A theory-based model of translation practices in public health participatory research

This article explores the innovative practices of actors specifically mandated to support interactions between academic researchers and their partners from the community during public health participatory research. Drawing on the concept of translation as developed in actor-network theory and found in the literature on knowledge transfer and the sociology of intermediate actors, we build a theory-based model of the translation practices developed by these actors at the interface between community and university. We refine this model by using it to analyse material from two focus groups comprising participants purposively selected because they work at the nexus between research and practice. Our model of translation practices includes cognitive (dealing with the contents of the research), strategic (geared to facilitating the research process and balancing power relationships among the partners) and logistic practices (the hands-on tasks of coordination). Combined, these three types of translation practices demonstrate that actors working at the interface in participatory research contribute to multidirectional exchanges and the co-construction of knowledge among research partners. Beyond the case of participatory research, theorising translation practices helps understand how knowledge is produced at the interface between academic and experiential (or lay) knowledge.     

Lost in translation: a genealogy of the "social capital" concept in public health

STUDY OBJECTIVE: To examine the genealogy of the social capital concept in public health, with attention to the epistemological concerns and academic practices that shaped the way in which this concept was translated into public health. DESIGN: A citation-network path analysis of the public health literature on social capital was used to generate a genealogy of the social capital concept in public health. The analysis identifies the intellectual sources, influential texts, and developments in the conceptualisation of social capital in public health. PARTICIPANTS: The population of 227 texts (articles, books, reports) was selected in two phases. Phase 1 texts were articles in the PubMed database with "social capital" in their title published before 2003 (n = 65). Phase 2 texts are those texts cited more than once by phase 1 articles (n = 165). MAIN RESULTS: The analysis shows how the scholarship of Robert Putnam has been absorbed into public health research, how three seminal texts appearing in 1996 and 1997 helped shape the communitarian form that the social capital concept has assumed in public health, and how both were influenced by the epistemological context of social epidemiology at the time. CONCLUSIONS: Originally viewed in public health research as an ecological level, psychosocial mechanism that might mediate the income inequality-health pathway, the dominance of the communitarian approach to social capital has given disproportionate attention to normative and associational properties of places. Network approaches to social capital were lost in this translation. Recovering them is key to a full translation and conceptualisation of social capital in public health.     

The measurement of bridging social capital in population health research

Social capital is defined as the resources available to individuals and groups through membership in social networks. The definition is consistent with either an individualistic approach or a collective approach. Social capital can be further classified according to bonding versus bridging social capital (e.g. relationships between individuals who are homogeneous or heterogeneous with respect to social class, race/ethnicity, or other attributes). We conducted a systematic review via Pubmed, the ISI web of knowledge and OVID of the studies that examined bridging social capital in public health settings. Our results indicate lack of consistency or uniformity in the operationalization of bridging social capital. We identify some promising approaches to measurement that should be further investigated in future studies.     

Integrating social epidemiology into public health research and practice for maternal depression

The impact of maternal depression on women and their families has been well documented. Given the prevalence and impact of this problem, one important strategy is to strengthen and expand our public health approaches. Although principles of social epidemiology are increasingly used in the field of maternal and child health, few public health efforts to address maternal mental health have incorporated ecosocial frameworks such as community connectedness, quality of social relationships, and social capital. One method to augment current public health approaches to maternal depression is through the incorporation of a perspective focusing on community, cohesion, group membership, and connectedness--a concept often described as social capital. We describe the relevance of this ecosocial perspective for mental health promotion programs for mothers.     

The utility of social capital in research on health determinants

Social capital has become a popular subject in the literature on determinants of health. The concept of social capital has been used in the sociological, political science, and economic development literatures, as well as in the health inequalities literature. Analysis of its use in the health inequalities literature suggests that each theoretical tradition has conceptualized social capital differently. Health researchers have employed a wide range of social capital measures, borrowing from several theoretical traditions. Given the wide variation in these measures and an apparent lack of consistent theoretical or empirical justification for their use, conclusions about the likely role of "social capital" on population health may be overstated or even misleading. Elements of a research agenda are proposed to further elucidate the potential role of factors currently subsumed under the rubric of "social capital."     

