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Qualitative Health Research, 2017.
Abstract: The growth of the Internet has led to an increase in researchers utilizing online methods. Online communities such as forums, blogs, and video platforms are particularly useful for research involving populations that are Internet savvy, seldom heard or discussing sensitive or illicit behavior. Drawing upon the experiences of four doctoral health students who are using online methods, this article discusses the value and benefits of conducting online research as well as the limitations and difficulties encountered. Consideration is given to the methodological and ethical implications of online research. Our own research leads us to reflect on participants’ perceptions of what is public, preserving anonymity and protecting participants from harm.
Low levels of hepatitis C diagnosis and testing uptake among people who inject image and performance enhancing drugs in England and Wales, 2012-15
Drug and Alcohol Dependence Volume 179, 1 October 2017, Pages 83-86, 2017.
Abstract: Introduction: People injecting image and performance enhancing drugs (IPEDs) have traditionally not been perceived as being at high risk of hepatitis C virus (HCV) infection. However, recent studies indicate the HCV antibody (anti-HCV) prevalence in this group is 10-times that in the general population. HCV testing uptake and undiagnosed infections are examined using data from a voluntary unlinked-anonymous survey. Method: People injecting IPEDs across England and Wales completed a short bio-behavioural survey (2012–15). Anti-HCV status and self-reports of HCV testing were used in the analysis. Results: The participants median age was 31 years, 98% were men, 14% had also injected psychoactive drugs and the anti-HCV prevalence was 4.8% (N = 564). Among those who had never injected psychoactive drugs the anti-HCV prevalence was 1.4%; among those who had recently injected psychoactive drugs (preceding 12 months) prevalence was 39% and among those who had done this previously 14% (p < 0.001). Overall, 37% had been tested for HCV: among those who had recently injected psychoactive drugs 78% had been tested, as had 56% of those who had injected psychoactive drugs previously; 33% of those never injecting psychoactive drugs were tested (p < 0.001). Overall, 44% of those with anti-HCV were aware of this; however, only 14% of those who had never injected psychoactive drugs were aware. Conclusions: One-in-twenty people who inject IPEDs have anti-HCV. HCV infections among those who had never injected psychoactive drugs were mostly undiagnosed, though this group had a lower prevalence. Targeted HCV testing interventions are also needed for those injecting IPEDs.
Reflexivity, positionality and power in cross-cultural participatory action research with research assistants in rural Cambodia
Education Action Research, Pages 1-15 | Received 25 Nov 2016, Accepted 12 May 2017, Published online: 05 Jun, 2017.
Abstract: This paper draws on the experiences of a doctoral student undertaking a cross-cultural, cross-language participatory action research (PAR) project in rural Cambodia. Cambodia is a largely Buddhist country with a complex history of religion, invasion, colonisation, war and oppression. Despite a democratic constitution, political control and fear of challenging authority are ever present; and all had an impact on the participation and development of this project. I recruited eight volunteer community health workers (CHWs) and two research assistants (RAs) with an aim to explore methods and challenges faced when trying to improve health with and for community members. Over eight participatory workshops and a two-day training session CHWs identified, implemented and reflected on solutions to community health problems. Simultaneously, the RAs and I reflected on the processes and challenges we faced. Creating opportunity for reflexivity allowed for discussion to emerge around culture, position and power and how these were impacting on the research process and outcomes. Established social hierarchical power structures in Cambodia presented challenges to undertaking a PAR project with emancipatory and social change aims. Such structures also impacted on the ability and readiness of participants to be critical and analytical. The importance of the RAs as cultural navigators and the necessity of embracing their situated knowledge as both an insider and outsider is a key finding.
‘If I don’t look good, it just doesn’t go up’: A qualitative study of young women’s drinking cultures and practices on Social Network Sites
Int J Drug Policy. 2016 Dec;38:50-62, 2016.
Abstract BACKGROUND: Young women in the UK often partake in a culture of intoxication in the pursuit of pleasure and friendship fun. Experiences of intoxication and drinking spaces remain highly gendered, and relative to men, women continue to find their behaviours in drinking spaces more constrained and scrutinised. Simultaneously, young women now express themselves via Social Network Sites (SNS), where they display drinking experiences and where they perform, negotiate and display contemporary femininities. METHODS: The research explored young women's experiences of drinking and intoxication, the use of SNS in their drinking cultures and the display of drinking practices on SNS through group interviews (n=12) with women (n=37) aged 16-21 from one city in the North-West of England, UK. RESULTS: The practice of uploading drinking photographs to SNS played an important role in displaying young women's popularity, enhancing friendship fun and belonging, and in positioning the hyper-sexual feminine look as the norm in drinking spaces. Both intoxication and the hyper-sexual and feminine look challenged traditional notions of respectable femininity, while the highly groomed feminine look itself was threatened by drunkenness. As such, young women invested much work and effort in self-surveillance and in managing the display of their drinking behaviours on SNS. CONCLUSION: The dilemmas in contemporary femininity created by the juxtaposition of hyper-sexual femininity and the culture of intoxication are reproduced on SNS. Controlling and restricting certain content on SNS with the aim of achieving the 'right' feminine self-presentation resulted in a narrowly set of body oriented and behavioural feminine attributes being presented as the norm, and an overly positive online representation of young women's drinking experiences.
