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Macassa G, McGrath C, Roy MJ, Stål F, Hiswåls AS, Rashid M, Karlsson U, Olsson R, Silva JP, Vinberg S, Marttila A. Perceptions of Health and Wellbeing Among Employees in a Work Integration Social Enterprise in Sweden. Ann Glob Health 2023; 89:31. [PMID: 37187968 PMCID: PMC10178577 DOI: 10.5334/aogh.4065] [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: 01/25/2023] [Accepted: 04/29/2023] [Indexed: 05/17/2023] Open
Abstract
Background Work Integration Social Enterprises (WISEs) constitute an important vehicle for providing employment opportunities for disadvantaged groups. Objective The goal of this qualitative case study is to explore perceptions of health and wellbeing among employees working in a WISE located in the Gävleborg region, in east central Sweden. Methods Data were gathered using 16 in-depth, semi-structured interviews with the social enterprise employees. Results Findings were categorized into three main categories: the importance of financial independence and societal benefits; team spirit and a sense of belonging; and improved quality of life and wellbeing. Conclusion The participants perceived that working in the WISE gave them a feeling of freedom and increased their self-esteem because of the possibility to earn an income. Also, they were satisfied with their job (e.g., with regard to work quality and flexibility) and believed that their work contributed to society. Moreover, through working in a WISE, the participants felt a sense of belonging and togetherness through interaction with co-workers and managers, and an improved quality of life for themselves and their families.
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Affiliation(s)
- Gloria Macassa
- Department of Public Health and Sports Science, Faculty of Occupational and Health Sciences, University of Gävle, Kungsbacksvägen 47, 80176 Gävle, Sweden
- EPIUnit–Instituto de Saude Publica, Universidade do Porto, Rua das Taipas 135, 4050-600 Porto, Portugal
- Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Rua das Taipas, nº 135, 4050-600 Porto, Portugal
| | - Cormac McGrath
- Department of Education, Stockholm University, Frescativägen 54, 10691 Stockholm, Sweden
| | - Michael J. Roy
- Yunus Centre for Social Business and Health, Glasgow Caledonian University, M201, George Moore Building, Glasgow G4 0BA, United Kingdom
| | - Frida Stål
- Department of Public Health and Sports Science, Faculty of Occupational and Health Sciences, University of Gävle, Kungsbacksvägen 47, 80176 Gävle, Sweden
| | - Anne Sofie Hiswåls
- Department of Public Health and Sports Science, Faculty of Occupational and Health Sciences, University of Gävle, Kungsbacksvägen 47, 80176 Gävle, Sweden
| | - Mamunur Rashid
- Department of Public Health and Sports Science, Faculty of Occupational and Health Sciences, University of Gävle, Kungsbacksvägen 47, 80176 Gävle, Sweden
| | - Ulf Karlsson
- Coompanion Gävleborg, Drottninggatan 18, 803 20 Gävle, Sweden
| | - Rooney Olsson
- Coompanion Gävleborg, Drottninggatan 18, 803 20 Gävle, Sweden
| | - Jose Pedro Silva
- EPIUnit–Instituto de Saude Publica, Universidade do Porto, Rua das Taipas 135, 4050-600 Porto, Portugal
- Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Rua das Taipas, nº 135, 4050-600 Porto, Portugal
- Instituto de Sociologia da Universidade do Porto, Faculdade de Letras da Universidade do Porto, Via Panorâmica, 4150-564, Porto, Portugal
| | - Stig Vinberg
- Department of Health Sciences, Faculty of Humanities, Mid Sweden University, Holmgatan 10, 851 70 Sundsvall, Sweden
| | - Anneli Marttila
- Department of Public Health and Sports Science, Faculty of Occupational and Health Sciences, University of Gävle, Kungsbacksvägen 47, 80176 Gävle, Sweden
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Kelly D, Teasdale S, Steiner A, Mason H. Men's Sheds in Scotland: the potential for improving the health of men. J Public Health Policy 2021; 42:258-270. [PMID: 33542483 PMCID: PMC8192322 DOI: 10.1057/s41271-020-00268-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/28/2020] [Indexed: 11/21/2022]
Abstract
Recent policy focus is on the 'non-obvious' role of community-based organisations in tackling causes of poor health, such as social exclusion. Men's Sheds are a type of community-based organisation offering health and wellbeing benefits to men, despite this not being the explicit reason they exist. A qualitative study was conducted in Scotland to identify sustainability challenges that impact on the ability of Sheds to become a formal healthcare service. Findings showed that a reliance on ageing and retired volunteers to undertake operational tasks and generate income to fund activities affected the ability of Sheds to sustain and develop. Further, members preferred their Sheds to remain informal and flexible to fit their specific needs. Although Sheds are recognised for their health and wellbeing benefits to men, policymakers must recognise that formalising their activities might detract from the Shed's primary aims. This paper summarises specific policy implications and recommendations, taking into consideration tensions between the expectations placed on Sheds to expand into formal healthcare delivery, and the needs of Shed users. HIGHLIGHTS: Men's Shed are known for their ability to contribute to men's health and wellbeing. The potential of Shed to take on a formal healthcare role is questionable because of a reliance on ageing and retired volunteers and a preference to remain informal. Policymakers must recognise that although Sheds might be well placed to offer formal health care this may detract from their primary aims.
