Kadiminekak Kiwabigonem: Barriers and Facilitators to Fostering Community Involvement in a Prenatal Program in an Algonquin Community

摘要

Background: Inequities in maternal child health exist for Aboriginal populations in Canada. Community involvement in health services programming can reduce health inequities, but barriers and facilitators to community involvement have been understudied. The primary aim of this study was to answer the question: What are the barriers and facilitators to fostering com-munity involvement in the development and implementation of a prenatal program in the Rapid Lake Algonquin community? To this end, this study also examined the questions: a) What are the health-related needs of preand postnatal women in Rapid Lake?, and b) How could these needs best be met in light of the community’s current context and available resources? Methods: A focused ethnography was conducted over 3 months, with 21 participants. Data collection included semistructured interviews, pilot programs, participant observation, and fieldnotes, and was followed by thematic analysis. Results: Barriers to community involvement included political tensions, historical relationships with government institutions, cultural knowledge, language and literacy, and lack of health promotion events in the setting. Facilitators included incentives, trusted group leaders, social capital, regularity of activities, and a sense of community. Four needs were identified including effects of alcohol and drug use during pregnancy, nutrition, exercise, and social support. Three themes for how to best meet these needs in a community program emerged: sharing the knowledge and experiences of community members, involving families, and integrating traditional teachings into programs. Results can be used to support efforts toward community involvement in prenatal health services in other rural Aboriginal communities.