Identifying solutions to increase participation in physical activity interventions within a socio-economically disadvantaged community: a qualitative study

Background: There is an urgent need to increase population levels of physical activity, particularly amongst those who are socio-economically disadvantaged. Multiple factors influence physical activity behaviour but the generalisability of current evidence to such ‘hard-to-reach’ population subgroups is limited by difficulties in recruiting them into studies. Also, rigorous qualitative studies of lay perceptions and perceptions of community leaders about public health efforts to increase physical activity are sparse. We sought to explore, within a socio-economically disadvantaged community, residents’ and community leaders’ perceptions of physical activity (PA) interventions and issues regarding their implementation, in order to improve understanding of needs, expectations, and social/environmental factors relevant to future interventions.

Methods: Within an ongoing regeneration project (Connswater Community Greenway), in a socio-economically disadvantaged community in Belfast, we collaborated with a Community Development Agency to purposively sample leaders from public- and voluntary-sector community groups and residents. Individual semi-structured interviews were conducted with 12 leaders. Residents (n=113), of both genders and a range of ages (14 to 86 years) participated in focus groups (n=14) in local facilities. Interviews and focus groups were recorded, transcribed verbatim and analysed using a thematic framework.

Results: Three main themes were identified: awareness of PA interventions; factors contributing to intervention effectiveness; and barriers to participation in PA interventions. Participants reported awareness only of interventions in which they were involved directly, highlighting a need for better communications, both inter- and intra-sectoral, and with residents. Meaningful engagement of residents in planning/organisation, tailoring to local context, supporting volunteers, providing relevant resources and an ‘exit strategy’ were perceived as important factors related to intervention effectiveness. Negative attitudes such as apathy, disappointing experiences, information with no perceived personal relevance and limited access to facilities were barriers to people participating in interventions.

Conclusions: These findings illustrate the complexity of influences on a community’s participation in PA interventions and support a social-ecological approach to promoting PA. They highlight the need for cross-sector working, effective information exchange, involving residents in bottom-up planning and providing adequate financial and social support. An in-depth understanding of a target population’s perspectives is of key importance in translating PA behaviour change theories into practice.

Community Arts and Appropriate Internet Technology: Participation, Materiality, and the Ethics of Sustainability in the Digitally Networked Era

This thesis establishes appropriate internet technology as a matter of sustainability for the community arts field. It begins with a contextual review that historicises community art in relation to technological, cultural, and political change. It goes on to identify key challenges for the field resulting from the emerging socio-cultural significance of the internet and digital media technologies. A conceptual review of the literature positions these issues in relation to Internet Studies, integrating key concepts from Software Studies and the computational turn with approaches from the fields of ICT for Development (ICT4D), Critical Design, and Critical Making. Grounded in these intersecting literatures the thesis offers a new pragmatic ethics of appropriate internet technology: one involving an alternative philosophical platform from which suitable internet-based technologies can be designed and assembled by practitioners. I interrogate these ideas through an in-depth investigation of CuriousWorks, an Australian community arts organisation, focusing on their current internet practices. The thesis then reflects on some experimental interventions I designed as part of the study for the purpose of provoking shifts in the field of community arts. The research findings form the foundation of a series of recommendations offered to practitioners and policy makers that may guide their critical and creative uses of internet technologies in the future.

A Smart Grid Information System for Demand Side Participation: Remote Control of Domestic Appliances to Balance Demand

Due to the intermittent nature of renewable generation it is desirable to consider the potential of controlling the demand-side load to smooth overall system demand. The architecture and control methodologies of such a system on a large scale would require careful consideration. Some of these considerations are discussed in this paper; such as communications infrastructure, systems architecture, control methodologies and security. A domestic fridge is used in this paper as an example of a controllable appliance. A layered approach to smart-grid is introduced and it can be observed how each smart-grid component from physical cables, to the end-devices (or smart-applications) can be mapped to these set layers. It is clear how security plays an integral part in each component of the smart-grid so this is also an integral part of each layer. The controllable fridge is described in detail and as one potential smart-grid application which maps to the layered approach. A demonstration system is presented which involves a Raspberry Pi (a low-power, low-cost device representing the appliance controller).

