Wanda Thomas Bernard

Participatory Action Research (PAR): An Approach for Improving Black Women's Health in Rural and Remote Communities

Women are among the most disadvantaged members of any community, and they tend to be at greatest risk of illness. Black women are particularly vulnerable and more prone than White women to illnesses associated with social and economic deprivation, including heart disease and diabetes. They utilize preventive health services less often, and when they fall ill, the health of their families and communities typically suffers as well. This article discusses the process of doing innovative participatory action research (PAR) in southwest Nova Scotia Black communities. The effort resulted in the generation of a database, community action, and interdisciplinary analysis of the intersecting inequities that compromise the health and health care of African Canadian women, their families, and their communities. This particular research effort serves as a case study for explicating the key tenets of PAR and the barriers to and contradictions in implementing PAR in a community-academic collaborative research project.

“With God in our lives he gives us the strength to carry on”: African Nova Scotian women, spirituality, and racism-related stress

This mixed-methods study explored the racism-related experiences of 50 mid-life African-heritage women living in Nova Scotia, Canada, along with their use of spirituality as a coping strategy for dealing with racism-related stress. Four standardised instruments, along with qualitative in-depth interviews, were used to examine womens experiences of racism, depression, stress, and spirituality. Spirituality provided a key coping mechanism for racism-related stress, providing church community, spiritual community, faith, guidance, a personal relationship with God, and a source of meaning-making. For some women, spiritual belief provided a means of cognitive reinterpretation, allowing them to make sense of racism and other life challenges, recasting these as tests and trials which they were capable of surmounting with Gods blessing and protection. Implications for mental health practitioners include working with spiritual and religious venues to help lessen stigma against mental health problems.

Cancer Care Experiences and the Use of Complementary and Alternative Medicine at End of Life in Nova Scotia’s Black Communities

Purpose: This qualitative study examines the meanings that African Canadians living in Nova Scotia, Canada, ascribe to their experiences with cancer, family caregiving, and their use of complementary and alternative medicine (CAM) at end of life. Design: Case study methodology using in-depth interviews were used to examine the experiences of caregivers of decedents who died from cancer in three families. Findings: For many African Canadians end of life is characterized by care provided by family and friends in the home setting, community involvement, a focus on spirituality, and an avoidance of institutionalized health services. Caregivers and their families experience multiple challenges (and multiple demands). There is evidence to suggest that the use of CAM and home remedies at end of life are common. Discussion: The delivery of palliative care to African Canadian families should consider and support their preference to provide end-of-life care in the home setting.

Awareness of Palliative Care and End-of-Life Options Among African Canadians in Nova Scotia:

Purpose: To assess, using qualitative methods, the knowledge African Canadians living in Nova Scotia have regarding their options for palliative and end-of-life (EOL) care. Design: This project engaged caregivers in a Black community in Nova Scotia, Canada, in an exploration of palliative and EOL care. A group of six caregivers who cared for someone who had died were recruited through purposive sampling. The caregivers met three times to (1) discuss their experiences, (2) receive a presentation from the palliative care service, and (3) discuss whether those services would be beneficial. This was followed by a community meeting to discuss the findings. Findings: Knowledge of options for palliative care services is limited. Family centered care may be a reason why “system” is generally not aware of the EOL experiences of African Nova Scotians. Discussion: Information about palliative care services is not filtering down to the community in a way that is meaningful to families. Families tend to self-select services that assist them in providing care in the home setting. There is a need to engage Black communities and palliative care services in developing culturally appropriate services.

“You feel you have to be made of steel”: The strong Black woman, health, and well-being in Nova Scotia

ABSTRACT The “strong Black woman” construct has been well-documented in the United States as both an aspirational icon and a constricting burden for African-heritage women. It has not been examined among African-Canadians. Drawing on qualitative interviews and standardized measures with 50 African-heritage women in Eastern Canada, our analysis reveals their perceptions of the construct as both strongly endorsed as a source of cultural pride, yet also acknowledged to take a terrible toll on health and well-being. The construct arises from and directly benefits racism. It is imperative that health professionals understand the ways it shapes health and help-seeking behaviors.

Social Work with Racialized Groups: Frameworks for Practice

This article considers the historical legacy of European dominance over individuals from racialized groups. It discusses the social construction of race as it relates to culture and the subsequent oppression of individuals from racialized groups. Practice frameworks for working with individuals from racialized groups are discussed and implications for social work practice are also included.

The Role of Spirituality at End of Life in Nova Scotia’s Black Community

This study used qualitative in-depth interviews and focus groups to examine the role of spirituality at end of life (EOL) in Nova Scotia’s Black community. We also examined data from another research project that examined health issues in the Black community. The purpose of this research was to examine the issue of spirituality from the perspective of family caregivers, and spiritual leaders who have cared for someone who has died. More specifically, we explored how spirituality is expressed and how it serves as a coping mechanism during times of suffering and hardship at the EOL. Principal findings include the need for health providers to be aware of the spiritual needs of families of African descent and to include spirituality as a part of the EOL care plan.