Social Model Of Health Research Articles

Modern Aspects of Cataract Surgery from the Standpoint of the Medical and Social Health Model. Review

Modern Aspects of Cataract Surgery from the Standpoint of the Medical and Social Health Model. Review

Reassessing Cervical Cancer Prevention: Evaluating the NHS Cervical Cancer Screening Programme Through the Health Belief Model and Global Health Promotion Strategies

Cervical cancer remains a significant public health issue in the United Kingdom, with disparities in screening coverage and outcomes persisting despite robust national programs. This critical analysis evaluates the NHS Cervical Screening Programme (CSP) through the lens of the Health Belief Model (HBM) and global health promotion strategies, such as those outlined in the Ottawa Charter. The analysis explores how individual beliefs about susceptibility, severity, benefits, and barriers influence participation in cervical screening, while also critiquing the CSP's reliance on these factors to the potential exclusion of broader social determinants of health. Key findings reveal that while the HBM provides a valuable framework for understanding individual health behaviors, its emphasis on personal responsibility may overlook significant socioeconomic and cultural barriers, leading to inequities in screening uptake. Furthermore, the CSP's approach, though well-intentioned, may inadvertently undermine patient autonomy by promoting a top-down model of health promotion. The analysis is supported by data from the 2022-2023 Cervical Screening Standards Data Report and other contemporary sources, highlighting the need for more culturally sensitive and equitable strategies. Recommendations for policymakers include the enhancement of targeted interventions for high-risk groups, improved communication strategies, and the integration of a social model of health that considers the broader determinants of health. Future studies are encouraged to explore the sociocultural factors influencing screening behaviors and to evaluate the effectiveness of new screening technologies and integrated HPV vaccination programs. This analysis underscores the importance of rethinking cervical cancer prevention strategies to ensure they are inclusive, equitable, and aligned with the principles of health promotion.

A systematic review of literature examining the application of a social model of health and wellbeing.

Following years of sustained pressure on the UK health service, there is recognition amongst health professionals and stakeholders that current models of healthcare are likely to be inadequate going forward. Therefore, a fundamental review of existing social models of healthcare is needed to ascertain current thinking in this area, and whether there is a need to change perspective on current thinking. Through a systematic research review, this paper seeks to address how previous literature has conceptualized a social model of healthcare and, how implementation of the models has been evaluated. Analysis and data were extracted from 222 publications and explored the country of origin, methodological approach, and the health and social care contexts which they were set. The publications predominantly drawn from the USA, UK, Australia, Canada and Europe identified five themes namely: the lack of a clear and unified definition of a social model of health and wellbeing; the need to understand context; the need for cultural change; improved integration and collaboration towards a holistic and person-centred approach; measuring and evaluating the performance of a social model of health. The review identified a need for a clear definition of a social model of health and wellbeing. Furthermore, consideration is needed on how a model integrates with current models and whether it will act as a descriptive framework or, will be developed into an operational model. The review highlights the importance of engagement with users and partner organizations in the co-creation of a model of healthcare.

The process of nurses' role negotiation in general practice: A grounded theory study.

