Home > Publications
2016
Lois Orton, Emma Halliday, Michelle Collins, Matt Egan, Sue Lewis, Ruth Ponsford, Katie Powell, Sarah Salway, Anne Townsend, Margaret Whitehead & Jennie Popay.
Putting context centre stage: evidence from a systems evaluation of an area based empowerment initiative in England Journal Article
In: Critical Public Health, vol. 27, no. 4, pp. 447 - 489, 2016.
Abstract | Links | Altmetric | Tags: Communities, Empowerment, Inequalities, Inequality
@article{,
title = {Putting context centre stage: evidence from a systems evaluation of an area based empowerment initiative in England},
author = {Lois Orton, Emma Halliday, Michelle Collins, Matt Egan, Sue Lewis, Ruth Ponsford, Katie Powell, Sarah Salway, Anne Townsend, Margaret Whitehead & Jennie Popay.},
doi = {10.1080/09581596.2016.1250868},
year = {2016},
date = {2016-10-27},
journal = {Critical Public Health},
volume = {27},
number = {4},
pages = {447 - 489},
abstract = {It is now widely accepted that context matters in evaluations of the health inequalities impact of community-based social initiatives. Systems thinking offers a lens for uncovering the dynamic relationship between such initiatives and their social contexts. However, there are very few examples that show how a systems approach can be applied in practice and what kinds of evidence are produced when this happens. In this paper, we use data from ethnographic fieldwork embedded within a multi-site mixed method evaluation to demonstrate how a systems approach can be applied in practice to evaluate the early stages of an area-based empowerment initiative – Big Local (funded by the Big Lottery Fund and delivered by Local Trust). Taking place in 150 different local areas in England and underpinned by an ethos of resident-led collective action, Big Local offers an illustration of the applicability of a systems approach to better understand the change processes that emerge as social initiatives embed and co-evolve within a series of local contexts. Findings reveal which parts of the social system are likely to be changed, by what mechanisms, and with what implications. They also raise some salient considerations for knowledge generation and methods development in public health evaluation, particularly for the evaluation of social initiatives where change does not necessarily happen in linear or predictable ways. We suggest future evaluations of such initiatives require the use of more flexible designs, encompassing qualitative approaches capable of capturing the complexity of relational systems processes, alongside more traditional quantitative methods.},
keywords = {Communities, Empowerment, Inequalities, Inequality},
pubstate = {published},
tppubtype = {article}
}
It is now widely accepted that context matters in evaluations of the health inequalities impact of community-based social initiatives. Systems thinking offers a lens for uncovering the dynamic relationship between such initiatives and their social contexts. However, there are very few examples that show how a systems approach can be applied in practice and what kinds of evidence are produced when this happens. In this paper, we use data from ethnographic fieldwork embedded within a multi-site mixed method evaluation to demonstrate how a systems approach can be applied in practice to evaluate the early stages of an area-based empowerment initiative – Big Local (funded by the Big Lottery Fund and delivered by Local Trust). Taking place in 150 different local areas in England and underpinned by an ethos of resident-led collective action, Big Local offers an illustration of the applicability of a systems approach to better understand the change processes that emerge as social initiatives embed and co-evolve within a series of local contexts. Findings reveal which parts of the social system are likely to be changed, by what mechanisms, and with what implications. They also raise some salient considerations for knowledge generation and methods development in public health evaluation, particularly for the evaluation of social initiatives where change does not necessarily happen in linear or predictable ways. We suggest future evaluations of such initiatives require the use of more flexible designs, encompassing qualitative approaches capable of capturing the complexity of relational systems processes, alongside more traditional quantitative methods.
Joanna Reynolds
‘Missing out’: Reflections on the positioning of ethnographic research within an evaluative framing Journal Article
In: Ethnography, 2016.
