In our first webinar about health disparities and Parkinson’s, moderator David Leventhal reminded us that we see people at events, classes, clinics, support groups, and programs who do not fully represent the diversity of our nation. We noticed this for a long time and wondered why, but we moved on. We now recognize that this absence is not an accident. It’s not something that just happens, and it’s not by chance. It’s the result of deeply rooted systemic health and cultural inequalities and inequities and disparities. And we are not satisfied with just noticing this anymore. We want to understand it. We want to learn from it, and we want to change it.”
By choosing to facilitate a group discussion about health disparities and Parkinson’s, you are a significant part of that change. While we don’t pretend to be experts, we want to provide advice for leading conversations around these important topics. We’re excited that you are eager to explore these with us as we all work to help everyone get the care they need to live well.
Steps for Success
- Prepare yourself. An essential first step in facilitating deep conversations is to build your knowledge base. Explore books, articles, documentaries, webinars, and podcasts about the subject to learn as much as you can. This education will not only help you lead informed, productive conversations but will also allow you to reflect on the values, beliefs, biases, and experiences you bring to the group. (Not sure where to get started? Check out our blog post with definitions, suggested readings, and more, as well as the first webinar in our Health Disparities and Parkinson’s series.) Remember, though, that you do not need to be an expert to lead a meaningful discussion. Do your homework, but don’t let the fact that you don’t, and won’t, know everything stop you from jumping into these crucial conversations.
- List your goals as a facilitator. What do you hope to achieve by leading a discussion about health disparities and Parkinson’s? What problems are you trying to solve, if any? What does a successful conversation on this topic look like to you?
- Choose a media format and create a schedule. Does your group want to discuss books, podcasts, webinars, articles, or a combination? Invite input from attendees and plan based on their preferences. Are you planning on discussing a webinar? Organize a viewing party. Want to read a collection of essays? Take a poll to select the list. If you foster a sense of community before the discussion, participants will feel more comfortable sharing their thoughts.
- Set the stage for an open discussion. For in-person meetings, arrange the seating so all participants can see one another—a circle or U-shape works well. If your group meets online, invite attendees to share their video, which typically makes for a more intimate and personable space. (Keep in mind that attendees who choose to leave their cameras off have reasons for doing so; acknowledge this in your invitation and support those who choose not to share their video.)
- Before you open the discussion, create group guidelines or ground rules for the conversation. These should set standards for a common language, encourage openness and respect, create a judgment-free space, allow for equal speaking time, and promote acceptance of diverse ideas, values, and beliefs.
- Ask your group to list their goals for the discussion, as you did yourself in step two. Refer back to those goals if the conversation gets sidetracked; this allows you to return to the subject at hand without making someone else feel unheard.
- Use the questions below or your own set of prompts to guide the discussion. Remember to allow time for everyone to share, and if someone dominates the conversation, step in and invite others to contribute.
- Remember that conversations around equity, access, and disparities must be ongoing. Encourage your group (and yourself) to reflect on the ideas you talked about during the discussion and focus on the growth process as you continue learning more about the subject.
- End the conversation with a call to action. This action can be as simple as choosing the next reading or viewing assignment or writing down goals for the subsequent discussion or as challenging as asking participants to do one thing each week (or even day) for a month to help mitigate health disparities in their community.
- Remember that we’re all learning together. You’re not expected to be an expert simply because you’re facilitating a conversation. Take time to process what you learned during the discussion and use these reflections to help shape your plans for future conversations.
The questions and prompts you use to guide your conversations will change depending on the topics and media your group chooses. Still, here are some general questions you can ask to kick off your discussion, or if you need to guide the conversation back to the subject at hand.
- Why do health and healthcare disparities matter to you?
- What are some of the current challenges of addressing disparities that you see in your community?
- What did our reading/viewing/listening teach you about social determinants of health? How do you think that plays out in the Parkinson’s community?
- How do inequality and social injustice produce health consequences?
- What were insights from the authors or speakers that were most compelling, interesting, or surprising to you?
- How are health, social, and economic resources allocated in your community or society? How does that impact people living with Parkinson’s?
