Hodges' Model: Welcome to the QUAD: August 2019

- learn about the conceptual framework Hodges' model. A tool that can help integrate HEALTH and SOCIAL CARE, INFORMATICS and EDUCATION. The model is situated, facilitates person-centredness, integrated - holistic care and reflective practice. A new site using Drupal is an ongoing aim - the creation of a reflective workbench. Email: h2cmng @ yahoo.co.uk Welcome

Friday, August 30, 2019

What is Population Health? c/o The King's Fund

individual - self - person - citizen
|
INTERPERSONAL : SCIENCES
humanistic ----------------------------------------------- mechanistic
SOCIOLOGY : POLITICAL
|
other - family - community - population

Mental Health & Well-being


Physical Health & Well-being




Local & National
Government, Services


Related posts W2tQ:
https://hodges-model.blogspot.com/search?q=%22population+health%22


Source:
@HICLancaster and @TheKingsFund


Wednesday, August 28, 2019

Environment, Social, Governance [ESG]

As Greeta Thunberg arrives in New York for the:

CLIMATE ACTION SUMMIT, 23 SEPTEMBER 2019

... it is interesting to consider not just where 'health' sits within business and commerce, but the themes and issues that it has reached. Now, we are more aware of the dependencies, for example air quality, physical and mental health, but we are still to finish the chapter titled: "The Damage Done".

'Capitalism' remains rapacious in terms of resource use (ironically if the market and prices are cyclical) and we must acknowledge all of economics, from stock exchanges, to cities, to villages in developing countries, but the challenge remains to transform the geometry of our economics to that of a sustainable circle. As per the climate debate, in some instances, we might close certain industries and leave some classes of minerals, elements, fossil fuels in the ground. We should accept that while some economies are more circular than others, sometimes you cannot circle a square?

Below is an investment hierarchy in which I have highlighted health. Education, literacy and environmental awareness are, if not issues (which they are, especially their respective economics) they are much needed individual actions to achieve progress.

The media notes that next month's summit will include 'world leaders'. I wonder how many business leaders will be present? This would be an indicator of corporate social responsibility, looking very positive in the annual report (even if the self-regulation has not yet achieved homeostatis). If you can advise with figures, or if I find the information later next month I will post here.

MSCI ESG Key Issue Hierarchy

3 Pillars 


10 Themes


37 ESG Key Issues

Environment    Climate change
Carbon emissions  Product carbon footprint 
Financing environmental impact
Climate change vulnerability
Natural resources 
Water stress  Biodiversity & land use 
Raw material sourcing
Pollution & waste 
Toxic emissions & waste   Electronic waste Packaging 
Material & Waste
Environmental opportunities
Clean tech 
Green building   Renewable energy
Social    Human capital
Labor management   Health & safety
Human capital development Supply chain labor standards
Product liability 
Product safety & quality  Chemical safety
Financial product safety  Privacy & data security 
Responsible investment  Health & demographic risk
Stakeholder opposition
Controversial Sourcing
Social opportunities 
Access to communications  Access to Health care
Access to finance   Nutrition Health
Governance  Corporate governance*
Board* Pay* Ownership* Accounting*
Corporate behavior 
Business ethics Anti-competitive practices
Tax transparency Corruption & instability
Financial system instability
* Corporate Governance Theme carries weight in the ESG Rating model for all companies. In 2018, we introduce subscores for each of the four underlying issues: Board, Pay, Ownership, and Accounting. https://www.msci.com/documents/10199/123a2b2b-1395-4aa2-a121-ea14de6d708a






My source (MSCI ESG Key Issue Hierarchy p.27):
Norrington, J. (2019) Future Proof Investments, Investors Chronicle, 18-25 April. pp.24-28.

Monday, August 26, 2019

"IV Square" by Sandra Blow RA.


Sandra Blow RA. IV Square (2004)


Screenprint on paper. The Golder - Thompson Gift (2010) (c) The Estate of Sandra Blow

A second print from this issue of Printmaking Today, in which I can see the need for the 'Public Understanding of Science' amid great uncertainty.


My source:
Simmons, R. A Collection of Collections, Printmaking Today, Spring 2019, Volume 28. pp.36-37.


