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Theory of Change Questionnaire & Results

Theory of Change Questionnaire

Theory of Change Questionnaire

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Theory of Change Questionnaire Results

Theory of Change Questionnaire Results

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1. WHO- Who is Body Brave’s population of focus?

1. Where will Body Brave do its work?

What specific outcomes do you want to achieve?

Additional actors

Skills

Approaches

Approaches link and reinforce

Essential activities

Approach contribute to impact

Resource allocation

Column 12

Out of scope : children under 17; not focusing on work/reach outside of Canada.

Body Brave serves adult clients who are on their recovery journey and self identify as having, or have had, an eating disorder/disordered eating(ED/DE). No formal medical diagnosis is necessary. Body Brave(BB) is for adults only ,clients are 17 years old and older. Clients are not under 17 years of age. Body Brave is not high intensity service but rather low intensity service and does not replace in patient or out patient high intensity acute care treatment options. Body brave embraces diversity equity and inclusion and is for all persons of all: races, gender identities,  cultures and backgrounds. In the future, caregivers of clients who identify with ED/DE could be included in BB scope as users of our services. Peer support clients could also be included in future plans for BB work and scope and priority population.

Body Brave will continue to work remotely/virtually across Ontario with further reach in 5 -10 years across Canada with satellite locations either franchised or managed directly by BB staff

For this question I have zeroed in on two streams for outcomes and evaluations rathe than identify numbers or data sets:

1.Micro level-recognizing and evaluating individual contributions and achievements-and setting bench marks for staff eg-too often staff are streamed into narrow job functions, the need is identify staff functions and recognize the role and scope and subsequently assigning outcomes for each role and each function x number of groups per year; x number of admin problem solving queries ; x number of turnovers of staff and Board and analyze the why ( possibly through exit interviews) Identify what works and connect to positive outcomes/moments

2. Macro level--evaluate the effectiveness of Body Brave as an organization meeting the processes as set out in a strategic plan. How do we at Body Brave determine effectiveness of our organization? Asking the following questions may help -are we relevant and why; should we limit/narrow our scope and not become “too much to too many”; do clients still need us in the way that they used to in 2019-2020?; are we gathering info from clients, Community, organizations (StJoes, HHS, NEDIC, EDNS, Sheena Place etc) about their needs/wants of us at BB in relation to eating disorders recovery?; to what extent are we scanning the larger environment to be on focus/in focus on ED?DE.

Who are the key champions for BB? Groups include our funders and our like- minded ED/DE organizations. We need to build a team powerful enough to guide and support big change in the years ahead. This team develops the right mission, vision and values for BB and strategy for change efforts to guide us into the future. Included in this group includes people outside of ED world , and includes funders from political leaders in provincial and federal Ministries(MOH) , philanthropic leaders. A full literature review could be conducted to obtain and gain knowledge and influence to carry us into the future. Link to research projects and publish findings raising profile of BB as a key “go to” for ED DE information and support.

One of the areas of expertise at BB is the lived experience of its staff, Board, volunteers and students. This informs the deep understanding of the core business. Core team and Board members should include people familiar with ED/DE and have business acumen. It is important to note that although BB is a democratic organization we need to also think of a firm structure with clear rules, boundaries, roles, regulations and clear decision making. BB is good at identifying client needs and creating an excellent platform to support technologically the recovery support program, care team and learn worlds platforms around those processes. Thinking ahead, how will technology help us and how could it hinder us and the clients. Adapting to and listening to client ‘s technological needs is as important as serving their ED/DE clinical needs and wants.

Formal authority

Well informed Board

Firm control of resources- both financial and human

Clear decision making processes

Formal policies and processes easily accessible

Technology expert(s)

Risk management and crisis management formally addressed in a Business Continuity Plan

Qualified and skilled clinicians for clinical aspects of BB(eg assessment and treatment, intake, group offerings )

DEI approaches at all levels of organization

Compassionate, non judgemental, ethical and caring approach for all members of staff, volunteers, Board and students.

In general, all of these above ten approaches link to create a staff, volunteer, Board and student commitment to BB. By this I mean , that there is a clear mission and vision for us to be guided and follow. The shared values allow each of us individually, and collectively as a whole, to work together as a cohesive team. This collective vision allows the identified BB goals to be moved to action and be measured.

All are essential but I am taking this question in a slightly different direction. I wish to emphasize the nature of our health care work at BB eating disorders. When clinicians come together with non clinical staff, volunteers, students, it is necessary to create a common language. If we do not “do” that , our vision for people with ED/DE, becomes a barrier to listening, understanding and working together. Defining terms and building a common vision and direction that is completely understood is essential to strategic planning and BB intended impact as described below.

