1. General data about the activity Activity / Art Hive Name * - - Circle of Care Calls Meet me at the Mall St-Henri & Beyond Creative Science Shop Concordia Art Hive PSC Art Hive Other Location * - - By Phone Cavendish Mall Online Concordia University (SGW) Concordia University (Loyola) PSC Other Date / Time of the activity Name of the people who completed the form *
Name of facilitator and community members (If they agree to have their names written here)
Only numbers are allowed. if no participants of a specific category is present, please select 0.
Total number of participants present * Approximate number of Older adults (65 or older) * Approximate number of Children (18 or younger) * Approximate number of Students * How many NEW participants * How did new participants find the event? *
Based on answers from the participants
3. Observations or reflections on Equity, Diversity and Inclusion (EDI)
Data collected here will inform us if the activitities hold an inclusive, diverse, and equitable space.
Please note the discussions related to these three components in this section and how the community was encouraged to embrace a more
EDI perspective and welcome the under-represented groups. The notes will reflect also any spontaneous self-identification with a group
(age, gender, sexual orientation, ethnicity/race, disability, religion, neighborhood, language, etc).
If a question does not apply, please leave it blank.
Reflections on the composition of the group Were there any discussions related to EDI topics If self-identification occurred, what may have facilitated it? If needed, was a common ground found? If so, how (shared goals, community projects, etc.)? What could be done to reach out for under-represented perspectives? (If any suggestions from the group) List action steps to reach out for under-represented perspectives. How and when? Who offered to reach out?
Name the team members or community members who offered to help, or organizations that were
mentioned in the discussions for each action step
4. Creative Arts Expression
This section refers to any artistic expression present in the activity (art, drama, poetry, creative writing, design, music, dance and movement, baking, gardening, etc.)
Forms of expression *
Art, drama, poetry, music, baking, gardening, etc.. - Please write approximate numbers of persons using these forms of expression, e.g. art (12), poetry (1), music (1), gardening (1)
Themes & symbols *
please do not write techniques and art materials here
Art materials or instruments used
Please write the materials and the approximate number of persons using the same type of material (e.g. yarn (2), acrylic (5), collage (1), watercolour (1), guitar (1)).
Expressive Therapies Continuum (ETC) * 5. Discussion Themes
This section will inform us about the discussions between the participants in the activity. We will look into the recurrence of some of the discussions themes in time, to understand what is important for our community. Due to technical constraints, this category seems long. However, the recommendation is to write all the themes down in one paragraph, then to check in what sub-category they fit better. If the discussions do not cover one or more of the bellow sub-categories, please leave them blank.
Discussion themes: related to community Discussion themes: related to artmaking Discussion themes: self-care and personal successes Discussion themes: challenges Discussion themes: other 6. Highlights
Describe the highlights of the activity, what worked well and needs to be mentioned, to inspire other communities. The ultimate goal is to collect what our team does well and what happens in our community, to transmit this knowledge further. Due to technical constraints, this category seems long. However, the recommendation is to write all the highlights down in one paragraph, then to check what sub-category matches better. If the highlights do not cover one or more of the bellow sub-categories, please leave them blank. Participants' leadership is a required question since is is very important for our project!
Highlights: holding the physical/digital space Highlights: community experience Highlights: accessible, third-space studio environment Highlights: participants' leadership *
e.g. participants taking lead in explaining a technique to the group - or offering to do a skill share, or an idea about a community activity they want to start, participants being ambassadors for our activities, etc.
Highlights: boundaries Highlights: other 7. Challenges
Describe the challenges of the activity. What needs to be looked at more carefully, what needs improvement, to transmit this knowledge to other communities. Due to technical constraints, this category seems long. However, the recommendation is to write all the themes down in one paragraph, then to check in what sub-category the fit better. If the discussions do not cover one or more of the bellow sub-categories, please leave them blank. If you have other sub-categories than the below ones, please write all in "Other".
Challenges: holding the physical/digital space Challenges: community experience Challenges: artmaking Challenges: accessible, third space studio environment Challenges: participants' leadership Challenges: boundaries Challenges: other 8. Circles of Care connections *
e.g. friendships forming between participants, participant(s) sharing resources of self-care activities with the group, participants opening discussions about their circle of care, etc.
Please do not write names
10. Action steps and further follow up
In these section we collect the interests of our participants and themes of activities they may like to develop or participate in. If you need to have certain materials, or refill them, etc., if the Outreach Coordinators or other members of the team need to be announced,
Proposed themes/interests from paticipants
Action items required and who will follow up
Potential research questions