The snakes and ladders of user involvement:moving beyond Arnstein

For 35 years, Arnstein's ladder of citizen participation has been a touchstone for policy makers and practitioners promoting user involvement. This article critically assesses Arnstein's writing in relation to user involvement in health drawing on evidence from the United Kingdom, the Netherlands, Finland, Sweden and Canada. Arnstein's model, however, by solely emphasizing power, limits effective responses to the challenge of involving users in services and undermines the potential of the user involvement process. Such an emphasis on power assumes that it has a common basis for users, providers and policymakers and ignores the existence of different relevant forms of knowledge and expertise. It also fails to recognise that for some users, participation itself may be a goal. We propose a new model to replace the static image of a ladder and argue that for user involvement to improve health services it must acknowledge the value of the process and the diversity of knowledge and experience of both health professionals and lay people.

Divided care and the Third Way:user involvement in statutory and voluntary sector cancer services

In health care, as in much of the public sphere, the voluntary sector is playing an increasingly large role in the funding, provision and delivery of services and nowhere is this more apparent than in cancer care. Simultaneously the growth of privatisation, marketisation and consumerism has engendered a rise in the promotion of 'user involvement' in health care. These changes in the organisation and delivery of health care, in part inspired by the 'Third Way' and the promotion of public and citizen participation, are particularly apparent in the British National Health Service. This paper presents initial findings from a three-year study of user involvement in cancer services. Using both case study and survey data, we explore the variation in the definition, aims, usefulness and mechanisms for involving users in the evaluation and development of cancer services across three Health Authorities in South West England. The findings have important implications for understanding shifts in power, autonomy and responsibility between patients, carers, clinicians and health service managers. The absence of any common definition of user involvement or its purpose underlines the limited trust between the different actors in the system and highlights the potentially negative impact of a Third Way health service.

Community involvement in urban nature conservation : case studies of the Urban Wildlife Group 1980-85

The effectiveness of the strategies employed by the Urban Wildlife Group (a voluntary conservation organisation) to provide and manage three urban nature parks has been evaluated, using a multiple methods methodology. Where the level of community interest and commitment to a project is high, the utilisation of the community nature park strategy (to maximise benefits to UWG and the community) is warranted. Where the level of interest and commitment of the local community is low, a strategy designed to encourage limited involvement of the community is most effective and efficient. The campaign strategy, whereby the community and UWG take direct action to oppose a threat of undesirable development on a nature park, is assessed to be a sub-strategy, rather than a strategy in its own right. Questionnaire surveys and observations studies have revealed that urban people appreciate and indeed demand access to nature parks in urban areas, which have similar amenity value to that provided by countryside recreation sites. Urban nature parks are valued for their natural character, natural features (trees, wild flowers) peace and quiet, wildlife and openness. People use these sites for a mixture of informal and mainly passive activities, such as walking and dog walking. They appear to be of particular value to children for physical and imaginative play. The exact input of time and resources that UWG has committed to the projects has depended on the level of input of the local authority. The evidence indicates that the necessary technical expertise needed to produce and manage urban nature parks, using a user-oriented approach is not adequately provided by local authorities. The methods used in this research are presented as an `evaluation kit' that may be used by practitioners and researchers to evaluate the effectiveness of a wide range of different open spaces and the strategies employed to provide and manage them.

Media, ecology and conservation:using the media to protect the world's wildlife and ecosystems

The second book in The Converging World series, Media, Ecology and Conservation focuses on global connectivity and the role of new digital and traditional media in bringing people together to protect the world's endangered wildlife and conserve fragile and threatened habitats. New media offers opportunities for like-minded individuals, community groups, businesses and public organisations to learn and work cooperatively for the good of all species. One of the key themes of this book explores the important issue of how new information and communication technologies mediate the natural world, and our understanding of our place in it. By exploring the role of film, television, video, photography and the internet in animal conservation in the USA, India, Africa, Australia and the United Kingdom John Blewitt investigates the politics of media representation surrounding important controversies such as the trade in bushmeat, whaling and habitat destruction. The work and achievements of media/conservation activists are located within a cultural framework that simultaneously loves nature, reveres animals but too often ignores the uncomfortable realities of species extinction and animal cruelty.

Introduction: the media, animal conservation and environmental education

Natural History filmmaking has a long history but the generic boundaries between it and environmental and conservation filmmaking are blurred. Nature, environment and animal imagery has been a mainstay of television, campaigning organisations and conservation bodies from Greenpeace to the Sierra Club, with vibrant images being used effectively on posters, leaflets and postcards, and in coffee table books, media releases, short films and viral emails to educate and inform the general public. However, critics suggest that wildlife film and photography frequently convey a false image of the state of the world’s flora and fauna. The environmental educator David Orr once remarked that all education is environmental education, and it is possible to see all image-based communication in the same way. The Media, Animal Conservation and Environmental Education has contributions from filmmakers, photographers, researchers and academics from across the globe. It explores the various ways in which film, television and video are, and can be, used by conservationists and educators to encourage both a greater awareness of environmental and conservation issues, and practical action designed to help endangered species. This book is based on a special issue of the journal Environmental Education Research.

The media, animal conservation and environmental education

Natural History filmmaking has a long history but the generic boundaries between it and environmental and conservation filmmaking are blurred. Nature, environment and animal imagery has been a mainstay of television, campaigning organisations and conservation bodies from Greenpeace to the Sierra Club, with vibrant images being used effectively on posters, leaflets and postcards, and in coffee table books, media releases, short films and viral emails to educate and inform the general public. However, critics suggest that wildlife film and photography frequently convey a false image of the state of the world’s flora and fauna. The environmental educator David Orr once remarked that all education is environmental education, and it is possible to see all image-based communication in the same way. The Media, Animal Conservation and Environmental Education has contributions from filmmakers, photographers, researchers and academics from across the globe. It explores the various ways in which film, television and video are, and can be, used by conservationists and educators to encourage both a greater awareness of environmental and conservation issues, and practical action designed to help endangered species. This book is based on a special issue of the journal Environmental Education Research.

Critical practice and the public pedagogy of environmental and conservation media

Natural History filmmaking has a long history but the generic boundaries between it and environmental and conservation filmmaking are blurred. Nature, environment and animal imagery has been a mainstay of television, campaigning organisations and conservation bodies from Greenpeace to the Sierra Club, with vibrant images being used effectively on posters, leaflets and postcards, and in coffee table books, media releases, short films and viral emails to educate and inform the general public. However, critics suggest that wildlife film and photography frequently convey a false image of the state of the world’s flora and fauna. The environmental educator David Orr once remarked that all education is environmental education, and it is possible to see all image-based communication in the same way. The Media, Animal Conservation and Environmental Education has contributions from filmmakers, photographers, researchers and academics from across the globe. It explores the various ways in which film, television and video are, and can be, used by conservationists and educators to encourage both a greater awareness of environmental and conservation issues, and practical action designed to help endangered species. This book is based on a special issue of the journal Environmental Education Research.