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Community research for participation : from theory to method
\"This book bridges a major gap in knowledge by considering, through a range of reflexive chapters from different disciplinary backgrounds, both theoretical and practical issues relating to community research methodologies. The international contributors consider a number of key epistemological, ontological and methodological questions. They explore what community peer research means in a range of settings, for a range of people, for the quality of data and subsequent findings, and for the production of rigorous social research. The collection will also stimulate thinking about how methodological advancement can be made in the field. It is the first book of its kind to combine practical and methodological reflections with clearly presented recommendations about how the approach can be used.Presenting the latest thinking in the field and providing summaries, case studies and review questions, 'Community research for participation' will be invaluable to students, researchers, academics and practitioners who aim to place community members at the centre of their research.\"--Publisher's website.
Book
Healthcare bricolage in Europe’s superdiverse neighbourhoods: a mixed methods study
Background
Studies of the relationship between diverse populations, healthcare access and health outcomes have been dominated by approaches focusing on ethno-national groups or specific healthcare sectors. Healthcare bricolage conceptualises the processes by which individuals use multiple resources to address health concerns. It is relevant in superdiverse neighbourhoods with complex populations. This paper is original in its application of mixed methods to examine the extent to which, and the reasons why, individuals engage in healthcare bricolage.
Methods
The study utilized a parallel sequential methodology. Eight superdiverse neighbourhoods were selected, two in each of Bremen, Birmingham, Lisbon and Uppsala. Ethnographic research scoping the nature of each healthcare ecosystem was followed by 160 interviews (20 each neighbourhood) with a maximum variation sample of residents undertaken October 2015 to December 2016. Interviewees were asked to recall a health concern and describe actions taken to attempt resolution. Data was coded with a MAXQDA codebook checked for inter-coder reliability. Interview findings enabled identification of five types of bricolage, the nature of healthcare resources utilised and the factors which influenced residents’ tactics. Results were used to design a household survey using new questions and validated epidemiological instruments implemented January to October 2017. Respondents were identified using random address files and interviewed in person or by telephone. Multinomal logistic regressions were used to estimate the effect of changing the values of determinants on the probability of observing an outcome.
Results
Age, gender, level of education, migration background and extent of functional limitation were associated with bricolage tactics. Individuals demonstrating high levels of agency were more likely than those with low levels to engage in bricolage. Residents with high levels of trust in physicians were less likely to bricolage than those with lower levels of trust. Levels of health literacy showed no significant effects.
Conclusions
The nature and severity of health concern, trust in physicians and agency shaped residents’ bricolage tactics. The concept of bricolage enabled us to make visible the actions and resources utilised around public healthcare systems that would otherwise remain outwith healthcare access research. Actions were frequently undertaken via networks offering insights into healthcare-seeking behaviour.
Journal Article
Community groups in context : local activities and actions
In the past decade community groups have been portrayed as the solution to many social problems. Yet the role of 'below the regulatory radar' community action has received little research attention and thus is poorly understood in terms of both policy and practice. Focusing on self-organised community activity, this book offers the first collection of papers developing theoretical and empirically grounded knowledge of the informal, unregistered, yet largest, part of the voluntary sector. The collection includes work from leading academics, activists, policy makers and practitioners offering a new and coherent understanding of community action 'below the radar'.
Book
Problem or Opportunity? Asylum Seekers, Refugees, Employment and Social Exclusion in Deprived Urban Areas
The UK has become a leading proponent of European restrictionalism and has focused its efforts on developing policy that excludes asylum seekers from mainstream society. Dispersal policy has focused upon sending asylum seekers to excluded urban areas where there is an excess of available housing. This paper discusses the potential impacts of this approach on the economic prosperity and social cohesion of UK dispersal areas and focuses specifically on new migrants who arrived under the NASS dispersal programme. It demonstrates that, whilst newly arrived asylum seekers and refugees (ASRs) have both skills and qualifications, they are currently experiencing high levels of unemployment and those who are employed are working in low-skilled jobs with earnings far below the average. The paper contends that the high levels of unemployment and underemployment currently experienced by ASRs may serve to exclude them from society in dispersal areas and in so doing exacerbate the general levels of social exclusion in those areas. It is argued that ASRs could offer new opportunities for deprived areas if initiatives were introduced to help them access work commensurate with their skills and qualifications.
