Now showing 1 - 10 of 22
  • Publication
    Examining the Media Portrayal of Obesity Through the Lens of the Common Sense Model of Illness Representations
    This study examined the Irish media discourse on obesity by employing the Common Sense Model of Illness Representations. A media sample of 368 transcripts was compiled from newspaper articles (n = 346), radio discussions (n = 5), and online news articles (n = 17) on overweight and obesity from the years 2005, 2007, and 2009. Using the Common Sense Model and framing theory to guide the investigation, a thematic analysis was conducted on the media sample. Analysis revealed that the behavioral dimensions of diet and activity levels were the most commonly cited causes of and interventions in obesity. The advertising industry was blamed for obesity, and there were calls for increased government action to tackle the issue. Physical illness and psychological consequences of obesity were prevalent in the sample, and analysis revealed that the economy, regardless of its state, was blamed for obesity. These results are discussed in terms of expectations of audience understandings of the issue and the implications of these dominant portrayals and framings on public support for interventions. The article also outlines the value of a qualitative analytical framework that combines the Common Sense Model and framing theory in the investigation of illness narratives.
      516Scopus© Citations 7
  • Publication
    A realist review protocol on communications for community engagement in maternal and newborn health programmes in low- and middle-income countries
    Background: Community engagement (CE) has been increasingly implemented across health interventions, including for maternal and newborn health (MNH). This may take various forms, from participatory women’s groups and community health committees to public advocacy days. While research suggests a positive influence of CE on MNH outcomes, such as mortality or care-seeking behaviour, there is a need for further evidence on the processes of CE in different settings in order to inform the future development and implementation of CE across programmes. Communication is an integral component of CE serving as a link between the programme and community. The aim of the realist review described in this protocol is to understand how, why, to what extent, and for whom CE contributes to intended and unintended outcomes in MNH programming, focusing on the communication components of CE. Methods: Realist review methodology will be used to provide a causal understanding of what communication for CE interventions in MNH programming work, for whom, to what extent, why, and how. This will be done by developing and refining programme theories on communications for CE in MNH through a systematic review of the literature and engaging key experts for input and feedback. By extrapolating context-mechanism-outcome configurations, this review seeks to understand how certain contexts trigger or inhibit specific mechanisms and what outcomes this interaction generates when communication in CE interventions is used in MNH programming. Discussion: A realist philosophy is well-suited to address the aims of this study because of the complex nature of CE. The review findings will be used to inform a realist evaluation case study of CE for an MNH programme in order to ascertain transferable findings that can inform and guide engagement activities in various settings. Findings will also be shared with stakeholders and experts involved in the consultative processes of the review (through workshops or policy briefs) in order to ensure the relevance of these findings to policy and practice.
    Scopus© Citations 4  30
  • Publication
    Weight stigma and narrative resistance evident in online discussions of obesity
    This study sampled 2872 obesity-relevant comments from three years of interest from a multi-topic online message board. An inductive thematic analysis was conducted and three themes were evident: reactions and responses to obesity and obese bodies, diminished status of overweight/obese persons, and narrative resistance to an overweight/obese identity. Obesity stigma was pervasive and the discussion of the issue revealed it to be highly acceptable. Consistent with previous research, dominant representations of obese persons as lazy and unintelligent with poor self-control were evident. The analysis provided valuable insight into experiences of explicit stigma, the social and psychological repercussions of overt stigma and norms regarding the perception of obese bodies. There was a prevailing notion that the opinions and insights of overweight and obese persons on the issue of weight were not credible and were perceived as biased. Furthermore, individuals sought to distance themselves from the undesirable labels of 'overweight' and 'obese' by enacting narrative resistance to negotiate the social meaning of excess weight and endeavouring to place themselves on the ‘safe’ side of this boundary. These results highlight the pervasive nature of weight stigma and the social acceptability of such attitudes and beliefs. Furthermore, it highlights the richness of data that may be obtained by examining social media interactions as a window into the naturally-occurring discourse on obesity and stigma.
