Advancing Allyship Through Anti-Oppression Workshops for Public Health Students: A Mixed Methods Pilot Evaluation

Abstract

This pilot mixed methods evaluation describes the impact of an anti-oppression workshop on allyship development among a group of public health graduate students. After completing a mandatory anti-oppression workshop, a survey including closed- and open-ended questions was administered to 41 public health students specializing in health promotion. Closed-ended questions gathered basic demographic data and Likert-type scale responses to assess changes in participant knowledge, awareness, and attitudes surrounding anti-oppression concepts discussed during the workshop, while open-ended questions asked respondents to reflect on how such changes might influence their development as allies. A response rate of 65.85% (27 respondents) was achieved. The majority of the study group were between the ages of 20 and 24 years (74.07%), self-identified as straight (77.8%), and self-identified as non-White (77.8%), while almost the entire group identified as female (92.59%). Five key themes emerged from a directed content analysis of qualitative data, identifying the importance of anti-oppression workshops for allyship development: conducive environments, positionality, knowledge, active listening and learning, and advocacy. These themes were used to construct a mixed methods joint display for comparative interpretation of quantitative and qualitative data. Mixed methods analysis revealed that anti-oppression workshops can promote allyship development by increasing knowledge of key terms and concepts associated with anti-oppression and facilitating critical reflections on power, privilege, and social location. Our findings demonstrate a profound need for ongoing anti-oppression training among future public health students and professionals.

Keywords

health promotion health equity public health graduate student

Anti-oppression is a principled framework that recognizes and challenges the underlying inequities in power and privilege that perpetuate oppression (Preston-Shoot, 1995; Sánchez-Flores, 2017). Anti-oppression has gained significant attention across multiple disciplines and there are several methods of educational delivery, including trainings, workshops, and courses, that aim to promote the uptake of anti-oppressive principles through critical dialogue and engaging activities. Anti-oppression workshops are one method that have assumed an increasingly important role in health promotion (HP)—a prominent and value-laden public health field embracing reflexivity and empowerment, with a large emphasis on allyship (Labonte, 1994; Nixon, 2019).

Allyship has been defined in numerous ways (Vaccaro et al., 2020). Bishop (2002) defines an ally as someone who recognizes the unearned privilege they receive from society’s patterns of injustice and takes responsibility for changing those patterns for the better. Allyship does not follow a single or rigid developmental model but rather is a dynamic, ongoing, and deeply personal process with no decisive end stage (LeMaire et al., 2020). An important step in this process is the awareness of “social location”—a term denoting the intersection of our personal identities (e.g., age, gender, race, sexual orientation, religion, class), social experiences, and behaviors throughout our life course, and how they relate to our differing positions in a social structure (Daynes, 2007).

Many authors have noted the inextricable link between allyship development and anti-oppression training (Murad, 2010; Nixon, 2019). Allyship allows individuals to support those around them and become cognizant of what they can do to promote social change (Garran et al., 2015; Kumashiro, 2012). Encouraging allyship development among public health professionals through the inclusion of anti-oppression workshops is thus integral to achieving the values of health equity and social justice on which public health and HP are based (Issitt, 2003; Robards et al., 2019; Wu et al., 2019).

Although there is a limited amount of studies that focus on teaching anti-oppression in postsecondary education, those that exist highlight the importance of social justice in pedagogy (Garran et al., 2015; Stewart et al., 2014). However, pedagogies that include anti-oppression often exclude allyship. Despite the growing interest in health inequities, power differentials, and allyship in research and practice, the empirical evidence regarding the impact of anti-oppression workshops on allyship development is lacking in public health (Garran et al., 2015; Nixon, 2019; Wu et al., 2019). Thus, we seek to examine how anti-oppression workshops influence allyship development for a group of public health graduate students specializing in HP.

Method

Anti-Oppression Workshop

For the purposes of this pilot evaluation, we focused on a mandatory anti-oppression workshop held for first-year public health graduate students in the HP program at the Dalla Lana School of Public Health. The workshop took place in mid-September 2019, spanned approximately 2 hours, and was facilitated by a local emotional literacy educator with significant experience providing instruction on intersectionality and anti-oppression to schools and workplaces across Ontario, Canada.