50% Choosing partners-financial and political partners—key champions of change—who have the “power” to remove barriers. Partners must be engaged in ED/DE and not just seeking side benefits (eg photo op!). Determining partner accountabilities is equally important as identifying who they are.

10%Ownership of the vision and implementation plan

30%Define how staff are responsible, accountable for each stage of strategic plan- through job descriptions, role clarity—Is everyone equal is a provocative question

20%Commitment of financial or staffing resources to meet the needs of the strategic plan

Less focus on family/support teams directly → limiting to resources on how to speak with your support team, and resources directing them to personal support, for example.

Canadians directly struggling with EDs

Across Canada

An increase in knowledge, hope, and feeling of community for folks struggling with EDs

Better understanding of how to navigate the ED care landscape (i.e., how to get care for the different levels of support required)

Others impacted by EDs (families/support team, care providers, hospitals) for more education purposes & sharing other resources

additional ED organizations across Canada to strengthen support folks can have

government leaders to fund

Voices of lived experience from many perspectives (self, family/caregiver, care provider)

Evidence informed services

Client focused approach

Innovative, solution-based thinking

Many connections within the ED/health landscape

Tech-savy → which influences how we can offer programs

High passion for the work being done

Respectful staff → more likely to share and challenge opinions/ideas for growth and best practices for BB and clients

Harm reduction approach/education

Environmental scan of what is currently being offered in the ED landscape (including restrictions, audience, types of services)

Organizational clean-up & updating of both internal (roles, policies, processes) and external (resources, processes, feedback) work

Build a strong connection with other organizations to leverage off of everyones unique work (i.e., NEDIC’s information, EDNS’ peer support, our RSP…)

Feedback from diverse groups with lived-experience and evaluation of services

advocacy and awareness of ED

low-intensity groups and services

By conducting an environmental scan of what is currently offered in the ED landscape and building relationships with those folks, we are following a harm reduction approach→ exemplifying that there are many different paths to recovery & meeting everyone where they are. Some folks will need more intense treatment (i.e., hospital treatment, etc.) and having a space to inform them of where to go- while still offering our lower intensity supports when possible.

Evaluation and feedback from a diverse group directly links to our harm reduction approach. Looking at if our groups are meeting the needs of our community and if our services are actually impactful.

An organizational clean up is linked to all of the above approaches. We can better access who can support different roles, how to reduce the burden on staff and confusion for staff and clients, and allows us to listen to feedback- rather than gather it but not have the capacity to make those changes.

Advocacy and awareness reduces the stigma attached to EDs (harm reduction approach), broadcasts the need of supports to larger stakeholders (funding), and advertises BB services to have a greater reach to those looking for support.

Harm reduction education to staff

Ensuring everyone on the team is educated on who is what role, what platform is being used for what

Offering low-intensity services (RSP, Treatment groups) → looking at how many/which are most impactful

Creating easy to follow resources for folks to navigate BB services and other available services

Pre- and post evaluations on groups & RSP feedback forms

Social media/newsletters to keep clients informed and updated & target groups outside our current community

Harm reduction education to staff allows BB to know more on how to better shift into a harm reduction approach to services

Complete understanding of staff roles, how they may overlap, who to reach out to for what, and where to find all information is essential to give clients the best support and reduce team burn out

reducing client confusion with both BB and the ED landscape not only improves the clients experience with receiving support, but can reduce the admin burden of answering FAQs. Plus gives larger funders (government) an idea of how many barriers there are to receiving care.

Evaluations show if we are reaching our outcomes of building hope/education/community with our supports

organizational clean-up/up-keep: 25% (more of an up-front % and then lower as we go on)

Environmental scan & updates to environment: 5%

Groups & services (prep, evaluation, conducting): 55%

Advocacy & awareness (socials, newsletter, building relationships, etc. : 15%

Training and Education; any research project that is not advancing us towards out intended outcomes; extensive data collection and analysis; Body Peace (unless it’s focus is on advancing us to our intended outcomes)

Individuals with eating disorders / disordered eating

Largely virtual - treatment services will be accessible online in every province and territory in Canada. I love the idea of having ‘satellite’ in person clinics in every province.

