New communities, new relations: The impact of community organization on health outcomes

Durie, Robin; Wyatt, Katrina

doi:10.1016/j.socscimed.2007.05.039

Cited by 36 publications

(26 citation statements)

References 10 publications

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“…As Gatrell [30] and others explain (e.g., [24,25], [28]), in terms of a complex system like place, nonlinearity addresses the empirical fact that, more often than not, small or large changes in some aspect of a place (e.g., its health system, educational system, etc), particularly in the form of health interventions (e.g., new outpatient program, new educational accountability measures, etc) do not regularly lead to their expected, linearly related outcomes (e.g., a 25 % increase in prenatal care or graduation rates, etc. ).…”

Section: Chapter 9 Places Are Nonlinearmentioning

confidence: 77%

“…Health Outcomes Sprawl and the community-level segregation of wellbeing are linked to a variety of health outcomes in the literature, in particular early warning measures (e.g., birth weight), adult health measures (e.g., hypertension), mental health (e.g., stress and wellbeing) and mortality (e.g., [9,28]). For our study, to track the impact of sprawl on community-level health, we employed the following measures from the Summit-QLP: 1st trimester care, childhood immunizations (early life); teen pregnancies (adolescent health); child and elder abuse (mental health); and years of life lost per death (adult health and mortality)-See Table 3.1.…”

Section: Contextual Factors As Shown Inmentioning

confidence: 99%

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Place and Health as Complex Systems

Castellani¹,

Rajaram²,

Buckwalter³

et al. 2015

SpringerBriefs in Public Health

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Section: Chapter 9 Places Are Nonlinearmentioning

confidence: 77%

Section: Contextual Factors As Shown Inmentioning

confidence: 99%

Place and Health as Complex Systems

Castellani¹,

Rajaram²,

Buckwalter³

et al. 2015

SpringerBriefs in Public Health

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“…This complexity has to be considered in the design and assessment of change interventions [10,31,34] as well as in the theories to understand them [35-38]. For example, the use of the evidence-based scores from clinical trials, which were better known and expected by some of the GPs, may not always be the most appropriate way for evaluating HPP activities in PHC [39-41].…”

Section: Discussionmentioning

confidence: 99%

Health promotion in primary care: How should we intervene? A qualitative study involving both physicians and patients

Calderón

Balagué

Cortada

et al. 2011

BMC Health Serv Res

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BackgroundThe effects of tobacco, physical exercise, diet, and alcohol consumption on morbidity and mortality underline the importance of health promotion and prevention (HPP) at the primary health care (PHC) level. Likewise, the deficiencies when putting such policies into practice and assessing their effectiveness are also widely recognised. The objectives of this research were: a) to gain an in-depth understanding of general practitioners' (GPs) and patients' perceptions about HPP in PHC, and b) to define the areas that could be improved in future interventions.MethodsQualitative methodology focussed on the field of health services research. Information was generated on the basis of two GP-based and two patient-based discussion groups, all of which had previously participated in two interventions concerning healthy lifestyle promotion (tobacco and physical exercise). Transcripts and field notes were analysed on the basis of a sociological discourse-analysis model. The results were validated by triangulation between researchers.ResultsGPs and patients' discourses about HPP in PHC were different in priorities and contents. An overall explanatory framework was designed to gain a better understanding of the meaning of GP-patient interactions related to HPP, and to show the main trends that emerged from their discourses. GPs linked their perceptions of HPP to their working conditions and experience in health services. The dimensions in this case involved the orientation of interventions, the goal of actions, and the evaluation of results. For patients, habits were mainly related to ways of life particularly influenced by close contexts. Health conceptions, their role as individuals, and the orientation of their demands were the most important dimensions in patients' sphere.ConclusionsHPP activities in PHC need to be understood and assessed in the context of their interaction with the conditioning trends in health services and patients' social micro-contexts. On the basis of the explanatory framework, three development lines are proposed: the incorporation of new methodological approaches according to the complexity of HPP in PHC; the openness of habit change policies beyond the medical services; and the effective commitments in the medium to long term by the health services themselves at the policy management level.

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“…In contrast to early health psychology writings (e.g., Matarazzo, 1980Matarazzo, , 1982, which promised to solve hitherto intractable health problems with some forward planning and application of psychological understandings of behaviour, a CAS perspective acknowledges that health outcomes cannot be controlled by savvy health psychologists. However, we may be able to introduce components into the system that reduce inequalities, and guide healthrelated actions in the right direction (Durie & Wyatt, 2007). Even then, because change is intimately tied to context, CAS-informed interventions are likely to produce unforeseen effects in health behaviour (Greenhalgh & Stones, 2010;Greenhalgh et al 2014Greenhalgh et al , 2015Keshavarz et al 2010).…”

Section: Resultsmentioning

confidence: 99%

Complex adaptive systems: a new approach for understanding health practices

Gomersall

2018

Health Psychology Review

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This article explores the potential of complex adaptive systems (CAS) theory to inform behaviour change research. A CAS describes a collection of heterogeneous agents interacting within a particular context, adapting to each other's actions. In practical terms, this implies that behaviour change is (1) socially and culturally situated; (2) highly sensitive to small baseline differences in individuals, groups, and intervention components; and (3) determined by multiple components interacting 'chaotically'. Two approaches to studying CAS are briefly reviewed. Agent-based modelling is a computer simulation technique that allows researchers to investigate 'what if' questions in a virtual environment. Applied qualitative research techniques, on the other hand, offer a way to examine what happens when an intervention is pursued in real-time, and to identify the sorts of rules and assumptions governing social action. Although these represent very different approaches to complexity, there may be scope for mixing these methods - for example, by grounding models in insights derived from qualitative fieldwork. Finally, I will argue that the concept of CAS offers one opportunity to gain a deepened understanding of health-related practices, and to examine the social psychological processes that produce health-promoting or damaging actions.

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New communities, new relations: The impact of community organization on health outcomes

Cited by 36 publications

References 10 publications

Place and Health as Complex Systems

Place and Health as Complex Systems

Health promotion in primary care: How should we intervene? A qualitative study involving both physicians and patients

Complex adaptive systems: a new approach for understanding health practices

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