The objectives of the workshop were to (1) arrive at a common understanding of anti-oppression terms and concepts, (2) cultivate a critical and intersectional worldview, and (3) build individual comfort, confidence, and collective commitment to navigate public health practice as allies with an anti-oppressive lens.

Study Design

This mixed methods evaluation followed a convergent design with concurrent timing and equal priority of the quantitative and qualitative components (Creswell & Clark, 2018). In alignment with the “questionnaire variant” design described by Creswell and Clark (2018), our evaluation relied on a single survey containing both closed- and open-ended questions. Closed-ended questions gathered basic demographic data and Likert-type scale responses to assess changes in participant knowledge, awareness, and attitudes surrounding anti-oppression concepts discussed during the workshop, while open-ended questions asked respondents to reflect on how such changes might influence their development as allies in HP practice. Compelling quotes from the open-ended questions could thus be used to validate, contrast, or enrich quantitative results gleaned from the closed-ended questions, thereby providing an empirical and more comprehensive account of the relationship between anti-oppression workshops and allyship development. Given the logistic and financial constraints of this student-led study, a rapid mixed methods questionnaire was both feasible and ideally suited to capture the nuanced personal journey of allyship development.

Study Sample and Recruitment

First-year students enrolled in a Master of Public Health —HP program were targeted for recruitment during an HP I class at the end of the Fall 2019 semester, which provided ample time for students to reflect on and apply concepts from the workshop prior to completing the evaluation. Eligibility criteria included (1) enrollment in the Master of Public Health —HP program, (2) registration in the compulsory CHL5801 (HP I) course at the time of data collection, and (3) attendance at the mandatory anti-oppression workshop. Students were thus excluded if they were enrolled in HP I but registered in other programs for which the course served as an elective.

Data Collection

Data collection was completed using the online platform Google Forms. Study aims, estimated length of participation, and anonymity features were outlined on the first page of the study form. Under the informed consent section, participants were asked to respond to a series of closed- and open-ended questions, which respectively formed the quantitative and qualitative components of the data collection process. Informed by relevant literature on allyship development, the survey sought to examine how participation in an anti-oppression workshop might influence allyship in practice for this cohort of future HP professionals. This study was approved by the University of Toronto Health Sciences Research Ethics Board—Protocol No. 38214.

Quantitative, Qualitative, and Mixed Methods Analysis

Descriptive data analysis was conducted using SAS 9.4. Categorical variables were expressed and summarized as frequencies. Qualitative analysis proceeded through a directed content analysis (Hickey & Kipping, 1996; Hsieh & Shannon, 2005; Potter & Levine-Donnerstein, 1999), in which data are coded and counted in the development of theoretically informed themes. As opposed to a conventional inductive content analysis, directed content analysis is more structured and deductive in nature. We thus drew on existing theories and concepts to guide the analysis and produce results that derived from, validated, and extended prevailing knowledge of the phenomenon. Two student reviewers (TTJ and JFB) independently analysed open-ended responses from the survey, developing a set of preliminary codes that drew on concepts and terminology from existing literature on anti-oppression and allyship development (Bhattacharyya et al., 2014; Edwards, 2006; Gibson, 2014; Moeschberger et al., 2006). The reviewers met to discuss codes and resolved any discrepancies in language and/or description. The resulting codebook was then applied to the data, and code frequencies were calculated to determine key insights for use in the development of themes (Hsieh & Shannon, 2005). Biweekly team meetings provided an ongoing opportunity to receive additional feedback on the codebook and reach consensus on the synthesis of core themes. Following incorporation of team insights, reviewers TTJ and JFB performed a final round of analysis, which resulted in a set of five themes informed by existing theories, concepts, and terms from anti-oppression and allyship development literature.

