Community-Based Research
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2008 CBR Award of Merit Recipients
The third annual Community Based Research Award of Merit sponsored in partnership by the Centre for Urban Health Initiatives and the Wellesley Institute was presented at the Wellesley Institute’s 10th Anniversary Celebration in Toronto. Each project team that was recognized has demonstrated exemplary participation in community based research.
Each nomination was reviewed by the Selection Committee. Nominations were scored and ranked according to how well they demonstrated exemplary community based research practice according to the definition and evaluation criteria expressed in the call for award nominations. The Selection Committee was unified in their decision to name the Award of Merit project team and the honourable mention.
The award package includes registration fees for one project team member to attend a local or national conference of their choice; the publication and printing of a project poster; a copy of, “Methods in Community-Based Participatory Research for Health”, edited by Barbara A. Israel et al.; an organizational membership to Community Campus Partnerships for Health (CCPH); project publicity facilitated by the Centre for Urban Health Initiatives; an invitation to present the project at the Centre for Urban Health Initiatives’ monthly seminar series, Spotlight on Urban Health Research and personalized award certificates for each member of the project team. As part of the project publicity, the project team displayed a project poster at the Award Ceremony. Project summaries and posters can be viewed below.
2008 CBR Award of Merit Winner: Erika Khandor & Kate Mason (Street Health) and the Street Health Community Health Survey Project Team
Erika Khandor & Kate Mason (Street Health) and the Street Health Community Health Survey Project Team (Erika Khandor, Kate Mason, Sandy Alcott, Matthew Aaron, Jean Guy Belanger, Kevin Desmoulin, Kevin Dickman, Brian Donovan, Mohamed Gedi, Andrea Jackson, Marcia Jarman, Steven Leckie, Robert MacKay, Jim Meeks, Brandi Nashkewa, Brock Slade, Shirley Chiu, Laura Cowan, Nick Falvo, Bob Gardner, Beric German, Evie Gogosis, Kathy Hardill, Fiona Husband, Dr. Stephen Hwang, Sarah Innis, Brenda Roche, J.P. Thompson, Michael Treuman, Katerina Cizek, Gerry Flahive, Heather Frise, Jennifer Humphries, Davida Nemeroff, Dr. Joel Ray, Catherine Moravac, Alice Gorman, Jane Gutteridge, Jess Maher, Adrienne Weigand, Meghan Lloyd, Emma Wilkins and Keneisha)
Photo of Susan by Keneisha; Photo of Joe by Meghan; Photo of Nancy by Keneisha –
all courtesy of the National Film Board of Canada
In the winter of 2006/2007, Street Health, a community-based health care agency serving homeless people, conducted a survey of 368 homeless adults in downtown Toronto about their health status and access to health care and other services. The study was funded by The Wellesley Institute, United Way of Greater Toronto, and the Metcalf Foundation
The study involved extensive collaboration with community, academic and institutional partners including Casey’s House, Regent Park Community Health Centre, the Centre for Research on Inner City Health at St. Michael’s Hospital and the National Film Board of Canada. The total number of team members was 43 which including fifteen peer researchers with lived experience of homelessness.
The Street Health Report 2007, released in September 2007, presents the findings of this study. It discusses the nature of homelessness in Toronto and its root causes, followed by an exploration of the daily living conditions of homeless people. It then presents findings on the physical and mental health status of homeless people, how they use health care services, and the barriers homeless people face when using these services. Where possible, it compares the health of homeless people in our survey with available information for the general population. It also explains how the health status of homeless people has changed since the 1992 when the first Street Health Report on the health and health care access of homeless people in Toronto was published.
Key Findings:
- 74% of the homeless people in the survey had at least one serious physical health condition. 52% of the total sample had two or more.
- 56% had experienced serious depression in the past year
- 35% had been physically assaulted or beaten up in the past year.