Increased number of individuals reaching out for help with their ED / disordered eating; increased number of people accessing community treatment for EDs; increased number of individuals feeling hope and autonomy about their recovery; decreased number of people on waitlists/decreased waittimes for higher levels of care (that might be a bit advantageous and not directly BB, but the idea is if more people get better community care then there’s less of a need for extensively long waitlists for higher levels of care like hospital based programs); increased awareness of eating disorders and improved understanding of how to navigate the health care system for EDs; a shift in our approach to the treatment of EDs to be more impactful and appropriate for clients, wherever they may be in their journey to recovery

Government (all levels), hospitals programs such as St Joes, doctors and nurse practitioners and other HCPs, HFHT and other health teams in ON - nationally, health clinics of all kinds.

We are good at listening to and lifting up voices of lived experience (although we are certainly not perfect at this either) - the fact that this is a core value of ours and woven into all that we do, sets us apart and makes us approachable and allows cts to feel more accepted and respected. Our treatment program offerings are unique (I wouldn’t say based on rigorous evidence, but rather a combo of some evidence + lived experience + they are evidence generating). Body Brave is very compassionate and has very passionate staff, contractors, volunteers, students etc. who try very hard to meet the clients where they are at. We are also good at being innovative and creative (ex, the whole RSP).

Absolutely critical would be support and/or treatment sessions (any or all of the following: live and pre recorded support sessions, live treatment groups, intake calls of some form, 1:1 sessions). Specifically I think our RSP and treatment groups are critical.

I think the RSP and treatment groups go together because the RSP is really the ‘virtual waiting room’ to access live treatment groups, 1:1 work, and other forms of treatment outside of BB.

RSP - some sort of self assessment and pre recorded sessions Treatment groups - I think there’s value in both 10-week and drop in treatment groups. I think it’s essential we have different types of groups to better suit individuals with different types of EDs at different points on their journey to recovery, to avoid being too general 1:1 treatment - intake calls and medical assessments (I think medical assessments are vital to mitigate risk and help higher risk folks get properly flagged and assessed) Training and education - I’m not sure this is absolutely essential for impact/outcomes. Indirectly, yes, but not necessarily directly essential. Research - specifically research on our groups, potentially a future project about RSP…

RSP - allows increased # of folks reaching out for help to GET some form of help right away and a self assessment allows them to better navigate the healthcare system to avoid long waitlists for a level of treatment that may or may not be appropriate. Also an important virtual waitingroom while waiting for HLOC. Treatment groups - we are offering community based virtual treatment which is much more affordable and can reach many more individuals than hospital based programs, and can reach many more people sooner. 1:1 treatment - same as above Training and ed - awareness…again this approach feels more indirect to the intended impact Research - by conducting research on our unique groups we can continue to advance them and share our learnings with the world for better ED care all around, and further advocate for more funding towards community ED treatment options such as BB. More research on self assessment tools would be amazing to help better direct folks in the healthcare system.

RSP - 35% Treatment groups - 35% 1:1 treatment - 15% Training and ed - 5% Research - 10%

Less emphasis on spreading training programs. Ideally, less time spent on fundraising so we can focus on the work itself.

Young people aged 17-35 with disordered eating or eating disorders, in Canada

Both Canada-wide (RSP) and provincial (treatment groups)

Measurable change in ED behaviours, measurable change in quality of life, measurable change in self-esteem. Engagement with the RSP. Effective assessment of high risk clients. Development and testing of system navigation tools.

Organizations such as EDNS, Bridgepoint, NIED, NEDIC, as well as mental health organizations such as MHCC, CMHA, CAMH. Also, students from selected universities

Committed engagement by each member of the team. Healthcare professionals involved in treatment programs. Evidence-generating, innovative programming. Strong commitment to student education.

Awareness-generating about EDs and their impact is a key approach - both thru the RSP and treatment programs. 2. Engaging with students allows us to contribute to the development of a workforce knowledgable about EDs. 3. A team-based approach is central to our work. 4. Respect for our clients is another key approach. 5. Our work must be data-driven and iterative. 5. Stepped Care approach

Thru the RSP, we are able to generate awareness about EDs among our clients and the members of their care team. Similarly, we build knowledge about EDs in our treatment groups, and by educating our students. We treat clients as well as team members with respect. We believe in the value of each team member, including our students.

Robust evaluation strategies are essential for impact, in all areas of our work. Fostering of a mutual learning environment helps us to draw on the strengths of each team member. Good communication is an aspect of all our approaches that is essential for impact. Innovative problem-solving is another key aspect of our approaches.

