Parenting in Adversity and Individual Perceptions of (In)Access to Health and Social Support Services: A Sensemaker® Study

Abstract

Having access to services for health and social support has been shown to greatly affect the health and well-being of individuals, communities, and society globally. However, great disparities in accessing services exist across sub-populations. Evidence indicates that individuals living in adversity in Canada have inequitable access to health and social services. This research focused on Canadian parents experiencing varying levels of adversity in Kingston, Ontario. The three main objectives were: 1) To explore the relationship between a parent’s self-reported adversity and their perceptions and experiences of accessing health and social services in Kingston, Ontario; 2) To describe the ways adversity might create barriers and facilitate opportunities for access to health and/or social support services; and 3) To demonstrate the use of a SenseMaker® survey in public health research in a Canadian context. This study contributes Canadian data to a larger international comparative study taking place between 2019 and 2020 in Canada, Mongolia, Thailand and the Democratic Republic of the Congo. A SenseMaker® survey starts with a micro-narrative prompt (and the subsequent capture of an audio recorded or type written story), followed by questions that generate an understanding of the micro-narrative from the participants perspective as well as sociodemographic information. A purposive sample of 106 participants in Kingston, Ontario was recruited through a community-based organization and in open public spaces. The data were analyzed using a modified QUAGOL coding protocol (Dierckx de Casterlé et al., 2012). A conceptual model was produced that was informed by previous theory and the collected qualitative data. Modifications to previous understandings of access were highlighted. This research contributes to our understanding of health care and social service experiences and accessibility among parents across diverse contexts of adversity. Ultimately, this could help inform the work of health and social service providers.