Mixed methods analysis was conducted through the construction of a “joint display,” in which quantitative and qualitative data are integrated for comparative interpretation (Creswell & Clark, 2018). In our joint display, theoretically informed themes were used to organize the table and merge related quantitative and qualitative data. Drawing inspiration from Moseholm et al. (2017), themes and their corresponding quantitative and qualitative data are presented side-by-side in three columns, while a fourth column provides comparative interpretation. Within each organizing theme, the two data sets were compared and their relationship was categorized as one of three types: confirmation (the results from both types of data reinforce one another), discordance (the results from the two data sets are inconsistent or contradictory), or expansion (the results from the two data sets converge or diverge in ways that expand existing knowledge of anti-oppression workshops and allyship development).

Results

Sample sociodemographic characteristics are presented in Table 1. A total of 41 surveys were administered to the CHL5801 HP I class late November 2019, with 27 respondents, a response rate of 65.85%. The majority of the study group were between the ages of 20 and 24 (74.07%), self-identified as “straight” (heterosexual; 77.8%), and self-identified as non-White (77.8%), while almost the entire group identified as female (92.59%).

Table 1.

Participant Demographics.

Characteristic	Responses (n = 27), n (%)
Age (years)
<25	20 (74.07)
≥25	7 (25.93)
Gender
Female	25 (92.59)
Sexual orientation
Straight	21 (77.78)
Sexual minority	6 (22.22)
Race^a
White	6 (22.22)
Non-White	21 (77.78)
Previous education
Health Sciences^b	17 (62.96)
Social Sciences	10 (37.04)

Non-White include African, Caribbean, East Asian, South Asian, and Southeast Asian. ^bHealth Sciences include interdisciplinary, nursing, and sciences.

Directed Content Analysis

Directed content analysis resulted in the generation of five themes, which describe the influence of the anti-oppression workshop on allyship development in this group of HP students: conducive environments, positionality, knowledge, active listening and learning, and advocacy. Themes and their operational definitions are presented in Table 2. Informed by existing literature on anti-oppression and allyship development, these themes were used to identify relevant quotes and quantitative data for use in the mixed methods analysis and construction of the joint display.

Table 2.

Themes Derived by Qualitative Analysis.

Theme	Description
Conducive environments	Systems of oppression (White supremacy, heterosexism, patriarchy, ableism, colonialism, etc.) permeate and are simultaneously perpetuated by institutions of higher learning (Edwards, 2006; Kivel, 2002). Individual classrooms can serve to reinforce these harmful dynamics or, conversely, offer a platform for students to discuss, interrogate, and resist them (Edwards, 2006). If sparked in a safe and open educational environment, these challenging discussions can illuminate the realities of privilege and oppression for students and form the bedrock of allyship development (Gibson, 2014; Moeschberger et al., 2006). This theme highlights that, for some, the anti-oppression workshop promoted a learning environment conducive to allyship development.
Positionality	Many expressed that the anti-oppression workshop stimulated reflexivity with regard to social location and its connection to both personal and institutional bias. This theme reflects two key components of allyship development, namely, a critical understanding of one’s position in the broader sociopolitical context and their attendant role in social justice movements (Bhattacharyya et al., 2014; Edwards, 2006; Moeschberger et al., 2006).
Knowledge	Knowledge acquired through constant learning and unlearning is integral to allyship development (Gibson, 2014). Anti-oppressive language and terminology are particularly significant forms of knowledge in allyship, as they inform our understanding of oppression and shape our responses to it (Carlson et al., 2019; Turney, 2014). However, the discourse of anti-oppression remains highly politicized and contested, often in ways that misconstrue the concept of allyship and, in spite of good intentions, reinforce oppressive power dynamics (Carlson et al., 2019). Clarity and critical engagement with common language and concepts employed in anti-oppressive practice are thus paramount to meaningful allyship and were expressed here as outcomes of the anti-oppression workshop.
Active listening and learning	Beyond supportive learning environments, allyship development requires ongoing learning through active listening. By “revealing, hearing, and understanding unseen others” (Palmer-Mehta, 2016, p. 4180), active listening can contribute to allyship development by illuminating the interlocking systems of oppression that manifest in and affect the day-to-day lives of those in our social, educational, and/or professional lives (Gibson, 2014; Moeschberger et al., 2006). In the context of this evaluation, some students expressed a vision of allyship centered on the practice of active listening, through which they might better understand the experiences of oppression faced by peers with whom they do not share identity or community.
Advocacy	Advocating for social justice beyond the classroom is, for some authors, allyship realization (Bhattacharyya et al., 2014; Edwards, 2006; Moeschberger et al., 2006). Advocacy represents the translation of anti-oppressive values and concepts into tangible action performed by allies, who use their knowledge, skills, and power to support diverse communities or causes and enact transformative social change (Gibson, 2014). Some students in this evaluation expressed that the anti-oppression workshop served to enhance their comfort and capacity to advocate for social justice beyond the classroom—at home, at work, or in other domains of their lives.

