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Ruleman AM, Clendennen SL, Chen B, Harrell MB. Reasons for multiple tobacco product and cannabis co-use among Texas young adults. Addict Behav 2024; 156:108063. [PMID: 38824720 DOI: 10.1016/j.addbeh.2024.108063] [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: 01/13/2024] [Revised: 05/10/2024] [Accepted: 05/11/2024] [Indexed: 06/04/2024]
Abstract
OBJECTIVE This study examines differences in reasons for e-cigarette, cigarette, and cannabis use across exclusive, dual, co-, and poly co-users. METHODS Participants were 645 young adults who reported past 30-day (P30D) use of e-cigarettes, cigarettes, or cannabis at wave 14 (Fall, 2021) of the Texas Adolescent Tobacco Marketing and Surveillance System (TATAMS). Exclusive users reported P30D use of one product, dual users reported P30D use of e-cigarettes and cigarettes, co-users reported use of cannabis and one tobacco product, and poly co-users reported P30D use of all three products. Participants were asked if they agreed with a series of reasons for using their respective products. Multinomial logistic regression analyses were conducted to examine associations between reasons for use and pattern of use, controlling for sex, race/ethnicity, and lifetime product use. RESULTS 26.36 % of P30D users reported cannabis and tobacco use. Poly co-users were more likely to report using e-cigarettes because their friends do than e-cigarette co-users (aRRR = 2.64; 95 %CI = 1.19-5.83) and dual tobacco users (aRRR = 5.11; 95 %CI = 1.73-15.12). Poly co-users were more likely to smoke cigarettes while drinking alcohol (aRRR = 4.68; 95 %CI = 1.06-20.72) or to experience a pleasurable buzz (aRRR = 5.48; 95 %CI = 1.62-18.57) than exclusive cigarette users. Poly co-users more often reported using cannabis for taste (aRRR = 3.13; 95 %CI = 1.51-6.51), because their friends use it (aRRR = 2.19; 95 %CI = 1.08-4.42), and while drinking alcohol (aRRR = 2.13; 95 %CI = 1.03-4.41) than exclusive cannabis users. CONCLUSIONS Given that reasons for use differ significantly among types of multiple product users and exclusive users, interventions should be tailored to address the specific tobacco and cannabis use practices of young adults.
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Affiliation(s)
- Ashlynn M Ruleman
- University of Texas Health Science Center, School of Public Health, 1836 San Jacinto Blvd, Austin, TX 78701, USA.
| | - Stephanie L Clendennen
- University of Texas Health Science Center, School of Public Health, 1836 San Jacinto Blvd, Austin, TX 78701, USA
| | - Baojiang Chen
- University of Texas Health Science Center, School of Public Health, 1836 San Jacinto Blvd, Austin, TX 78701, USA
| | - Melissa B Harrell
- University of Texas Health Science Center, School of Public Health, 1836 San Jacinto Blvd, Austin, TX 78701, USA
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Wright-Pedersen S, Vidgen H, Gallegos D. Children's descriptions of their involvement within everyday food practices. Appetite 2024; 200:107517. [PMID: 38815691 DOI: 10.1016/j.appet.2024.107517] [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: 02/29/2024] [Revised: 05/20/2024] [Accepted: 05/23/2024] [Indexed: 06/01/2024]
Abstract
BACKGROUND The way in which children interact with food has a profound impact on their health and wellbeing. However, most research, strategy and policy where food is the focus are derived from adult perspectives. There is limited understanding of children's perspectives of the nature of their everyday food practices, and their level of involvement and influence. This work garnered children's (8-12 years old) descriptions of, and involvement in, their everyday food practices. METHODS Forty-two children from 28 families from across Brisbane (Australia) participated in qualitative creative draw-and-tell interviews and 20 of these children (from 15 families) also completed Photovoice data collection. Data were abductively analysed through a social practice theory lens. RESULTS Children reported engaging in food planning, acquisition, preparation, consumption and tidy-up practices, to varying degrees of 'less involved', 'in partnership with adults or other children' or 'independently'. This was influenced largely by the willingness of adults to relinquish control and children's desire to participate, as well as other contextual factors. Children were more independent in consumption practices, as well as packing lunchboxes and preparing food spaces (as preparation practices). Partnerships were established more so within food acquisition and preparation practices, with less involvement described within planning and tidy-up practices. CONCLUSIONS The findings add new knowledge and depth and breadth to that already obtained from parents, teachers and adult researchers, highlighting the importance of privileging children's voices when investigating their food experiences. This work may be used to guide adults to invite and support children to be involved in food practices that they report being less involved in, as well as inform how best to work with and include children in future research and food and nutrition strategies and policies.
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Affiliation(s)
- Sophie Wright-Pedersen
- Centre for Childhood Nutrition Research, Faculty of Health, Queensland University of Technology (QUT), 62 Graham Street, South Brisbane, QLD, 4101, Australia; School of Exercise and Nutrition Sciences, Faculty of Health, Queensland University of Technology (QUT), 149 Victoria Park Road, Kelvin Grove, QLD, 4059, Australia.
| | - Helen Vidgen
- School of Exercise and Nutrition Sciences, Faculty of Health, Queensland University of Technology (QUT), 149 Victoria Park Road, Kelvin Grove, QLD, 4059, Australia.
| | - Danielle Gallegos
- Centre for Childhood Nutrition Research, Faculty of Health, Queensland University of Technology (QUT), 62 Graham Street, South Brisbane, QLD, 4101, Australia; School of Exercise and Nutrition Sciences, Faculty of Health, Queensland University of Technology (QUT), 149 Victoria Park Road, Kelvin Grove, QLD, 4059, Australia.
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3
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Girard IM, Ward P, Durey A, McLean C, Lund S, Calache H, Baker SR, Slack-Smith L. A qualitative meta-synthesis of carers' perceptions of factors influencing preschool children's oral hygiene practices-A social practices perspective. Community Dent Oral Epidemiol 2024. [PMID: 38769714 DOI: 10.1111/cdoe.12973] [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: 08/24/2023] [Revised: 01/25/2024] [Accepted: 04/26/2024] [Indexed: 05/22/2024]
Abstract
OBJECTIVES This study comprises a synthesis of published qualitative studies from developed countries on the perspectives of carers regarding the oral hygiene toothbrushing practices of preschool children, through the lens of social practice theory. METHODS A search of the following electronic databases was conducted for all available years: MEDLINE, EMBASE and Global Health using the Ovid platform; Dentistry & Oral Sciences Source (DOSS), Cumulative Index to Nursing and Allied Health Literature (CINAHL) and Scopus. Included qualitative studies reported primary caregivers' perceptions of oral hygiene practices (focusing on toothbrushing) in preschool children (0-5 years old) in developed countries. A thematic synthesis of the qualitative findings was undertaken for the results of each study. RESULTS Eleven articles were included in this meta-synthesis. The focus of this paper was toothbrushing practices. A conceptual map of toothbrushing as a social practice was developed. Key findings included practice elements (meanings, competences, and materials), spatial and temporal aspects, and barriers and facilitators to performance. CONCLUSIONS The application of a social practice lens to published qualitative research on the oral hygiene of preschool children provided insights into the meanings and competences related to toothbrushing, as perceived by primary caregivers. However, it also revealed limited information on material, spatial and temporal aspects of toothbrushing practices, indicating the importance of considering social practice theory as a framework in future research to address this gap. Furthermore, exploring toothbrushing in connection with related social practices has the potential to increase understanding of factors influencing oral health in preschool children.
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Affiliation(s)
- Ivana Matic Girard
- School of Population and Global Health, The University of Western Australia, Perth, WA, Australia
| | - Paul Ward
- Torrens University, Research Centre for Public Health, Equity and Human Flourishing, Adelaide, South Australia, Australia
| | - Angela Durey
- School of Population and Global Health, The University of Western Australia, Perth, WA, Australia
| | - Caitlan McLean
- Torrens University, Research Centre for Public Health, Equity and Human Flourishing, Adelaide, South Australia, Australia
| | - Stephan Lund
- School of Population and Global Health, The University of Western Australia, Perth, WA, Australia
| | - Hanny Calache
- Department of Rural Clinical Sciences, La Trobe Rural Health School, La Trobe University, Bendigo, Victoria, Australia
| | - Sarah R Baker
- School of Clinical Dentistry, Sheffield University, Sheffield, UK
| | - Linda Slack-Smith
- School of Population and Global Health, The University of Western Australia, Perth, WA, Australia
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Gittings L, Hodes R, Kom P, Mbula S, Pantelic M. 'Remember there is that thing called confidentiality': experiences of institutional discrimination in the health system among adolescent boys and young men living with HIV in the Eastern Cape province of South Africa. CULTURE, HEALTH & SEXUALITY 2024; 26:575-587. [PMID: 37480578 DOI: 10.1080/13691058.2023.2232023] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/18/2022] [Accepted: 06/28/2023] [Indexed: 07/24/2023]
Abstract
Adolescents and men are two populations that perform poorly within the HIV cascade of care, having worse AIDS-related health outcomes, and experiencing higher levels of HIV-related stigma. This paper explores institutional health system discrimination as experienced by adolescent boys with perinatally-acquired HIV, situating them within the social and gendered contexts of the Eastern Cape Province, South Africa. Life history narratives (n = 36) and in-depth semi-structured interviews (n = 32) with adolescent boys living with HIV aged 13-22 were conducted in 2017-2018. In-depth semi-structured interviews with biomedical and traditional health practitioners (n = 14), analysis of health facility files (n = 41) and clinic observations were also conducted. Together, triangulated sources point to an incongruence between the complex needs of adoelscent boys and young men living with HIV and their experiences within the health system. Two institutional discrimination-related deterrents to retention in care were identified: (1) lack of confidentiality due to health facility layouts and practices that visibilised people living with HIV; and (2) mistreatment in the form of shouting. This article contributes to the limited literature on the experiences of young men within the HIV continuum of care, focusing on how stigma influences how young men experience and engage with the health sector.
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Affiliation(s)
- Lesley Gittings
- School of Health Studies, Faculty of Health Sciences, Western University, London, Canada
- Centre for Social Science Research, University of Cape Town, Cape Town, South Africa
| | - Rebecca Hodes
- Department of Anthropology, Archaeology and Social Development, Humanities Faculty, Pretoria University, South Africa
| | - Phakamani Kom
- Oxford Research South Africa, East London, South Africa
| | | | - Marija Pantelic
- Department of Primary Care and Public Health, Brighton and Sussex Medical School, University of Sussex, Falmer, UK
- Department of Social Policy and Intervention, University of Oxford, Oxford, UK
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5
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Mac Fadden I, Cocchioni R, Delgado-Serrano MM. A Co-Created Assessment Framework to Measure Inclusive Health and Wellbeing in a Vulnerable Context in the South of Europe. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:510. [PMID: 38673421 PMCID: PMC11050556 DOI: 10.3390/ijerph21040510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/10/2024] [Revised: 04/05/2024] [Accepted: 04/15/2024] [Indexed: 04/28/2024]
Abstract
Rapid urbanisation exacerbates health and wellbeing disparities in vulnerable contexts and underscores the imperative need to develop innovative and participatory co-creation approaches to understand and address the specificities of these contexts. This paper presents a method to develop an assessment framework that integrates top-down dimensions with bottom-up perspectives to monitor the impact of inclusive health and wellbeing interventions tailored to the neighbourhood's needs in Las Palmeras, a vulnerable neighbourhood in Cordoba (Spain). Drawing upon studies in the literature examining urban health and wellbeing trends, it delineates a participatory and inclusive framework, emphasising the need for context-specific indicators and assessment tools. Involving diverse stakeholders, including residents and professionals, it enriches the process and identifies key indicators and assessment methods. This approach provides valuable insights for managing innovative solutions, aligning them with local expectations, and measuring their impact. It contributes to the discourse on inclusive urban health by advocating for participatory, context-specific strategies and interdisciplinary collaboration. While not universally applicable, the framework offers a model for health assessment in vulnerable contexts, encouraging further development of community-based tools for promoting inclusive wellbeing.
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Affiliation(s)
- Isotta Mac Fadden
- Department of Agriculture Economics, Universidad de Córdoba, E-14005 Córdoba, Spain;
| | | | - María Mar Delgado-Serrano
- WEARE Research Group, Department of Agriculture Economics, Universidad de Córdoba, E-14005 Córdoba, Spain
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Durey A, Ward P, Haynes E, Baker SR, Calache H, Slack-Smith L. Applying Social Practice Theory to Explore Australian Preschool Children's Oral Health. JDR Clin Trans Res 2024:23800844241235615. [PMID: 38623874 DOI: 10.1177/23800844241235615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/17/2024] Open
Abstract
INTRODUCTION Despite substantial research and provision of dental care, significant morbidity remains for children's oral health. Guided by social practice theory (SPT), this research moves away from the often-ineffective focus on changing individual behavior to rethinking the centrality of the social world in promoting or undermining oral health outcomes. We define social practice as a routinized relational activity linking and integrating certain elements (competence, materials, and meanings) into the performance of a practice that is reproduced across time and space. OBJECTIVE To investigate oral health in preschool children in Perth, Western Australia, using social practice theory. METHODS With no definitive methodology for investigating SPT, we chose focused ethnography as a problem-focused, context-specific approach using mainly interviews to investigate participants' experience caring for their children's oral health. The focus of analysis was the practice of oral health care, not individual behavior, where themes identified from participants' transcripts were organized into categories of elements and performance. RESULTS Eleven parents, all of whom were married or partnered, were interviewed in 2021. Findings identified social practices relevant to oral health within parenting and family relations linked to routine daily activities, including shopping, consumption of food and beverages, and toothbrushing. Oral health literacy was reflected in integrating competence, materials, and meanings into performing oral health care, notably preferences for children to drink water over sugary beverages and information often being sourced from social media and mothers' groups rather than health providers. CONCLUSION Focusing on social practices as the unit of analysis offers a more layered understanding of elements in young children's oral health care that can indicate where the problem may lie. Findings provide an opportunity to consider future research and policy directions in children's oral health. KNOWLEDGE TRANSFER STATEMENT Examining social practices related to young children's oral health care identifies parents/carers' knowledge about, for example, toothbrushing, the resources required, and why toothbrushing is important. Analyzing these separate elements can reveal both enablers and barriers to oral health care. This provides researchers, clinicians and policymakers an opportunity to focus on not changing individual behavior but understanding how social context impacts parents/carers' capacity to make optimum decisions around young children's oral health.