Abstract | Links | Altmetric | Tags: Communities, Empowerment, health, Inequalities, Inequality, Social integration
@article{,
title = {‘Missing out’: Reflections on the positioning of ethnographic research within an evaluative framing},
author = {Joanna Reynolds},
doi = {10.1177/1466138116664106},
year = {2016},
date = {2016-08-17},
journal = {Ethnography},
abstract = {Contemporary approaches to evaluating ‘complex’ social and health interventions are opening up spaces for methodologies attuned to examining contextual complexities, such as ethnography. Yet the alignment of the two agendas – evaluative and ethnographic – is not necessarily comfortable in practice. I reflect on experiences of conducting ethnographic research alongside a public health evaluation of a community-based initiative in the UK, using the lens of ‘missing out’ to examine intersections between my own ethnographic concerns and those of the communities under study. I examine potential opportunities posed by the discomfort of ‘missing out’, particularly for identifying the processes and spaces of inclusion and exclusion that contributed both to my ethnographic experiences and to the realities of the communities engaging with the initiative. This reveals productive possibilities for a focus on ‘missing out’ as a form of relating for evaluations of the impacts of such initiatives on health and social inequalities.},
keywords = {Communities, Empowerment, health, Inequalities, Inequality, Social integration},
pubstate = {published},
tppubtype = {article}
}
Contemporary approaches to evaluating ‘complex’ social and health interventions are opening up spaces for methodologies attuned to examining contextual complexities, such as ethnography. Yet the alignment of the two agendas – evaluative and ethnographic – is not necessarily comfortable in practice. I reflect on experiences of conducting ethnographic research alongside a public health evaluation of a community-based initiative in the UK, using the lens of ‘missing out’ to examine intersections between my own ethnographic concerns and those of the communities under study. I examine potential opportunities posed by the discomfort of ‘missing out’, particularly for identifying the processes and spaces of inclusion and exclusion that contributed both to my ethnographic experiences and to the realities of the communities engaging with the initiative. This reveals productive possibilities for a focus on ‘missing out’ as a form of relating for evaluations of the impacts of such initiatives on health and social inequalities.
2015
Dr Ruth Ponsford, Michelle Collins, Matt Egan, Sue Lewis, Lois Orton, Sarah Salway, Anne Townsend, Emma Halliday, Margaret Whitehead, Jennie Popay.
In: The Lancet, vol. 386, 2015.
Abstract | Links | Altmetric | Tags: Big Local, Communities, Empowerment, Inequalities, Inequality
@article{,
title = {Development of a framework for identifying and measuring collective control as a social determinant of health: findings from an evaluation of a natural policy experiment in empowerment},
author = {Dr Ruth Ponsford, Michelle Collins, Matt Egan, Sue Lewis, Lois Orton, Sarah Salway, Anne Townsend, Emma Halliday, Margaret Whitehead, Jennie Popay.},
doi = {10.1016/S0140-6736(15)00902-2},
year = {2015},
date = {2015-11-13},
journal = {The Lancet},
volume = {386},
abstract = {Background
Interventions to develop community-level empowerment and participation are advocated within public health strategies that emphasise the importance of control as a social determinant of health. Approaches to defining and measuring collective control, however, are limited. We developed and applied a contextually specific framework for identifying the emergence of collective control in the early stage of a UK area-based community empowerment initiative.
Methods
Existing conceptualisations of collective control were used as a basis for development of a logic model, and then framework, for identifying emergent markers of control at the level of intracapability, intercapability, and extra group action. The concepts of power within, power to, and power with were used as overarching categories under which markers of collective control capability and action were identified. The framework was applied to qualitative data generated by our team for this primary analysis from in-depth case studies carried out in ten intervention neighbourhoods in England. Data included contextual area information, 150 interviews, ethnographic observation, participatory group exercises, and the review of 30 local intervention plans. Data were coded in NVivo (version 10) with a predefined thematic framework. Narrative memos were developed and compared and contrasted within and across sites. Ethics approval for the study was awarded by Lancaster University on behalf of Liverpool and Lancaster Universities Collaboration for Public Health Research, and by each individual research institution.
