Goals for today
Brief overview of what we did (methods)
Review mental health and health study
findings and next steps
Discussion of recommendations and
action steps -- your feedback here!
What is Speaking for Ourselves?
 A community-wide assessment
 Focus on needs, strengths, and service gaps
 Nine ( five) immigrant communities in
Hennepin and Ramsey counties
Immigrant communities included:
 SE Asian
 East African
─ Cambodian
─ Oromo
─ Hmong
─ Somali
─ Karen
 Liberian
─ Vietnamese
 Latino
─ Lao
(we started with 9 and went down to 5…)
Topic areas of interest
Education
Health and mental health
Transportation, housing,
safety
Employment, financial
literacy, security
Community and social
engagement
The immigrant experience
Timeline
Community
kick-off event
December 2012
Data collection
November 2013 – June 2014
Reconvene
Release/disseminate report
Action steps
Winter 2015 – Summer 2015
March-September 2013
July 2014 – Winter 2015
Summer 2015 and beyond
Advisory board
convened
Interpretation and
reporting of data
Actionable
opportunities
Goals of Speaking for Ourselves
Using a process that:
Reflects the community’s voice and perspective
Moves beyond “what” into “why” and “how”
Uses innovative, culturally-based methods
Builds stronger relationships with communities
and organizations
Goals of Speaking for Ourselves
Resulting in:
Better service delivery (increased access & trust)
Policy change
Changed perceptions (debunk stereotypes)
Communities value the research
Who are the “stakeholders”?
All these groups are critical for the project to succeed:

Wilder Foundation and Wilder Research

Advisory Board and Buy-A-Question partners

Service providers, nonprofits, and advocates

Funders, policy makers, and the media

Community members
Learn about what we did…
First: Who is eligible for this study?
All study respondents must be:

Part of a cultural community included in the study

Born outside the United States or have at least one
parent born outside of the United States

18 years of age or older

Live in Hennepin County or Ramsey County*
*A few respondents fell outside of Hennepin and Ramsey counties (they initially said they were in these counties when
being screened for eligibility, but at the end of the survey provided an address which belonged to another county)
Next: How did we find people?
We used Respondent Driven Sampling (RDS),
which is a sampling method and an analysis
method
-
Sampling = how we find eligible people to complete the
interview
-
Analysis = how we determine if the sample is
representative of the population
How did we use RDS to find people?
 We conducted canvassing and door knocking to
gather “seeds” aka the first 5-10 respondents
from each cultural community
 “Seeds” vary by:
─ Census tract
─ Gender
─ Age
Insert map visuals
• Put in Jane’s maps or the old census tract maps
that Jenny made
How did we use RDS to find people?
Hmong
326 & 327*
(Thomas-Dale,
Saint Paul)
Karen
304 & 305*
(North End,
Saint Paul)
371 & 372
(West Saint Paul)
Latino
Liberian 268.07 & 268.09*
(Brooklyn Park)
Somali
1016 & 1021
(Hawthorne/
Jordan, North
Minneapolis)
306.01
(Payne-Phalen,
Saint Paul)
84 & 85
(Powderhorn,
South Mpls)
210.01
(Robbinsdale)
1048* & 59.01 &
335
1260
(Summit-U,
(Cedar/Riverside) Saint Paul)
or Elliot Park or
Phillips West
268.12* & 268.20* 307.03 & 307.04
(Brooklyn Park)
(East Side,
Saint Paul)
327* & 337*
(Thomas-Dale,
Saint Paul)
268.09*
(Brooklyn Park)
248.02 & 249.02
(Richfield)
374.03
(Battle Creek,
Saint Paul)
422.02
(Maplewood)
317.02 & 346.02
(East Side,
Saint Paul)
1025
(Logan Park,
NE Minneapolis)
260.06 & 260.07
(Eden Prairie)
How did we use RDS to find people?

After we found our “seeds”…
─ Seeds were invited to refer up to 3 people (“referrals”) from their cultural
community

Referrals must be:


Part of a cultural community included in the study
Born outside the United States or have at least one parent born outside of the
United States