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Affiliation(s)
- Danielle Kelly
- Yunus Centre for Social Business and Health, Glasgow Caledonian University, M201 George Moore Building, Cowcaddens Road, Glasgow, G4 0BA UK
| | - Simon Teasdale
- Yunus Centre for Social Business and Health, Glasgow Caledonian University, M201 George Moore Building, Cowcaddens Road, Glasgow, G4 0BA UK
| | - Artur Steiner
- Yunus Centre for Social Business and Health, Glasgow Caledonian University, M201 George Moore Building, Cowcaddens Road, Glasgow, G4 0BA UK
| | - Helen Mason
- Yunus Centre for Social Business and Health, Glasgow Caledonian University, M201 George Moore Building, Cowcaddens Road, Glasgow, G4 0BA UK
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Lokman L, Chahine T. Business models for primary health care delivery in low- and middle-income countries: a scoping study of nine social entrepreneurs. BMC Health Serv Res 2021; 21:211. [PMID: 33750372 PMCID: PMC7941720 DOI: 10.1186/s12913-021-06225-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Accepted: 03/01/2021] [Indexed: 11/30/2022] Open
Abstract
Background Social enterprises are organizations created to address social problems that use business models to sustain themselves financially. Social enterprises can help increase access to primary health care in low resource settings. Research on social enterprises in health care have focused either on high-income countries, or on secondary and tertiary care in low- and middle-income countries, where common business models include differential pricing to cross-subsidize low income populations. This is the first study to examine social enterprises providing primary health care in low- and middle-income countries using primary data. The purpose is to determine whether social enterprise is a viable model in this setting and to identify common patterns and characteristics that could inform the work of social entrepreneurs, funders, and researchers in this area. Methods We identify social entrepreneurs working to deliver primary health care in low- and middle-income countries who have been vetted by international organizations dedicated to supporting social entrepreneurship. Through in-depth interviews, we collect information on medical processes, business processes, social impact, and organizational impact according to the Battacharyya et al. framework. We then conducted qualitative analysis to identify common patterns emerging within these four categories. Results Common characteristics in the business models of primary health care social enterprises include flat rate rather than differential pricing and cross-subsidizing across services rather than patients. Subscription packages and in-house IT systems were utilized to generate revenue and increase reach through telemedicine, franchising, and mobile units. In some cases, alternate revenue streams are employed to help break even. About half of the social enterprises interviewed were for-profit, and about half non-profit. The majority faced challenges in engaging with the public sector. This is still a nascent field, with most organizations being under 10 years old. Conclusions Social enterprise has been demonstrated as a feasible model for providing primary health care in low resource settings, with key characteristics differing from the previously commonly studied social enterprises in tertiary care. There are opportunities to complement existing public health systems, but most organizations face challenges in doing so. More research and attention is needed by researchers, governments and funders to support social entrepreneurs and avoid parallel systems.
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Affiliation(s)
- Lutfi Lokman
- Harvard T.H. Chan School of Public Health, Boston, USA
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4
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Donfouet HPP, Mohamed SF, Otieno P, Wambiya E, Mutua MK, Danaei G. Economic valuation of setting up a social health enterprise in urban poor-resource setting in Kenya. Soc Sci Med 2020; 266:113294. [PMID: 32927381 DOI: 10.1016/j.socscimed.2020.113294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 08/07/2020] [Accepted: 08/11/2020] [Indexed: 10/23/2022]
Abstract
The failure of the market and government to provide quality healthcare services have been the motivation to set up social health enterprise. However, the value for money associated with setting up a social health enterprise in sub-Sahara African countries has been relatively unexplored in the literature. The study presents the first empirical estimates of the mean willingness-to-pay (WTP) for setting up a social health enterprise that will simultaneously run a health center and provide health insurance scheme in an urban resource-poor setting and explores whether the benefits outweigh the costs. The contingent valuation method is used to estimate the mean WTP for the health insurance scheme proposed by the social health enterprise in Viwandani slum (Nairobi, Kenya). The survey was conducted between June and July 2018 on 300 households. We find that the feasibility of setting up a social health enterprise could be promising with 97 percent of respondents willing to pay about US$ 2 per person per month for a scheme that would provide quality healthcare services. More importantly, setting up the social health enterprise will yield a positive net profit, and investors could expect US$ 1.11 in benefits for each US$ 1 of costs of investment in setting up the social health enterprise. We, therefore, conclude that this health policy in this urban resource-poor setting could be a viable solution to reach the neglected urban households in the Kenyan slums.
