Beyond the volcanoes: Community education and action to improve health equity in rural Nicaragua

Background: Health inequities related to gender, ethnicity, socioeconomic status, and geography exist in rural Nicaragua. The purpose of this ongoing project is to improve health equity in rural Nicaragua through social transformation using community-based participatory action research. Bronfenbrenner's ecological model of human development, school health, and primary health care theories provided the framework for this research.

Methods: Community-based participatory action research involves six phases: partnership, assessment, planning, implementation, evaluation, and dissemination. In the implementation phase, the goal was to use the data obtained during the assessment and planning phases to implement an action plan to reach the community's health-related goals. Community members actively engaged in health education through the use of sociodramas during a community forum. Pre- and post-test surveys were used to assess readiness for change and knowledge regarding respiratory illness symptoms and causes of those symptoms related to indoor air pollution.

Results: Thirty-five community members participated in the community forum. Pre-test surveys indicated the community members' readiness to implement prevention mechanisms to improve indoor air pollution. Post-test surveys indicated a significant difference in knowledge attained during the community forum using sociodramas to deliver health education regarding respiratory illness symptoms (p = .05) and causes of those symptoms related to indoor air pollution (p = .03).

Conclusion: Results from the sociodramas were used by community members to guide the redesign of open fire stoves to improve ventilation and reduce respiratory disease in planning for community action. Partnership in community health education and action provides a mechanism to engage community members in social justice through working toward a common goal—health for all.