- Which issues most affect health in your community specifically? (Examples could include housing, jobs, income, transportation, racism, schools, social exclusion, civic engagement, land use, development, etc.) How?
- What did you learn in your reading/watching/listening about the differences between health disparities and health equity? What’s an example of a health difference that you would not consider to be a health disparity?
- Whose responsibility is it to address inequities in health and society?
- Who makes the decisions that affect your local Parkinson’s community? Who’s missing from the table? How can community members gain access to power? If you had the power, how would you change the process? What decisions would you make differently? What additional resources would you need? What are the priorities for action?
- How was this reading/webinar/podcast the same or different from other media you have seen, read, or heard on these issues? In what ways did it confirm or challenge the ideas you held?
- What questions surfaced that you’d like to know more about?
Managing Group Dynamics
Regardless of the subject, group discussions can be challenging to facilitate for several reasons. Here are some scenarios you may face as a facilitator, as well as advice on how to navigate each situation.
Remind your group that everyone has different learning and sharing styles and that some people are naturally more extroverted and talkative. In contrast, others may not speak out immediately but enjoy participating when they feel ready. Mention that if members know they typically have a lot to say in meetings, they should ask themselves, “Do I recognize when I’ve been speaking more than others?” and “Am I giving space for others to chime in?”
- What should I do if a member of the group starts dominating the conversation with their own stories? One way is to set a firm structure before the discussion begins, such as a round-robin in which everyone is invited to speak in turn for a set amount of time. Offer each attendee three minutes to offer a response to a question, then ask the next person to do the same. If your group is large enough, you can split the group into smaller groups to allow everyone more time to share. If someone continues to monopolize the conversation, step in with a comment such as, “[Name of another group member], you looked like you had something you wanted to say. Would you like to jump in?” or “I’d love to hear [name of another participant]’s thoughts on the question. What do you think?”
- What do I do if the conversation feels like it’s going into unproductive and negative territory? Practice respectful redirection and return to the topic at hand by asking the next question on the list. If this doesn’t work, mention what you’ve read about the power of positive thinking and how your group members can practice this during the group conversation to reinforce the habit.
- What’s the best question I can ask to redirect someone who is stuck on a thought or story that’s taking the group off course? Take a similar step as mentioned above, thanking the person for sharing their story and inviting someone else to answer the next discussion question. Politely redirecting the conversation back to the set questions can get you back on track without making anyone feel embarrassed.
- What’s the best way to handle someone who wants to play the role of expert? Remind the person that you’d love to hear everyone’s input. You can also link something they’ve said to a new question. For example, “I like what you said about [x]. What does someone else think?”
- What if there is dead air or I can’t get or keep the conversation going? Sometimes, pausing for up to 30 seconds can be a useful facilitating tool, allowing participants to collect their thoughts and for more introverted people to speak up. If no one chimes in after about 30 seconds, try rephrasing the question or taking a step back to introduce a more straightforward question, such as “What is one word you would use to describe what you thought about [x]?” You can also move on to a different question, or you can change strategies and suggest everyone takes turns asking questions they’ve had—no answers allowed.
- What’s the best way to reset the group before closing the session? Summarize the discussion’s key points and ask for feedback to see if you’ve accurately captured the main themes. Discuss the call to action and steps for meeting again, if there are any. Invite attendees to follow up with you or the group afterward with additional thoughts and ideas.
HEALTH DISPARITIES DISCUSSION TOOLKIT
There are many books, podcasts, videos, webinars, and essays about health disparities that your group could discuss. To make it easy for new facilitators to get their feet wet, we have included this Discussion Toolkit that includes everything from the media choice to questions and feedback surveys. Have an idea for another health disparities discussion kit? Please let us know at firstname.lastname@example.org.
To download the Health Disparities Discussion Toolkit, click here.
Share Your Feedback
Were there any “aha” moments during your conversation? Any topics your group uncovered that you’d like to know more about? By sharing your feedback, you can help other facilitators learn from your experiences. You can complete our survey after each discussion group you lead.