1
|
van den Bekerom L, van Gestel LC, Schoones JW, Bussemaker J, Adriaanse MA. Health behavior interventions among people with lower socio-economic position: a scoping review of behavior change techniques and effectiveness. Health Psychol Behav Med 2024; 12:2365931. [PMID: 38903803 PMCID: PMC11188964 DOI: 10.1080/21642850.2024.2365931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Accepted: 06/04/2024] [Indexed: 06/22/2024] Open
Abstract
Background Behavior change interventions can unintendedly widen existing socio-economic health inequalities. Understanding why interventions are (in)effective among people with lower socio-economic position (SEP) is essential. Therefore, this scoping review aims to describe what is reported about the behavior change techniques (BCTs) applied within interventions and their effectiveness in encouraging physical activity and healthy eating, and reducing smoking and alcohol consumption according to SEP. Methods A systematic search was conducted in 12 electronic databases, and 151 studies meeting the eligibility criteria were included and coded for health behavioral outcomes, SEP-operationalization, BCTs (type and number) and effectiveness. Results Findings suggest that approaches for measuring, defining and substantiating lower SEP vary. Current studies of behavior change interventions for people of different SEP do not systematically identify BCTs, making systematic evaluation of BCT effectiveness impossible. The effectiveness of interventions is mainly evaluated by overall intervention outcomes and SEP-moderation effects are mostly not assessed. Conclusion Using different SEP-operationalizations and not specifying BCTs hampers systematic evidence accumulation regarding effective (combinations of) BCTs for the low SEP population. To learn which BCTs effectively improve health behaviors among people with lower SEP, future intervention developers should justify how SEP is operationalized and must systematically describe and examine BCTs.
Collapse
Affiliation(s)
- Loes van den Bekerom
- Health Campus The Hague/Department of Public Health and Primary Care, Leiden University Medical Center, The Hague/Leiden, the Netherlands
| | - Laurens C. van Gestel
- Health, Medical and Neuropsychology Unit, Leiden University, Leiden, the Netherlands
| | - Jan W. Schoones
- Directorate of Research Policy, Leiden University Medical Center, Leiden, the Netherlands
| | - Jet Bussemaker
- Health Campus The Hague/Department of Public Health and Primary Care, Leiden University Medical Center, The Hague/Leiden, the Netherlands
- The Institute of Public Administration, Leiden University, Leiden, the Netherlands
| | - Marieke A. Adriaanse
- Health Campus The Hague/Department of Public Health and Primary Care, Leiden University Medical Center, The Hague/Leiden, the Netherlands
- Health, Medical and Neuropsychology Unit, Leiden University, Leiden, the Netherlands
| |
Collapse
|
2
|
Coetzer JA, Loukili I, Goedhart NS, Ket JCF, Schuitmaker-Warnaar TJ, Zuiderent-Jerak T, Dedding C. The potential and paradoxes of eHealth research for digitally marginalised groups: A qualitative meta-review. Soc Sci Med 2024; 350:116895. [PMID: 38710135 DOI: 10.1016/j.socscimed.2024.116895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 04/10/2024] [Accepted: 04/15/2024] [Indexed: 05/08/2024]
Abstract
Whilst the transformation towards digital healthcare is accelerating, there is still a substantial risk of excluding people with a distance to the online world. Groups like people with a low socioeconomic position, people with a migrant background or the elderly, who are already most at risk of experiencing health inequalities, are simultaneously experiencing increased digital exclusion. Researchers play a role in determining how eHealth access is framed and can thus impact how the barriers to its use are addressed. This qualitative meta-review critically evaluates the way researchers (as authors) discuss eHealth use in digitally marginalised groups. Specifically, it seeks to understand how eHealth is framed to address existing health systems problems; how the barriers to eHealth use are presented and which solutions are provided in response; and who authors suggest should be responsible for making eHealth work. The results of this review found four paradoxes in how current literature views eHealth use. Firstly, that health systems problems are complex and nuanced, yet eHealth is seen as a simple answer. Secondly, that there are many political, social and health systems-based solutions suggested to address eHealth use, however most of the identified barriers are individually framed. This focus on personal deficits results in misallocating responsibility for making these systemic improvements. Thirdly, although eHealth is meant to simplify the tasks of patients and healthcare workers, these are the groups most often burdened with the responsibility of ensuring its success. Lastly, despite tailoring eHealth to the user being the most suggested solution, researchers generally speak about groups as a homogenous entity - thus rendering tailoring difficult. Ultimately, this review finds that a shift to focus research on addressing systemic issues on a systems level is necessary to prevent further exacerbating existing health inequalities.