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Affiliation(s)
- Hermann Pythagore Pierre Donfouet
- African Population and Health Research Center, APHRC Campus, 2nd Floor, Manga Close, Off Kirawa Road, P.O. Box: 10787-00100, Nairobi, Kenya; University of Rennes 1, CREM UMR-CNRS 6211, 7 Place Hoche, 35065, RENNES Cedex, France.
| | - Shukri F Mohamed
- African Population and Health Research Center, APHRC Campus, 2nd Floor, Manga Close, Off Kirawa Road, P.O. Box: 10787-00100, Nairobi, Kenya.
| | - Peter Otieno
- African Population and Health Research Center, APHRC Campus, 2nd Floor, Manga Close, Off Kirawa Road, P.O. Box: 10787-00100, Nairobi, Kenya.
| | - Elvis Wambiya
- African Population and Health Research Center, APHRC Campus, 2nd Floor, Manga Close, Off Kirawa Road, P.O. Box: 10787-00100, Nairobi, Kenya.
| | - Martin Kavao Mutua
- African Population and Health Research Center, APHRC Campus, 2nd Floor, Manga Close, Off Kirawa Road, P.O. Box: 10787-00100, Nairobi, Kenya.
| | - Goodarz Danaei
- Harvard T.H. Chan School of Public Health, United States.
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Hutchinson CL, Berndt A, Forsythe D, Gilbert-Hunt S, George S, Ratcliffe J. Valuing the impact of health and social care programs using social return on investment analysis: how have academics advanced the methodology? A systematic review. BMJ Open 2019; 9:e029789. [PMID: 31446413 PMCID: PMC6720245 DOI: 10.1136/bmjopen-2019-029789] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVES To identify how social return on investment (SROI) analysis-traditionally used by business consultants-has been interpreted, used and innovated by academics in the health and social care sector and to assess the quality of peer-reviewed SROI studies in this sector. DESIGN Systematic review. SETTINGS Community and residential settings. PARTICIPANTS A wide range of demographic groups and age groups. RESULTS The following databases were searched: Web of Science, Scopus, CINAHL, Econlit, Medline, PsychINFO, Embase, Emerald, Social Care Online and the National Institute for Health and Care Excellence. Limited uptake of SROI methodology by academics was found in the health and social care sector. From 868 papers screened, 8 studies met the criteria for inclusion in this systematic review. Study quality was found to be highly variable, ranging from 38% to 90% based on scores from a purpose-designed quality assessment tool. In general, relatively high consistency and clarity was observed in the reporting of the research question, reasons for using this methodology and justifying the need for the study. However, weaknesses were observed in other areas including justifying stakeholders, reporting sample sizes, undertaking sensitivity analysis and reporting unexpected or negative outcomes. Most papers cited links to additional materials to aid in reporting. There was little evidence that academics had innovated or advanced the methodology beyond that outlined in a much-cited SROI guide. CONCLUSION Academics have thus far been slow to adopt SROI methodology in the evaluation of health and social care interventions, and there is little evidence of innovation and development of the methodology. The word count requirements of peer-reviewed journals may make it difficult for authors to be fully transparent about the details of their studies, potentially impacting the quality of reporting in those studies published in these journals. PROSPERO REGISTRATION NUMBER CRD42018080195.
