Designing for and Reflecting upon Resilience in Health and Wellbeing

Resilience has been a long-standing theme in HCI research and design. However, prior work has different conceptualizations of resilience, tackles resilience at different scales, and focuses on resilience as the ability to adapt to adversity. This one-day workshop will bring together HCI researchers, interaction designers, healthcare professionals, healthcare service users, and carepartners to critically reflect upon the epistemological stances on resilience and foreground the notion of resilience in health and wellbeing research. Our workshop themes include: 1) reflecting upon the diverse conceptualizations of resilience; 2) designing for resilience from a social justice perspective; 3) designing for multi-stakeholder resilience for individuals, families, communities, and society

Navigational health literacy

info:eu-repo/semantics/publishedVersio

Exploring perceptions, barriers, and facilitators of access to primary health services among African immigrant women in the U.S. : a study of Ethiopian immigrant women

Access to healthcare services remains a top public health concern in the United States and immigrants are disproportionately affected by low rates of health insurance coverage and poor access to healthcare services. It is reported that 23 percent of lawfully present immigrants and 45 percent of undocumented immigrants are uninsured as compared to the 8 percent of uninsured citizens. Particularly, immigrant women experience multiple barriers in accessing healthcare services and are at higher risk of health problems. Within the immigrant women population, African immigrant women have the lowest access and utilization of healthcare, a high rate of HIV and STDs, high rate of employment in unskilled labor that is hazardous and with no protection. However, African immigrant women remained understudied and underrepresented in the immigrant health literature. This study explored the perceptions, barriers, and facilitators experienced by African immigrant women in accessing primary healthcare (PHC) with a particular focus on Ethiopian immigrant women (EIW). A qualitative design with a phenomenological approach was conducted to investigate what challenges were experienced by EIW and how they experienced them. Data were collected using in-depth interviews with EIW (N=21) aged 18 and older (M=36.6) conducted both in-person and virtually via phone and Zoom. Interviews were audio-recorded and transcribed verbatim. Data were analyzed thematically using Nvivo12 software. Findings showed that the transition and adjustment into a new country and healthcare system delayed EIW's timely access to PHC services. EIW believe that PHC in the U.S. is of better quality but inaccessible. Compared to their past experiences, EIW started using annual general checks ups in the U.S. but tended to avoid PHC unless they are faced with severe health issues or had maternal care needs. Lack of trust in the PHC system that was underlined by personal barriers including contradictory health beliefs, language and communication, and limited health literacy hindered EIW's access to PHC. Findings demonstrated that structural barriers, mainly immigration status, unaffordability of PHC, complexity, and discrimination in healthcare impeded EIW's access to PHC. Social support and having a stable job were the two major facilitators to accessing PHC. The findings suggested that in addition to expanding customized health information, translation, maternal health, and affordable care services; it is imperative to make immigration policy reform, decolonize the PHC system and diversify the health workforce. As the first known study on EIW's PHC experience, the study highlighted the need to view access through a lens of everyday life struggles of immigrant women, investigate the lack of trust, and move toward a structural approach in understanding and addressing barriers to access among immigrant women.Includes bibliographical references

Barriers to Abortion Access: An Ethnography of the Clinic

Abortion access is constrained at various socio-cultural levels. While policy may be the most publicized level at which abortion access is determined, barriers to access are highly influenced by a variety of phenomena, including the cultural orientations of the clinic itself. In this thesis I examine the ways that the clinical context both enhances and constrains access to abortion. In this light, the abortion clinic is studied as a dynamic actor in an individual’s pursuit of abortion, and one whose structures, protocols, and cultural orientations are not taken for granted, but rather analyzed through the lens of a praxis-oriented, critical anthropology. Data collected by participant observation, informal and in-depth interviews, and surveys reveal the ways that community-level stigma of abortion along with the legacy of biomedicine manifest at the clinical level to both intensify and mitigate salient logistical, cognitive, and structural barriers to abortion

The Steering Towards Readiness Framework : The Lived Experience of Clinical Facilitators in Identifying, Assessing and Managing Students at Risk of Not Being Ready to Practice as Beginning Practitioners Within Western Australian Health Settings