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Affiliation(s)
- A Durey
- School of Population and Global Health, The University of Western Australia, Perth, Western Australia, Australia
| | - P Ward
- Research Centre for Public Health, Equity and Human Flourishing, Torrens University, Adelaide, SA, Australia
| | - E Haynes
- School of Population and Global Health, The University of Western Australia, Perth, Western Australia, Australia
| | - S R Baker
- School of Clinical Dentistry, Sheffield University, Sheffield, UK
| | - H Calache
- La Trobe University, Department of Clinical Sciences, La Trobe Rural Health School, Bendigo, VIC, Australia
| | - L Slack-Smith
- School of Population and Global Health, The University of Western Australia, Perth, Western Australia, Australia
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7
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Blank ML, Hoek J. Smoking, vaping and drinking: A qualitative analysis of Aotearoa New Zealand young adults who tried e-cigarettes to stop smoking tobacco. Addiction 2024; 119:686-695. [PMID: 38114132 DOI: 10.1111/add.16413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 11/01/2023] [Indexed: 12/21/2023]
Abstract
BACKGROUND AND AIM Social practices such as smoking-drinking co-use often go 'hand-in-hand', linked by the coordination of materials, skills and meanings. However, the experience of using e-cigarettes while drinking among people who smoke (and drink) remains underexplored. We used social practice theory to show how smoking, vaping and drinking intersect and to explain how vaping created two new social practices among people who tried e-cigarettes to stop smoking: 'vaping-drinking' co-use and 'smoking-vaping-drinking' poly-use. METHODS We conducted five in-depth interviews over 18-24 weeks during 2018-19, with each of nine Aotearoa New Zealand young adults aged 20-29 years. Participants smoked daily, did not regularly use e-cigarettes at entry and wished to try vaping to stop smoking. We analysed participants' reports of smoking or vaping while drinking using thematic analysis. RESULTS Individual participants reported both co-use and poly-use occasions throughout the study. Vaping-drinking co-use arose from practice 'replacement' processes, where vaping fully substituted smoking. Smoking-vaping-drinking poly-use arose from 'adjacency' processes where vaping complemented smoking. Participants used both processes flexibly over time, which required new skills in material, temporal, pleasure and social coordination to try to recreate valued meanings of comfort, security and communality associated with well-established smoking-drinking practices. Unsuccessful coordination attempts maintained smoking-drinking co-use. CONCLUSION Among Aotearoa New Zealand young adult smokers who want to use vaping to stop smoking, drinking occasions may help to maintain existing smoking-drinking practices and facilitate the development of vaping-drinking co-use and smoking-vaping-drinking poly-use practices, potentially prolonging individuals' exposure to smoking.
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Affiliation(s)
- Mei-Ling Blank
- Department of Preventive and Social Medicine, University of Otago, Ōtepoti Dunedin, Aotearoa, New Zealand
| | - Janet Hoek
- Department of Public Health, University of Otago, Te Whanganui-a-Tara Pōneke, Wellington, Aotearoa, New Zealand
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McCoy CA, Johnston E, Hogan C. The impact of socioeconomic status on health practices via health lifestyles: Results of qualitative interviews with Americans from diverse socioeconomic backgrounds. Soc Sci Med 2024; 344:116618. [PMID: 38324976 DOI: 10.1016/j.socscimed.2024.116618] [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: 06/07/2023] [Revised: 12/08/2023] [Accepted: 01/18/2024] [Indexed: 02/09/2024]
Abstract
We performed 55 qualitative interviews with Americans from diverse socioeconomic backgrounds from a small city in the Northeast to better understand the complex process through which socioeconomic status (SES) influences the health practices persons carry out. We argue that SES not only influences health practices directly, but also via shaping interviewees' health lifestyles. We describe four connected ways that SES shapes interviewees' health lifestyles: (a) the impact of physical and mental illness on how much time, energy, and resources can be devoted to health; (b) the impact of social connections on opportunities to engage in healthy practices; (c) variation in interviewees' sense of control over health and health practices; and (d) how intentional and planned out interviewees' health lifestyles are. Although explored previously, the aim of this study is to examine how these elements come together to form into distinct styles of health shaped by the socioeconomic background of our respondents.
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Affiliation(s)
- Charles Allan McCoy
- University of Nottingham Medical School at Derby, Medical Sciences and Graduate Entry Medicine, Derby, United Kingdom.
| | - Eliana Johnston
- State University of New York, College at Plattsburgh, Department of Sociology, New York, United States
| | - Cellan Hogan
- City University of New York, Queens College, Department of Educational and Community Programs, New York, United States
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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.
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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
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Kemper JA, Spotswood F, White SK. The emergence of plastic-free grocery shopping: Understanding opportunities for practice transformation. JOURNAL OF ENVIRONMENTAL MANAGEMENT 2024; 349:119290. [PMID: 37918237 DOI: 10.1016/j.jenvman.2023.119290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/03/2023] [Revised: 09/24/2023] [Accepted: 10/06/2023] [Indexed: 11/04/2023]
Abstract
Despite consumer concern for sustainability, avoiding plastic packaging, particularly in food shopping, is difficult due to its pervasiveness and usefulness. Yet achieving changes in consumer behaviour is an important part of environmental management approaches towards a circular economy and plastic reduction. This research explores how everyday food shopping practices might adapt and evolve to become more sustainable through consumers avoiding, reducing, or replacing plastic packaging in their grocery shopping. This qualitative research, based on eighteen semi-structured interviews with sustainably-oriented consumers, finds that plastic-free shopping practices are challenging for even committed practitioners. However, we illuminate four mechanisms representing 'bright spots' (i.e., points of optimism) that offer specific opportunities for environmental management. We define these as destabilisation, envisioning, emotional connection and adaptation. Destabilisation and envisioning help with recruitment of practitioners to plastic-free shopping, and emotional connection and adaptation help support practitioner loyalty and commitment. Further, consumer reflexivity and habituated sustainable-orientation supports practice recruitment, stabilisation and transition. We discuss the implications of our findings for environmental management approaches to 'behaviour change', focusing on the role of policymakers, social marketers, retailers, and manufacturers in fostering competitive, stable plastic-free grocery shopping.
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Affiliation(s)
- Joya A Kemper
- University of Canterbury Business School, University of Canterbury, 22 Kirkwood Avenue, Ilam, Christchurch 8140, New Zealand.
| | | | - Samantha K White
- Lincoln University, Ellesmere Junction Road, Lincoln, New Zealand
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11
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Blanchard AK, Ansari S, Rajput R, Colbourn T, Houweling TAJ, Lorway R, Isac S, Prost A, Anthony J. 'That is because we are alone': A relational qualitative study of socio-spatial inequities in maternal and newborn health programme coverage in rural Uttar Pradesh, India. Glob Public Health 2024; 19:2348640. [PMID: 38716491 DOI: 10.1080/17441692.2024.2348640] [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: 11/16/2023] [Accepted: 04/22/2024] [Indexed: 05/15/2024]
Abstract
This qualitative study was conducted in Uttar Pradesh state, India to explore how interrelated socio-economic position and spatial characteristics of four diverse villages may have influenced equity in coverage of community-based maternal and newborn health (MNH) services. We conducted social mapping and three focus group discussions in each village, among women of lower and higher socio-economic position who recently gave birth, and with community health workers (n = 134). Data were analysed in NVivo 11.0 using thematic framework analysis. The extent of socio-economic hierarchies and spatial disparateness within the village, combined with distance to larger centers, together shaped villages' level of socio-spatial remoteness. Disadvantaged socio-economic groups expressed being more often spatially isolated, with less access to infrastructure, resources or services, which was heightened if the village was physically distant from larger centers. In more socio-spatially remote villages, inequities in coverage of MNH services that disadvantaged lower socio-economic position groups were compounded as these groups more often experienced ASHA vacancies, as well as greater distance to and poorer perceived quality of health services nearest the village. The results inform a conceptual framework of 'socio-spatial remoteness' that can guide public health research and programmes to more comprehensively address health inequities within India and beyond.
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Affiliation(s)
- Andrea K Blanchard
- Institute for Global Public Health, University of Manitoba, Winnipeg, Canada
| | | | | | - Tim Colbourn
- Institute for Global Health, University College London, London, UK
| | | | - Robert Lorway
- Institute for Global Public Health, University of Manitoba, Winnipeg, Canada
| | - Shajy Isac
- Institute for Global Public Health, University of Manitoba, Winnipeg, Canada
- India Health Action Trust, Lucknow, India
| | - Audrey Prost
- Institute for Global Health, University College London, London, UK
| | - John Anthony
- Institute for Global Public Health, University of Manitoba, Winnipeg, Canada
- India Health Action Trust, Lucknow, India
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12
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Del Rio Carral M, Volpato L, Michoud C. 'I wanted to share with you some of my healthy habits': YouTubers' staging of health-related practices. Psychol Health 2024; 39:68-90. [PMID: 35350936 DOI: 10.1080/08870446.2022.2057495] [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: 07/07/2021] [Accepted: 03/18/2022] [Indexed: 10/18/2022]
Abstract
Professional YouTubers have become highly popular in producing video content through self-mediation. Objective. The present article aimed to study ways in which lifestyle YouTubers construct health practices in their videos within the YouTube media culture. Design. We conducted a narrative and visual analysis across a selection of 15 videos. Results. Results showed that YouTubers' practices and recommendations for a better life were structured around three themes: Eating to live well; Exercising to live well; Resting to live well and, a fourth cross-cutting theme on Practices aimed at self-development to achieve health and happiness. YouTubers were mainly female presenting, as well as middle/upper-class and white appearing. An overall optimistic tone characterised their health stories, as they delivered personal experiences of success on becoming healthy, happy, and better persons, while encouraging viewers to act similarly. Our findings suggested that YouTubers actively contribute to construct unprecedented definitions of health, enhanced by the social media culture and broader societal logics of healthism and postfeminism. Conclusion. Our study constitutes an original contribution to critical health psychology by examining some of the paradoxes raised by social media influencers like YouTubers regarding health and wellbeing.
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Affiliation(s)
- María Del Rio Carral
- Psychology, MOULINE, University of Lausanne- UNIL-Mouline, Lausanne, Switzerland
| | - Lucia Volpato
- Psychology, MOULINE, University of Lausanne- UNIL-Mouline, Lausanne, Switzerland
| | - Chloé Michoud
- Psychology, MOULINE, University of Lausanne- UNIL-Mouline, Lausanne, Switzerland
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Paul J, Merz S, Bergholz A, König F, Weigt J, Eich-Krohm A, Apfelbacher C, Holmberg C. Social health: rethinking the concept through social practice theory and feminist care ethics. MEDICAL HUMANITIES 2023; 49:752-759. [PMID: 37657910 DOI: 10.1136/medhum-2022-012535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/21/2023] [Indexed: 09/03/2023]
Abstract
The social sciences have long shown that health is not born of pure biology, empirically (re)centred the social and material causes of disease, and affirmed the subjective experiences of disease. Disputed both in popular and academic discourses, social health has variously attempted to stress the social aspects of health. Existing conceptions remain analytically limited as they are predominantly used as descriptors for populational health. This article theorises social health as an analytical lens for making sense of the relations, affects and events where health unfolds and comes into expression. Drawing on social practice theory, feminist care ethics and posthumanism this conceptual paper re-imagines how social health might be conceived as lived social practices anchored in care. Care within our framework acknowledges the unavoidable interdependency foundational to the existence of beings and stresses the 'know how' and embodied practices of care in the mundane in order to emphasise that care itself is absolutely integral to the maintenance of social health. The article argues that health needs to be understood as a verb intrinsically (re)made in and through social contexts and structures and comprised of meaningful, human-human and human-non-human interactions. Ultimately, in theorising social health through mundane care practices, we hope to open up research to making sense of how the doing of health unfolds inside often banal, patterned forms of social activity. Such taken-for-granted social practices exemplify the often overlooked lived realities that comprise our health. To understand health in its own right, we argue, these everyday practices need to be interrogated.
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Affiliation(s)
- Joshua Paul
- Institute for Social Medicine and Epidemiology, Medizinische Hochschule Brandenburg CAMPUS GmbH, Neuruppin, Germany
| | - Sibille Merz
- Institute for Social Medicine and Epidemiology, Medizinische Hochschule Brandenburg CAMPUS GmbH, Neuruppin, Germany
| | - Andreas Bergholz
- Institute for Social Medicine and Epidemiology, Medizinische Hochschule Brandenburg CAMPUS GmbH, Neuruppin, Germany
| | - Franziska König
- Institute for Social Medicine and Epidemiology, Medizinische Hochschule Brandenburg CAMPUS GmbH, Neuruppin, Germany
| | - Julia Weigt
- Faculty of Medicine, Otto-von-Guericke-University Magdeburg Institute of Social Medicine and Health Economics, Magdeburg, Germany
| | - Astrid Eich-Krohm
- Faculty of Medicine, Otto-von-Guericke-University Magdeburg Institute of Social Medicine and Health Economics, Magdeburg, Germany
| | - Christian Apfelbacher
- Faculty of Medicine, Otto-von-Guericke-University Magdeburg Institute of Social Medicine and Health Economics, Magdeburg, Germany
| | - Christine Holmberg
- Institute for Social Medicine and Epidemiology, Medizinische Hochschule Brandenburg CAMPUS GmbH, Neuruppin, Germany
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Persson Waye K, Löve J, Lercher P, Dzhambov AM, Klatte M, Schreckenberg D, Belke C, Leist L, Ristovska G, Jeram S, Kanninen KM, Selander J, Arat A, Lachmann T, Clark C, Botteldooren D, White K, Julvez J, Foraster M, Kaprio J, Bolte G, Psyllidis A, Gulliver J, Boshuizen H, Bozzon A, Fels J, Hornikx M, van den Hazel P, Weber M, Brambilla M, Braat-Eggen E, Van Kamp I, Vincens N. Adopting a child perspective for exposome research on mental health and cognitive development - Conceptualisation and opportunities. ENVIRONMENTAL RESEARCH 2023; 239:117279. [PMID: 37778607 DOI: 10.1016/j.envres.2023.117279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/09/2023] [Revised: 09/27/2023] [Accepted: 09/29/2023] [Indexed: 10/03/2023]
Abstract
Mental disorders among children and adolescents pose a significant global challenge. The exposome framework covering the totality of internal, social and physical exposures over a lifetime provides opportunities to better understand the causes of and processes related to mental health, and cognitive functioning. The paper presents a conceptual framework on exposome, mental health, and cognitive development in children and adolescents, with potential mediating pathways, providing a possibility for interventions along the life course. The paper underscores the significance of adopting a child perspective to the exposome, acknowledging children's specific vulnerability, including differential exposures, susceptibility of effects and capacity to respond; their susceptibility during development and growth, highlighting neurodevelopmental processes from conception to young adulthood that are highly sensitive to external exposures. Further, critical periods when exposures may have significant effects on a child's development and future health are addressed. The paper stresses that children's behaviour, physiology, activity pattern and place for activities make them differently vulnerable to environmental pollutants, and calls for child-specific assessment methods, currently lacking within today's health frameworks. The importance of understanding the interplay between structure and agency is emphasized, where agency is guided by social structures and practices and vice-versa. An intersectional approach that acknowledges the interplay of social and physical exposures as well as a global and rural perspective on exposome is further pointed out. To advance the exposome field, interdisciplinary efforts that involve multiple scientific disciplines are crucial. By adopting a child perspective and incorporating an exposome approach, we can gain a comprehensive understanding of how exposures impact children's mental health and cognitive development leading to better outcomes.