Sunday, August 25, 2019

Book: "Range: How Generalists Triumph in a Specialised World"

individual
|
INTERPERSONAL : SCIENCES
humanistic ----------------------------------------------- mechanistic
SOCIOLOGY : POLITICAL
|
other - group - population


In searching for a book cover image above I came across this one:

http://www.game-changer.net/tag/generalists/

This Venn diagram is interesting in itself, but please reflect upon it across the 'range' of Hodges' model? What stands out to me is how corporations and health care still grapple with this question.

It appears they struggle to find the 'magic' - let alone multiply it.


Book cover - Amazon UK

My source: Derbyshire, J., Don't be outfoxed in a wicked world, FT Weekend, Life&Arts, 3-4 Augist, 2019. p.9.


Saturday, August 24, 2019

Was that last post 'really' sponsored?*

It occurred to me that the last post would be ideal as a 'sponsored' effort. Many posts are incidentally, or voluntarily 'sponsored'. I wish a few were in fact. This commercial thought was prompted by an email three weeks ago that referred to mention of 'due diligence' in a post from 2009. The suggestion was that if I could add a link to an article by this real estate company, and let them know, then they could 'syndicate' this W2tQ. Reply sent, but nothing heard as yet.

In that last post I was careful to avoid referring to 'c*sme*ic', lest the floodgates open ;-) and this blog's potential 'long tail' be revealed.

In between the 'Barber's model' post: another email.

This, points to a post in March 2016 and (again) the possibility of collaboration. Their focus is Python and data libraries. Well this is really encouraging! I've replied, but I'm not sure if there will be a sponsored post, or something in the side bar. I've no time to fully understand 'SEO' and advertising. That is not the blog's objective. I am aware though that this blog is ancient and Google's algorithms have and continue to change.

Some income would help with conference registrations, accommodation and travel; and to revisit hosting which I cancelled recently (as unused). My main laptop (2017) is poorly too. They do get hammered a bit. Being conscious of 'false economy' in the politics of health, social care and the environment, perhaps I should return to the MacBook fold?

*It wasn't.

Friday, August 23, 2019

Barber's model of hairdressing - "Care in the Community"?

Through the 1980s and 90s when models of nursing and nursing theory were flavour of the month, I remember a conversation that being so numerous, there was no doubt a "Model of Hairdressing" too. This is not to denigrate hairdressing in anyway (not at all Sis!).  I've actually considered this as a demonstration of the scope of Hodges' model. This post even prompted me to check the previous 2379 to see if I've been here before on W2tQ, but it appears not. (I do have an article somewhere - a parody on 'models of care'.)

There is a developmental tale here though, that is itself interesting. The story runs from the late 90s early 2000s thinking about hair, its qualities, scalp problems, nits (and diplomacy), health and safety at work, the equipment, the pictures displayed - advertising, ingredients, person-centredness, position - comfort and mobility, safety with some preparations and processes, gender and cultural aspects, the history of barbers and of the other 'services': ("Something for the weekend sir?"). So clearly hairdressing like all employment can be complex and rewarding. In addition: there are hosts of medical conditions and psychological factors (for example, self neglect*, phobias, children's reactions) that can affect the hair; its care, management, loss and compensating for this (with specialist help) as needed.

The social event that a visit to the hairdressers / barbers invites, was apparent as a child recalling my mother's former visits and the local 'news' that followed afterwards. In the later 2000's the need for dementia friendly communities was a further development, which is now a global initiative. Business owners can see changes in their regular customers too. Many businesses seek to sustain this awareness and sensitivity in their approach and business. On my visits, the whole process is very relaxing. A further invitation as we shift from the sinks to the chair and mirror. There we are reflected in a before and after. The banter may also include the aspirations and educational options as students work through part-time work. As you may also have heard, over the past few years the actual and potential role of barber's in mental health has been more formally recognised:

https://www.thelionsbarbercollective.com/about-us/

https://www.independent.co.uk/life-style/hairdresser-suicide-prevention-mental-health-tom-chapman-safe-space-torquay-a7644021.html

Recognised also in the arts:

individual - SELF
|
INTERPERSONAL : SCIENCES
talk - HUMANISTIC - chat ----------------------------------------------- snip - MECHANISTIC - buzz..
SOCIOLOGY : POLITICAL
|
OTHERS - population

Mental health

Physical health

Public mental health policy


*What are the thresholds that pertain here - no doubt there are several - compounded?