Mixed Methods Analysis

The mixed methods joint display is presented in Table 3. For the themes positionality and knowledge, quantitative and qualitative data confirmed one another in ways that reinforced existing literature on allyship development. The anti-oppression workshop increased knowledge of key anti-oppression terms and promoted critical awareness of social locations. These changes advanced allyship development in ways consistent with existing literature, although a one-time workshop may not have provided adequate time to foster deeper understandings of social justice issues. There was discordance between the quantitative and qualitative data with regard to the themes of active listening and learning as well as advocacy. Across open-ended questions respondents expressed visions of allyship concentrated on both active listening and advocacy, yet quantitative support for the development of these skills was weak or lacking altogether. While consistent with literature that emphasizes the lengthy and ongoing process of allyship development (Bhattacharyya et al., 2014; Edwards, 2006; Gibson, 2014; Moeschberger et al., 2006), these results may suggest a shortcoming of the anti-oppression workshop, which focused more on short-term changes in knowledge and awareness than tangible capacity building. Finally, the quantitative and qualitative data organized under the theme conducive environments converged to expand existing knowledge on anti-oppression workshops and allyship development. These data illustrate that anti-oppression workshops can create environments conducive to allyship development for some but not all students. In exposing underlying racial tensions in the cohort, these results urge us to expand our understanding of the allyship development process and confront the challenging question: “who can be an ally?”

Table 3.

Mixed Methods Integration: A Joint Display.