Collapse
Affiliation(s)
- Jessica A Coetzer
- Athena Institute, Faculty of Science, VU University, De Boelelaan 1085, 1081HV, Amsterdam, the Netherlands.
| | - Ibrahim Loukili
- Department of Ethics, Law & Humanities, Amsterdam UMC, De Boelelaan 1089a, F-vleugel medische faculteit, Amsterdam, The Netherlands.
| | - Nicole S Goedhart
- Department of Ethics, Law & Humanities, Amsterdam UMC, De Boelelaan 1089a, F-vleugel medische faculteit, Amsterdam, The Netherlands.
| | - Johannes C F Ket
- VUmc, Medische Bibliotheek, De Boelelaan 1117, 1081 HV, Amsterdam, the Netherlands.
| | | | - Teun Zuiderent-Jerak
- Athena Institute, Faculty of Science, VU University, De Boelelaan 1085, 1081HV, Amsterdam, the Netherlands.
| | - Christine Dedding
- Department of Ethics, Law & Humanities, Amsterdam UMC, De Boelelaan 1089a, F-vleugel medische faculteit, Amsterdam, The Netherlands.
| |
Collapse
|
3
|
Qi Y, Reijneveld SA, Almansa J, Brouwer S, Vrooman JC. Diverging death risks: Mortality as a corollary of economic, social, cultural and person capital. SSM Popul Health 2024; 25:101644. [PMID: 38486801 PMCID: PMC10937154 DOI: 10.1016/j.ssmph.2024.101644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 02/21/2024] [Accepted: 02/22/2024] [Indexed: 03/17/2024] Open
Abstract
Introduction Diverging death risks are associated with a wide range of social factors, including not only education and income but also other economic and non-economic resources. The aim of this study was to assess the association of mortality risks with four types of resources: economic, social, cultural and person capital. Methods We used data of 2,952 participants from the Disparities in the Netherlands survey and annual mortality data from Statistics Netherlands for the period 2014 to 2021. Economic capital was measured through education, income, occupation, home equity, and liquid assets. Social capital was measured by the strength of social ties, the size of the core discussion network, and access to people in resourceful positions; cultural capital by lifestyle, digital skills, and mastery of English, and person capital by self-rated health, impediments to climbing stairs, self-confidence, self-image, people's appearance, and body mass index. To accommodate the fact that each capital was derived from several indicators, we used Partial Least Squares (PLS) Cox Regression. Results In multiple regression, higher economic, cultural, and person capital were associated with lower mortality (hazard ratio, 0.77; 95% confidence interval [CI, 0.65 to 0.90], 0.77 [0.64-0.93] and 0.80; [0.70-0.92]), adjusted for all capital measures and sex. Conclusion The finding that more economic, cultural and person capital is associated with lower mortality provides empirical support for an approach that uses a broad spectrum of capital measures - hitherto rarely included simultaneously in epidemiological research - in order to understand diverging death risks. By integrating sociological concepts, cohort data, and epidemiological research methods, our study highlights the need for further research on the interplay between different forms of resources in shaping health inequalities. In designing public health interventions, we advocate the adoption of a multidimensional capital-based framework for tackling social disparities in mortality.