Wednesday, August 21, 2019

"Bleak House" - not just a book: Family Homelessness

individual - home?
|
INTERPERSONAL : SCIENCES
humanistic - HOME? ----------------------------------------------- mechanistic - HOME?
SOCIOLOGY : POLITICAL
|
home? - population






"Bleak House"
- a work of fiction ...

Charles Dickens - Bleak House


"Bleak Houses"
- a work of Government ...

Bleak Houses - Report



See also:
The Stranger in the Mirror in Bleak House

Book cover - Waterstones

My source
Radio 4 and BBC 2 - Newsnight

Monday, August 19, 2019

Grief, mourning and commemoration in the North


individual - PLANET
|
INTERPERSONAL : SCIENCES
humanistic ----------------------------------------------- mechanistic
SOCIOLOGY : POLITICAL
|
PLANET - population

grief

mourning


August 2019
415ppm CO2

Cultural

change
and
loss

Collective
grief
 &
mourning

"Ok is the first Icelandic glacier to lose its status as glacier. In the next 200 years, all our glaciers are expected to follow the same path. This monument is to acknowledge that we know what is happening and know what needs to be done. Only you know if we did it."

Friday, August 16, 2019

"Finishing It" - Poems No Pills or poems On pills?


individual - self
|
INTERPERSONAL : SCIENCES
humanistic ----------------------------------------------- mechanistic
SOCIOLOGY : POLITICAL
|
group- population

First work as Poet Laureate



Poet


Laureate



Simon Armitage


My sources:
Laureate's poem on a pill aims to tackle cancer, News, The Times, 14 August, 2019, p.14.

Singh, A., A pill with cancer's name on it is Poet Laureate's first work, The Daily Telegraph, 14 August, 2019, p.9.

Image source:
Sutton and Croydon Guardian
https://www.yourlocalguardian.co.uk/news/17835799.poem-paying-tribute-sutton-cancer-research-micro-engraved-onto-tiny-pill/

Wednesday, August 14, 2019

2 + 2 = ?

individual - self
|
INTERPERSONAL : SCIENCES
humanistic ----------------------------------------------- mechanistic
SOCIOLOGY : POLITICAL
|
group- population








2 + 2 = 5


a notice put up in Moscow during the first Five Year Plan, indicating
the possibility of getting the job done in four years, if workers put
their backs into it


Burgess, A. "1985", 1978


2 + 2 = 5 - stands out in three other senses:

Firstly, it stands politically for the healthcare enterprise as a whole, that is, the NHS, private sector, organisations of various kinds, volunteers, carers; plus theory, practices, management and being political let's add policies. This is due to the ongoing nature and level of political healthcare dialogue and debate. The Left, the Right, funding, history, public engagement, the electoral cycle and associated political party advertising.

The arithmetic above is a dialogue. A dialogue that lurches from politician's promises, to their knowledge that health care staff will still deliver. The health care workforce knows the logic very well: it is summed up in what is termed workforce planning.

Second, what I have previously referred to as 'legacy issue', those health care, health systems problems that have been ongoing problems across several decades as experienced (wrestled with) by successive professionals and today's new students and trainees. These are 'problems' by virtue of being:
  • poorly defined (often by their cussedness, not for want of efforts)
    • What is the history, the root of 'care' and 'caring'?
  • the siloed nature of knowledge;
    • by subjects, i.e., sciences, history, economics, sociology
    • dichotomised knowledge and concepts, i.e., mind-body, subjective-objective, quality-quantity ...
  • being universal;
    •  spanning the individual and group
    •  being national and global
    •  being global in Planetary terms
  • the need for multiple disciplines with the standpoints and interests that arise;
  • the dynamics of time: history, present, future;
  • The meaning of 'progress' - scientifically, technically, socially and politically;
  • Identity and personhood in the health context
    • Well-being
    • Ill-being
  • Integration of the above.

Thirdly, Hodges' model has four explicit care - knowledge - domains. In healthcare we must always have due regard for the spiritual dimensions of our patients, carers, community and the communities of practice that we work within. So, in Hodges' model, or more accurately encompassing the whole model and extending beyond it we must contemplate and be cognizant that 2+2 does indeed equal '5'.


Source: Burgess, A. "1985", London Hutchinson (1978).
Spotted in Sam Read's bookshop Grasmere.