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Affiliation(s)
- Claire Louise Hutchinson
- Nursing & Health Sciences, Flinders University, Adelaide, South Australia, Australia
- School of Health Sciences, University of South Australia Division of Health Sciences, Adelaide, South Australia, Australia
| | - Angela Berndt
- School of Health Sciences, University of South Australia Division of Health Sciences, Adelaide, South Australia, Australia
| | - Deborah Forsythe
- School of Health Sciences, University of South Australia Division of Health Sciences, Adelaide, South Australia, Australia
| | - Susan Gilbert-Hunt
- School of Health Sciences, University of South Australia Division of Health Sciences, Adelaide, South Australia, Australia
| | - Stacey George
- Nursing & Health Sciences, Flinders University, Adelaide, South Australia, Australia
| | - Julie Ratcliffe
- Nursing & Health Sciences, Flinders University, Adelaide, South Australia, Australia
- Institute for Choice, Business School, University of South Australia, Adelaide, SA, Australia
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Kelly D, Steiner A, Mazzei M, Baker R. Filling a void? The role of social enterprise in addressing social isolation and loneliness in rural communities. JOURNAL OF RURAL STUDIES 2019; 70:225-236. [PMID: 31787802 PMCID: PMC6876679 DOI: 10.1016/j.jrurstud.2019.01.024] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Accepted: 01/21/2019] [Indexed: 05/09/2023]
Abstract
Social isolation and loneliness has been classed as a major public health concern due to its negative physical and mental health implications, and living in a remote or rural area is a prominent contributing risk factor. Community-led social enterprise models are recognised in government policy as a potential preventative measure for social isolation and loneliness, yet there is a lack of understanding of their application in rural contexts. The objectives of this paper are to investigate the role of social enterprise in addressing social isolation and loneliness in rural communities, and to explore the pathways in which social enterprise activity may act upon the health and wellbeing of social enterprise beneficiaries. We also discuss the capacity of rural community members to deliver and sustain such services. The study used in-depth interviews over a three-year period with 35 stakeholders from seven social enterprises in the Highlands and Islands of Scotland, including board members, staff, volunteers and service users. Findings showed that social enterprises are successfully providing activities that counteract factors contributing to social isolation and feelings of loneliness, leading to wider health and wellbeing benefits for individuals. However, the sustainability and continuity of social enterprises are questionable due to the burden on smaller populations, limited expertise and knowledge of running social enterprises, and effects on the personal lives of social enterprise volunteers and staff. This study supports suggestions that social enterprises can be generators of health and wellbeing through their varied remit of activities that impact on the social determinants of health. However, it also shows that relying on social enterprise as a particular solution to social isolation and loneliness is precarious due to complexities associated with rurality. Therefore, rural policy and practice must move away from a 'one size fits all' approach to tackling social isolation and loneliness, recognise the need for local level tailored interventions and, through harnessing the potential or rural social enterprises, enable flexible service provision that correlates with rural context.
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Affiliation(s)
- Danielle Kelly
- Yunus Centre for Social Business and Health, Glasgow Caledonian University, M201 George Moore Building, Cowcaddens Road, Glasgow, G4 0BA, United Kingdom
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7
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Macaulay B, Roy MJ, Donaldson C, Teasdale S, Kay A. Conceptualizing the health and well-being impacts of social enterprise: a UK-based study. Health Promot Int 2019; 33:748-759. [PMID: 28369450 PMCID: PMC6202920 DOI: 10.1093/heapro/dax009] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Social enterprises-businesses that work for social benefit rather than for the maximization of financial returns to shareholders or owners-could potentially prove to be an innovative and sustainable way of tackling 'upstream' social determinants of health. However, empirical work focusing upon how, and to what extent, social enterprise-led activity may impact upon health and well-being is still relatively scarce. This study examines how social enterprises portray their impact, and how such impacts may be considered in health and well-being terms. Through analysing evaluative reports of the work of social enterprises in Scotland (n = 17) utilizing a 'process coding' method, we investigate both the self-reported impacts of the work of social enterprises and the mechanisms by which these are said to be derived. Revisiting previous conceptualizations in the extant literature, this work allows us to present an 'empirically-informed' conceptual model of the health and well-being impacts of social enterprise-led activity, and thus presents a significant advance on previous hypothetical, theoretically-based conceptualizations. It is considered that these findings further improve our overall knowledge of ways in which social enterprise and other parts of the third sector could be considered as potentially valuable 'non-obvious' public health actors.
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Affiliation(s)
- Bobby Macaulay
- Yunus Centre for Social Business and Health, Glasgow Caledonian University, Cowcaddens Road, Glasgow, UK
| | - Michael J Roy
- Yunus Centre for Social Business and Health, Glasgow Caledonian University, Cowcaddens Road, Glasgow, UK.,Glasgow School for Business and Society, Glasgow Caledonian University, Cowcaddens Road, Glasgow, UK
| | - Cam Donaldson
- Yunus Centre for Social Business and Health, Glasgow Caledonian University, Cowcaddens Road, Glasgow, UK
| | - Simon Teasdale
- Yunus Centre for Social Business and Health, Glasgow Caledonian University, Cowcaddens Road, Glasgow, UK.,Glasgow School for Business and Society, Glasgow Caledonian University, Cowcaddens Road, Glasgow, UK
| | - Alan Kay
- Yunus Centre for Social Business and Health, Glasgow Caledonian University, Cowcaddens Road, Glasgow, UK
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8
