Home Visiting Collaborative Improvement And Innovation Network 2.0

Stages of Parent LeadershipParent involvement and parent leadership in CQIis both a skill set and a culture that needs to beintentionally developed. This toolkit breaks downfive stages in which awardees and LIAs can integrate parent leadership into their CQI initiativesand then sustain parents’ involvement. The continuum ranges from early readiness to partnerin CQI to long-term strategies for bolstering theinfrastructure and team functioning needed forparent leadership to continue to flourish.Infant and Early Childhood Home VisitingProgram tip sheet; it has since been furtherdeveloped.8 These stages are not linear; rather,they suggest various approaches to engagingparents in CQI work. For example, teams withparent leaders who actively lead CQI initiativesmay still need shorter-term strategies to learnfrom a broader proportion of participants, ormedium-term strategies to recruit additionalpartners. Using multiple strategies also creates avariety of ways for parents to participate. Not allparent leaders will want to participate regularlyon a CQI team or actively lead an initiative butmay still want to contribute. Offering multipleopportunities and ways to participate allowsparent leaders to better match their interestsand skills to different needs and activities.This Continuum of Parent Leadership isadapted from a scale created by CincinnatiChildren’s Hospital and Medical Center7 and wasfeatured in the 2017 Partnering With Families inContinuous Quality Improvement: The Maternal,STAGE 1STAGE 2STAGE 3STAGE 4STAGE 5Assess and increaseteam’s readiness topartner in CQISet partnership goalsand build sharedunderstanding, andcommitmentEngage in short-termstrategies to learn moreabout your community,build relationships, andrecruit parent partnersEngage in mediumterm strategies to buildinfrastructure, trainparents in CQI, anddevelop Parent LeadersEngage in long-termstrategies to createauthentic team partnerships and to successfullysustain Parent LeadershipPurpose of this ToolkitThis STAGEtoolkit forThisintendedto be all-inclusive1 parent leadershipSTAGE in2 CQI was STAGE3 toolkit is notSTAGE4STAGE 5developed to accelerate the efforts of awardeesbut rather to provide you with a set of materialsEngage inYoumediumEngagelong-termand LIAs to successfully incorporate parent Engage in short-termfor getting started.can adaptandinmodifySet partnership goalsstrategiesto createstrategies to learnmorematerialsterm strategiesto buildAssess and increaseleadershipinto their CQI obuild nticteampartnerteam’s readinesstoinformationprovidedherecome frommeet your specific needs.understanding,and bothbuild relationships,andparents in CQI, andships and to of homevisiting and arerecruit parent partnersdevelopParent Leaderssustain ParentbyLeadershipAlthough thematerialsare categorizedtheintended to be easily adapted for your nand current needs. These materials are levant to LIA CQI teams; awardees can alsotools and strategies to build robust parent leadapply them to their own improvement effortsership in your organization. It will be helpful toand their leadership in supporting LIAs in CQI.visit this toolkit regularly as your team advancesPlease note that this toolkit does not cover CQIalong the continuum; in each stage, new toolsmethods; these are clearly described in theand concepts will be relevant to your efforts toSTAGE 2STAGESTAGE3STAGEin4 CQI initiatives.STAGE 5HV-CoIIN2.0 1Model for Improvement eLearningpartnerwith parentsseries and in the Design Options for HomeEngage in short-termEngage in mediumEngage in long-termSetToolkit.partnership goalsVisitingEvaluation CQIstrategies to createstrategies to learn moreterm strategies to buildAssess and increaseand build sharedauthentic team partnerabout your community,infrastructure, trainteam’s readiness tounderstanding, andships and to successfullybuild relationships, andparents in CQI, andpartner in CQI7Myers, S., Powell, J., Fritz, C., commitmentJofriet, A., Moore, L., Monti,& ngrecruitL.,parentpartnersL. (2015).developParent LeadersParentLeadership8community input v3.0.Zeribi, K., Mackrain, M., Arbour, M., & O’Carroll, K. (2017, August). Partnering with families in continuous quality improvement: The Maternal, Infant, and Early Childhood Home Visiting Program. OPRE Report #2017-47. Washington, DC: Officeof Planning, Research and Evaluation, U.S. Department of Health and Human Services. Produced by James Bell Associates.3STAGE 1STAGE 2STAGE 3STAGE 4STAGE 5

