8. Health promotion activities and outreach - I
Health promotion tasks
Many different health promotion activities were undertaken by the Lay Health Promoters/Participatory Researchers (LHP/PRs). The goal was to provide better health education and outreach to Hispanic women in the Ottawa area. In this process, the LHP/PRs established and renewed links between the community and health service organizations; encouraged interest in the community to participate in Centretown Community Health Centre (CCHC) health promotion activities in areas other than cancer screening; and increased the visibility of Mujer Sana - Comunidad Sana, and of specific CCHC health promotion activities, as a source of valid information that could be easily accessed by women in the community.
Activities included: contacting women individually and visiting them in their homes; demonstrating BSE; accompanying women to services; advocating on their behalf; providing workshops on health issues emphasizing breast and cervical cancer screening; developing and providing shopping mall displays; organizing and participating in larger community information events; identifying and providing new resources for women; making referrals to CCHC and other agencies. Go to Key findings to find out more about the effectiveness of the activities.
Program planing
An intensive participatory program planning process was completed by the end of January 2002. All four partners contributed their ideas and integrated them into one program model. A [project logic model] was developed to summarize the key elements of the program. An overview of program activities with projected outreach targets also was developed. We hoped to reach 1000 Hispanic women through the project's different activities.
In January 2002, after completion of the three-month training, eleven Lay Health Promoters/Participatory Researchers were hired formally as CCHC employees. The Project Co-ordinator directly supported their work through individual meetings. Issues related to program planning also were discussed at Project Team meetings attended by LHP/PRs, and at meetings of sub-committees such as the research committee. LHP/PRs had regular weekly team meetings to assess and plan the next activities. Workplans and priorities were periodically reviewed and adjusted, in response to research findings, to ensure links between research and practice.
Outreach
Outreach activities began in February 2002. The first emphasis was on reaching women individually to conduct in-depth interviews and, later to administer a health knowledge and behaviour survey. The survey proved to be an effective tool to reach marginalized Hispanic women to collect information on community needs. The health promotion activity was built into the research interview protocol: the Participatory Researchers (PRs), in their role as Lay Health Promoters (LHPs), provided accurate cancer-screening information in Spanish after they had completed the survey; they answered questions and clarified myths and misconceptions about cancer. They identified other areas of need and provided additional information or referral. They also invited women to the second major public outreach event organized by the project, the 'Health Festival'. For more details see Resources and Key findings from interviews and survey with Hispanic women.
As community leaders, the LHP/PRs used a combination of many different methods to approach Hispanic women, beginning with their 'natural helpers' network of friends and neighbours. The Hispanic community in Ottawa communicates actively through word-of-mouth, and this led to many additional women to whom the LHP/PRs had not previously talked. In addition, LHP/PRs made a concerted effort to be present and identifiable at many community events, from soccer games to christening parties. Many also took the initiative to approach other Spanish-speaking women wherever they encountered them: at the bus stop, on the way to their child's school, at the hairdresser, in the shopping mall. Churches are important sites where different segments of the Ottawa Hispanic community gathers, and a special effort was made to attend the events of various churches, and to work in collaboration with church employees and organizations to inform them about the project. As the project became better known and more visible, Spanish-speaking people also started to call LAZO and the Mujer Sana/Comunidad Sana office directly.
Health Festival
The Health Fair or 'Festival de Salud' brought together approximately 250 members of the Hispanic community in Ottawa, as well as members of other ethno-racial communities. The event was held at Centretown Community Health Centre (CCHC) on a Saturday, which made it possible for working people and their children to attend, and to use the whole space of the community centre (which is generally closed on week-ends). A festival atmosphere was created by the Lay Health Promoter/Participatory Researchers (LHP/PRs), who decorated the locale with posters, balloons, and streamers. Local Hispanic restaurants and stores contributed to this event by providing a hot buffet lunch and many door prizes. A Latin American band played in the foyer, which encouraged many participants to dance and sing along after the formal presentations and activities had ended.
Each room in the Community Centre was organized to play a different function related to the Mujer Sana - Comunidad Sana project, and the community was invited to visit all of them at their leisure. Several rooms had a number of displays with LHP/PRs and other resource people present to answer questions. A video was shown in another room, about the importance of regular cancer screening tests and how to do breast self-examination. One room was reserved for women only. This allowed more privacy in talking with an LHP/PR about concerns or being shown breast self-examination. There was child care in the Centre's child care room, and food in the Centre's community kitchen.
The event was conducted in Spanish and English. LHP/PRs provided useful health information in both languages. Many activities for children were available so mothers could attend the different workshops. The event was enriched by the participation of a number of organizations: The Canadian Breast Cancer Network, Breast Cancer Action, Ontario Breast Screening Program and City of Ottawa Public Health, all of whom had resource people and displays at the event. The Canadian Breast Cancer Network also co-sponsored the festival.
Politicians, diplomats and representatives of different organizations were also present, including, Mac Harb, MP for Ottawa Centre; Elizabeth Arnold, Ottawa City councilor, as well as representatives of the Mexican, Colombian and Salvadoran embassies. The event increased the visibility of the LHP/PRs and the accessibility of cancer screening information to the community. Go to Evaluation of the Health Festival for more information about the success of this event.