Tuesday, August 13, 2019

Individual & Group process - Collective Intelligence [CI] c/o Radcliffe, et al. (2019)

No explanation is needed as to why this paper caught my attention in a tweet that featured the figure [2] below? The context is medical, not nursing and the extended multidisciplinary team, but as per the threshold concepts post the focus is decision making.

From a nursing perspective and using Hodges' model the 'individual processes' would include data gathering, patient assessment, liaison with relatives and colleagues and reflection to integrate information. Evidence-based sources will also be involved depending on the reason for referral, the patients (relatives) account, and the status of the diagnosis. Information technology input will be through the electronic health record that should also provide a history of previous episodes of care and the conclusions reached.

Within Hodges' model below I have added socio-technical and governance. Perhaps, as a systematic scoping review and applied to a specific healthcare profession there is less emphasis on the 'political' dimensions of decision making (management, policy, rules, reporting, targets). Equally from a nursing perspective there is the 'data cleaning' within the research process but then also nurses, and students in particular not being negatively impacted by comments about a forthcoming clinical placement, or a patient / client who has been referred (or referred) to the service / team.




individual - self
|
INTERPERSONAL : SCIENCES
humanistic ----------------------------------------------- mechanistic
SOCIOLOGY : POLITICAL
|
group- population

individual as subject of mental health Dx

Individual knowledge and experience
Reflection
Learning and decision-making styles and bias
(positive and negative?)
Feedback from Collective Intelligence?


individual as subject of physical Dx


Analysis
Individual Input
Group Input
Synthesis

Information Technology

Collaborative working
Clinical Teams

Level of SOCIO-technical
integration
outcomes
Studies were:
 individual or group process
several a combination.

governance


My source:

Radcliffe, K., Lyson, H. C., Barr-Walker, J., & Sarkar, U. (2019). Collective intelligence in medical decision-making: A systematic scoping review. BMC Medical Informatics and Decision Making, 19(1), 158. https://doi.org/10.1186/s12911-019-0882-0

Saturday, August 10, 2019

Threshold Concepts: Reflection on chaos, complexity and AI

Here are the reflections on the photograph posted in June following the Conference on Threshold Concepts:



Chaos can occur in any one ... or all of the four domains of Hodges' model. The same applies to order.

http://homepages.math.uic.edu/~kjerland/Lorenz/lorenz_attractor.html


This is a characteristic of chaos and chaotic systems.

Chaos can arise at any time: in the here and now, being sown now for the future (climate change?), or springing from the past, as in pleasurable, or traumatic memories.

While the Lorenz attractor and other graphical examples are grounded in mathematics and science, in #h2cm we need to imagine the butterfly diagram extended across and simultaneously at work across the models four domains.



individual - self
|
INTERPERSONAL : SCIENCES
humanistic ----------------------------------------------- mechanistic
SOCIOLOGY : POLITICAL
|
group- population












Even in instances of riot and anarchy there will be pockets of 'order', but would you would want to take your chance of finding one? Amid talk of being in the wrong place, at wrong time; to what extent is this dependent upon who we associate with socially? Or, what we believe is the political course we might, should, will, must follow?

The context of Prof. Land's slide is learning and decision making. As a 'political' matter when chaos occurs, how is it manifested in disintegration? Can we hear the 'gears grind'? What exactly goes awry? Is it the processes as in the timing, leadership and with it responsibility?

The slide is powerful in giving support, to clinical decision-making as a context in which complex decision making is very common and simultaneously encompasses political, rationale and judgemental (ethical) forms of decision making.

Hodges' model can also facilitate recognition of differentiation between relational chaos and the explicit state of decision-making. For example, a healthcare practitioner and client/patient/carer may have achieved empathy and rapport, but the complex demands of the clinical decision still presents a great deal of uncertainty. Alternately in instances when the relationship is being forged then the communications: verbal and non-verbal (and a function of the clinical team) can be a confounding factor if not negotiated professionally (and in socially acceptable terms by members of the public). Another useful perspective is Personal and Public Involvement (PPI) at what point is this achieved? What are the thresholds in the public's learning, as they engage and are engaged if they are not to label the initiative as a checkbox exercise? Again Hodges' model can help us to reflect upon the scope and complexity of such situations.


AI, artificial intelligence was mentioned (I'm sure?) in the presentation and the benefits of AI in healthcare are already being realised. This is tempered with the requirement for AI systems to be able to explain their 'reasoning', rather than this be taken at face value. As AI takes on tasks that include initial automated screening of job applications that include videos then another dimension of learning is presented to students.