Continuum Stage 1:Assess and increase team’s readiness to partner in CQIThe tools in this section—a summaryof why parent leadership is important,and a readiness assessment—will helpget your team on board with the idea ofpartnering with parents and more fullyunderstand your starting point.TOOLS INCLUDED IN THIS SECTION The Benefits of Parent Leadership in CQI Readiness Assessment for Parent Involvement andLeadership in CQISTAGE 1STAGE 2STAGE 3STAGE 4STAGE 5Assess and increaseteam’s readiness topartner in CQISet partnership goalsand build sharedunderstanding, andcommitmentEngage in short-termstrategies to learn moreabout your community,build relationships, andrecruit parent partnersEngage in mediumterm strategies to buildinfrastructure, trainparents in CQI, anddevelop Parent LeadersEngage in long-termstrategies to createauthentic team partnerships and to successfullysustain Parent LeadershipCONTINUUM OF PARENT INVOLVEMENT AND LEADERSHIP IN CQISTAGE 1STAGE 2STAGE 3STAGE 4STAGE 5Assess and increaseteam’s readiness topartner in CQISet partnership goalsand build sharedunderstanding, andcommitmentEngage in short-termstrategies to learn moreabout your community,build relationships, andrecruit parent partnersEngage in mediumterm strategies to buildinfrastructure, trainparents in CQI, anddevelop Parent LeadersEngage in long-termstrategies to createauthentic team partnerships and to successfullysustain Parent Leadership4

The Benefits of Parent Leadership in CQIWhat is Parent Leadership in CQI?HOW TO USE THIS TOOLParent leaders have a uniqueperspective and valuable expertiseto offer. parent leadership in CQI isdeveloped when parents are able tocontribute their knowledge and skills;offer input and feedback regardingvarious short-, medium-, and long-termCQI strategies; and have a meaningfulrole in CQI projects. parent leadershipis successfully achieved when parentsand professionals build effectivepartnerships that combine professionalknowledge and expertise with livedexperience and expertise.These benefits can be helpful talking pointsthat you can customize as you explore theidea of parent leadership with others inyour organization. Awardees may find thislist helpful in building parent leadership intheir state, territory, or tribe and in encouraging LIAs to build parent leadership. LIAscan use this list to encourage their seniorleaders, stakeholders, and other CQI teammembers to support and strengthenparent leadership.Who are Parent Leaders?Parent leaders may be parents; they may also begrandparents, guardians, and/or foster parentswho are in a parenting role, have experiencewith and knowledge about using resources orservices that strengthen their family, and canspeak from the perspective of a “parent.”What are the Benefits of Parent Leadership in CQI?9Benefits to parents who participate:Benefits to the program: Parents gain a better understanding ofthe system Parents as team members can lead toincreased parent satisfaction with services Parents appreciate being listened to andhaving their opinions valued Parents bring an additional and importantperspective to the work Parents can become advocates in theircommunity Parents help build neighborhood and community connections Parents learn new skills Parents develop relationships with other teammembers and build their sense of communityParents help brainstorm the reasons thata problem exists and solutions that can betested and help accelerate change Parents provide a critical feedback loop Parents help ensure that materials areparent-friendly Parents can support the team in the testingprocess and help the team study the results Parents ensure that materials utilized areparent friendly Is considered, “Best Practice” in CQI9Adapted from VanDerMoere, R., & Dietrich, B. (2016, September). Parent Role in Continuous Quality Improvement.Presentation at the Michigan Home Visiting Initiative Parent Mini-Conference, Lansing, MI.5

