Culture Counts: A Guide to Best Practices for Developing Health Promotion Initiatives in Mental Health and Substance Use with
Ethnocultural Communities
In chapter 3 - Gather and analyze information:
On this page:
Remember that in the capacity-building model for health promotion, the process of developing the initiative is important.
Involving the community in gathering information and planning the initiative helps to:
- produce an initiative that fits the community
- raise awareness about community mental health and substance use issues
- build confidence that community members can find a way to address the community’s problems themselves
- build interest and support in the initiative once it is launched.
It is important to have the participation of a wide range of community members in the information-gathering process so that
different points of view are expressed and included in the development of the health promotion initiative.
- Try to get a mixture of participants according to age, gender, socio-economic status and length of residency in Canada.
- Choose information-gathering methods that best suit literacy levels and communication preferences (e.g., oral versus written
surveys) and are more likely to result in open, honest responses.
- Group meetings should be held in convenient locations where community members will feel at ease.
“Some people may feel intimidated about going to a modern office building for a meeting. It is best to hold a meeting in a
place they will feel comfortable with.”
-- Baldev Mutta, Punjabi Community Health Centre |
- Transportation, childcare, access for people with disabilities and use of members’ first language are some points to consider
when making meeting and funding arrangements.
- Have separate groups for men and women and different age groups where custom or the issue under discussion makes it appropriate.
- Have smaller groups to give a sense of security (for example, recent refugees may find being in large groups stressful).
If possible, the community partner agencies should organize and run the information-gathering sessions involving community
members. They will already know the community well and have a high level of trust among its members. This puts them in an
excellent position for recruiting facilitators, interviewers and participants. They will know best what types of information-gathering
activities are best suited to their community and will probably have access to facilities for them.
Having the community partner take responsibility for running the information-gathering activities is not only likely to be
more efficient and effective but confirms your respect for and trust in the abilities of the community agency’s staff.
Example: For the Culture Counts project, rather than specify how funds for focus groups were to be used, CAMH project coordinators
had each of the community partners use the funds as they saw fit. This was not only practical, since each community had different
needs (some needed to cover transportation costs for participants, some needed childcare, some wanted to provide refreshments)
but confirmed the commitment to true partnership.
To learn more about getting the community involved:
When you are gathering information about sensitive issues such as mental health and substance use, it is important to protect
people’s privacy. It is also important to make sure people are giving the information freely and know they can choose not
to answer questions if they don’t want to. They also need to know how the information will be used.
- Make sure the reasons for gathering the information and the right not to answer are explained in their own language by someone
from the partner agency.
- Make sure everyone gathering information understands that they should never put pressure on people to answer questions they
do not wish to answer.
Keep it confidential
- Make sure the all participants—in focus groups, interviews, surveys—know that the information you gather will only be used
by you for the purposes of this initiative.
- Keep the information safe from loss or misuse--paper records should be kept in a safe location; computer records should be
protected with a password.
- Do not attach names to the information.
To learn more about ethics in research:
Depending on what information-gathering methods you choose to use, you will need people to run group meetings and do interviews.
Whenever possible, meeting facilitators and interviewers should come from the community. Along with their language skills,
they will know how to talk to people in ways that put them at ease and show respect. People are less likely to take part in
discussions and interviews if they feel disrespected, even when the disrespect is not intentional.
“As someone brought up in the Tamil culture, I know how to talk to people in respectful ways that an outsider may not know.
For instance, in the Tamil culture, an older woman is addressed as “Mother,” even if she is not your mother. Someone who was
a teacher is called “Teacher” or “Master.”
--Dr. Krishanthy Shu, Vasantham (Tamil Seniors Wellness Centre) |
However, it may be best to ask participants whether they prefer to have a facilitator or interviewer from the community or
one from outside the community. Community members may be more open with someone from their own cultural background than they
would be with someone who is not. On the other hand, they may feel freer discussing difficult issues such as mental health
and substance use problems with someone from outside the community.
When looking for facilitators and interviewers, you and your partners should try to find people who:
- have experience working on other community-building projects, who are bilingual and bicultural (having an understanding of
both mainstream society and the ethnocultural community)
- have a background in the issue you are dealing with (for example, if depression is the issue, someone with a mental health
counseling background would be ideal)
- are interested in and enthusiastic about the initiative
- have training or are willing to be trained as interviewers and facilitators.
Train facilitators and interviewers
Facilitating and interviewing are skills that need to be developed through training and experience. You and your partners
may not be able to find enough people in the community with these skills, so will have to provide training.
