On the Periphery: Examining Women’s Exclusion from Core Leadership Roles in the “Extremely Gendered” Organization of Men’s Club Football in England

This paper frames men’s club football as an “extremely gendered” organization to explain the underrepresentation of women leaders within the industry. By analyzing women’s leadership work over a 30-year period, we find that women’s inclusion has been confined to a limited number of occupational areas. These areas are removed, in terms of influence and proximity, from the male players and the playing of football. These findings reveal a gendered substructure within club football that maintains masculine dominance in core football facing leadership roles and relegates women to a position of peripheral inclusion in leadership roles. Through a discourse analysis of gender pay gap reports, we show that men’s football clubs legitimatize women’s peripheral inclusion by naturalizing male-dominance at the organizational core. These findings are significant as they demonstrate that men’s football clubs, as masculine conferring organizations, have excluded women from core roles in order to maintain their masculine character while superficially accepting women into roles that do not challenge the association of football with hegemonic masculinity. As such, organizational change may only be possible if women are granted greater access to core organizational roles. This paper offers a new theoretical framework for “extremely gendered” organizations that can be applied to other sporting and male-dominated contexts to analyze women’s access to core leadership roles

Translating qualitative data into intervention content using the Theoretical Domains Framework and stakeholder co-design: a worked example from a study of cervical screening attendance in older women

Background Previous screening interventions have demonstrated a series of features related to social determinants which have increased uptake in targeted populations, including the assessment of health beliefs and barriers to screening attendance as part of intervention development. Many studies cite the use of theory to identify methods of behaviour change, but fail to describe in detail how theoretical constructs are transformed into intervention content. The aim of this study was to use data from a qualitative exploration of cervical screening in women over 50 in the UK as the basis of intervention co-design with stakeholders using behavioural change frameworks. We describe the identification of behavioural mechanisms from qualitative data, and how these were used to develop content for a service-user leaflet and a video animation for practitioner training. The interventions aimed to encourage sustained commitment to cervical screening among women over 50, and to increase sensitivity to age-related problems in screening among primary care practitioners. Methods Secondary coding of a qualitative data set to extract barriers and facilitators of cervical screening attendance. Barrier and facilitator statements were categorised using the Theoretical Domains Framework (TDF) to identify relevant behaviour change techniques (BCTs). Key TDF domains and associated BCTs were presented in stakeholder focus groups to guide the design of intervention content and mode of delivery. Results Behavioural determinants relating to attendance clustered under three domains: beliefs about consequences, emotion and social influences, which mapped to three BCTs respectively: (1) persuasive communication/information provision; (2) stress management; (3) role modelling and encouragement. Service-user stakeholders translated these into three pragmatic intervention components: (i) addressing unanswered questions, (ii) problem-solving practitioner challenges and (iii) peer group communication. Based on (ii), practitioner stakeholders developed a call to action in three areas – clinical networking, history-taking, and flexibility in screening processes. APEASE informed modes of delivery (a service-user leaflet and a cartoon animation for practitioners). Conclusion The application of the TDF to qualitative data can provide an auditable protocol for the translation of qualitative data into intervention content

Challenges and opportunities for cervical screening in women over the age of 50 years: a qualitative study

Background Cervical cancer is a preventable disease. Cases in women age >50 years are predicted to rise by 60% in the next two decades, yet this group are less likely to attend for screening than younger women. Aim To seek novel solutions to the challenges of cervical screening in women >50 years of age by examining practitioner and service-user experiences. Design and setting Semi-structured interviews were conducted with 28 practitioners and 24 service users >50 years of age, recruited via UK primary care networks in Northern England in 2016–2017, to explore experiences related to cervical screening. Method An inductive thematic analysis was conducted to explore the data. Results Findings are presented under three key themes. The first, exploring the barriers to successful cervical screening, examines the influences of sexuality and early experiences of screening on attendance, and how preventive health care becomes a low priority as women age. The second, the role of relationships, explores how peer talk shapes attitudes towards cervical screening, how teamwork between practitioners engenders investment in cervical screening, and how interactions between service users and primary care over time can significantly affect intentions to screen. The third, what constitutes good practice, describes practical and sensitive approaches to screening tailored to women aged >50 years. Conclusion Good practice involves attention to structural and practical challenges, and an understanding of the role of relationships in shaping screening intentions. Experienced practitioners adapt procedures to increase sensitivity, and balance time invested in problem solving against the benefits of reaching practice targets for attendance. Building networks of expertise across multiple practices can increase practitioner skill in screening this age group