This study aims to evaluate the socioeconomic and health impacts of nursing-led livelihood programs among indigenous women in Sitio Monicayo, Pampanga, Philippines. The programs, initiated in 2016, include bracelet making, rag making, and liquid dishwashing. Using an explanatory sequential mixed methods design, Phase 1 surveys Aeta women to assess changes in household income, employment, and six domains: Program Benefits, Facilitation, Self-Confidence, Resilience, Future Intentions, and Barriers. Nonparametric analyses are used to examine program outcomes. Phase 2 involves semi-structured interviews with a subset of participants to contextualize quantitative results, focusing on nutrition, stress reduction, access to medicines, preventive care, and caregiving. Integration through joint displays is planned to highlight alignment and discordance between survey scores and lived experiences. The study seeks to explore the role of nursing-led livelihood interventions in addressing both economic empowerment and social determinants of health, in alignment with the Sustainable Development Goals on poverty, good health and well-being, and decent work.
This study investigates the socioeconomic and health outcomes of nursing-initiated livelihood programs implemented among indigenous Aeta women in Sitio Monicayo, Pampanga, Philippines. The livelihood programs-bracelet making, rag making, and liquid dishwashing-were introduced in 2016 by nursing faculty in partnership with the local community. The research employs an explanatory sequential mixed methods design. In Phase 1, a nonrandomized cross-sectional survey is conducted with Aeta women who have participated in the livelihood programs for at least six months. Outcomes include household income change, employment shifts, and six composite domains: Program Benefits, Facilitation, Self-Confidence, Resilience, Future Intentions, and Barriers. Nonparametric analyses (Wilcoxon signed-rank, McNemar-Bowker, Kruskal-Wallis, and Spearman's correlations) are performed using SPSS v29. In Phase 2, semi-structured interviews are conducted with a purposively selected subgroup of participants to contextualize the quantitative findings. Interviews explore barriers and enablers of participation, and their impact on nutrition, stress reduction, preventive care, and caregiving roles. Thematic analysis follows Braun and Clarke's framework, with member checking used to validate findings. Integration is achieved through joint displays to align, complement, or contrast quantitative and qualitative outcomes. Data quality assurance: Data entry is checked for completeness and internal consistency. Predefined rules for range and coding consistency are applied across variables. A pilot test is conducted before main data collection to ensure reliability and validity of measures. Source data verification is performed by cross-checking survey and interview records with program participation logs. Sample size: The sample size (N=25 for survey, n=10 for interviews) is based on available program participants and is designed to capture both breadth and depth of experience. Statistical analysis plan: The primary quantitative outcomes are household income change and employment shifts. Secondary outcomes include composite scores for empowerment and barriers. Qualitative findings are coded inductively and deductively, and integrated with quantitative data to explain mechanisms and identify discordances. This study was reviewed and approved by the Angeles University Foundation Ethics Review Committee (2024-CON-Faculty-004).
Study Type
OBSERVATIONAL
Enrollment
25
A set of community-based livelihood initiatives introduced in 2016 and facilitated by nursing faculty in partnership with local leaders. Activities included bracelet making, rag making, and liquid dishwashing. The programs aimed to provide sustainable income, build women's confidence and skills, and indirectly improve health outcomes by addressing poverty-related social determinants of health.
Angeles University Foundation
Angeles City, Pampanga, Philippines
Household Income Change
Change in reported monthly household income before and after participation in livelihood programs, measured using self-reported survey data. Analyzed using Wilcoxon signed-rank test.
Time frame: (pre-program, recalled) and at enrollment (current, 2024)
Employment Status Shift
Change in primary employment status (self-employment, wage work, farming/fishing, or unemployed) before and after program participation, measured using categorical survey data. Analyzed using McNemar-Bowker test.
Time frame: From pre-program participation (recalled baseline) to current status at enrollment (2024)
Program Benefits Score
Composite score based on a 5-item questionnaire developed for this study, using a 5-point Likert scale (1 = Strongly Disagree to 5 = Strongly Agree), Range: 1-5. Interpretation: Higher scores indicate greater perceived program benefits (better outcome).
Time frame: At enrolment (2024)
Self-Confidence and Skill Development Score
Composite score based on a 6-item questionnaire developed for this study, using a 5-point Likert scale (1 = Strongly Disagree to 5 = Strongly Agree). Range: 1-5. Interpretation: Higher scores indicate greater self-confidence and skill development (better outcome).
Time frame: At enrolment (2024)
Facilitation and Partnerships Score
Composite score based on a 4-item questionnaire developed for this study, using a 5-point Likert scale (1 = Strongly Disagree to 5 = Strongly Agree). Range: 1-5. Interpretation: Higher scores indicate stronger program facilitation and organizational support (better outcome).
Time frame: At enrolment (2024)
Basic Needs and Economic Resilience Score
Composite score based on a 5-item questionnaire developed for this study, using a 5-point Likert scale (1 = Strongly Disagree to 5 = Strongly Agree). Range: 1-5. Interpretation: Higher scores indicate greater ability to meet household needs and manage financial shocks (better outcome).
Time frame: At enrolment (2024)
Future Intentions Score
Composite score based on a 3-item questionnaire developed for this study, using a 5-point Likert scale (1 = Strongly Disagree to 5 = Strongly Agree). Range: 1-5. Interpretation: Higher scores indicate stronger plans for sustaining or expanding program participation and work opportunities (better outcome).
Time frame: At enrolment (2024).
Perceived Barriers Score
Composite score based on a 6-item questionnaire developed for this study, using a 5-point Likert scale (1 = Strongly Disagree to 5 = Strongly Agree). Range: 1-5. Interpretation: Higher scores indicate greater perceived barriers (worse outcome).
Time frame: At enrolment (2024).
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