The experience of potentially vulnerable people during cold weather: implications for policy and practice

To examine the experience of potentially vulnerable people during cold weather to inform interventions aimed at improving well-being. Qualitative study. Telephone interviews with 35 individuals who could be considered to be potentially vulnerable during cold weather. Individuals were interviewed on two occasions during the winter of 2012-13, one or two days after a level 3 cold weather alert, as defined by the Cold Weather Plan for England, had been issued. Participants were largely unaware of the health risks associated with low temperatures, especially cardiovascular risk. There was a clear distinction between the thermal experience of people in social housing, which was newer, had efficient heating, was well insulated and well-maintained, and owner occupiers living in older, harder to heat homes. Most participants relied on public transport, and many faced arduous journeys to reach basic facilities. Vulnerability to cold was mediated to a significant extent by practical social support from family members. Resources should be targeted at people in hard to heat homes and those that are socially isolated. The repertoire of initiatives aimed at reducing cold-related mortality and morbidity could usefully be augmented by efforts to reduce social isolation and build community resilience

The role of professional elites in healthcare governance:Exploring the work of the medical director

Medical leaders occupy a prominent position in healthcare policy in many countries, both in terms of the governance of quality and safety within healthcare organisations, and in broader system-wide governance. There is evidence that having doctors on hospital boards is associated with higher quality services. What is not known is how they have this effect. Analysing data collected from observations, interviews and documents from 15 healthcare providers in England (2014-2019), we elaborate the role of medical directors in healthcare governance as 'translation work', 'diplomatic work', and 'repair work'. Our study highlights the often enduring emotional effects of repeated structural changes to clinical services. It also contributes to theories of professional restratification, showing the work of medical directors as regional 'political elites', and as 'corporate elites' in publicly-funded healthcare systems

Government wants healthcare staff to change patients' behaviour - but that's unlikely to work

Lorelei Jones examines government efforts encouraging healthcare professionals to get patients to change their behaviour. Drawing on her ethnographic research in England, together with analysing various educational practices and training materials used she explains why these efforts are unlikely to accomplish governmental objectives

Challenges, Alternatives, and Educational Strategies in Reaching Limited Income Audiences

Delivering effective Extension programs to limited income audiences is a challenging task because of the many barriers associated with their living conditions. This study explored how EFNEP program assistants reach this audience effectively. A focus group interview was conducted with a selected group of experienced program assistants to identify challenges, alternatives, and effective educational strategies they use to reach limited income audiences. Findings of the study revealed that there are unique challenges, alternatives, and educational strategies in reaching limited audiences effectively. The recommendations in this article should be helpful in designing and delivering Effective extension programs for limited income audiences

Incorporating Farmers’ Market Tours into the Expanded Food and Nutrition Education Program: Best Practices and Lessons Learned

Research indicates that low-income consumers are less likely to shop at farmers’ markets and that these individuals are often those with the lowest intake of fresh fruits and vegetables. This project aimed to improve familiarity with farmers’ markets among low-income consumers through guided tours of farmers’ markets, implemented as part of the Expanded Food and Nutrition Education Program (EFNEP). EFNEP Program Assistants (PAs) in five counties in North Carolina received training and partnered with a local Cooperative Extension agent to deliver a farmers’ market tour at the mid-point of a nine-lesson series on healthy eating. Forty-eight participants completed the series, completing a pre-and post-class series behavior change assessment and dietary recall. At entry, 54% of participants said they ate food that came from a local farm, compared to 94% at exit. Interviews with all PAs found that participants: plan to visit the farmers’ market again in the future, tried new recipes with foods purchased at the market, and learned how to talk with and ask questions of farmers’ market vendors. We argue that farmers’ market tours are a promising strategy for increasing familiarity with local foods, when carried out as part of a series of nutrition education classes