Title: Research Skills Building/Enhancement and Research Protocol Development Project
Funding Agency: Ontario HIV Treatment Network
Award:$27,640.00
Investigators: Esther Tharao, Notisha Massaquoi, 
                      Marsha Brown
Anticipated Date of Completion: April 2002

Project Description:
This project will enable Women’s Health in Women’s Hands to build and enhance its capacity to carryout research both in-house and externally. Research training will be provided through workshops to provide conceptual understanding and practical utilization of research findings through activities designed to provide hands on approach learning of the research process and methods. This will provide the research skills required to enable staff, board members and/or volunteers to incorporate research activities in their everyday work.

With the support and guidance from the research officer the staff will form a research team with representation from the clinical and health promotion units and work together using their newly gained research skills to develop research protocols to investigate: the experiences of Black women and women of color with the Ontario prenatal HIV Testing program.

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Title: Racism as a Determinant of Health: The Impact of Racism on the Health of Young Women of Color
Funding Agency: The Canadian Race Relations Foundation
Award:$27,698.50
Investigators: Dr. Alisha Ali (co-investigator), Notisha Massaquoi (co-investigator), Marsha Brown (research assistant)
Published: March 2003
Collaborating Institutions: Women’s Mental Health Program Centre for Addiction and Mental Health

Final Report: "Racial Discrimination as a Health Risk for Female Youth: Implications for Policy and Healthcare Delivery in Canada"

Project Description:
There is growing evidence that the experience of racial discrimination can have a pervasive and devastating impact on the health and well-being of racial minorities. One factor that has been implicated in the exacerbation of this impact is the current inadequacy in the delivery of healthcare services to provide culturally appropriate care to all individuals. This inadequacy is particularly apparent in the context of the need for sensitive and compassionate care for women of colour who face the multiple oppressive forces of racial and sexual discrimination. Women's Health in Women's Hands is a community health centre dedicated to providing anti-racist care to immigrant and refugee women and women of colour. Its mandate emphasizes ensuring excellence in all aspects of quality care with a particular focus on addressing the damaging influence of racism on women's physical and mental health. Within this focus, significant evidence has emerged to suggest that young women of colour are especially vulnerable to racist experiences within the healthcare system and that the health needs of these young women are often overlooked by mainstream forms of service delivery. Accordingly, we are applying for funding within the subject area of Racism and Youth to support this proposed research initiative to explore racial discrimination as a health risk for female youth, and to generate policies and strategies to develop anti-racist, culturally competent modes of practice for this population within Canada's healthcare system.

The purpose of this research is to address the need for anti-racist healthcare delivery for female youth who are racial minorities between the ages of 16 and 22 years. Anti-racist healthcare delivery is defined as service delivery which acknowledges and emphasizes: (a) power as a factor that influences the life chances and socio-economic situation of racial minority citizens; (b) the cultural differences, which may act as barriers to service among the people who work within and those who seek the assistance of human service organizations ( e.g. linguistic differences) and (c) the lived experiences of minority group members and understands their reality within the context of the dominant culture (James, 1996).

The specific research question addressed in this project is: What improvements need to be made in the delivery of anti-racist healthcare for female youth of colour? The project will involve the articulation of health concerns affecting female minority youth that have not been sufficiently addressed within healthcare delivery, as well as the development of programing and policy initiatives directed at addressing these concerns. The project will consist of a participatory process which will include young women of colour as collaborating consultants at every stage of design and implementation. All aspects of conceptualization, information-gathering, and reporting will be guided by principles of anti-racist and anti-sexist empowerment of these female youth. Furthermore, the entire research team will consist of women who are racial minorities, including the two lead researchers.

The specific objectives of this project are consistent with a participatory action-research approach. Specifically, the first objective is to utilize the perspectives of young women of colour and anti-racist practitioners to determine the improvements that need to be made in the provision of anti-racist health care for racial minority female youth. The second objective is to design and implement concrete initiatives to fulfill these identified improvements in a range of healthcare settings including both community health centres and mainstream hospital settings. These initiatives will focus on six key areas of policy and program development as outlined below in the section entitled "policy/program and national relevance".

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Title: Silent Voices of the AIDS Epidemic”: African and Caribbean Women, their Understanding of the Various Dimensions of HIV/AIDS and Factors that contribute to their Silence
Funding Agency: The National Health Research and Development Program
Award:$25,000.00
Investigators: Esther Tharao, Notisha Massaquoi, 
                      Senait Teclom
Completed Date: April 2004
Executive Summary: Link to Executive Summary Report

Final Report: "Silent Voices of the HIV/AIDS Epidemic: African and Caribbean Women in Toronto 2002 - 2004"

Project Description:
Women’s Health in Women’s Hands Community Health Centre (WHIWH) requested funding to develop a participatory action research project to explore the factors that contribute to the lack of involvement of African and Caribbean women living in Toronto in HIV/AIDS initiatives and also to identify solutions and strategies which will ensure their increased participation.

