Prairie Women's Health Centre of Excellence

  Uncovering Sex And Gender Differences in use patterns of Self-Help and Support Groups


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Prairie Women's Health Centre of Excellence
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Winnipeg, MB
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The research and publication of this study were funded by the Prairie Women's Health Centre of Excellence (PWHCE). The PWHCE is financially supported by the Women's Health Contribution Program, Bureau of Women's Health and Gender Analysis, Health Canada. The views expressed herein do not necessarily represent the views of the PWHCE or the official policy of Health Canada.

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R. Barnett


Self-help and support groups have gained in popularity since the 1970s. Self-help/support groups provide a component of social support, one of the determinants of health. These groups have been popular forms for health promotion, education, action and empowerment of "patients". Self-help/support groups span the continuum of health services from acute to rehabilitation. They can provide complementary support to professional interventions across the life span, and are consistent with the Institute for Gender and Health (IGH) priority for promoting health in the context of chronic conditions and disabilities. They are also used to promote positive health behaviours through self-care/prevention including in the IGH priority area of addictions. Health Canada's Natural Health Products Directorate links health promotion (including self-help groups) with its definition of complementary and alternative therapies.

The Prairie Women's Health Centre of Excellence (PWHCE) and the Canadian Women's Health Network (CWHN) are two parts of the Women's Health Contribution Program, supported through the Bureau of Women's Health and Gender Analysis of Health Canada. Social support as an influence and determinant of women's health has been part of the work supported by PWHCE. PWHCE has commissioned or been involved in policy-oriented, and community-based research and analysis about social support in relation to Aboriginal women, lesbians, older women and women living in rural communities. CWHN is a national voluntary organization working to improve the health and lives of girls and women in Canada and the world by collecting, producing, distributing and sharing knowledge, ideas, education, information, resources, strategies and inspirations. CWHN provides easy access to reliable health information, resources and research, and communicates the research findings and policy recommendations of the Centres of Excellence for Women's Health and Working Groups in timely and innovative ways. PWHCE and CWHN collaborated on the development and conduct of this project.

Self-help/support groups are rapidly becoming essential components of care given the funding demands upon health care services. Self-help/support groups are not a substitute for health care services. They are one means to produce positive health outcomes. They need to be reinforced and nurtured by other necessary services, and require collaboration with those services. Research about self-help/support groups is important for an ageing Canadian population facing reduced health care services. A growing national health promotion discourse mirrors demands of Canadians to be more involved in decision-making in health care services and their becoming "empowered" in their own health care. Especially in rural areas, and in cases of rare and chronic diseases, people are using self-help/support groups to take control and responsibility for their own health. Participants and practitioners alike believe that self-help/support groups are an outstanding way of providing care.

Research shows that participation in self-help/support groups can improve health. Randomized clinical studies in the 1980's about metastasized breast cancer showed higher rates of cancer survival for group members. Dr. Dean Ornish's program for treating heart disease makes extensive use of self-help groups. He wrote:

"At first I viewed our support groups simply as a way to stay on other aspects of the program I considered more important such as diet, exercise and stress management. Over time I began to realize that group support was itself one of the most powerful interventions."
Studies have also identified wider societal benefits such as:
  •  Creating, strengthening and developing community
  •  Initiating improvements in the medical, social service and education systems
  •  Reducing health care costs
Understanding why health promotion interventions and health behaviours such as participation in self-help/support groups are, or are not, effective also requires consideration of sex and gender differences - the socially constructed roles and relationships, attitudes, meanings and relative power ascribed to men and women in society - because men and women enact these activities differently. We know that women and men differ in health status and patterns of disease, and in their use of the health care system. Understanding why these differences occur (i.e. how sex and gender are determinants of health), and how to improve health outcomes has led to a range of research and evaluation initiatives.

However, research about sex and gender differences in the utilization and value of self-help/support groups is inadequate. The literature is predominantly sex and gender neutral, limiting the effective uptake of knowledge by practitioners and participants in these groups.

The intent of this report is to provide a better understanding of the roles and values of self-help/support groups by examining their issues more particularly through sex and gender analysis. It foresees how the sharing of research and best practices can promote more specific programming with clear sex and gender outcome measures which contribute to the improvement of health status and the health care system. Gender analysis will also help to improve access to self-help/support groups by many diverse communities.

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