Health in the Hubs Phase 1: Neighbours and Nurses Working Together
Description:
Health in the Hubs is an ongoing partnership between the McMaster University School of Nursing (SON) and three local community planning teams (LPT) representing different neighbourhoods in the City of Hamilton: Crown Point, McQuesten, and South Sherman. The partnership is not a time limited project. Rather, it is an ongoing contribution by the SON to work initiated and driven by local residents, service providers and members of places of worship to make these neighbourhoods a healthy and safe place to live, work, play and raise a family.
This report describes the results of a community consultation undertaken by the SON in partnership with LPTs in three neighbourhoods. This phase of the project known as Health in the Hubs Phase 1: Neighbours and Nurses Working Together, set out to work side by side with the LPTs in collecting opinions about what people thought were the main issues affecting the health and happiness of people living in their neighbourhood. The project applied a community-based participatory research approach where residents from each LPT who have knowledge of local neighbourhood conditions were hired and equitably partnered with nursing students and faculty researchers to carry out the research. Hiring local residents and working side by side with LPTs was integral to the project from both a philosophical and practical approach. It was more than a symbolic gesture. The local resident coordinators hired from the neighbourhoods were able to develop information gathering strategies, to adjust the language used in the survey tools and to demonstrate a commitment to the project beyond a paid role. The Health in the Hubs team believed this was an example of a local capacity building intervention that created mutual ownership of the project. Moreover, the team knew that the resident coordinators hired for the project had considerable knowledge about their neighbourhoods and strong networks from which they were able to facilitate the gathering of opinions. Together, local residents and nursing students (supervised by faculty) conducted door-to-door interviews which included three open-ended survey questions. The goal of this community consultation was to produce a list of: 1) priority issues, 2) causes, and 3) strategies to address the issues developed by residents in each neighbourhood.
A total of 681 participants from the three neighbourhoods generated 1,205 issues, 956 causes and 1,032 strategies. To understand the results of the consultation, two levels of analysis were conducted. In the first level, data on issues was coded using the Ottawa Charter for Health Promotion (1986) on fundamental conditions and resources for health. From this analysis results were presented to the three LPTs where decisions were made on a top issue to be the focus of Phase 2 of the project: Street Smarts <--> Book Smarts. The three issues chosen, one per neighbourhood, were: walkability of the neighbourhood (Crown Point); job creation through social enterprise (McQuesten); and beautification of the neighbourhood (South Sherman). In Phase 2, community members act as co-investigators working alongside academics to determine the best practice strategies for addressing the issues selected. A further level of analysis was conducted using the software NVivo 9. This level of analysis was conducted in order to generate major and minor themes derived from the data on issues, causes and strategies. In examining the data for themes identified pertaining to the issues, there were some similarities as well as differences amongst the three neighbourhoods. Quality of neighbourhood life, cleanliness and illegal activities was cited as a top five theme for all three neighbourhoods. But even amongst these shared issues, the words used to describe the theme varied. For example, a unique word used to describe cleanliness in Crown Point was “soot”; in McQuesten it was “pests” and in South Sherman “sanitation.” Within each shared theme the residents chose particular words to reflect at the ground level what was happening in each neighbourhood.
Each neighbourhood was also unique in describing the issue of most concern. In Crown Point, descriptions of the environment related to air quality and soot were mentioned as having a key impact on health. In addition, major eastwest and north-south thoroughfares presented health and safety concerns for the families living in the areas as these roads encourage rapid transit through the neighbourhood and provide little, if any, benefit to the residents of the area. In McQuesten, concerns over lack of available jobs and youth unemployment were raised. In South Sherman, issues of quality of neighbourhood life as a result of property concerns and illegal activity were an urgent priority.
When themes were grouped into categories, similarities amongst the three neighbourhoods were less apparent. There was a great deal of variability between neighbourhoods on what respondents identified as important issues. One neighbourhood consistently stood out as different from the other two for each category and the outlier was never the same neighbourhood. For Crown Point it was Environment & Neighbourhood; for McQuesten it was Employment & Education; and for South Sherman it was Crime & Safety. The only category similar amongst the three neighbourhoods was Environment & Neighbourhood. In understanding challenges faced by urban environments, this Phase 1 project demonstrates that even though certain neighbourhoods might be similar from a socioeconomic point of view, they were quite diverse in identifying priorities for their neighbourhoods.
The key lesson learned in the process of working side by side with LPTs was that prescribed approaches for generating opinions employing outsider, expert generated ideas had little resonance with people living in neighbourhoods. Instead, learning what residents said was important and the words they used to describe their concerns offered insights into what was most enlightening. Paying attention to potential approaches residents believed may be of use offered opportunities for residents and the university to work together as partners and to choose what might work in shaping the way forward. There appeared to be much untapped potential to make sustainable change to improve the health and happiness of people living in their neighbourhoods.
Key Messages
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Local residents have strengths and resources, not the least of which is intimate knowledge about their neighbourhoods.
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Research conducted in neighbourhoods will need to consider processes that: achieve trust, are mutually owned, co-evolve, are co-produced, and make a commitment beyond the scope of the project.
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Residents in three neighbourhoods shared common observations on their priorities regarding health and happiness.
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Although neighbourhoods might be similar from a socioeconomic point of view and have shared experiences, individual neighbourhoods can be quite diverse in identifying their priorities and in moving forward on matters of interest to them.
Type of Resource:
Report
Publication Date:
2011
Location:
Hamilton, ON, Canada