Theme	Proportion	Quotes	Mixed methods interpretation
1. Conducive environments	44.44% of participants agree that they feel more comfortable engaging in conversations about anti-oppression in the classroom51.85% of participants agree that they find the institution’s environment to be supportive for conversations related to social justice and anti-oppression	[A benefit of the anti-oppression workshop was] greater engagement with classmates, getting to know peers, [and becoming] more comfortable speaking up.	Expansion: Qualitative and quantitative data diverge with regard to whether the workshop was able to foster a conducive environment for allyship development. One quote in particular highlights that this divergence may reflect underlying racial tensions in the HP-1 cohort. This insight, alongside the relatively weak quantitative support for this theme, suggests that anti-oppression workshops, and the conducive environments they intend to create, may inadvertently centre the comfort and experiences of White students over students of color and reinforce (rather than mitigate) systems of White privilege.
		[A benefit of the anti-oppression workshop was] increasing [my] ability to have conversations surrounding oppression.
		[The workshop] brought [our] cohort to the same level of comfort discussing things about social justice, oppression, etc.
		[The workshop] sparked conversations between students and got them to begin talking about issues of social justice and oppression.
		[The workshop] created a safe and open space for discussion.
		I think [the workshop] quite inadvertently revealed how much work there is to be done in our cohort regarding racial tensions and white privilege. However, there wasn’t a lot of room to address this in a way that was comfortable for POC students.
2. Positionality	62.96% of participants agree that they feel more aware of institutional biases around anti-oppression terms and concepts74.07% of participants agree that they are more aware of any personal biases they have toward anti-oppression terms and concepts85.19% of participants agree that they have a better sense of their own social location	[The benefits of the anti-oppression workshop were] self-reflection [and] supporting a critical understanding of institutions	Confirmation: The anti-oppression workshop served to promote critical awareness of bias and social location among HP-1 students. These changes were reinforced by qualitative insights, which further identified recognition of positionality as a key feature of allyship. This confirmatory relationship between the quantitative and qualitative data lends credence to existing literature, which emphasize critical understanding of one’s position in the broader sociopolitical context and in processes of social change as key stages of allyship development.
		[The workshop] increased [my] awareness of social positionality and frameworks through which society operates that may be oppressive to others outside of [my own] personal positionality
		[A benefit of the anti-oppression workshop was] considering our own positionality and the power we hold
		[The training promoted] introspection and awareness of positionality, critical awareness of sociopolitical environment . . . challenging [your] own biases and prejudices
		[Embodying allyship means] recognizing [your] own positionality, . . . thinking about systemic structures of oppression rather than focusing on individual acts
3. Knowledge	51.85% of participants agree that they feel more confident in their understanding of social justice issues59.26% of participants agree that they feel more familiar with the term “intersectionality”66.67% of participants agree that they feel more familiar with the term “anti-oppression”	[A benefit of the workshop was] learning more about what [anti-oppression] actually means and how it’s different from other similar terms	Confirmation: The anti-oppression workshop promoted student familiarity with key terms and concepts in anti-oppressive discourse. Many students expressed that this linguistic and conceptual familiarity contributed to their development as allies. However, only half of the students expressed confidence in their understanding of social justice issues, a sentiment that is reflected in the last quote. Together, these data indicate that while a one-time workshop may promote more superficial knowledge of terms and concepts, a deeper understanding of social justice issues likely requires ongoing anti-oppressive education, thereby confirming the prevailing notion that allyship development is a continuous process of learning and unlearning. One does not “arrive” at allyship after a single session but consistently strives to embody allyship through consistent anti-oppressive education and practice.
		[The workshop] brings everyone onto the same page in terms of understanding key concepts of social justice/anti-oppression
		[Allyship looks like] the careful use of inclusive and non-othering language
		[Embodying allyship means] being cognizant of the terminology [you] use
		[The workshop was] good but I think it would be better if the training was ongoing as opposed to just a one-day training. It’s easy to forget things learned in a one-day training and to really gain skills that you can use elsewhere, ongoing trainings are more effective
4. Active listening and learning	N/A	[Embodying allyship means] active listening and constant learning	Discordance: When creating this joint display table, none of the quantitative survey items appeared compatible with this theme. While active listening and learning emerged across open-ended responses about allyship in HP practice, none of the Likert-type scale questions about postworkshop changes in knowledge, awareness, and attitudes seemed to capture this concept. This illustrates a striking but thought-provoking divergence of the data sets and suggests that formal anti-oppression workshops should focus more on content or activities meant to enhance active listening skills, so as to promote the kinds of allyship described by this HP cohort.
		[Allyship looks like] practicing empathy and listening to my peers who have different lived experiences than I do, which allows me to better understand social equity issues I may not have personally experienced
		[Embodying allyship means] increasing self-education, fostering discussion with folks of different backgrounds and experiences
		[Embodying allyship means] being a listener
		[Embodying allyship means] listening more closely to others in discussions around social justice, lived experiences of oppression, etc.
		[Allyship looks like] learning from more marginalized groups and listening to how I can help versus trying to implement my own solutions
5. Advocacy	48.15% of participants feel that they have the skills to engage in conversations about anti-oppression outside of the classroom	[Allyship looks like] advocating for others in spaces where they may not feel included	Discordance: While some respondents described a vision of allyship involving advocacy outside the classroom, less than half felt they had the skills to realize this vision. This discrepancy in the data may reflect a shortcoming of the workshop. Some allyship scholars view social justice advocacy and action as a later stage of allyship development. It is possible that this discordance in the data stems from a one-time workshop that did not adequately equip students with practical skills for social justice advocacy beyond the classroom. This discrepancy may also reflect a diverse pool of student respondents with varying degrees of comfort engaging in such advocacy—a disparity that will only continue to widen without explicit attention to advocacy and capacity building in future anti-oppression trainings.
		[Embodying allyship means] trying to speak up for others and advocate for individuals when they are unable to do so
		[Allyship looks like] creating space for others to speak
		[Embodying allyship means] being aware of the space I take up, advocating for multiple voices and perspectives at work [or] in class

Note. HP = health promotion.

