Implementing community-based health promotion capacity for diverse equity-seeking women
Funding
Canadian Institutes for Health Research
Aim
Women in Canada face inequities in access to and quality of care for many health issues. These disparities are heightened among ethno-culturally diverse immigrant women. As a result, immigrant women seek health promotion programs and services from community agencies (e.g. immigrant settlement agencies) that are local, familiar, and culturally safe. We aimed to learn about the ideal characteristics of community-based health promotion, and current and needed capacity for health promotion among community agencies. This knowledge could inform the development or improvement of community-based health promotion for equity-seeking immigrant women in Canada.
Key Findings
- A review of 19 studies published from 2017 to 2023 found that most focused on health promotion for African or Latin American individuals in faith-based organizations, with few studies concentrating solely on women and none addressing 2SLGBTQ+ women. Cultural tailoring was minimal, usually limited to using participants’ first language. Training community health workers to provide health promotion education and facilitate in-person group sessions led to improvements in knowledge, self-efficacy, behaviour modification intentions, behaviour change, and health outcomes. A small number of studies highlighted the need for dedicated funding, personnel, training, and partnerships with academic and healthcare organizations to support community agencies in delivering effective health promotion. [BMJ Public Health 2024;2:e001023] [Infographic-Review]
- Interviews with 24 ethno-culturally diverse immigrant women exposed to community agency health promotion, and 22 managers/staff of 20 community agencies across Canada revealed that:
- Both groups identified similar health promotion topics of most value to immigrant women: navigating the healthcare system, sexual and reproductive health rights, mental health support, and healthy lifestyle behaviours
- The current health promotion services typically include workshops and lectures aimed at increasing client knowledge and behaviour, delivered both in-person and virtually, with healthcare professionals and staff from partner agencies supporting these initiatives. Health promotion at community agencies was typically delivered through weekly group sessions lasting an hour or more
- Agencies varied widely in funding, staff dedicated to health promotion, space health promotion policies, technology support, regular program evaluation; and partnerships with healthcare, academic and other community organizations
- To develop, maintain or expand/improve health promotion, agency staff recommended increasing funding for health promotion, developing policies to guide health promotion programs and services, increasing the number of trained staff dedicated to health promotion, and fostering partnerships with healthcare, academic and community organizations to leverage and enhance health promotion capacity [Infographic-Interviews]
- We created a case book of 19 exemplar community agency health promotion programs from across Canada. Health promotion topics included healthy lifestyle behaviours, gender-based violence prevention, health system navigation, parenting skills, chronic disease prevention, dental care, immunization, mental health support and women’s sexual and reproductive health rights. The case book compiles what we learned from agencies, which can inform the development and improvement of community-based health promotion. Link to PDF
Impact
This study captures both evidence-based and experiential knowledge of the capacity needed for community agency health promotion capacity. The casebook will enable community agencies to develop or strengthen their programs, making culturally-safe health promotion available to diverse women across Canada. Knowledge of the capacity needed by community agencies for health promotion and strategies to implement it can be used by healthcare leaders to inform decisions about organizing and funding services. This may stimulate action among provincial, territorial, and regional healthcare systems seeking solutions to mitigate a strained healthcare system and enable self-determination among community agencies and equity-seeking groups. This work will also unify researchers and collaborators with a common interest in community agency health promotion, and in future, may give rise to inter-sectoral research teams that focus on immigrant women.