To explain the process by which nurses' roles are negotiated in general practice. Primary care nurses do important work within a social model of health to meet the needs of the populations they serve. Latterly, in the face of increased demand and workforce shortages, they are also taking on more medical responsibilities through task-shifting. Despite the increased complexity of their professional role, little is known about the processes by which it is negotiated. Constructivist grounded theory. Semi-structured interviews were conducted with 22 participants from 17 New Zealand general practices between December 2020 and January 2022. Due to COVID-19, 11 interviews were via Zoom™. Concurrent data generation and analysis, using the constant comparative method and common grounded theory methods, identified the participants' main concern and led to the construction of a substantive explanatory theory around a core category. The substantive explanatory theory of creating place proposes that the negotiation of nurse roles within New Zealand general practice is a three-stage process involving occupying space, positioning to do differently and leveraging opportunity. Nurses and others act and interact in these stages, in accordance with their conceptualizations of need-responsive nursing practice, towards the outcome defining place. Defining place conceptualizes an accommodation between the values beliefs and expectations of individuals and pre-existing organizational norms, in which individual and group-normative concepts of need-responsive nursing practice are themselves developed. The theory of creating place provides new insights into the process of nurses' role negotiation in general practice. Findings support strategies to enable nurses, employers and health system managers to better negotiate professional roles to meet the needs of the populations they serve, while making optimum use of nursing skills and competencies. Findings can inform nurses to better negotiate the complexities of the primary care environment, balancing systemic exigencies with the health needs of populations. What Problem Did the Study Address? In the face of health inequity, general practice nurses in New Zealand, as elsewhere, are key to meeting complex primary health needs. There is an evidence gap regarding the processes by which nurses' roles are negotiated within provider organizations. A deeper understanding of such processes may enable better use of nursing skills to address unmet health need. What Were the Main Findings? Nurses' roles in New Zealand general practice are determined through goal-driven negotiation in accordance with individual concepts of need-responsive nursing practice. Individuals progress from occupying workspaces defined by the care-philosophies of others to defining workplaces that incorporate their own professional beliefs, values and expectations. Negotiation is conditional upon access to role models, scheduled dialogue with mentors and decision-makers, and support for safe practice. Strong clinical and organizational governance and individuals' own positive personal self-efficacy are enablers of effective negotiation. Where and on Whom Will the Research Have Impact? The theory of Creating Space can inform organizational and individual efforts to advance the roles of general practice nurses to meet the health needs of their communities. General practice organizations can provide safe, supported environments for effective negotiation; primary care leaders can promote strong governance and develop individuals' sense of self-efficacy by involving them in key decisions. Nurses themselves can use the theory as a framework to support critical reflection on how to engage in active negotiation of their professional roles. The authors adhered to relevant EQUATOR guidelines using the COREQ reporting method. Researchers and participants currently working in general practice were involved in the development of this study. By the process of theoretical sampling and constant comparison, participants' comments helped to shape the study design. WHAT DOES THIS PAPER CONTRIBUTE TO THE WIDER GLOBAL CLINICAL COMMUNITY?: An understanding of the processes by which health professionals negotiate their roles is important to support them to meet the challenges of increased complexity across all health sectors globally.

Pragati: Sculpting a Social Model of Health in a Resource-Poor Context

This article focuses on Pragati—A Field Action Project of the Centre for Health and Mental Health, School of Social Work, Tata Institute of Social Sciences, Mumbai, India, and critically examines the project’s development. The project is uniquely positioned because it is one of the first community health models in India that social work professionals started. The article discusses the project’s work over the last three decades and argues for theory-based interventions focusing on rights-based and people-centred approaches. The article highlights the role of social work in health, the project’s strategies, successes, failures, lessons learned and the importance of an intervention-based people-centred model.

Family doctors’ perception of violence against women

Objective: This study aimed to evaluate the perception of family doctors about violence against women. Methods: This is a cross-sectional study, developed with 158 doctors from the Family Health Strategy of Teresina/Piauí, from March to April 2019, through a questionnaire adapted from the Social Perception Indicator System of the Institute of Applied Economic Research. Results: The findings indicate that male doctors, specialists, with over 25 years of training and more than 60 years of age, have a perception of violence against women based on the patriarchal model, as a problem of an intimate nature and of blaming of the woman. Conclusion: Medical training is necessary to conduct a care practice for women in situations of violence, giving them a reception guided by the social health model.

Climate change, society, and health inequities.

Climate change, society, and health inequities.