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Affiliation(s)
- Kerstin Persson Waye
- School of Public Health and Community Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden.
| | - Jesper Löve
- School of Public Health and Community Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Peter Lercher
- Institute of Highway Engineering and Transport Planning, Graz University of Technology, Graz, Austria
| | - Angel M Dzhambov
- Institute of Highway Engineering and Transport Planning, Graz University of Technology, Graz, Austria; Department of Hygiene, Faculty of Public Health, Medical University of Plovdiv, Plovdiv, Bulgaria; Research Group "Health and Quality of Life in a Green and Sustainable Environment", SRIPD, Medical University of Plovdiv, Plovdiv, Bulgaria; Environmental Health Division, Research Institute at Medical University of Plovdiv, Medical University of Plovdiv, Bulgaria
| | - Maria Klatte
- Cognitive and Developmental Psychology, University of Kaiserslautern-Landau, Kaiserslautern, Germany
| | - Dirk Schreckenberg
- Centre for Applied Psychology, Environmental and Social Research (Zeus GmbH), Hagen, Germany
| | - Christin Belke
- Centre for Applied Psychology, Environmental and Social Research (Zeus GmbH), Hagen, Germany
| | - Larisa Leist
- Cognitive and Developmental Psychology, University of Kaiserslautern-Landau, Kaiserslautern, Germany
| | - Gordana Ristovska
- Institute of Public Health of the Republic of North Macedonia, Skopje, Macedonia
| | - Sonja Jeram
- National Institute of Public Health, Ljubljana, Slovenia
| | - Katja M Kanninen
- A.I. Virtanen Institute for Molecular Sciences, University of Eastern Finland, Kuopio, Finland
| | - Jenny Selander
- Unit of Occupational Medicine, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Arzu Arat
- Unit of Occupational Medicine, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Thomas Lachmann
- Cognitive and Developmental Psychology, University of Kaiserslautern-Landau, Kaiserslautern, Germany; Centro de Investigación Nebrija en Cognición (CINC), Universidad Nebrija, Madrid, Spain
| | - Charlotte Clark
- Population Health Research Institute, St George's, University of London, London, United Kingdom
| | - Dick Botteldooren
- Department of Information Technology, Faculty of Engineering and Architecture, Ghent University, Ghent, Belgium
| | - Kim White
- National Institute for Public Health and the Environment, Netherlands
| | - Jordi Julvez
- Institut D'Investigació Sanitària Pere Virgili (IISPV), Clinical and Epidemiological Neuroscience Group (NeuroÈpia), Reus, Spain
| | | | - Jaakko Kaprio
- Institute for Molecular Medicine Finland and Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Gabriele Bolte
- Institute of Public Health and Nursing Research, University of Bremen, Bremen, Germany
| | - Achilleas Psyllidis
- Department of Sustainable Design Engineering, Delft University of Technology, Delft, the Netherlands
| | - John Gulliver
- Population Health Research Institute, St George's, University of London, London, United Kingdom; Centre for Environmental Health and Sustainability & School of Geography, Geology and the Environment, University of Leicester, Leicester, United Kingdom
| | - Hendriek Boshuizen
- Department for Statistics, Datascience and Mathematical Modelling, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - Alessandro Bozzon
- Department of Sustainable Design Engineering, Delft University of Technology, Delft, the Netherlands
| | - Janina Fels
- Institute for Hearing Technology and Acoustics, RWTH Aachen University, Aachen, Germany
| | - Maarten Hornikx
- Department of the Built Environment, Eindhoven University of Technology, Eindhoven, the Netherlands
| | - Peter van den Hazel
- International Network on Children's Health, Environment and Safety, Ellecom, the Netherlands
| | | | - Marco Brambilla
- Data Science Laboratory, Politecnico di Milano, Milan, Italy
| | | | - Irene Van Kamp
- National Institute for Public Health and the Environment, Netherlands
| | - Natalia Vincens
- School of Public Health and Community Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
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Opoku P, Osei-Tutu A, Oti-Boadi M. Psychosocial impacts of caring for a child with a genetic disorder in Accra, Ghana. J Community Genet 2023; 14:565-574. [PMID: 37581869 PMCID: PMC10725383 DOI: 10.1007/s12687-023-00662-y] [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: 11/25/2022] [Accepted: 08/08/2023] [Indexed: 08/16/2023] Open
Abstract
Caregivers caring for a child with a genetic condition may experience psychosocial distress, which may be compounded by the context in which the caring takes place. Few studies have examined psychosocial distress and support among caregivers caring for a child with a genetic disorder in low-middle-income countries such as Ghana. The purpose of the current study was to investigate the psychosocial impacts of caring for a child with a genetic disorder in an urban setting in Ghana's capital, Accra. We conducted individual interviews among 17 caregivers who were taking care of children with various genetic disorders including, albinism, Edward's syndrome, osteogenesis imperfecta, sickle cell disease, and spondyloepiphyseal dysplasia congenita. Thematic analysis of the data revealed three main themes on the psychosocial impacts, including: (1) self-blame, guilt, and shame; (2) sleep and mood disturbances; and (3) discrimination and stigmatization. We observed three themes about support: (1) psychological support; (2) family and community support; and (3) institutional support. Participants reported limited support from professionals such as psychologists. Discussion focuses on the supportive care needs of caregivers and implications for genetic counselling awareness, advocacy, and training.
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Affiliation(s)
- Paul Opoku
- Department of Psychology, University of Ghana, Accra, Ghana
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Mugavin J, Room R, Callinan S, MacLean S. How do people drink alcohol at a low-risk level? HEALTH SOCIOLOGY REVIEW : THE JOURNAL OF THE HEALTH SECTION OF THE AUSTRALIAN SOCIOLOGICAL ASSOCIATION 2023; 32:311-326. [PMID: 37162256 DOI: 10.1080/14461242.2023.2209090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Accepted: 04/26/2023] [Indexed: 05/11/2023]
Abstract
Reducing the risks associated with drinking is an ongoing public health goal. Approximately two-fifths of Australian adults consume alcohol within low-risk guidelines, yet little is known about their drinking patterns or practices. In this paper, we use social practice theory to consider low-risk drinking at home as a routinised social practice with material, meaning and competence dimensions. We analysed open-text survey responses from 252 Australian adults (30-65, 89% female) who were considered low-risk drinkers. A low-risk drinking occasion was typically closely linked to other practices such as eating dinner or connecting with family or friends. Drinking alcohol, even in small amounts, was associated with enjoyment. Being attuned to bodily sensations and applying some self-imposed rules were competencies that allowed low-risk drinkers to avoid intoxication. Low-risk drinking practices entail some elements that can inform health promotion, including encouraging efforts to limit drinking to times of the day (e.g. during meals) and to attend to bodily feelings of sufficiency. The study also shows how low-risk drinking is entangled with gendered and age-related norms about drinking, and facilitated by rarely being in 'intoxigenic' environments. These factors are imbricated with individual decisions in our respondents' capacity to consume alcohol moderately.
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Affiliation(s)
- Janette Mugavin
- Centre for Alcohol Policy Research, La Trobe University, Bundoora, Australia
| | - Robin Room
- Centre for Alcohol Policy Research, La Trobe University, Bundoora, Australia
- Centre for Social Research on Alcohol and Drugs, Department of Public Health Sciences, Stockholm University, Stockholm, Sweden
| | - Sarah Callinan
- Centre for Alcohol Policy Research, La Trobe University, Bundoora, Australia
| | - Sarah MacLean
- Centre for Alcohol Policy Research, La Trobe University, Bundoora, Australia
- School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Australia
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Wittels P, Kay T, Mansfield L. Enabling mothers of young children in a low SES area to co-design the support they are seeking for the adoption of healthy behaviours. Perspect Public Health 2023:17579139231205488. [PMID: 37850725 DOI: 10.1177/17579139231205488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2023]
Abstract
AIMS There is a need for interventions that meet the needs of low socioeconomic status (SES) groups, to encourage the adoption of healthy diets and physical activity, in line with current public health guidance. This qualitative research used co-production, a method which actively involves the relevant community, to identify and describe public health interventions to support a group of mothers of young children living in a low SES area. METHODS A group of 20 mothers took part in three in-depth qualitative interviews to discuss in detail the type of support that would be of value to them for the adoption and maintenance of healthy behaviours. The mothers were subsequently invited to take part in a public engagement project, a community-based self-help group. RESULTS Four themes explained the principles of interventions that would be of value in supporting the mothers with the adoption of healthy behaviours, namely, a community-based self-help group, support for the whole family and support in the home and influencing the environment. These were then further developed into two types of intervention (1) learning for self-help and family care, which encompassed the first three learning-based themes and (2) community of support, which covered influencing the environment and the experience of the community-based self-help group. CONCLUSION Co-production enabled a group of mothers of young children, from a low SES area, to describe the type of support that would help them with the establishment and maintenance of healthy lifestyle behaviours. A community-based self-help group warrants further research.
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Affiliation(s)
- P Wittels
- Brunel University London, Kingston Lane, London UB8 3PH, UK
| | - T Kay
- Independent Researcher, Brunel University London, London, UK
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18
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McQuoid J, Lowery BC, Wright LS, Cohn AM. Outdoor Medical Cannabis Advertising in Oklahoma: Examining Regulatory Compliance and Social Meanings in Billboard Content. Subst Use Misuse 2023; 58:1425-1437. [PMID: 37338932 PMCID: PMC11145737 DOI: 10.1080/10826084.2023.2223299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/21/2023]
Abstract
Background: Medical cannabis currently dominates the U.S. cannabis advertising landscape. The public is increasingly exposed to outdoor cannabis advertising, which increases positive attitudes about and intentions to use cannabis. Research is lacking regarding outdoor cannabis advertising content. This article characterizes the content of outdoor cannabis advertising in Oklahoma, one of the fastest growing U.S. medical cannabis markets. Methods: We conducted a content analysis of cannabis advertising billboard images (n = 73) from Oklahoma City and Tulsa, photographed May 2019-November 2020. We followed a primarily inductive, iterative team approach to thematically analyze billboard content in NVIVO. We reviewed all images, identified a broad coding taxonomy, and then incorporated emergent codes and those related to advertising regulation (e.g. youth/children). We totaled frequencies of code application across billboards and reexamined billboards for final themes. Results: Major themes were social meanings related to cannabis subculture, formal medical systems, and nature, and the presence of company contact information. Minor themes related to convenience, price promotions, store proximity, U.S. affiliation, product quality, and spirituality. State advertising regulation violations were rare, with the exception of content that may promote curative or therapeutic effects (4%) and misrepresentation of product state of origin (1.4%). Conclusion: Outdoor medical cannabis advertising in Oklahoma blurs boundaries between formal medical discourses and cannabis subculture that is suspicious of messaging from authorities and regards cannabis as harmless and natural. Increased monitoring of advertising regulation compliance and greater understanding of social discourses within emerging markets is needed to promote public health within the context of cannabis advertising.
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Affiliation(s)
- Julia McQuoid
- Department of Family and Preventive Medicine, TSET Health Promotion Research Center, University of Oklahoma Health Sciences Center, University of Oklahoma College of Medicine
| | - Bryce C. Lowery
- Christopher C. Gibbs College of Architecture, University of Oklahoma
| | - LaNita S. Wright
- Department of Health Promotion and Physical Education, Kennesaw State University
| | - Amy M. Cohn
- Department of Pediatrics, TSET Health Promotion Research Center, University of Oklahoma Health Sciences Center, University of Oklahoma College of Medicine
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Keene CM, Euvrard J, Amico KR, Ragunathan A, English M, McKnight J, Orrell C. Conceptualising engagement with HIV care for people on treatment: the Indicators of HIV Care and AntiRetroviral Engagement (InCARE) Framework. BMC Health Serv Res 2023; 23:435. [PMID: 37143067 PMCID: PMC10161576 DOI: 10.1186/s12913-023-09433-4] [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: 08/12/2022] [Accepted: 04/14/2023] [Indexed: 05/06/2023] Open
Abstract
BACKGROUND As the crisis-based approach to HIV care evolves to chronic disease management, supporting ongoing engagement with HIV care is increasingly important to achieve long-term treatment success. However, 'engagement' is a complex concept and ambiguous definitions limit its evaluation. To guide engagement evaluation and development of interventions to improve HIV outcomes, we sought to identify critical, measurable dimensions of engagement with HIV care for people on treatment from a health service-delivery perspective. METHODS We used a pragmatic, iterative approach to develop a framework, combining insights from researcher experience, a narrative literature review, framework mapping, expert stakeholder input and a formal scoping review of engagement measures. These inputs helped to refine the inclusion and definition of important elements of engagement behaviour that could be evaluated by the health system. RESULTS The final framework presents engagement with HIV care as a dynamic behaviour that people practice rather than an individual characteristic or permanent state, so that people can be variably engaged at different points in their treatment journey. Engagement with HIV care for those on treatment is represented by three measurable dimensions: 'retention' (interaction with health services), 'adherence' (pill-taking behaviour), and 'active self-management' (ownership and self-management of care). Engagement is the product of wider contextual, health system and personal factors, and engagement in all dimensions facilitates successful treatment outcomes, such as virologic suppression and good health. While retention and adherence together may lead to treatment success at a particular point, this framework hypothesises that active self-management sustains treatment success over time. Thus, evaluation of all three core dimensions is crucial to realise the individual, societal and public health benefits of antiretroviral treatment programmes. CONCLUSIONS This framework distils a complex concept into three core, measurable dimensions critical for the maintenance of engagement. It characterises elements that the system might assess to evaluate engagement more comprehensively at individual and programmatic levels, and suggests that active self-management is an important consideration to support lifelong optimal engagement. This framework could be helpful in practice to guide the development of more nuanced interventions that improve long-term treatment success and help maintain momentum in controlling a changing epidemic.