    Scopus© Citations 65  854
  • Publication
    Factors that influence family and parental preferences and decision making for unscheduled paediatric healthcare: a systematic review protocol
    There is a plethora of factors that dictate where parents and families choose to seek unscheduled healthcare for their child; and the complexity of these decisions can present a challenge for policy makers and healthcare planners as these behaviours can have a significant impact on resources in the health system. The systematic review will seek to identify the factors that influence parents' and families' preferences and decision making when seeking unscheduled paediatric healthcare.  Five databases will be searched for published studies (CINAHL, PubMed, SCOPUS, PsycInfo, EconLit) and grey literature will also be searched. Inclusion and exclusion criteria will be applied and articles assessed for quality. A narrative approach will be used to synthesise the evidence that emerges from the review. By collating the factors that influence decision-making and attendance at these services, the review can inform future health policies and strategies seeking to expand primary care to support the provision of accessible and responsive care. The systematic review will also inform the design of a discrete choice experiment (DCE) which will seek to determine parental and family preferences for unscheduled paediatric healthcare. Policies such as SlĂĄintecare that seek to expand primary care and reduce hospital admissions from emergency departments need to be cognisant of the nuanced and complex factors that govern patients' behaviour.
    Scopus© Citations 4  181
  • Publication
    The emergence and portrayal of obesity in The Irish Times: Content analysis of obesity coverage, 1997-2009
    Both global obesity prevalence rates and media attention to obesity have increased significantly in recent years. The current study examined the representation of obesity in The Irish Times, from 1997 to 2009. A quantitative content analysis was conducted on 479 articles to examine how the causes, consequences, and solutions to obesity have been portrayed and how obesity has been described. A frame analysis was also conducted to examine the dominant frames over time. It was found that attention to obesity was positively correlated with time, indicating coverage has increased significantly over the period examined. Regarding reported causes and solutions, the behavioral frame has been dominant, though environmental and mixed-frame stories have become more frequent. The presence of the genetic frame was consistently low. The study provides an overview of how the issue is being represented in Ireland's paper of record and informs health communicators of the dominant and trending messages and the implications for individuals' formation of illness representations.
    Scopus© Citations 22  310
  • Publication
    A Rapid Realist Review of Group Psychological First Aid for Humanitarian Workers and Volunteers
    Humanitarian workers are at an elevated risk of occupational trauma exposure and its associated psychological consequences, and experience increased levels of anxiety, depression, and post-traumatic stress disorder (PTSD) compared to the general population. Psychological first aid (PFA) aims to prevent acute distress reactions from developing into long-term distress by instilling feelings of safety, calmness, self- and community efficacy, connectedness and hope. Group PFA (GPFA) delivers PFA in a group or team setting. This research sought to understand ‘What works, for whom, in what context, and why for group psychological first aid for humanitarian workers, including volunteers?’ A rapid realist review (RRR) was conducted. Initial theories were generated to answer the question and were subsequently refined based on 15 documents identified through a systematic search of databases and grey literature, in addition to the inputs from a core reference panel and two external experts in GPFA. The findings generated seven programme theories that addressed the research question and offered consideration for the implementation of GPFA for the humanitarian workforce across contexts and age groups. GPFA enables individuals to understand their natural reactions, develop adaptive coping strategies, and build social connections that promote a sense of belonging and security. The integrated design of GPFA ensures that individuals are linked to additional supports and have their basic needs addressed. While the evidence is sparce on GPFA, its ability to provide support to humanitarian workers is promising.
