Theory of Change (ToC)

Background
The TIP-CARD team hosted a two-day Theory of Change (ToC) workshops online on 27 August and 17 September 2020. A total of 32 stakeholder representatives from different sectors were invited to participate in the ToC workshops, including family carers and the public, subvented services, self-financing and private service, health care service, academic, government, statutory and policy advisory bodies. The workshop was facilitate by Gloria Wong (Project Co-ordinator, TIP-CARD), Doris Yu (Co-Principal investigator, TIP-CARD) and Terry Lum (Co-Principal investigator, TIP-CARD). During the workshops, participants were involved in group discussions and brainstorming exercises following the ToC guideline of STRiDE. The aim of the workshop was to co-develop a 10-year dementia road map for Hong Kong. Following each day of the workshop, a joint webinar was organised in collaboration with the STRiDE team, including academic staffs and other stakeholders from Brazil, India, Indonesia, Jamaica, Kenya, Mexico, South Africa, and UK.

 

Day 1: ToC Workshop cum TIP-CARD & STRiDE Joint Webinar: 27 August 2020
ToC Workshop: 
1.   Overview of the TIP-CARD project 
2.   Discussion 

a. Identifying challenges: problems and knowledge gaps in Hong Kong (group discussion) 

b. Agreeing on impact (all stakeholder representatives) 

c. Developing an outcomes map (group discussion) 

d. Logic and evidence check (all stakeholder representatives) 

3.   AOB and next meeting

TIP-CARD & STRiDE Joint Webinar:

1.  Welcome and Introduction

2.  Modelling dementia to develop policy and practice in England: The MODEM Study

Professor Martin Knapp
Professor of Health and Social Care Policy & Professorial Research Fellow, Care Policy and Evaluation Centre (CPEC), The London School of Economics and Political Science
In this talk, Professor Knapp shared with us the key lessons learned from the study MODEM (modelling outcome and cost impacts of interventions for dementia) that has recently been completed, including findings related to the question “What’s the big picture up to 2040 in England?”

3. Dementia: Hong Kong situation and an ongoing SWOT analysis

Dr Gloria Wong
Associate Professor, Department of Social Work and Social Administration, The University of Hong Kong
As Hong Kong moves forward to develop a comprehensive dementia roadmap, what are the unique strengths, weaknesses, opportunities, and threats this rapidly ageing Chinese population faces? Dr Wong presented preliminary findings from a SWOT analysis and invite your input and comments.

Day 2: ToC Workshop cum TIP-CARD & STRiDE Joint Webinar: 17 September 2020
ToC Workshop: 
1.    Recap of the outcome maps 
2.    Discussion 

a. Logic and evidence check (all stakeholder representatives) 
b. Developing strategies and interventions (group discussion) 
c. Checking assumptions (group discussion) 
d. Deciding on ceiling of accountability (all stakeholder representatives) 

3.    AOB and next steps

TIP-CARD & STRiDE Joint Webinar:
1.    Welcome and Introduction
2.    Understanding and using cost of dementia data to inform policy in different resource settings

Ms Adelina Comas-Herrera
Assistant Professorial Research Fellow, Care Policy and Evaluation Centre (CPEC), The London School of Economics and Political Science 
In this talk, Comas-Herrera shared with us her hands-on experience of developing and applying cost of dementia in England to inform dementia policy and plan, and how she is transferring that experience to guide similar processes in lower and middle-income countries that has different contexts and data availability. Audiences were able to appreciate the necessity of having locally relevant data given the great variations in assumptions, cost perspectives, and implications.

3.    Estimating the healthcare and societal cost of dementia in Hong Kong

Dr Hao Luo
Assistant Professor, Department of Social Work and Social Administration & Department of Computer Science, The University of Hong Kong
Although as a high-income area, Hong Kong has relatively accessible records of public healthcare and long-term care service use, as well as other big data sources, the task to compile a complete picture of the local cost of dementia is not straightforward. In this talk, Dr Luo walked us through the available information in Hong Kong, the areas needing new information, and some unique challenges, including the assumptions of replacement versus opportunities costs in a highly stretched labour force with heavy reliance on foreign domestic helpers.

 

Stakeholders Agreement: Where Do We Want to Get to in 10 Years?

Final impact statements:
1.    Hong Kong becomes a dementia-friendly city where people living with dementia and carers can lead normal life and age-in-place with dignity, meaning, and quality of life.
2.    Hong Kong has reduced number of people living with dementia through effective prevention.

Examples of suggested outcomes/interventions by sectors:
Housing and Environment

  • Pilot dementia-friendly housing programme 

  • Guidelines of dementia friendliness for housing professionals

Policy and Philanthropy

  • Carer-friendly employment practice

  • Dementia-specific policy and legal framework

Public and Community

  • Life course approach in education, prevention and awareness programme from young age

  • Wide use of informal education channel 

Social (including long-term care), Health and Medical care

  • Clear triage and care path for system efficiency

  • One-stop locality-based collaborative care with neighbourhood and wider sector engagement

Families Living with Dementia

  • Carers are prevented from excessive stress, burden & isolation, & able to maintain positive family dynamics

  • Carers are equipped with proper knowledge & skills, and supported by accessible respite services 

Final ToC Map (in progress):
Our team is consolidating the ideas from the stakeholders for the details of intervention, outcome, assumptions and final ToC Map. It will be used as a blueprint for a planned simulation modelling analysis in the next stage of the study.

Coming soon!

Stakeholders in ToC workshop

We have engaged 32 key stakeholders representing the following sectors and organisations:

  • Family Carers & Public Representatives

    • Big Silver Community

    • Faculty of Education, The University of Hong Kong

    • Charles K Kao Foundation for Alzheimer’s Disease

  • Representatives from Subvented Services Sector

    • Helping Hand

    • Hong Kong Council of Social Service

    • Christian Family Service Centre

    • The Hong Kong Society for Rehabilitation

    • Evangelical Lutheran Church Social Service - Hong Kong

  • Representatives from Self-financing & Private Sector

    • Jockey Club Centre for Positive Ageing

    • Hong Kong Alzheimer's Disease Association

    • Hiu Kwong Nursing Service Limited

  • Representatives from Healthcare Sector

    • Hospital Authority

    • World Organisation of Family Doctors

  • Representatives from Academic Sector

    • The University of Hong Kong

    • The Chinese University of Hong Kong

  • Representatives from Government, Statutory & Policy Advisory Bodies

    • Food and Health (Health), Food and Health Bureau, HKSAR Government

    • Elderly Commission, HKSAR Government

    • Hong Kong Housing Society

    • Social Welfare Department, HKSAR Government

  • Representatives from Philanthropy Organisations

    • Lee Hysan Foundation

    • Simon K.Y. Lee Foundation

    • The Hong Kong Jockey Club Charities Trust

    • Tin Ka Ping Foundation