Training may take some time, but remember that part of the purpose of your initiative is to increase the community’s capacity
and the skills of its members. Perhaps there is someone in your organization who can offer training in these skills. If not,
it may be worth using some of your initiative funding to hire a trainer. The quality of information you will get through interviews
and group meetings such as focus groups largely depends on the skill of the interviewers and facilitators, so training will
be a worthwhile investment.
Facilitators and interviewers should be given guidelines on how to conduct group meetings and interviews—topics to cover,
questions to ask, keeping to the agenda, avoiding bias, and so on.
Example:LRDG focus group facilitation guide (PDF)
“CAMH staff worked with the community partners to develop a focus group facilitation guide, assisted with the format and identified
the method for interpreting messages. CAMH staff members opened each focus group session by welcoming all the participants;
this gave credibility to the project, showed interest in the community and support for the project partners.”
—Maria J. Benevides, MSW, RSW, Portuguese Mental Health and Addiction Service |
Acknowledge volunteer work
You and your partners may be relying on volunteers to facilitate group meetings, conduct surveys and interviews and perform
other tasks needed to develop and run your initiative.
Many will give their time freely to help their community. However, everyone needs to have his or her efforts recognized now
and then. Giving formal, public recognition to those who give their time and labour to the community encourages the people
involved and can help interest others in volunteering.
Some ways to recognize and thank volunteers:
- present them with certificates, plaques, framed photos
- thank them at community meetings and at the launch of the initiative
- thank them in newsletters and other communications
- write a press release about their efforts
- offer to act as a reference for potential employers
- where possible and appropriate, provide honoraria to volunteers (in the focus groups, some volunteers appreciated an honorarium,
while others were somewhat offended by the idea).
“Little things make a difference. For example, if young people volunteer to lead focus groups, giving them a certificate of
acknowledgement or having a newspaper write up an article about them are good ways of showing appreciation.”
--Baldev Mutta, Punjabi Community Health Centre |
To learn more about rewarding volunteers:
Your planning for information-gathering should include processes for recording information. You want to make sure the information
is as complete and accurate as possible. You also want to ensure everyone records the information in the same way to make
analysis easier.
Surveys and questionnaires have the advantage of having the recording method built into the tool itself. For interviews and
group sessions, different recording methods should be considered. Whatever method you choose, be sure the reasons for recording
the information and how the information will be used are explained to participants.
To tape or not to tape
For both interviews and group meetings, an obvious method for getting a record of everything that is said is electronic recording,
either with audio or video tape/disc.
Advantages of electronic recording:
- Electronic recording can be reviewed over and over again to catch things that a human note-taker might miss.
- It might be more reliable if a dispute should arise over what was said.
Disadvantages of electronic recording:
- Technological breakdowns can lead to some contributions being inaudible or misheard.
- When sensitive issues are being discussed, some people may feel uncomfortable having their words electronically recorded.
- It requires equipment and possibly someone with special skills to set up and operate it.
- It may require formal consent from participants.
- The results will have to be transcribed.
Note-taking
If people are uncomfortable with being recorded electronically or the recording equipment is not available, someone will have
to take notes.
Advantages of note-taking:
- A skilful note-taker may capture things, such as gestures and the identity of a speaker, that electronic recording may miss.
Disadvantages of note-taking:
- The quality of the notes depends on the skills of the note-taker.
- Some content may be missed.
Tip: Where possible, facilitators and interviewers should not be the note-takers. Having another person take notes leaves the
interviewer or facilitator free to concentrate on interviewing or facilitating and may be less distracting for participants.
“Visible” note-taking
A variation on note-taking for group meetings is “visible” note taking—writing meeting notes on a chalkboard, whiteboard,
or flip chart so that everyone can see them.
Advantages of visible note-taking:
- errors or misunderstandings to be cleared up as you go
- it can act as an organizational tool--everyone can see what has been discussed.
Disadvantages of visible note-taking:
- flipcharts and boards can be awkward to transport
- notes can be difficult to transcribe (one option is to use a digital camera to photograph the boards or flipcharts)
- can seem a bit too formal
- some content may be lost.
Use more than one method
Perhaps an ideal solution is to use both electronic recording and some form of written note-taking. Using more than one method
may lead to a fuller record of the activity. Tapes will still have to be transcribed, of course, and both notes and transcriptions
may also have to be translated.
Often the only result of a meeting or interview is a document relating what was said by each participant. While this should
be useful information, other types of records can add to it. For example:
- Facilitators and interviewers might keep an informal log of their experiences, ideas and problems. These might be used in
process and outcome evaluations.
- Photos taken during meetings and interviews (as long as participants agree) can be used in reports and displays.
- Participants can be asked to evaluate activities. This could be done through quick questionnaires, with space for adding their
suggestions.
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