- 59% do not have a family doctor
- 28% had been refused health care in the past year because they did not have a health card
- 40% said that they had been judged unfairly or treated with disrespect by a doctor or medical staff at least once the past year.
Street Health conducted this study to create current evidence on which to ground its ongoing advocacy efforts and those of other community groups addressing poverty and homelessness.
For this reason, the report outlines an action plan of targeted policy and program recommendations to improve the health of homeless people and to ultimately end homelessness.
In partnership with the National Film Board of Canada’s Filmmaker-in-Residence project, the study also conducted qualitative interviews and portrait photographs with a sub sample of the study participants that were used to create a photo and sound exhibit, as well as a 9-minute film entitled Street Health Stories.
The Street Health Report 2007 and other research publications by Street Health are available at www.streethealth.ca. The Street Health Stories film is available on You Tube.
The dissemination of results has been extensive including presentations at four Universities, deputations to the Toronto Board of Health and the Police Services Board and meetings with the Minister of Health and Long-Term Care, representatives of Seaton House and the Toronto Central Local Health Integration Network. There has been widespread media attention in the Toronto Sun, Toronto Star, Globe & Mail, and numerous broadcasts on CBC TV, CBC Radio and Radio-Canada.
2008 CBR Award of Merit Honourable Mention: Dr. Uzo Anucha (Faculty of Social Work, York University) and the Promoting Breast Health among Ethno-cultural Women in an Underserved Health Region: Barriers, Facilitators and Best Practices Project Team
Dr. Uzo Anucha (Faculty of Social Work, York University) and the Promoting Breast Health among Ethno-cultural Women in an Underserved Health Region: Barriers, Facilitators and Best Practices Project Team (Kathy Thomas, Colleen Mitchell, Nombuso Dlamini, Lucia Yiu, Daphne Jeyapal, Helen Leung, Rania Azmi, Farrukh Lodhi, Scholastica Lyanga, Min Zheng, Xaiomei Song, Kyunghee Song, Sahar El-Tayeb Elgali, Sophia Demitri, Nazi Asgary, Fatima Issa, Robertine Mbombo, Sophie Mulamba Ngalula, Zakeiah Zarabi, Shahnaz Hussain, Fatima Farah, Arvind Sharda, Perla Cory, Sonal Thaker)
The Promoting Breast Health among Ethno-cultural Women in an Underserved Health Region: Barriers, Facilitators and Best Practices Project focused on better understanding the barriers and facilitators to accessing breast screening and health promotion services in Windsor/Essex County. The project focused on ethno-cultural women from continental Africa, Asia (South Asians, East Asians and West Asians) who experience language and cultural challenges. The findings informed the development of a culturally competent education and awareness programs for women and health care providers thereby building the capacity of the Windsor/Essex community to promote breast health within a growing diverse population.
The project team consisted of seven community partners including the Multicultural Council of Windsor Essex County; the South Asian Centre of Windsor, Windsor Women Working with Immigrant Women; the Windsor Essex County Health Unit, and the Ontario Breast Screening Program. In total there were 25 members on the project team.
The project sought to understand the ethno-cultural women’s experiences with breast health such as routine screening (breast self-examination, clinical breast examination and mammography); the ethno-cultural women’s experiences with breast cancer treatment and Windsor/Essex community’s capacity to provide culturally competent breast health interventions to ethno cultural-women within the context of language and cultural differences. Using a Community Dialogue Approach, the project completed a comprehensive literature review that summarized existing research regarding breast screening practices among ethno-cultural women in North America; a survey that assessed the capacity of Windsor/Essex community to provide culturally competent breast health care and in-depth interviews with 80 ethno-cultural women to explore their knowledge of breast cancer; beliefs regarding breast cancer; perceptions of health; and breast screening practices.
