Grant: Travel Awards - Institute Community Support

Community participation has been identified as a key facilitator of community health among marginalized populations in international health statements. These international health statements, however, do not stipulate the ways and means to engage marginalized populations in community participation strategies. To improve our understanding of community participation with marginalized populations we examined efforts to engage marginalized populations in Ontario Community Health Centres (CHCs), which are primary health care organizations serving 74 high-risk communities throughout the province of Ontario. We carried out a comparative analysis of four in-depth qualitative case studies of community participation initiatives in Ontario CHCs with three objectives: (1) to describe how participation with marginalized populations differs from engagement with other types of publics; (2) to identify the specific features of participation initiatives with marginalized populations (e.g., the approaches and methods); and (3) to identify the challenges of engaging marginalized populations. Our findings demonstrate that enabling the participation of marginalized populations requires CHCs to attend to the barriers experienced by marginalized populations that constrain their participation. A community development approach to participation was described to address the barriers related to marginalization and the associated social and cultural characteristics of the marginalized population. Limitations of the community development principles were demonstrated by cultural values and beliefs that shape the motivation and willingness of a marginalized population to participate and resist efforts to enable their efforts to enable their participation in health service planning and decision making.