Journal Article
New Migrants’ Social Integration, Embedding and Emplacement in Superdiverse Contexts
This article focuses on how newcomers form social relations when settling in the UK, and the role of these relations in regards to their sense of belonging as well as access to resources that support integration. By bringing together the concept of social integration with scholarship on embedding and sociabilities of emplacement, the article demonstrates how a combination of serendipitous encounters, ‘crucial acquaintances’ and more enduring friendships with other migrants, co-ethnics and members of the majority population support migrants’ settlement. Drawing on two qualitative studies on migrant settlement, it shows the importance of social relations with other migrants during settlement, and subsequently critically reflects on how the notion of ‘bridging social capital’ has been used in policy discourse. By doing so, the article contends that the notion of ‘integration’ needs to reflect the social ‘unit’ into which migrants are supposed to integrate.
Journal Article
Bricolage as conceptual tool for understanding access to healthcare in superdiverse populations
This paper applies, for the first time, the concept of bricolage to understand the experiences of superdiverse urban populations and their practices of improvisation in accessing health services across healthcare ecosystems. By adopting the concept of healthcare bricolage and an ecosystem approach, we render visible the agency of individuals as they creatively mobilise, utilise, and re-use resources in the face of constraints on access to healthcare services. Such resources include multiple knowledges, ideas, materials, and networks. The concept of bricolage is particularly useful given that superdiverse populations are by definition heterogeneous, multilingual and transnational, and frequently in localities characterised as ‘resource-poor’, in which bricolage may be necessary to overcome such constraints, and where mainstream healthcare providers have limited understanding of the challenges that populations experience in accessing services. The ‘politics of bricolage’ as neoliberal strategies of self-empowerment legitimising the withdrawal of the welfare state are critically discussed. Conflicting aspects of bricolage are made explicit in setting out tactics of relevance to researching the practices of bricolage.
Journal Article
Superdiversity, migration and use of internet-based health information – results of a cross-sectional survey conducted in 4 European countries
Background
Studies of factors associated with the use of Internet-based health information generally focus on general, rather than migrant populations. This study looked into the reasons why Internet-based health information is used and the effects of migration-related factors, other socio-demographic characteristics and health-related factors on the tendency to consult the Internet.
Methods
In a cross-sectional survey conducted in eight superdiverse neighbourhoods - two each in Birmingham, United Kingdom; Bremen, Germany; Lisbon, Portugal and Uppsala, Sweden - participants were presented with six scenarios and asked to indicate the resources they most relied on when addressing a health concern from a given list. The scenarios included establishing the underlying causes of a health concern and seeking information about prescription drugs, treatments and services available as part of the public healthcare system. The list of resources included the public healthcare system, alternative medicine, family and friends, and the Internet. Frequencies for which the Internet was consulted for each different scenario were calculated and compared across the participating cities. The association between consulting Internet-based health information and migration-related factors, and further socio-demographic characteristics as well as health-related factors such as self-reported health and health literacy was assessed using multivariable logistic regressions.
Results
Of the 2570 participants from all four cities who were included in the analyses, 47% had a migrant background and 35% originated from non-EU countries. About a third reported relying on Internet-based health information for at least one of the given scenarios. The two most frequently chosen scenarios were to find out about other possible treatments and prescription drugs. Generally, using Internet-based health information was negatively associated with being a first generation migrant (OR 0.65; 95% CI 0.46–0.93), having poor local language competency (OR 0.25; 95% CI 0.14–0.45), older age (≥60 years, OR 0.21; 95% CI 0.15–0.31), low education (OR 0.35; 95% CI 0.24–0.50) and positively associated with low trust in physicians (OR 2.13; 95% CI 1.47–3.10).