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Caló F, Roy MJ, Donaldson C, Teasdale S, Baglioni S. Exploring the contribution of social enterprise to health and social care: A realist evaluation. Soc Sci Med 2019; 222:154-161. [DOI: 10.1016/j.socscimed.2019.01.007] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2017] [Revised: 10/29/2018] [Accepted: 01/04/2019] [Indexed: 11/28/2022]
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9
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Hutchinson CL, Berndt A, Gilbert-Hunt S, George S, Ratcliffe J. Valuing the impact of health and social care programmes using social return on investment analysis: how have academics advanced the methodology? A protocol for a systematic review of peer-reviewed literature. BMJ Open 2018; 8:e022534. [PMID: 30530579 PMCID: PMC6303612 DOI: 10.1136/bmjopen-2018-022534] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2018] [Revised: 10/10/2018] [Accepted: 10/17/2018] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION Unlike other forms of evaluation, social return on investment (SROI) methodology offers a way of placing values on personal, social and community outcomes, not just economic outcomes. Developed in 2000, there have been calls for greater academic involvement in development of SROI, which to date has been more typically implemented in-house or by consultants. This protocol describes a systematic review of SROI analysis conducted on health and social care programmes which represent a significant sector of social enterprise internationally. The aims of the systematic review are to (1) identify the extent to which academics have adopted SROI methodology, (2) how academics have interpreted, used and developed SROI methodology and (3) to assess the quality of studies published under peer review. METHODS AND ANALYSIS The systematic review will include peer-reviewed studies since 2000 published in English. Search terms will be 'social return on investment' or 'SROI'. Health and social care interventions will be identified in the initial screening given the proliferation of possible key words in these areas. Databases to be searched include Web of Science, Scopus, Medline, Social Care Online and National Institute for Health and Care Excellence. Two reviewers will independently conduct initial screening based on titles and abstracts against the inclusion criteria. Data extracted will include date of intervention, country, study design, aim of intervention/programme, participants and setting, health and social care measures used, and SROI ratio. The quality of studies will be assessed by two reviewers using a SROI quality framework designed for the purpose of this study. ETHICS AND DISSEMINATION The systematic review will review existing published academic literature; as such, ethics approval is not required for this study. A paper of the systematic review will be submitted to a peer-reviewed journal. PROSPERO REGISTRATION NUMBER CRD42018080195.
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Affiliation(s)
| | - Angela Berndt
- School of Health Sciences, University of South Australia, Adelaide, South Australia, Australia
| | - Susan Gilbert-Hunt
- School of Health Sciences, University of South Australia, Adelaide, South Australia, Australia
| | - Stacey George
- College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
| | - Julie Ratcliffe
- Institute for Choice, UniSA Business School, University of South Australia, Adelaide, South Australia, Australia
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Two false positives do not make a right: Setting the bar of social enterprise research even higher through avoiding the straw man fallacy. Soc Sci Med 2018; 217:42-44. [DOI: 10.1016/j.socscimed.2018.09.058] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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11
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Macaulay B, Mazzei M, Roy MJ, Teasdale S, Donaldson C. Differentiating the effect of social enterprise activities on health. Soc Sci Med 2018; 200:211-217. [PMID: 29421468 PMCID: PMC5906639 DOI: 10.1016/j.socscimed.2018.01.042] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2017] [Revised: 01/25/2018] [Accepted: 01/31/2018] [Indexed: 11/29/2022]
Abstract
An emerging stream of literature has focused on the ways in which social enterprises might act on the social determinants of health. However, this previous work has not taken a sufficiently broad account of the wide range of stakeholders involved in social enterprises and has also tended to reduce and simplify a complex and heterogeneous set of organisations to a relatively homogenous social enterprise concept. In an attempt to address these gaps, we conducted an empirical investigation between August 2014 and October 2015 consisting of qualitative case studies involving in-depth semi-structured interviews and a focus group with a wide variety of stakeholders from three social enterprises in different regions of Scotland. We found that different forms of social enterprise impact on different dimensions of health in different ways, including through: engendering a feeling of ownership and control; improving environmental conditions (both physical and social); and providing or facilitating meaningful employment. In conclusion, we highlight areas for future research.
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Affiliation(s)
- Bobby Macaulay
- Yunus Centre for Social Business and Health, Glasgow Caledonian University, Glasgow, UK.
| | - Micaela Mazzei
- Yunus Centre for Social Business and Health, Glasgow Caledonian University, Glasgow, UK
| | - Michael J Roy
- Yunus Centre for Social Business and Health, Glasgow Caledonian University, Glasgow, UK; Glasgow School for Business and Society, Glasgow Caledonian University, Glasgow, UK
| | - Simon Teasdale
- Yunus Centre for Social Business and Health, Glasgow Caledonian University, Glasgow, UK; Glasgow School for Business and Society, Glasgow Caledonian University, Glasgow, UK
| | - Cam Donaldson
- Yunus Centre for Social Business and Health, Glasgow Caledonian University, Glasgow, UK
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12
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Kirkman A, Wilkinson J, Scahill S. Thinking about health care differently: nurse practitioners in primary health care as social entrepreneurs. J Prim Health Care 2018; 10:331-337. [DOI: 10.1071/hc18053] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
ABSTRACT
INTRODUCTIONChallenges facing the primary health-care sector mean that policymakers and clinicians need to think and act differently to move forward. The principles of social entrepreneurship have been implemented successfully for improved health outcomes in other developed nations. There is a knowledge gap around whether nurse practitioners (NPs) in New Zealand primary health care (PHC) align with these principles.
