Engaging Families to Build Healthy Communities

Context: Adverse Childhood Experiences and Adverse Community Environments in combination represent family and community level factors that limit children, families and communities from reaching their full potential. Despite these significant challenges, every community has examples of resilience.<br />
Objectives: To understand the factors that impact family and community resilience for families facing adversity and families’ ideas on how to improve their communities.<br /> Study Design and Analysis: Using community-based participatory action research methods, the I-CREAte (Innovations for Community Resilience, Equity and Advocacy) team conducted a multiple case study design exploring the lived experiences of nine families experiencing adversity, focusing on their perceived strengths, barriers, and proposed solutions to improving resilience for their families and communities. Directed content analysis was used to analyze each case independently. Subsequently, all cases were brought together in a multiple case study analysis.<br />
Setting and Population: This study took place in Kingston, Frontenac, Lennox and Addington counties in Ontario, Canada. Nine families (cases) were recruited who self-identified as experiencing adversity. Family experiences of adversity ranged from exposure to racism, substance use, poverty, disability, migration, single parenthood, and exposure to different forms of interpersonal and community violence.<br />
Instrument: Visual timelines, semi structured interviews, and photovoice were included as data collection tools for each of the nine cases.<br />
Results: Through the use of thematic analysis, twelve themes were retained which significantly impacted families’ experience of resilience. These included: lack of community safety, impacts of COVID-19, Indigenous community needs and experiences, challenges to Integration for newcomers, anti-discrimination, family supports, rights-based approach, impacts of material deprivation, health system navigation challenges, healthy cities, social support networks, and family friendly substance use treatment needs. A lack of awareness and embodiment of rights, otherwise known as epistemic injustice, was noticeable in many families.<br />
Conclusions: The ways in which themes impacted individual families and intersected with each other present many opportunities for meaningful community intervention to improve the well-being of families.<br />

Data files for this study cannot be shared due to confidentiality. The following documentation have been included: Qualtrics survey tool, letter of information and consent and assent tools, semi structured focus group interview guides, semi-structured in-depth interview guides, Photovoice interview guides, validation protocol for knowledge dissemination