18 years of age or older

Live in Hennepin or Ramsey County

Must not be a family member

Must not live at respondent’s address
─ Each referral who completed the survey was invited to refer up to 3
additional people from their cultural community (and so on!)
How did we keep track
of respondents?
• Referrals who completed the
survey created “chains”
•
Each “chain” created a “wave”
(8+ “waves” are recommended)
•
Each respondent was assigned a
confidential identification number
•
Social networks were tracked
using detailed spreadsheets to
document seeds, chains, and
waves
What did we give people for
participating in the study?
 Respondent incentives included:
- $20 for completing the survey
- $5 for each referral
 (Respondents were also asked for contact
information if they had interest in receiving the
study findings and hearing about next steps.)
Who are the respondents?
All
respondents
(N=459)
Hmong
(N=105)
Karen
(N=101)
Latino
(N=101)
Liberian
(N=60)
Somali
(N=69)
Hennepin
47%
40%
0%
58%
85%
57%
Ramsey
49%
51%
100%
40%
10%
35%
Other
4%
9%
0%
2%
5%
9%
Female
65%
61%
77%
81%
42%
55%
Male
35%
39%
23%
19%
58%
45%
18-29
25%
26%
24%
20%
37%
18%
30-49
54%
32%
68%
66%
48%
65%
50+ years
21%
42%
8%
14%
15%
18%
County of residence
Gender
Age
How many seeds, referrals and waves?
Total number of:
All
respondents Hmong
(N=459)
(N=105)
Karen
(N=101)
Latino
(N=101)
Liberian
(N=60)
Somali
(N=69)
Seeds
41
11
7
11
3
9
Referrals
395
94
94
90
57
60
--
11
7
8
9
6
Maximum number of waves
Where
Hmong
respondents
live
Where Karen
respondents
live
Where Latino
respondents
live
Where
Liberian
respondents
live
Where Somali
respondents
live
Where all
respondents
live
Strengths
─ This approach extended our reach – the perspectives of many
people from these “hard to find” immigrant and refugee
communities are included
─ This is the best available data on immigrant groups in the Twin
Cities on a range of topics
─ RDS sampling is more culturally responsive than “cold calling”
methods and worked well in some communities
─ Falls somewhere in the middle on the range of the research
spectrum from pure convenience sampling (which is seem as
biased, invalid) to scientific random sampling (which is not seen
as appropriate in many immigrant communities)
 data are in practice fairly representative of the population
Limitations
─ Data are not statistically representative of the
population
─ RDS is extremely expensive and labor-intensive;
therefore, we were not able to fully exhaust the RDS
sampling method in any community (we had to let
chains drop)
─ Four communities were dropped, mainly due to
staffing limitations (unable to hire and retain bilingual
staff who could put in enough hours)
A sneak peek of
preliminary findings
Three-quarters (73%) of
Speaking for Ourselves
participants reported their
overall physical health as
good to excellent.
Key finding: Physical health by cultural community
All respondents (N=459)
Hmong (N=105)
21%
18%
12%
34%
19%
21%
49%
6%
17%
3%
3%
Karen (N=101)
6%
Latino (N=101)
10%
Liberian (N=60)
Somali (N=69)
18%
59%
28%
27%
14%
47%
32%
71%
7%
40%
12%
9%
2%
15%
1%
Key finding: Physical health by gender
Female (N=298)
Male (N=160)
17%
28%
16%
36%
22%
24%
31%
16%
7%
4%
Key finding: Physical health by age
Age 18-49 (N=360)
Age 50+ (N=95)
23%
13%
19%
15%
33%
40%
20%
24%
5%
8%
Key finding: Physical health by county
Respondents Hennepin County (N=212)
Respondents Ramsey County (N=225)
27%
15%
24%
13%
32%
36%
10%
33%
3%
7%
Key finding
The biggest health concerns
many Speaking for
Ourselves participants have
for their community are
diabetes, unhealthy
eating, and lack of access
to healthy food.
Percent of participants who rated these issues as a
“major problem” for their cultural community
(respondents rated items provided in a list)
All
respondents
(N=459)
Hmong
(N=105)
Karen
(N=101)
Latino
(N=101)
Liberian
(N=60)
Somali
(N=69)
61%
68%
51%
70%
45%
68%
Lack of physical exercise
61%
72%
37%
69%
62%
68%
Alcohol abuse
59%
83%
52%
68%
58%
22%
Obesity
51%
77%
17%
72%
42%
44%
Unhealthy eating habits
50%
70%
21%
55%
52%
54%
Illegal drug use
36%
40%
24%
56%
37%
22%
Prescription drug abuse
31%
41%
26%
37%
25%
28%
Lack of access to healthy food
30%
37%
20%
31%
32%
35%
Diabetes
Tobacco use/ smoking
65%
91%
26%
80%
55%
64%
Lack of health insurance,
cost of health care, and
cost of insurance are
major barriers to Speaking
for Ourselves participants in
terms of accessing needed
health care for their
families.
Participants say…
 “Some people aren't healthy and can't afford to pay for their health
care.” – Karen respondent
 “It’s like a form of discrimination. I went to the hospital. They didn’t
accept me and referred me to a specialty/private doctor. Because I
didn’t have medical [insurance].” – Latino respondent
 “No insurance. People are afraid of huge bill payments and based upon
income, some people are not sure.” – Liberian respondent
Although the self-reported
emotional health of
respondents is quite good
overall, there is stigma
associated with mental health
problems, and many Speaking for
Ourselves participants reported at
least some symptoms of stress,
depression, or other emotional
problems.
How would you rate your emotional health?
Next steps
April and May: Meetings in the community (like
this one) to vet preliminary results and discuss
possible recommendations and action steps
June: Community BBQ to celebrate public release
of study findings
Possible action-oriented event in Sept. 2015 for
community-based organizations and leaders,
policy-makers, and media (contingent on funding)
Discussion questions
• What key issues or topics that we covered are currently
being addressed by these cultural communities and
organizations that serve them in policy, programming,
and/or public arenas?
• What is most interesting about these findings?
• Do you have any concerns or questions about the way
we presented the study methods or results so far?
• Do you have any suggested action steps for public
policymakers and service providers based on the
results? (Review and discuss draft action steps in report)
Thank you for inviting us!
Contact us
Nicole MartinRogers, PhD
Wilder Research
Senior Research Manager
nicole.martinrogers@wilder.org
Denise Hanh Huynh, MPP
Wilder Research
Research Associate
denise.huynh@wilder.org
Data ownership, use, sharing, & authorship
 Level 1: Individual data

Will NEVER be shared

Wilder Research will not report aggregate data when cell
sizes are smaller than 10
 Level 2: De-identified data files

Requests will be handled via consultation with Advisory
Board during study and by appointed Wilder Research
staff member following study conclusion
 Level 3: Summary reports and data tables

Wilder Research will make these public