AIMTo explore whether and how the innovative activities of primary care NPs can be described as socially entrepreneurial.
METHODSA descriptive qualitative approach was used with data collected using semi-structured interviews with NPs working in primary care (n = 7). Data were analysed using general inductive thematic analysis techniques.
RESULTSNurse practitioners interviewed worked in government-subsidised private general practice businesses. Two main themes emerged: (1) the nursing model of care aligned with social entrepreneurship; and (2) building social capital. NPs described a desire to see health care delivered differently and this aligned with acting as a social entrepreneur. Social capital emerged through the requirement to establish significant collaborative relationships.
DISCUSSIONIt was found that NPs’ work can be described as socially entrepreneurial. The holistic, person and community-centred model of NP care has an ultimate mission of improved health outcomes. Social capital is built through collaborative relationships with other health-care providers, individual service users and the community. However, the juxtaposition of the business model in primary care prevents NPs from initiating and leading sustainable change.
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Vickers I, Lyon F, Sepulveda L, McMullin C. Public service innovation and multiple institutional logics: The case of hybrid social enterprise providers of health and wellbeing. RESEARCH POLICY 2017. [DOI: 10.1016/j.respol.2017.08.003] [Citation(s) in RCA: 51] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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14
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Roy MJ, Lysaght R, Krupa TM. Action on the social determinants of health through social enterprise. CMAJ 2017; 189:E440-E441. [PMID: 28385717 DOI: 10.1503/cmaj.160864] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Affiliation(s)
- Michael J Roy
- Yunus Centre for Social Business and Health, Glasgow Caledonian University, Glasgow, UK
| | - Rosemary Lysaght
- School of Rehabilitation Therapy, Queen's University, Kingston, Ont
| | - Terry M Krupa
- School of Rehabilitation Therapy, Queen's University, Kingston, Ont
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15
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Wright NMJ, Hearty P, Harris L, Burnell A, Pender S, Oxnard C, Charlesworth G. Supporting research readiness in social enterprise health services. BMC Health Serv Res 2017; 17:653. [PMID: 28903754 PMCID: PMC5598075 DOI: 10.1186/s12913-017-2607-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2016] [Accepted: 09/08/2017] [Indexed: 11/10/2022] Open
Abstract
Health-based social enterprises are spun out of the NHS, yet continue to provide NHS-funded services. With the spin-out, however, formal processes for research governance were lost. Patients have a right to take part in research, regardless of where they access healthcare. This paper discusses the barriers to social enterprises undertaking applied health research and makes recommendations to address the need for equivalence of governance processes with NHS trusts.
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Affiliation(s)
- Nat M J Wright
- Spectrum Community Health CIC, Wakefield, UK. .,Yorkshire and Humber Clinical Research Network, Yorkshire, UK.
| | | | | | | | - Sue Pender
- City Health Care Partnership CIC, Hull, UK
| | - Chris Oxnard
- Yorkshire and Humber Clinical Research Network, Yorkshire, UK
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16
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Theorising lifestyle drift in health promotion: explaining community and voluntary sector engagement practices in disadvantaged areas. CRITICAL PUBLIC HEALTH 2017. [DOI: 10.1080/09581596.2017.1356909] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Roy MJ, Baker R, Kerr S. Conceptualising the public health role of actors operating outside of formal health systems: The case of social enterprise. Soc Sci Med 2017; 172:144-152. [PMID: 27842999 PMCID: PMC5223783 DOI: 10.1016/j.socscimed.2016.11.009] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2016] [Revised: 09/14/2016] [Accepted: 11/07/2016] [Indexed: 10/31/2022]
Abstract
This paper focuses on the role of actors that operate outside formal health systems, but nevertheless have a vital, if often under-recognised, role in supporting public health. The specific example used is the 'social enterprise', an organisation that seeks, through trading, to maximise social returns, rather than the distribution of profits to shareholders or owners. In this paper we advance empirical and theoretical understanding of the causal pathways at work in social enterprises, by considering them as a particularly complex form of public health 'intervention'. Data were generated through qualitative, in depth, semi-structured interviews and a focus group discussion, with a purposive, maximum variation sample of social enterprise practitioners (n = 13) in an urban setting in the west of Scotland. A method of analysis inspired by critical realism - Causation Coding - enabled the identification of a range of explanatory mechanisms and potential pathways of causation between engagement in social enterprise-led activity and various outcomes, which have been grouped into physical health, mental health and social determinants. The findings then informed the construction of an empirically-informed conceptual model to act as a platform upon which to develop a future research agenda. The results of this work are considered to not only encourage a broader and more imaginative consideration of what actually constitutes a public health intervention, but also reinforces arguments that actors within the Third Sector have an important role to play in addressing contemporary and future public health challenges.