Collapse
Affiliation(s)
- Yuwei Qi
- University of Groningen, University Medical Center Groningen, Department of Health Sciences, Groningen, the Netherlands
| | - Sijmen A. Reijneveld
- University of Groningen, University Medical Center Groningen, Department of Health Sciences, Groningen, the Netherlands
| | - Josué Almansa
- University of Groningen, University Medical Center Groningen, Department of Health Sciences, Groningen, the Netherlands
| | - Sandra Brouwer
- University of Groningen, University Medical Center Groningen, Department of Health Sciences, Groningen, the Netherlands
| | - J. Cok Vrooman
- Utrecht University, Department of Sociology/ICS, Utrecht, the Netherlands
- The Netherlands Institute for Social Research|SCP, the Netherlands
| |
Collapse
|
4
|
Balasooriyan A, van der Veen MH, Bonifácio CC, Dedding C. Understanding parental perspectives on young children's oral health (≤ 4 years) growing up in a disadvantaged neighbourhood of Amsterdam, the Netherlands: an exploratory study. BMC Public Health 2024; 24:627. [PMID: 38413935 PMCID: PMC10900557 DOI: 10.1186/s12889-024-18073-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 02/12/2024] [Indexed: 02/29/2024] Open
Abstract
BACKGROUND Families' understanding towards oral health problems among young children is poorly studied. More insight into parents' experiences, especially of those living in disadvantaged neighbourhoods, is needed to address persistent oral health inequalities. This qualitative study aims to explore parental perspectives on children's oral health (≤ 4 years) and the opportunities they see to improve children's oral health. METHODS Forty-seven mothers and five fathers with different migration backgrounds from a disadvantaged neighbourhood in Amsterdam, the Netherlands, participated in our study. Semi-structured interviews (n = 27), participant observations (n = 7) and one focus group discussion were conducted. A thematic data analysis was used. RESULTS Parents describe their daily life with young children as busy, hectic and unpredictable. Parents seem to be most concerned about parenting. Mothers, in particular, feel fully responsible for raising their children and managing daily complexities. While most parents value their children's oral health, they all experience challenges. Parents find it hard to limit daily candy intake and to handle unwilling children during tooth brushing. They feel limited support for these issues from their household, social network and professionals. CONCLUSION Parental struggles in children's oral health are complex and interrelated as they occur across family, societal, community and professional levels. Given the complex daily reality of families with young children, establishing and maintaining healthy oral health habits seems not at the top of parents' minds. They ask for advice in the upbringing of their children backed up by social support, increased attention to children's oral health within the community and professional assistance. Collaborating with parents as knowledgeable partners might be the first step in acting upon the endeavour to address oral health inequality among young children.
Collapse
Affiliation(s)
- Awani Balasooriyan
- Department of Preventive Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU Amsterdam, Amsterdam, The Netherlands.
| | - Monique H van der Veen
- Department of Preventive Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU Amsterdam, Amsterdam, The Netherlands
- Department of Paediatric Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU Amsterdam, Amsterdam, The Netherlands
| | - Clarissa Calil Bonifácio
- Department of Paediatric Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU Amsterdam, Amsterdam, The Netherlands
| | - Christine Dedding
- Department of Ethics, Law and Humanities, Amsterdam University Medical Centre (UMC), Amsterdam, The Netherlands
| |
Collapse
|
5
|
Xiao SX, Korous KM, Hewitt SL, Nguyen D. Family economic pressure and early adolescents' prosocial behavior: The importance of considering the types of prosocial behavior. J Adolesc 2023; 95:1220-1231. [PMID: 37211871 DOI: 10.1002/jad.12196] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 04/23/2023] [Accepted: 05/12/2023] [Indexed: 05/23/2023]
Abstract
BACKGROUND Prior research findings are mixed regarding whether prosocial behavior is positively or negatively related to socioeconomic status and its correlates, such as economic pressure. This may be due to the lack of considerations for the type of prosocial behavior. AIMS In this study, we aimed to examine how six types of prosocial behavior (i.e., public, anonymous, compliant, emotional, dire, and altruistic) are related to economic pressure among early adolescents. We hypothesized that family economic pressure would be associated with each type of prosocial behavior in differing ways. MATERIALS & METHODS Participants were 11-14 years old (N = 143, Mage = 12.2 years, SDage = 0.87, 63 boys, 1 trans-identified boy, 55 girls), early adolescents and their parents. Among them, 54.6% were non-Hispanic/Latinx (NH/L) White, 23.8% were NH/L Black, 11.2% were NH/L Asian, 2.1% were NH/L Multiracial, and 8.4% were Hispanic/Latinx. Parents reported family economic pressure and adolescents' six types of prosocial behavior. RESULTS Path analysis revealed that economic pressure was negatively associated with emotional and dire prosocial behavior over and above age, gender, and race/ethnicity. Family economic pressure was unrelated to public, anonymous, compliant, and altruistic prosocial behavior. DISCUSSION These findings show some support for the Family Stress Model, such that economic stress might hinder youth's prosocial development. At the same time, youth may have similar levels of certain types of prosocial behavior regardless of their family's economic pressure. CONCLUSION This research provided insight into the complex relation between economic pressure and youth's prosocial behavior which varies depending on the type of behavior.