Shared decision making in patients at risk of cancer: The role of domain and numeracy

Background
Shared decision making has become an integral part of medical consultation. Research has, however, reported wide differences in individuals' desires to be involved in the decision-making process, and these differences in preferences are likely to be the result of a number of factors including age, education and numeracy.

Objective
To investigate whether patients at genetic risk for cancer had preferences for shared decision making that differed depending on medical domain (general health vs. cancer) and whether decision preferences are linked to numeracy abilities.

Methods
Four hundred and seventy-six women who consented to participate in response to an email sent by a local branch of the U.S.-based Cancer Genetics Network (CGN) to its members. Participants completed the Control Preference Scale, as well as an objective and subjective numeracy scales.

Results
Decision domain (cancer vs. general health) was not associated with women's preferences for involvement in decision making. Objective and subjective numeracy predicted a preference for decision involvement in general, and only objective numeracy was predictive with regard to cancer.

Conclusion
Participants were equally likely to state they wanted to play an active, collaborative or passive role in both medical domains (general and cancer). High-numeracy participants were more likely to express a desire for an active role in general and in case they were diagnosed with cancer.

Practice implications
Health authorities' recommendations to clinicians to include patients in their medical decisions are supported by patients' desires, and clinicians should be cognizant of their patients' preferences as well as their numeracy skills.

Unpacking the Roma Participation Puzzle: Presence, Voice and Influence

The idea that Roma communities need to be included in public life is rather uncontroversial, widely accepted by Roma activists, academics and policy-makers in national and transnational political contexts. But, what do we mean by participation? Are we talking about formal political structures or do we refer to the capacity of ordinary Roma to have a presence in public life? The right to participation for minorities is specified by international norms but is interpreted differently in national contexts. Nevertheless, participation alone is not enough, thus minorities require 'effective' participation given that the utilitarian principles of liberal democracy means that groups such as Roma will always be outvoted. This article is based on the conviction that addressing the multiple and inter-connected issues facing Roma communities across Europe requires the participation of Roma in social, economic and political life. Whilst the article acknowledges the structural barriers which inhibit attempts to foster the integration of Roma communities, it does consider different conceptions of political participation including presence, voice and influence and how these are understood by the European Union and its member states with regards to Roma.

Power, Pedagogy and Participation: ethics and pragmatics in research with young people

This article addresses issues of methodology and ethical reflexivity when attempting to investigate the opinions of young people. Drawing specifically on three studies of young people's understandings of citizenship and their views on topical issues, two from England and one from Lebanon, the authors present ways in which the ethical and practical challenges of such research can be met. While acknowledging the power relationship between researchers and informants, they suggest that what they call ‘pedagogical research approaches’ built on a participative methodology can open up a space where both parties benefit. They argue that, when working in schools, teacher educators can take advantage of this status to present themselves simultaneously as insiders and outsiders. The authors have devised what are intended to be non-exploitative research instruments that permit the gathering of useful qualitative data during a short encounter. They illustrate their approach with examples of classroom activities they have developed to provide simultaneously a valid learning experience and usable data.

The Participation of Disabled Children and Young People: A Social Justice Perspective

There is an increasing expectation that children, young people and their parents should participate in decisions that affect them. This includes decisions about their health and social care and collective or public decisions about the way in which such services are designed, delivered and evaluated. Indeed this has become a policy priority across the United Kingdom. The participation of disabled children and young people, however, has been slow to develop in the United Kingdom and concerns have been expressed about progress in this area. Drawing on the results of an Economic and Social Research Council-funded, mixed-methods study, the aim of this article is to explore the participation of disabled children and young people through a social justice lens. Participants, recruited by purposeful sampling, included 18 disabled children and young people, 77 parents and 90 professionals from one health and social care trust in Northern Ireland. There were four phases of data collection: surveys to parents and professionals, parent interviews, interviews with children and young people using creative and participatory techniques, and a focus group with professionals. Results showed that for most disabled children and young people, decision-making was firmly grounded in a family-centred model. However, when children and young people were drawn into participatory processes by adults and recognised as partners in interactions with professionals, they wanted more say and were more confident about expressing their views. Choices, information and resources were at times limited and this had a key impact on participation and the lives of these children, young people and their parents. The article concludes by exploring implications for further research and practice. The need for a two-pronged, social justice approach is recommended as a mechanism to advance the participation agenda.

The participation of disabled children, young people and their parents in health and social care. Implications for policy and practice

No abstract available