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Klepac B, Mowle A, Riley T, Craike M. Government, governance, and place-based approaches: lessons from and for public policy. Health Res Policy Syst 2023; 21:126. [PMID: 38031069 PMCID: PMC10685506 DOI: 10.1186/s12961-023-01074-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 11/10/2023] [Indexed: 12/01/2023] Open
Abstract
BACKGROUND Place-based approaches are increasingly applied to address the determinants of health, many of which are complex problems, to ultimately improve population health outcomes. Through public policy, government actions can affect the effectiveness of place-based approaches by influencing the conceptualisation, development, implementation, governance, and/or evaluation of place-based approaches. Despite the important role of public policy, there has been limited examination of public policy related to place-based approaches. We add to the limited knowledge base by analysing Australian national public policy, to explore: (1) the definitions, conceptualisations, and characteristics of place-based approaches in public policy; (2) the government's perception and communication of its role in place-based approaches; and (3) the extent to which government policy reflects the necessary conditions for successful place-based governance developed by Marsh and colleagues, namely localised context, embedded learning, and reciprocal accountability. METHODS This research was underpinned by the Theory of Systems Change and methodologically informed by the READ approach to document analysis. Ritchie and Spencer's framework method was utilised to analyse the data. RESULTS We identified and reviewed 67 policy documents. In terms of conceptualisation, common characteristics of place-based approaches related to collaboration, including community in decision-making, responsiveness to community needs, and suitability of place-based approaches to address complex problems and socio-economic determinants of health. Three roles of government were identified: funder, partner, and creator of a supportive policy environment. From the three criteria for successful place-based governance, localised context was the most dominant across the documents and reciprocal accountability the least. CONCLUSIONS Based on our findings, we drew key implications for public policy and research. There was a disproportionate emphasis on the bottom-up approach across the documents, which presents the risk of diminishing government interest in place-based approaches, potentially burdening communities experiencing disadvantage beyond their capacities. Governments engaged in place-based approaches should work towards a more balanced hybrid approach to place-based approaches that maintain the central functions of government while allowing for successful place-based governance. This could be achieved by promoting consistency in conceptualisations of 'place-based', employing an active role in trust building, advancing the creation of a supportive policy environment, and embedding 'learning' across place-based approaches.
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Affiliation(s)
- Bojana Klepac
- Mitchell Institute for Education and Health Policy, Victoria University, Footscray Park Campus, Pathways in Place, Melbourne, VIC, Australia.
| | - Amy Mowle
- Mitchell Institute for Education and Health Policy, Victoria University, Footscray Park Campus, Pathways in Place, Melbourne, VIC, Australia
| | - Therese Riley
- Mitchell Institute for Education and Health Policy, Victoria University, Footscray Park Campus, Pathways in Place, Melbourne, VIC, Australia
| | - Melinda Craike
- Mitchell Institute for Education and Health Policy, Victoria University, Footscray Park Campus, Pathways in Place, Melbourne, VIC, Australia
- Institute for Health and Sport, Victoria University, Melbourne, VIC, Australia
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Lamph G, Nowland R, Boland P, Pearson J, Connell C, Jones V, Wildbore E, L Christian D, Harris C, Ramsden J, Gardner K, Graham-Kevan N, McKeown M. Relational practice in health, education, criminal justice, and social care: a scoping review. Syst Rev 2023; 12:194. [PMID: 37833785 PMCID: PMC10571424 DOI: 10.1186/s13643-023-02344-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 09/04/2023] [Indexed: 10/15/2023] Open
Abstract