Readiness Assessment for Parent Involvement and Leadership in CQIHow to Use this ToolThis assessment helps CQI team members evaluate their feelings about partnership with parentleaders and their organizational readiness to do so. Ideally, each CQI team member and otherpartners would complete the assessment individually and then compare results, which will giveyou a more comprehensive view of the team’s readiness. The results of this assessment should beused as a conversation guide among your team members to identify opportunities and areas forimprovement before you embark on the journey of partnering with parent leaders.Personal Readiness toPartner with Parents in CQI1Notat All2ABit3Neutral4Yes, at All2ABit3Starting4In Progress5Strength!Comments(Optional)I believe that parents bring uniqueexpertise to a CQI teamI believe that parent perspectivesin terms of improving services areas important as my ownI can clearly state what isexpected of parents in their roleon a CQI teamI feel comfortable sharing datatransparently with parent leadersI feel comfortable talking aboutour problems openly with parentleadersI am willing to test ideas toimprove services that parentscontributeI feel comfortable with parentsleading initiatives as part of ourCQI workLeadership Readiness toPartner with Parents in CQIOur mission statement clearlycommits to parent leadershipLeaders in our state, territory, or tribebelieve that parent leadership in CQIefforts is a priority6

Readiness Assessment for Parent Involvement and Leadership in CQILeadership Readiness toPartner with Parents in CQI1Notat All2ABit3Starting4In Progress5Strength!Comments(Optional)1Notat All2ABit3Starting4In Progress5Strength!Comments(Optional)Leaders model that the opinions ofparent leaders should influence policyand prioritiesPersonnel are expected (i.e., it ispart of their job description) tocollaborate with parent leadersto improve qualityInfrastructure to SupportParent Leadership in CQIOur state, territory, or tribe hasadvisory boards or councils to enableand support parent leadershipOur state, territory, or tribal programsinclude role descriptions for parentleaders to collaborate in CQIFinancial resources have beencommitted to infrastructure or opportunities to build parent leadershipThere are parents ready to work withour state, territory, or tribe to improvethe quality of our servicesThere are information or communication mechanisms to share CQI datawith parentsOur state, territory, or tribe hastraining programs to orient parentleaders to their role and to teachthem about CQIThere are opportunities for parentleaders to meet and to learn fromone another’s CQI experiencesTechnology or other supports areavailable to encourage and enableparent leaders to participate in CQImeetingsZeribi, K., Mackrain, M., Arbour, M., & O’Carroll, K. (2017). Partnering with families in continuous quality improvement: The Maternal, Infant, and Early Childhood Home Visiting Program. OPRE Report #2017-47.Washington, DC: Office of Planning, Research and Evaluation, U.S. Department of Health and Human Services. Produced by James Bell Associates.7

Empathy Building ResourcesEmpathy researcher BrenéBrown10 describes four mainattributes of empathy: Seeing the world as others see it Being nonjudgmental Understanding another’s feelings Communicating understanding of another’sfeelingsHOW TO USE THESE RESOURCESEmpathy-building is an important buildingblock of meaningful communication andrelationships. Building empathy is also a greatway to increase a team’s readiness for authentic partnerships—not just with families, butalso with those who work in the home visitingand early childhood system. These resourceswill help your team learn more about theimportance of empathy and begin to developthis skill.There are a variety of resources on developingempathy in order to foster meaningful communication. Here are three we recommend: Walk a Mile Cards (http://walkamilecards.com/) were designed to build empathyfor those with specific diseases or medicalconditions. However, you can build on thismodel, using real scenarios from multipleperspectives in your organization—homevisitors, supervisors, family members, andother stakeholders—to create your own set ofcards. This could be a great empathy-buildingactivity for team meetings, learning sessions,or other events, helping to keep lived experiences at the center of what we do. This short video, Brené Brown on Empathy(https://youtu.be/1Evwgu369Jw), is a great wayto launch a discussion on empathy-buildingwith your team. Watch it together duringyour team meeting (or ask team membersto watch it before the meeting) and discusshow empathy-building might help your teamprepare to welcome parent leaders. Improv games and exercises are a fun way toimprove communication and empathy—andthey are also great team-building activities!Check out these five improv exercisessuggested by The Emotion Machine, anonline resource on psychology and self-improvement hieda, K. (2014, August 12). Brené Brown on Empathy vs. Sympathy: Empathy never starts with the words “at least.”Psychology Today. Retrieved from pathy-08