Findings
Application of the framework showed that collective control manifested in different ways and to varying degrees across field sites. We observed the emergence of new forms of group organising and decision making; the development of collective efficacy and linkages with other organisations; and the beginnings of community action taking place. The emergence of collective control was shaped by existing relationships between residents and histories with local organisations, as well as through features of the intervention itself, such as the provision of tailored support from national organisations. The processes of developing collective control for those involved were unstable, subject to struggle, and part of a continuing, dynamic, nonlinear process.},
keywords = {Big Local, Communities, Empowerment, Inequalities, Inequality},
pubstate = {published},
tppubtype = {article}
}
Background
Interventions to develop community-level empowerment and participation are advocated within public health strategies that emphasise the importance of control as a social determinant of health. Approaches to defining and measuring collective control, however, are limited. We developed and applied a contextually specific framework for identifying the emergence of collective control in the early stage of a UK area-based community empowerment initiative.
Methods
Existing conceptualisations of collective control were used as a basis for development of a logic model, and then framework, for identifying emergent markers of control at the level of intracapability, intercapability, and extra group action. The concepts of power within, power to, and power with were used as overarching categories under which markers of collective control capability and action were identified. The framework was applied to qualitative data generated by our team for this primary analysis from in-depth case studies carried out in ten intervention neighbourhoods in England. Data included contextual area information, 150 interviews, ethnographic observation, participatory group exercises, and the review of 30 local intervention plans. Data were coded in NVivo (version 10) with a predefined thematic framework. Narrative memos were developed and compared and contrasted within and across sites. Ethics approval for the study was awarded by Lancaster University on behalf of Liverpool and Lancaster Universities Collaboration for Public Health Research, and by each individual research institution.
Findings
Application of the framework showed that collective control manifested in different ways and to varying degrees across field sites. We observed the emergence of new forms of group organising and decision making; the development of collective efficacy and linkages with other organisations; and the beginnings of community action taking place. The emergence of collective control was shaped by existing relationships between residents and histories with local organisations, as well as through features of the intervention itself, such as the provision of tailored support from national organisations. The processes of developing collective control for those involved were unstable, subject to struggle, and part of a continuing, dynamic, nonlinear process.
Interventions to develop community-level empowerment and participation are advocated within public health strategies that emphasise the importance of control as a social determinant of health. Approaches to defining and measuring collective control, however, are limited. We developed and applied a contextually specific framework for identifying the emergence of collective control in the early stage of a UK area-based community empowerment initiative.
Methods
Existing conceptualisations of collective control were used as a basis for development of a logic model, and then framework, for identifying emergent markers of control at the level of intracapability, intercapability, and extra group action. The concepts of power within, power to, and power with were used as overarching categories under which markers of collective control capability and action were identified. The framework was applied to qualitative data generated by our team for this primary analysis from in-depth case studies carried out in ten intervention neighbourhoods in England. Data included contextual area information, 150 interviews, ethnographic observation, participatory group exercises, and the review of 30 local intervention plans. Data were coded in NVivo (version 10) with a predefined thematic framework. Narrative memos were developed and compared and contrasted within and across sites. Ethics approval for the study was awarded by Lancaster University on behalf of Liverpool and Lancaster Universities Collaboration for Public Health Research, and by each individual research institution.
Findings
Application of the framework showed that collective control manifested in different ways and to varying degrees across field sites. We observed the emergence of new forms of group organising and decision making; the development of collective efficacy and linkages with other organisations; and the beginnings of community action taking place. The emergence of collective control was shaped by existing relationships between residents and histories with local organisations, as well as through features of the intervention itself, such as the provision of tailored support from national organisations. The processes of developing collective control for those involved were unstable, subject to struggle, and part of a continuing, dynamic, nonlinear process.
Emma Halliday, Lois Orton, Matt Egan, Sue Lewis, Katie Powell, Anne Townsend, Rachel Tyrrell, Margaret Whitehead, Jennie Popay.
In: The Lancet, 2015.