The findings from this research informed the development of a health promotion workshop to increase the knowledge of newcomer women from ethno-cultural communities on breast cancer and the importance of breast screening. The project partnered with several settlement organizations and ethnic associations in delivering 18 health promotion workshops that were attended by 256 women. Pre and post test evaluation of the workshops indicated that there were positive intervention effects for the women in all areas including general breast cancer and screening knowledge, perceived benefits to clinical breast exams and to mammograms, as well as perceived barriers to both clinical breast exams and mammograms. In addition 128 people from religious, ethnic, health and newcomer organizations attended four community forums for the purpose of knowledge translation and mobilization to improve the delivery of culturally competent programs.
This community based research project has emphasized the importance of community based health promotion research for raising awareness of gaps in services in Windsor-Essex County; to increasing capacity of organizations to deliver culturally competent programs and to promoting breast cancer screening among ethno-cultural women.
2007 CBR Award Recipients
The second annual Community Based Research Award of Merit sponsored in partnership by the Centre for Urban Health Initiatives, the Wellesley Institute, and University College at the University of Toronto was presented at the 10th Anniversary Community-Campus Partnerships for Health Conference in Toronto. Each project team that was recognized has demonstrated exemplary academic participation in community based research .
2007 CBR Award of Merit Winner: Dr. June Larkin (Women and Gender Studies Institute, University of Toronto) and the Toronto Teen Survey (TTS) Project Team
Dr. June Larkin (Women and Gender Studies Institute, University of Toronto) and the Toronto Teen Survey (TTS) Project Team (Dr. Sarah Flicker, Crystal Layne, Karen Chan, Jason Poole, Peggy Harowitz, Susan Flynn, Hazalle Palmer, Adrian Guta, Melissa Dickie, Roxana Salehi, Robb Travers, Emily Dauria and the Youth Advisory Committee: Susannah Samuels, Stanley Ing, Sam Cash, Rosimay Venancio, Pamela Cornali-Motta, Nikole Smith, Janice Bunga, Nyla Obaid, Melani Madeira, Hatauv Andalebi-Abadan, Feven Abraham, David Anokye, Claudia Cornali-Motta, Brette Greer-Hall, Ayesha Jabbar, Andrea Lake & Alice Namu)
Photo contributed by Community-Campus Partnerships for Health
The aim of the Toronto Teen Survey (TTS) is to gather information from youth on assets, gaps and barriers that currently exist in sexual health education and services and to use the information to involve community partners in the development of a city-wide strategy to increase positive sexual health outcomes for diverse
The TTS research project is a partnership between the Gendering Adolescent AIDS Prevention Project (
One of the successes and innovations of this CBR project has been the involvement of teens in all stages of the TTS project design, development, implementation, and evaluation. Youth have been directly involved as co-investigators and advisory group members in a way that stimulates their learning, and empowers them to increase awareness of issues in their own communities.
A diverse group of youth was recruited for a Youth Advisory Committee (YAC). The YAC were provided with training in research methods and information on youth sexual heath, and developed a youth-friendly survey tool (see attached) and research protocol The YAC’s diversity with respect to gender, race, sexual orientation, socio-economic status, religion, ability, and immigration status reflects the diversity of the youth the project seeks to serve.
Based on recommendations from the YAC, members are continuing to be involved in this project by taking the lead in survey administration. We believe this will lead to richer data collection because peer-to-peer presentations draw on the credibility young people enjoy among their peers, leverage the power of role modeling and provide flexibility in meeting diverse needs for today’s youth. For the remainder of the project, YAC members will continue to be integral members of the research data collection, analysis and dissemination team.
The involvement of youth in this project is a unique way to involve the target community in all stages of the research. True to the goals of CBR, the YAC have reported positive benefits to participation. The feedback from the youth who participated in the project was very positive with youth reporting that they felt they had increased knowledge of survey design and community engagement, in addition to increased knowledge about sexual health and community resources.
Once data collection is complete, results will be presented to focus groups of service providers currently engaged in sexual health promotion who will provide input into the development of a comprehensive, coordinated city-wide strategy to improve and target sexual health services for youth that takes into account the diversity of youth communities and necessary approaches.