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Affiliation(s)
- Michael J Roy
- Yunus Centre for Social Business and Health, Glasgow Caledonian University, Glasgow, UK; Glasgow School for Business and Society, Glasgow Caledonian University, Glasgow, UK.
| | - Rachel Baker
- Yunus Centre for Social Business and Health, Glasgow Caledonian University, Glasgow, UK
| | - Susan Kerr
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK
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Roy MJ. The assets-based approach: furthering a neoliberal agenda or rediscovering the old public health? A critical examination of practitioner discourses. CRITICAL PUBLIC HEALTH 2016; 27:455-464. [PMID: 28670100 PMCID: PMC5470106 DOI: 10.1080/09581596.2016.1249826] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2016] [Accepted: 10/12/2016] [Indexed: 10/25/2022]
Abstract
The 'assets-based approach' to health and well-being has, on the one hand, been presented as a potentially empowering means to address the social determinants of health while, on the other, been criticised for obscuring structural drivers of inequality and encouraging individualisation and marketisation; in essence, for being a tool of neoliberalism. This study looks at how this apparent contestation plays out in practice through a critical realist-inspired examination of practitioner discourses, specifically of those working within communities to address social vulnerabilities that we know impact upon health. The study finds that practitioners interact with the assets-based policy discourse in interesting ways. Rather than unwitting tools of neoliberalism, they considered their work to be about mitigating the worst effects of poverty and social vulnerability in ways that enhance collectivism and solidarity, concepts that neoliberalism arguably seeks to disrupt. Furthermore, rather than a different, innovative, way of working, they consider the assets-based approach to simply be a re-labelling of what they have been doing anyway, for as long as they can remember. So, for practitioners, rather than a 'new' approach to public health, the assets-based public health movement seems to be a return to recognising and appreciating the role of community within public health policy and practice; ideals that predate neoliberalism by quite some considerable time.
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Affiliation(s)
- Michael J Roy
- Yunus Centre for Social Business and Health/Glasgow School for Business and Society, Glasgow Caledonian University, Glasgow, UK
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Mason C, Barraket J, Friel S, O'Rourke K, Stenta CP. Social innovation for the promotion of health equity. Health Promot Int 2016; 30 Suppl 2:ii116-25. [PMID: 26420807 DOI: 10.1093/heapro/dav076] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
The role of social innovations in transforming the lives of individuals and communities has been a source of popular attention in recent years. This article systematically reviews the available evidence of the relationship between social innovation and its promotion of health equity. Guided by Fair Foundations: The VicHealth framework for health equity and examining four types of social innovation--social movements, service-related social innovations, social enterprise and digital social innovations--we find a growing literature on social innovation activities, but inconsistent evaluative evidence of their impacts on health equities, particularly at the socio-economic, political and cultural level of the framework. Distinctive characteristics of social innovations related to the promotion of health equity include the mobilization of latent or unrealised value through new combinations of (social, cultural and material) resources; growing bridging social capital and purposeful approaches to linking individual knowledge and experience to institutional change. These have implications for health promotion practice and for research about social innovation and health equity.
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Affiliation(s)
- Chris Mason
- Centre for Social Impact Swinburne, Swinburne University of Technology, Hawthorn, VIC, Australia
| | - Jo Barraket
- Centre for Social Impact Swinburne, Swinburne University of Technology, Hawthorn, VIC, Australia
| | - Sharon Friel
- Regulatory Institutions Network (RegNet), Australian National University, Canberra, ACT, Australia
| | - Kerryn O'Rourke
- Victorian Health Promotion Foundation (VicHealth), Melbourne, VIC, Australia
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Roy MJ, Hackett MT. Polanyi’s ‘substantive approach’ to the economy in action? Conceptualising social enterprise as a public health ‘intervention’. ACTA ACUST UNITED AC 2016. [DOI: 10.1080/00346764.2016.1171383] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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21
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Kidd SA, Kerman N, Cole D, Madan A, Muskat E, Raja S, Rallabandi S, McKenzie K. Social Entrepreneurship and Mental Health Intervention: a Literature Review and Scan of Expert Perspectives. Int J Ment Health Addict 2015. [DOI: 10.1007/s11469-015-9575-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Grech G, Zhan X, Yoo BC, Bubnov R, Hagan S, Danesi R, Vittadini G, Desiderio DM. EPMA position paper in cancer: current overview and future perspectives. EPMA J 2015; 6:9. [PMID: 25908947 PMCID: PMC4407842 DOI: 10.1186/s13167-015-0030-6] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2015] [Accepted: 02/26/2015] [Indexed: 12/31/2022]
Abstract
At present, a radical shift in cancer treatment is occurring in terms of predictive, preventive, and personalized medicine (PPPM). Individual patients will participate in more aspects of their healthcare. During the development of PPPM, many rapid, specific, and sensitive new methods for earlier detection of cancer will result in more efficient management of the patient and hence a better quality of life. Coordination of the various activities among different healthcare professionals in primary, secondary, and tertiary care requires well-defined competencies, implementation of training and educational programs, sharing of data, and harmonized guidelines. In this position paper, the current knowledge to understand cancer predisposition and risk factors, the cellular biology of cancer, predictive markers and treatment outcome, the improvement in technologies in screening and diagnosis, and provision of better drug development solutions are discussed in the context of a better implementation of personalized medicine. Recognition of the major risk factors for cancer initiation is the key for preventive strategies (EPMA J. 4(1):6, 2013). Of interest, cancer predisposing syndromes in particular the monogenic subtypes that lead to cancer progression are well defined and one should focus on implementation strategies to identify individuals at risk to allow preventive measures and early screening/diagnosis. Implementation of such measures is disturbed by improper use of the data, with breach of data protection as one of the risks to be heavily controlled. Population screening requires in depth cost-benefit analysis to justify healthcare costs, and the parameters screened should provide information that allow an actionable and deliverable solution, for better healthcare provision.
