Research task
Since this was a demonstration research project, we collected a lot of information,
using many different qualitative and quantitative methods. These methods included
individual and group interviews, written surveys, focus groups, activity logs,
chart reviews, participant observation, and reviews of all project documents.
A detailed description of the research design for
the Mujer Sana/Comunidad Sana demonstration project is available elsewhere.
Some of the key research
activities are described below.
In-depth interviews with Hispanic women
The Lay Health Promoters/Participatory Researchers (LHP/PRs) conducted 33
in-depth interviews with other Hispanic women in Ottawa. They
spoke with women about their families' history of immigration, current situation,
state of health, social integration, community involvement, and stresses they
were experiencing, as well as about their cancer screening practices and barriers
to the use of health services. The Spanish [interview schedule] was developed
during the [training course] using a collective and participatory process
involving all the LHP/PRs. Challenges included choosing language and terms
that would be appropriate for women from the 20 different Spanish-speaking
countries presently living in Ottawa.
Since the Lay Health Promoters were also to be Participatory Researchers,
they learned and practiced interviewing techniques, including attentive listening,
probing, and objectivity. They also learned how to use protocols correctly
to obtain informed consent from women they were interviewing; how to maintain
confidentiality; and how to ensure the technical quality of a recorded interview.
They each transcribed their own interviews, and learned about accuracy, appropriate
notation and structure in qualitative transcription.
The fact that community women themselves undertook these interviews with
their peers, rather than only being used as 'subjects' of the research, provided
unique insights into the reality of Hispanic women in Ottawa, and strengthened
community capacity immensely. According to one LHP/PR:
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Interview analysis
A group of five LHP/PRs and two co-investigators, took on the task of analysing these interviews. Working together, we developed
a coding framework and a manual indexing system. Two LHP/PRs learned to use NUD∗IST, a computer-assisted qualitative data analysis
software, assisted by one of the key partners, the Community Health Research Unit. This helped the group to sort, sift, and
summarize the findings. Summaries of preliminary findings were then presented to the whole group of LHP/PRs, for discussion and
collective verification.
Go to Findings from interviews and surveys with Hispanic women for more information about results from these interviews.
Survey with Hispanic women
Lay Health Promoters also used their Participatory Researcher skills to conduct an extensive 90-item survey on cancer
screening, general health behaviours, and acculturation. The survey included items adapted from the Spanish version of a survey
originally developed for the 'Pathways' project at the Northern California Cancer Centre, U.S.,1 as well as original items developed
for this research. In the process of adapting items, we became aware of the importance of taking into account differences in the
health systems of the two countries, and how they impacted on the concepts used and the choices offered in a health practices
questionnaire. We also noted some important differences in the type of vocabulary and the level of Spanish considered appropriate
for a community survey in both countries (United States and Canada). After the Mujer Sana survey was developed and pilot tested,
the LHP/PRs successfully surveyed 212 Hispanic women within two months. Our Spanish-speaking research assistants entered the survey
data into an SPSS data base. Preliminary summary tables were developed and discussed at several key points, first among the LHP/PRs
and co-investigators, and then with all the project members, to help understand the meaning of the results and find ways to
integrate new learnings into practice.
Reference:
1) Pasick, R.J., D'Onofrio, C.N. & Otero-Sabogal, R. (1996). Similarities and
differences across cultures; questions to inform a third generation for health
promotion research. Health Education Quarterly, 23 (Supplement),
S142-S161
