Mechanisms that Trigger a Good Health-Care Response to Intimate Partner Violence in Spain. Combining Realist Evaluation and Qualitative Comparative Analysis Approaches

Background. Health care professionals, especially those working in primary health-care services, can play a key role in preventing and responding to intimate partner violence. However, there are huge variations in the way health care professionals and primary health care teams respond to intimate partner violence. In this study we tested a previously developed programme theory on 15 primary health care center teams located in four different Spanish regions: Murcia, C Valenciana, Castilla-León and Cantabria. The aim was to identify the key combinations of contextual factors and mechanisms that trigger a good primary health care center team response to intimate partner violence. Methods. A multiple case-study design was used. Qualitative and quantitative information was collected from each of the 15 centers (cases). In order to handle the large amount of information without losing familiarity with each case, qualitative comparative analysis was undertaken. Conditions (context and mechanisms) and outcomes, were identified and assessed for each of the 15 cases, and solution formulae were calculated using qualitative comparative analysis software. Results. The emerging programme theory highlighted the importance of the combination of each team’s self-efficacy, perceived preparation and women-centredness in generating a good team response to intimate partner violence. The use of the protocol and accumulated experience in primary health care were the most relevant contextual/intervention conditions to trigger a good response. However in order to achieve this, they must be combined with other conditions, such as an enabling team climate, having a champion social worker and having staff with training in intimate partner violence. Conclusions. Interventions to improve primary health care teams’ response to intimate partner violence should focus on strengthening team’s self-efficacy, perceived preparation and the implementation of a woman-centred approach. The use of the protocol combined with a large working experience in primary health care, and other factors such as training, a good team climate, and having a champion social worker on the team, also played a key role. Measures to sustain such interventions and promote these contextual factors should be encouraged.

The role of authenticity in tourism planning: empirical findings from southeast Spain

Tourism is the main economic activity in many towns in the province of Alicante in southeast Spain and has turned this area into a paradigmatic example of mass tourism on the Mediterranean coast. Since the 1960s, the province's coastal towns have opted for a development model centred on what is known as 'residential tourism' or 'second-home tourism', with few exceptions, such as Benidorm. We wish to put forward the argument that the main social agents in the tourism sector have not perceived the 'search for authenticity' as a factor that may attract tourists to this area. To this end, we will start by reviewing critically the theoretical discourse about the role played by authenticity in the motivation of tourists. Then we will discuss some of the results obtained from empirical, qualitative research that included 37 in-depth interviews. As a guide for our empirical research, we use a model based on the stakeholder theory. The epistemological difficulties faced by researchers do not justify certain critical arguments that try to highlight the impossibility of operationalising essential concepts and approaches such as that of authenticity. Therefore, it is necessary that empirical research continues to delve into the sociological keys that determine the 'search for authenticity' in the tourists' experience.