“But I Am Not One to Judge Her Actions”: Thematic and Discursive Approaches to University Students’ Responses to Women Who Smoke While Pregnant

Understanding how the Australian vaccine-refusal movement perceives itself

Public health responses to the vaccine-refusal (VR) movement are hindered by inadequate research about the movement's aims, identity and perceived value for its members. This study examined how members of the VR movement in Australia described the movement and what being part of it meant to them. Descriptions of the VR movement by 696 members from across Australia were collected between January and May in 2017 via an online survey. The data were analysed using thematic discourse analysis. Members' understandings of the movement and the beliefs underpinning these understandings were examined. Vaccine refusal was underpinned by distinct epistemic beliefs. Participants believed that mainstream vaccine promotion relies on dishonest communication of compromised research. They saw the VR movement as a science-based movement, researching both 'mainstream' and 'hidden' knowledge, promoting scientific values and advocating for better vaccine studies. Participants believed responsible parenting requires personally researching healthcare choices. Participants constructed the movement's identity in relation to common criticisms of vaccine refusal. These were discredited and repurposed to portray the movement as being brave and righteous. Participants believed people in the movement are astute, informed, responsible and courageous. They believed many members were impacted by vaccine-related harms, from which the movement now saves others. They saw themselves as fighting for an inconvenient truth that the mainstream ignores. Vaccine promotion needs to address the epistemic beliefs associated with vaccine refusal, yet these have been inadequately understood. Our findings contribute to understanding these beliefs. Furthermore, our findings suggest what messages targeting vaccine-refusing people should focus on. This may include acknowledging the significant effort that vaccine-refusing people invest in trying to protect their children, catering to vaccine-refusing people's high engagement and desire for detailed information, and avoiding stigmatising or confrontational vaccine-promotion strategies.

Doing critical feminist research: A Feminism & Psychology reader

As we approach Feminism & Psychology’s 30th anniversary, we reflect on and explore what makes the journal distinctive – its emphasis on critical feminist psychology. In this article and the accompanying Virtual Special Issue, we outline five methodological considerations that we believe are at the heart of critical feminist scholarship: 1) the politics of asking questions; 2) attention to language/discourse; 3) reflexivity; 4) representation and intersectionality; and 5) mobilizing research for social change. We then draw across a set of 15 articles published in the archives of Feminism & Psychology that showcase one or more of these key features and demonstrate the ‘doing’ of critical feminist psychology. These articles are housed on the journal’s website, as is an additional paper developed for students or those in a position of learning, which explores central ideas and debates that have culminated in critical feminist psychology.

The mad leading the blind: Perceptions of the vaccine-refusal movement among Australians who support vaccination

BACKGROUND

Vaccine refusal is shaped by the social ecology in which it occurs. How people who refuse vaccines are communicated to and treated may affect the nature and strength of their negative vaccine beliefs, and their responsiveness to health promotion messages. Yet little is known about how people who refuse vaccines are perceived by the public. Our research examined perceptions among pro-vaccine Australians of the vaccine-refusal movement.

METHODS

Descriptions of the vaccine-refusal movement by 2666 pro-vaccine Australians were analysed using thematic discourse analysis. Descriptive themes were identified via inductive, iterative coding. Discourse analysis techniques were then used to interpret latent beliefs about the vaccine-refusal movement.

RESULTS

Participants had negative and stigmatising perceptions of the vaccine-refusal movement. They believed the movement is dangerous, misinformed, and comprised of charlatans and fools who are unintelligent, selfish, overly emotional, conspiratorial and scientifically illiterate. Discursive analysis showed that these perceptions were underpinned by beliefs that people would have to be defective in some way to believe anti-vaccine rhetoric. Furthermore, perceptions were underpinned by beliefs that the movement spreads not only disease, but also dangerous ideas that were seen to attack the social order, institutions, values and reason. Participants' intensely-negative views related to their inability to imagine why someone would refuse vaccines.

CONCLUSIONS

This research provides a focused, qualitative account of public perceptions of the vaccine-refusal movement. The findings are concerning: stigma towards vaccine-refusing people may adversely affect their wellbeing and entrench their negative vaccine beliefs. The research suggests that more compassionate, nuanced discussion of vaccine refusal in the public sphere is needed. It also supports the need to systematically examine public attitudes towards vaccine refusal as a determinant of vaccine confidence.

Childhood obesity in Mexico: A critical analysis of the environmental factors, behaviours and discourses contributing to the epidemic

Mexico has the highest prevalence globally for children who are overweight. We conducted a qualitative study to understand childhood obesity in Mexico and the complex factors at play. Data were collected at three elementary schools in a low socio-economic area in Mexico City. Semi-structured interviews were conducted with 60 children, 24 parents and 28 teachers. The children interviewed were between the ages of 8 and 12 years old. Interview texts were analysed using NVivo 9 and 10 and thematic discourse analysis was used. Findings revealed how children’s choices around nutrition and physical activity were constrained by their environment and discursive constructions.

