Community-based health promotion for socially disadvantaged mothers as health managers of their families: strategies for accessing the target group and their effectiveness

Abstract

Aim Children from socially disadvantaged families are deprived concerning their health status as well as their cognitive and emotional development. They show less positive health-related behaviors and less psycho-social resources. Socially disadvantaged families can hardly be reached by conventional health services and health promoting measures, and even if they are reached, the measures' effectiveness is only limited. Therefore, aim of the BMBF-funded research project "GO-Healthy in east Leipzig" is to develop a community-based approach for health promotion by which, in particular, the access to the target group of the socially disadvantaged is improved. Subjects and methods Participatory and low-threshold interventions are integrated with already existing structures within the respective urban district. Multipliers are assigned and impart information as well as their knowledge and experiences to the target group in a manner apt and suitable to their everyday lives. Results From January 2010 to June 2011, 1,300 women took part in health-promotion measures offered within the scope of the project. Women disposing of a low income (>50%) and having a migration background (70%) were sufficiently reached, in contrast to women with a low educational level (22%). Personal contact proved to be the most important way to access the people (80%). Most frequently, activities carried out by health mediators and enjoyable activities were attended. Social contacts turned out to be an especially important motivation for participation. Conclusion Strategies such as participation and the assignment of multipliers are suitable approaches to successfully develop and implement health-promotion measures in the community/urban-district setting. To integrate health education with enjoyable, action-oriented activities in a casual manner facilitates accessing socially disadvantaged persons.

Typology of organizational innovation components: building blocks to improve access to primary healthcare for vulnerable populations

“…Lay women living in the target district who are already involved in community associations – particularly those from migrant or low socioeconomic backgrounds – are trained in health education to lead activities for mothers. Also, personnel from barbershops, nail studios and food stores are recruited and trained to inform and encourage mothers to get a medical examination for their children [ 120 ]. Healthcare navigation by community health workers for Hispanic community members: La Vida trains Hispanic community members to act as Promotores to help hard-to-reach Hispanics who have or are at risk for diabetes access social and health services.…”

“…Lay women living in the target district who are already involved in community associations – particularly those from migrant or low socioeconomic backgrounds – are trained in health education to lead activities for mothers. Also, personnel from barbershops, nail studios and food stores are recruited and trained to inform and encourage mothers to get a medical examination for their children [ 120 ].…”

“…The 90 selected peer-reviewed studies were set in: the USA (n = 60) , Canada (n = 9) [91][92][93][94][95][96][97][98][99], Australia (n = 8) [100][101][102][103][104][105][106][107], UK (n = 6) [108][109][110][111][112][113], New Zealand (n = 2) [114,115], Israel (n = 2) [116,117], Italy (n = 1) [118], Mexico (n = 1) [119], and Germany (n = 1) [120]. For the environmental scan survey, 45.0% of responses originated from Canada, 40.8% from Australia, 9.4% from others countries (e.g., Ireland, UK, USA, Netherlands, Italy, Israel, Switzerland, Cameroon, India, Indonesia, Sudan) and 4.8% were missing country information [16].…”