Reimagining community health psychology: maps, journeys and new terrains

Accounting for access to healthcare: Analyzing interview talk of hard-to-reach regions' residents and mobile medical units' professionals in Greece

This study explores how social actors account for psychosocial barriers to healthcare access. Interviews with 17 residents in remote regions of Greece and 12 professionals employed by Mobile Medical Units were analyzed using the tools and concepts of critical discursive social psychology. Analysis indicated that, oriented to different accountability concerns, residents tended to attribute reluctance to seek medical help to structural barriers, while professionals leaned toward psychological and individual-centered explanations. Findings also highlighted the construction of living in hard-to-reach areas as both a "cure" and a "curse" for residents' capacity to achieve a healthy status, representing remote communities as both enhancing solidarity and social support and as promoting stigmatization against illness and social isolation. Building upon prior discourse-oriented approaches in health psychology, the study seeks to exemplify how a discursive and rhetorically oriented research agenda can be employed to explore how health inequalities are enacted and (re)produced in social interactions.

Social Group Membership, Social Identities, and Mental Health Experiences in Urban Poor Communities in Ghana: A Critical Social Psychology Inquiry

Social groups and identities significantly influence mental health outcomes, yet their impact in resource-poor communities remains understudied. We explored the role of social group memberships and identities in shaping mental health experiences in two urban poor communities in Ghana. Data from 77 participants were analyzed thematically, revealing widespread engagement in social groups that provide access to both material and symbolic resources. However, these groups also serve as sources of tension and contribute to the stigmatization and marginalization of vulnerable members. Those affected include individuals with severe mental disorders, men experiencing depression, young men involved in substance abuse, family caregivers, migrant and tenant households, and otherwise healthy individuals with recurring psychosocial challenges. The groups exacerbate mental health challenges and restrict access to care among marginalized populations. The findings underscore the need for targeted interventions aimed at enhancing mental health support and reducing stigma in resource-poor settings.

Health Psychology Services for People in Disadvantaged Regions of Hungary: Experiences from the Primary Health Care Development Model Program

BACKGROUND

The importance of community health psychology in providing complex bio-psycho-social care is well documented. We present a mixed-method outcome-monitoring study of health psychology services in the public-health-focused Primary Health Care Development Model Program (2012-2017) in four disadvantaged micro-regions in northeast Hungary.

METHODS

Study 1 assessed the availability of the services using a sample of 17,003 respondents. Study 2 applied a follow-up design to measure the mental health outcomes of the health psychology services on a sample of 132 clients. In Study 3, we conducted focus-group interviews to assess clients' lived experiences.

RESULTS

More mental health issues and higher education predicted a higher probability of service use. Follow-up showed that individual and group-based psychological interventions resulted in less depression and (marginally) higher well-being. Thematic analysis of the focus-group interviews indicated that participants deemed topics such as psychoeducation, greater acceptance of psychological support, and heightened awareness of individual and community support important.

CONCLUSIONS

The results of the monitoring study demonstrate the important role health psychology services can play in primary healthcare in disadvantaged regions in Hungary. Community health psychology can improve well-being, reduce inequality, raise the population's health awareness, and address unmet social needs in disadvantaged regions.

Grandmothers: Central scaffolding sources impacting maternal and infant feeding practices in Colombia

A growing body of evidence highlights that maternal and child nutrition programmes need to extend beyond the mother-child dyad by adopting a family systems approach, particularly in the Global South. Guided by a sociocultural and community psychology understanding of health, the paper explores factors identifying grandmothers as central resources for nutrition programmes. The study was conducted in a Colombian urban periphery applying a qualitative longitudinal design (prenatal and postpartum). It is based on interviews with adolescent mothers and mothers in their 20s (n = 35 at T1; n = 21 at T2), grandmothers (n = 15 at T1; n = 12 at T2) and community/public stakeholders (n = 17). Many of the participants live in low-income households headed by grandmothers, who adjust feeding practices to the extent of their economic capacity. Findings reveal grandmothers play a central role in decision-making and in enabling a holistic support system for the dyad. This is defined as grandmothers' scaffolding; it covers nutrition advice, breastfeeding and infant feeding, cultural practices, caregiving and maternal mental health. The study helps build the evidence-base for the transferability of a family systems approach to Global South regions by using sociocultural and community psychology concepts to fortify the rationale for including grandmothers in maternal and child nutrition programmes. It argues for the need to continue raising the visibility of key actors like grandmothers and for nutrition programmes to align themselves more flexibly with the needs of families experiencing poverty.