BACKGROUND Establishing and maintaining relationships and ways of connecting and being with others is an important component of health and wellbeing. Harnessing the relational within caring, supportive, educational, or carceral settings as a systems response has been referred to as relational practice. Practitioners, people with lived experience, academics and policy makers, do not yet share a well-defined common understanding of relational practice. Consequently, there is potential for interdisciplinary and interagency miscommunication, as well as the risk of policy and practice being increasingly disconnected. Comprehensive reviews are needed to support the development of a coherent shared understanding of relational practice. METHOD This study uses a scoping review design providing a scope and synthesis of extant literature relating to relational practice focussing on organisational and systemic practice. The review aimed to map how relational practice is used, defined and understood across health, criminal justice, education and social work, noting any impacts and benefits reported. Searches were conducted on 8 bibliographic databases on 27 October 2021. English language articles were included that involve/discuss practice and/or intervention/s that prioritise interpersonal relationships in service provision, in both external (organisational contexts) and internal (how this is received by workers and service users) aspects. RESULTS A total of 8010 relevant articles were identified, of which 158 met the eligibility criteria and were included in the synthesis. Most were opinion-based or theoretical argument papers (n = 61, 38.60%), with 6 (3.80%) critical or narrative reviews. A further 27 (17.09%) were categorised as case studies, focussing on explaining relational practice being used in an organisation or a specific intervention and its components, rather than conducting an evaluation or examination of the effectiveness of the service, with only 11 including any empirical data. Of the included empirical studies, 45 were qualitative, 6 were quantitative, and 9 mixed methods studies. There were differences in the use of terminology and definitions of relational practice within and across sectors. CONCLUSION Although there may be implicit knowledge of what relational practice is the research field lacks coherent and comprehensive models. Despite definitional ambiguities, a number of benefits are attributed to relational practices. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42021295958.
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Affiliation(s)
- Gary Lamph
- School of Nursing and Midwifery, Edge Hill University, Lancashire Ormskirk, UK
| | - Rebecca Nowland
- School of Nursing and Midwifery, University of Central Lancashire, Preston, UK.
| | - Paul Boland
- IMPlementation and Capacity Building Team (IMPaCT), Applied Health Research Hub (AHRh), University of Central Lancashire, Preston, UK
| | - Jayn Pearson
- Criminal Justice Partnership, University of Central Lancashire, Preston, UK
| | - Catriona Connell
- Salvation Army Centre for Addiction Services and Research, Faculty of Social Sciences, University of Stirling, Stirling, UK
| | - Vanessa Jones
- School of Psychology and Counselling, The Open University, Milton Keynes, UK
| | | | - Danielle L Christian
- IMPlementation and Capacity Building Team (IMPaCT), Applied Health Research Hub (AHRh), University of Central Lancashire, Preston, UK
| | - Catherine Harris
- Health Technology Assessment Unit, University of Central Lancashire, Preston, UK
| | | | - Kathryn Gardner
- School of Psychology and Humanities, University of Central Lancashire, Preston, UK
| | - Nicola Graham-Kevan
- School of Psychology and Humanities, University of Central Lancashire, Preston, UK
| | - Mick McKeown
- School of Nursing and Midwifery, University of Central Lancashire, Preston, UK
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Popay J, Halliday E, Mead R, Townsend A, Akhter N, Bambra C, Barr B, Anderson de Cuevas R, Daras K, Egan M, Gravenhorst K, Janke K, Kasim AS, McGowan V, Ponsford R, Reynolds J, Whitehead M. Investigating health and social outcomes of the Big Local community empowerment initiative in England: a mixed method evaluation. Public Health Res (Southampt) 2023; 11:1-147. [PMID: 37929801 DOI: 10.3310/grma6711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2023] Open
Abstract
Background Most research on community empowerment provides evidence on engaging communities for health promotion purposes rather than attempts to create empowering conditions. This study addresses this gap. Intervention Big Local started in 2010 with £271M from the National Lottery. Ending in 2026, it gives 150 relatively disadvantaged communities in England control over £1M to improve their neighbourhoods. Objective To investigate health and social outcomes, at the population level and among engaged residents, of the community engagement approach adopted in a place-based empowerment initiative. Study design, data sources and outcome variables This study reports on the third wave of a longitudinal mixed-methods evaluation. Work package 1 used a difference-in-differences design to investigate the impact of Big Local on population outcomes in all 150 Big Local areas compared to matched comparator areas using secondary data. The primary outcome was anxiety; secondary outcomes included a population mental health measure and crime in the neighbourhood. Work package 2 assessed active engagement in Big Local using cross-sectional data and nested cohort data from a biannual survey of Big Local partnership members. The primary outcome was mental well-being and the secondary outcome was self-rated health. Work package 3 conducted qualitative research in 14 Big Local neighbourhoods and nationally to understand pathways to impact. Work package 4 undertook a