Health promotion, social epidemiology, and social capital: associations and perspectives for public health

The idea of health promotion predates the use of the actual term. However, the incorporation of this idea and the practice of health promotion were influenced by the Canadian health reform movement, which echoed the voices of many others who were concerned with the influence of the physical and social environment on health. This provided the basis for the World Health Organization to launch a series of conferences beginning with the Alma Ata Conference in 1977 and followed by the Ottawa Conference, from which resulted the first international document on health promotion, known as the Ottawa Charter. Although health promotion has been the subject of a wide range of studies, the concept is still not well understood and its explicit practice is limited. Health conferences have been important for keeping the notion of equity in health alive, while the gap between the rhetoric of these conferences and practice remains to be bridged. However, the rise of social epidemiology and the development of the concept of social capital for health could bring new insights into traditional epidemiology in order to narrow this gap. The purpose of this paper is to elucidate these concepts and to describe the roles they play in public health in order to stimulate further debate.     

Generating social capital through public health leadership training: a six-year assessment

Social capital, or a sense of partnership leading to shared goals, provides a means for addressing today's public health workforce challenges. This concept is particularly important in underserved rural areas, though efforts to intentionally generate social capital have been limited. Within the rural state of Kansas, the Kansas Public Health Leadership Institute (KPHLI) has implemented a social capital pre/post assessment to quantify the impact of KPHLI training on social capital within the state's decentralized public health system. This paper discusses 38 assessment items related to bonding, bridging and linking social capital. The assessment was completed pre and post training by 130 of 148 scholars (87.8%) in six KPHLI training cycles. Data were analyzed using Wilcoxon paired t-tests in SPSS. Thirty-five of 38 items demonstrated statistically significant increases at post-test, across all 10 sub-domains. Leadership training by the KPHLI fosters quantifiable increases in characteristics of social capital, which are essential for public health systems to cope with increased workforce demands and prepare for accreditation. This study represents a key first step in examining the deliberate generation of social capital within a decentralized rural environment.     

鼓励社会资本投入医疗卫生的政策建议

本文讨论社会资本投入医疗卫生事业问题时，我们把社会资本定义为活动于医疗卫生行业以外的所有其他行业的资本，包括国有资本、私有资本和混合资本。政府财力资源不属于生产要素，政府财力投入卫生系统没有增值目的；社会资本投入医疗卫生事业有增值目的。因此需要采取不同形式回报。[第一段]     

The spirit of the intervention: reflections on social effectiveness in public health intervention research

This paper suggests that public health intervention research would benefit from more thorough considerations of the social dynamics in which public health interventions are embedded. Rather than simply asking ‘What works?’, researchers should examine the social effectiveness of intervention programmes; i.e. (i) the creation of shared understandings among researchers and practitioners and (ii) the ways in which programmes reconfigure social relationships. Drawing on the theoretical work of philosopher Charles Taylor and sociologist Marcel Mauss, we suggest that the term ‘the spirit of the intervention’ may enable researchers to further articulate – and hence discuss – the source of an intervention’s social effectiveness. The empirical impetus of the paper lies in our experiences as an interdisciplinary team of researchers, trained in social science and public health and now working within intervention research. We describe our attempts at reconciling the methodological requirements of an effect evaluation, modelled on the randomised clinical trial, with a process of intervention development grounded in ethnographic methods. In particular, we discuss how we have grappled with the schism between fidelity and adaptation, which is a key methodological issue in intervention research. While public health intervention research tends to conceptualise programmes as fixed and bounded entities, we argue that ‘the spirit of the intervention’ offers a conceptual starting point for reflections on programmes as on-going social processes. In order to capture and explore this dimension of public health interventions, a great deal of potential lies in a further engagement between intervention research, ethnographic methods and social theory.     

An introduction of the concept of social capital into health promotion activities

Social factors, such as networks, institutions, trust, and social norms, are currently known as "Social Capital", the concept of which seeks to provide a basis for visualization and measurement of phenomena stemming from such factors. As a considerable amount of research has demonstrated that collective actions may be established with a greater degree of ease in communities with well-accumulated social factors, we can promote collective actions of Health Promotion activities through the concept of Social Capital and thereby establish more effective intervention. It is to be expected that theoretical research and operational experience using Social Capital may contribute to enhancing the effectiveness of Health Promotion activities, improving various health determinants through collective action.     