Discussion

In equipping public health students with an anti-oppressive lens and intersectional worldview, the workshop offered a reflexive opportunity for students to develop as allies. The workshop challenged preconceived notions about what anti-oppression learning looks like, as participants reported an improved understanding of allyship through greater active listening, despite this skill not being an explicit aim of the workshop. Participants also reported increased knowledge and understanding of anti-oppression terms and concepts, including a deeper and more critical understanding of their own social location.

Participants articulated deeper insights into the lived experiences of their peers, and how they may use their position of power toward becoming better advocates. However, non-White participants reported discomfort in fully expressing their thoughts during the anti-oppression workshop. Therefore, despite the knowledge that was gained during the workshop, there is a need to further explore how anti-oppression workshops can strive toward creating a safer and more conducive environment for allyship development, in which all participants feel comfortable engaging in challenging conversations.

As public health professionals, a lack of recognition of our role as allies is a disservice to the communities we serve. Public health is meant to protect and improve the health and well-being of all people in society (World Health Organization, 1986). However, our current public health climate is not a reflection of these values. For instance, the role of complex and intersecting social determinants of health is often overlooked in the broader public health landscape (Baker et al., 2018). As health inequities are embedded in institutions such as academia, upstream approaches rooted in anti-oppression must be prioritized to further promote allyship development through HP pedagogy.

This study demonstrates the substantial benefits of anti-oppression workshops in increasing knowledge and awareness as it pertains to allyship development. Given that only half of the participants felt comfortable engaging in conversations about anti-oppression outside the classroom, it is evident that a single workshop is not enough to provide the groundwork for a lifetime of advocacy. Allyship, as cited in the literature, is not achieved through a single learning session or workshop—it is a constant and fluid process we must reflect on and carry throughout our role as public health professionals (LeMaire et al., 2020). Nevertheless, the workshop provided participants with knowledge and awareness around anti-oppressive practices, which is a promising starting point for allyship development.

Implications for Future Practice

Allyship plays an undeniable role in promoting health equity and social justice. However, it has not been adequately explored within public health pedagogies. Future investigations may benefit from testing the applicability of anti-oppression workshops that incorporate allyship development within public health and other health care fields. Future workshops should consider the following: (1) creating safe spaces for non-White students, (2) prioritizing skills-building in active listening and advocacy, and (3) supporting allyship development as an ongoing process beyond workshops. Given the limited evidence, this study may provide the groundwork for other institutions to implement anti-oppression workshops for both public health students and professionals.

Limitations

This study presents some limitations regarding the generalization of results. First, there was a relatively small sample size of 27 respondents, who only represented first-year students enrolled in the Master of Public Health—HP program at the Dalla Lana School of Public Health. Although there was a 65.85% response rate, it is challenging to generalize findings as this represents only a small subset of the population. Additionally, due to time, resources, and data collection constraints, the depth of responses collected for the open-ended questions was limited, affecting the overall saturation of data. Despite these limitations, these findings are extremely beneficial in highlighting the importance of anti-oppression workshops in formal training and allyship development for public health students and professionals.

Conclusion

Anti-oppression training is an important component to include in public health students’ learning and growth. In this evaluation, participants found that the anti-oppression workshop deepened their understanding of the complexities of anti-oppressive practices through the acknowledgement of their own social location. Our findings demonstrate the need for anti-oppression workshops to be embedded in public health pedagogy, as well as the need for training on diversity and enhancing tangible skills such as active listening and advocacy. This evaluation contributes to the limited evidence on anti-oppression workshops in public health pedagogy and outlines recommendations for future practices in public health and other health-related fields.

Footnotes

Acknowledgements

The authors wish to acknowledge the vital contribution of the facilitator, Karen B. K. Chan, for running the anti-oppression workshop.

Declaration of Conflicting Interests

The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding

The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: A modest stipend was received from the department for the workshop.

ORCID iDs

Gifty Djulus

Joseph Friedman Burley

Harsh Naik

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