Title: Populating the Public Health Evidence Base: an historical perspective on area-based interventions
1Populating the Public Health Evidence Base an
historical perspective on area-based
interventions
- Presenter Dr Sara Mallinson
- Professor Jennie Popay, Dr Pam Attree,Dr Bev
French
2Populating the Public Health Evidence Base a
call for innovative strategies
- This work is exploring ways of identifying and
synthesising information from diverse sources in
order to inform policy decisions and enhance
local implementation. - We are focusing on the relationship between place
and health in the context of areabased
initiatives (ABIs).
3- Evidence of effects?
- We have have 40 years of ABI experience in
deprived localities to inform contemporary social
policy development and implementation. However
the evidence on the impact of previous
initiatives is thin. - Evidence from earlier social policy
implementation has not been accumulated
centrally. - Evaluations have been variable both in terms of
quality and method because evaluating ABI health
impacts is tricky. -
4- Can we learn from the past?
- Methods for evaluating contemporary social
programmes is a growing field of academic
endeavour in the UK and elsewhere (eg via the
Campbell Collaboration). -
- But what can we learn from earlier initiatives?
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- Is there historical evidence we can identify and
explore? -
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5- The challenge for historically sensitive evidence
based policy - What do we want to know about the local history
of policy implementation and why? -
- What kinds of materials can provide us with
knowledge about local processes? - Are resources to inform a study of local policy
history accessible? - Is it feasible to systematically review
historical evidence on local policy context?
6Our Research Social Capital, History and
Policy Implementation A synthesis and review
of the literature. Aims To understand how
local historical context might shape the
implementation of contemporary area-based
interventions to improve health. To explore
the methodological challenges of identifying,
retrieving and synthesising evidence from
diverse literatures and other resources.
7- Why the Social Capital focus?
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- Definitions of social capital are contested. We
are focusing on the constructs of trust and
participation/engagement because it has been
mooted that - 1. Trust and civic engagement might be more
health enhancing than other dimension of social
capital. - 2. Trust and engagement may buffer some
communities against the worst effects of
deprivation. - 3. The breakdown of trust and engagement might
be one of the pathways through which income
inequality exerts its influence on mortality. - .
8- The Community Development Project
-
- We are using a case-study approach.
- Our target ABI is the Community Development
Project (CDP) that ran from 1969-1978. - The CDP was a home office initiative to tackle
poverty and deprivation. At the time it was - Britains largest ever government funded
social- action experiment. (Loney,1983)
9- The CDP
- Announced by the Wilson government in 1969, it
encompassed twelve sites around Britain with
marked deprivation. - The initial aim was to identify ways of creating
a more integrated community by building
inter-agency ties to support and promote
self-help and participation in the community. - Total cost was 5 million. The Home Office
supplied 75 of the funding, the host LA
contributed the remaining 25.
10- The CDP
- Each CDP had a steering group consisting of local
authority officers and councillors, voluntary
sector representatives and a Home Office
representative. - Each site had an action team consisting of a
director and action workers plus a research team
and research director who were linked to an
academic institution. - All the CDP sites produced working papers,
interim reports and final reports to the Home
Officer detailing their activities and
evaluations.
11- Fieldwork Sites
- We selected four sites on the basis of
geographic, cultural and historical factors. Our
sites are - Newington, Southwark.
- Glyncorrwg, Upper Afan.
- Hillfields, Coventry.
- Cleator Moor, Cumbria.
12- Central searches
- A search for published materials produced at the
time the CDPs were running. - Secondly, a search of wider and more recent
literatures about the CDP and more general
concepts relevant to its implementation.
13- Published Documents
- We have used
- Web-of-Knowledge
- COPAC
- WorldCat
- Public Library Catalogues
- JISC mail a call for expert advice.
- Key reference snowballing.
14- The Site Searches main aims
- To identify and map diverse documentary sources
of information about the CDP which are accessible
in the local sites but not identifiable through
traditional search strategies done by the central
Lancaster team (newspapers, pamphlets, minutes,
local reports). - Identify a range of people with knowledge of the
CDP and conduct oral history interviews with a
purposively selected sample (residents, CDP
action and research team members, councillors,
local officers etc)
15What challenges have we experienced?
- Time consuming and labour intensive to map and
access materials locally. - Records are incomplete and partial.
- Using a narrative synthesis model to extract
information but the materials are diverse,
unstructured and non-research making appraisal
difficult.
16An historical approach to narrative evidence
synthesis
- Authentification Who wrote this? For what
purpose and in what context? - Corroboration What do different sources
contribute to the story? - Connection What recurrent themes emerge from
across the sources?
17Potential
- Connecting past and present initiatives and
experiences. - Unearthing locally significant information about
the successes and failings of previous trenches
of ABIs. - Beginning to map existing materials for future
synthesis (creation of searchable archives?)
s.mallinson_at_lancaster.ac.uk