Social inequality and health: the role of social capital

The aim of the article is to examine whether and to what degree the unequal distribution of social capital in the population explains the relationship between socioeconomic position and health in Norway. Theoretical insight and empirical evidence seem to suggest that social capital mediates the effect of socioeconomic position on health outcomes. However, only a few studies have addressed this question and those that have done so have used few and simple indicators of social capital. This study is based on a nationwide cross-sectional survey (N = 3190) commissioned by Statistics Norway. The survey was designed to cover a comprehensive set of variables measuring different aspects of the theoretical construct of social capital. Two health outcomes, self-perceived health and longstanding illness, were analysed. The results showed that the mediating role of social capital between socioeconomic position and health was negligible for both health outcomes. After controlling for socio-demographic variables and socioeconomic position, only neighbourhood satisfaction and generalised trust showed a significant association with self-perceived health, whereas none of the social capital variables had any significant association with longstanding illness. Some theoretical and methodological implications of the results are discussed.     

Healthy research in cities: a case study on the translation of health research into action in The Netherlands

Health research plays a prominent role in Healthy City projectsin urban neighbourhoods. This article explores the problemsthat arise when research is used as a tool to promote healthaction. A special focus is on strategies to assess health needs.Additionally, a theoretical framework of ‘Cultures ofHealth’ is introduced. In a case study, a health promotionproject in an urban neighbourhood is examined in which researchplays a major role. The research, designed as action research,originates positive outcomes and demonstrates an adequate rolefor research on healthy cities.     

The impact of a health campaign on health social capital

Referring to literature in sociology, mass communication, and public health, we conceptualize and operationally define "health social capital" and "individual health social capital" and then posit and test a model for its development in response to a public health media campaign. The campaign evaluated here was designed to stimulate behaviors that would provide a more supportive social environment for children and youth, an environment which we consider to be richer in aggregate health social capital. The association model of advertising was employed to explain the development of individual health social capital measures of awareness, attitude, and behavior. With cross-sectional data (1998, n = 614; 1999, n = 1087; 2000, n = 1388), we examine the results for changes in awareness, attitude, and behavior over time and the significant links between these dependent variables and media campaign exposure. The results show significant increases in awareness and attitude, but not in behavior. Structural equation modeling revealed different patterns of influence for newspaper and TV campaign exposure.     

社会资本在健康领域的应用现状

在解释收入不平等对健康差异的影响作用时，流行病学家引入了社会资本的概念，尽管社会资本理论自身还存在很多争议，但其与健康关系的研究引起了众多学者的兴趣。本文从各种社会资本的概念，社会资本在健康领域研究中的应用，社会资本影响健康的可能机制，各种测量方法和存在的不足以及在中国目前的应用现状等方面进行了浅析。     

Neighbourhood life and social capital: the implications for health

Social capital has been linked to health outcomes, though there are some inconsistencies in the research and the link is dependent on the measures of social capital and health used. In this paper, we argue that social capital is multifaceted and its relationship with health is complex. We explore the relationship between a number of elements of neighbourhood life and neighbourhood-based social capital, and health, using both qualitative and quantitative methods. The paper reports on a study of the Western suburbs of Adelaide and the analysis of 2400 questionnaires and 40 in-depth interviews. A partial least-square path analysis was undertaken with the questionnaire data. It considered the impact of perceptions of the physical environment, neighbourhood connections, neighbourhood trust, reciprocity, perceived safety and local civic action, and a number of demographic variables, on physical and mental health as measured by the SF-12. Of the neighbourhood-related variables, only perceived neighbourhood safety was related to physical health, with neighbourhood safety and neighbourhood connections related to mental health. Of the demographic variables, higher-income level and educational achievement were related to better physical and mental health. In addition, physical health was lower and mental health higher within older age groups. The inter-relationships between the neighbourhood variables and demographic differences in experience of neighbourhood were also examined. The thematic analysis of the interviews linked a number of social aspects of neighbourhood, the physical neighbourhood environment, perceptions of safety, civic activities and availability of local services, to health outcomes. The paper concludes that there is a need for more complex measures of social capital and that socio-economic factors are of relatively greater importance in determining health.