The TTS research project is an excellent example of a successful community-university partnership. The project is community-based and community-focused in its purposes, processes and objectives and has strong potential to assist PPT and other community partners to positively increase outcomes in the area of sexual health for youth through increasing awareness, mobilizing knowledge and influencing public policy. At PPT we believe firmly believe that forming collaborations between academic researchers and community-based organizations serve to improve health promotion research and service.
CIHR recognizes Toronto Teen Survey Research Team for Student Mentorship & Engagement
View the poster for the Toronto Teen Survey (TTS) Project
2007 CBR Award of Merit Honourable Mention:
Dr. Izumi Sakamoto (Faculty of Social Work, University of Toronto) and the Coming Together: Homeless Women, Housing and Social Support Project Team (Josie Ricciardi, Angela Robertson, Jen Plyler and Natalie Wood)
The research project “Coming Together: Homeless Women, Housing and Social Support” is a community-based research project using staged photography exploring how women and transwomen who are homeless and marginally housed build support networks with each other in order to survive. This is a joint project between the University of Toronto Faculty of Social Work, Regent Park Community Health Centre, and Sistering - A Woman’s Place. The research team collected data and identified key themes that were then explored in an art making process with other women/transwomen at drop-in centres across the city.
The project set out to learn the following: How do women/transwomen form and use friend (social support) networks?; What is the impact of differences among women/transwomen (e.g., Aboriginal heritage, immigration status, drug use) on women’s membership in informal support networks?; How can social services assist women in enhancing these friend networks?; What do homeless women envision safe and appropriate housing to look like?
The project activities involved compiling a literature review and conducting in-depth interviews with women/transwomen who were homeless and marginally housed and their service providers. Once the initial analysis of the interviews was complete, an advisory board of women/transwomen who experienced homelessness was formed to further guide data analysis and determine next steps according to a grounded theory approach. In consultation with a community artist, the advisory board chose the art medium of “staged photography” to generate and express the research outcomes. The advisory board and research team traveled to four drop-in centres to engage groups of women/transwomen in the art making process. Through painting, costumes, theatre and photography, groups of women/transwomen who are homeless or marginally housed, created scenes depicting their own visions of inclusion, friendship and safe space.
Key themes through the interviews and art-making process identified included: Characteristics and functions of social networks for women/transwomen who are homeless and marginally housed; Violence and trauma in the lives of women/transwomen; Importance of safe space, homes and housing; Changes needed in social services, agencies and policies (e.g., need for more Aboriginal led services and trans-inclusive services, and for the creation of accessible counseling services).
Coming Together: Homeless Women, Housing and Social Support” Report
Executive Summary - Coming Together: Homeless Women, Housing and Social Support
Read more about Dr. Sakamoto's presentation in CUHI's Spotlight on Urban Health Seminar Series.
View the poster for the Coming Together: Homeless Women, Housing and Social Support Project
2007 CBR Award of Merit Honourable Mention:
Dr. Laura Simich (Social Equity & Health Studies Program, Centre for Addiction & Mental Health) and the Study of Sudanese Settlement in Ontario Project Team (Dr. Hayley Hamilton, B. Khamisa Baya, Sarah Bukhari, Huda Bukhari, Huda Abuzeid, David Lugeron, Dr. Haile Fenta, Dr. Iman Ahmed, Dr. Owens Wiwa)
Since the 1990s, thousands of skilled Sudanese have migrated from Sudan to Canada for economic and educational opportunities. The most relevant “push” factor for recent Sudanese newcomers is the brutal, 20-year war in Southern Sudan, which has killed and displaced millions. Coming from one of the world’s top refugee-producing countries, Southern Sudanese are among the most vulnerable of Canada's recent newcomers. Many Northern Sudanese also have migrated because of the impact of the ongoing war. Existing settlement and integration, social and health services in Canada have not met the needs of Sudanese immigrants and refugees in general, a situation made more complex by ethnolinguistic diversity within the Sudanese population.