Collapse
Affiliation(s)
- Sonya Xinyue Xiao
- Department of Psychological Sciences, Northern Arizona University, Flagstaff, Arizona, USA
| | | | - Sarah L Hewitt
- School of Social and Behavioral Sciences, Arizona State University, Phoenix, Arizona, USA
| | - Diana Nguyen
- T. Denny Sanford School of Social and Family Dynamics, Arizona State University, Tempe, Arizona, USA
| |
Collapse
|
6
|
Livingstone KM, Olstad DL, McNaughton SA, Nejatinamini S, Dollman J, Crawford D, Timperio A. Do food-related capabilities, opportunities and motivations of adolescents mediate the association between socioeconomic position in adolescence and diet quality in early adulthood? Int J Behav Nutr Phys Act 2023; 20:70. [PMID: 37308957 DOI: 10.1186/s12966-023-01477-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 06/01/2023] [Indexed: 06/14/2023] Open
Abstract
BACKGROUND Socio-economic position (SEP) in adolescence may influence diet quality over the life course. However, knowledge of whether individual and environmental determinants of diet quality mediate the longitudinal association between SEP and diet quality is limited. This study examined whether and to what extent food-related capabilities, opportunities and motivations of adolescents mediated the longitudinal association between SEP in adolescence and diet quality in early adulthood overall and by sex. METHODS Longitudinal data (annual surveys) from 774 adolescents (16.9 years at baseline; 76% female) from ProjectADAPT (T1 (baseline), T2, T3) were used. SEP in adolescence (T1) was operationalized as highest level of parental education and area-level disadvantage (based on postcode). The Capabilities, Opportunities and Motivations for Behaviour (COM-B) model was used as a framework to inform the analysis. Determinants in adolescence (T2) included food-related activities and skills (Capability), home availability of fruit and vegetables (Opportunity) and self-efficacy (Motivation). Diet quality in early adulthood (T3) was calculated using a modified version of the Australian Dietary Guidelines Index based on brief dietary questions on intake of foods from eight food groups. Structural equation modelling was used to estimate the mediating effects of adolescents' COM-B in associations between adolescent SEP and diet quality in early adulthood overall and by sex. Standardized beta coefficients (β) and robust 95% confidence intervals (CI) were generated, adjusted for confounders (T1 age, sex, diet quality, whether still at school, and living at home) and clustering by school. RESULTS There was evidence of an indirect effect of area-level disadvantage on diet quality via Opportunity (β: 0.021; 95% CI: 0.003 to 0.038), but limited evidence for parental education (β: 0.018; 95% CI: -0.003 to 0.039). Opportunity mediated 60.9% of the association between area-level disadvantage and diet quality. There was no evidence of an indirect effect via Capability or Motivation for either area-level disadvantage or parental education, or in males and females separately. CONCLUSIONS Using the COM-B model, the home availability of fruit and vegetables (Opportunity) of adolescents explained a large proportion of the association between area-level disadvantage in adolescence and diet quality in early adulthood. Interventions to address poor diet quality among adolescents with a lower SEP should prioritize environmental determinants of diet quality.
Collapse
Affiliation(s)
- Katherine M Livingstone
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, 3220, Australia.
| | - Dana Lee Olstad
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Sarah A McNaughton
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, 3220, Australia
| | - Sara Nejatinamini
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - James Dollman
- Alliance for Research in Exercise, Nutrition and Activity, University of South Australia, Adelaide, 5000, Australia
| | - David Crawford
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, 3220, Australia
| | - Anna Timperio
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, 3220, Australia
| |
Collapse
|
7
|
Dijkstra I, Horstman K. Clarifying how social epidemiological research constructs the category of low socioeconomic status: A response to Kamphuis et al. Soc Sci Med 2023; 317:115610. [PMID: 36542926 DOI: 10.1016/j.socscimed.2022.115610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 12/09/2022] [Indexed: 12/23/2022]
Abstract
In our previous article, published in this journal, we argued that epidemiology has a constructive role with regard to socioeconomic health inequalities. We concluded that, as long as the construction of LSES remains unquestioned, social epidemiology might continue to (re)produce what it examines: LSES populations 'known to be unhealthy'. Recently, in this journal, Kamphuis et al. responded to our article. While they welcomed our reflections, the authors also posed critique to our arguments. In this paper, we respond to that critique and deepen the discussion on the use of (L)SES categories in social epidemiology. For this purpose, we further clarify our arguments and state that in health inequality research it is important to: 1) Pay attention to the unintended effects of research; 2) Consider the origin and effects of explanatory concepts; and 3) reflect on the norms of cultural capital.