“Once you’ve been there, you’re always recovering”: exploring experiences, outcomes, and benefits of substance misuse recovery
Drugs and Alcohol Today, (2016) Vol. 16 Iss: 1, pp.29 - 38, 2016.
Abstract: Purpose: – Recovery is a central component of UK substance misuse policy, however, relatively little is known about the views and meanings of recovery by those experiencing it. The purpose of this paper is to explore these factors, and understand how service user experiences align to current understandings of “recovery capital”. Design/methodology/approach: – This paper draws on qualitative interviews with 32 individuals from six UK recovery communities, including those commissioned by a statutory service (n=8) and a peer-led recovery community (n=24). Findings: – Meanings of recovery differed between people in abstinence-based communities and those not; however, all had consistent views on their own recovery outcomes and the benefits they believed recovery brought. All viewed recovery as a process; a continuous journey with no end-point. Internal motivation, peer support, social networks and daily structure were integral to supporting individuals achieve and maintain recovery. Key benefits of recovery reflected recovery capital and included positive relationships, sense of belonging, increased self-worth and confidence, employment and education. Research limitations/implications: – This research shows that recovery experiences and outcomes are not centred entirely on the individual but are wider, more holistic. Maintaining recovery involves being connected to themselves and to the wider environment: family, friends, peers and society. Although the recovery capital model has many elements that were discussed by the participants of this research, the discourse they used does not align with the model. To validly measure and quantify recovery outcomes, individuals need to identify with the measures themselves. Practical implications: – From policy and commissioning perspectives, these findings suggest benefits of recovery that were viewed by participants as indicators of success: demonstrate elements which support recovery; and highlight key social value outcomes which people attribute to recovery. Social implications: – These “softer”, qualitative benefits should be considered by policy-makers, commissioners, statutory and non-statutory services in order to evidence outcomes. However, it should also be recognised that a temporally static approach to assessing recovery may be in contradiction to the meaning and perspectives held by those in recovery communities who conceptualise it as a long term and ongoing process. Originality/value: – This paper adds to understandings of experiences and meanings of recovery, with a particular focus on the measurement of outcomes and their meanings, and the role of abstention and continued drug use within the recovery process.
Drugs: Education, Prevention and Policy, Pages 1-8, 2016.
Abstract: Aim: The aim of the paper was to identify changes in the extent and patterns of anabolic steroid use in the United Kingdom to better understand the public health implications within the context of the current health-related evidence base. Methods: Using the two time points between 1995 (prior to legislation changes in the United Kingdom) and 2015, a review of the evidence related to health harms was conducted, in conjunction with needle and syringe programme (NSP) data in Cheshire & Merseyside (UK) relating to anabolic steroid users. Findings: Dramatic increase in the number of anabolic steroid users accessing NSPs, 553 in 1995 to 2446 in 2015, now accounting for 54.9% of clients. With the inclusion of pharmacy NSPs, this rose to 5336 individual anabolic steroid users. Conclusions: Key changes in our knowledge during the 20 years, in particular, in relation to HIV prevalence, changes in the market and patterns of use make anabolic steroid use a public health concern. In the context of increasing numbers of injectors, there is a need for comprehensive interventions.
Grassroots responses to violence against women and girls in post-earthquake Nepal: Lessons from the field
Kay Standing, Sara Parker, Sapana Bista
Gender & Development, Volume 24, Issue 2, 2016 Special Issue: Violence Against Women and Girls, pages 187-204, 2016.
Abstract: Violence against women and girls (VAWG), including sexual violence, can increase after natural disasters. This article provides evidence from Nepal, a country where progress has been made on gender equality but VAWG remains an endemic problem. Research since the earthquakes involving women activists and non-government organisations indicates the continuing challenges facing disaster response efforts to prevent VAWG and protect women. Women and girls in camps and temporary shelters feel threatened and insecure due to the risk of violence and lack of privacy. Humanitarian aid, health care, and disaster responses can challenge VAWG, and offer safe spaces for women and girls to be established. This article draws on the views of grassroots women’s activists in Nepal and shares lessons for development and humanitarian workers about steps to be taken to challenge and minimise VAWG in emergency situations.
An exploration of alcohol advertising on social networking sites: an analysis of content, interactions and young people’s perspectives
Addiction Research & Theory, 2016.