Conclusion
Our findings indicate the need to consider migration background and language competency when promoting the provision of healthcare services via the Internet so that information and services are widely accessible.
Journal Article
Refugees, Acculturation Strategies, Stress and Integration
The advent of super-diversity and politicisation of migration has been accompanied by heightened interest in migrant settlement. Much has been written in policy and academic fields about the importance of integration, particularly in relation to the settlement of refugees. However, little attention has been paid to the varied settlement experiences of individual refugees, or how personal, cultural and experiential factors combine to influence settlement experiences. This paper turns to cross-cultural psychology's discussion of acculturation processes and, in particular, Berry's acculturation strategies (Berry, 1997) to look at the different factors that influence acculturation and how these factors impact upon the ability of individual refugees to integrate. Using qualitative data collected from 138 interviews with refugees living in Birmingham, England, the paper shows how a range of group and individual factors, relating to their experiences both in refugees’ home and host countries, influences the acculturation strategies adopted by different refugees. It shows that in the current policy environment many refugees lack choice about acculturation strategy, are vulnerable to psychosocial stress and struggle to integrate.
Journal Article
Experiences of primary care professionals providing healthcare to recently arrived migrants: a qualitative study
The main objectives of the study were to explore the experiences of primary care professionals providing care to recent migrants in a superdiverse city and to elicit barriers and facilitators to meeting migrants' care needs. This paper focuses on a strong emergent theme: participants' descriptions and understandings of creating a fit between patients and practices.
An exploratory, qualitative study based on the thematic analysis of semistructured interviews.
A purposive sample of 10 practices. We interviewed 6 general practitioners, 5 nurses and 6 administrative staff; those based at the same practice opted to be interviewed together. 10 interviewees were from an ethnic minority background; some discussed their own experiences of migration.
Creating a fit between patients and practice was complex and could be problematic. Some participants defined this in a positive way (reaching out, creating rapport) while others also focused on ways in which patients did not fit in, for example, different expectations or lack of medical records. A small but vocal minority put the responsibility to fit in on to migrant patients. Some participants believed that practice staff and patients sharing a language could contribute to achieving a fit but others outlined the disadvantages of over-reliance on language concordance. A clearly articulated, team-based strategy to create bridges between practice and patients was often seen as preferable.
Although participants agreed that a fit between patients and practice was desirable, some aimed to adapt to the needs of recently arrived migrants, while others thought that it was the responsibility of migrants to adapt to practice needs; a few viewed migrant patients as a burden to the system. Practices wishing to improve fit might consider developing strategies such as introducing link workers and other 'bridging' people; however, they could also aim to foster a general stance of openness to diversity.
Journal Article
Migrant place-making in super-diverse neighbourhoods: Moving beyond ethno-national approaches
Whilst attention has previously focused on the importance of monolithic ethnic identities on migrant place-making, less attention has been paid to how place-making proceeds in super-diverse urban neighbourhoods where no single ethnic group predominates. This paper makes an original contribution by identifying the factors that shape migrants’ affinity with, or alienation from, super-diverse neighbourhoods. Through using and critiquing an analytical framework developed by Gill (2010 Pathologies of migrant place making: The case of Polish migrants to the UK. Environment and Planning A 42(5): 1157–1173) that identifies ‘ideal’ and ‘pathological’ place-making strategies, the paper contrasts two super-diverse neighbourhoods in the UK with different histories of diversity. We show how ‘ideal’ migrant place-making is more likely to occur where there is a common neighbourhood identity based around diversity, difference and/or newness, and where those with ‘visible’ differences can blend in. In contrast, ‘pathologies’ are more likely where the ongoing churn of newcomers, coupled with the speed and recency of change, undermine migrants’ affinity with place and where the diversity of the neighbourhood is not yet embedded. Even where neighbourhood identity based on diversity is established, it may alienate less visible migrants and culminate in a new form of (minority) white flight.
Journal Article