Awareness-generating about EDs is central to our work, both thru the RSP and our treatment programs. 2. Our work with students helps to build awareness about EDs, as well as helping to develop an engaged workforce. 3. Our team-based approach draws on the strengths of each individual member to maximize our impact. 4. Our engagement with clients is based on respect and mutual learning.

Awareness-generating about EDs thru the RSP and groups: 60% 2. Education of students: 20% 3. Team-building activities, meetings, etc: 10% 4. Evaluation/data analysis: 10%

Not 100% sure I understand the question... possibly youth affected by ED/DE? And organizations that target youth specifically?

1. Individuals (adults 17+) struggling with eating disorders/disordered eating

2. Care providers (e.g., healthcare providers, caregivers/loved ones) supporting with individuals (adults 17+) struggling with eating disorders/disordered eating

Support = Nationally (across Canada)

Treatment = Provincially in Ontario

Ensure equitable and timely access to high-impact, individualized care for ED/DE sufferers and their care providers

Shifts in the cultural structure of ED/DE care in Canada toward greater diversity and inclusion (especially from those with lived experience)

Body Brave service users (i.e., adult clients) and their care providers (e.g., loved ones/caregivers, healthcare providers)

National, provincial, and local policy makers (e.g. MPs) and advocacy coalitions (e.g., NIED, NEDIC, EDO, etc.)

National and provincial organizations/institutions who share similar values to Body Brave and offer complementary services (e.g., EDNS)

Institutional and 3rd party researchers (e.g., McMaster, Western, etc. phD students)

work/care we provide is informed by evidence AND lived experience

innovative and flexible services that strive to support clients across the continuum of the ‘recovery spectrum’ (rather than force one kind of care/treatment approach onto everyone)

‘gritty’ (in a good way) and supportive team culture

technologically motivated organization which makes us unique within traditional healthcare spaces

**(Variety/Flexibility):**1. Provide a variety of ED/DE services that can be systematically and sustainably be scaled up or down to adapt (or ‘flex’) to the needs of users

**(Education/Outreach):**3. Incorporate aspects of mental health literacy/system navigation education into ALL programs to equip users with the tools and resources needed to access individualized care (even beyond BB) - WHILE also engaging in regular coalition building at national, provincial, and local levels to connect system together

(Evaluation/Innovation): 5. Continuously evaluate services/programs to inform development needs and contribute to laying the foundation of accessible and equitable ED/DE research

Offering variety of services (within our capacity) that can adapt to users’ needs + incorporating mental health literacy/system navigation into ALL programs = meets users where they are, then equips them with the knowledge/skills they need to design their own ‘care team’ beyond Body Brave = increases support we can provide + collaboration with broader healthcare system + sustainability of our services

Continuously evaluating our service delivery and impact = increase efficiency of our work + increase clinical impact of services we offer = increases buy-in from other organizations/government = increases exposure and likelihood of sustainable funding

1. **(Variety/Flexibility):** Match between client needs and intervention (ie., duration + intensity); equitability of services; accessibility of services

2. (Education/Outreach): method of communication with clients and care providers; ability to engage external organizations (i.e., coalition building)

3. (Evaluation/Innovation): availability and engagement of external organizations/researchers; data management/security provisions.

Variety/flexibility + education/outreach = connects people with the right resources at the right time for their unique needs + empowers them to be an active participate in their care journey → ensures equitable and timely access to high-impact, individualized care for ED/DE sufferers and their care providers

Evaluation/innovation → helps to shift the delivery of ED/DE care in Canada toward greater diversity and inclusion (especially from those with lived experience)

25% variety/flexibility

25% education/outreach

50% evaluation/innovation

Body Brave might not prioritize training & education,

Body Brave’s population of focus are individuals in between inpatient and outpatient care that temporarily require a place to go, with the goal to enter inpatient or outpatient care.

Body Brave will do its work all across Canada with its accessible resources and services.

Body Brave offers a stress-free, easy-to-access service with an ecosystem that clients can enter and exit when they need to. This would include simple, easy to understand onboarding and resources & services that are accessible at any time.

Body Brave will need to work with a government body to ensure fluidity of services in the health care system and to avoid friction with other organizations in the work that we do.

Body Brave is distinctly good at what it does due to its flexibility to change, and data informed programming and services from our programming data collection efforts.

Open lines of communication with our clients, autonomy for clients in the way they access our services, variety of services based on group or individualized treatment.

Our approaches link to each other through openness and giving the most options to clients while fostering communication with our community to better inform the direction of our services.

