IDEAS home Printed from https://ideas.repec.org/a/plo/pone00/0220109.html
   My bibliography  Save this article

Risk work or resilience work? A qualitative study with community health workers negotiating the tensions between biomedical and community-based forms of health promotion in the United Kingdom

Author

Listed:
  • Nicola K Gale
  • Manbinder S Sidhu

Abstract

Emplaced health promotion interventions, delivered by community health workers are increasingly being used internationally. However, the application of epidemiological risk knowledge to individuals within such communities is not straightforward and creates tensions for community health workers who are part of the communities that they are serving. Situated qualitative interview data were co-produced with community health workers employed in a superdiverse, deprived, post-industrial region of the United Kingdom, using photo-voice methods, to develop an account of how they made sense of the challenges of their work. The analysis draws on and develops theories of risk work and resilience work, which draw on practice theory. The key findings were that, first, being a critical insider enabled community health workers to make sense of the diverse constraints on health and lifestyles within their community. Second, they understood their own public health role as limited by operating within this context, so they articulated their occupational identity as focused on supporting clients to make small but sustainable changes to their own and their families’ lifestyles. Third, the uncertainties of translating population based risk information to individual clients were (at least partially) resolved at an embodied level, with the community health workers identifying as accessible and trusted role models for the value of changed lifestyles. The article is important for policy and practice as it provides a critique of a rapidly evolving new mode of delivery of public health services, and insights on the development of this new public health workforce.

Suggested Citation

  • Nicola K Gale & Manbinder S Sidhu, 2019. "Risk work or resilience work? A qualitative study with community health workers negotiating the tensions between biomedical and community-based forms of health promotion in the United Kingdom," PLOS ONE, Public Library of Science, vol. 14(7), pages 1-19, July.
  • Handle: RePEc:plo:pone00:0220109
    DOI: 10.1371/journal.pone.0220109
    as

    Download full text from publisher

    File URL: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0220109
    Download Restriction: no

    File URL: https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0220109&type=printable
    Download Restriction: no