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Affiliation(s)
- Godfrey Grech
- Department of Pathology, Faculty of Medicine and Surgery, University of Malta, Msida, Malta
| | - Xianquan Zhan
- Key Laboratory of Cancer Proteomics of Chinese Ministry of Health, Xiangya Hospital, Central South University, Changsha, China
| | - Byong Chul Yoo
- Colorectal Cancer Branch, Division of Translational and Clinical Research I, Research Institute, National Cancer Center, Gyeonggi, 410-769 Republic of Korea
| | - Rostyslav Bubnov
- Clinical Hospital 'Pheophania' of State Management of Affairs Department, Kyiv, Ukraine ; Zabolotny Institute of Microbiology and Virology, National Academy of Sciences of Ukraine, Kyiv, Ukraine
| | - Suzanne Hagan
- Dept of Life Sciences, School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK
| | - Romano Danesi
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | | | - Dominic M Desiderio
- Department of Neurology, University of Tennessee Center for Health Science, Memphis, USA
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Roy MJ, Donaldson C, Baker R, Kerr S. The potential of social enterprise to enhance health and well-being: a model and systematic review. Soc Sci Med 2014; 123:182-93. [PMID: 25037852 DOI: 10.1016/j.socscimed.2014.07.031] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2013] [Revised: 07/10/2014] [Accepted: 07/12/2014] [Indexed: 10/25/2022]
Abstract
In recent years civil society organisations, associations, institutions and groups have become increasingly involved at various levels in the governance of healthcare systems around the world. In the UK, particularly in the context of recent reform of the National Health Service in England, social enterprise - that part of the third sector engaged in trading - has come to the fore as a potential model of state-sponsored healthcare delivery. However, to date, there has been no review of evidence on the outcomes of social enterprise involvement in healthcare, nor in the ability of social enterprise to address health inequalities more widely through action on the social determinants of health. Following the development of an initial conceptual model, this systematic review identifies and synthesises evidence from published empirical research on the impact of social enterprise activity on health outcomes and their social determinants. Ten health and social science databases were searched with no date delimiters set. Inclusion and exclusion criteria were applied prior to data extraction and quality appraisal. Heterogeneity in the outcomes assessed precluded meta-analysis/meta-synthesis and so the results are therefore presented in narrative form. Five studies met the inclusion criteria. The included studies provide limited evidence that social enterprise activity can impact positively on mental health, self-reliance/esteem and health behaviours, reduce stigmatization and build social capital, all of which can contribute to overall health and well-being. No empirical research was identified that examined social enterprise as an alternative mode of healthcare delivery. Due to the limited evidence available, we discuss the relationship between the evidence found and other literature not included in the review. There is a clear need for research to better understand and evidence causal mechanisms and to explore the impact of social enterprise activity, and wider civil society actors, upon a range of intermediate and long-term public health outcomes.
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Affiliation(s)
- Michael J Roy
- Yunus Centre for Social Business and Health, Glasgow Caledonian University, Glasgow, UK; Glasgow School for Business and Society, Glasgow Caledonian University, Glasgow, UK.
| | - Cam Donaldson
- Yunus Centre for Social Business and Health, Glasgow Caledonian University, Glasgow, UK
| | - Rachel Baker
- Yunus Centre for Social Business and Health, Glasgow Caledonian University, Glasgow, UK
| | - Susan Kerr
- Institute for Applied Health Research, Glasgow Caledonian University, Glasgow, UK
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