Abstract: Young people increasingly communicate and interact via social digital media such as Social Network Sites (SNS), where they discuss and display alcohol-related content. SNS have also become an important aspect of the alcohol industry’s multi-platform marketing strategies, which may contribute to the creation of intoxigenic digital spaces in which young people learn about alcohol. This paper presents findings of a content analysis of the extent, nature, and user interaction with SNS-based alcohol marketing for brands popular among young people in the UK. It provides a systematic analysis of both official and user generated marketing content on brand Facebook and Twitter profiles, and user interaction with such content. Findings from peer group interviews (N = 14) also present young people’s (N = 70) perspectives and experiences regarding alcohol marketing on SNS. New SNS engagement marketing strategies extended existing multi-platform brand marketing. Young people interacted with such strategies as part of their identity-making practices, yet through a discourse of immaturity distanced themselves from certain brands, online marketing practices and the idea that their own actions were influenced by marketing. Local night life economy marketing appeared more meaningful and relevant to young people and led to further interaction with brand marketing. Implications of the findings are discussed in relation to the influence of alcohol marketing on young people, and the implications for current regulatory frameworks.
Black box towards glass box: ‘Mapaloguing’ a typology of public health CPD activities in UK in 2011/12
Journal of Public Health, pp. 1–10, 2016.
Abstract: Background: The 1996 Faculty of Public Health study of specialists continuing professional development (CPD) diaries indicated forward-looking approaches. There has been little substantive research on public health CPD records since. Methods: Mixed methods research assessed 795 CPD records/reflective notes from 2011/12. The quantitative methods aimed to analyse types of new learning; a qualitative sub-sample analysis of reflective standards will be reported elsewhere. Many current CPD categories were non-specific and situational, including conferences/workshops and learning as part of the job. These were later classified to a new CPD typology of 13 learning-orientated categories with sub-types. Results: Most (572 = 71.9%) activities fell into current FPH CPD categories that did not identify the learning topic. The new categorization identified four most common CPD learning types: about health protection topics, key specialist knowledge/skills, experiences handling new public health systems and educator/trainer requirements. Conclusions: This new typology illustrates wide-ranging CPD activities, including work-based opportunities from shifts in organizations and policies. A CPD ‘Mapalogue’ is proposed, with ‘Mapaloguing’ as an analytical research process, combining mapping of influences and direction of CPD alongside cataloguing actual CPD undertaken. This could inform individual professionals' choice menu for CPD and personal development and increase the profession's transparency and understanding of long-term trends.
Effect of a sport-for-health intervention (SmokeFree Sports) on smoking-related intentions and cognitions among 9-10 year old primary school children: a controlled trial
Dr Ciara McGee, Joanne Trigwell, Stuart Fairclough, Rebecca Murphy, Dr Lorna Porcellato, Michael Ussher, Lawrence Foweather
BMC Public Health, BMC series – open, inclusive and trusted 16:445, 2016.
Abstract: Background: Preventing children from smoking is a public health priority. This study evaluated the effects of a sport-for-health smoking prevention programme (SmokeFree Sports) on smoking-related intentions and cognitions among primary school children from deprived communities. Methods: A non-randomised-controlled trial targeted 9-10 year old children from Merseyside, North-West England. 32 primary schools received a programme of sport-for-health activities over 7 months; 11 comparison schools followed usual routines. Data were collected pre-intervention (T0), and at 8 months (T1) and one year post-intervention (T2). Smoking-related intentions and cognitions were assessed using an online questionnaire. Intervention effects were analysed using multi-level modelling (school, student), adjusted for baseline values and potential confounders. Mixed-sex focus groups (n = 18) were conducted at T1. Results: 961 children completed all assessments and were included in the final analyses. There were no significant differences between the two study groups for non-smoking intentions (T1: β = 0.02, 95 % CI = -0.08–0.12; T2: β = 0.08, 95 % CI = -0.02–0.17) or for cigarette refusal self-efficacy (T1: β = 0.28, 95 % CI = -0.11–0.67; T2: β = 0.23, 95 % CI = -0.07–0.52). At T1 there was a positive intervention effect for cigarette refusal self-efficacy in girls (β = 0.72, 95 % CI = 0.21–1.23). Intervention participants were more likely to ‘definitely’ believe that: ‘it is not safe to smoke for a year or two as long as you quit after that’ (RR = 1.19, 95 % CI = 1.07–1.33), ‘it is difficult to quit smoking once started’ (RR = 1.56, 95 % CI = 1.38–1.76), ‘smoke from other peoples’ cigarettes is harmful’ (RR = 1.19, 95 % CI = 1.20–2.08), ‘smoking affects sports performance’ (RR = 1.73, 95 % CI = 1.59–1.88) and ‘smoking makes ‘no difference’ to weight’ (RR = 2.13, 95 % CI = 1.86–2.44). At T2, significant between-group differences remained just for ‘smoking affects sports performance’ (RR = 1.57, 95 % CI = 1.43–1.72). Focus groups showed that SFS made children determined to remain smoke free and that the interactive activities aided children’s understanding of smoking harms. Conclusion: SFS demonstrated short-term positive effects on smoking attitudes among children, and cigarette refusal self-efficacy among girls. Although no effects were observed for non-smoking intentions, children said that SFS made them more determined not to smoke. Most children had strong intentions not to smoke; therefore, smoking prevention programmes should perhaps target early adolescents, who are closer to the age of smoking onset.