Women organizing for women: disjunctures in the consumption and provision of health and wellness services for single mothers

Current social services provided in Canada for low-income women are primarily 'crisis management' in nature as they almost exclusively provide safe housing, adequate nutrition or employment training, and many are under severe financial pressure due to a shifting public policy. As a result, services offered for single mothers living below the poverty line rarely deal with health promotion in terms of physical activity, even though it has been demonstrated that socioeconomic status is a key determinant of health (Frankish, Milligan & Reid, 1996). Although there are many positive mental and physical health benefits associated with regular physical activity (King 1991), its organizational context remains problematic for those who live in poverty and are unable or unwilling to conform to dominant expectations inherent with the consumption of modern forms of physical activity. A moral reasoning tone pervades prescriptions for maintaining and improving health, and those unable to achieve and maintain good health are considered individually responsible, thus obscuring organizational and structural factors that limit involvement. The purpose of this case study of the YWCA was to examine the provision and consumption of health and wellness services for low-income single mothers. Research questions were posed in four areas: i) what meanings do low-income single mothers and YWCA service providers associate with the provision of health and wellness services; ii) how are health and wellness services located within the political, social and economic context of the YWCA; iii) are there points of disjuncture between the provision and consumption of health and wellness services for low-income single mothers; and iv) if points of disjuncture are uncovered, what are the possibilities for emancipatory change in service provision? Several bodies of literature were reviewed to inform the study: social construction of poverty, ideologies of health and physical activity, feminist organization theory, and feminist action research (FAR). FAR is a research process that merges participatory action research with critical feminist theory. Key principles of feminist action research include: 1) gender as a central piece to emerging explanatory frameworks (Maguire, 1987); 2) collaboration and negotiation at all stages of the research process between the researcher, the service providers and the research participants (Green et al., 1995); 3) empowerment through giving control of the research process and decision making to the research participant, while deconstructing the power structures associated with social class (Fals-Borda, 1991; Fawcett, 1991); and 4) social/organizational action and emancipatory change enabled through the democratic production of knowledge (Green et al., 1995). The research methodology involved an examination of: 1) The meanings and experiences of eleven low-income single mothers participating in the FOCUS Pre-employment Training Program which has a wellness component. The data collection strategies included focus groups; a validation meeting the original participants; observations during group meetings and program sessions; and informal discussions. 2) The meanings and experiences of five service providers who were either facilitators of FOCUS or occupied management positions in the YWCA. The data collection strategies included one-on-one semi-focused interviews; observations of program meetings, group and informal discussions; and a final meeting to discuss potential change. 3) Relevant documents, including brochures, pamphlets, reports and promotional flyers to obtain background and contextual information about the YWCA. The data was analyzed using inductive analysis and the qualitative software program, Q.S.R. NUD.IST. The overall finding was that neither the service providers nor the single mothers viewed wellness as a priority. At the organizational level, the explanation for this finding was that physical activity opportunities were not valued by the funders, whereas employment training was their primary concern. The YWCA's upscale health and wellness services, which offered another opportunity for single mothers to participate, catered on a fee-for-service basis to middle and upper income women and men and pursued a market-driven ideology towards service provision, thus making low-income single mothers' involvement less likely. The social, economic and political context in which FOCUS was situated had a profound influence on the nature of service delivery, and funding constraints were a source of stress for the service providers and infringed on the nature and scope of the services offered for the single mothers. Themes related to points of disjuncture included the service providers' attitudes towards the provision of health and wellness services. Some providers believed that within the confines of the organizational structure and the FOCUS program guidelines, the physical activity opportunities offered to the women were sufficient. Conversely, other providers believed that the organization could take a more active and critical role in determining routes for change and establishing stronger connections between health and wellness activities and the other components of the FOCUS program. All of the service providers alluded to the importance of the women's input and the "organic growth" of the program, however the program's strict curriculum and scarce evaluations resulted in a non-collaborative approach to service delivery. From the single mothers' perspectives, stereotypes of the lazy and unmotivated "welfare single mother" inhibited their involvement in community life, including organized forms of physical activity (Fraser & Gordon, 1994; Lord, 1994; Belle, 1990). The women reported experiences with discrimination, a cycle of poverty, complications with social assistance, social stigmas, and childcare responsibilities as their major constraints. Three main reasons for the women's lack of participation were their low sense of entitlement towards physical activity, their ambivalence towards their bodies, and little access to wellness facilities. However, involvement in health and wellness activities was a low-priority for the FOCUS participants, though some of the single mothers mentioned the desirability of incorporating more regular activity sessions into the FOCUS curriculum. Other tensions arose between the realities and ideals of feminist organizing. Distinctions based on class, ethnicity and age separated the upper managerial service providers, the on-site facilitators, and the women accessing the program, perpetuating an elitist, non-collaborative and hierarchical organizationial structure. Based on the single mothers and the service providers' suggestions, four major recommendations for change were provided. First, the participants should be central to and fully collaborative in the organizational processes of the YWCA. Second, if the women involved in the program value physical activity, they should determine ways in which it can become a part of their daily reality. Third, for those involved with the planning and implementation of the FOCUS program, the role of the funders vis a vis the needs of the participants should be determined, and a consistent and 'women-centered' approach to service delivery established. Finally, the YWCA's approach to wellness service delivery should be evaluated and re-conceptualized so that it fulfills and is congruent with the YWCA mission statement. What remained unexplored by the service providers was the potential for the women to redefine hegemonic notions of physical activity (Birrell & Richter, 1987) and to be involved in a meaningful and self-expressive form of activity (Hargreaves, 1990). By listening to the various perspectives and situating experiences within the organizational, political, economic and social contexts, this study provided the beginnings of a critical understanding of the tensions involved in women organizing for women to promote physical activity.