SUCCESSFUL OUTREACH STRATEGIES: A NATIVE PERSPECTIVE
Michael H. Blatchford
Executive Director, ASSIST! to Independence
There is a lot of talk about “outreach” in most service
delivery plans, and certainly in many priorities for many funding
sources. But what does outreach really mean, and how can any one
agency be successful at providing it? What is deemed successful?
First we must define what it is, why we want to do it, and who we
will be reaching out to.
Typically outreach means that we are going outside our normal scope
of operation to provide information, resources or services to those
not in our immediate service area. In an urban area it could mean
going outside the city limits, or targeting a particular group of
people, such as teenagers. The hot area for outreach now is for
under-served or under-represented populations. This typically means
minorities, but certainly changes depending on geographic location
and service delivery areas. It is estimated that one in four individuals
with disabilities do not receive adequate services or get the help
they need to be independent. So how do we provide outreach? Most
people respond that ways to begin would include brochures or flyers,
telephone surveys, E-mail, or hiring an outreach person. In many
urban areas, this may be an effective strategy. However, in many
rural areas, and especially on the Reservation, these methods are
not successful.
The Navajo Reservation covers over 3400 square miles, encompasses
four states, and is larger than the state of West Virginia. The
“urban” areas on the Reservation have populations of
less than 3000 people. Over 60% of the population do not have running
water, electricity or telephones. Many people, particularly elders,
do not read and cannot speak English. Over 70% of the population
live over 50 miles from any medical facility. There is no word in
the Navajo language for disability. Transportation, language and
geographic barriers are huge obstacles. So, where do we begin? Obviously,
the typical approaches to outreach are not going to work here.
First, we have to decide what exactly we mean by outreach. Our
Center for Independent Living, in Tuba City, provides the four core
services (advocacy, peer mentoring, skills training, information
& referral), as well as Rehab Technology Services and a Functional
Assessment Clinic, to individuals with disabilities and chronic
conditions. We are already located in the heart of a rural area,
providing services to what would typically be defined as both under-represented
and under-served, so we could say that just by our mere existence
on the Reservation we were already providing outreach. However,
we defined our outreach efforts as expanding services so they could
be easily accessed by individuals living outside the Tuba City area.
Once you decide on what outreach means, then you have to determine
who you will be reaching out to. At our Center, we decided to focus
our efforts on individuals living outside the Tuba City area, who
would typically not have access to information through traditional
methods, and who would not have easy access to transportation. To
a large extent, this would be our elders living out in remote parts
of the Reservation.
So, we have defined both “outreach” and who we want
to provide outreach to, now how do we find these folks? They aren’t
going to have tv’s or radios, and may only get their mail
once every month or two, and they probably aren’t going to
speak English. The third step to me is the key to providing effective
outreach. You must look within the community itself and develop
good collaborative partnerships with others who are providing services.
In most rural areas, and especially the Reservation, you cannot
come in as an outsider and expect to be received with open arms.
You must work with people in the community who are already established
and have contact with others in the community who trust them. Again,
let me use our Center in Tuba City as an example. In looking at
our community, the people who have regular contact with those who
would be defined as “home-bound”, are the Public Health
Nurses (PHN) and the Community Health Representative (CHR). They
are the key to initiating contact with people who otherwise would
not have access to information about services. They are also the
people who have the best understanding of what an individual may
need to be independent. So, the staff at our Center provided in-service
training to all the CHR and PHN staff to educate them about independent
living, and what our program had to offer. Then, we listened to
what they felt was needed most in terms of services. This is another
key to effective outreach, the ability to listen and making adaptions
based on the input of those in the community. Because we were willing
to listen, we were able to maintain an effective dialog and keep
our outreach and service delivery methods fluid. In this particular
case, the PHN or CHR will, through their normal course of work,
visit the home of an individual with a disability or chronic condition
to provide medical services. They discuss health issues, and talk
to the client about they types of things they might need to help
them become more independent at home. If they feel someone would
benefit from our services, they make a referral to our Center. Someone
from our staff will then make a home visit, usually accompanied
by the CHR or PHN, until trust is developed with the client. Throughout
the course of our contact with the individual, we maintain contact
with the referral source, keeping them updated on the progress and
status of the services being provided, so they can share this information
with the client on a regular basis.
The fourth element to effective outreach is to have a face within
the community. If you only come into the community every two or
three months, you aren’t going to be very successful. You
must provide on-going follow-up efforts with those you are reaching
out to. For example, each community on the Navajo Reservation is
governed by a local Chapter House. The Chapters usually are connected
to Senior Programs, who provide meals, and are responsible for community
activities. Most of the Chapters, in conjunction with the CHR program,
have community health fairs once a year, which our Center always
participates in.
The fifth component for effective outreach is being flexible in
the “how” of providing services, and being willing to
adapt them to accommodate the culture. For example, as I mentioned
earlier, there is no word in Navajo for disability. So as we are
talking to people and trying to gather information that would help
us better serve them, we have to take a different approach and change
our “language”. Nine times out of ten, if we ask someone
what there disability is, they will say they do not have one. But
if we ask what they have difficulty with or how their health is,
they might respond...I don’t see very well, or I walk with
a limp, or have to use a wheelchair or I have trouble holding things.
It is then our job to translate this information into a format that
fits our record keeping categories. Yes, it is important to fill
in all the categories and get the numbers to maintain or receive
additional funding. But, we can be sensitive to cultural issues
and change our approach to gathering information so the culture
is respected. If we do this, we will actually get better data, and
be able to provide better services.
There probably is no one template that we can plug into and be
able to provide effective outreach because our communities are so
diverse. In conclusion, I can only offer the strategies that have
worked for our Center on the Navajo Reservation as a guideline,
and hope they will be helpful as you look at ways to provide outreach
that will be effective in your communities:
1. Define outreach specifically as it relates to your organization.
2. Define the target group or population you want to reach out
to.
3. Establish partnerships with established community resources.
LISTEN!
4. Maintain a presence within the community...provide on-going
follow-up.
5. Adapt your methods to respect the culture.
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