‘Health psychology’ or ‘psychology for health’? A history of psychologists’ engagement with health in South Africa

In contrast to the institutionalization of health psychology in North America and Europe, much psychological work on health issues in South Africa emerged as part of a critical revitalization of South African psychology as a whole, coinciding with the dismantling of Apartheid and global shifts in health discourse. The field’s development reflects attempts to engage with urgent health problems in the context of rapid sociopolitical changes that followed democratic transition in the 1990s, and under new conditions of knowledge production. We provide an account of these issues, as well as reflections on the field’s future, as inflected through the experiences of 12 South African psychologists whose careers span the emergence of health-related psychology to the present day.

When Equity is Central to Research: Implications for Researchers and Consumers in the Research Team

This paper is a response to our recognition that approaches to equity and consumer involvement in research differed in emphasis between our researchers and jurisdictions. Whilst we shared common aspirations we varied in our priorities between equity groups and methods to represent consumer interests. New Zealand has a historical focus on equity for indigenous Maori and shares with Canada concern about enduring inequalities that affect people’s lives.

Rethinking prefigurative politics: Introduction to the special thematic section

This special thematic section responds to the 21st century proliferation of social movements characterised by the slogans ‘another world is possible’ and ‘be the change you want to see’. It explores prefigurative politics as a means of instantiating radical social change in a context of widening global inequalities, climate change, and the crises and recoveries of neoliberal global capitalism. ‘Prefigurative politics’ refers to a range of social experiments that both critique the status quo and offer alternatives by implementing radically democratic practices in pursuit of social justice. This collection of articles makes the case for psychologists to engage with prefigurative politics as sites of psychological and social change, in the dual interests of understanding the world and changing it. The articles bridge psychology and politics in three different ways. One group of articles brings a psychological lens to political phenomena, arguing that attention to the emotional, relational and intergroup dynamics of prefigurative politics is required to understand their trajectories, challenges, and impacts. A second group focuses a political lens on social settings traditionally framed as psychological sites of well-being, enabling an understanding of their political nature. The third group addresses the ‘border tensions’ of the psychological and the political, contextualising and historicising the instantiation of prefigurative ideals and addressing tensions that arise between utopian ideals and various internal and external constraints. This introduction to the special section explores the concept and contemporary debates concerning prefigurative politics, outlines the rationale for a psychological engagement with this phenomenon, and presents the articles in the special thematic section. The general, prefigurative, aim is to advance psychology’s contribution to rethinking and remaking the world as it could be, not only documenting the world as it is.

'Eh! I felt I was sabotaged!': facilitators' understandings of success in a participatory HIV and IPV prevention intervention in urban South Africa

Participatory approaches to behaviour change dominate HIV- and intimate partner violence prevention interventions. Research has identified multiple challenges in the delivery of these. In this article, we focus on how facilitators conceptualize successful facilitation and how these understandings may undermine dialogue and critical consciousness, through a case study of facilitators engaged in the delivery of Stepping Stones and Creating Futures and ten focus-group discussions held with facilitators. All facilitators continually emphasized the importance of discussion and active engagement by participants. However, other understandings of successful facilitation also emerged, including group management--particularly securing high levels of attendance; ensuring answers provided by participants were 'right'; being active facilitators; and achieving behaviour change. These in various ways potentially undermined dialogue and the emergence of critical thinking. We locate these different understandings of success as located in the wider context of conceptualizations of autonomy and structure; historical experiences of work and education; and the ongoing tension between the requirements of rigorous research and those of participatory interventions. We suggest a new approach to training and support for facilitators is required if participatory interventions are to be delivered at scale, as they must be.

'Drinking with respect': Drinking constructions of men who live in a Cape Winelands farm community in South Africa

This article aims to provide a community-specific understanding of a subgroup of South African men who exhibit particularly high rates of hazardous alcohol consumption. Adopting a social constructionist framework, we interviewed 13 Cape Winelands men who lived on farms to explore their drinking constructions. We present three themes that shed light on problematic drinking in this group: (1) the notion of weekend binge-drinking as 'respectable' drinking, (2) drinking as shared activity that fulfils various psycho-social needs and (3) a sense of powerlessness to affect their own or their children's alcohol consumption. These findings are viewed against a specific socio-historical backdrop.

The narrative psychology of community health workers

Community health psychology is an approach which promotes community mobilisation as a means of enhancing community capacity and well-being and challenging health inequalities. Much of the research on this approach has been at the more strategic and policy level with less reference to the everyday experiences of community workers who are actively involved in promoting various forms of community change. This article considers the narrative accounts of a sample of 12 community workers who were interviewed about their lives. Their accounts were analysed in terms of narrative content. This revealed the tensions in their everyday practice as they attempted to overcome community divisions and management demands for evidence. Common to all accounts was a commitment to social justice. These findings are discussed with reference to opportunities and challenges in the practice of community work.