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Affiliation(s)
- Claire M Keene
- Oxford Centre for Global Health Research, Nuffield Department of Medicine, University of Oxford, Oxford, UK.
| | - Jonathan Euvrard
- Centre for Infectious Disease Epidemiology and Research, School of Public Health and Family Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - K Rivet Amico
- Health Behaviour and Health Education, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Ayesha Ragunathan
- Oxford Centre for Global Health Research, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Mike English
- Oxford Centre for Global Health Research, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Jacob McKnight
- Oxford Centre for Global Health Research, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Catherine Orrell
- Department of Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
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Girán J, Girán KA, Ormándlaky D, Pozsgai É, Kiss I, Kollányi Z. Determinants of pupils' energy drink consumption - Findings from a Hungarian primary school. Heliyon 2023; 9:e15954. [PMID: 37206032 PMCID: PMC10189414 DOI: 10.1016/j.heliyon.2023.e15954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 04/19/2023] [Accepted: 04/27/2023] [Indexed: 05/21/2023] Open
Abstract
Consumption of energy drinks is harmful in childhood and adolescence, and its increasing popularity makes it a public health threat in this age group. Our study aimed to assess energy drink (ED) consumption and identify the context and determinants of its consumption at a Hungarian primary school. A mixed-method approach was used for the research, including a survey filled in by 157 10-15-year-old pupils and World Café workshops (WCWs) involving pupils, home-room teachers, and Parental Council representatives (N = 39). The Jamovi 2.2.5. The software was used to perform descriptive statistics and logistic regression, and a causal loop diagram was created based on the results of the WCWs. The survey results revealed that almost one-third of the pupils consumed EDs regularly, and most daily consumers drank high amounts (500ml). Most students considered ED consumption unhealthy, yet every fifth drank them. Buying breakfast on the way to school increased the odds of ED consumption almost threefold. According to the WCWs' findings, the determinants of ED consumption were embedded in two critical contextual sets; one was the need for energy and concentration boost and the Perception of high social acceptance of ED consumption. Our results suggest that interventions to reduce students' ED consumption need to include increased parents' involvement in controlling their children's screen time and encouraging them to provide breakfast at home for their children. There is also an urgent need to restrict the marketing of EDs and strictly regulate access to EDs for under-18s.
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Affiliation(s)
- János Girán
- University of Pécs, Medical School, Department of Public Health Medicine, Szigeti út 12, Pécs 7624, Hungary
- Corresponding
| | - Kyra Anna Girán
- Eötvös Lóránd University, Faculty of Education and Psychology, Psychology BA Program, Kazinczy u. 23-27, Budapest 1075, Hungary
| | - Dalma Ormándlaky
- Kodály Zoltán Catholic Primary School and Kindergarten for Singing and Music in Komló, Templom tér 2, Komló 7300, Hungary
| | - Éva Pozsgai
- University of Pécs, Medical School, Department of Public Health Medicine, Szigeti út 12, Pécs 7624, Hungary
- University of Pécs, Medical School, Department of Primary Health Care, Szigeti út 12, Pécs 7624, Hungary
| | - István Kiss
- University of Pécs, Medical School, Department of Public Health Medicine, Szigeti út 12, Pécs 7624, . Hungary
| | - Zsófia Kollányi
- Eötvös Loránd University, Faculty of Social Sciences, Institute of Economics, Pázmány P. stny. 1/A, Budapest 1117, Hungary
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Winkler LL, Toft U, Glümer C, Bloch P, Buch-Andersen T, Christensen U. Involving supermarkets in health promotion interventions in the Danish Project SoL. A practice-oriented qualitative study on the engagement of supermarket staff and managers. BMC Public Health 2023; 23:706. [PMID: 37072841 PMCID: PMC10111755 DOI: 10.1186/s12889-023-15501-5] [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: 05/09/2022] [Accepted: 03/21/2023] [Indexed: 04/20/2023] Open
Abstract
BACKGROUND Supermarkets have been suggested as relevant settings for environmental and educational initiatives encouraging healthier shopping and eating decisions, but in the literature, limited attention has been paid to the context, perspectives, and everyday practices of supermarket staff. The aim of this study was to examine the engagement of supermarket staff in a health promotion project from a practice-oriented perspective. METHODS The study was based on qualitative data collected in the supermarket setting of Project SoL; a community-based health promotion project in Denmark. We conducted 26 in-depth interviews with store managers and other key staff members in seven participating supermarkets. In addition, we collected data on planning, implementation, and perceptions of supermarket staff of in-store interventions and other project-related activities. These field data included short telephone interviews, observational notes, photos, and audiotapes of meetings. Data were analysed from the perspective of practice theory. RESULTS Although supermarket staff found community-based health promotion meaningful to engage in, the study observed that their engagement was challenged by a business mindset, practical routines and structural requirements favouring sales promotion over health promotion. Nevertheless, there were also examples of how health promotion activities and ways of thinking were successfully incorporated in everyday staff practices during and after Project SoL. CONCLUSIONS Our findings point to both potentials and challenges for using supermarkets as settings for health promotion. The voluntary engagement of supermarket staff in community-based health projects cannot stand alone but should be supplemented by more long-lasting strategies and policies regulating this and other food environments. Context-sensitive and practice-oriented analyses in local food environments could inform such strategies and policies to make sure they target unwanted elements and practices and not just individual behavior.
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Affiliation(s)
- Lise L Winkler
- Center for Clinical Research and Prevention, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Nordre Fasanvej 57, Frederiksberg, 2000, Denmark.
| | - Ulla Toft
- Center for Clinical Research and Prevention, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Nordre Fasanvej 57, Frederiksberg, 2000, Denmark
| | - Charlotte Glümer
- Center for Clinical Research and Prevention, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Nordre Fasanvej 57, Frederiksberg, 2000, Denmark
- Center for Diabetes, Vesterbrogade 121, 3rd floor, København V, 1620, Denmark
| | - Paul Bloch
- Health Promotion Research, Steno Diabetes Center Copenhagen, Borgmester Ib Juuls Vej 83, Herlev, 2730, Denmark
| | - Tine Buch-Andersen
- Center for Clinical Research and Prevention, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Nordre Fasanvej 57, Frederiksberg, 2000, Denmark
| | - Ulla Christensen
- Section of Social Medicine, Department of Public Health, University of Copenhagen, Gothersgade 160, København K, 1123, Denmark
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Kemper JA, Kapetanaki AB, Spotswood F, Roy R, Hassen H, Uzoigwe AG, Fifita 'IME. Food practices adaptation: Exploring the coping strategies of low-socioeconomic status families in times of disruption. Appetite 2023; 186:106553. [PMID: 37044177 PMCID: PMC10084628 DOI: 10.1016/j.appet.2023.106553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 03/21/2023] [Accepted: 04/03/2023] [Indexed: 04/14/2023]
Abstract
COVID-19 impact on global and national food systems, along with associated physical restrictions, lockdowns, and school closures, have led to dramatic changes in families' everyday food practices. Our research explored the way food practices adapted and emerged, allowing families to cope with the disruption caused by COVID-19. We recruited 18 low socio-economic status families with primary school children across the United Kingdom and New Zealand to partake in two interviews, a survey, and the use of an ethnographic app. Analysis illuminates that this disruption triggered the emergence of three practices that were necessary to carry on and mitigate the impact of disrupted food practices; 'asking for help', 'planning' and 'research and experimentation'. As a way to deal with disruption to their food practices, many participants called on the support of the community, including the use of food banks and the sharing of food. Participants discussed the way they had to plan their food, which often involved the expansion of practices formerly enacted to a small degree, such as curation of online shopping lists and stockpiling. Food research and experimentation also emerged as largely new practices, such as freezing foods, learning new recipes online (YouTube), experimenting with new ingredients and recipes. As such, for some participants, experimentation and research transformed cooking practices into leisure practices. The findings have practical implications for policy makers and non-governmental organisations, such as providing formal support that is accessible while reducing any associated stigma. Designing interventions that integrate planning routines within food practices can help build skills (e.g., bulk cooking and freezing) which can be vital during disruptions, aiding families to cope with the difficulties and aftermath of sudden and large-scale disruption, such as a pandemic.
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Affiliation(s)
- Joya A Kemper
- Department of Management, Marketing and Entrepreneurship, University of Canterbury Business School, Kirkwood Drive, Christchurch, New Zealand.
| | | | - Fiona Spotswood
- University of Bristol Business School, Howard House, Bristol, United Kingdom.
| | - Rajshri Roy
- Department of Nutrition and Dietetics, Faculty of Medical and Health Sciences, School of Medical Sciences, University of Auckland, Grafton, Auckland, New Zealand.
| | - Hela Hassen
- King's Business School, King's College London, United Kingdom.
| | - Anthonia Ginika Uzoigwe
- Department of Sociology, School of Social Science, University of Auckland, 58 Symonds Street, Auckland, 1010, New Zealand.
| | - 'Ilaisaane M E Fifita
- Department of Marketing, University of Auckland Business School, 12 Grafton Road, Auckland, New Zealand.
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23
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Mannell J, Washington L, Khaula S, Khoza Z, Mkhwanazi S, Burgess RA, Brown LJ, Jewkes R, Shai N, Willan S, Gibbs A. Challenges and opportunities in coproduction: reflections on working with young people to develop an intervention to prevent violence in informal settlements in South Africa. BMJ Glob Health 2023; 8:e011463. [PMID: 36990642 PMCID: PMC10069549 DOI: 10.1136/bmjgh-2022-011463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Accepted: 03/09/2023] [Indexed: 03/31/2023] Open
Abstract
Coproduction is widely recognised as essential to the development of effective and sustainable complex health interventions. Through involving potential end users in the design of interventions, coproduction provides a means of challenging power relations and ensuring the intervention being implemented accurately reflects lived experiences. Yet, how do we ensure that coproduction delivers on this promise? What methods or techniques can we use to challenge power relations and ensure interventions are both more effective and sustainable in the longer term? To answer these questions, we openly reflect on the coproduction process used as part of Siyaphambili Youth ('Youth Moving Forward'), a 3-year project to create an intervention to address the social contextual factors that create syndemics of health risks for young people living in informal settlements in KwaZulu-Natal province in South Africa. We identify four methods or techniques that may help improve the methodological practice of coproduction: (1) building trust through small group work with similar individuals, opportunities for distance from the research topic and mutual exchanges about lived experiences; (2) strengthening research capacity by involving end users in the interpretation of data and explaining research concepts in a way that is meaningful to them; (3) embracing conflicts that arise between researchers' perspectives and those of people with lived experiences; and (4) challenging research epistemologies through creating spaces for constant reflection by the research team. These methods are not a magic chalice of codeveloping complex health interventions, but rather an invitation for a wider conversation that moves beyond a set of principles to interrogate what works in coproduction practice. In order to move the conversation forward, we suggest that coproduction needs to be seen as its own complex intervention, with research teams as potential beneficiaries.
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Affiliation(s)
| | | | | | | | - Smanga Mkhwanazi
- Gender and Health Research Unit, South African Medical Research Council, Pretoria, South Africa
| | - Rochelle A Burgess
- Institute for Global Health, University College London, London, UK
- Department of Social Work, University of Johannesburg, Auckland Park, South Africa
| | - Laura J Brown
- Institute for Global Health, University College London, London, UK
| | - Rachel Jewkes
- Gender and Health Research Unit, South African Medical Research Council, Pretoria, South Africa
- Office of the Executive Scientist, South African Medical Research Council, Pretoria, South Africa
| | - Nwabisa Shai
- Gender and Health Research Unit, South African Medical Research Council, Pretoria, South Africa
| | - Samantha Willan
- Gender and Health Research Unit, South African Medical Research Council, Pretoria, South Africa
| | - Andrew Gibbs
- Gender and Health Research Unit, South African Medical Research Council, Pretoria, South Africa
- Psychology, University of Exeter, Exeter, UK
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24
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Schmidt RA, Wey TW, Harding KD, Fortier I, Atkinson S, Tough S, Letourneau N, Knight JA, Fraser WD, Bocking A. A harmonized analysis of five Canadian pregnancy cohort studies: exploring the characteristics and pregnancy outcomes associated with prenatal alcohol exposure. BMC Pregnancy Childbirth 2023; 23:128. [PMID: 36855094 PMCID: PMC9972615 DOI: 10.1186/s12884-023-05447-2] [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: 10/03/2022] [Accepted: 02/14/2023] [Indexed: 03/02/2023] Open
Abstract
BACKGROUND As a teratogen, alcohol exposure during pregnancy can impact fetal development and result in adverse birth outcomes. Despite the clinical and social importance of prenatal alcohol use, limited routinely collected information or epidemiological data exists in Canada. The aim of this study was to pool data from multiple Canadian cohort studies to identify sociodemographic characteristics before and during pregnancy that were associated with alcohol consumption during pregnancy and to assess the impact of different patterns of alcohol use on birth outcomes. METHODS We harmonized information collected (e.g., pregnant women's alcohol intake, infants' gestational age and birth weight) from five Canadian pregnancy cohort studies to consolidate a large sample (n = 11,448). Risk factors for any alcohol use during pregnancy, including any alcohol use prior to pregnancy recognition, and binge drinking, were estimated using binomial regressions including fixed effects of pregnancy cohort membership and multiple maternal risk factors. Impacts of alcohol use during pregnancy on birth outcomes (preterm birth and low birth weight for gestational) were also estimated using binomial regression models. RESULTS In analyses adjusting for multiple risk factors, women's alcohol use during pregnancy, both any use and any binge drinking, was associated with drinking prior to pregnancy, smoking during pregnancy, and white ethnicity. Higher income level was associated with any drinking during pregnancy. Neither drinking during pregnancy nor binge drinking during pregnancy was significantly associated with preterm delivery or low birth weight for gestational age in our sample. CONCLUSIONS Pooling data across pregnancy cohort studies allowed us to create a large sample of Canadian women and investigate the risk factors for alcohol consumption during pregnancy. We suggest that future pregnancy and birth cohorts should always include questions related to the frequency and amount of alcohol consumed before and during pregnancy that are prospectively harmonized to support data reusability and collaborative research.
