4.1. ANÁLISIS DE LOS RESULTADOS
4.1.2. ENCUESTA DIRIGIDA A ESTUDIANTES
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Figure 7: Key Challenges
Theme One: In defining key challenges, Outreach and Promotion emerged as the most prominent theme, with 83% of respondents specifically citing problems with marketing. First and foremost for TWC to be successful, there must be a common understanding of what TWC is and what it represents for Boyle Heights. There was extensive concern about mission and messaging. Several individuals felt that an overall outreach strategy was missing – and truly needed. One tenant captured this belief,
observing, “There is a lack of consensus about what TWC truly is – what it represents – this is crucial. We need to decide just what we are and get the message out there.” Interviewees agreed that the Center and its administrative structure needs to make a more thoughtful and intentional effort at creating marketing materials that accurately represent all facets of the Center. Another tenant offered their opinion that, “We need an outreach plan – we need
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Key Challenges
Lack of Accessibility (58%) TWC Staffing
Funding (58%)
Delayed Move‐In (67%) Logistics/Infrastructure (75%)
Lack of Commmunication/Cohesion (75%) Sustainability Concerns
No Clear Understanding of Roles/
Responsibilities
Marketing ‐ Outreach and Promotion (83%)
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materials and we need bodies to do the outreach.” There was great concern that not everyone in the Boyle Heights community was aware of TWC and the services it offered.
“There are people we need to reach, who don’t know about us – and many of them have the greatest health needs,” one individual explained. It is clear that there is a desire for effective leadership in this arena. These interviews aligned with one of the key recommendations raised early on by The Network – the need for a unified and
comprehensive marketing/outreach plan. Tenants raised concern that many of these recommendations continue to fall by the wayside. Raising the question as to why the evaluation was conducted in the first place and whether the recommendations made were taken seriously by TWC administration.
Theme Two: Another key challenge that emerged focused on problems with communication and cohesion with the vast majority of individuals describing problems in this area. This challenge was very strongly connected with the marketing concerns previously identified. The interwoven uneasiness characterized 75% of the
individuals interviewed – their thoughts and feelings were repeated in multiple interviews.
Tenants expressed strong feelings about the lack of clear and concise communication between TWC Staff and the tenants. For many, their concerns were best captured in the words of one individual who noted, “There are just no realistic goals and clear expectations”
about what is needed from the tenants. Several noted that their capacity has changed since drafting their original proposal but despite this, the Center staff has not been willing to engage in conversations or updates. One individual discussed his concerns:
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“There is a serious need for a strategic plan. Right now I don’t think there is one and that’s not a good thing – this all fosters anxiety and a negative reaction from folks. We need to feel like we are all in this together and that we all have a road map for change.”
This theme also tied in closely with individual concerns about roles and responsibilities.
One individual reinforced the need for a strategic plan and alignment saying, “There are a lot of hands in the pot, we need to come together intentionally and strategically – our realities need to align.” What clearly emerged from the themes identified through interview
analysis was the need for The Wellness Center to create and present a united, integrated front to both Boyle Heights residents and to the medical community. TWC staff must recognize that not all tenants are service providers, not all have the same levels of capacity, and finally, not all tenants have enough funding to meet TWC demands without being allotted the time and space to secure additional funding.
Theme Three: The majority of individuals interviewed expressed concerns about the TWC structure, particularly logistics and infrastructure, with problems surrounding their lack of voice in any planning or structure. This challenge was consistently cited by 75% of the individuals interviewed and represents an area warranting future attention.
One individual was very direct, noting “Partners do not have enough say in the process.”
Again, this theme overlaps with other challenges, particularly the lack of communication and the inability to define roles and responsibilities. From interview accounts, it appears that the needs of tenants were consistently overlooked in the planning process. Given the multiple agendas operating throughout the planning process, this is not surprising, but the
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interviewees were insistent that this now had to be addressed. A related concern was well summarized by one individual who described how “the intake process is really
complicated…it’s unnecessarily invasive and repetitive.” This belief represents serious concerns on the part of tenants who are required to ensure confidentiality and respect HIPPA. Interviewees raised related concerns surrounding specific leadership and bureaucratic concerns. Many respondents believe that there are key structural pieces missing from TWC model, namely, communication, transparency, and accountability. This issue is exacerbated by the lack of a clear relationship between funding entities, LAC, TWC administration, and tenants. Overall, TCW tenants concerns clustered the belief expressed by one interviewee who seemed to express what many were feeling:
“The Center is wonderful and it’s important to the community but it needs to live up to its promise. Right now we all are feeling that the center is lacking a sense of organizational effectiveness – time, planning, and cooperation are all missing – and this is key. All of the agencies here are dedicated to what we are doing but we need good, strong infrastructure and communicated. For some reason, this isn’t happening.”
Theme Four: Challenges that resulted from the delayed move represented a key theme for two‐thirds of the individuals interviewed. Along with this strong emphasis on post‐move‐in problems, over half of the interviewees described now facing
funding problems that resulted from the late move‐in. One individual embodied the reaction of many interviewees as they explained the problems that faced their agency:
“We were forced to develop our infrastructure all at once.
The building was not functional before move‐in, which impacted programmatic deliverables, timelines, and scope of work – it caused confusion. We expected to move into a stable environment – we knew there would be problems,
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but nothing approached what we found when we tried to move in. Nothing was ready.”
There was confusion, lack of preparation, and no sign of infrastructure. Several tenants discussed their inability to secure funding as a direct result of the continually delayed move‐in; this was a problem most notably for the smaller, local agencies. One individual who was interviewed recalled,
“We expected to hit the ground running, and it was a rude awakening when we had to stop in our tracks and take care of things – like getting the phone hooked up – that should have been taken care of for us. Only now that we are actually in the facility can we begin fundraising. This has been a serious problem for us.”