cost-benefit analysis using the life satisfaction approach to value the benefits of Big Local, which used the work package 1 estimate of Big Local impact on life satisfaction. Results At a population level, the impacts on 'reporting high anxiety' (-0.8 percentage points, 95% confidence interval -2.4 to 0.7) and secondary outcomes were not statistically significant, except burglary (-0.054 change in z-score, 95% confidence interval -0.100 to -0.009). There was some effect on reduced anxiety after 2017. Areas progressing fastest had a statistically significant reduction in population mental health measure (-0.053 change in z-score, 95% confidence interval -0.103 to -0.002). Mixed results were found among engaged residents, including a significant increase in mental well-being in Big Local residents in the nested cohort in 2018, but not by 2020; this is likely to be COVID-19. More highly educated residents, and males, were more likely to report a significant improvement in mental well-being. Qualitative accounts of positive impacts on mental well-being are often related to improved social connectivity and physical/material environments. Qualitative data revealed increasing capabilities for residents' collective control. Some negative impacts were reported, with local factors sometimes undermining residents' ability to exercise collective control. Finally, on the most conservative estimate, the cost-benefit calculations generate a net benefit estimate of £64M. Main limitations COVID-19 impacted fieldwork and interpretation of survey data. There was a short 4-year follow-up (2016/20), no comparators in work package 2 and a lack of power to look at variations across areas. Conclusions Our findings suggest the need for investment to support community organisations to emerge from and work with communities. Residents should lead the prioritisation of issues and design of solutions but not necessarily lead action; rather, agencies should work as equal partners with communities to deliver change. Funding This project was funded by the National Institute for Health and Care Research (NIHR) Public Health Research Programme (16/09/13) and will be published in full in Public Health Research; Vol. 11, No. 9. See the NIHR Journals Library website for further project information.
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Affiliation(s)
- Jennie Popay
- Division of Health Research, Lancaster University, Lancaster, UK
| | - Emma Halliday
- Division of Health Research, Lancaster University, Lancaster, UK
| | - Rebecca Mead
- Division of Health Research, Lancaster University, Lancaster, UK
| | - Anne Townsend
- Division of Health Research, Lancaster University, Lancaster, UK
| | - Nasima Akhter
- Department of Anthropology, Durham University, Durham, UK
| | - Clare Bambra
- Population Health Sciences Institute, Newcastle University, Newcastle-upon-Tyne, UK
| | - Ben Barr
- Department of Public Health, Policy and Systems, The University of Liverpool, Liverpool, UK
| | | | - Konstantinos Daras
- Department of Public Health, Policy and Systems, The University of Liverpool, Liverpool, UK
| | - Matt Egan
- Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK
| | - Katja Gravenhorst
- Department of Health Services Research and Policy, London School of Hygiene & Tropical Medicine, London, UK
| | - Katharina Janke
- Division of Health Research, Lancaster University, Lancaster, UK
| | | | - Victoria McGowan
- Population Health Sciences Institute, Newcastle University, Newcastle-upon-Tyne, UK
| | - Ruth Ponsford
- Department of Health Services Research and Policy, London School of Hygiene & Tropical Medicine, London, UK
| | - Joanna Reynolds
- Division of Health Research, Lancaster University, Lancaster, UK
| | - Margaret Whitehead
- Department of Public Health, Policy and Systems, The University of Liverpool, Liverpool, UK
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Rong T, Ristevski E, Carroll M. Exploring community engagement in place-based approaches in areas of poor health and disadvantage: A scoping review. Health Place 2023; 81:103026. [PMID: 37084705 DOI: 10.1016/j.healthplace.2023.103026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 03/18/2023] [Accepted: 04/03/2023] [Indexed: 04/23/2023]
Abstract
A scoping review was conducted to explore the characteristics, barriers, and enablers of community engagement in place-based approaches to improving health outcomes in a designated area of poor health and disadvantage. The Joanna Briggs Institute methodology for scoping reviews was used. Forty articles met the inclusion criteria of which 31 were conducted in the United Kingdom, United States, Canada, or Australia, and 70% used qualitative methods. The health initiatives were delivered in multiple settings including neighbourhoods, towns, and regions and with a range of population groups including Indigenous and migrant communities. Trust, power, and cultural considerations were the most significant barriers and enablers to community participation in place-based approaches. Developing trust is key to success in community-led, place-based initiatives.