Despite the alarmingly high death rate from AIDS of Ontario women from HIV endemic countries and the high rates of maternal-infant transmission, African and Caribbean women are noticeably absent from AIDS prevention initiatives and/or support programs. The goal of this project is to conduct a participatory action research project to find the reasons behind the isolation and invisibility of target population. The proposed research will also investigate the needs and concerns of these women and the level of their awareness about the various dimensions of HIV/AIDS. It will further study the underlying gaps in the HIV/AIDS services which might pose barriers to access for African and Caribbean women. The information collected will facilitate the development of strategies which would allow community stakeholders, service providers and policy setters to overcome the problem.
Research questions would seek to reveal the factors contributing to this lack of involvement. Questions related to risk behaviors, cultural norms, values and practices, racism, discrimination, and accessibility will be included. Attitudes, determinants, perceptions and impacts of HIV testing will also be explored.

The project methodology begins with the idea that the target population have particular insights about the problem and solutions to the problem. Thus, the proposed method begins with the real life experiences of African and Caribbean women. They will actively participate in all stages of the research: defining research questions, strongly influencing and shaping the research process, and interpreting the findings.
Therefore, by employing a variety of methods at different stages of the research process, it has been ensured that the community participants’ will be able to provide their inputs through various channels: Project Advisory Committee, Community Participants/Informants and Technical Sub-committee.

The data-gathering tools that will be used in this project are:
In-depth interviews with ‘key-informants to gather detailed description of the research questions. The inside knowledge gained from interviews will provide an in-depth understanding of hard-to-measure concepts.

Focus group discussions will be used in the proposed research for generating answers to the research hypotheses/questions, for conducting needs assessment and evaluation of HIV/AIDS programs/services/ initiatives, and also for developing recommendations, new strategies and future action plan.

The views and opinions of service-providers on relevant research questions are important components of the present research. Hence, there will be a one-day Consultation held with the service-providers.

Literature/Program review will also be carried out in order to get a sense of what studies/programs have been done previously, what have been the outcomes of those research, is there any common theories or useful statements, are there gaps in the existing literature/programs.

The proposed research project will empower the target population with enhanced knowledge and awareness about issues related to HIV/AIDS, so that they challenge the status quo and create the conditions for their full and equal participation. The research process itself will heighten sensitivity and awareness about HIV/AIDS in the target communities and it will stimulate them to act collectively to prevent further spread of the disease. The information and recommendations in the project report will enable community stakeholders, government policy makers and other agencies to develop effective HIV/AIDS Prevention Programs to address identified needs and gaps for this highly affected, under-served and largely ignored population. Last, but not least, the project will serve as a community based research model which can be used by other organizations and also by Women’s Health in Women’s Hands when doing similar research on other health issues.

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Title: Revisiting the “Personal is Political”: Immigrant Women’s Health Promotion
Funding Agency: Canadian Institutes of Health Research
Award:$118,420.00
Investigators: Dr. Denise Gastaldo (Principle Investigator), Dr. Nazilla Khanlou (co-investigator), Deone Curling (co-investigator), Notisha Massaquoi (co-investigator)
Anticipated Date of Completion: September 2004
Collaborating Institutions: University of Toronto Faculty of Nursing

Resources developed based on the study and summary of study findings

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Title: Collaborative Process to Achieve Access to Primary Health Care for Black Women and Women of Colour.
Funding Agency: Ministry of Health
Award:$469,300
Investigators: Dr. Charmaine William (Principle Investigator), Notisha Massaquoi (Co-investigator)
Partners: Planned Parenthood of Toronto, Sistering, Rexdale Community Health Centre and Parkdale Community Health Centre
Anticipated Date of Completion: July 2006
Collaborating Institutions: Faculty of Social Work at the University of Toronto

Project Description: Women's Health in Women's Hands has received funding in the sum of $469,300 from the Ministry of Health for a research project entitled: A Collaborative Process to Achieve Access to Primary Health Care for Black Women and Women of Colour. Women's Health will be acting as the lead research agency in the project, which is a partnership with Planned Parenthood of Toronto, Sistering, Rexdale Community Health Centre and Parkdale Community Health Centre. Dr. Charmaine William from the faculty of Social Work at the University of Toronto will be acting as the Principle Investigator in the study. The two-year project will use its findings to identify barriers and recommend solutions to improve access to health care for Black women and women of color.

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Title: Promoting Equity in Access to Post-Trial HIV Vaccines for Black Women in Canada: Risks, Barriers and Adoption Intentions
Funding Agency: Canadian Institutes of Health Research
Award:$95,550
Investigators: Dr. Peter Newman (Principal Investigator) Dr. Charmaine Williams, Dr. Izumi Sakamoto, and Notisha Massaquoi (Co-investigators) 
Community Partner: Women’s Health in Women’s Hands
Anticipated Date of Completion: 2006
Collaborating Institutions: Faculty of Social Work at the University of Toronto


Project Description: Women's Health in Women's Hands will be acting as the community partner with The Faculty of Social Work at The University of Toronto, which has been funded by the Canadian Institutes of Health research for - $95,550. The purpose of this study is to assess HIV vaccine acceptability among Black (African and Caribbean origin) women in Toronto. There is currently no HIV/AIDS vaccine available, however, this project is preparation for the time when effectiveness and safety of the vaccines have been established through clinical trials. This study is a first step toward developing social marketing, education and prevention programs that are required to ensure appropriate dissemination of HIV vaccines when they are available in the near future. 

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