CFHJ

Engaging ‘Special Groups’ (Hard-to-Reach/Stigmatized Communities)

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Rosie Perez-Leight

(If it wasn’t) for the grace of DNA, the luck of NO accidental injury and healthy living go I?
Or
Aren’t we ALL partly part of a ‘Special Group’ or Community?

     When thinking of ‘Engagement’ (in health care) I think of ‘Participatory Communication’ in the form of information, guidance, mentorship and comfort with related Healthcare value and benefits. Further, if I were to put 20 people in one tiny imaginary room and, if I were to separate them into groups (as a representation of the personal intricacies of their lives and the lives of their family and close friends) like;
 

  • Special Interest – including Smokers, legal/illegal drug and alcohol use and Anti-Vaxxers (SI),

  • Special Group(s) – including LGBTQIA (SG),

  • Developmentally Disabled – including genetic anomalies and rare diseases (DD),

  • Women’s Health Issues (WHI),

  • Cultural/Religious Groups (CRG),

  • Mental Health Communities (MHC),

  • Homeless Communities (HC),

  • Senior Communities (SC),

  • and Tribal Nations (TN)

    I imagine that I would find a representation of each group (listed) either directly or indirectly personally related to the subject(s) in my tiny room. This kind of imagining helps me to understand that the idea of having to engage ‘Special Groups or Communities’ should be an idea of the past because currently we are ALL in one way or another connected TO or are a part OF (directly or indirectly) these hard-to-reach/stigmatized communities.
 
    And yet it is wondered; Are we as the ‘direct or indirect’ connected part(s) of these ‘Special’ communities really hard to reach? To communicate with? To engage? To help? To correctly manage? Or, is that a myth of our current health care structure, insurance programs, research monies, special interest group biases, health care academics and governments (trying to save a dime).

Locking onto the Communication Breakdown
 
   Genuine effective participatory communication (in healthcare) should ensure that all affected parties (or groups) have equal influence towards the objective of an initiative through a participatory process including (gsdrc.org):

  • “Two-way communication”

  • “Broad consensus” by as many stakeholders (group members) as needed

  • Balanced inclusiveness in consideration of “time, resources, interests and knowledge” of stakeholders (group members)

If (as I believe) ‘Engagement’ is ‘Participatory Communication’ and; If there is NO engagement of said ‘special’ groups by and with the current powerful Healthcare communities; Then we must be facing a failure to communicate (Cool Hand Luke, 1967).
 
But, before we can lock onto this communication breakdown and start building communication bridges we must examine the habits, traditions and antiquated policies of the ‘thinkers and doers’ of the healthcare and insurance industries and the research, government and academic institutions that are non-inclusive and are major contributors to the rhetoric of healthcare inequalities that produce inequitable care.
 
Still More Questions in the Realm of Wondering
 
So, HOW do we ‘Engage’ the Special Group aka Hard-to-Reach/Stigmatized Communities?
 
and; can it be considered that these ‘Special Groups’ are no longer ‘Special’ as they are Normal to our diverse American society?
 
And finally; How do we as separate diverse communities (online and off) contribute to the improvement of equitable healthcare communication?
 
It’s Time for Engagement
 
    Breaking through community silos and popping the bubbles of industries and institutions is difficult because of the inherent variety of perspectives and biases that make the objective of ‘Engagement’ (of Special Groups/Hard-to-Reach Communities) almost impossible. However, I believe that the first step to ‘Engagement’ lies in everyone (including industries and institutions) understanding their unique connections to ‘Special Groups/Communities’ as well as their (perhaps unintentional) part in supporting the silos and bubbles that exclude these same communities. This type of recognition will help bolster ‘Engagement’ by getting past the obstacles that create the ‘special’ labels which help build a community atmosphere of exclusion. It’s time for Engagement with ideas that promote possibilities/actions that connect and include All Communities in equitable healthcare.

“How Communication Factors In” by the Director

     The previous blog covered many nuances involved when defining special groups. As you can see, it is a difficult task, but a necessary one for healthcare professionals to actively ‘engage’ in to meet their patient’s needs. The Patient Centered Outcome Research Institute (PCORI), has created a helpful 4-step guide for researchers and professionals who wish to improve their practices engaging hard to reach populations.

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