Putting context centre stage: evidence from a systems evaluation of an area based empowerment initiative in England

被引:37
|
作者
Orton, Lois [1 ]
Halliday, Emma [2 ]
Collins, Michelle [2 ]
Egan, Matt [3 ]
Lewis, Sue [4 ]
Ponsford, Ruth [3 ]
Powell, Katie [5 ]
Salway, Sarah [5 ]
Townsend, Anne [6 ]
Whitehead, Margaret [1 ]
Popay, Jennie [2 ]
机构
[1] Univ Liverpool, Div Publ Hlth & Policy, Liverpool, Merseyside, England
[2] Univ Lancaster, Dept Hlth Res, Lancaster, England
[3] London Sch Hyg & Trop Med, Dept Social & Environm Hlth Res, London, England
[4] Univ Durham, Ctr Hlth Inequal Res, Dept Geog, South Rd, Durham, England
[5] Univ Sheffield, Sch Hlth & Related Res, Sect Publ Hlth, Sheffield, S Yorkshire, England
[6] Univ Exeter, Sch Med, Coll House,St Lukes Campus, Exeter, Devon, England
关键词
Health inequalities; area-based initiatives; social context; systems theory; evaluation; INTERVENTIONS; POLICY; COMMUNITIES; LESSONS; PROGRAM;
D O I
10.1080/09581596.2016.1250868
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
It is now widely accepted that context matters in evaluations of the health inequalities impact of community-based social initiatives. Systems thinking offers a lens for uncovering the dynamic relationship between such initiatives and their social contexts. However, there are very few examples that show how a systems approach can be applied in practice and what kinds of evidence are produced when this happens. In this paper, we use data from ethnographic fieldwork embedded within a multi-site mixed method evaluation to demonstrate how a systems approach can be applied in practice to evaluate the early stages of an area-based empowerment initiative - Big Local (funded by the Big Lottery Fund and delivered by Local Trust). Taking place in 150 different local areas in England and underpinned by an ethos of resident-led collective action, Big Local offers an illustration of the applicability of a systems approach to better understand the change processes that emerge as social initiatives embed and co-evolve within a series of local contexts. Findings reveal which parts of the social system are likely to be changed, by what mechanisms, and with what implications. They also raise some salient considerations for knowledge generation and methods development in public health evaluation, particularly for the evaluation of social initiatives where change does not necessarily happen in linear or predictable ways. We suggest future evaluations of such initiatives require the use of more flexible designs, encompassing qualitative approaches capable of capturing the complexity of relational systems processes, alongside more traditional quantitative methods.
引用
收藏
页码:477 / 489
页数:13
相关论文
共 23 条
  • [1] Area reputation as an under-acknowledged determinant of health inequalities: evidence from a systems evaluation of a major community empowerment initiative in England
    Ponsford, Ruth
    Halliday, Emma
    Collins, Michelle
    Egan, Matthew
    Scott, Courtney
    Popay, Jennie
    LANCET, 2018, 392 : 72 - 72
  • [2] Pathways to mental health improvement in a community-led area-based empowerment initiative: evidence from the Big Local 'Communities in Control' study, England
    McGowan, V. J.
    Wistow, J.
    Lewis, S. J.
    Popay, J.
    Bambra, C.
    JOURNAL OF PUBLIC HEALTH, 2019, 41 (04) : 850 - 857
  • [3] Community empowerment and mental wellbeing: longitudinal findings from a survey of people actively involved in the big local place-based initiative in England
    Akhter, N.
    McGowan, V. J.
    Halliday, E.
    Popay, J.
    Kasim, A.
    Bambra, C.
    JOURNAL OF PUBLIC HEALTH, 2023, 45 (02) : 423 - 431
  • [4] CLABSI reduction using evidence based interventions and nurse empowerment: a quality improvement initiative from a tertiary care NICU in Pakistan
    Hussain, Ali Shabbir
    Ahmed, Anjum Mohyuddin
    Arbab, Saba
    Ariff, Shabina
    Ali, Rehan
    Demas, Simon
    Zeb, Jehan
    Rizvi, Arjumand
    Saleem, Ali
    Farooqi, Joveria
    ARCHIVES OF DISEASE IN CHILDHOOD, 2021, 106 (04) : 394 - 400
  • [5] Place-based governance and leadership in decentralised school systems: evidence from England
    Greany, Toby
    JOURNAL OF EDUCATION POLICY, 2022, 37 (02) : 247 - 268
  • [6] Capturing complexity in the evaluation of a major area-based initiative in community empowerment: what can a multi-site, multi team, ethnographic approach offer?
    Orton, Lois
    Ponsford, Ruth
    Egan, Matt
    Halliday, Emma
    Whitehead, Margaret
    Popay, Jennie
    ANTHROPOLOGY & MEDICINE, 2019, 26 (01) : 48 - 64
  • [7] Assessing the Effectiveness of Business Support Services in England Evidence from a Theory-Based Evaluation
    Mole, Kevin F.
    Hart, Mark
    Roper, Stephen
    Saal, David S.
    INTERNATIONAL SMALL BUSINESS JOURNAL, 2009, 27 (05) : 557 - 582
  • [8] Evaluation of silicone-based wristbands as passive sampling systems using PAHs as an exposure proxy for carcinogen monitoring in firefighters: Evidence from the firefighter cancer initiative
    Baum, Jeramy L. R.
    Bakali, Umer
    Killawala, Chitvan
    Santiago, Katerina M.
    Dikici, Emre
    Kobetz, Erin N.
    Solle, Natasha Schaefer
    Deo, Sapna
    Bachas, Leonidas
    Daunert, Sylvia
    ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY, 2020, 205
  • [9] Can area-based regeneration programmes ever work? Evidence from England's New Deal for Communities Programme
    Lawless, Paul
    POLICY STUDIES, 2012, 33 (04) : 313 - 328
  • [10] Building collective control and improving health through a place-based community empowerment initiative: qualitative evidence from communities seeking agency over their built environment
    Egan, Matt
    Abba, Katherine
    Barnes, Amy
    Collins, Michelle
    McGowan, Vicki
    Ponsford, Ruth
    Scott, Courtney
    Halliday, Emma
    Whitehead, Margaret
    Popay, Jennie
    CRITICAL PUBLIC HEALTH, 2021, 31 (03) : 268 - 279