1. Annual AAISA Summit
Innovative Practices in Settlement and Integration
Health Literacy Partnerships – Improving the Health Outcomes of Multi barriered Immigrant Women
Presented by: Celestina Akinkunmi
Settlement and Integration Department Manager
September 21, 2018

2. OUR MANDATE VISION: Empower Immigrant Women. Enrich Canadian Society.
MISSION: To engage and integrate all immigrant women and their families in the community.
VALUES: Integrity. Equity. Inclusiveness. Innovation. Leadership.

3. The Project CIWA & MOSAIC PCN
Improve the health literacy outcomes of LESLLA learners
Reduce the barriers to accessing health care services
CIWA & MOSAIC PCN
The Health Literacy Partnership project focuses on improving the health outcomes of multi-barriered immigrants and refugees. It is a 2-year partnership between Calgary Immigrant Women’s Association (CIWA) and MOSAIC Primary Care Network (MOSAIC PCN).
Through health literacy interventions that pilot new tools and training for each of the three participant groups, the project aims:
to improve the health literacy outcomes of LESLLA learners
to reduce the barriers to accessing health care services faced by adult immigrants and refugees with limited literacy and language proficiency

4. Health Literary Partnership
Building Partnerships
LESLLA Learners
Literacy
Practitioners
Health Literary Partnership
Healthcare
Practitioners
The partnership will draw on the expertise of three participant groups by -
working with LESLLA learners to improve their knowledge, skills and confidence in accessing healthcare services and communicating with healthcare professionals
At the heart of the Health Literacy Partnership are adult language learners who are also learning to read and write for the first time in their lives, in a language that is also new to them. LESLLA stands for Literacy Education and Second Language Learning for Adults. LESLLA learners come from immigrant and refugee backgrounds and have limited or interrupted formal schooling.
working with healthcare professionals to improve their knowledge, skills and confidence in serving and communicating with LESLLA learners
working with literacy instructors to improve their knowledge, skills and confidence in providing tools and methods of instruction to help learners increase their health literacy and access accurate health information

5. Low literacy & numeracy
Low Literacy and Health
Low literacy & numeracy
Reduced use of healthcare services
Poor health outcomes
“Low literacy and numeracy are associated with a reduced use of healthcare services and poor health outcomes in chronic, emergent and preventive disease care...These basic skills are social determinants of health, a category of factors influencing health that is increasingly recognized as directly relevant to patients’ clinical care. These factors influence health through the life course and are associated with mortality…Adults with low literacy and numeracy are…less able to manage chronic health conditions due to their lack of understanding self-management requirements…(and) less likely to seek health information and more likely to miscommunicate with their health providers” (Open Door Collective, 2017b, p.1-2).

6. Barriers to information
Health Care Access Barriers
Language barriers
Barriers to information
Cultural differences
“Approximately 60% of adult Canadians have low levels of health literacy, with certain populations experiencing much lower levels…(including) recent immigrants and those with lower levels of education…and low English proficiency.” (Hernandez, 2013, p.38)
A 2016 scoping review of research regarding Canadian immigrants’ unique experiences in accessing health care found that “there are unmet health care access needs specific to immigrants to Canada…the most common access barriers were found to be language barriers, barriers to information, and cultural differences. These findings, in addition to low cultural competency reported by interviewed health care workers in the reviewed articles, indicate inequities in access to Canadian health care services for immigrant populations” (Kalich et al., 2016, p.697).

7. Improving Health Literacy
Inter-sectoral Approach
Develop knowledge
Raise awareness and build capacity
Build infrastructure and partnerships
Limited health literacy, therefore, is an important issue because is “has negative implications for health outcomes, health care quality, and health care costs…(and) it is a serious and costly problem that is likely to grow as the population ages and incidence of chronic disease increases” (Mitic & Rootman, 2012, p.11).
In An Inter-sectoral Approach for Improving Health Literacy for Canadians, Mitic & Rootman (2012) identify the following three fundamental components that are essential to their comprehensive strategy for building health literacy in the population;
Develop knowledge
Raise awareness and build capacity
Build infrastructure and partnerships
Our project contains elements of all three of those components.
Creating innovative partnerships that use evidence-based strategies is crucial to improving health literacy, but “research on how to augment health literacy is still evolving and there are few established ‘best’ practices. Therefore, promising practices and ideas that emerge from community experience and/or cultural knowledge should be included in the mix of strategies to be used,” (Mitic & Rootman, 2012, p.26).

8. MOSAIC Refugee Health Clinic
Building Partnerships
Pebbles in the Sand students
MOSAIC Refugee Health Clinic
Pebbles in the Sand / LINC instructors

9. MOSAIC PCN Refugee Clinic
Stage1: Identifying Needs & Strengths
Pebbles in the Sand students
MOSAIC PCN Refugee Clinic
Pebbles in the Sand / LINC instructors
Attend focus groups
Complete healthcare professional survey
Complete literacy practitioner survey

10. MOSAIC PCN Refugee Clinic
Stage 2: Providing shared experiences
Pebbles in the Sand students
MOSAIC PCN Refugee Clinic
Pebbles in the Sand / LINC instructors
2-year project involvement
Tour Mosaic Refugee Clinic
Visit Pebbles
in the Sand classes

11. MOSAIC PCN Refugee Clinic
Stage 3: Development training and resources
Pebbles in the Sand students
MOSAIC PCN Refugee Clinic
Pebbles in the Sand / LINC instructors
2-year project involvement
Work together on creating health literacy tools
Access shared portal
for resources
All partners provide feedback and recommendations

12. MOSAIC PCN Refugee Clinic
Stage 4: Training and Piloting of Tools and Evaluation
Pebbles in the Sand students
MOSAIC PCN Refugee Clinic
Pebbles in the Sand / LINC instructors
2-year project involvement
All partners attend information sessions and workshops on piloting tools
All partners attend health literacy celebrations

13. FUNDED BY

14. Thank you!
Contact Information:
Celestina Akinkunmi
Settlement and Integration Department Manager
Calgary Immigrant Women’s Association
First Street Plaza – Suite 200, Ave SE
Calgary, Alberta T2G 4Z6
Tel: (403)
Fax: (403)