In this paper, findings from a detailed literature review (which was commissioned in March 2002 by Queen Margaret University College, UK) on Gypsy/Travellers' health are presented as well as suggestions on wherè`g aps'' exist in related empirical research. The review found that much of the existing research is out of date and found few thorough empirical studies of the health of Gypsy/Traveller communities in Scotland. The authors found that a predominant focus within the literature concerns health beliefs and cultural practices, with far less discussion about the material problems of poverty and social exclusion which affect Traveller communities. Emphasis is given in this paper to problems of access, health inequalities and wider concerns with social inclusion/exclusion. The authors identify the main challenges for health promotion among Gypsy/Traveller families in Scotland and argue that a key route to tackling social exclusion may lie in adopting a community development approach.
Journal of Nursing and Healthcare of Chronic Illness 2, 153-163 Risk, resilience and vulnerability in children and adolescents in relation to long-term conditions: the example of Eastern Europe and Central Asia Aims. In this study, the authors examine issues for harmful risk taking and adverse risk behaviours among children and adolescents in respect of chronic illness and long-term conditions, such as those brought about through exposure to blood-borne viruses. The example of the position of children and young people in Eastern Europe and Central Asia is given. Background. Many formidable obstacles exist for public health, education and social work authorities in Eastern Europe and Central Asia. These make interventions and preventive work with children and adolescents with long-term conditions in these countries particularly challenging. Methods. A survey was conducted by the authors of selected indicators for countries in Eastern Europe and Central Asia, based on data collected in 2009 from secondary sources. Key patterns for adverse risk factors relevant for long-term conditions in these countries, using selected indicators, are analysed. The main elements of a model, the Risk, Resilience and Vulnerability Model, are set out; these are based on the results of previous empirical research by the writers on the topic of risk in the UK and in Eastern Europe and Central Asia, and are combined here in an innovative manner to provide a framework for facilitating developments in theory and practice. Findings. In the survey of selected indicators, it was found that children and adolescents in Eastern Europe and Central Asia face a range of enhanced risks of an adverse nature. The Risk, Resilience and Vulnerability Model is recommended as a model for forging approaches and programmes across health sectors and settings, including schools, street shelters and penal institutions. It is also contended that the development of middle range theory, such as that underpinning the model, is a valuable resource for fashioning creative and empowering approaches for working with a child-centred, developmental perspective that can bring together diverse agendas. Conclusions. It is contended that unless and until holistic and cross-sectoral approaches to tackling the problems for children and adolescents with chronic illness and long-term conditions, much time, effort and scarce resources will be wasted Relevance to clinical practice. The Risk, Resilience and Vulnerability Model facilitates holistic and cross-sectoral approaches for working with children and adolescents with chronic illness and long-term conditions. Health promoters, educationalists and social care agencies need to work with positive models of risk and to better support children and adolescents by understanding how they perceive risk and through developing their skills and informal coping strategies.
This research examines the experiences of project workers in one ScottishHealth Board area in evaluating community development for health initiatives. A field study was undertaken, involving semi-structured telephone interviews with workers from 15 community health projects across the Lothians: Supplementary data were gathered by documentary analysis. A predominance of process evaluation was found, with a bias toward the use of qualitative methods. Impact evaluation was also undertaken. Lack of resources emerged as a major problem. The need for training in research methods and evaluation techniques and a greater understanding of the community-development approach on the part of funding bodies was identified. There was no indication that negotiations took place between projects and funders regarding criteria and methods. Clear guidance from funders about their expectations regarding evaluation would be welcome.
The aim of this research was to assist the Health Education Board for Scotland in the development of a strategic approach for supporting health promotion activity in the voluntary sector. As well as interviews with representatives from the statutory and voluntary sectors, a key research method called facilitated discussion groups was designed to draw on participants' practical and strategic experiences and to develop collective wisdom by encouraging an exchange of views. Issues concerning involvement in health-related activities, funding and partnerships were raised. The strengths and weaknesses of a partnership approach were also examined. Suggestions for a national strategy are outlined: these include the need to tackle the funding problems and capacity building of the voluntary sector. Recommendations for good practice in multi-agency working are also made.
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