident

University of Vermont Family Practice Residency

Milton, VT

On 24 Feb 2003 20:00 EST you wrote:

>

> Hi!

> I am with a group of senior nursing students connected to the La Buena Salud

> Wellness project in Idaho, which attempts to bring wellness services to

> Hispanic Migrant Farmworkers. We are looking for ways to evaluate client

> satisfaction satisfaction with the student's services. One of the

> difficulties encountered is that many clients are not literate in their

> primary language or english so written surveys are out. Any ideas? Is anyone

> using something that is working? We appreciate any leads you can give us!

> R. Hulen, RN

>

>

>

>

> _________________________________________________________________

> MSN 8 helps eliminate e-mail viruses. Get 2 months FREE*.

> http://join.msn.com/?page=features/virus

>

>

>

> To Post a message, send it to: Groups

>

> To Unsubscribe, send a blank message to:

-unsubscribe

>

>

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Using the "one-on-one" personal interview method is a viable option for administering the evaluation instrument to clients, if you have access to bilingual community health workers and a budget to pay for their time. Or, maybe you can work out some sort of sweat equity exchange between agencies. Lots of studies have been done among migrant workers, using the interview method. Contact Bobi Ryder at the National Center for Farmworker Health (NCFH) : ryder@.... She should be able to direct you to individuals who have used that method, for some practical advice. The NCFH sponsors this listserv, but she may not have seen your request, yet.

N. Tolentino, Oregon

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Hello,

I work for Migrant Health Promotion, and we run programs for promotores de

salud. Over the last several years, we have also worked successfully with

lay health workers in FL, MI, and IL to adminster surveys with farmworkers.

We have achieved very good response rates, but it is time intense. If you

would like more information, feel free to contact me at: tbooker@....

Thank you, Tori Booker

At 10:43 AM 2/23/2003 -0700, you wrote:

>

>Hi!

>I am with a group of senior nursing students connected to the La Buena Salud

>Wellness project in Idaho, which attempts to bring wellness services to

>Hispanic Migrant Farmworkers. We are looking for ways to evaluate client

>satisfaction satisfaction with the student's services. One of the

>difficulties encountered is that many clients are not literate in their

>primary language or english so written surveys are out. Any ideas? Is anyone

>using something that is working? We appreciate any leads you can give us!

>R. Hulen, RN

>

>

>

>

>_________________________________________________________________

>MSN 8 helps eliminate e-mail viruses. Get 2 months FREE*.

>http://join.msn.com/?page=features/virus

>

>

>

>To Post a message, send it to: Groups

>

>To Unsubscribe, send a blank message to:

-unsubscribe

>

>

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