The Women s Health Educator Program

Transcription

1 The Women s Health Educator Program

2 City of Hamilton Public Health Services The experiences of immigrant women who have accessed breast health information and breast screening through the Women s Health Educator program The Ontario Training Center Alumni Event October 21, 2010 Toronto, Ontario

3 Research Team Hamilton Public Health Services Joanne Crawford Angela Frisina Faye Parascandalo Tricia Hack St. Joseph s Immigrant Women s Center Fatima Homid Abir Alsaid Snober Naz Xiaoxin Michelle Ji Thuy Dam

4 Presentation Outline Background Objective Research methods Findings Implications for change Where we are today

5 Background Immigrant women underutilize preventive health services, such as cancer screening Barriers to access for immigrant women: Language barrier Male health care provider Structural (Black & Zsoldos, 2003; Alba et al., 2005; MacDonald & Kennedy, 2007)

6 Strategies for Outreach Increased participation in cancer screening: Lay health educators Provide outreach Tailor strategies to women Also called peer educators, lay navigators or community health advisors (Black, Yamada, & Mann, 2002; Chui, 2003; Flax & Earp, 1999; Lisovicz et al., 2006; Navarro, Raman, McNicholas, & Loza, 2007)

7 Hamilton: Context One of the most frequent places of settlement Initial Pilot Project LED to implementation of Women s Health Educators (WHE) program 4 WHEs: Arabic, Chinese, South Asian, & Vietnamese

8 Objective To describe immigrant women s (Arabic, Chinese, South Asian, and Vietnamese) experience accessing breast health information and breast cancer screening through the Women s Health Educators Program Purpose: Immigrant women s perspectives would provide the most valuable contribution to learn about the program and to make modifications that reflect changing needs of respective communities served

9 Research Methods Participatory Action Research (PAR) Qualitative exploration: Paulo Freire Purposive sampling Immigrant women 40 years & older Accessed the WHE program from focus groups &14 semi-structured interviews Transcripts audio-taped, transcribed & translated into English Thematic analysis by two investigators & one external reviewer; member-checking

10 Findings: Participants 82 immigrant women Arabic: 36%; Chinese: 16%; South Asian: 31%; Vietnamese: 17% 64%: 50 years 36%: years 85% had a family physician 17% preferred English [but also their own language]

11 Findings: Themes

12 Inspiring change in health behavior Yes, I totally changed some not healthy ways I used to practice...now my thinking changed, and I become more knowledgeable about my breast s health and the quality of my food too. ~Arabic woman~ There are absolute changes, and now I read a lot, eat really healthy food, keep watching my food, and try my best to follow up about any topic related [to] breast cancer. ~Arabic woman~

13 Hope with breast cancer I used to believe that women when they have breast cancer always die, and no treatment for it, but after attending those sessions I learned that there are treatments and procedures and there is too many women had survived. Always there is hope to live ~Arabic woman~ I learned many things from the health session then I came to know about the cancer disease I feel very afraid when I heard about the breast cancer. If I go for the test every year and if there is any problem regarding cancer or any disease then I ll be aware soon. I want to live therefore I go for checkup every year. ~South Asian woman~

14 WHE Distinction: Knowing & being there I feel more confident, safe and comfortable with a translator [Women s Health Educator] accompanying me to OBSP. I felt I understood my own health. There was more freedom to ask questions ~Vietnamese woman~ I feel more secured with the interpreter [Women s Health Educator] accompanying me there. Besides, I don t speak much English and there is no way that I can communicate with the doctor and nurse there, so I definitely need an interpreter. This is very important for me ~Chinese woman~

15 Responsiveness of cancer screening staff When I went for OBSP for the first time, I was confused and upset. The lady doctor checked me very well, after my complete checkup I was relaxed and happy. ~South Asian woman ~ I think the services here are good and very human-oriented. Like they sent the car to pick us up and drop us home and the nurses and doctor there were very nice to us. ~ Chinese woman ~ Staff were women which is great, and all of them are friendly, kind and they gave us the comfort to do tests, both Pap test And mammogram. ~ Arabic woman ~

16 Valuing Women s Health I am really grateful that the city is doing this project now and it really helps us. This what I like about Canada; the city is very considerate and human-oriented towards people ~ Chinese woman ~ In China, people don t have a high awareness of preventing breast cancer in a pro-active way. But things are different in Canada. They provide us with workshops and there is an interpreter who speaks Chinese at the workshop ~Chinese woman ~

17 Woman to Woman Support Especially when we went to attending the health presentation, we met with all ladies of our community and we shared our views with them. ~South Asian woman~ We get two benefits in health and social life, before the sessions [WHE] we were sitting at home only, but now we meet new women and we learn important information about our health which is great ~Arabic woman~

18 Reflection of Family Doctor Role I wouldn t have paid so much attention to breast cancer if I hadn t been to this program. It would be already too late if my family doctor finds something in my breast. ~Chinese woman~ Sometimes we cannot explain to the doctor about the disease if they can give us interpreter it will be useful for us. ~ South Asian woman~ If there is anything different [breast changes], then I have to tell my doctor right away. ~ Vietnamese woman~

19 Implications for Change Enhancements to WHE Program: Content: Stories of women with early breast cancer Expert presenters, such as doctors Other health topics Process: Regular sessions (i. e. monthly), 2 week notice of session Use of videos to share information, & capture women s stories Put health messaging in cultural newspapers Dissemination: More outreach to newcomers in other communities in Hamilton

20 Where we are today 5 community forums held to report back: Immigrant women, OBSP & MWHP Women s health sessions continue Partnership with Woman Alive program & Healthy Eating series South Asian community: Monthly sessions Health messaging in cultural newspapers from public health Video s: Colorectal cancer screening Media campaign for breast screening using story telling

21 Thank you to our WHE Lisa Wang, Roodaba Alvi, Sana Khairo, & Kimmy Phuong

22 Lasting words.. When I came to Canada, I was surprised about how much they care for women s health ~Arabic women ~