Community readiness and momentum: identifying and including community-driven variables in a mixed-method rural palliative care service siting model

Abstract Background Health service administrators make decisions regarding how to best use limited resources to have the most significant impact. Service siting models are tools that can help in this capacity. Here we build on our own mixed-method service siting model focused on identifying rural Ca...

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Main Authors: V. A. Crooks, M. Giesbrecht, H. Castleden, N. Schuurman, M. Skinner, A. Williams
Format: Article
Language:English
Published: BMC 2018-04-01
Series:BMC Palliative Care
Subjects:
Online Access:http://link.springer.com/article/10.1186/s12904-018-0313-5
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spelling doaj-9509d33829f64a2d8fcfc2126df327592020-11-24T21:19:16ZengBMCBMC Palliative Care1472-684X2018-04-0117111210.1186/s12904-018-0313-5Community readiness and momentum: identifying and including community-driven variables in a mixed-method rural palliative care service siting modelV. A. Crooks0M. Giesbrecht1H. Castleden2N. Schuurman3M. Skinner4A. Williams5Department of Geography, Simon Fraser UniversityDepartment of Geography, Simon Fraser UniversityDepartment of Geography and Planning and Department of Public Health Sciences, Queens UniversityDepartment of Geography, Simon Fraser UniversityTrent School of the Environment, Trent UniversitySchool of Geography & Earth Sciences, McMaster UniversityAbstract Background Health service administrators make decisions regarding how to best use limited resources to have the most significant impact. Service siting models are tools that can help in this capacity. Here we build on our own mixed-method service siting model focused on identifying rural Canadian communities most in need of and ready for palliative care service enhancement through incorporating new community-driven insights. Methods We conducted 40 semi-structured interviews with formal and informal palliative care providers from four purposefully selected rural communities across Canada. Communities were selected by running our siting model, which incorporated GIS methods, and then identifying locations suitable as qualitative case studies. Participants were identified using multiple recruitment methods. Interviews were transcribed verbatim and the transcripts were reviewed to identify emerging themes and were coded accordingly. Thematic analysis then ensued. Results We previously introduced the inclusion of a ‘community readiness’ arm in the siting model. This arm is based on five community-driven indicators of palliative care service enhancement readiness and need. The findings from the current analysis underscore the importance of this arm of the model. However, the data also revealed the need to subjectively assess the presence or absence of community awareness and momentum indicators. The interviews point to factors such as educational tools, volunteers, and local acknowledgement of palliative care priorities as reflecting the presence of community awareness and factors such as new employment and volunteer positions, new care spaces, and new projects and programs as reflecting momentum. The diversity of factors found to illustrate these indicators between our pilot study and current national study demonstrate the need for those using our service siting model to look for contextually-relevant signs of their presence. Conclusion Although the science behind siting model development is established, few researchers have developed such models in an open way (e.g., documenting every stage of model development, engaging with community members). This mixed-method study has addressed this notable knowledge gap. While we have focused on rural palliative care in Canada, the process by which we have developed and refined our siting model is transferrable and can be applied to address other siting problems.http://link.springer.com/article/10.1186/s12904-018-0313-5Palliative careCanadaRuralCommunityService siting
collection DOAJ
language English
format Article
sources DOAJ
author V. A. Crooks
M. Giesbrecht
H. Castleden
N. Schuurman
M. Skinner
A. Williams
spellingShingle V. A. Crooks
M. Giesbrecht
H. Castleden
N. Schuurman
M. Skinner
A. Williams
Community readiness and momentum: identifying and including community-driven variables in a mixed-method rural palliative care service siting model
BMC Palliative Care
Palliative care
Canada
Rural
Community
Service siting
author_facet V. A. Crooks
M. Giesbrecht
H. Castleden
N. Schuurman
M. Skinner
A. Williams
author_sort V. A. Crooks
title Community readiness and momentum: identifying and including community-driven variables in a mixed-method rural palliative care service siting model
title_short Community readiness and momentum: identifying and including community-driven variables in a mixed-method rural palliative care service siting model
title_full Community readiness and momentum: identifying and including community-driven variables in a mixed-method rural palliative care service siting model
title_fullStr Community readiness and momentum: identifying and including community-driven variables in a mixed-method rural palliative care service siting model
title_full_unstemmed Community readiness and momentum: identifying and including community-driven variables in a mixed-method rural palliative care service siting model
title_sort community readiness and momentum: identifying and including community-driven variables in a mixed-method rural palliative care service siting model
publisher BMC
series BMC Palliative Care
issn 1472-684X
publishDate 2018-04-01
description Abstract Background Health service administrators make decisions regarding how to best use limited resources to have the most significant impact. Service siting models are tools that can help in this capacity. Here we build on our own mixed-method service siting model focused on identifying rural Canadian communities most in need of and ready for palliative care service enhancement through incorporating new community-driven insights. Methods We conducted 40 semi-structured interviews with formal and informal palliative care providers from four purposefully selected rural communities across Canada. Communities were selected by running our siting model, which incorporated GIS methods, and then identifying locations suitable as qualitative case studies. Participants were identified using multiple recruitment methods. Interviews were transcribed verbatim and the transcripts were reviewed to identify emerging themes and were coded accordingly. Thematic analysis then ensued. Results We previously introduced the inclusion of a ‘community readiness’ arm in the siting model. This arm is based on five community-driven indicators of palliative care service enhancement readiness and need. The findings from the current analysis underscore the importance of this arm of the model. However, the data also revealed the need to subjectively assess the presence or absence of community awareness and momentum indicators. The interviews point to factors such as educational tools, volunteers, and local acknowledgement of palliative care priorities as reflecting the presence of community awareness and factors such as new employment and volunteer positions, new care spaces, and new projects and programs as reflecting momentum. The diversity of factors found to illustrate these indicators between our pilot study and current national study demonstrate the need for those using our service siting model to look for contextually-relevant signs of their presence. Conclusion Although the science behind siting model development is established, few researchers have developed such models in an open way (e.g., documenting every stage of model development, engaging with community members). This mixed-method study has addressed this notable knowledge gap. While we have focused on rural palliative care in Canada, the process by which we have developed and refined our siting model is transferrable and can be applied to address other siting problems.
topic Palliative care
Canada
Rural
Community
Service siting
url http://link.springer.com/article/10.1186/s12904-018-0313-5
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