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  • Author or Editor: Alison Williams x
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Action research on health inequalities

Improving health in populations in which health is poor is a complex process. This book argues that the traditional government approach of exhorting individuals to live healthier lifestyles is not enough - action to promote public health needs to take place not just through public agencies, but also by engaging community assets and resources in their broadest sense.

The book reports lessons from the experience of planning, establishing and delivering such action by the five-year Sustainable Health Action Research Programme (SHARP) in Wales. It critically examines the experience of SHARP in relation to current literature on policy; community health and health inequalities; and action research. The authors make clear how this regional development has produced opportunities for developing general concepts and theory about community-based policy developments that are relevant across national boundaries and show that complex and sustained community action, and effective local partnership, are fundamental components of the mix of factors required to address health inequalities successfully.

The book concludes by indicating the connections between SHARP and earlier traditions of community-based action, and by arguing that we need to be bolder in our approaches to community-based health improvement and more flexible in our understanding of the ways in which knowledge and inform developments in health policy.

The book will be of interest to practitioners and activists working in community-based projects; students in community development, health studies and medical sociology; professionals working in health promotion, community nursing and allied areas; and policy makers working at local, regional and national levels.

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This chapter sums up the key findings of this study on the role of action research in addressing health inequalities in Wales. It explains that much of the evidence on social determinants of health indicates that the most important determinants are nothing to do with the institutional domain of health at all. The chapter commends the accomplishments of the Sustainable Health Action Research Programme (SHARP), which has systematically sought to add to the understanding of both the character of health inequalities and of the possibilities for taking intelligent local action to address them.

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This article advances understanding of the unpaid care–paid work nexus for carers of a person with a disability or illness, or a frail older relative. It examines the relationship between care intensity (measured in terms of both care hours and care strain) and withdrawal from work (measured in terms of both withdrawal of time spent in paid work and withdrawal from career development and progression). The analysis reveals that care strain has a stronger relationship with all dimensions of work withdrawal than care hours. It also reveals that the relationship between care strain and work withdrawal is moderated by a family-supportive work environment. The article sheds new light on the potential role of workplace cultures in mitigating the impacts of work–care conflict.

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This chapter explores the tools and methods used to include children's voices in disaster risk management (DRM) that we found to be effective during the different stages of the CUIDAR project. Examples include creative and artistic methods such as drawing, participatory mapping, photovoice, active thinking and planning, storytelling, and video and performance art. In working with these tools, our aim was to inform and foster communication and informal learning, and give more value to the local and grounded knowledges of children and young people, their families and communities, suggesting practical ways of promoting intergenerational learning. Policy-makers and practitioners can use these tools, methods and examples for inspiration, and to promote more child-centred disaster management and civil protection in Europe and beyond.

Specific tools were found to be useful to involve children and young people in the different towns, cities and countries where we worked. These were adapted locally to foster participants’ interest and capacity through the iterations of our participatory project design: ‘to discover and ask questions’, ‘to investigate and take action’ and ‘to share ideas and advocate’, as detailed in Chapters 2 and 3. First, we describe some of these tools and resources used in the Dialogues with Children, illustrating their specificity and use. Then we address questions related to the ethics of using participatory approaches, and reflect on our experience when working with children and young people in this particular domain.

If the aim is to promote more inclusive DRM, what methods are best suited to allow children to influence the direction of a project or a discussion? Since the 1990s, interest in working with children and young people in participatory action projects has led to the development and use of what are often described as ‘childfriendly’ methods.

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