Collapse
Affiliation(s)
- Ilse Dijkstra
- Care and Public Health Research Institute (CAPHRI) Maastricht University, Maastricht PO Box 616, 6200, MD, Maastricht, the Netherlands.
| | - Klasien Horstman
- Care and Public Health Research Institute (CAPHRI) Maastricht University, Maastricht PO Box 616, 6200, MD, Maastricht, the Netherlands.
| |
Collapse
|
8
|
Bakker MM, Putrik P, Dikovec C, Rademakers J, Vonkeman HE, Kok MR, Voorneveld-Nieuwenhuis H, Ramiro S, de Wit M, Buchbinder R, Batterham R, Osborne RH, Boonen A. Exploring discordance between Health Literacy Questionnaire scores of people with RMDs and assessment by treating health professionals. Rheumatology (Oxford) 2022; 62:52-64. [PMID: 35438147 PMCID: PMC9788830 DOI: 10.1093/rheumatology/keac248] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 02/21/2022] [Accepted: 03/02/2022] [Indexed: 01/01/2023] Open
Abstract
OBJECTIVES We studied discordance between health literacy of people with rheumatic and musculoskeletal diseases (RMDs) and assessment of health literacy by their treating health professionals, and explored whether discordance is associated with the patients' socioeconomic background. METHODS Patients with RA, spondyloarthritis (SpA) or gout from three Dutch outpatient rheumatology clinics completed the nine-domain Health Literacy Questionnaire (HLQ). Treating health professionals assessed their patients on each HLQ domain. Discordance per domain was defined as a ≥2-point difference on a 0-10 scale (except if both scores were below three or above seven), leading to three categories: 'negative discordance' (i.e. professional scored lower), 'probably the same' or 'positive discordance' (i.e. professional scored higher). We used multivariable multilevel multinomial regression models with patients clustered by health professionals to test associations with socioeconomic factors (age, gender, education level, migration background, employment, disability for work, living alone). RESULTS We observed considerable discordance (21-40% of patients) across HLQ domains. Most discordance occurred for 'Critically appraising information' (40.5%, domain 5). Comparatively, positive discordance occurred more frequently. Negative discordance was more frequently and strongly associated with socioeconomic factors, specifically lower education level and non-Western migration background (for five HLQ domains). Associations between socioeconomic factors and positive discordance were less consistent. CONCLUSION Frequent discordance between patients' scores and professionals' estimations indicates there may be hidden challenges in communication and care, which differ between socioeconomic groups. Successfully addressing patients' health literacy needs cannot solely depend on health professionals' estimations but will require measurement and dialogue. VIDEO ABSTRACT A video abstract of this article can be found at https://www.youtube.com/watch?v=ggnB1rATdQ4.
Collapse
Affiliation(s)
- Mark M Bakker
- Department of Internal Medicine, Division of Rheumatology, Maastricht UMC.,CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht
| | - Polina Putrik
- Department of Internal Medicine, Division of Rheumatology, Maastricht UMC.,CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht
| | - Cédric Dikovec
- Department of Internal Medicine, Division of Rheumatology, Maastricht UMC
| | - Jany Rademakers
- CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht.,Nivel Netherlands Institute for Health Services Research, Utrecht
| | - Harald E Vonkeman
- Department of Psychology, Health and Technology, University of Twente, Enschede.,Department of Rheumatology and Clinical Immunology, Medisch Spectrum Twente, Arthritis Center Twente, Enschede
| | - Marc R Kok
- Department of Rheumatology and Clinical Immunology, Maasstad Hospital, Rotterdam
| | | | - Sofia Ramiro
- Department of Rheumatology, Leiden UMC, Leiden.,Department of Rheumatology, Zuyderland Medical Center, Heerlen
| | - Maarten de Wit
- Tools2Use Patient Association, Amsterdam, The Netherlands
| | - Rachelle Buchbinder
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University.,Monash Department of Musculoskeletal Health and Clinical Epidemiology, Cabrini Health, Melbourne, Australia
| | - Roy Batterham
- Faculty of Public Health, Thammasat University, Bangkok, Thailand
| | - Richard H Osborne
- Centre for Global Health and Equity, Swinburne University of Technology, Melbourne, Australia
| | - Annelies Boonen
- Department of Internal Medicine, Division of Rheumatology, Maastricht UMC.,CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht
| |
Collapse
|
9
|