Health and justice is by default complex. Consider, the task of being seen by society that justice is duly served and doing so with a duty of care and welfare of the prisoners. To this, we can add the aspiration of custody being rehabilitative. For a prisoner, even on remand, there will be times when health needs and patiency must be recognised. When a long-term prisoner becomes chronically ill, this can present a major challenge to law-makers, prisoners, their families, the healthcare team and society.

individual - self
|
INTERPERSONAL : SCIENCES
humanistic ----------------------------------------------- mechanistic
SOCIOLOGY : POLITICAL
|
group- population

Identity (use of name, touch ...)
(My) PURPOSE
Beliefs, Personal values
 Safety (personal) Thresholds
Trigger warning
Critical - critique 
not taking it personally


PROCESS
[Space] - physical &
degrees of freedom in decision making
constraints
Rationale*
Evidence
Theory
Quantitative Research


Qualitative Research


Patient : Healthcare practitioner
decision making
 PRACTICE
Critical - agreeing to disagree

Schism - 'distance'

Consensus (bridge building)
 Autonomy (in decision making)
Administration / Bureaucracy
Professionalism
Anti- 'X' movements
Riot and anarchy
safety (POLICY)
Critical - political




*While placed within the sciences domain, 'rationale' can be evidenced physically, psychologically,  politically and socially.  It is this that forces us to acknowledge the several edges of chaos.

See also:
Inaugural Scottish Threshold Concepts Conference: TCs in Action [i]


Images:
http://homepages.math.uic.edu/~kjerland/Lorenz/lorenz_attractor.html

https://www.thingiverse.com/thing:3774260/comments
(Original image)

Friday, August 09, 2019

Targeting poverty (in Hodges' model) c/o The Economist

"Indian politicians are promising more cash for the poor. They should be less selective. "

[ by the quarter - make progress ...? ]


individual - self
|
INTERPERSONAL : SCIENCES
humanistic ----------------------------------------------- mechanistic
SOCIOLOGY : POLITICAL
|
group- population

"Targeting welfare is costly and difficult in a country like India.


If it looks for signs such as straw roofs, it will almost certainly miss many poor people, especially in the cities.


How is the state supposed to identify the poorest 50m households in a country where income and spending are so hard to track?


The political economy of targeted schemes is also tricky. In countries with minimal welfare states, schemes with few beneficiaries also have few supporters, and therefore risk being quietly wound down or diminished by inflation. And any formula used to target the bottom 20% is likely to be so opaque that people will never know whether they should have been included or not, so cannot fight for their entitlements."



"Two years ago a government report suggested a bold new approach. Instead of a universal basic income - an idea doing the rounds in rich countries - create a nearly universal scheme from which you exclude the richest quarter of the population."


Source: Leaders. Welfare in India: The beauty of breadth. The Economist, April 6, 2019, p.14.
Print edition.
https://www.economist.com/leaders/2019/04/06/a-better-anti-poverty-plan-for-india

Wednesday, August 07, 2019

One Hundred and Eleven [vertebrae]

individual - self
|
INTERPERSONAL : SCIENCES
humanistic ----------------------------------------------- mechanistic
SOCIOLOGY : POLITICAL
|
group- population


111 + Self-Care = Sustainable Health Care System ?

Monday, August 05, 2019

VOGUE: As they say - don't judge a ''book' just by its cover ...


... there is a resource to help you really reflect!


individual - self
|
INTERPERSONAL : SCIENCES
humanistic ----------------------------------------------- mechanistic
SOCIOLOGY : POLITICAL
|
group- population

"The 16th spot on the cover will appear
 in print as a silver reflective mirror, to
 show how you, the reader, are part of 
 this extraordinary moment in time –
 and to encourage you to use your own
 platform to bring change."


FORCE
CHANGE


Vogue, September cover

CHANGE
FORCE



*Whatever your chosen career at this 
point in time and throughout your 
lifelong aspirations and learning.
Best wishes!


Cover image source: Vogue.

Sunday, August 04, 2019

Pandemic Bonds: Beware perverse incentives and instruments?

individual - self
|
INTERPERSONAL : SCIENCES
humanistic ----------------------------------------------- mechanistic
SOCIOLOGY : POLITICAL
|
group- population



Geography
Number of Countries
Number of fatalities
Instruments: Legal, Science, Social, Policy, Financial ... ?


