Ahmad Farah, Ferrari Manuela, Moravac Catherine, Lofters Aisha, Dunn Sheila
School of Health Policy & Management, York University, Toronto, Ontario, Canada.
Centre for Research on Inner City Health, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada.
Health Soc Care Community. 2017 Mar;25(2):630-640. doi: 10.1111/hsc.12352. Epub 2016 Apr 24.
Engagement of community members to act as peer workers is a key feature of many community-centred health promotion programmes. However, little is known about their experiences beyond the commonly reported themes of fulfilment through helping people in need and improvement of personal confidence, self-esteem and self-care. This gap in the literature is of particular interest given increasing involvement of peer workers in community-centred programmes addressing health disparities, such as uptake of cancer screening. This paper aims to explore experiences of the peer leaders who worked for the Cancer Awareness: Ready for Education and Screening (CARES) project to promote awareness, knowledge, and uptake of breast and cervical cancer screening among under-/never-screened women who belonged to ethnic minority, recent immigrant and low-income communities in Toronto, Canada. In 2013, three focus groups were conducted with 14 peer leaders to explore their experiences. All were immigrant women between 30 and 50 years of age. All discussions were audio recorded and transcribed verbatim. We used situational maps and analysis to create a visual representation of the data, and to investigate peer leaders experiences. Situational analysis was chosen to bring to light dominant and also silent underlying aspects which define the meaning of being a peer leader. The first level of analysis identified main themes that characterised peer leaders' experience: (i) Helping others (women, friends and family) and themselves by improved self-confidence, self-awareness and self-care and (ii) Redefining professional and social positions through their project activities leading to professional development and networking. The second level of analysis explored the redefining process and identified some peer leaders' negotiations in relation to knowledge (science vs. myth), beliefs (fear vs. assurance) and boundaries (private vs. work). Adding to the literature on the peer workers' experience, the findings are discussed in relation to empowerment of peer workers, training implications and theoretical contributions.
让社区成员担任同伴工作者是许多以社区为中心的健康促进项目的一个关键特征。然而，除了通过帮助有需要的人而获得成就感以及个人信心、自尊和自我护理得到提升这些常见主题外，对于他们的经历我们知之甚少。鉴于同伴工作者越来越多地参与到以社区为中心、旨在解决健康差距问题（如癌症筛查的推广）的项目中，文献中的这一空白尤其引人关注。本文旨在探讨为“癌症意识：教育与筛查准备”（CARES）项目工作的同伴领导者的经历，该项目旨在提高加拿大多伦多少数族裔、新移民和低收入社区中未接受过筛查/从未接受过筛查的女性对乳腺癌和宫颈癌筛查的认识、知识水平以及筛查率。2013年，我们与14名同伴领导者进行了三次焦点小组讨论，以探究他们的经历。她们均为年龄在30至50岁之间的移民女性。所有讨论均进行了录音，并逐字转录。我们使用情境地图和分析方法来直观呈现数据，并调查同伴领导者的经历。选择情境分析是为了揭示那些定义同伴领导者角色意义的显性和隐性方面。第一级分析确定了同伴领导者经历的主要主题：（i）通过增强自信、自我意识和自我护理来帮助他人（女性、朋友和家人）以及自己；（ii）通过项目活动重新定义职业和社会地位，从而实现职业发展和建立人际关系网络。第二级分析探讨了重新定义的过程，并确定了一些同伴领导者在知识（科学与误解）、信念（恐惧与确信）和界限（私人与工作）方面的协商情况。在补充关于同伴工作者经历的文献的同时，我们还结合同伴工作者的赋权、培训意义和理论贡献对研究结果进行了讨论。
