The Masculine Habitus as 'Distributed Cognition': A Case Study of 5- to 6-Year-Old Boys in an English Inner-City, Multi-Ethnic Primary School

This article provides a case study demonstrating the active role that 5- to 6-year-old boys in an English inner-city, multi-ethnic primary school play in the appropriation and reproduction of their masculine identities. It is argued that the emphasis on physicality, violence and racism found among the boys cannot be understood without reference to the immediate contexts of the local community and the school within which they are located. In making this argument the article draws upon and applies the concept of the habitus and develops this with the notion of 'distributed cognition' as proposed in sociocultural theory. Some of the implications of this analysis for working with boys in early years settings are discussed in the conclusion.

Development of a Complex Intervention for Secondary Prevention of Coronary Heart Disease in Primary Care Using the UK Medical Research Council Framework

Objective: To apply the UK Medical Research Council (MRC) framework for development and evaluation of trials of complex interventions to a primary healthcare intervention to promote secondary prevention of coronary heart disease. Study Design: Case report of intervention development. Methods: First, literature relating to secondary prevention and lifestyle change was reviewed. Second, a preliminary intervention was modeled, based on literature findings and focus group interviews with patients (n = 23) and staff (n = 29) from 4 general practices. Participants’ experiences of and attitudes toward key intervention components were explored. Third, the preliminary intervention was pilot-tested in 4 general practices. After delivery of the pilot intervention, practitioners evaluated the training sessions, and qualitative data relating to experiences of the intervention were collected using semistructured interviews with staff (n = 10) and patient focus groups (n = 17). Results: Literature review identified 3 intervention components: a structured recall system, practitioner training, and patient information. Initial qualitative data identified variations in recall system design, training requirements (medication prescribing, facilitating behavior change), and information appropriate to the prospective study participants. Identifying detailed structures within intervention components clarified how the intervention could be tailored to individual practice, practitioner, and patient needs while preserving the theoretical functions of the components. Findings from the pilot phase informed further modeling of the intervention, reducing administrative time, increasing practical content of training, and omitting unhelpful patient information. Conclusion: Application of the MRC framework helped to determine the feasibility and development of a complex intervention for primary care research.