January 2002

Hiring

CCHC hires a Spanish-speaking physician.

Formative
Evaluation

Partners participate to evaluate project to date, including process indicators and development of partnership.

Training
Evaluation

Evaluation data is summarized and compiled; implications for programming and further continuing education needs of the LHP/PRs are highlighted.

Programming
Activities

A program plan for the up-coming year is developed with contributions from all project partners; outreach targets are set.

LHP/PRs

LHP/PRs formally become part-time employees of CCHC; CCHC welcomes them by providing a special focus on the Mujer Sana program during a staff meeting.

In-Depth
Interviews

Additional 22 in-depth interviews are conducted by the LHPs also trained as participatory researchers (PRs).

Mujer Sana
Health Survey

Mujer Sana Health Survey, based on items derived from U.S., and other surveys, is adapted for Ottawa context and tested; final version is completed after six drafts.

LHP/PRs are trained to administer the survey and obtain informed consent.

LHP/PRs record additional reflections about each interview.

Research data management system is developed and maintained.

Data is stored and processed at Gentium to maximize confidentiality.

Staff Survey

A CCHC staff survey (data to be used for the CCHC case study and outcome evaluation) is developed, tested, revised and distributed to all CCHC staff.

TV Interview

TV interview with a project team member appears on Rogers Cable TV for the Spanish edition: Revista Latinoamericana.

Client Data

Data collection begins at the Ontario Breast Screening Program (OBSP) on all women accessing the program.

Article

“Building Community with Lay Health Promoters” appears in the Canadian Research Institute for the Advancement of Women (CRIAW) Newsletter, Winter 2002.

February 2002

Survey And
Outreach

LHP/PRs begin to reach out to Hispanic women and conduct 212 surveys; also invite women and their families to the upcoming Health Festival.

Health
Promotion
Activities

LHP/PRs provide information on screening for breast and cervical cancer as part of their outreach activities.

Health Festival

LHP/PRs begin planning the Health Festival.

Training

Nurse from Breast Cancer Action gives additional training to LHP/PRs on breast health.

Outreach And
Dissemination

Committee develops and implements media strategy for the Health Festival.

Health
Promotion
Activities

LHP/PRs provide information on screening for breast and cervical cancer as part of their outreach activities.

Program
Documentation

Activity logs are developed to facilitate consistent data collection by the LHP/PRs.

LHP/PRs begin recording their experiences in activity logs.

Group
Capacity
Building

LHP/PRs meet on a weekly basis as a team to discuss programming, outreach, and research activities; they rotate being the meeting chair and taking minutes during the meetings. LAZO madrinas participate on voluntary basis to help support research capacity activities.

Staff Survey

42 surveys are received; data is entered and summarized.

Chart Review

Charts are reviewed to identify women who had received a complete check up between June 2000 and June 2001.

An additional check list is developed with input from CCHC's Primary Care practitioners, to provide the project with systematic recording on breast and cervical screening and referral at CCHC. See Linking Research and Practice.

Article

Article about the project appears in the Carleton University, School of Social Work Alumni Newsletter.

Confidentiality
Protocol

Confidentiality protocol is developed and implemented by LHP/PRs, highlighting the importance of confidentiality within communities.

March 2002

Advisory
Committee
Meeting

Input into ensuring support services for Hispanic women diagnosed with cancer or needing referrals for other health services; an ad-hoc sub-committee is struck: the Navigation Committee.

AC develops first indicators on community capacity.

Health
Education
Resources

LHP/PRs continue the process which was started during the training, of gathering and assessing health education resources in Spanish, and finish compiling information kits to be provided to women during workshops or follow-ups.

Health
Festival

Over 200 people - including 60 children - attend the Health Festival; event combines providing health information to women, and celebrating as a community with food and music; local Spanish businesses contribute considerably to the event. The Canadian Breast Cancer Network co-sponsors the event.

Evaluation

Evaluation mechanisms for the Health Festival are developed and data are collected, entered and summarized.

Results are provided to project members and used to plan up-coming outreach strategies and workshop content.

Survey
Follow-Ups

Issues identified by LHP/PRs on interview logs are summarized; many need follow-up.

Follow-ups are planned; LHP/Ps are encouraged to accompany women to health service visits, if necessary.

Participatory
Researchers
Interviews

Interviews are conducted with LHP/PRs about their experiences as participatory researchers to date.

Primary Care

Individual meetings with CCHC’s primary care staff are conducted to identify a process for collecting data systematically on cancer screening procedures.

April 2002

Workshops

LHP/PRs continue to develop a workshop format and pilot it at CCHC. This process was started during the training.

Evaluation

Tools are developed to facilitate evaluation of workshops and other events and to collect data.

Article

Article co-authored by co-investigator and LHP/PRs: “Mujer Sana, Comunidad Sana, Building Ottawa’s Latin American Community Capacity And Health Through Participatory Research” is published in Social Planning Council of Ottawa’s magazine: Our Social Capital. 2, 15-17.,.

Navigation
Committee

Ad-hoc committee meets to ensure that LHP/PRs have sufficient information about available services to women diagnosed with cancer, and also to prepare organizations to serve Hispanic women.