Louvel S, Soulier A. Biological embedding vs. embodiment of social experiences: How these two concepts form distinct thought styles around the social production of health inequalities. Soc Sci Med 2022; 314:115470. [PMID: 36327636 DOI: 10.1016/j.socscimed.2022.115470] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 09/10/2022] [Accepted: 10/18/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVES This article compares research on biological embedding and the embodiment of social experiences, two concepts proposed in the 1990s to introduce a new perspective on the social production of health inequalities. We draw on Ludwig Fleck's concept of 'thought style' (1935/2008) to question the possible emergence of a common research program around the processes by which the social becomes biological. METHODS We compiled a corpus of 322 articles referring to either biological embedding or to the embodiment of social experiences, identified in the Web of Science core collection and published from 1990 to 2021. We analyzed the articles' use of these concepts using scientometric indicators and qualitative content analysis. RESULTS Initial differences between the research agendas associated with biological embedding and embodiment are strengthened as both concepts circulate around scientific communities studying the social production of health inequalities. Thought styles formed around embedding and embodiment differ significantly in terms of shared references, sets of methods and research questions, and policy recommendations. Research on biological embedding forms a thought style shared by researchers in the biomedical and public health sciences. Conversely, the concept of embodiment of social experiences connects perspectives from biomedical, public health, human and social sciences, and gathers three thought styles, one identical to that of biological embedding and two formed in social epidemiology and in medical anthropology. CONCLUSIONS Acknowledging the differences between the concepts and divergences in their evolution provides an opportunity for identification of topics where thought styles are either complementary or in tension.
Collapse
Affiliation(s)
- Séverine Louvel
- PACTE - Sciences Po Grenoble, 1030 Avenue Centrale, Domaine Universitaire, 38040 Grenoble Cedex 09, France.
| | - Alexandra Soulier
- IHPST - Institut D'histoire et de Philosophie des Sciences et des Techniques (UMR 8590), Maison de La Philosophie - Marin Mersenne, 13, Rue Du Four, 75006 Paris, France.
| |
Collapse
|
10
|
Vossen E, van der Gulden JWJ, van Genabeek JA, Schaap R, Anema JR, Schaafsma FG. Process evaluation of the 'Grip on Health' intervention in general and occupational health practice. BMC Health Serv Res 2022; 22:1459. [PMID: 36451237 PMCID: PMC9713133 DOI: 10.1186/s12913-022-08801-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Accepted: 11/07/2022] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND For working patients with a lower socioeconomic position, health complaints often result from a combination of problems on multiple life domains. To prevent long-term health complaints and absence from work, it is crucial for general and occupational health professionals to adopt a broad perspective on health and to collaborate when necessary. This study aimed to evaluate how the 'Grip on Health' intervention is implemented in general and occupational health practice to address multi-domain problems and to promote interprofessional collaboration. METHOD A process evaluation was performed among 28 general and occupational health professionals, who were trained and implemented the Grip on Health intervention during a six-month period. The 'Measurement Instrument for Determinants of Innovations' was used to evaluate facilitators and barriers for implementing Grip on Health. Data included three group interviews with 17 professionals, a questionnaire and five individual interviews. RESULTS While most health professionals were enthusiastic about the Grip on Health intervention, its implementation was hindered by contextual factors. Barriers in the socio-political context consisted of legal rules and regulations around sickness and disability, professional protocols for interprofessional collaboration, and the Covid-19 pandemic. On the organizational level, lack of consultation time was the main barrier. Facilitators were found on the level of the intervention and the health professional. For instance, professionals described how the intervention supports addressing multi-domain problems and has created awareness of work in each other's healthcare domain. They recognized the relevance of the intervention for a broad target group and experienced benefits of its use. The intervention period was, nevertheless, too short to determine the outcomes of Grip on Health. CONCLUSION The Grip on Health intervention can be used to address problems on multiple life domains and to stimulate interprofessional collaboration. Visualizing multi-domain problems appeared especially helpful to guide patients with a lower socioeconomic position, and a joint training of general and occupational health professionals promoted their mutual awareness and familiarity. For a wider implementation, stakeholders on all levels, including the government and professional associations, should reflect on ways to address contextual barriers to promote a broad perspective on health as well as on collaborative work.