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Affiliation(s)
- Rose A. Schmidt
- grid.17063.330000 0001 2157 2938Dalla Lana School of Public Health, University of Toronto, Toronto, ON Canada ,grid.155956.b0000 0000 8793 5925Institute for Mental Health Policy Research, Centre for Addiction and Mental Health (CAMH), Toronto, ON Canada
| | - Tina W. Wey
- grid.63984.300000 0000 9064 4811Research Institute of the McGill University Health Centre, Montreal, QC Canada
| | - Kelly D. Harding
- Canada Fetal Alcohol Spectrum Disorder Research Network, Vancouver, BC Canada ,grid.258970.10000 0004 0469 5874Department of Psychology, Laurentian University, Sudbury, ON Canada
| | - Isabel Fortier
- grid.63984.300000 0000 9064 4811Research Institute of the McGill University Health Centre, Montreal, QC Canada
| | - Stephanie Atkinson
- grid.25073.330000 0004 1936 8227Department of Pediatrics, McMaster University, Hamilton, ON Canada
| | - Suzanne Tough
- grid.22072.350000 0004 1936 7697Owerko Centre at the Alberta Children’s Hospital Research Institute, University of Calgary, Calgary, AB Canada ,grid.22072.350000 0004 1936 7697Cumming School of Medecine, University of Calgary, Calgary, AB Canada
| | - Nicole Letourneau
- grid.22072.350000 0004 1936 7697Owerko Centre at the Alberta Children’s Hospital Research Institute, University of Calgary, Calgary, AB Canada
| | - Julia A. Knight
- grid.17063.330000 0001 2157 2938Dalla Lana School of Public Health, University of Toronto, Toronto, ON Canada ,grid.250674.20000 0004 0626 6184Lunenfeld-Tanenbaum Research Institute, Sinai Health, Toronto, ON Canada
| | - William D. Fraser
- grid.86715.3d0000 0000 9064 6198Department of Obstetrics and Gynecology, University of Sherbrooke, Sherbrooke, QC Canada
| | - Alan Bocking
- grid.17063.330000 0001 2157 2938Department of Obstetrics and Gynecology, University of Toronto, Toronto, ON Canada
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25
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Lyons AC, Young J, Blake D, Evans P, Stephens C. Home drinking practices among middle-class adults in midlife during the COVID-19 pandemic: Material ubiquity, automatic routines and embodied states. Drug Alcohol Rev 2023. [PMID: 36757806 DOI: 10.1111/dar.13610] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 12/11/2022] [Accepted: 12/20/2022] [Indexed: 02/10/2023]
Abstract
INTRODUCTION Harmful drinking is increasing among mid-life adults. Using social practice theory, this research investigated the knowledge, actions, materials, places and temporalities that comprise home drinking practices among middle-class adults (40-65 years) in Aotearoa New Zealand during 2021-2022 and post the COVID-19 pandemic lockdowns. METHODS Nine friendship groups (N = 45; 26 females, 19 males from various life stages and ethnicities) discussed their drinking practices. A subset of 10 participants (8 female, 2 male) shared digital content (photos, screenshots) about alcohol and drinking over 2 weeks, which they subsequently discussed in an individual interview. Group and interview transcripts were thematically analysed using the digital content to inform the analysis. RESULTS Three themes were identified around home drinking practices, namely: (i) alcohol objects as everywhere, embedded throughout spaces and places in the home; (ii) drinking practices as habitual, automatic and conditioned to mundane everyday domestic chores, routines and times; and (iii) drinking practices intentionally used by participants to achieve desired embodied states to manage feelings linked to domestic and everyday routines. DISCUSSION AND CONCLUSIONS Alcohol was normalised and everywhere within the homes of these midlife adults. Alcohol-related objects and products had their own agency, being entangled with domestic routines and activities, affecting drinking in both automatic and intentional ways. Developing alcohol policy that would change its ubiquitous and ordinary status, and the 'automatic' nature of many drinking practices, is needed. This includes restricting marketing and availability to disrupt the acceptability and normalisation of alcohol in the everyday domestic lives of adults at midlife.
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Affiliation(s)
- Antonia C Lyons
- Centre for Addiction Research, Department of Social and Community Health, University of Auckland, Auckland, New Zealand.,School of Health, Te Herenga Waka Victoria University of Wellington, Wellington, New Zealand
| | - Jessica Young
- School of Health, Te Herenga Waka Victoria University of Wellington, Wellington, New Zealand
| | - Denise Blake
- School of Health, Te Herenga Waka Victoria University of Wellington, Wellington, New Zealand
| | - Penny Evans
- School of Health, Te Herenga Waka Victoria University of Wellington, Wellington, New Zealand
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26
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De Salis HF, Martin R, Mansoor Z, Newton-Howes G, Bell E. A realist review of residential treatment for adults with substance use disorder. Drug Alcohol Rev 2023; 42:827-842. [PMID: 36747370 DOI: 10.1111/dar.13615] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 12/15/2022] [Accepted: 12/30/2022] [Indexed: 02/08/2023]
Abstract
ISSUES Completion of residential treatment for substance use disorder (SUD) relates to improvements in substance use and mental health. Findings from systematic reviews have been equivocal about which interventions work best for clients. There has been limited attention to the theories that explain the effectiveness of residential treatment. APPROACH We conducted a realist review of the literature to identify program theories that would explain successful and unsuccessful outcomes from residential treatment for SUD. The unit of analysis was context-mechanism-outcome (CMO). Inclusion criteria were studies of residential treatment of more than 30 days for adults with SUD. Pharmacological studies were excluded. KEY FINDINGS We identified 24 studies from 5748 screened. The studies were from settings comprising Indigenous programs, faith-based programs, psycho-social interventions and therapeutic communities and were conducted in North America, Scandinavia, Continental Europe and Australasia. We chose six CMO configurations as the best explanations for outcomes from residential treatment. Theories that best explained the mechanisms of change were the need to belong, meaning in life, and self-determination theory. IMPLICATIONS Previous research has noted similar outcomes from different residential treatment interventions, but has not been able to explain these similarities. In contrast, our findings suggest that the outcomes can be explained by causal mechanisms that apply across all programs, regardless of the philosophy of treatment. CONCLUSION We identified six CMO configurations whose mechanisms of change could be explained by three overarching theories-the need to belong, meaning in life and self-determination theory. The findings apply across ethnicities and genders.
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Affiliation(s)
- Henry F De Salis
- Department of Psychological Medicine, University of Otago, Wellington, New Zealand
| | - Rachelle Martin
- Rehabilitation Teaching and Research Unit, Department of Medicine, University of Otago, Wellington, New Zealand.,Burwood Academy Trust, Burwood Hospital, Christchurch, New Zealand
| | - Zara Mansoor
- Department of Psychological Medicine, University of Otago, Wellington, New Zealand
| | - Giles Newton-Howes
- Department of Psychological Medicine, University of Otago, Wellington, New Zealand
| | - Elliot Bell
- Department of Psychological Medicine, University of Otago, Wellington, New Zealand.,Rehabilitation Teaching and Research Unit, Department of Medicine, University of Otago, Wellington, New Zealand
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27
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Spotswood F, Gurrieri L. Understanding health inequalities through a practice-oriented 'capabilities' perspective. Motherhood and leisure time physical activity. SOCIOLOGY OF HEALTH & ILLNESS 2023; 45:423-445. [PMID: 36377671 PMCID: PMC10099979 DOI: 10.1111/1467-9566.13585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Accepted: 11/01/2022] [Indexed: 06/16/2023]
Abstract
In this article, we explore how a capabilities perspective can advance practice theoretic conceptualisations of persistent health inequalities. Specifically, we seek to understand the capabilities necessary for recruitment to leisure time physical activity (LTPA) practices by low SES mothers, a group traditionally excluded from LTPA. Our study illuminates that mothers living a life of social disadvantage face difficulties in becoming recruited to LTPA practices despite, in many cases, the availability of elements required for performance. We identify that temporal, support and energy capabilities are necessary for low SES mothers to become recruitable to LTPA. The dispossession of these capabilities signals inequalities in the constellation of practices that configure this group's lived experiences, in turn giving rise to practice absence and further consolidating patterns of inequality. We offer a framework of practice capabilities and health inequalities to guide future practice-oriented scholarship in the sociology of illness and health, which signals how capabilities may enable or constrain recruitment to health-promoting practices, give rise to inequalities and condition the possibility of practice absence.
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Affiliation(s)
- Fiona Spotswood
- University of Bristol Business School, University of BristolBristolUK
| | - Lauren Gurrieri
- School of Economics, Finance and MarketingRMIT UniversityMelbourneVictoriaAustralia
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28
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Abbas S, Kermode M, Khan MD, Denholm J, Adetunji H, Kane S. What Makes People With Chronic Illnesses Discontinue Treatment? A Practice Theory Informed Analysis of Adherence to Treatment among Patients With Drug-Resistant Tuberculosis in Pakistan. Int J Health Policy Manag 2023; 12:6576. [PMID: 37579474 PMCID: PMC10125133 DOI: 10.34172/ijhpm.2022.6576] [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: 06/30/2021] [Accepted: 12/27/2022] [Indexed: 08/16/2023] Open
Abstract
BACKGROUND Non-adherence to treatment is a frequently observed phenomenon amongst those on long-term treatment for chronic illnesses. This qualitative study draws upon the tenets of 'practice theory' to reveal what shapes patients' ability to adhere to the demanding treatment for drug-resistant tuberculosis (DR-TB) at three treatment sites in Khyber-Pakhtunkhwa (KP) province of Pakistan. METHODS This qualitative study involved observation of service provision over a period of nine months of stay at, and embedment within the three treatment sites and in-depth interviews with 13 service providers and 22 patients who became non-adherent to their treatment. RESULTS Consistent with the extensive research based on the barriers and facilitator approach, both patients, and providers in our study also talked of patients' doubts about diagnosis and treatment efficacy, side-effects of drugs, economic constraints, unreliable disbursements of monetary incentive, attitude of providers and co-morbidities as reasons for non-adherence to treatment. Applying a practice theory perspective yielded more contextualised insights; inadequate help with patients' physical complaints, unempathetic responses to their queries, and failure to provide essential information, created conditions which hindered the establishment and maintenance of the 'practice' of adhering to treatment. These supply-side gaps created confusion, bred resentment, and exacerbated pre-existing distrust of public health services among patients, and ultimately drove them to disengage with the TB services and stop their treatment. CONCLUSION We argue that the lack of supply-side 'responsiveness' to patient needs beyond the provision of a few material inputs is what is lacking in the existing DR-TB program in Pakistan. We conclude that unless Pakistan's TB program explicitly engages with these supply side, system level gaps, patients will continue to struggle to adhere to their treatments and the TB program will continue to lose patients. Conceptually, we make a case for reimagining the act of adherence (or not) to long-term treatment as a 'Practice.'
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Affiliation(s)
- Shazra Abbas
- Nossal Institute for Global Health, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Michelle Kermode
- Nossal Institute for Global Health, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
| | | | - Justin Denholm
- Department of Infectious Diseases, University of Melbourne, Melbourne, VIC, Australia
| | - Hamed Adetunji
- Faculty of Public Health & Health Informatics, Umm Al Qura University, Makkah Almukarramah, Saudi Arabia
| | - Sumit Kane
- Nossal Institute for Global Health, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
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29
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van Leersum CM, Konrad KE, Siebrand E, Malik ZB, den Ouden MEM, Bults M. Engaging older adults with a migration background to explore the usage of digital technologies in coping with dementia. Front Public Health 2023; 11:1125834. [PMID: 37124775 PMCID: PMC10140574 DOI: 10.3389/fpubh.2023.1125834] [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: 12/16/2022] [Accepted: 03/15/2023] [Indexed: 05/02/2023] Open
Abstract
Background Coping with dementia can imply particular challenges for people with a migration background due to diversity in their life course, personal characteristics, and living environment. Some of the services available for people with dementia include digital technologies for care, providing health services, and maintaining or increasing participation, independence, and safety. This study aimed to explore the role of digital technology in coping with dementia in the lives of older adults with a migration background, and the possibilities to engage and collaborate with older adults. Methods This study combined a qualitative interview-based approach with citizen science principles in the design and execution of a project studying the use of Anne4Care. Results and discussion Participants valued that technology should provide health benefits and fit into aspects of their daily lives. Anne4Care was considered helpful in staying independent and connecting to loved ones in their country of birth. The participants needed to learn new competencies to work with the device, and not all had the material prerequisites, such as an internet connection. Still, this learning process was considered purposeful in their life, and the virtual assistant could be integrated into care and daily practices. The involvement of the older adults with dementia as co-researchers made them feel valuable and as equal partners during this research. An important prerequisite for the involvement of older adults with a migration background was existing relations with carers and care organizations. Conclusion Digital care technologies to cope with dementia can become a valuable part of care practices in the lives of older adults with a migration background. Involving older adults in the development of technology, acknowledging their expertise and needs, and working together in short iterations to adapt the technology for their specific needs and situations were experienced as valuable by the researchers, older adults, and care professionals.