Preliminary
Survey
Results

Preliminary results from the survey with Spanish speaking women are compiled, focusing on current breast cancer and cervical cancer screening. Results are used to plan the focus of up-coming health promotion activities.

LHP/PRs Peer
Interviews

Process of interviewing LHP/PRs about their first experiences with conducting research is continued; LHP/PRs conduct peer interviews; results are summarized in preparation for an article on ‘Immigration and Health’.

Symposium

Participation in the symposium: “Research and Evaluation in a Learning Community”; organized by the Community-based Research Network of Ottawa, April 18, 2002.

Networking opportunities are used and new AC members are recruited.

Conference

Participation in the conference: “Building the Ottawa Mosaic. Conference on Issues regarding Ethno-cultural Minorities in Ottawa”, April 25, 2002 organized by the Social Planning Council of Ottawa and Local Agencies Serving Immigrants (LASI).

LHP/PRs participate and speak about the project during workshops; use networking opportunities.

May 2002

Teaching
Breast Self
Examination

CMA announces downgrade of recommendation to teach BSE from a “C” to a “D” (considered harmful), which has implications for the health promotion activities of this project.

Scientific literature is consulted.

Professional advise from the Advisory Committee (Ontario Breast Screening Program (OBSP) and family physicians); from CCHC (primary care staff); and Ontario Women’s Health Council is sought immediately. Project Team adopts the position that LHP/PRs will continue to teach BSE if the woman is interested in learning about it.

Workshops And
Shopping Center
Displays

LHP/PRs begin to conduct workshops and shopping centre displays to reach out to Spanish-speaking and other ethnoracial minority women.

Ongoing
Training

CCHC Spanish-speaking physician and nurse practitioner each conduct a training session with LHP/PRs re: cervical cancer to address more complex questions that are coming up in working with women.

Spanish-speaking social worker from another community centre (also a LAZO madrina and AC member) provides a refresher training session on co-facilitation skills.

Workplan
Review

An intensive workplan review takes place (research, programming, administration) leading to adjustments of project activities to reflect the changing needs of the project.

Research and evaluation design is reviewed.

Article

Article co-authored by co-investigators and LHP/PRs : “Immigrant Women Implementing Participatory Research in Health Promotion” is submitted to the Western Journal of Nursing Research.

Project
Model

Decision is taken to focus available resources on a comprehensive and accessible write-up of the entire project and its process, of greater interest to all partners and community members, rather than only presenting the curriculum materials as an LHP training manual.

Case
Study

Documents from CCHC are obtained for the case study review.

In-Depth
Interview
Analysis

Qualitative analysis of interviews begins; a team of Spanish-speaking co-investigators and LHP/PRs begin the systematic analysis of 33 in-depth interviews, developing codes and indices.

Algonquin
Practicum

Negotiations to have LHP/PR's work recognized as a first year practicum for the Algonquin College Social Service Worker Program are successful.

Sustainability

Transfer and Sustainability Committee faces impasse: to request more funds, need more detailed project plans than can be developed by committee alone; and also need renewed commitment from current partners, or alternative partners.. Partners confirm the importance of continued funding for the project after March 2003. Current partners' commitments to the project, beyond end of the current funding period, are not yet firm. Suggestions are made to explore alternative arrangements and other partners.

Communication
Structure

Need to improve communication among all members involved in the project is identified; a process to address and resolve conflicts is initiated.

Project
Review

Three project partners (including LHP/PR) and the coordinator review findings, directions, and identify topics, issues, and process for beginning to write articles about the project in a participatory way during a weekend retreat.

June 2002

Presentations

Information about the project is presented at the Association of Ontario Health Centres in Toronto. A group of LHP/PRs participates in the presentation.

Home Workshops

LHP/PRs continue workshops and begin to conduct ‘home workshops’.

Church
Presentations

LHP/PRs begin to do presentations at churches, since many women can be reached this way.

Research
Assistant

Summer research assistant is hired, mostly for data entry.

Data Entry

Data from survey with Hispanic women is entered into SPSS. Among preliminary findings: one third of respondents seek health-related information in Spanish on the internet.

Web-Site

Decision is taken to develop a bilingual (Spanish and English) Mujer Sana website, rather than only a paper document about the project.

The graphic designer is again contracted, to develop the website.

Analysis:
In-Depth
Interviews

A "qualitative analysis" group including co-investigators and LHP/PR, continue to deepen qualitative research skills as they analyse Spanish interviews.

Documents are indexed in computer-assisted qualitative analysis software (NUD∗IST).

Community
Forum

Proposal is submitted to the Multicultural Health Coalition requesting support for a forum presenting experiences and findings from the project; financial and networking support is sought.

Research
Interns

Two University of Ottawa summer interns, linked to CHRU, are interested in supporting the project; they conduct additional interviews with CCHC staff for the case study, compile preliminary findings, and undertake a first analysis of six in-depth interviews translated into English for comparative purposes.

July-August 2002

Health Survey
Analysis

Preliminary Health Survey tables are prepared for analysis.

Interview
Coding

LHP/PRs receive training in computerized qualitative data entry and code all interviews in NUD∗IST.

English
Testing

LHP/PRs take the Carleton Assessment of English Language again, to determine if they improved their English scores.

Health
Promotion
Programming

Workshops for Hispanic women, shopping centre displays and individual contacts continue throughout the summer.