The Study of Sudanese Settlement in Ontario was the first major study in Canada on the settlement and integration of Sudanese immigrants and refugees. The study sample included 220 Sudanese (10% of recent Sudanese newcomers in Ontario) from all immigration classes in seven Ontario cities. The study provided a sociodemographic profile of the population, described settlement needs and social determinants of health, expectations and mental well being, barriers to service utilization, and sociocultural influences on the settlement and integration process. Quantitative and qualitative data analysis used the framework of population health, which asserts that social determinants of health (e.g. income, family environment, social support and access to services)--impact mental and physical health. This psychosocial perspective is distinct from a more common and narrow emphasis on refugee trauma. Study recommendations helped to bring about more effective programs and service delivery models for this and other recent newcomer groups.
This study would not have been possible were it not thoroughly grounded in CBR methods, reciprocity and ongoing collaboration, relying largely on the strengths of the Sudanese community. By working together, the research team met many practical challenges. We could not rely on well-established community associations to engage study participants. Community trust was built through close collaboration with Sudanese investigators who were equal partners in the research from proposal writing to dissemination of findings. The desire to have an ethnically representative study sample imposed additional requirements: face-to-face community advisory meetings in all sites, translating lengthy questionnaires into six languages and hiring nearly 50 Sudanese interviewers across seven cities. The time pressures of applied research were also formidable, but manageable in the spirit of collaboration.
The reward is having had direct impact. The research did not just ‘sit on the shelf.’ Citizenship and Immigration Canada acted on the research team’s recommendations by involving Sudanese in consultations and research dissemination, improving life-skills orientation for new Sudanese refugees and hiring additional Sudanese settlement workers to better meet the community's social support needs. Most important, this research empowered Sudanese community members. A follow-up project managed by the Association of Sudanese Women in Research disseminated research findings to the community, city officials, social agencies and charitable organizations in the seven cities. As a result, the United Way of Greater Toronto and CIC have invested in new settlement and community programs to enhance Sudanese health and wellbeing.
View the poster for the Study of Sudanese Settlement in Ontario Project
Read more about Laura Simich's presentation in CUHI's Spotlight on Urban Health Seminar Series.
CUHI Supports Community-Based Research Network
In recent years, there has been a noticeable increase in the number of community-based research (CBR) projects conducted in the
To determine the initial direction and priorities for the Network, three open forums were organized in 2007. Interest in these forums was unexpectedly high, each drawing dozens of participants including researchers, students and community members. The forums were held in community settings and each featured a presentation about a successful local CBR project. Participants also had opportunities to provide input into the Network’s mission and mandate. Based on participants’ input, the TCBRN established its founding mission:
To increase and sustain the capacity of local health and social service organizations and academic partners in the GTA to conduct effective Community-Based Participatory Research leading to evidence-based action and policy change.
The TCBRN pursues this mission by offering support for networking, collaboration, learning and action among community and academic researchers.
Over the last two years, the TCBRN has been guided by a volunteer Steering Committee with representatives from Access Alliance, Community-Campus Partnerships for Health, Ontario Women’s Health Network, Planned Parenthood Toronto,
For Us, By Us: Peer Research 101 is a video, produced for the web, that features the voices of community members who have worked on local CBR projects. They discuss how and why they became involved in research, what they did as peer researchers, and some of the benefits and challenges of this research approach. The 30-minute video is being used by local agencies as a tool for education and training. It was produced by Lisa Campbell with support from the CBR Working Group of the Health and Learning Knowledge Centre of the Canadian Council on Learning.
A public forum took place May 22 to highlight key findings from the environmental scan and will feature a screening of For Us, By Us: Peer Research 101. For further details or to view the video online, please visit the TCBRN website: http://www.torontocbr.ca . To learn more about the TCBRN or joining the Steering Committee, please send an email to: info@torontocbr.ca.