Benefits for Parent Leadership in CQIUnderstanding the benefits for parent leadership in CQI is an importantbuilding block for creating team commitment. An intentional dialog is a greatway to increase a team’s readiness for authentic partnerships—not just withfamilies, but also with those who work in the home visiting and early childhoodsystem. This process will help your team learn more about the importance ofwhy you would want to include parent leaders on your CQI team.Note: Dialogue is intended to create sharedunderstanding and meaning. Dialogue tendsto have a slower pace as group members seekto understand one another’s perspectives andviewpoints and deeply listen to one another’sideas; the conversation flows, and judgments,opinions, and disagreements are suspended.There are many ways to have a dialog regardingthe benefits for including parent leaders in CQI,but we recommend the following fourstep process:Step 1:Set aside time for team members toengage in dialogue regarding theteam’s goals for parent leadership.Identify a facilitator and a recorderfor this dialogue.Step 2: Begin by reviewing: The Benefits ofParent Leadership in CQI on page 5.Step 3: Conduct the dialogue session.Step 4: Come to a consensus regarding themost important goals.9 Which benefits move us closer to the changeor improvements we want to see? Which benefits could make a real differenceand impact in our work? Which benefits generate key results? Which benefits are consistent with thepurpose of our CQI work?

Continuum Stage 2:Set partnership goals and build shared understanding and commitmentThis stage offers your team theopportunity to pause and reflect onwhat you learned from your readinessassessment, empathy building andbenefit prioritization activities.TOOLS INCLUDED IN THIS SECTION: Goal-Setting for Parent Leadership in CQI Action Plan Worksheet for Parent Leadership in CQIYou can determine your goals for buildingparent leadership and identify and access theresources you need to accomplish those goals.Just as your team sets goals for improvement, itis also valuable to set goals for what you hope toaccomplish regarding parent leadership in yourCQI efforts. For example, one team may alreadyhave some parent leaders and now aims to diversify the group by recruiting additional partners.Another team may be just starting their effortsSTAGE1 leadershipSTAGE2 working STAGE 3to buildparentand is stillon team members’ readiness.STAGE 4STAGE 5Set partnership goalsand build sharedunderstanding, andcommitmentEngage in short-termstrategies to learn moreabout your community,build relationships, andrecruit parent partnersEngage in mediumterm strategies to buildinfrastructure, trainparents in CQI, anddevelop Parent LeadersEngage in long-termstrategies to createauthentic team partnerships and to successfullysustain Parent LeadershipSTAGE 1STAGE 2STAGE 3STAGE 4STAGE 5Assess and increaseteam’s readiness topartner in CQISet partnership goalsand build sharedunderstanding, andcommitmentEngage in short-termstrategies to learn moreabout your community,build relationships, andrecruit parent partnersEngage in mediumterm strategies to buildinfrastructure, trainparents in CQI, anddevelop Parent LeadersEngage in long-termstrategies to createauthentic team partnerships and to successfullysustain Parent LeadershipAssess and increaseteam’s readiness topartner in CQICONTINUUM OF PARENT INVOLVEMENT AND LEADERSHIP IN CQISTAGE 1STAGE 2STAGE 3STAGE 4STAGE 5Assess and increaseteam’s readiness topartner in CQISet partnership goalsand build sharedunderstanding, andcommitmentEngage in short-termstrategies to learn moreabout your community,build relationships, andrecruit parent partnersEngage in mediumterm strategies to buildinfrastructure, trainparents in CQI, anddevelop Parent LeadersEngage in long-termstrategies to createauthentic team partnerships and to successfullysustain Parent Leadership10

