1996/97 PCERII Funded Research Abstract
Research Title: Minority Nurses for Minority Populations: A Pilot Study in Public Health Nursing
Research Team:
(University of Alberta) - Principal Investigator
Research Domain(s): Public Services and Political
For over 15 years, Community Health and Prevention Services (CHPPS) of the Capital Health Authority (formerly Edmonton Board of Health) has striven to be responsive to the evolving health issues within the immigrant population. Several strategies have been tried. The most recent initiative was to hire three nurses (all immigrants) with Mandarin, Chinese and Vietnamese language skills as Community Health Nurses in the four health centres in the northeast quadrant of the city. This pilot project commenced in January of 1996.
An action research project to explore the potential roles and responsibilities of these three nurses in enhancing public health services and community development possibilities in Vietnamese and Cantonese populations in northeast Edmonton was developed in collaboration with health centre staff. What was anticipated was a research approach that allowed for innovation in developing the potential embedded in the position while also providing the data required for evaluation of benefits, statisfaction, efficiency and effectiveness. Thirteen more specific research questions were developed and these questions guided development of the research methods. A conceptual framework centred on the concept of hybridity in culturally diverse societies guides the study.
A research group of three health centre supervisors, five public health nurses in the perinatal program, a community health developer, the three nurses in the multicultural positions and a researcher (myself) was formed. The research group started meeting monthly in March of 1996 and will continue to meet until March of 1997. These meetings are being audiotaped and transcribed verbatim. Research group members were asked to keep reflective journals of thoughts, feelings, ideas and concerns they have about the initiative. All research team members have been interviewed twice (and most three times) regarding their expectations, concerns and thoughts about the progress and potential of the initiative. The emphasis of the third (final) interviews has been on what we have learned and recommendations for the future. All interviews were audio-taped and have been transcribed verbatim.
In March of 1996, a questionnaire was sent to all public health nurses at the four health centres soliciting input regarding their concerns with regard to working with immigrant populations, their experiences providing care via interpreters and their perceptions regarding hiring immigrant nurses to work as public health nurses for specific populations. Several issues were raised and were instrumental in developing preliminary questions for focus groups held with staff at each centre. Interpretation of what was happening and the rationale became part of all the focus groups. The focus group meetings were audio-taped and transcribed with data reported back to the research group. The second round of focus groups involved the three multicultural nurses sharing what they are learning and strategies they are using in their work to bridge cultural differences. Staff were invited to respond, ask questions and suggest changes. A third round of focus groups was held in November/December.
Records of the number of interactions health centre staff have with Vietnamese and Chinese clients (home visits, prenatal classes, immunization, telephone contact) are being kept to assess whether utilization of services increases as the availability of the Cantonese and Vietnamese-speaking nurses becomes known. Interpretation costs will be compared with those of the previous year. Any new programs or changes in programs that have been implemented or recommended as a consequence of the research process will be tracked. Twelve client interviews will be done (nine are complete) to ascertain client satisfaction with services, needs not met and recommendations for change. Six of the clients will have received nursing services from one of the project nurses and six from a nurse accompanied by an interpreter.
Analysis has been ongoing as the project proceeds but there is a need to return to the data and be more systematic in content analysis, detecting themes, and putting this all together so that the group can examine patterns and extend the analysis beyond its instrumental use in responding to events as they occur.