Clinical facilitators (CFs) are a fundamental resource for student registered nurses (RNs) as they facilitate the consolidation of theory and practice in preparation for registration with the Nursing and Midwifery Board of Australia (NMBA). Health service providers (HSPs) and higher education providers (HEPs) require CFs to identify, assess and manage (I, A & M) the risks of final placement nursing students and, in doing so, protect risk to patient safety. This research aimed to explore the lived experience of CFs in Western Australia in identifying, assessing and managing risk of a student progressing to be a RN. The study used an interpretative phenomenological approach with Heideggerian hermeneutical principles and commentary to guide the exploration and analysis of nine in-depth interviews with CFs. Follow-up interviews substantiated the initial findings. The five major themes identified were ‘The contexts’ of the HSPs’ and CFs’ toolboxes; the CFs’ ‘Responses to navigating current conditions’; and three phases of a final placement: termed ‘Navigating current traffic conditions’, ‘Forging ahead’ and ‘Reaching the destination’. The findings revealed how participants took this journey not only with students, but with other nurses, academics and colleagues. The Steering Towards Readiness framework developed during the study highlights how CFs rely on themselves and/or on other nurses to support students on a final placement. Students were identified as not being independent in the workplace and ready only with support. Further debriefing for CFs to better I, A & M risk was needed. This research used an innovative approach to describe how the contexts, resources and attributes of nurses, students and CFs influence how risk to student readiness is identified, assessed and managed on a student’s final placement. The study paves the way for an examination of the likelihood of risk and possible strategies to actively engage the CF in a cooperative relationship with educational and health setting providers. Such a relationship may assist in the graduation of industry-ready and capable graduates

Case management for older persons with multi-morbidity. Experiences of an intervention from the perspectives of older persons, family members, case managers and health and social care staff members

Complex health systems make it difficult to ensure a continuity of care for older persons with multi-morbidity, and risk fragmented care. Fragmented care could affect the quality and safety of the care provided. Case management could provide an approach to counteract this unfavourable situation. Case management is practised by case managers and aims to improve the coordination of healthcare and social services. To better understand and to advance the progress of case management, there is a need for knowledge that provides rich descriptions of case management in practice. This knowledge must come from different perspectives important for the intervention. Thus, the overall aim of this thesis was to explore the experiences of a case management intervention aimed at older persons with multi-morbidity, from the perspectives of case managers, older persons, family members and health and social care staff members.The work of this thesis is based on an ethnographic approach and explores case management from multiple perspectives. For Study I, the sample consisted of case managers (n=9). Data were collected by a group interview, individual interviews and participant observations. Data analysis was informal and formal, and comprised a thematic analysis of the interview material. For Study II, the sample consisted of family members of older persons with multi-morbidity (n=16). Data were collected by individual interviews and analysed using interpretive phenomenology. For Study III, the sample consisted of older persons (75+) with multi-morbidity (n=13). Individual interviews and participant observations were part of the data collection. Data analysis was influenced by Roper and Shapira’s framework for ethnographic analysis. For Study IV the sample consisted of health and social care staff members (n=10). Individual interviews were conducted and subsequently analysed using thematic analysis. The findings from all studies (I-IV) illustrated different perspectives of a case management intervention, conducted by case managers. In Study I, the case managers’ experiences of their everyday work could be interpreted as challenging current professional identity. Study II showed that the family members’ experiences could be interpreted as helps to fulfil my unmet needs. In Study III, the older persons’ experiences were interpreted into four themes which were someone providing me with a trusting relationship; someone assisting me; someone who is on my side; and someone I do not need at present. In Study IV, health and social care staff members’ experiences were interpreted into the following three themes: could bridge gaps in an insufficient health system; emerging improvements call for engagement; and an intervention in the mist with vague goals and elements.In summary, the findings indicate that establishing trusting relationships was important and this trust enabled the case managers to conduct their everyday work. Consequently, case management interventions need to put emphasis on building trust between the case managers and the participants. To facilitate trusting relationships it is envisaged that it could be of help if the case managers are in a neutral position, act as an individual contact, and have regular contact with the participants. Continuity of the case managers’ services seems to be important for developing trusting relationships. The case managers’ everyday work put forth challenges of trying to make sense of their role as case manager. Thus, when intervening with case management it is important to present a clear description of the case manager’s professional responsibility to all involved. Using working groups as an intermediate for conducting improvement work at an organisational level seems to show promises. But, engagement amongst its representatives is vital for it to be successful. Expectations regarding the working groups and the intervention needs be made clear and discussed throughout the course of the intervention. Thus, a vital part of the preparation for the case management intervention should be to explicitly set the expectations for all involved parties

