Barriers and enablers to optimal consumer involvement in research: the perspectives of health and medical researchers in the UK

Numerous reasons exist for involving consumers in research, falling mainly into three categories: moral/ethical, methodological, and political. The moral and ethical reasons for involving consumers in research centre on concepts of rights, citizenship and democracy, specifically related to publicly funded research whereby the word ‘consumer’ is seen as a synonym for ‘taxpayer’. The methodological reasons focus on the potential benefits that consumer involvement may have on the research process, including increasing its relevance, credibility, dissemination and transferability of research findings. The political imperative is centred on current policy directives in addition to requirements by research funding agencies, research governance organisations, and research ethics committees (RECs)

A case for reorienting health systems and investing in primary health care in Australia

In recent times, many developing countries have been going through a process of re-orienting health policy and services towards early detection and prevention, rather than solely on the treatment and on-going management, of illness and disease. For example, in the UK, the fundamental philosophy underpinning the approach to funding primary healthcare is analogous to the adage ‘prevention is better than cure’, with the NHS Improvement Plan stating that “If England is to secure world-class standards of health, the enormous human, financial and physical resources available to the NHS need to be focussed on the prevention of disease and not just its treatment”. Within Australia, there are similar shifts in thinking and policy, with the development of the National Preventative Health Taskforce, which has been tasked with developing a National Preventative Health Strategy

The alcohol industry, neo-liberalism and the political economy of health

Writing in the Australasian Medical Journal Bond, Daube, & Chikritzhs present a fascinating analysis of previously confidential, internal industry documents. The documents became available due to the 1998 Master Settlement Agreement, which was originally initiated to allow public access to internal tobacco industry documents, but since some alcohol companies are controlled by tobacco companies (in this case, Phillip Morris), the internal documents of the alcohol companies (in this case, Miller Brewing Company) became available. It is also interesting to note that Kraft foods is also controlled by Phillip Morris, which means that researchers interested in food policy, marketing and regulation can now access potentially useful documentation on the underlying intentions of a particular food company. The paper presented an analysis of a vast array of alcohol industry documents, and the authors discuss a number of key areas with which the alcohol industry stated their concerns. Within this Editorial, I wish to highlight the implications of many of these concerns within two areas of social and political thought: the political economy of health, and the impact of neo-liberalism

HIV among immigrants living in high-income countries: a realist review of evidence to guide targeted approaches to behavioural HIV prevention

Immigrants from developing and middle-income countries are an emerging priority in HIV prevention in high-income countries. This may be explained in part by accelerating international migration and population mobility. However, it may also be due to the vulnerabilities of immigrants including social exclusion along with socioeconomic, cultural and language barriers to HIV prevention. Contemporary thinking on effective HIV prevention stresses the need for targeted approaches that adapt HIV prevention interventions according to the cultural context and population being addressed. This review of evidence sought to generate insights into targeted approaches in this emerging area of HIV prevention

Will the need for effective communication between doctors redefine primary care?

The medical profession differentiated into specialities decades ago. Most doctors are no longer able to serve everyone who might seek medical advice. Put simply surgeons are not expert in psychiatry. Therefore all doctors regularly refer patients to colleagues in other specialties. Geography and logistic considerations determine that doctors seldom ‘talk’ to one another when seeking opinions or advice. To date the main medium of communication between doctors is the traditional ‘letter’. There are numerous studies reporting the impact of this communication and most conclude that doctors often fail to pen enough information when they write to each other. Why articulate people don’t seem to communicate ‘effectively’ on paper, and increasingly online, is the subject of this editorial

Do your patients trust you? A sociological understanding of the implications of patient mistrust in healthcare professionals

The trust that patients invest in healthcare professionals and their advice has been shown to facilitate positive clinical outcomes, although there is evidence that patient trust in expertise, including healthcare professionals, has been declining over the years. Questions about whether or not to trust healthcare professionals have been raised recently in international media by Australian pop icon Kylie Minogue, who spoke of her alleged initial misdiagnosis with breast cancer and went on to tell women that they should ‘follow their intuition’ rather than placing unquestioning trust in doctors or medical advice. Given the power of the media in shaping public opinion, there is a potential for such stories to further impact on the already potentially friable doctor-patient relationships, with questions of trust taking centre-stage. Therefore, an understanding of the nature of trust, in addition to the reasons for the decline in patient trust, is exceedingly important for health professionals. This paper presents an overview of social theories of trust that provide a lens through which we can analyse the development of mistrust in healthcare, and identifies ways in which healthcare professionals may aim to facilitate and sustain patient trust

Reworking the sociology of trust: making a semantic distinction between trust and dependence

Trust, as a sociological construct, has become increasingly important in recent times but an agreed definition is yet to be found. A potentially useful way of ‘defining’ trust is by distinguishing it from other semantically similar concepts. Niklas Luhmann has provided semantic distinctions between trust and familiarity, and trust and confidence. The purpose of this paper is to provide empirical evidence of a further semantic distinction between trust and dependence. This distinction allows us to further define trust and also to investigate the difference between ‘trust’ and ‘dependence’

Smoking and stress

Primary care-based smoking cessation interventions are often less effective among low-SES groups. Higher stress levels may explain the lower quit rate and higher prevalence of smoking in low-SES groups, and why the relative smoking prevalence rate is not declining at an equitable rate (same prevalence rate as higher SES groups). To understand these issues, this paper sought answers to two questions: is stress perceived by ex-smokers and current smokers as a barrier to quitting; and does stress act as a barrier to quitting in relation to other barriers in disadvantaged areas

Improving Access to, Use of, and Outcomes from Public Health Programs: The Importance of Building and Maintaining Trust with Patients/Clients

This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.The central argument in this paper is that “public trust” is critical for developing and maintaining the health and wellbeing of individuals, communities, and societies. I argue that public health practitioners and policy makers need to take “public trust” seriously if they intend to improve both the public’s health and the engagement between members of the public and public health systems. Public health practitioners implement a range of services and interventions aimed at improving health but implicit a requirement for individuals to trust the practitioners and the services/interventions, before they engage with them. I then go on to provide an overview of the theory of trust within sociology and show why it is important to understand this theory in order to promote trust in public health services. I then draw on literature in three classic areas of public health—hospitals, cancer screening, and childhood immunization—to show why trust is vital in terms of understanding and potentially improving uptake of services. The case studies in this paper reveal that public health practitioners need to understand the centrality of building and maintaining trusting relationships with patients/clients because people who distrust public health services are less likely to use them, less likely to follow advice or recommendations, and more likely to have poorer health outcomes