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165 The biographical turn in health studies ELEVEN The biographical turn in health studies Wendy Rickard This chapter offers an overview of existing biographical methods in health studies. The focus comes from my own efforts over the past few years to draw together a picture of some potentialities, possibilities and challenges of using biographical methods in health studies, both in research with marginalised groups and individuals, and in university teaching. I came to the topic initially from British oral history work in the two different – but both highly

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Paper No.2. Institute of Economic Affairs. Scrivens, E. and Henneh, A. (1989) 'Working for patients: making the internal market effective', Public Money and Management, Winter, pp. 53-57. Social Services Select Committee (1990) Community care: planning and co-operation, Eighth Report, 1989-90, London: HMSO. 142 Policy and Politics Voluntary Organisations Personal Social Services Group (1986) The future of the social services. Wagner, G. (1988) Residential care: a positive choice, National Institute of Social Work. Bob Hudson Institute of Health Studies University of

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Policy, October. Tillinghast (1989) Unisex pricing in long term insurance: report for the Equal Opportunities Commission, April. Titmuss, R. (1963) Essays on the Welfare State, London: Unwin University Books, • Trades Union Congress (1989) Equality of occupational pension schemes, London. Whitaker's Almanack (1991) London: J, Whitaker and Son Limited. Woods. R. (1990) 'Battle of sexes sparks chaos over pensions', Sunday Times, 27 May. Jane Keithley University of Durham Institute of Health Studies

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. and Wikler, J. (1991) 'Turkey-baster babies: the demedicalisation of artificial insemination', Mil/bank Quarterly, Vol. 69, No, 1, pp. 5-40. Lesley Doyal Professor of Health Studies Faculty of Health and Community Studies University of the West of England Bristol Doyal: Managing conception 93

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wellbeing. For instance, one online news headline stated confidently: ‘Spending 2 hours in nature each week can make you happier and health, study says’ ( Gravier 2019 ). The second problem was the categorical nature of the two-hour threshold and how this was reported in some parts of the media. The New York Times for instance had a bold header, ‘How Much Nature Is Enough? 120 Minutes a Week, Doctors Say’ ( Sheikh 2019 ). The article talked of an ideal amount of time, suggesting even that two hours might be a ceiling (‘enough’) rather than a tentative threshold level

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Steps to Impact for Health and Care Researchers
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EPDF and EPUB available Open Access under CC-BY-NC-ND licence.

Written by a leading expert in the field, this practical and accessible book is an essential guide to knowledge exchange, impact and research dissemination in health and social care.

Providing the why, what, who, how and when of research impact, the book helps researchers turn raw findings into useful, high-impact evidence for policymakers, practitioners and the public. It includes insightful interviews from leading journalists, science communicators, researchers and influencers in health and social care, as well as practical exercises, insider tips and case studies. The book will help researchers at all stages of their career to maximise the impact of their work.

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., Petticrew, M., Graham, H., Macintyre, S., Bambra, C. and Egan, M. (2004) ‘Evidence for public health policy on inequalities: assembling the evidence jigsaw’, Journal of Epidemiology and Community Health, 58: 817–21. WHO (World Health Organization) (2008) School policy framework: Implementation of the WHO global strategy on diet, physical activity and health, Geneva: WHO, http:// whqlibdoc.who.int/publications/2008/9789241596862_eng.pdf Erin P. Hobin (ephobin@uwaterloo.ca) and Barbara Riley Department of Health Studies and Gerontology, University of Waterloo, and

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It is not always obvious what is seen as valid evidence. Different stakeholders have different needs and value different kinds of information. This might include surveys, local health needs information, general media coverage as well as published research. Even for published research, it is not always easy to judge what is most reliable or relevant. This has become more of a problem with the exponential increase in scientific and other outputs, accelerated by trends towards Open Access publishing. Readers need help to filter and prioritise the evidence which is of most value to them. At our evidence centre, we did this with a community of people working and using health services who told us what research mattered to them. Researchers need to involve their target audience at all stages of their projects to ensure their research stays relevant to their readership. Early engagement will help to stay focused on the problems and outcomes that matter to that audience and to understand the ways in which they might make sense of the findings. This will help to translate formal academic knowledge into evidence which will support and inform everyday practice. There are insights on making your research inclusive and reaching diverse audiences.

It seems obvious what we are talking about when we are talking about evidence. It is published research, right? Not always. Evidence means different things to different people. And asking for the ‘best evidence’ or ‘most relevant evidence’ may end up with very different kinds of information, depending on who it is for and the nature of the question. Let’s take just one example – social prescribing (Box 3.1).

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This chapter starts with a brief overview of where we are in the history of understanding how health and social care research moves into practice (or not) and why it matters, including the time taken for research to have traction. I consider the mismatch between research which is produced and information which decision-makers want. Increasing volumes of information of all kinds now make it harder for research to be seen. There is a short account of scholarly debates on the way in which research influences practice and how our thinking has changed, from researchers broadcasting findings to more nuanced understanding of the complex interactions between researcher and user working in dynamic systems. This matters because it informs the practical steps and tactics needed to get your research noticed and understood. The chapter ends with five general steps for better engagement, which are tailored for different audiences in later chapters. There are also pointers to broader bodies of work on impact and implementation, which overlap but extend further than the scope of this book.

I was at a meeting discussing recent research we had summarised for ambulance staff and services on emergency care. The showpiece was a large randomised trial, one of the largest of its kind in an out-of-hospital setting, comparing mechanical devices with manual compressions in treating cardiac arrests (Gates et al 2017). The high-quality trial showed no real difference in survival rates between the two. Given the high costs of the automated devices, it suggested potential cost savings for the service. But discussion at this event became heated.

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Florence Nightingale was prescient in noting the effort needed to promote and engage people in research. Evidence rarely speaks for itself or, in her words, is ‘self-executive’ (McDonald 2005). In her own work around the report to the Indian Sanitary Commission, she worked tirelessly and skilfully – ‘four heavy years’ – to create demand for the finished product. This included lobbying MPs and working with policymakers at all levels to improve health and hygiene of ordinary soldiers. The final report was a magisterial two-volume affair of over 2,000 pages, with data and statistics from a survey of all military stations in India.

Her genius was to add 23 pages of her own ‘observations’, essentially her commentary on the data, including free-text summaries and stories from the thousands of pages of survey returns. These were attractive, accessible and illustrated with woodcuts. Grouped under readable headings, from overcrowding to diet, they included her own acerbic analysis, pulling no punches – ‘There is no drainage, in any sense in which we understand the word. The reports speak of cesspits as if they were dressing-rooms’ (Cook 1913). These popular texts had mass circulation and were sent and promoted to public people of standing from John Stuart Mill to (even) Queen Victoria. Abridged versions of the whole report were distributed in advance to military and medical officers, with commendations and forewords from people of influence. She briefed journalists and sent early review copies to appear in periodicals, from The Economist to The Spectator. In effect, she created ‘pull’ for the report with recommendations for reform which was published in 1863.

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