      176Scopus© Citations 11
  • Publication
    PReSaFe: a model of barriers and facilitators to patients providing feedback on experiences of safety
    Objective: The importance of involving patients in reporting on safety is increasingly recognised. Whilst studies have identified barriers to clinician incident reporting, few have explored barriers and facilitators to patient reporting of safety experiences. This paper explores patient perspectives on providing feedback on safety experiences. Design/Participants: Patients (n=28) were invited to take part in semi-structured interviews when given a survey about their experiences of safety following hospital discharge. Transcripts were thematically analysed using NVivo10. Setting: Patients were recruited from four hospitals in the UK. Results: Three themes were identified as barriers and facilitators to patient involvement in providing feedback on their safety experiences. The first, cognitive-cultural, found that whilst safety was a priority for most, some felt the term was not relevant to them because safety was the ‘default’ position, and/or because safety could not be disentangled from the overall experience of care. The structural-procedural theme indicated that reporting was facilitated when patients saw the process as straightforward, but that disinclination or perceived inability to provide feedback was a barrier. Finally, learning and change illustrated that perception of the impact of feedback could facilitate or inhibit reporting. Conclusions: When collecting patient feedback on experiences of safety, it is important to consider what may help or hinder this process, beyond the process alone. We present a staged model of prerequisite barriers and facilitators, and hypothesise that each stage needs to be achieved for patients to provide feedback on safety experiences. Implications for collecting meaningful data on patients' safety experiences are considered.                  
    Scopus© Citations 21  271
  • Publication
    The co-design, implementation and evaluation of a serious board game ‘PlayDecide patient safety’ to educate junior doctors about patient safety and the importance of reporting safety concerns
    Background: We believe junior doctors are in a unique position in relation to reporting of incidents and safety culture. They are still in training and are also ‘fresh eyes’ on the system providing valuable insights into what they perceive as safe and unsafe behaviour. The aim of this study was to co-design and implement an embedded learning intervention – a serious board game – to educate junior doctors about patient safety and the importance of reporting safety concerns, while at the same time shaping a culture of responsiveness from senior medical staff. Methods: A serious game based on the PlayDecide framework was co-designed and implemented in two large urban acute teaching hospitals. To evaluate the educational value of the game voting on the position statements was recorded at the end of each game by a facilitator who also took notes after the game of key themes that emerged from the discussion. A sample of players were invited on a voluntary basis to take part in semi-structured interviews after playing the game using Flanagan’s Critical Incident Technique. A paper-based questionnaire on ‘Safety Concerns’ was developed and administered to assess pre-and post-playing the game reporting behaviour. Dissemination workshops were held with senior clinicians to promote more inclusive leadership behaviours and responsiveness to junior doctors raising of safety concerns from senior clinicians. Results: The game proved to be a valuable patient safety educational tool and proved effective in encouraging deep discussion on patient safety. There was a significant change in the reporting behaviour of junior doctors in one of the hospitals following the intervention. Conclusion: In healthcare, limited exposure to patient safety training and narrow understanding of safety compromise patients lives. The existing healthcare system needs to value the role that junior doctors and others could play in shaping a positive safety culture where reporting of all safety concerns is encouraged. Greater efforts need to be made at hospital level to develop a more pro-active safe and just culture that supports and encourages junior doctors and ultimately all doctors to understand and speak up about safety concerns.
      403Scopus© Citations 16
  • Publication
    'Fat is your fault': Gatekeepers to health, attributions of responsibility and the portrayal of gender in the Irish media representation of obesity
    We investigated the representation of obesity in the Irish media by conducting an inductive thematic analysis on newspaper articles (n=346) published in 2005, 2007 and 2009 sampled from six major publications. The study analysed the media's construction of gender in discussions of obesity and associated attributions of blame. Three dominant themes are discussed: the caricatured portrayal of gender, women as caregivers for others, and emotive parent-blaming for childhood obesity. Men were portrayed as a homogenous group; unaware and unconcerned about weight and health issues. Dieting and engaging in preventative health behaviours were portrayed as activities exclusively within the female domain and women were depicted as responsible for encouraging men to be healthy. Parents, specifically mothers, attracted much blame for childhood obesity and media messages aimed to shame and disgrace parents of obese children through use of emotive and evocative language. This portrayal was broadly consistent across media types and served to reinforce traditional gender roles by positioning women as primarily responsible for health. This analysis offers the first qualitative investigation into the Irish media discourse on obesity and indicates a rather traditional take on gender roles in diet and nutrition.
    Scopus© Citations 41  987
  • Publication
    A systematic review and narrative synthesis of the experiences of caring for older people living with dementia in sub-Saharan Africa
    (University of York, 2019-06-24) ; ;
    The broad review question will be: What are the experiences of caring for older people with dementia in sub-Saharan Africa (SSA)?
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