Abstract | Links | Altmetric | Tags: Communities, Empowerment, Inequalities, Inequality
@article{,
title = {Understanding area-based community empowerment initiatives as events in systems and the implications for evaluating their potential to affect health inequalities},
author = {Emma Halliday, Lois Orton, Matt Egan, Sue Lewis, Katie Powell, Anne Townsend, Rachel Tyrrell, Margaret Whitehead, Jennie Popay.},
doi = {10.1016/S0140-6736(15)00879-X},
year = {2015},
date = {2015-11-13},
journal = {The Lancet},
abstract = {Background
Evaluation of community empowerment initiatives for their effects on health inequalities presents a paradox to researchers. By definition, such initiatives aim to empower people to influence decisions that affect their lives. However, once empowered, people might not necessarily take the decisions that the originators of the intervention desired. The inability to control the implementation of an intervention goes against all the basic principles of intervention trials. We studied a community empowerment initiative, using a systems approach, to see whether any ensuing diversity of implementation could be used as an advantage rather than be a problem for an evaluation design.
Methods
We conducted qualitative in-depth case studies in ten intervention neighbourhoods in England, including a total of 150 resident interviews and ethnographic observation, interviews with the national organisations involved, and a review of plans from 30 intervention sites. Data were coded in NVivo (version 10) in a pre-defined thematic framework. Narrative memos were developed and compared and contrasted across sites.
Findings
The initiative's overarching objective was to increase confidence and skills to enable residents to identify priorities and take action in their neighbourhoods. Our fieldwork found that the core objective was pursued in different ways: building connections across people living or working in the neighbourhood, promoting social participation, improving or so-called lifting an area's external reputation, achieving material improvements (eg, parks), and addressing debt or unemployment. Diversity in starting points of local area systems also contributed to divergence in the aspirations that residents identified, the actions being taken to achieve them, and the change in processes that ensued.},
keywords = {Communities, Empowerment, Inequalities, Inequality},
pubstate = {published},
tppubtype = {article}
}
Background
Evaluation of community empowerment initiatives for their effects on health inequalities presents a paradox to researchers. By definition, such initiatives aim to empower people to influence decisions that affect their lives. However, once empowered, people might not necessarily take the decisions that the originators of the intervention desired. The inability to control the implementation of an intervention goes against all the basic principles of intervention trials. We studied a community empowerment initiative, using a systems approach, to see whether any ensuing diversity of implementation could be used as an advantage rather than be a problem for an evaluation design.
Methods
We conducted qualitative in-depth case studies in ten intervention neighbourhoods in England, including a total of 150 resident interviews and ethnographic observation, interviews with the national organisations involved, and a review of plans from 30 intervention sites. Data were coded in NVivo (version 10) in a pre-defined thematic framework. Narrative memos were developed and compared and contrasted across sites.
Findings
The initiative's overarching objective was to increase confidence and skills to enable residents to identify priorities and take action in their neighbourhoods. Our fieldwork found that the core objective was pursued in different ways: building connections across people living or working in the neighbourhood, promoting social participation, improving or so-called lifting an area's external reputation, achieving material improvements (eg, parks), and addressing debt or unemployment. Diversity in starting points of local area systems also contributed to divergence in the aspirations that residents identified, the actions being taken to achieve them, and the change in processes that ensued.
Evaluation of community empowerment initiatives for their effects on health inequalities presents a paradox to researchers. By definition, such initiatives aim to empower people to influence decisions that affect their lives. However, once empowered, people might not necessarily take the decisions that the originators of the intervention desired. The inability to control the implementation of an intervention goes against all the basic principles of intervention trials. We studied a community empowerment initiative, using a systems approach, to see whether any ensuing diversity of implementation could be used as an advantage rather than be a problem for an evaluation design.
Methods
We conducted qualitative in-depth case studies in ten intervention neighbourhoods in England, including a total of 150 resident interviews and ethnographic observation, interviews with the national organisations involved, and a review of plans from 30 intervention sites. Data were coded in NVivo (version 10) in a pre-defined thematic framework. Narrative memos were developed and compared and contrasted across sites.
Findings
The initiative's overarching objective was to increase confidence and skills to enable residents to identify priorities and take action in their neighbourhoods. Our fieldwork found that the core objective was pursued in different ways: building connections across people living or working in the neighbourhood, promoting social participation, improving or so-called lifting an area's external reputation, achieving material improvements (eg, parks), and addressing debt or unemployment. Diversity in starting points of local area systems also contributed to divergence in the aspirations that residents identified, the actions being taken to achieve them, and the change in processes that ensued.