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Affiliation(s)
- Catharina M. van Leersum
- Science, Technology, and Policy Studies, Faculty of Behavioural, Management, and Social Sciences, University of Twente, Enschede, Netherlands
- *Correspondence: Catharina M. van Leersum,
| | - Kornelia E. Konrad
- Science, Technology, and Policy Studies, Faculty of Behavioural, Management, and Social Sciences, University of Twente, Enschede, Netherlands
| | - Egbert Siebrand
- Ethics and Technology Research Group, Saxion University of Applied Science, Deventer, Netherlands
| | - Zohrah B. Malik
- Technology, Health and Care Research Group, Saxion University of Applied Science, Enschede, Netherlands
| | - Marjolein E. M. den Ouden
- Technology, Health and Care Research Group, Saxion University of Applied Science, Enschede, Netherlands
| | - Marloes Bults
- Technology, Health and Care Research Group, Saxion University of Applied Science, Enschede, Netherlands
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30
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Gittings L, Colvin C, Hodes R. Traditional and biomedical health practices of adolescent boys and young men living with perinatally-acquired HIV in the Eastern Cape Province of South Africa. Glob Public Health 2023; 18:2205917. [PMID: 37156226 PMCID: PMC10660542 DOI: 10.1080/17441692.2023.2205917] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 04/11/2023] [Indexed: 05/10/2023]
Abstract
Men are less vulnerable to HIV acquisition than women, but have poorer HIV-related health outcomes. They access HIV services less, and are more likely to die on antiretroviral therapy. The adolescent epidemic presents further challenges, and AIDS-related illness is the leading cause of death among adolescents in sub-Saharan Africa. We explored the health practices of adolescent boys and young men (aged 13-22) living with perinatally-acquired HIV and the processes through which these practices are formed and sustained. We engaged health-focused life history narratives (n = 35), semi-structured interviews (n = 32) and analysis of health facility files (n = 41), alongside semi-structured interviews with traditional and biomedical health practitioners (n = 14) in the Eastern Cape, South Africa. Participants did not access traditional products and services for HIV, a finding that deviates from much of the literature. Findings suggest that health practices are mediated not only by gender and culture, but also childhood experiences of growing up deeply embedded in the biomedical health system.
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Affiliation(s)
- Lesley Gittings
- School of Health Studies, Faculty of Health Sciences, Western University, London, Canada
- Centre for Social Science Research, University of Cape Town, Cape Town, South Africa
| | - Christopher Colvin
- Department of Public Health Sciences, University of Virginia, Charlottesville, VA, USA
- Division of Social and Behavioural Sciences, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
- Department of Epidemiology, Brown University, Providence, RI, USA
| | - Rebecca Hodes
- Centre for Sexualities, AIDS & Gender, University of Pretoria, Pretoria, South Africa
- Department of Historical and Heritage Studies, University of Pretoria, Pretoria, South Africa
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31
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Newman PA, Tepjan S, Fongkaew K, Akkakanjanasupar P, de Lind van Wijngaarden JW, Chonwanarat N. Multilevel Factors Impacting PrEP Engagement Among Young Gay Men and Young Transgender Women in Thailand: A Qualitative Analysis. J Int Assoc Provid AIDS Care 2023; 22:23259582231188221. [PMID: 37461326 DOI: 10.1177/23259582231188221] [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] [Indexed: 07/20/2023] Open
Abstract
Half of new HIV infections in Thailand are among young people, the majority of whom are young gay and other men who have sex with men (YMSM) and young transgender women (YTGW). Amid low pre-exposure prophylaxis (PrEP) coverage, we explored practice-based factors that impact PrEP engagement among YMSM and YTGW. In 2018, we conducted 4 focus group discussions with 20 YMSM and 5 YTGW, and 22 in-depth interviews (5 in 2022) with healthcare providers (HCPs), community-based organization (CBO)/nongovernmental organization (NGO) staff, and peer educators. The inclusion of PrEP in universal healthcare coverage, including YMSM and YTGW, is a substantial facilitator of PrEP use; however, systemic barriers at microsocial (lack of communication about PrEP from HCPs, teachers, parents), mesosocial (healthcare-service fragmentation, lack of PrEP-competent HCPs), and macrosocial levels (annual quotas on free HIV-testing, HIV- and sexual-stigma) constrain and disincentivize adolescents' engagement with PrEP. National scale-up of youth-friendly and LGBT-affirmative CBO/NGO clinics, HCP training, and tailored programs to support adolescents' adherence may promote PrEP engagement among YMSM and YTGW in Thailand.
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Affiliation(s)
- Peter A Newman
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Canada
| | | | - Kangwan Fongkaew
- Faculty of Humanities and Social Sciences, Burapha University, Chonburi, Thailand
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32
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Sørensen JB, Housseine N, Maaløe N, Bygbjerg IC, Pinkowski Tersbøl B, Konradsen F, Sequeira Dmello B, van Den Akker T, van Roosmalen J, Mookherji S, Siaity E, Osaki H, Khamis RS, Kujabi ML, John TW, Wolf Meyrowitsch D, Mbekenga C, Skovdal M, L Kidanto H. Scaling up Locally Adapted Clinical Practice Guidelines for Improving Childbirth Care in Tanzania: A Protocol for Programme Theory and Qualitative Methods of the PartoMa Scale-up Study. Glob Health Action 2022; 15:2034136. [PMID: 35311627 PMCID: PMC8942528 DOI: 10.1080/16549716.2022.2034136] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Effective, low-cost clinical interventions to improve facility-based care during childbirth are critical to reduce maternal and perinatal mortality and morbidity in low-resource settings. While health interventions for low- and lower-middle-income countries are often developed and implemented top-down, needs and circumstances vary greatly across locations. Our pilot study in Zanzibar improved care through locally co-created intrapartum clinical practice guidelines (CPGs) and associated training (the PartoMa intervention). This intervention was context-tailored with health-care providers in Zanzibar and now scaled up within five maternity units in Dar es Salaam, Tanzania. This PartoMa Scale-up Study thereby provides an opportunity to explore the co-creation process and modification of the intervention in another context and how scale-up might be successfully achieved. The overall protocol is presented in a separate paper. The aim of the present paper is to account for the Scale-up Study’s programme theory and qualitative methodology. We introduce social practice theory and argue for its value within the programme theory and towards qualitative explorations of shifts in clinical practice. The theory recognizes that the practice we aim to strengthen – safe and respectful clinical childbirth care – is not practiced in a vacuum but embedded within a socio-material context and intertwined with other practices. Methodologically, the project draws on ethnographic and participatory methodologies to explore current childbirth care practices. In line with our programme theory, explorations will focus on meanings of childbirth care, material tools and competencies that are being drawn upon, birth attendants’ motivations and relational contexts, as well as other everyday practices of childbirth care. Insights generated from this study will not only elucidate active ingredients that make the PartoMa intervention feasible (or not) but develop the knowledge foundation for scaling-up and replicability of future interventions based on the principles of co-creation and contextualisation.
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Affiliation(s)
- Jane Brandt Sørensen
- Global Health Section, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Natasha Housseine
- Medical College, Aga Khan University, Medical College East Africa, Dar Es Salaam Campus Tanzania
| | - Nanna Maaløe
- Global Health Section, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.,Department of Obstetrics and Gynaecology, Hvidovre University Hospital, Hvidovre, Denmark
| | - Ib Christian Bygbjerg
- Global Health Section, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Britt Pinkowski Tersbøl
- Global Health Section, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Flemming Konradsen
- Global Health Section, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Brenda Sequeira Dmello
- Global Health Section, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.,Medical College, Aga Khan University, Medical College East Africa, Dar Es Salaam Campus Tanzania.,Comprehensive Community Based Rehabilitation in Tanzania Tanzania
| | - Thomas van Den Akker
- Athena Institute is the department, Athena Institute, VU University, Amsterdam, The Netherlands.,Department of Obstetrics and Gynaecology, Leiden University Medical Centre, Leiden, The Netherlands
| | - Jos van Roosmalen
- Athena Institute is the department, Athena Institute, VU University, Amsterdam, The Netherlands.,Department of Obstetrics and Gynaecology, Leiden University Medical Centre, Leiden, The Netherlands
| | - Sangeeta Mookherji
- Department of Global Health, George Washington University Milken Institute School of Public Health, Washington DC, US
| | - Eunice Siaity
- Medical college, Aga Khan University, School of Nursing and Midwifery East Africa, Dar Es Salaam Campus Tanzania
| | - Haika Osaki
- Global Health Section, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.,Medical College, Aga Khan University, Medical College East Africa, Dar Es Salaam Campus Tanzania
| | - Rashid Saleh Khamis
- Global Health Section, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Monica Lauridsen Kujabi
- Global Health Section, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Thomas Wiswa John
- Global Health Section, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.,Medical College, Aga Khan University, Medical College East Africa, Dar Es Salaam Campus Tanzania
| | - Dan Wolf Meyrowitsch
- Global Health Section, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Columba Mbekenga
- Medical college, Aga Khan University, School of Nursing and Midwifery East Africa, Dar Es Salaam Campus Tanzania
| | - Morten Skovdal
- Section for Health Services Research, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Hussein L Kidanto
- Medical College, Aga Khan University, Medical College East Africa, Dar Es Salaam Campus Tanzania
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Tanyitiku MN, Nicholas G, Sullivan JJ, Njombissie Petcheu IC, On SLW. Snail meat consumption in Buea-Cameroon: exposures to foodborne pathogens through social practices assessed in 2019 and 2021. Arch Public Health 2022; 80:256. [PMID: 36550566 PMCID: PMC9784249 DOI: 10.1186/s13690-022-01009-8] [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: 03/30/2022] [Accepted: 11/29/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Snail meat is an important source of nutrition in Cameroon, but the food safety risks are poorly understood. We characterized public health risks from snail meat consumption as a social system in Cameroon, by examining local snail practices that expose snail meat handlers and consumers to foodborne pathogens. METHODS We used exploratory qualitative approaches, that is, lived experience, face-to-face in-depth interviews, participant observation and a focus group, to explore fifteen key informants' routines and lived experiences, and perceptions of two health officials on the food safety practices around snail meat consumption in Cameroon. This information was organized and interpreted using Soft Systems Methodology and Social Practice Theory, which permitted a systemic appreciation of local practices. RESULTS We distinguished five kinds of actors (snail vendors, market sellers, street vendors, street eaters and home consumers), who performed seven successive practices (picking, selling, cracking, washing, cooking, hawking and eating). We then identified three worldviews about snails: family support or to reduce poverty, a source of nutrition and a food choice (taste, preference). Our findings revealed participants' competences were based on childhood learning and 'inborn' experiences, and materials used in snail activities reflected participants' parentage and 'state of poverty'. Although most interviewees highlighted 'unhygienic conditions' when explaining snail picking locations, participants believed washing and cooking should kill all contaminants. CONCLUSION Several opportunities for human exposures to foodborne pathogens including snail picking in domestic wastes and sewage, the selling of unpackaged live snails, improper snail meat washing and hawking in loosely closed buckets, were apparent from our analysis. These findings suggest fruitful opportunities aimed at improving health outcomes among African snail meat handlers and consumers.
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Affiliation(s)
- Mary Nkongho Tanyitiku
- grid.16488.330000 0004 0385 8571Department of Wine, Food and Molecular Biosciences, Faculty of Agriculture and Life Sciences, Lincoln University, RFH Building, Room 081, Lincoln, 7647 New Zealand
| | - Graeme Nicholas
- grid.16488.330000 0004 0385 8571Department of Wine, Food and Molecular Biosciences, Faculty of Agriculture and Life Sciences, Lincoln University, RFH Building, Room 081, Lincoln, 7647 New Zealand
| | - Jon J. Sullivan
- grid.16488.330000 0004 0385 8571Department of Pest-Management and Conservation, Lincoln University, Lincoln, New Zealand
| | | | - Stephen L. W. On
- grid.16488.330000 0004 0385 8571Department of Wine, Food and Molecular Biosciences, Faculty of Agriculture and Life Sciences, Lincoln University, RFH Building, Room 081, Lincoln, 7647 New Zealand
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A critical qualitative inquiry of the social practices of older adult gamblers: implications for public health risk prevention. AGEING & SOCIETY 2022. [DOI: 10.1017/s0144686x22001179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Abstract
Older adults' participation in gambling is increasing internationally. Due to their lifestage, older adults may be vulnerable to gambling-related harm. When investigating older adults' gambling, researchers have mostly focused on the individual characteristics of ‘problem gamblers’. Less is known about the socio-cultural, environmental and commercial factors that may influence older adults' gambling behaviours. Utilising Social Practice Theory, this critical qualitative inquiry of N = 40 Australian older adults (aged 55 and over) explored how social practices influenced gambling participation. Using a Constructivist Grounded Theory approach, data were interpreted using a reflexive thematic analysis. Theme 1 identified how gambling practices fulfilled older adults' social needs. Gambling was embedded in social activities and created a sense of belonging. Theme 2 highlighted how gambling became an everyday part of some participants' lives, with a range of routines constructed around gambling. While social factors influenced routinised gambling behaviours, the accessibility of gambling products in everyday settings contributed to engagement with gambling. This study demonstrates that a range of social, environmental and commercial factors may influence and routinise the gambling practices of older adults. Interventions aimed at preventing and reducing routine gambling participation among older adults should acknowledge the interplay between agency and social structure. Public health responses should aim to disrupt routine behaviours associated with gambling for older adults.
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A social practice theory approach to exploring the ubiquity of quizzes in dementia care settings. AGEING & SOCIETY 2022. [DOI: 10.1017/s0144686x22001052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Abstract
Quizzes are a ubiquitous part of the dementia social care landscape. This article explores why. Using an ethnographic approach which draws on close analysis of communication, we examine dementia quizzes as a ‘social practice’, and what such a lens can tell us about their popularity in social care settings. Vignettes of real interactions drawn from ten different quizzes recorded in four different group settings attended by 28 people living with dementia and 15 staff members are presented to highlight particular issues. We show that the conditions of post-diagnosis dementia social care are uniquely well suited to an activity such as quizzes which are malleable, requiring little preparation or materials, and impose a communication framework which can help to organise the interactional space. Quizzes also draw on previously forged interactional competences, such as turn-taking and question–answer sequences, a skill that has been shown to persist even as dementia progresses. Finally, we argue that the meaning of quizzes with people with dementia feeds into wider societal values and associations attached to memory, dementia and personhood. The extent to which quizzes are akin to a ‘test’ or a fun and enjoyable social activity rests in how they are enacted. We suggest that practice can be adapted, developed and made more inclusive through input from people living with dementia themselves.
