Literacy is considered one of the most important determinants of health among Canadians (Ronson & Rootman, 2004). Engaging communities in identifying the critical connections between literacy and health is an important aspect of addressing health literacy. This article describes how participatory research, undertaken through university-community partnership, resulted in the identification and prioritization of actions to improve practices and policies addressing health literacy needs of largely rural population in Atlantic Canada. The Health Literacy in Rural Nova Scotia Research Project studied links between literacy and health by exploring the experiences of people living in rural northeastern Nova Scotia. A multidisciplinary research team from St. Francis Xavier University (including faculty from the Adult Education, Human Nutrition, and Nursing Departments), partnered with five community-based literacy and health organizations in three counties, within the Guysborough Antigonish Strait Health Authority (GASHA), to a) explore factors that influence ways adults limited in literacy access and act upon health information and services; and b) identify strategies for that build upon existing capacities for achieving health. This collaborative research project explored the lived experiences of people whose daily lives are determined by limited literacy, as well as the insights of professionals who provide education and health-related services to them. Community leaders, with awareness of the socio-economic conditions in the region, also provided their insight on how literacy and health interacted. A Community Participatory Research Approach Community-based research is increasingly being called for to enhance understanding of the complex issues that affect our health (Seifer & Calleson, 2004). More specifically, participatory research can engage community members who have the knowledge, experience, and expertise related to such issues. Participatory research is a systematic inquiry, with the collaboration of those affected by the issue being studied, for purposes of education and taking action or effecting change (Green et al., 1994). This approach is known to take considerable time and commitment from all who are involved. However, efforts can lead to outcomes that are relevant beyond academic boundaries with knowledge transferred to various community stakeholders, resulting in community-led actions addressing important health problems (McCaulay et al., 1999). Community partners involved in the participatory research project, described in this article, were clear from the onset that the aim of the research should be to effect in policies and practices to build capacity for health among residents in their communities. This participatory research project stemmed from local community health board's concern that low literacy could be preventing some residents' access to health resources, services, and information. This problem was brought to the attention of university researchers, who were able to access some preliminary funding to undertake district workshops in the fall of 2000 from the Social Sciences and Humanities Research Council of Canada (National Literacy Secretariat Valuing Literacy in Canada Strategic Grant Program). The aim of these sessions was to determine if this issue was deemed by community members and practitioners to merit further study, how the research should be undertaken, and who should help guide the process of inquiry, Workshop participants included adult learners in literacy programs, adults with low literacy skills not in programs, as well as practitioners and managers from the fields of community health and literacy Their input confirmed the need to explore the links between health and literacy in their communities; it also informed the design of the study. For example, they recommended that personal interviews should be conducted with individual adults who have experienced literacy difficulties, while focus groups should be used to encourage dialogue among practitioners from literacy and health practice settings. …
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