The Experience of Capacity Building among Health Education Workers in the Yukon
Horton, Janet E., MacLeod, Martha L. P., Canadian Journal of Public Health
Background: Capacity building has developed as a health promotion approach that enables people to address determinants of health and to improve health outcomes. Although capacity building has been much discussed, little is known about what it means to build capacity in northern communities. This study explores the meaning and experience of capacity building in the Yukon.
Methods: A qualitative study, using an interpretive descriptive analysis, was undertaken through individual and small-group interviews with 21 Yukon health education workers associated with the Yukon College Public Health and Safety unit as first aid instructors. Participants were randomly selected from four groupings of Yukon communities, based on size. Transcripts were analyzed and interpreted for the health education workers' understanding, experience and observations of the outcomes of capacity building.
Results: Findings about capacity building are reported in relation to meaning, process, role of the health education worker and capacity-building outcomes. Themes that emerged indicate the ways in which health educators build on strengths, their focus on achieving an end of immediate importance within the community, and how they live in relationship with the community while undertaking capacity-building activities.
Conclusion: In Yukon communities, the influence of relational practices of health education workers living and working in their communities on enhancing community capacity should not be underestimated. Further clarification of the concepts and appropriate measurement of capacity building and community capacity, particularly for rural and northern communities, may help support practice that contributes to redressing health inequities.
Key words: Health education; Yukon; health promotion; qualitative research
In the Yukon, health inequities persist despite significant investments in health and social services. Evidence suggests that Yukon health inequities are related to social and economic factors, with rural residents more likely to be affected by poor health.1-5 Capacity building has developed as an approach to working with people in communities to enable them to effectively address determinants of health and to improve health outcomes.6-8 Although capacity building has been much discussed, little is known about what it means to build capacity in northern communities. The Yukon College Public Health and Safety (YCPHS) unit makes first aid instruction, food-safe and health promotion programs accessible to Yukon people.9 The experiences of the YCPHS first aid instructors provide insight into how capacity building occurs in northern communities. The purpose of the study was to gain an understanding of capacity-building process and outcomes within the Yukon context. The research question was: what is the meaning and experience of capacity building for health education workers in the Yukon context?
The Yukon is a vast, sparsely populated land in northern Canada. Roughly three quarters of the 30,255 Yukon citizens live in the capital city of Whitehorse, with the rest living in 16 communities throughout the territory. Rural Yukon community populations range from 57 to over 1,800 people.10 One community is accessible only by air or water; the others are within one to six hours drive of Whitehorse. First Nations people comprise roughly one quarter of the population.
The research was undertaken as a qualitative descriptive study,11 with an interpretive description orientation that acknowledges the constructed and contextual nature of experience while allowing for shared realities.12 The design was similar to Hawe et al.'s study of the meaning and experience of capacity building among Australian health promotion workers.13 Like Hawe et al., the study explored the topics of meaning, process, outcomes and issues or dilemmas for workers, but collected data through individual and small-group interviews rather than focus groups. …