"On Wednesday [24 July], the World bank said it  would give $300m in grants and loans to DRC to step up its aid response.

But funding connected to the World Bank's pandemic bonds, issued in 2017 have been less forthcoming. One relatively small slice - the so-called "cash" element - has delivered $31.4m to help with the crisis."

Ebola's latest resurgence in central Africa has led to more than 1,700 fatalities. But for the insurance element of the bonds to pay out, the disease must cross an international border and there must be at least 20 fatalities in the second country.

The total possible insurance payout for Ebola is $150m and comes in three tranches: when 250, 750 and 2,500 people have died across at least two countries, $45m, $45m and $60m, respectively, will be disbursed."


Pandemic Bonds

World Bank:
Pandemic Emergency Financing Facility

DRC - Rwanda border


My source: Asgari, N. (2019) World Bank pandemic bonds spark Ebola anger, FT Weekend, 27-28 July, p.17.

Photograph - adapted from original by The Independent.

Saturday, August 03, 2019

Seeking Care & Global Cultural Neutrality in White Houses(?)


The email concerned a book
- | White Houses | -
 and posed a question.

Needless to say it caught my attention ...

Is White a Statement or a Neutral Surface for Expression?


This is a question I ask myself, but in respect of Hodges' model.

To what extent is Hodges' model neutral across cultures?

Remove the green, blue and red colours I adopted for the care domains  and what you have is a blank sheet; an empty conceptual space.

Is it empty? 

Very quickly it can become filled with what the person, patient, client, group ... brings with them.

Hodges' model is a stage. Several stages.

It is a theater.

It is a challenge for the performer, as they take their turn. As they navigate the space, they seek to ensure, assure, obtain feedback that the other - listener(s) are with them; whether in agreement or not.
Hodges' model is an arena for personal, group reflection, debate, argument(ation) or as described these days - co-production.


How suitable is #h2cm as a tool to support global health objectives, such as, the Social Development Goals and the Social Determinants of Health (and their ongoing development)? For me, Hodges' model is not just a neutral surface, it is a neutral substrate for the many forms of knowledge needed to solve the problems of the 21st Century.

individual - self
|
INTERPERSONAL : SCIENCES
humanistic ----------------------------------------------- mechanistic
SOCIOLOGY : POLITICAL
|
group- population


My source: Thames & Hudson

Later in the summer - autumn I might post another photo in memory of my father and a holiday ...

Friday, August 02, 2019

Int. Handbook of Health Literacy - Ed. Okon, et al. c/o HIFA


International Handbook of Health Literacy

Dear HIFA colleagues*,

I was interested to see the publication of this new book International Handbook of Health Literacy, edited by Orkan Okan and colleagues.

Kudos to the editors and authors, who have made the content freely available here:

http://www.oapen.org/viewer/web/viewer.html?file=http://www.oapen.org/document/1005225

The early pages note: 'Besides the ongoing and tremendous public health efforts addressing health literacy in Europe, North America and the Australasian region, there is only little to no work still in Africa, very little in the Middle East, India and South America, and also very little in Russia and the Slavic countries in Europe.' Nevertheless, 'health literacy has been placed high on the agenda in the WHO Southeast Asia Region via the introduction of a health literacy toolkit for low- and middle-income countries to help communities to develop their own solutions'.

There is a chapter on 'A stated preference discrete choice health literacy intervention framework for the control of non-communicable diseases (NCDs) in Africa' by Kenneth Yongabi Anchang and Theckla Kwangsa Mbunwe.Selected extracts below:

--
The function of health literacy in ensuring a healthy condition in individuals and communities is especially relevant in Africa, which is plagued with high endemic diseases, and in settings in which healthcare resources and infrastructure are, for the most part, limited (O’Sullivan et al, 2003; Remais et al, 2012).

Current health promotion interventions in current use in Cameroon and Africa at large are inadequate as they are too exo-centric in style, language and construction – a health literacy intervention culled from a very exo-centric set-up and tailored for the European context, for instance, may not be transferable to Africa.

Health promotion exercises in Africa are currently too linear in application. Linearity here means providing a solution to a certain problem without taking into account the contextual barriers of its wider implementation, which may be entirely different from what the researcher or facilitator wants to provide, as well as its perceived urgency and necessity.