Many of the interviewees revealed their feelings of surprise that the infrastructure of TWC was not as well organized as they had anticipated. There was recognition that problems were anticipated, but not the type or extent that was experienced. Attending to all of these problems diverted their attention and energies from fundraising and maintaining
relationships with ongoing and sustaining funders. “We thought we wouldn’t have to deal with any of this,” one individual recalled, “that’s why we joined the Center. But we wound up experiencing double the problems.” Funding loomed large as an ongoing challenge,
exacerbated by the delayed move. Again aligning with The Network recommendations, this ongoing concern regarding funding adds to the anxiety about the sustainability of TWC model. Related to sustainability, several tenants expressed the need for outcome
development in order to measure – and validate – the Center’s success. When coupled with the concern about building a solid clientele, many of the interviewees feel that the Center’s future is troubled and uncertain.
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Theme Five: Lack of accessibility presented a major challenge facing The Wellness Center, a perception shared by tenants and community members. This is the one challenge that arose in both formal interviews and informal discussion with community members. For the most part, tenants and district office staff agreed on challenges and problems, while community members were simply thrilled to have The Wellness Center operating. However, with this challenge, everyone was in agreement. In addition, there was a strong sense of urgency accompanying the remarks of those who discussed accessibility. As one individual insisted,
“This is far more important than any of the administrative, structural, and marketing concerns and needs to be solved
immediately. I am embarrassed to try giving directions to clients.
I keep thinking of how someone might try to walk to the Wellness Center from the parking lot – if they try to come up that staircase, they could slip and fall. And we’ve got clients who are already uncertain about the health care system. It’s difficult enough to navigate online – now it’s difficult to navigate from the parking lot.”
Another individual described how, “The complex landscape of the LAC‐USC campus and parking lot is enough to keep them from setting foot at TWC.” There was a significant amount of concern expressed “about the safety of consumers coming to TWC." One tenant raised their concern that, “there is not enough signage – we have to give extensive directions, which exacerbates the pressure to get people here.” Four community members were quite vocal in their concerns noting, “The Center is great but I can’t park and walk there – they’re crazy if they think it’s easy to get to,” while another older woman asked, “What are we going to do when it rains?” The following photographs and instructions depicted in Figure
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8 and 9 are two sections of a handout created by TWC tenants to provide understandable directions to clients.49
Figure 8: Parking Directions
For those who cannot or choose not to make the 7‐10 minute walk up the steep staircase, TWC has implemented a free shuttle service. Still, for the tenants interviewed, this was not enough. The shuttle, they suggested, should run through the nearby
communities and work to coordinate schedules with the metro lines for those who not have reliable transportation. Below is a map depicting the shuttle schedule and route. The shuttle is expected to stop at four “convenient” locations at 15‐minute intervals. For those dependent on the shuttle service, they must leave ample time for parking and transport when calculating the time needed to arrive on time for their appointments. Community members claimed that this was an unrealistic and “un‐welcoming” plan; one suggested that
49 TWC Parking. (2014).
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there be a town hall meeting to discuss how to create better access to The Wellness Center.
“I don’t want to wind up with a broken leg,” one remarked while another laughingly added,
“I want to go to The Wellness Center for preventive medicine – not rehabilitation.”
Figure 9: The Wellness Center Shuttle
TWC Model: Missing Pieces, Future, and Replicability
Nearly all of the individuals interviewed expressed their belief that if TWC were operating at full capacity, the Center would be representative of and responsive to the needs of the Boyle Heights community. At this time, however, and as a result of the challenges listed above, interviewees agreed that the Center has not yet reached full capacity. Moving forward, respondents identified several services that they felt could be enhanced:
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Disability Services/Accessibility Immigration Services
Direct Health Services (ex: Dental) Substance Abuse Services
Cancer Services (National Organization) Support Group Services
Culturally and linguistically appropriate programming Youth programming (Arts and Sports)
Respondents agreed that this first year represented a critical time for TWC. As part of this, tenants expressed hope that the Center will develop both internal and external (third‐
party) evaluation models so that they can more thoroughly measure their successes and desired outcomes. There was careful thought about the future and the vision that would best guide TWC. The individuals interviewed were very clear about what was both needed and desired in the months ahead:
See a steady flow of traffic and expanded services.
Become a nationally recognized model funded by the Federal government.
Build stronger relationships with the medical and nonprofit sectors Develop trust amongst members of the East Los Angeles community.
Gain a better understanding of the role of all stakeholders
Set specific benchmarks/outcomes identified that are achievable and transformational
Provide “programming worth coming back for.”
During interviews, the issue of replicability was discussed at length. It is key to note that the discussions of the prospects for replicability of a model refers to The Wellness Center model as a whole – most notably, a co‐located multi‐tenant model with collaborative programming. There were varying degrees of enthusiasm about this model, as portrayed in Figure 10, with 91% of respondents voicing their belief that the comprehensive and holistic model of providing health care services, education, and prevention methods is replicable. However, once the interviewer drilled down into perceptions and nuances, one
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out of four individuals voiced some hesitation. Individuals explained that to truly
determine if the model was replicable, the Center must first have the time and opportunity to operate at full capacity and with full effectiveness. One respondent indicated that the model is not yet replicable explaining that the internal structure, lack of transparency and accountability, and poor definition of roles and responsibilities remain as key areas of concern.
Figure 10: Is TWC Model Replicable?
Building on this discussion, and based on the research at other community based wellness centers, multi‐tenant nonprofit organizations offering health and wellness services to residents are characterized by both the capacity to grow and the ability to be
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