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Affiliation(s)
- Tanya Rong
- Monash Rural Health - Churchill, Monash University, Northways Road, Churchill, Victoria, 3842, Australia.
| | - Eli Ristevski
- Monash Rural Health - Warragul, Monash University, 15 Sargeant Street, Warragul, Victoria, 3820, Australia.
| | - Matthew Carroll
- Monash Rural Health - Churchill, Monash University, Northways Road, Churchill, Victoria, 3842, Australia.
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Loblay V, Garvey K, Shiell A, Kavanagh S, Hawe P. Icing or cake? Grant competitions as a model for funding chronic disease prevention in Tasmania, Australia. Health Promot Int 2022; 37:6722650. [PMID: 36166260 PMCID: PMC9514227 DOI: 10.1093/heapro/daac115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Competitive grant funding is a well-established mechanism for generating activity and interventions in the field of chronic disease prevention. Yet grant competitions may be burdensome for organizations, and money may not be enough to bring about lasting change in communities. In this study, we explore the dynamics of awarding and receiving money in the context of a state-level government grant competition to support community organizations and promote community-driven action for health and well-being in Tasmania, Australia. Drawing on reflections of successful grant recipients and real-time observation of grant decision-making, we consider the role and value of grant competitions both for individual organizations and for generating broader change processes. We found that grant competitions operated according to an ‘icing-on-the-cake’ approach to funding, whereby money was provided for extra activities and new initiatives. In this way, the grant competition was valuable not only for stimulating new programme activities but also to effect broader organizational change, such as developing planning capacity, igniting new directions and pushing organizations towards ‘health’-focused activities. But for smaller organizations, grant funding was often stretched to support core work (i.e. cake rather than icing). Grants targeting specific focus areas could be a drain on resources if they diverted staff time away from core activities. We suggest an alternative approach to funding in which grants are able to be more responsive to the needs of community organizations and the support they require, as well as to desired outcomes. We describe the policy response to the results to date.
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Affiliation(s)
- Victoria Loblay
- The Australian Prevention Partnership Centre, based at Menzies Centre for Health Policy and Economics, Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, New South Wales, Australia.,Youth Mental Health and Technology Team, Brain and Mind Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - Kate Garvey
- Department of Health, Tasmanian Government, Hobart, Tasmania, Australia.,School of Psychology and Public Health, La Trobe University, Melbourne, Victoria, Australia
| | - Alan Shiell
- School of Psychology and Public Health, La Trobe University, Melbourne, Victoria, Australia
| | - Shane Kavanagh
- School of Health & Social Development, Faculty of Health, Deakin University, Geelong, Victoria, Australia
| | - Penelope Hawe
- The Australian Prevention Partnership Centre, based at Menzies Centre for Health Policy and Economics, Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, New South Wales, Australia
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Popay J, Kaloudis H, Heaton L, Barr B, Halliday E, Holt V, Khan K, Porroche-Escudero A, Ring A, Sadler G, Simpson G, Ward F, Wheeler P. System resilience and neighbourhood action on social determinants of health inequalities: an English Case Study. Perspect Public Health 2022; 142:213-223. [PMID: 35801904 PMCID: PMC9284076 DOI: 10.1177/17579139221106899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
AIMS This article seeks to make the case for a new approach to understanding and nurturing resilience as a foundation for effective place-based co-produced local action on social and health inequalities. METHODS A narrative review of literature on community resilience from a public health perspective was conducted and a new concept of neighbourhood system resilience was developed. This then shaped the development of a practical programme of action research implemented in nine socio-economically disadvantaged neighbourhoods in North West England between 2014 and 2019. This Neighbourhood Resilience Programme (NRP) was evaluated using a mixed-method design comprising: (1) a longitudinal household survey, conducted in each of the Neighbourhoods For Learning (NFLs) and in nine comparator areas in two waves (2015/2016 and 2018/2019) and completed in each phase by approximately 3000 households; (2) reflexive journals kept by the academic team; and (3) semi-structured interviews on perceptions about the impacts of the programme with 41 participants in 2019. RESULTS A difference-in-difference analysis of household survey data showed a statistically significant increase of 7.5% (95% confidence