BMJ Public Health (Sep 2024)

Culturally safe community agency health promotion capacity for diverse equity-seeking women: a rapid theoretical review

  • Anna R Gagliardi,
  • Andrea N Simpson,
  • Elle Nelson,
  • Susmita Susmita,
  • Saleema Allana,
  • Oluwakemi C Amodu,
  • Swarna Weerasinghe,
  • Erin Ziegler

DOI
https://doi.org/10.1136/bmjph-2024-001023
Journal volume & issue
Vol. 2, no. 2

Abstract

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Objectives Immigrant and sexually/gender-diverse women (henceforth, women) face inequities in access to and quality of care. As a result, many seek health information from community agencies perceived as culturally safe. We aimed to generate knowledge on capacity needed for culturally safe community agency health promotion.Design Theoretical rapid review.Data sources Studies identified in MEDLINE, EMBASE, CINAHL, PsycINFO, Sociological Abstracts, Cochrane Library and the Joanna Briggs Institute Database of Systematic Reviews.Eligibility criteria Studies published in 2013 or later on health promotion for ethnoculturally, sexually and gender-diverse women led by community agencies (eg, settlement, cultural, support and faith).Data extraction/synthesis We extracted data on study characteristics, cultural tailoring, implementation with the Reach Effectiveness Adoption Implementation framework and health promotion capacity with the New South Wales framework.Results We included 19 studies published from 2017 to 2023. Most focused on health promotion to African or Latin American persons in faith-based organisations. Few studies focused solely on women, and no studies focused on or included 2SLGBTQ women. Few studies described cultural tailoring beyond the use of participants’ first language. Training of community health workers (CHWs) to deliver health promotion education, and CHW in-person group training of health promotion participants on a wide range of topics resulted in improved knowledge, self-efficacy, intention to modify behaviour, behaviour change and health outcomes. A few studies yielded some insight into what community agencies need to enable health promotion: dedicated funding and personnel, training in healthcare issues, space and partnerships with academic and healthcare organisations.Conclusions This study confirmed and enhanced our understanding of the health promotion role of community agencies and identified gaps that can inform future research on how to achieve culturally safe community agency health promotion for diverse women.