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Rier DA. Responsibility in Medical Sociology: A Second, Reflexive Look. THE AMERICAN SOCIOLOGIST 2022; 53:663-684. [PMID: 36246580 PMCID: PMC9540162 DOI: 10.1007/s12108-022-09549-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/05/2022] [Indexed: 06/16/2023]
Abstract
Personal responsibility has emerged as an important element in many countries' public health planning, and has attracted substantial debate in public health discourse. Contemporary medical sociology typically resists such "responsibilization" as victim-blaming, by privileged elites, that obscures important structural factors and inequities. This paper, based primarily on a broad review of how contemporary Anglophone medical sociology literatures treat responsibility and blame, points out advantages of taking responsibility seriously, particularly from the individual's perspective. These advantages include: empowerment; responsibility-as-coping-mechanism; moral dignity; and the pragmatic logic of doing for oneself, rather than passively awaiting societal reforms. We also offer possible reasons why sociologists and their subjects view these issues so differently, and suggest some areas for future research.
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Affiliation(s)
- David A. Rier
- Department of Sociology & Anthropology, Bar-Ilan University, 5290002 Ramat-Gan, Israel
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Reid DS, Macdowall WG, Lewis R, Hogan B, Mitchell KR, Bosó Pérez R, Gibbs J, Smith C, Attwood F, Mercer CH, Sonnenberg P, Bonell C. Online Sexual Partner Seeking as a Social Practice: Qualitative Evidence from the 4 th British National Survey of Sexual Attitudes and Lifestyles (Natsal-4). JOURNAL OF SEX RESEARCH 2022; 59:1034-1044. [PMID: 34792430 PMCID: PMC9519119 DOI: 10.1080/00224499.2021.1994516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Once perceived as a means for those unsuccessful at traditional dating, online dating has become normalized as a way to seek sexual or romantic partners. In 2019, we interviewed 40 British adults on the role of digital technologies in their sexual lives; this paper draws on the accounts of 22 who had used such technologies for seeking partners. We analyzed qualitative accounts of online partner seeking as a social practice, drawing on a sample diverse in age, gender and sexual orientation, and informed by sexual script and social practice theory. Our theoretically informed analysis emphasized the multiple meanings and goals involved, the affordances of the technology and individuals' skills. Our study provided several novel contributions. Young heterosexual people commonly used general social media, rather than dating apps, to meet partners; meeting partners often involved complex interplays between online and offline networks and encounters. Risks were defined not merely in relation to "risky others" but in terms of one's own actions or attitudes. Participants deployed various skills in minimizing harms such as non-consensual sharing of intimate images, and used self-care skills such as setting limits to engagement.
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Affiliation(s)
- David S Reid
- Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine
| | - Wendy G. Macdowall
- Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine
| | - Ruth Lewis
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow
| | | | | | - Raquel Bosó Pérez
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow
| | - Jo Gibbs
- Institute for Global Health, University College London
| | | | | | | | | | - Chris Bonell
- Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine
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Balaj M, Eikemo TA. Sick of social status: A Bourdieusian perspective on morbidity and health inequalities. SOCIOLOGY OF HEALTH & ILLNESS 2022; 44:1214-1250. [PMID: 35779001 PMCID: PMC9540620 DOI: 10.1111/1467-9566.13512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Accepted: 05/18/2022] [Indexed: 06/15/2023]
Abstract
Self-reported health (SRH) is one of the most frequently used measures for examining socioeconomic inequalities in health. Studies find that when faced with 'identical objective health', individuals in lower socioeconomic groups consistently report worse SRH than those in higher socioeconomic groups. Such findings are often dismissed as being the result of reporting bias, and existing literature dominated by the biomedical conception of SRH has not investigated the underlying social mechanisms at work. To address this limitation, drawing on the work of Bourdieu we employ a relational thinking between health and social position. By way of multiple correspondence analysis, we construct social space of health determinants for three European countries from different welfare states and map the trajectories of educational groups experiencing similar levels of morbidity and their relation to SRH. Differences in SRH observed among social groups for the same level of morbidity are understood in relation to the position and the relative power of individuals in different educational groups to maintain or improve their social conditions, especially with increasing levels of health loss. Our analysis indicates that reporting differences in SRH among educational groups emerges from objectively healthy individuals and follows differences in accumulation of social advantages and disadvantages.
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Affiliation(s)
- Mirza Balaj
- Centre for Global Health Inequalities Research (CHAIN)Department of Sociology and Political ScienceNorwegian University of Science and Technology (NTNU)TrondheimNorway
| | - Terje A. Eikemo
- Centre for Global Health Inequalities Research (CHAIN)Department of Sociology and Political ScienceNorwegian University of Science and Technology (NTNU)TrondheimNorway
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Hill KM, Johansson M, Smith J, Brown K, Davies EL. Connecting Through Dance: Understanding Conscious Clubbing Event Experiences. QUALITATIVE HEALTH RESEARCH 2022; 32:1721-1731. [PMID: 35861283 DOI: 10.1177/10497323221116804] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Individuals abstaining from alcohol consumption frequently find themselves in contexts encouraging consumption, with limited alternative social interaction opportunities. Conscious clubbing events exclude alcohol and drugs, possibly providing valuable social connections, but little is known about event benefits. Twelve conscious clubbing event attendees and facilitators aged 25-55 from across Europe participated in semi-structured photo-elicitation interviews, which were analysed using thematic analysis. Findings suggested that conscious clubbing appears to enhance health, healing and growth, aiding recovery from substance dependency and trauma. Positioned as a modern ritual, symbolic and ritualistic preparations and experiences promoted storytelling and self-discovery. Connecting through synchronised but unchoreographed movement, participants engaged in powerful journeys and transformative experiences detached from life constraints. Inclusive digital and face-to-face conscious clubbing communities provided a sense of meaning and belonging away from substance use pressures and harms, particularly for those marginalised within society. Findings provide important and in-depth insights, including novel harm prevention implications. Future work should consider participatory barriers, event sustainability and misconceptions to increase event availability and participation.
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Affiliation(s)
- Kimberley M Hill
- Psychology and Sociology Subject Group, Faculty of Health, Education and Society, 6087The University of Northampton, Northampton, UK
| | - Mattias Johansson
- Department of Social and Psychological Studies, 4209Karlstad University, Karlstad, Sweden
| | - Joanne Smith
- Research and Evidence Team, NHS North of England Commissioning Support Unit, Riverside House, Newburn, Newcastle upon Tyne, UK
| | - Kyle Brown
- Faculty of Business, Law and Social Sciences, 1725Birmingham City University, Birmingham, UK
| | - Emma L Davies
- The Centre for Psychological Research, 6395Oxford Brookes University, Oxford, UK
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Ditlevsen K, Halkier B, Holm L. Pathways of less healthy diets. An investigation of the everyday food practices of men and women in low income households. CRITICAL PUBLIC HEALTH 2022. [DOI: 10.1080/09581596.2022.2101917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- Kia Ditlevsen
- Department of Food and Resource Economics, University of Copenhagen, Copenhagen, Denmark
| | - Bente Halkier
- Department of Sociology, University of Copenhagen, Copenhagen, Denmark
| | - Lotte Holm
- Department of Food and Resource Economics, University of Copenhagen, Copenhagen, Denmark
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Shaping Physical Activity through Facilitating Student Agency in Secondary Schools in the Netherlands. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19159028. [PMID: 35897397 PMCID: PMC9331768 DOI: 10.3390/ijerph19159028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Revised: 07/14/2022] [Accepted: 07/21/2022] [Indexed: 01/26/2023]
Abstract
Schools can enable students' capability for lifelong physical activity (PA) by providing a physical, social and pedagogical context fostering students' agency. This entails allowing them to develop their autonomy and ability to shape PAs according to what they value. This paper explores whether, and, if so, how, school practices provide the conditions for developing and employing PA-related student agency. We followed a multiple case study design, partnering with six secondary schools in the Netherlands. We based our qualitative content analysis on the schools' policy documents and transcripts of interviews and focus groups with school management, teaching staff and supporting sports professionals. First, we analysed the space provided for PA-related student agency using the whole-of-school framework. Next, we used a social practice theory perspective to understand how each school practice allows for student agency. Results suggest that schools offer sufficient and varied PA opportunities but have not embedded deliberation with students on their meaningfulness and transfer to other contexts in their practices. We conclude that for schools to promote lifelong PA for students, there is a need for a pedagogical approach involving students' perspectives, participation and reflections, enabling them to transfer PAs to other (future) life settings.
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Quist J, Winther J, Friis A, Gram A, Blond M, Rosenkilde M, Jespersen A, Stallknecht B. Maintenance of cardiorespiratory fitness, body composition, and a physically active lifestyle after structured exercise interventions in individuals with overweight and obesity: A mixed-method follow-up study. PUBLIC HEALTH IN PRACTICE 2022; 4:100293. [PMID: 36570402 PMCID: PMC9773044 DOI: 10.1016/j.puhip.2022.100293] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Revised: 06/17/2022] [Accepted: 07/01/2022] [Indexed: 12/27/2022] Open
Abstract
Objectives The aim of this mixed-method study was to explore maintenance of physical activity and health effects one year after completion of exercise interventions in transport and leisure-time domains of everyday life. We hypothesised that routinisation of active commuting would lead to better maintenance of physical activity and health effects compared with leisure-time exercise. Study design Mixed-methods follow-up study. Methods Individuals with overweight/obesity, who completed a 6-month exercise intervention (active commuting by bike (BIKE), moderate (MOD) or vigorous intensity leisure-time exercise (VIG)), were after one year invited to participate in a follow-up visit which included measurements of cardiorespiratory fitness during an incremental bicycle test and body composition using dual-energy X-ray absorptiometry. Variability in maintenance practices was assessed in a sub-sample of participants who experienced the greatest improvements ('VO2peak improvers') and reductions ('VO2peak reducers'), respectively, in cardiorespiratory fitness. Semi-structured interviews were conducted (15-30 min) and analysed using systematic text condensation to identify barriers and facilitators associated with maintenance of physical activity. Results Out of the 74 participants completing an exercise intervention, 46 (62%) completed follow-up (BIKE: n = 14; MOD: n = 14; VIG: n = 18). Improvements in VO2peak and reductions in fat mass were maintained in BIKE and VIG. Body weight decreased in BIKE and fat free mass increased in VIG. Changes in VO2peak and anthropometry at follow-up did not differ between BIKE and MOD + VIG. Fat mass decreased and recreational physical activity increased in 'VO2peak improvers'. Findings from the interviews suggested that self-monitoring, collective exercising, and new personal exercise challenges facilitate maintenance of a physically active lifestyle. Conclusion Completion of a structured exercise intervention consisting of 6 months of active commuting or vigorous intensity leisure-time exercise was associated with long-term maintenance of improvements in VO2peak and body composition, whereas moderate intensity leisure-time exercise was not. In contrast to our hypothesis, active commuting was not associated with better maintenance of physical activity and health effects after the intervention compared with leisure-time exercise.
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Affiliation(s)
- J.S. Quist
- Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark,Clinical Research, Copenhagen University Hospital - Steno Diabetes Center Copenhagen, Herlev, Denmark,Corresponding author. Department of Biomedical Sciences, University of Copenhagen, Blegdamsvej 3, DK, 2200, Copenhagen, Denmark.
| | - J. Winther
- Department of Social Education, University College Copenhagen, Copenhagen, Denmark,Copenhagen Centre for Health Research in the Humanities, Saxo Institute, University of Copenhagen, Copenhagen, Denmark
| | - A.L. Friis
- Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - A.S. Gram
- Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - M.B. Blond
- Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark,Clinical Research, Copenhagen University Hospital - Steno Diabetes Center Copenhagen, Herlev, Denmark
| | - M. Rosenkilde
- Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - A.P. Jespersen
- Copenhagen Centre for Health Research in the Humanities, Saxo Institute, University of Copenhagen, Copenhagen, Denmark
| | - B.M. Stallknecht
- Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
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Robertson L, Hoek J, Blank ML. A qualitative analysis of electronic nicotine delivery systems (ENDS) uptake and use among young adult never-smokers in New Zealand. PLoS One 2022; 17:e0268449. [PMID: 35622846 PMCID: PMC9140280 DOI: 10.1371/journal.pone.0268449] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2021] [Accepted: 04/29/2022] [Indexed: 12/03/2022] Open
Abstract
Introduction Electronic nicotine delivery systems (ENDS) likely pose fewer health risks than smoking. Yet ENDS uptake has increased among never-smoking young adults, who likely face greater health risks relative to non-users of ENDS. To date, few qualitative studies have explored ENDS uptake and use by never-smokers. Methods We conducted in-depth, semi-structured interviews with 16 current ENDS users from New Zealand aged 18 to 24 years old who reported never having smoked cigarettes regularly. We explored participants’ experimentation with conventional tobacco products, trial, uptake and patterns of ENDS use, and their future intentions regarding both ENDS and conventional tobacco products. We managed the data using NVivo12 and used thematic analysis to interpret the transcripts. Results ENDS use enhanced connection and belonging by providing communal experiences and facilitating social interactions. Participants’ mastery of tricks generated social cachet within friendship groups and counteracted the ENDS-related stigma they experienced. Flavours, clouds and devices’ physical attributes provided stimulation and engagement, and some used ENDS for stress or appetite management. Lastly, participants rationalised ENDS uptake by referencing the far greater risks smoking posed. Conclusions ENDS uptake by young adult never-smokers is driven by both psycho-social and functional factors. ENDS provided shared hedonic experiences and physical pleasures, and generated both bonding and bridging social capital, although many participants had also experienced judgement from others for using ENDS. Policies that denormalise ENDS as recreational devices could discourage uptake by never-smokers, though measures will require careful nuancing to avoid deterring smokers from switching to ENDS.