Young Australian women's accounts of smoking and quitting: a qualitative study using visual methods

Background

Although the overall rate of smoking in Australia continues to decline, the rate of decline has begun to slow. Rates of smoking among young women in Australia have been a particular concern, which has led to the development of targeted public health campaigns. Poststructuralist theory has successfully been used in research to explore the way in which young women experience smoking. However, there is an absence of poststructuralist analysis of young women’s experiences of quitting. This study aims to address this gap.

Methods

We carried out 27 interviews with young Australian women smokers and ex-smokers. Eighteen of those women then participated in a photography activity and follow-up interviews. A Foucauldian discourse analysis of the data was conducted.

Results

Through our analysis, we identified three discourses: ‘The irresponsibility of smoking: Quitting as responsible’, ‘The difficulties of quitting: Smoking as addictive’, and ‘Making a decision to quit: Smoking as a choice’. In relation to these discourses, participants took up contradictory positions of responsibility and resistance, addiction and agency. Taking up these positions had implications for young women’s subjectivity, and the way they engaged with tobacco controls and cessation support.

Conclusions

The analysis highlights the complex and contradictory nature of young women’s experiences with smoking and quitting. The study’s findings are considered in relation to the improvement of tobacco control policies and cessation support programmes targeted at young women.

Individuals' explanations for their persistent or recurrent low back pain: a cross-sectional survey

BACKGROUND

Most people experience low back pain (LBP), and it is often ongoing or recurrent. Contemporary research knowledge indicates individual's pain beliefs have a strong effect on their pain experience and management. This study's primary aim was to determine the discourses (patterns of thinking) underlying people's beliefs about what causes their LBP to persist. The secondary aim was to investigate what they believed was the source of this thinking.

METHODS

We used a primarily qualitative survey design: 130 participants answered questions about what caused their LBP to persist, and where they learned about these causes. We analysed responses about what caused their LBP using discourse analysis (primary aim), and mixed methods involving content analysis and descriptive statistics to analyse responses indicating where participants learnt these beliefs (secondary aim).

RESULTS

We found that individuals discussed persistent LBP as 1) due to the body being like a 'broken machine', 2) permanent/immutable, 3) complex, and 4) very negative. Most participants indicated that they learnt these beliefs from health professionals (116, 89%).

CONCLUSIONS

We concluded that despite continuing attempts to shift pain beliefs to more complex biopsychosocial factors, most people with LBP adhere to the traditional biomedical perspective of anatomical/biomechanical causes. Relatedly, they often see their condition as very negative. Contrary to current "best practice" guidelines for LBP management, a potential consequence of such beliefs is an avoidance of physical activities, which is likely to result in increased morbidity. That health professionals may be the most pervasive source of this thinking is a cause for concern. A small number of people attributed non-physical, unknown or complex causes to their persistent LBP - indicating that other options are possible.

Physical Therapists' Ways of Talking About Overweight and Obesity: Clinical Implications

BACKGROUND

How people think and talk about weight is important because it can influence their behavior toward people who are overweight. One study has shown that physical therapists have negative attitudes toward people who are overweight. However, how this finding translates into clinical practice is not well understood. Investigating physical therapists' ways of thinking and speaking about overweight and obesity in the context of their work can provide insight into this underresearched area.

OBJECTIVES

The purpose of this study was to investigate physical therapists' ways of talking about overweight individuals and discuss clinical implications.

DESIGN

An interpretive qualitative design was used.

METHODS

The research team used discourse analysis, a type of inductive qualitative methodology, to guide data collection and analysis. The data came from 6 focus groups of 4 to 6 physical therapists in Queensland, Australia, who discussed weight in a physical therapy environment. Participants (N=27) represented a variety of physical therapy subdisciplines.

RESULTS

Data analysis identified 4 main weight discourses (ways of thinking and speaking about weight). Participants described patients who are overweight as little affected by stigma and difficult to treat. Furthermore, participants portrayed weight as having simple causes and being important in physical therapy. Alternate weight discourses were less frequent in these data.

CONCLUSIONS

The results indicated that some physical therapists' understandings of weight might lead to negative interactions with patients who are overweight. The findings suggest physical therapists require more nuanced understandings of: how patients who are overweight might feel in a physical therapy setting, the complexity of causes of weight, and possible benefits and disadvantages of introducing weight-management discussions with patients. Therefore, education should encourage complex understandings of working with patients of all sizes, including knowledge of weight stigma.