Goal-Setting for Parent Leadership in CQIThis process is an opportunity for theCQI team to pause and reflect on whatthey believe are the key activities thatneed to build parent leadership in CQIteam for home visiting system.HOW TO USE THIS TOOLJust as your team sets goals for improvement, it is also valuable to set goals forwhat you want to accomplish regardingparent leadership in your CQI efforts.Recruiting multiple parent leaders is agood way to ensure continuity and tomaintain ongoing parent leadership.Steps for Process:1.Staff either lead or identify a facilitator andflip chart recorder2. Conduct a Brainstorming activity with CQIteam members identifying the key benefitsof parent leadership in CQI that are important to the local community’s or region’shome visiting system (Directions follow)Prioritization – the process to select the toptwo or three goals for developing parent leadership in CQI.3. Conduct a Prioritization Process to identifythe top two or three CQI team goals forparent leadership in CQI (Directions follow) Distribute three stickers to each member Instruct members to vote for their top threegoals by placing their stickers next to theirpreferred choice on the flip chart of brainstormed ideas The top two or three vote getters are selectedare you CQI team’s priorities for developingparent leadership in CQIOne technique you could consider:Brainstorming – Its purpose is to generatemany positive and possible ideas.Directions to consider: Define the subject Key Local LeadershipGroup (LLG) you want to sustain. Pause and give everyone a minute or twoto think Invite members to call out ideas No discussion No judgment or criticism Build upon each other’s ideas The more ideas the better Record ideas on a flip chartDecide as a group which benefits are the most important for your team, and write a goal statementfor each one:Goal 1:Goal 2:Goal 3:Goal 4:You will use these goal statements when you create your action plan.11

Action Plan Worksheet for Parent Leadership in CQIHow to Use this ToolCreating a shared action plan ensures that allteam members are on the same page regardingthe goals for parent leadership. It can also help tosurface underlying assumptions about thetimeline, resources needed, and individualsresponsible for moving the work forward.Complete this worksheet for each goal yourteam identified.GOAL:SPECIFIC STRATEGIESOR ACTIVITIES TOACHIEVE THIS GOALTIMELINERESOURCESNEEDED1.2.3.4.12MEASURESOF SUCCESSPERSON(S)RESPONSIBLE

Continuum Stage 3:Engage in short-term strategies to learn more about yourcommunity, build relationships, and recruit parent partnersThis section of the toolkit providesTOOLS INCLUDED IN THIS SECTION:short-term strategies and tools to helpSTAGE1STAGE2STAGE3STAGE 4STAGE 5your team begin planning for parentTools for learning about your community:leadership by gathering informationEngage in short-termEngage in mediumEngage in long-termSet partnership goalsstrategies to learn moretermstrategiestobuildstrategies to createAssess yourand increaseaboutcommunitythroughsurveysSurvey Basicsand build sharedabout your community,infrastructure, trainauthentic team partnerteam’sreadinesstoand focusgroups. understanding, andbuild relationships,andparents in CQI,andships and to successfully ParentSatisfactionSurveypartner in CQIcommitmentrecruit parent partnersdevelop Parent Leaderssustain Parent Leadershiprecruit parent partnersdevelop Parent Leaderssustain Parent LeadershipIf you are not using surveys and focus groups Focus Group Basicsalready, these are grea

Continuum Stage 4: Engage in medium-term strategies to build infrastructure, train parents in CQI, and develop Parent Leaders 28 Principles for Financial Support of CQI Team Parent Leaders 29 Policies and Procedures for Financial Support of CQI Team Parent Leaders 30 Parent Leader Reimbursement Form 35 Basic Budget for Financial Support of CQI Team Parent Leaders 37