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Laliberte S, Varcoe C. The benefits of a historical-dialectical ontology to critical mental health promotion research. Health Promot Int 2021; 36:262-273. [PMID: 32361754 DOI: 10.1093/heapro/daaa024] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
In this article, we explore challenges and opportunities in research oriented to understanding the relations among elements of socio-economic life and mental health (MH) and the development and evaluation of mental health promotion (HP) initiatives. We review the population health intervention research (PHIR) literature and respond to recommendations regarding social determinants of health and health inequities-focused research. We discuss three inter-related issue areas: first, the continued dominance of linear and individually oriented theories within predominantly quantitative research approaches and the underdevelopment of ontological and theoretical perspectives that capture complexity; second, the inconsistent use of measures of socio-economic status and health with a lack of attention to taken for granted assumptions; and third, the continued focus on measuring MH challenges to the neglect of exploring the meaning of MH in a positive sense. We extend recommendations within the PHIR literature by sharing our application of a historical-dialectical ontological perspective within a process of social praxis with diverse Canadian young people with varying degrees of access to socio-economic resources. Young people were engaged to explore the relations among socio-economic processes, young people's MH and implications for mental HP. We argue that this ontological perspective can support the development of structurally oriented critical qualitative research approaches in PHIR.
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Affiliation(s)
- Shari Laliberte
- School of Health Sciences, Vancouver Community College, 1155 East Broadway, Vancouver, BC Canada V5T 4V5
| | - Colleen Varcoe
- School of Nursing, University of British Columbia, T201-2211 Wesbrook Mall, Vancouver, BC Canada V6T 2B5
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McGrath M, Duncan F, Dotsikas K, Baskin C, Crosby L, Gnani S, Hunter RM, Kaner E, Kirkbride JB, Lafortune L, Lee C, Oliver E, Osborn DP, Walters KR, Dykxhoorn J. Effectiveness of community interventions for protecting and promoting the mental health of working-age adults experiencing financial uncertainty: a systematic review. J Epidemiol Community Health 2021; 75:665-673. [PMID: 33931550 PMCID: PMC8223661 DOI: 10.1136/jech-2020-215574] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2020] [Revised: 03/01/2021] [Accepted: 03/23/2021] [Indexed: 02/02/2023]
Abstract
BACKGROUND The COVID-19 pandemic has created a period of global economic uncertainty. Financial strain, personal debt, recent job loss and housing insecurity are important risk factors for the mental health of working-age adults. Community interventions have the potential to attenuate the mental health impact of these stressors. We examined the effectiveness of community interventions for protecting and promoting the mental health of working-age adults in high-income countries during periods of financial insecurity. METHODS Eight electronic databases were systematically screened for experimental and observational studies published since 2000 measuring the effectiveness of community interventions on mental health outcomes. We included any non-clinical intervention that aimed to address the financial, employment, food or housing insecurity of participants. A review protocol was registered on the PROSPERO database (CRD42019156364) and results are reported in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. RESULTS From 2326 studies screened, 15 met our inclusion criteria. Five categories of community intervention were identified: advice services colocated in healthcare settings; link worker social prescribing; telephone debt advice; food insecurity interventions; and active labour market programmes. In general, the evidence for effective and cost-effective community interventions delivered to individuals experiencing financial insecurity was lacking. From the small number of studies without a high risk of bias, there was some evidence that financial insecurity and associated mental health problems were amenable to change and differences by subpopulations were observed. CONCLUSION There is a need for well-controlled studies and trials to better understand effective ingredients and to identify those interventions warranting wider implementation.
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Affiliation(s)
- Michael McGrath
- Division of Psychiatry, University College London, London, UK
- Department of Health Services Research and Policy, London School of Hygiene & Tropical Medicine, London, UK
| | - Fiona Duncan
- Department of Sport and Exercise Sciences, Durham University, Durham, UK
| | - Kate Dotsikas
- Division of Psychiatry, University College London, London, UK
| | - Cleo Baskin
- Department of Primary Care and Public Health, Imperial College London, London, UK
| | - Liam Crosby
- Department of Primary Care and Population Health, University College London, London, UK
| | - Shamini Gnani
- Department of Primary Care and Public Health, Imperial College London, London, UK
| | - Rachael Maree Hunter
- Department of Primary Care and Population Health, University College London, London, UK
| | - Eileen Kaner
- Institute of Health and Society, Newcastle University, Newcastle, UK
| | | | | | - Caroline Lee
- Cambridge Public Health, University of Cambridge, Cambridge, UK
- Cambridge Institute for Sustainability Leadership, Cambridge, UK
| | - Emily Oliver
- Department of Sport and Exercise Sciences, Durham University, Durham, UK
| | - David P Osborn
- Division of Psychiatry, University College London, London, UK
- Camden and Islington NHS Foundation Trust, London, UK
| | - Kate R Walters
- Department of Primary Care and Population Health, University College London, London, UK
| | - Jennifer Dykxhoorn
- Division of Psychiatry, University College London, London, UK
- Department of Primary Care and Population Health, University College London, London, UK
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