Collapse
Affiliation(s)
- Emma Vossen
- grid.16872.3a0000 0004 0435 165XDepartment of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health research institute, Van der Boechorststraat 7, 1081 BT Amsterdam, Amsterdam, The Netherlands ,grid.450078.e0000 0000 8809 2093HAN University of Applied Sciences, Laan van Scheut 10, 6525 EM Nijmegen, The Netherlands
| | - Joost W. J. van der Gulden
- grid.10417.330000 0004 0444 9382Department of Primary and Community Care, Radboudumc, Geert Grooteplein Noord 21, 6525 EZ Nijmegen, The Netherlands
| | | | - Rosanne Schaap
- grid.16872.3a0000 0004 0435 165XDepartment of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health research institute, Van der Boechorststraat 7, 1081 BT Amsterdam, Amsterdam, The Netherlands
| | - Johannes R. Anema
- grid.16872.3a0000 0004 0435 165XDepartment of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health research institute, Van der Boechorststraat 7, 1081 BT Amsterdam, Amsterdam, The Netherlands
| | - Frederieke G. Schaafsma
- grid.16872.3a0000 0004 0435 165XDepartment of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health research institute, Van der Boechorststraat 7, 1081 BT Amsterdam, Amsterdam, The Netherlands
| |
Collapse
|
11
|
Balasooriyan A, Dedding C, Bonifácio CC, van der Veen MH. Professionals’ perspectives on how to address persistent oral health inequality among young children: an exploratory multi-stakeholder analysis in a disadvantaged neighbourhood of Amsterdam, the Netherlands. BMC Oral Health 2022; 22:488. [DOI: 10.1186/s12903-022-02510-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Accepted: 10/18/2022] [Indexed: 11/16/2022] Open
Abstract
Abstract
Background
Oral health promotion interventions have had limited success in reaching families in disadvantaged neighbourhoods resulting in persistent oral health inequality. This qualitative study provides insight into professionals’ perspectives on children’s poor oral health (≤ 4 years), their perceptions of the roles and responsibilities, and opportunities for child oral health promotion strategies.
Methods
Thirty-Eight professionals from different domains (community, social welfare, general health, dental care, public health, private sector) working in a disadvantaged neighbourhood in Amsterdam, the Netherlands, participated through 24 semi-structured (group) interviews. Transcripts and notes were analysed through thematic analysis.
Results
Professionals indicate that unhealthy diet, children’s non-compliance, poor parental coping, parental low oral health literacy, parent’s negative attitude, family’s daily struggles, and insufficient emphasis on childhood caries prevention in dental practices, general healthcare and social welfare organisations, underlie poor oral health. They hold parents most responsible for improving young children’s oral health, but recognise that families’ vulnerable living circumstances and lack of social support are important barriers. Interestingly, non-dental professionals acknowledge their beneficial role in child oral health promotion, and dental professionals stress the need for more collaboration.
Conclusion
A broad child-, parental-, and societal-centred educational communication strategy is perceived as promising. Professionals working within and outside the dental sector acknowledge that local and collective action is needed. This involves a better understanding of family’s complex daily reality. Furthermore, intensifying child oral health knowledge in dental practices is essential in collaboration with families, general health and social welfare organisations.
Collapse
|
12
|
Kamphuis CBM, Oude Groeniger J, Beenackers MA, Van Lenthe FJ. A wake-up call for social epidemiologists studying health inequalities: Response to Dijkstra & Horstman. Soc Sci Med 2022; 303:115020. [PMID: 35569234 DOI: 10.1016/j.socscimed.2022.115020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Accepted: 05/05/2022] [Indexed: 11/16/2022]
Abstract
In their paper, published in this journal, Dijkstra & Horstman critically reflect on a selection of social epidemiological articles and examine how low socioeconomic status populations are constructed in these articles. They identify four components which they argue represent the "dominant thought style" of this literature: 1) proliferation, 2) generalization, 3) problematization and 4) individualization. We largely agree with their first two points, but strongly disagree with the other two, and explain why in our reply. All in all, we believe that their analysis is a wake-up call for social epidemiologists, rightly pointing to the risk that the relevance and moral origins of the use and study of categories, like 'low socioeconomic status', can easily become less visible, and therefore should be articulated and explained every time.