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Affiliation(s)
- Lindsay Robertson
- Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand
- * E-mail:
| | - Janet Hoek
- Department of Public Health, University of Otago, Wellington, New Zealand
| | - Mei-Ling Blank
- Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand
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Sustainable Consumption Research and the Role of Marketing: A Review of the Literature (1976–2021). SUSTAINABILITY 2022. [DOI: 10.3390/su14073999] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
There is a causal relationship between existential dangers to our biosphere and our unsustainable consumption practices. For more than three decades, academics and researchers have explored ideas to make consumption practices sustainable. Still, a practical and widely accepted solution to the problem is missing. This review aims for a theoretical and structural understanding of the literature to identify future avenues for marketing, to explore and increase its contribution to consumption sustainability research. The review used bibliometric and integrative review methods to synthesize knowledge. The review found that sustainable consumption research has proliferated since 2015, indicating a heightened interest in the field. There are four major schools of thought in sustainable consumption research, employing three interdependent micro, meso, and macro levels of analysis to understand consumption practices. By focusing on individual consumption behaviors, this review recommends that consumption sustainability be repositioned as a means of attaining a better quality of life for consumers. It involves reforming the consumer mindset toward progress based on pro-social and pro-ecological choices, training consumers in mindful consumption practices, and providing them with an infrastructure for consuming with a mindful mindset. It is recommended that marketing should refine itself as a pro-social discipline, with consumer well-being as its primary goal, and to become a leader in reshaping quality of life in terms of non-financial standards.
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"It's not just the hit itself": the social practice of injecting drug use among gay and bisexual men in Australia. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2022; 103:103642. [PMID: 35247865 DOI: 10.1016/j.drugpo.2022.103642] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Revised: 02/20/2022] [Accepted: 02/21/2022] [Indexed: 11/23/2022]
Abstract
BACKGROUND Injecting drug use is purportedly more common among gay and bisexual men (GBM) than the general Australian population. Approaches designed to support the wellbeing of people who inject drugs may not be effective for GBM who inject, due to divergent settings, substances, and/or symbolism. We sought to identify the critical elements shaping injecting among GBM as a social practice and the implications for health and psychosocial wellbeing. METHODS We conducted 19 in-depth interviews with GBM in Australia with lifetime experience of injecting drug use, adopting the Frameworks Method for data analysis. Framed by social practice theory, transcripts were coded to delineate the constituent material, competency, and meaning elements of GBM's injecting practices. We developed themes encompassing the dynamic interrelationship between practice elements and wellbeing aspects. RESULTS Of 19 participants interviewed (aged 24-60 years), 17 identified as gay, two as bisexual. Injecting histories ranged from 2-32 years; most injected methamphetamine (n = 18). Injecting involved the integration of sexual function with substances and injecting skills in dyadic/communal settings. Beyond traditional harm reduction aspects, 'safe injecting' concerned trustworthiness of fellow practitioners, preventing addiction, and maintaining a solid self-concept. Injecting occurred as a dyadic/communal practice, in which an uneven distribution of materials (substances, sexual capital) and competencies (self-injecting) influenced risk and power dynamics. Pleasurable meanings of belonging, desirability and self-actualisation - gained from communities of practice - conflicted with injecting-related stigma, social dependencies, and fear of harms to body, mind, and sense of self. CONCLUSION Injecting is a heterogenous practice, including among GBM. Shifting configurations of its composite elements influence GBM's perceptions and experiences of pleasure, risk, and harms. Efforts to support their wellbeing should take a dyadic/communal approach and seek to rectify the uneven distribution of material and competency elements in these settings.
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Hoek J, Edwards R, Waa A. From social accessory to societal disapproval: smoking, social norms and tobacco endgames. Tob Control 2022; 31:358-364. [PMID: 35241613 DOI: 10.1136/tobaccocontrol-2021-056574] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Affiliation(s)
- Janet Hoek
- Department of Public Health, University of Otago, Wellington, New Zealand
| | - Richard Edwards
- Department of Public Health, University of Otago, Wellington, New Zealand
| | - Andrew Waa
- Department of Public Health, University of Otago, Wellington, New Zealand
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Nyemcsok C, Pitt H, Kremer P, Thomas SL. Viewing young men’s online wagering through a social practice lens: implications for gambling harm prevention strategies. CRITICAL PUBLIC HEALTH 2022. [DOI: 10.1080/09581596.2022.2031888] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- Christian Nyemcsok
- Institute for Health Transformation, School of Health and Social Development, Faculty of Health, Deakin University, Geelong, Australia
| | - Hannah Pitt
- Institute for Health Transformation, School of Health and Social Development, Faculty of Health, Deakin University, Geelong, Australia
| | - Peter Kremer
- Centre for Sport Research, School of Exercise & Nutrition Sciences, Faculty of Health, Deakin University, Geelong, Australia
| | - Samantha L. Thomas
- Institute for Health Transformation, School of Health and Social Development, Faculty of Health, Deakin University, Geelong, Australia
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Adeosun KP, Greene M, Oosterveer P. Informal ready-to-eat food vending: a social practice perspective on urban food provisioning in Nigeria. Food Secur 2022; 14:763-780. [PMID: 35154516 PMCID: PMC8816685 DOI: 10.1007/s12571-022-01257-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 01/08/2022] [Indexed: 01/02/2023]
Abstract
AbstractThe way people access food in Nigeria is of central relevance for food security, health and sustainability. One key trend is the shift from household-based to primarily out-of-home food consumption as an increasing majority of the urban poor derive their daily nutrient intake from street foods. However, few studies have yet explored the role of the ready-to-eat food vending sector in urban food systems and the diets of the urban poor. This paper investigates the interrelations between these practices and the diversity of food groups provisioned among the urban poor in developing city contexts. A social practice approach is employed to explore differentiation among informal-ready-to-eat food vending practices in the city of Ibadan, Nigeria, in terms of their daily activities, competences and resources. Applied methods include GIS mapping, food log diaries, in-depth interviews and participant observation to map and classify informal-ready-to-eat food vending practices according to the nature of food provisioned and explore the everyday performances of different informal-ready-to-eat food vending practice initiatives and their relation to dietary diversity. The results reveal three key categories among these practices: traditional, processed and unprocessed—with varying levels of diversity in the food groups on offer. Traditional food vendors offer more diversified food compared to processed food vendors and unprocessed food vendors. The results reveal that material infrastructure, cooking bargaining and purchasing skills and nutritional knowledge are key to the diversity of food groups provisioned. The paper concludes by considering the wider relevance of these findings for urban food science and policy.
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Affiliation(s)
- Kehinde Paul Adeosun
- Environmental Policy Group, Wageningen University and Research Centre, Wageningen, The Netherlands
- Department of Agricultural Economics, University of Nigeria, Nsukka, Nigeria
| | - Mary Greene
- Environmental Policy Group, Wageningen University and Research Centre, Wageningen, The Netherlands
| | - Peter Oosterveer
- Environmental Policy Group, Wageningen University and Research Centre, Wageningen, The Netherlands
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49
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Myers C, Apondi E, Toromo JJ, Omollo M, Bakari S, Aluoch J, Sang F, Njoroge T, Morris Z, Kantor R, Braitstein P, Nyandiko WM, Wools-Kaloustian K, Elul B, Vreeman RC, Enane LA. "Who am I going to stay with? Who will accept me?": family-level domains influencing HIV care engagement among disengaged adolescents in Kenya. J Int AIDS Soc 2022; 25:e25890. [PMID: 35192747 PMCID: PMC8863355 DOI: 10.1002/jia2.25890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Accepted: 02/01/2022] [Indexed: 11/12/2022] Open
Abstract
INTRODUCTION Adolescents living with HIV (ALHIV, ages 10-19) have developmentally specific needs in care, and have lower retention compared to other age groups. Family-level contexts may be critical to adolescent HIV outcomes, but have often been overlooked. We investigated family-level factors underlying disengagement and supporting re-engagement among adolescents disengaged from HIV care. METHODS Semi-structured interviews were performed with 42 disengaged ALHIV, 32 of their caregivers and 28 healthcare workers (HCW) in the Academic Model Providing Access to Healthcare (AMPATH) program in western Kenya, from 2018 to 2020. Disengaged ALHIV had ≥1 visit within the 18 months prior to data collection at one of two sites and nonattendance ≥60 days following their last scheduled appointment. HCW were recruited from 10 clinics. Transcripts were analysed through thematic analysis. A conceptual model for family-level domains influencing adolescent HIV care engagement was developed from these themes. RESULTS Family-level factors emerged as central to disengagement. ALHIV-particularly those orphaned by the loss of one or both parents-experienced challenges when new caregivers or unstable living situations limited support for HIV care. These challenges were compounded by anticipated stigma; resultant non-disclosure of HIV status to household members; enacted stigma in the household, with overwhelming effects on adolescents; or experiences of multiple forms of trauma, which undermined HIV care engagement. Some caregivers lacked finances or social support to facilitate care. Others did not feel equipped to support adolescent engagement or adherence. Regarding facilitators to re-engagement, participants described roles for household disclosure; and solidarity from caregivers, especially those also living with HIV. Family-level domains influencing HIV care engagement were conceptualized as follows: (1) adolescent living situation and contexts; (2) household material resources or poverty; (3) caregiver capacities and skills to support adolescent HIV care; and (4) HIV stigma or solidarity at the household level. CONCLUSIONS Family-level factors are integral to retention in care for ALHIV. The conceptual model developed in this study for family-level influences on care engagement may inform holistic approaches to promote healthy outcomes for ALHIV. Developmentally appropriate interventions targeting household relationships, disclosure, HIV stigma reduction, HIV care skills and resources, and economic empowerment may promote adolescent engagement in HIV care.
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Affiliation(s)
- Courtney Myers
- Division of Infectious Diseases, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Edith Apondi
- Academic Model Providing Access to Healthcare (AMPATH), Eldoret, Kenya.,Moi Teaching and Referral Hospital, Eldoret, Kenya
| | - Judith J Toromo
- The Ryan White Center for Pediatric Infectious Disease and Global Health, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Mark Omollo
- Academic Model Providing Access to Healthcare (AMPATH), Eldoret, Kenya
| | - Salim Bakari
- Academic Model Providing Access to Healthcare (AMPATH), Eldoret, Kenya
| | - Josephine Aluoch
- Academic Model Providing Access to Healthcare (AMPATH), Eldoret, Kenya
| | - Festus Sang
- Academic Model Providing Access to Healthcare (AMPATH), Eldoret, Kenya
| | - Tabitha Njoroge
- Academic Model Providing Access to Healthcare (AMPATH), Eldoret, Kenya
| | - Zariel Morris
- Indiana University-Purdue University-Indianapolis, Indiana University, Indianapolis, Indiana, USA
| | - Rami Kantor
- Division of Infectious Diseases, Department of Medicine, Brown University Apert Medical School, Providence, Rhode Island, USA
| | - Paula Braitstein
- Academic Model Providing Access to Healthcare (AMPATH), Eldoret, Kenya.,Department of Epidemiology, Indiana University Fairbanks School of Public Health, Indianapolis, Indiana, USA.,Division of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.,Department of Medicine, School of Medicine, College of Health Sciences, Moi University, Eldoret, Kenya
| | - Winstone M Nyandiko
- Academic Model Providing Access to Healthcare (AMPATH), Eldoret, Kenya.,Department of Child Health and Pediatrics, School of Medicine, College of Health Sciences, Moi University, Eldoret, Kenya
| | - Kara Wools-Kaloustian
- Division of Infectious Diseases, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA.,Academic Model Providing Access to Healthcare (AMPATH), Eldoret, Kenya.,Indiana University Center for Global Health, Indianapolis, Indiana, USA
| | - Batya Elul
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York, USA
| | - Rachel C Vreeman
- Academic Model Providing Access to Healthcare (AMPATH), Eldoret, Kenya.,Department of Child Health and Pediatrics, School of Medicine, College of Health Sciences, Moi University, Eldoret, Kenya.,Department of Health System Design and Global Health, Icahn School of Medicine at Mount Sinai, New York, New York, USA.,Arnhold Institute for Global Health, New York, New York, USA
| | - Leslie A Enane
- The Ryan White Center for Pediatric Infectious Disease and Global Health, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, Indiana, USA.,Indiana University Center for Global Health, Indianapolis, Indiana, USA
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50
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Thorsen IK, Kayser L, Teglgaard Lyk-Jensen H, Rossen S, Ried-Larsen M, Midtgaard J. " I Tried Forcing Myself to do It, but Then It Becomes a Boring Chore": Understanding (dis)engagement in Physical Activity Among Individuals With Type 2 Diabetes Using a Practice Theory Approach. QUALITATIVE HEALTH RESEARCH 2022; 32:520-530. [PMID: 34964675 DOI: 10.1177/10497323211064598] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Lack of physical activity (PA) is common among individuals with type 2 diabetes (T2D). We apply a practice theory approach to investigate PA engagement in the context of T2D. Data were collected through semi-structured individual interviews (n = 23) and focus groups (n = 3x6) and analyzed by deductive-inductive reflexive thematic analysis using a practice theory framework. Forty-one purposefully selected individuals with T2D (29 men) between the ages of 54 and 77 years were included. The analysis resulted in three main themes informed by five subthemes, reflecting the key elements of practice theory (i.e., meanings, materialities, and competencies). One overarching theme identified PA engagement as an unsustainable and insurmountable project in constant and unequal competition with the practice of physical inactivity. To increase PA among individuals with T2D, future PA interventions and strategies should aim to establish a stronger link between PA and everyday life practices.
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Affiliation(s)
- Ida K Thorsen
- The Centre for Physical Activity Research, Rigshospitalet, 4321University of Copenhagen, Copenhagen, Denmark
| | - Lars Kayser
- Department of Public Health, 4321University of Copenhagen, Copenhagen, Denmark
| | | | - Sine Rossen
- Copenhagen Centre for Cancer and Health, Municipality of Copenhagen, Copenhagen, Denmark
| | - Mathias Ried-Larsen
- The Centre for Physical Activity Research, Rigshospitalet, 4321University of Copenhagen, Copenhagen, Denmark
| | - Julie Midtgaard
- Centre for Applied Research in Mental Health Care (CARMEN), Mental Health Centre Glostrup, Copenhagen University Hospital, Copenhagen, Denmark
- Department of Clinical Medicine, 4321University of Copenhagen, Copenhagen, Denmark
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