Individuals in Africa for the most part grow up either with no health knowledge, little health notion or wrong health information that has been passed on from their parents. Some health information is misconstrued and parcelled into local beliefs systems and superstitions, thus making it difficult to dispel over time and space.

In a community whose priority is potable water, a health literacy intervention on curbing diabetes and cancer may not be quickly be accepted and sustain. This urgent need may mask the need for a literacy programme that addresses hypertension or cancer. To this effect, a joint intervention approach of providing potable water and then educating people on hypertension and cancer is the way to go.

Interventions for health literacy and promotion must always be built first on the ‘available local health knowledge’ that might, for the most part, differ from what researchers and health literacy providers would consider as evidence or knowledge.

Best wishes, Neil
HIFA
<>

Some reflections:

This is a very welcome text and step for health literacy. Even in a tome of 766 pages (I have not read it all) it is difficult to address all themes of significance within the field; and in turn please everyone. That is the case here.

It's not that I've got an axe to grind: I've two axes - in #h2cm.

How far is it between lifespan and life course on one-hand; and health career and life chances on the other? Especially when these are examined critically in the context of the sustainable development goals and the social determinants of health.

Chapter 42
Salutogenesis and health literacy: The health promotion simplex!
Luis Saboga-Nunes, Uwe H. Bittlingmayer and Orkan Okan
When examining the scientific discourse around health literacy, we are surprised to see that while scholars have been extensively discussing the ‘literacy’ component of the composed term ‘health literacy’, discussion of the ‘health’ element is hardly to be found. ... Today, broad literacy concepts addressing functional, interactive and critical literacy are added to the health literacy discourse, giving way to multiliteracies and social literacies to merge with health literacy (see Chapters 14, 18, 36 and 39, this volume). This was not only the impetus for multiple research strains that broadened the theoretical and conceptual discussion, but also facilitated the uptake of health literacy by various research disciplines, such as healthcare, medicine, public health, education, psychology or sociology (p.649).
The need to rethink, and maybe also construct, the health component of the health literacy concept and its social representation needs to consider that health can be understood and approached in different ways (p.650).
As a volume of recent developments in health literacy, that includes an Integrative Model of eHealth Use (p.277, 278) there is (imho) a need for a generic conceptual framework upon which to base the local, global and glocal theory, practice, management and policy of health literacy.  Not only that but how health literacy relates to other forms of literacy. If not you are more likely - conceptually bound - to loose your footing socio-technically. As Saboga-Nunes et al. note, a normative framework is needed (p.651). Negotiating forms of literacy invariably entails questions about design and in chapter 39 avatars extends this to ethics. Hodges' model can readily encompass and incorporate simplicity, continua, complexity: health and literacy.

There is much more here in this great resource, to which I will return e.g. Chapter 43, Figure 43.2 Research traditions.

*My source

Thursday, August 01, 2019

The 'transdisciplinary' (and other forms - in Hodges' model?)

A transdisciplinary model of practice

"This model is different from the multidisciplinary and the interdisciplinary models, where occupational power, status and professional recognition are key issues.
‘Representatives of different disciplines are encouraged to transcend their separate conceptual, theoretical and methodological orientations in order to develop a shared approach to ... building a common conceptual framework’ (p.1351). Rosenfield.
The shared philosophical perspective that is created by all disciplines and public representatives enables practitioners to provide integrated services. All team members, including consumers, parents and community members, are involved in discussion, consensus building, decision making and implementation of the plan or the programme. Team members work together to explore different theories, conceptual frameworks, concepts or approaches that might be in the best interest of the patient, family and the community. This sharing of knowledge enables team members to learn from one another. Boundaries between disciplines are loosened, and overlap between services is recognized and incorporated into the plan, so that patients and families benefit from using similar but different resources in increasingly more practical and more meaningful ways." (p.1351).

Rosenfield, P.L. (1992) The potential of transdisciplinary research for sustaining and extending linkages between the health and social sciences. Soc Sci Med. Dec;35(11): 1343-57.

cited in:
Anderson, G.W., Monsen, R.B., Rorty, M. V. (2000) Nursing and Genetics: a feminist critique moves us towards transdisciplinary teams, Nursing Ethics, vol. 7, 3: pp. 191-204.
https://journals.sagepub.com/doi/10.1177/096973300000700302