Collapse
Affiliation(s)
- Carlijn B M Kamphuis
- Department of Interdisciplinary Social Science, Faculty of Social and Behavioural Sciences, Utrecht University, Utrecht, the Netherlands.
| | - Joost Oude Groeniger
- Department of Public Health, Erasmus MC, Rotterdam, the Netherlands; Department of Public Administration and Sociology, Erasmus University Rotterdam, Rotterdam, the Netherlands
| | | | - Frank J Van Lenthe
- Department of Public Health, Erasmus MC, Rotterdam, the Netherlands; Department of Human Geography and Spatial Planning, Faculty of Geosciences, Utrecht University, Utrecht, the Netherlands
| |
Collapse
|
13
|
Fairbrother H, Woodrow N, Crowder M, Holding E, Griffin N, Er V, Dodd-Reynolds C, Egan M, Lock K, Scott S, Summerbell C, McKeown R, Rigby E, Kyle P, Goyder E. ‘It All Kind of Links Really’: Young People’s Perspectives on the Relationship between Socioeconomic Circumstances and Health. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19063679. [PMID: 35329365 PMCID: PMC8950291 DOI: 10.3390/ijerph19063679] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 03/03/2022] [Accepted: 03/12/2022] [Indexed: 02/01/2023]
Abstract
Meaningful inclusion of young people’s perceptions and experiences of inequalities is argued to be critical in the development of pro-equity policies. Our study explored young people’s perceptions of what influences their opportunities to be healthy within their local area and their understandings of health inequalities. Three interlinked qualitative focus group discussions, each lasting 90 to 100 min, with the same six groups of young people (n = 42) aged 13–21, were conducted between February and June 2021. Participants were recruited from six youth groups in areas of high deprivation across three geographical locations in England (South Yorkshire, the North East and London). Our study demonstrates that young people understand that health inequalities are generated by social determinants of health, which in turn influence behaviours. They highlight a complex interweaving of pathways between social determinants and health outcomes. However, they do not tend to think in terms of the social determinants and their distribution as resulting from the power and influence of those who create and benefit from health and social inequalities. An informed understanding of the causes of health inequalities, influenced by their own unique generational experiences, is important to help young people contribute to the development of pro-equity policies of the future.
Collapse
Affiliation(s)
- Hannah Fairbrother
- Health Sciences School, University of Sheffield, Sheffield S10 2LA, UK
- Correspondence:
| | - Nicholas Woodrow
- ScHARR, University of Sheffield, Sheffield S1 4DA, UK; (N.W.); (M.C.); (E.H.); (E.G.)
| | - Mary Crowder
- ScHARR, University of Sheffield, Sheffield S1 4DA, UK; (N.W.); (M.C.); (E.H.); (E.G.)
| | - Eleanor Holding
- ScHARR, University of Sheffield, Sheffield S1 4DA, UK; (N.W.); (M.C.); (E.H.); (E.G.)
| | - Naomi Griffin
- Department of Sport and Exercise Science, Fuse|Durham University, Durham DH1 3HN, UK; (N.G.); (C.D.-R.); (C.S.); (P.K.)
| | - Vanessa Er
- Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK; (V.E.); (M.E.); (K.L.)
| | - Caroline Dodd-Reynolds
- Department of Sport and Exercise Science, Fuse|Durham University, Durham DH1 3HN, UK; (N.G.); (C.D.-R.); (C.S.); (P.K.)
| | - Matt Egan
- Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK; (V.E.); (M.E.); (K.L.)
| | - Karen Lock
- Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK; (V.E.); (M.E.); (K.L.)
| | - Steph Scott
- Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne NE1 4LP, UK;
| | - Carolyn Summerbell
- Department of Sport and Exercise Science, Fuse|Durham University, Durham DH1 3HN, UK; (N.G.); (C.D.-R.); (C.S.); (P.K.)
| | - Rachael McKeown
- Association for Young People’s Health, London SE1 4YR, UK; (R.M.); (E.R.)
| | - Emma Rigby
- Association for Young People’s Health, London SE1 4YR, UK; (R.M.); (E.R.)
| | - Phillippa Kyle
- Department of Sport and Exercise Science, Fuse|Durham University, Durham DH1 3HN, UK; (N.G.); (C.D.-R.); (C.S.); (P.K.)
| | - Elizabeth Goyder
- ScHARR, University of Sheffield, Sheffield S1 4DA, UK; (N.W.); (M.C.); (E.H.); (E.G.)
| |
Collapse
|