Barriers Encountered by Young People From Black and Minority Ethnic Communities Accessing Psychological Services: Clinical Psychologists’ Perspectives

This research explores clinical psychologist’s perspectives on barriers to accessing psychological services for young people from Black, Minority and Ethnic (BME) communities. This study follows an analysis of the current and historical contexts of clinical psychology and its relationship with ‘race’ thinking. Particular attention is paid to the theory and practice of clinical psychology and its application across different ethnic contexts, as well as the legislative backdrop as it relates to children and young people. These aspects are considered to be implicated in disparities in access to psychology services for BME young people and families. Eight clinical psychologists were interviewed, and the resulting transcripts analysed using thematic analysis from a critical realist epistemology. Three main themes were identified. Theme One concerns the profession’s predominant Whiteness and how this interacts with the task of improving access for BME young people and families. Theme Two considers the individual and systemic enablers and disablers to greater equality and how these are navigated by participants. Theme Three considers clinical psychologist’s perspectives on ethnic inequities in respect to how systems of language and service structure might create and ameliorate barriers to access. Implications for clinical psychology practice and further research are considered. The findings indicate more should be done on individual and structural levels to facilitate clinical psychologists improving access for BME young people and families

Working in the Public Interest? What must planners do differently? Critical thoughts on the state of planning

The current moment is generating huge challenges and raising significant questions about how our societies operate and the future of our cities and countryside. Economic shutdowns are bringing structural inequalities into sharp relief even as they illustrate the daunting scale of the transformations required to reduce our environmental impacts. Many pieces have already been written about how we might not just adapt to a post-Covid world but take the opportunity to build better, healthier, fairer, greener cities. Any hopes for significant change would entail fundamental shifts in the role of planning. At the same time, however, powerful property lobbies threaten a return to a business-as-usual model of development that is led not by care for people and place but the greedy hand of an ever less fettered free market. In England, this is symbolised by a new Conservative government promising to yet again radically streamline a planning system it sees as an impediment to economic recovery. Current circumstances also therefore challenge us to think more broadly about what planning and being a planner really mean in 2020. What is the purpose of planning? Do planners have the tools, resources, and capabilities to address significant societal challenges, and are they trusted to do so? What role should public authorities have and how might this interface with the logics of the market and private-sector driven development? And finally, what is the ‘public interest’ that planners often invoke as the foundation for their work, and how might it be compromised by the nature of the systems we operate in and where we work? The ESRC-funded Working in the Public Interest project has been seeking answers to these questions over the past three years. The project team from the University of Sheffield, Newcastle University and University College London has been engaging closely with contemporary planning practice in both the public and private sectors, focusing attention on what planners do all day. In depth interviews, focus groups to discuss contemporary challenges in planning, and extensive and engaged ethnography have yielded a rich set of insights into the state of planning and the nature of contemporary planning work across the UK. In this booklet we offer a series of brief overviews of key themes that this research has highlighted. Our aim here is not to offer a definition or detailed theoretical discussion of the public interest. Instead we hope to explore how various different facets of planning work are changing. At a broad level our argument is that a much wider range of issues and practices, including for example work-life balance and organisational change, need to be considered alongside issues such as professionalism and ethics when thinking about what it means to work in the public interest. In doing so we hope to stimulate broader debate within and beyond the planning profession about the nature and value of planning. We also aim to highlight a series of key questions and challenges that are shaping planners’ work and that will have significant implications for the future