interval (CI), 1.6 to 13.5) in the percentage of residents reporting that they felt able to influence local decision-making in the NFLs relative to the residents in comparator areas, but no effect attributable to the NRP in other evaluative measures. The analysis of participant interviews identified beneficial impacts of the NRP in five resilience domains: social connectivity, cultural coherence, local decision-making, economic activity, and the local environment. CONCLUSION Our findings support the need for a shift away from interventions that seek solely to enhance the resilience of lay communities to interventions that recognise resilience as a whole systems phenomenon. Systemic approaches to resilience can provide the underpinning foundation for effective co-produced local action on social and health inequalities, but they require intensive relational work by all participating system players.
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Affiliation(s)
- J Popay
- Professor, Division of Health Research, Lancaster University, Lancaster, UK
| | - H Kaloudis
- Senior Research Associate, Division of Health Research, Lancaster University, Bailrigg, Lancaster LA1 4YE, UK
| | - L Heaton
- Senior Manager CLAHRC Legacy Project, Division of Health Research, Lancaster University, Lancaster, UK
| | - B Barr
- Professor, Department of Public Health, Policy and Systems, University of Liverpool, Liverpool, UK
| | - E Halliday
- Senior Research Fellow, Division of Health Research, Lancaster University, Lancaster, UK
| | - V Holt
- Senior Research Associate, Division of Health Research, Lancaster University, Lancaster, UK
| | - K Khan
- Senior Research Associate, Division of Health Research, Lancaster University, Lancaster, UK
| | - A Porroche-Escudero
- Senior Research Associate, Lancaster Environment Centre, Lancaster University, Lancaster, UK
| | - A Ring
- Research Associate, Institute of Population Health, University of Liverpool, Liverpool, UK
| | - G Sadler
- Senior Research Associate, Division of Health Research, Lancaster University, Lancaster, UK
| | - G Simpson
- Research Fellow, Faculty of Medicine, University of Southampton, Southampton, UK
| | - F Ward
- Senior Research Associate, Division of Health Research, Lancaster University, Lancaster, UK
| | - P Wheeler
- EPBHC Theme Manager, Division of Health Research, Lancaster University, Lancaster, UK
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Kavanagh SA, Hawe P, Shiell A, Mallman M, Garvey K. Soft infrastructure: the critical community-level resources reportedly needed for program success. BMC Public Health 2022; 22:420. [PMID: 35236315 PMCID: PMC8889705 DOI: 10.1186/s12889-022-12788-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Accepted: 02/09/2022] [Indexed: 11/24/2022] Open
Abstract
Background The mechanisms typically used to fund health promotion in communities, either as part of an effort to scale-up programs or to support the design of local activities, often pay insufficient attention to the foundational means of enhancing well-being. Only recently have researchers begun to critically ‘unpack’ how funding processes connect with and activate local community capacities. Methods We conducted a thematic analysis of 33 interviews with policy and program administrators in public health and local community workers and volunteers. We invited them to expound on their understandings of resources - specifically, what needs to be in place to make funded programs successful and/or what do communities draw on to make funded programs effective. Results Policy and program administrators reflected mostly on the importance of traditional resources, such as adequate funding and staffing. Community-based participants often went further to describe psychological and sociological resources – the “soft infrastructure” which included trust and hope. Both groups emphasised the importance of building networks and relationships at multiple levels. Community workers also provided examples of how resources grow and improve in value in combination with other processes or through pathways of resource use or resource distribution. So, resources like information/knowledge are made more valuable when relayed locally. Physical amenities (e.g., meeting spaces, kitchens) have an instrumental role, but also act powerfully as a symbolic resource for identity. Participants reported that funding processes can damage the resources required for community health improvement. Funding instability undermines capacity. The ongoing threat of funding removal was described by one administrator as community “bullying”. Conclusions Processes of health promotion funding, and even standard processes of program scale-up and readiness assessment, risk underestimating the range of resources that are fundamental for community health improvement, particularly among disadvantaged communities. Funders should design ways to resource communities so that there is constant attention to and coaching of critically important diverse processes of resource growth, independent of program-specific funds. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-12788-8.
