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Evaluation of Women's Empowerment in a Community-Based Human Papillomavirus Self-Sampling Social Entrepreneurship Program (Hope Project) in Peru : A Mixed-Method Study

Evaluation of Women's Empowerment in a Community-Based Human Papillomavirus Self-Sampling Social Entrepreneurship Program (Hope Project) in Peru : A Mixed-Method Study


Title: Evaluation of Women's Empowerment in a Community-Based Human Papillomavirus Self-Sampling Social Entrepreneurship Program (Hope Project) in Peru : A Mixed-Method Study
Author: Shin, Michelle B.
Garcia, Patricia J.
Dotson, Mary Elizabeth
Valderrama, María
Chiappe, Marina
Ramanujam, Nimmi
Krieger, Marlee
Ásbjörnsdóttir, Kristjana
Barnabas, Ruanne V.
Iribarren, Sarah J.
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Date: 2022-06-13
Language: English
Scope: 1731746
Department: Faculty of Medicine
Series: Frontiers in Public Health; 10()
ISSN: 2296-2565
DOI: 10.3389/fpubh.2022.858552
Subject: cervical cancer; community-based cancer screening; empowerment; HPV self-sampling; Peru; social entrepreneurship; Humans; Male; Papillomavirus Infections; Alphapapillomavirus; Entrepreneurship; Female; Papillomaviridae; Public Health, Environmental and Occupational Health
URI: https://hdl.handle.net/20.500.11815/3788

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Citation:

Shin , M B , Garcia , P J , Dotson , M E , Valderrama , M , Chiappe , M , Ramanujam , N , Krieger , M , Ásbjörnsdóttir , K , Barnabas , R V , Iribarren , S J & Gimbel , S 2022 , ' Evaluation of Women's Empowerment in a Community-Based Human Papillomavirus Self-Sampling Social Entrepreneurship Program (Hope Project) in Peru : A Mixed-Method Study ' , Frontiers in Public Health , vol. 10 , 858552 , pp. 858552 . https://doi.org/10.3389/fpubh.2022.858552

Abstract:

Introduction: Understanding community women's relational and financial empowerment in social entrepreneurship could be the key to scaling up community-based human papillomavirus (HPV) self-sampling programs in low- and middle-income countries. The Hope Project, social entrepreneurship in Peru, trains women (Hope Ladies) to promote HPV self-sampling among other women in their communities. This study aims to evaluate the Hope Ladies' relational and financial empowerment after participating in the program. Materials and Methods: We evaluated the Hope Ladies' experiences of empowerment in social entrepreneurship using a parallel convergent mixed methods design. The Hope Ladies participated in semi-structured in-depth interviews (n = 20) and an eight-questions five-point Likert scale survey that evaluated their relational (n = 19)/financial (n = 17) empowerment. The interview and the survey questions were developed using three empowerment frameworks: Kabeer's conceptual framework, International Center for Research on Women's economic empowerment indicators, and the Relational Leadership Theory. Deductive content analysis was used to evaluate the interviews with pre-determined codes and categories of empowerment. Descriptive statistics were used to analyze the survey results. Qualitative and quantitative data were integrated through a cross-case comparison of emergent themes and corresponding survey responses during the results interpretation. Results: All Hope Ladies reported experiencing increased empowerment in social entrepreneurship. Interviews: The women reported challenges and improvement in three categories of empowerment: (1) resources (balancing between household and Hope Lady roles, recognition from the community as a resource, camaraderie with other Hope Ladies); (2) agency (increased knowledge about reproductive health, improved confidence to express themselves, and ability to speak out against male-dominant culture); and (3) achievement (increased economic assets, improved ability to make financial decisions, and widened social network and capital, and technology skills development). Survey: All (100%) agreed/totally agreed an increase in social contacts, increased unaccompanied visits to a healthcare provider (86%), improved confidence in discussing reproductive topics (100%), improved ability to make household decisions about money (57% pre-intervention vs. 92% post-intervention). Conclusions: The Hope Ladies reported improved relational and financial empowerment through participating in community-based social entrepreneurship. Future studies are needed to elucidate the relationship between empowerment and worker retention/performance to inform the scale-up of HPV self-sampling social entrepreneurship programs.

Description:

Funding Information: This work was supported by the University of Washington: School of Nursing, the United States Agency for International Development (USAID-DIV 7200AA19FA00001), Duke Universities Bass Connections project titled Analysis of Bringing Elements of Referral Services to Community Care, and GMaP Region 5 program of the Fred Hutch/University of Washington Cancer Consortium 3P30CA015704-46S5. Publisher Copyright: Copyright © 2022 Shin, Garcia, Dotson, Valderrama, Chiappe, Ramanujam, Krieger, Ásbjörnsdóttir, Barnabas, Iribarren and Gimbel.

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