Two key elements of health promotion are empathy and awareness, recognizing a health care need or gap in society and strategizing ways to meet or fill it.

With her Emerging Leaders in Health Care Promotion (ELiHP) project to improve prenatal care in Edmonton’s immigrant women population, Dr. Rachel Wang recognized the many barriers encountered by immigrant women and their families when expecting a child and/or planning a family.

“Language barriers, cultural practice differences, limited social support and a lack of knowledge of appropriate prenatal care – coupled with the fact that the immigrant woman population is often at a higher risk for poor health compared to Canadian women – means this population often doesn’t benefit from the type of prenatal health care that established Canadian women populations have routine access to,” Dr. Wang explains.

“Routine prenatal care is not a universal concept,” observes Dr. Wang. “Most immigrant families face barriers to accessing our health care system. While one objective of this health promotion project was to increase accessibility to information on prenatal care, we specifically wanted to emphasize the importance of prenatal care to achieving positive outcomes for both maternal and fetal health, including educating women on prenatal screening options available during pregnancy.”

“Routine prenatal care is not a universal concept ... Most immigrant families face barriers to accessing our health care system. - Dr. Rachel Wang

In December 2016, Dr. Wang collaborated with Elauna Boutwell, Program Coordinator at the Welcome Centre for Immigrants, Edmonton, and ELiHP project mentor Dr. Sue Chandra (Department of Obstetrics & Gynecology, University of Alberta) to lead a one-day lunch and learn workshop for 42 immigrant women, primarily from India and Southeast Asia. The workshop had a health and beauty component to encourage and facilitate socializing. With the guidance of Dr. Chandra, Dr. Wang developed and led the prenatal care presentation at the workshop and relied on the expertise of MC College for the health and beauty session at the end of the day. 

“Understanding cultural and ethnic considerations is key to delivering a workshop to the immigrant population,” says Dr. Wang. “Together we addressed culturally relevant topics which may otherwise have been overlooked in a clinical setting. As the afternoon progressed, we bonded and developed a sense of community, allowing for more important prenatal considerations and questions to be raised.” 

Dr. Wang was pleased with the many discussions among the immigrant women and the health care professionals during the workshop. “Instead of exit surveys, we gathered feedback by talking with the participants during the health and beauty session. This gave us an opportunity to personally engage with the immigrant women, to build a rapport and to provide a safe environment for them to talk and ask questions.” 

“The participants unanimously agreed that the workshop augmented their understanding of prenatal care, and many were happy to speak about differences in how they understood prenatal care within their own culture,” Dr. Wang adds, citing an example of one participant who was surprised to learn that ginger tea is considered safe during pregnancy as a treatment for nausea. She’d previously learned that ginger is detrimental after the first trimester. 

Dr. Wang valued the expertise that Dr. Chandra, a specialist in maternal-fetal medicine, brought to the project, as she helped Dr. Wang focus the workshop and the prenatal health care presentation on addressing ethnically relevant concerns. In addition to drawing on her clinical experience and knowledge for the health care presentation, Dr. Chandra also attended the workshop and participated in the follow-up Q&A session. 

“Dr. Chandra’s expertise on prenatal care was especially important for this presentation, where certain topics addressed high-risk pregnancies particular to specific ethnic backgrounds,” comments Dr. Wang.

Like every successful project, Dr. Wang noted a few things she would do differently in the future. Because a number of the workshop participants arrived with children, Dr. Wang says future events should consider providing child care. She also noted that “presentations to ethnic groups should take into consideration topics that are more relevant. For example, gestational diabetes is common amongst the Asian population, so it would be wise to spend more time on discussion of this topic.”

Reflecting on her experience with her ELiHP project, Dr. Wang says that she and Dr. Chandra will continue to reach out and collaborate with other immigrant settlement agencies to deliver more prenatal workshops. 

About the Emerging Leaders in Health Promotion grant Program

The Emerging Leaders in Health Promotion (ELiHP) grant program provides funding to help medical students and resident physicians conceive of and implement health promotion projects that support the development of their CanMEDS/FM core competencies, particularly health advocacy.

Jointly sponsored by the Alberta Medical Association, the Canadian Medical AssociationMD Financial Management and Joule, ELiHP projects facilitate the growth of physician leadership and advocacy skills in a mentored environment while enhancing the well-being of the general Alberta population through education, advocacy or community service.

Banner photo: (L to R) Elauna Boutwell, Program Coordinator, Welcome Centre for Immigrants, Edmonton; Dr. Sue Chandra, Department of Obstetrics & Gynecology, U of A; Dr. Rachel Wang, ELiHP project lead.