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Affiliation(s)
- Shane A Kavanagh
- School of Health & Social Development, Faculty of Health, Deakin University, Geelong, Victoria, Australia. .,The Australian Prevention Partnership Centre, 1240, Haymarket, New South Wales, Australia.
| | - Penelope Hawe
- Menzies Centre for Health Policy and Economics, University of Sydney, Sydney, Australia
| | - Alan Shiell
- Department of Public Health, School of Psychology and Public Health, La Trobe University, Bundoora, Victoria, Australia
| | - Mark Mallman
- Department of Public Health, School of Psychology and Public Health, La Trobe University, Bundoora, Victoria, Australia
| | - Kate Garvey
- Department of Public Health, School of Psychology and Public Health, La Trobe University, Bundoora, Victoria, Australia.,Department of Health, Hobart, Tasmania, Australia
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Popay J, Whitehead M, Ponsford R, Egan M, Mead R. Power, control, communities and health inequalities I: theories, concepts and analytical frameworks. Health Promot Int 2021; 36:1253-1263. [PMID: 33382890 PMCID: PMC8515177 DOI: 10.1093/heapro/daaa133] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
This is Part I of a three-part series on community empowerment as a route to greater health equity. We argue that community 'empowerment' approaches in the health field are increasingly restricted to an inward gaze on community psycho-social capacities and proximal neighbourhood conditions, neglecting the outward gaze on political and social transformation for greater equity embedded in foundational statements on health promotion. We suggest there are three imperatives if these approaches are to contribute to increased equity. First, to understand pathways from empowerment to health equity and drivers of the depoliticisation of contemporary empowerment practices. Second, to return to the original concept of empowerment processes that support communities of place/interest to develop capabilities needed to exercise collective control over decisions and actions in the pursuit of social justice. Third, to understand, and engage with, power dynamics in community settings. Based on our longitudinal evaluation of a major English community empowerment initiative and research on neighbourhood resilience, we propose two complementary frameworks to support these shifts. The Emancipatory Power Framework presents collective control capabilities as forms of positive power. The Limiting Power Framework elaborates negative forms of power that restrict the development and exercise of a community's capabilities for collective control. Parts II and III of this series present empirical findings on the operationalization of these frameworks. Part II focuses on qualitative markers of shifts in emancipatory power in BL communities and Part III explores how power dynamics unfolded in these neighbourhoods.
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Affiliation(s)
- Jennie Popay
- Division of Health Research, Lancaster University, Health Innovation One, Lancaster, LA1 4AT, UK
| | - Margaret Whitehead
- Department of Public Health and Policy, Whelan Building, University of Liverpool, Liverpool, L69 3GB, UK
| | - Ruth Ponsford
- Health Services Research & Policy, London School of Hygiene and Tropical Medicine, Tavistock Place, London, WC1H 9SH, UK
| | - Matt Egan
- Health Services Research & Policy, London School of Hygiene and Tropical Medicine, Tavistock Place, London, WC1H 9SH, UK
| | - Rebecca Mead
- Division of Health Research, Lancaster University, Health Innovation One, Lancaster, LA1 4AT, UK
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