    File URL: https://libkey.io/10.1371/journal.pone.0220109?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Blaxter, Mildred, 1997. "Whose fault is it? People's own conceptions of the reasons for health inequalities," Social Science & Medicine, Elsevier, vol. 44(6), pages 747-756, March.
    2. Gale, Nicola K. & Kenyon, Sara & MacArthur, Christine & Jolly, Kate & Hope, Lucy, 2018. "Synthetic social support: Theorizing lay health worker interventions," Social Science & Medicine, Elsevier, vol. 196(C), pages 96-105.
    3. Graham, Hilary, 2002. "Building an inter-disciplinary science of health inequalities: the example of lifecourse research," Social Science & Medicine, Elsevier, vol. 55(11), pages 2005-2016, December.
    4. Gale, Nicola & Dowswell, George & Greenfield, Sheila & Marshall, Tom, 2017. "Street-level diplomacy? Communicative and adaptive work at the front line of implementing public health policies in primary care," Social Science & Medicine, Elsevier, vol. 177(C), pages 9-18.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Garthwaite, Kayleigh & Bambra, Clare, 2017. "“How the other half live”: Lay perspectives on health inequalities in an age of austerity," Social Science & Medicine, Elsevier, vol. 187(C), pages 268-275.
    2. Mäkinen, Tomi & Laaksonen, Mikko & Lahelma, Eero & Rahkonen, Ossi, 2006. "Associations of childhood circumstances with physical and mental functioning in adulthood," Social Science & Medicine, Elsevier, vol. 62(8), pages 1831-1839, April.
    3. Davidson, Rosemary & Kitzinger, Jenny & Hunt, Kate, 2006. "The wealthy get healthy, the poor get poorly? Lay perceptions of health inequalities," Social Science & Medicine, Elsevier, vol. 62(9), pages 2171-2182, May.
    4. Emslie, Carol & Browne, Susan & MacLeod, Una & Rozmovits, Linda & Mitchell, Elizabeth & Ziebland, Sue, 2009. "'Getting through' not 'going under': A qualitative study of gender and spousal support after diagnosis with colorectal cancer," Social Science & Medicine, Elsevier, vol. 68(6), pages 1169-1175, March.
    5. Mielck, Andreas, 1998. "Perception of health inequalities in different social classes, by health professionals and health policy makers in Germany and the United Kingdom," Discussion Papers, Research Group Public Health P 98-202, WZB Berlin Social Science Center.
    6. Araviinthansai Subramaniam & Kalyani Kirtikar Mehta, 2024. "Exploring the Lived Experiences of Caregiving for Older Family Members by Young Caregivers in Singapore: Transition, Trials, and Tribulations," IJERPH, MDPI, vol. 21(2), pages 1-27, February.
    7. Braun, Virginia, 2008. ""She'll be right"? National identity explanations for poor sexual health statistics in Aotearoa/New Zealand," Social Science & Medicine, Elsevier, vol. 67(11), pages 1817-1825, December.
    8. Anders L. Hage Haugen & Kirsti Riiser & Marc Esser-Noethlichs & Ove Edvard Hatlevik, 2022. "Developing Indicators to Measure Critical Health Literacy in the Context of Norwegian Lower Secondary Schools," IJERPH, MDPI, vol. 19(5), pages 1-18, March.
    9. Howarth, David & Marteau, Theresa M. & Coutts, Adam P. & Huppert, Julian L. & Pinto, Pedro Ramos, 2019. "What do the British public think of inequality in health, wealth, and power?," Social Science & Medicine, Elsevier, vol. 222(C), pages 198-206.
    10. Chinn, Deborah, 2011. "Critical health literacy: A review and critical analysis," Social Science & Medicine, Elsevier, vol. 73(1), pages 60-67, July.
    11. Fubaihui Wang & Qingkai Zhen & Kaigang Li & Xu Wen, 2018. "Association of socioeconomic status and health-related behavior with elderly health in China," PLOS ONE, Public Library of Science, vol. 13(9), pages 1-14, September.
    12. Macintyre, Sally & McKay, Laura & Ellaway, Anne, 2005. "Are rich people or poor people more likely to be ill? Lay perceptions, by social class and neighbourhood, of inequalities in health," Social Science & Medicine, Elsevier, vol. 60(2), pages 313-317, January.
    13. Quesnel-Vallée, Amélie & Taylor, Miles, 2012. "Socioeconomic pathways to depressive symptoms in adulthood: Evidence from the National Longitudinal Survey of Youth 1979," Social Science & Medicine, Elsevier, vol. 74(5), pages 734-743.
    14. Cannuscio, Carolyn C. & Weiss, Eve E. & Fruchtman, Hannah & Schroeder, Jeannette & Weiner, Janet & Asch, David A., 2009. "Visual epidemiology: Photographs as tools for probing street-level etiologies," Social Science & Medicine, Elsevier, vol. 69(4), pages 553-564, August.
    15. Hodgins, Margaret & Millar, Michelle & M Barry, Margaret, 2006. ""...it's all the same no matter how much fruit or vegetables or fresh air we get": Traveller women's perceptions of illness causation and health inequalities," Social Science & Medicine, Elsevier, vol. 62(8), pages 1978-1990, April.
    16. Iveson, Matthew H. & Deary, Ian J., 2017. "Intergenerational social mobility and subjective wellbeing in later life," Social Science & Medicine, Elsevier, vol. 188(C), pages 11-20.
    17. Reinhard Schunck & Benedikt Rogge, 2012. "No causal effect of unemployment on smoking? A German panel study," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 57(6), pages 867-874, December.
    18. Elizabeth Rigby & Joe Soss & Bridget C. Booske & Angela M. K. Rohan & Stephanie A. Robert, 2009. "Public Responses to Health Disparities: How Group Cues Influence Support for Government Intervention," Social Science Quarterly, Southwestern Social Science Association, vol. 90(5), pages 1321-1340, December.
    19. Edge, Dawn & Rogers, Anne, 2005. "Dealing with it: Black Caribbean women's response to adversity and psychological distress associated with pregnancy, childbirth, and early motherhood," Social Science & Medicine, Elsevier, vol. 61(1), pages 15-25, July.
    20. de Almeida, Filipa & Scott, Ian J. & Soro, Jerônimo C. & Fernandes, Daniel & Amaral, André R. & Catarino, Mafalda L. & Arêde, André & Ferreira, Mário B., 2024. "Financial scarcity and cognitive performance: A meta-analysis," Journal of Economic Psychology, Elsevier, vol. 101(C).

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:plo:pone00:0220109. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: plosone (email available below). General contact details of provider: https://journals.plos.org/plosone/ .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.