A Model of Occupational Empowerment for Marginalized Populations in Community Environments

Fisher, Grace; Hotchkiss, Anita

doi:10.1300/j003v22n01_05

Cited by 4 publications

(3 citation statements)

References 17 publications

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“…In many cases, patients who used the Centres regularly played a role in shaping the physical and social milieu by voluntarily making coffee and replenishing supplies in the waiting areas, voluntarily helping with janitorial or maintenance tasks, and offering suggestions for how to make the physical space safer and more welcoming for women and children. Engaging in meaningful work-related activities through volunteer and temporary or occasional employment opportunities can be health promoting by enhancing people’s sense of self-efficacy, self-worth, and capacity to manage their health [55], as this patient described: …”

Section: Resultsmentioning

confidence: 99%

Closing the health equity gap: evidence-based strategies for primary health care organizations

Browne

Varcoe

Wong

et al. 2012

Int J Equity Health

233

241

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IntroductionInternational evidence shows that enhancement of primary health care (PHC) services for disadvantaged populations is essential to reducing health and health care inequities. However, little is known about how to enhance equity at the organizational level within the PHC sector. Drawing on research conducted at two PHC Centres in Canada whose explicit mandates are to provide services to marginalized populations, the purpose of this paper is to discuss (a) the key dimensions of equity-oriented services to guide PHC organizations, and (b) strategies for operationalizing equity-oriented PHC services, particularly for marginalized populations.MethodsThe PHC Centres are located in two cities within urban neighborhoods recognized as among the poorest in Canada. Using a mixed methods ethnographic design, data were collected through intensive immersion in the Centres, and included: (a) in-depth interviews with a total of 114 participants (73 patients; 41 staff), (b) over 900 hours of participant observation, and (c) an analysis of key organizational documents, which shed light on the policy and funding environments.ResultsThrough our analysis, we identified four key dimensions of equity-oriented PHC services: inequity-responsive care; trauma- and violence-informed care; contextually-tailored care; and culturally-competent care. The operationalization of these key dimensions are identified as 10 strategies that intersect to optimize the effectiveness of PHC services, particularly through improvements in the quality of care, an improved 'fit' between people's needs and services, enhanced trust and engagement by patients, and a shift from crisis-oriented care to continuity of care. Using illustrative examples from the data, these strategies are discussed to illuminate their relevance at three inter-related levels: organizational, clinical programming, and patient-provider interactions.ConclusionsThese evidence- and theoretically-informed key dimensions and strategies provide direction for PHC organizations aiming to redress the increasing levels of health and health care inequities across population groups. The findings provide a framework for conceptualizing and operationalizing the essential elements of equity-oriented PHC services when working with marginalized populations, and will have broad application to a wide range of settings, contexts and jurisdictions. Future research is needed to link these strategies to quantifiable process and outcome measures, and to test their impact in diverse PHC settings.

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Section: Resultsmentioning

confidence: 99%

Closing the health equity gap: evidence-based strategies for primary health care organizations

Browne

Varcoe

Wong

et al. 2012

Int J Equity Health

233

241

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“…A 2002 survey of homelessness in 25 large U.S. cities showed the number of requests for emergency shelter is increasing (Wolpin, 2003). The homelessness problem is not subsiding in the U.S., nor is it diminishing globally.…”

Section: The Problem Of Homelessnessmentioning

confidence: 99%

A Model of Occupational Empowerment for Marginalized Populations in Community Environments

Fisher

Hotchkiss

2008

Occupational Therapy In Health Care

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Globally there are individuals who are marginalized from mainstream society due to problems such as physical or psychological impairment, poor socio-economic circumstances, and occupational deprivation. Many develop learned helplessness syndrome, rendering them unable to control their lives and their destinies. This paper proposes a Model of Occupational Empowerment for providing services to these community populations. The model, a grounded theory, emerged from our work at a homeless shelter for women and children. Disempowering environments in the past had caused learned helplessness in the women at the shelter. Occupational engagement was used to empower them. We contend that the model may be used to guide occupational therapy practice with marginalized individuals and families in a number of community environments.

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“…La signifiance estégalement teintée par l'unicité de la personne (Townsend et Polatajko, 2013), son histoire (Persson, Eklund et Isacsson, 1999) et son besoin d'affiliation (Bejerholm et Eklund, 2006). Les retombées de l'engagement occupationnel sont nombreuses incluant sur la consolidation des compétences, le développement de l'identité (Mee, Sumsion et Craik, 2004), la réappropriation du pouvoir d'agir (Fisher et Hotchkiss, 2008) et la satisfaction envers la vie (Nilsson, Bernspång, Fisher, Gustafson et Löfgren, 2007). Considéré comme uń elément indispensable au vieillissement réussi (Nilsson et al, 2007 ;Tatzer, Van Nes et Jonsson, 2012), l'engagement dans des activités, notamment sociales, comporte aussi d'importants effets positifs sur la survie (Holt-Lunstad, Smith, Baker, Harris et Stephenson, 2015).…”

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Remodeler sa vie® (Lifestyle Redesign) : première étude pilote auprès d’aînés franco-canadiens

Lévesque¹,

Trépanier²,

Tardif³

et al. 2020

Can J Occup Ther

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Description. Récemment traduit et adapté au contexte franco-canadien, le programme Remodeler sa vie ( Lifestyle Redesign) vise le développement de modes de vie sains et porteurs de sens. On connaît toutefois peu l’influence de ce programme chez les aînés francophones. But. Décrire l’influence du programme Remodeler sa vie sur l’équilibre de vie, l’engagement dans les activités signifiantes, la compassion et la gratitude d’aînés franco-canadiens. Méthodologie. Une étude pilote mixte (préexpérimental et qualitatif clinique) a été réalisée auprès de 16 aînés répartis en deux groupes (avec et sans incapacités). Des questionnaires pré et post-intervention ainsi que des entretiens semi-dirigés ont été complétés. Résultats. Une augmentation de l’équilibre de vie de l’ensemble participants ( p = 0,03) et de l’engagement dans des activités signifiantes des aînés sans incapacité ( p = 0,02) a été observée. Les participants rapportaient des améliorations pour l’ensemble des résultantes. Conséquences. Remodeler sa vie est un programme prometteur pour promouvoir la santé des aînés franco-canadiens.

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A Model of Occupational Empowerment for Marginalized Populations in Community Environments

Cited by 4 publications

References 17 publications

Closing the health equity gap: evidence-based strategies for primary health care organizations

Closing the health equity gap: evidence-based strategies for primary health care organizations

A Model of Occupational Empowerment for Marginalized Populations in Community Environments

Remodeler sa vie® (Lifestyle Redesign) : première étude pilote auprès d’aînés franco-canadiens

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