Open Access Study protocol

Transforming primary healthcare by including the stakeholders involved in delivering care to people living in poverty: EQUIhealThY study protocol

Christine Loignon1*, Catherine Hudon1, Alexandrine Boudreault-Fournier2, Sophie Dupéré3, Ann C Macaulay4, Pierre Pluye4, Isabelle Gaboury1, Jeannie L Haggerty5, Martin Fortin1, Émilie Goulet1, Mireille Lambert6, Luce Pelissier-Simard1, Sophie Boyer7, Marianne de Laat7, Francine Lemire8, Louise Champagne9 and Martin Lemieux10

Author Affiliations

1 Faculty of Medicine and Health Sciences, Department of Family Medicine, Université de Sherbrooke, Québec, Canada

2 Department of Anthropology, University of Victoria, Victoria, British-Colombia, Canada

3 Faculty of Nursing, Université Laval, Québec, Canada

4 Participatory Research at McGill, McGill University, Québec, Canada

5 Department of Family Medicine, McGill University, Québec, Canada

6 Centre de santé et services sociaux du Chicoutimi, Québec, Canada

7 ATD Fourth World Movement Canada, Québec, Canada

8 The College of Family Physicians of Canada, Mississauga, ON, Canada

9 Academic Primary Care Unit Charles-LeMoyne, Québec, Canada

10 Academic Primary Care Unit Chicoutimi, Québec, Canada

For all author emails, please log on.

BMC Health Services Research 2013, 13:92  doi:10.1186/1472-6963-13-92

Published: 11 March 2013



Ensuring access to timely and appropriate primary healthcare for people living in poverty is an issue facing all countries, even those with universal healthcare systems. The transformation of healthcare practices and organization could be improved by involving key stakeholders from the community and the healthcare system in the development of research interventions. The aim of this project is to stimulate changes in healthcare organizations and practices by encouraging collaboration between care teams and people living in poverty. Our objectives are twofold: 1) to identify actions required to promote the adoption of professional practices oriented toward social competence in primary care teams; and 2) to examine factors that would encourage the inclusion of people living in poverty in the process of developing social competence in healthcare organizations.


This study will use a participatory action research design applied in healthcare organizations. Participatory research is an increasingly recognized approach that is helpful for involving the people for whom the research results are intended. Our research team consists of 19 non-academic researchers, 11 academic researchers and six partners. A steering committee composed of academic researchers and stakeholders will have a decision-making role at each step, including knowledge dissemination and recommendations for new interventions. In this project we will adopt a multiphase approach and will use a variety of methods, including photovoice, group discussions and interviews.


The proposed study will be one of only a few using participatory research in primary care to foster changes aimed at enhancing quality and access to care for people living in poverty. To our knowledge this will be the first study to use photovoice in healthcare organizations to promote new interventions. Our project includes partners who are targeted for practice changes and improvements in delivering primary care to persons living in poverty. By involving knowledge users, including service recipients, our study is more likely to produce a transformation of professional practices and encourage healthcare organizations to take into account the needs of persons living in poverty.

Participatory research; Poverty; Primary care; Photovoice; Knowledge transfer