Open communication is essential to offering the services that make the most sense to our clients and ensuring feedback is heard. Giving clients autonomy in the way they access our services gives them full control of their recovery and lessens the administrative burden of day-to-day operations. Offering variety of services allows clients of many different backgrounds with varying levels of comfort to enter the Body Brave ecosystem.

All three approaches facilitate accessibility, scaling of the organization, and individualized care. Open communication with clients ensure that we maintain accessibility, client autonomy decreases admin burden and allows for scaling of our services, and variety of services allow for individualized care.

Open communication - 40%, Client autonomy - 20%, Variety of Services - 40%

Hopefully not have to prioritize/rely of grants/loans, but instead be able to receive concrete sustainable funding recognized by the government/higher ups

Multiple platforms. Instead, create a basic, accessible app that is specific for Body Brave and our process for clients (not rely on other platforms to try and keep up with us, but instead, have our own ability and funding to make our own form of app).

Teens and adults struggling with an eating disorder/disordered eating looking to begin, continue, & or maintain recovery.

Virtually/Online spaces (Zoom, Careteam, email, phone, website) in Canada and globally providing services

1-1 treatment services in-person (optional, based on accessibility, HR clients)

Accessible, sustainable recovery for all clients.

Clients find our services ranging from low-intensity treatment to client centered, community based, intensive treatment helpful

Clients easily understand how to navigate our various platforms and find the resources they need in order to continue next steps

Body Brave is an accredited organization that is recognized nationally as eating disorder treatment, support, and educational organization.

Body Brave provides impactful treatment and support that improves clients QoL, hope, sense of self, self-awareness and compassion, and overall symptoms

Other organizations/hospitals/countries are aware of Body Brave and out offerings, properly referring clients to our services

Body Brave provides educational and treatment support/awareness to clients, health care providers, caregivers, and/or loved ones.

Communication processes are easy to navigate for clients and receive the support they need routinely

Body Brave is a highly happy, diverse, effective, efficient, and supportive team that is able to stay connected together.

Body Brave has updated policies, procedures, guidelines in all aspects for clients

Body Brave’s database is highly effective, efficient, and sustainable for our programming and service needs.

Clients are able to receive catered treatment (such as a specific circle of care on the team: Social worker, dietician, doctor, ect at Body Brave).

Providing proper/adequate compensation and pay for all workers (part-time, facilitators, full-time staff) with training, benefits and interactive/social events that improve overall moral, connectedness, confidence in work, providing space to attend to physical/mental health/well being.

Other community based treatment and support services

Collaborating with other ED organizations to create content (treatment groups, support sessions, educational content, public events/meetings)

We have a diverse set of groups with incredible facilitators

Our RSP is based on evidence and uses a stepped care approach that makes it easy for the clients to take control of their recovery

Our support services (ex: RSP - support sessions, check ins ect) provide low-barrier, non-committal options to clients that are overwhelmed with starting their recover journey

We are flexible and creative in the way that we approach problems to over-arching bigger picture issues within the ED community

Teaching and education. We are a teaching organization, and also educate health care providers - providing great care to those struggling even outside of our organization.

We are online, providing accessible services that are available to people province-wide

We are free of charge, or covered by OHIP

We use person-centered care that empowers clients

Networking/Marketing skills - very important in order to connect with other organizations and understanding how we can continue to expand and grow in different directions

Provide trainings such as DEI, AOP annually

ASIST training for all clinical team members

Provide Harm Reduction training/education to all members on the team

Have all team members attend board meetings annually - have all teams involved with each other

Provide best-practice for providers

Work from live experiences, understanding that clients & their needs without judgement

Creates a safe, inclusive, equitable & welcoming space for all

Increase of overall teams understanding of other teams roles/responsibilities

Be able to advocate for our clients & our services

Client-centered care that works with the clients to better understand their goals, needs and struggles

Education & social justice

Continuous learning for staff/students

Easy & automated onboarding processes for clients/staff/students/volunteers (internally & externally)

Routinely check ins with clients throughout their time at BB, seeing if they need to step-up or step-down their care at any time

Narrow down out platforms

Update/change/remove/create new processes, policies, procedures that focus on positive impact, efficient & effective services, and guidance for clients/staff

Admin (manual): 5% (automated): 20%

Treatment: 25%

Support: 25%

Education: 10%

Students: 5%

Staff wellbeing: 7%

Internal trainings: 3%

There are no rows in this table

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Wordcloud Theory of Change Questionnaire Results

Wordcloud Theory of Change Questionnaire Results

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