Determinants of routine cervical screening participation in underserved women: a qualitative systematic review

Objective Routine, population-wide cervical screening programmes reduce cervical cancer incidence and mortality. However, socioeconomically deprived communities and ethnic minority groups typically have lower uptake in comparison to the general population and thus are described as ‘underserved.’ A systematic qualitative literature review was conducted to identify relevant determinants of participation for these groups. Methods Online databases were searched for relevant literature from countries with well-established, call-recall screening programmes. Overall, 24 articles were eligible for inclusion. Data was synthesized via Framework synthesis. Dahlgren & Whitehead’s social model of health was used as a broad a priori coding framework. Results Participation was influenced by determinants at multiple levels. Overall, patient-provider relationships and peer support facilitated engagement. Cultural disparities, past healthcare experience and practical barriers hindered service access and exacerbated negative thoughts, feelings and attitudes towards participation. Complex interrelationships between determinants suggest barriers have a cumulative effect on screening participation. Conclusions These findings present a framework of psychosocial determinants of cervical screening uptake in underserved women and emphasise the role of policy makers and practitioners in reducing structural barriers to screening services. Additional work, exploring the experience of those living within socioeconomically disadvantaged areas, is needed to strengthen understanding in this area.

COVID-19 en residencias de mayores: factores estructurales y experiencias que avalan un cambio de modelo en España

The effects of COVID-19 pandemic on older people living in care homes have been devastating. In Spain approximately 3% of the cases and 40% of the deaths have occurred in this group. In addition, due to measures taken to control the crisis, the incidence of geriatric syndromes has increased, and residents’ fundamental rights have been violated. In this article we describe structural factors of care homes and their relationship with public health services that have influenced the impact of the pandemic. We suggest different types of group homes, and models of provision/coordination with public health services that have given excellent results protecting nursing homes residents from COVID-19, as alternative models to conventional residences and to the regular provision of health care services. We recommend that these successful experiences are taken into account in the transformation of the social-health model (to one integrated and focused on people) that has begun to be implemented in some Autonomous Communities of Spain.

Advancing Action on Health Equity Through a Sociolegal Model of Health.

In the field of public health, the law and legal systems remain a poorly understood and substantially underutilized tool to address unfair or unjust societal conditions underpinning health inequities. The aim of our article is to demonstrate the value of expanding from a social model of health to a sociolegal model of health and empowering health actors to use the law more strategically in the pursuit of health equity. We propose a modified version of the framework for the social determinants of health (SDoH) equity developed by the 2008 World Health Organization Commission on the Social Determinants of Health by conceptually integrating the functions of the law as identified by the 2019 Lancet-O'Neill Institute Commission on Global Health and Law. Access to justice provides a critical intersection between social models of public health and work in the justice fields. Addressing the inequities produced through the policies and institutions governing society unites the causes of those seeking to enhance access to justice and those seeking to reduce health inequities. Health justice partnerships (HJPs) are an example of a sociolegal model of health in action. Through the resolution of health issues with legal solutions at the individual level, the dismantling of service silos at the institutional level, and policy and law reform at the systemic level, HJPs demonstrate how the law can be used as a tool to reduce social and health inequities. Greater attention to law as a tool for health creates space for increased collaboration among legal and health scholars, practitioners, and advocates, particularly those working in the areas of the social determinants of health and access to justice, and a promising avenue for reducing health inequities.

Student perspectives on a state-wide relationships and sexual health programme in South Australian schools, 2006–2017

ABSTRACT Relationships and sexual health education is an accepted part of the school curriculum to support adolescent development. In recent years, the nature of this education has expanded to include topics encompassing a social model of health (e.g. with a focus on gender roles). There has, however, been limited exploration of student views about the inclusion of these topics. This paper presents student feedback on South Australia’s Relationships and Sexual Health Programme, a state-wide curriculum produced by the state’s major sexual and reproductive health organisation. The findings are drawn from an annual survey conducted from 2006 to 2017, involving 29,533 secondary school students aged 12–16 years. Regression analyses were used to assess the relationship between the year the survey was conducted and student ratings of the programme (‘good/excellent’ vs ‘poor/satisfactory’) and, separately, the individual topics students’ considered most important. There was a positive association between survey year and rating the programme as ‘good/excellent’ with regard to providing a ‘safe and supportive classroom environment’, and a small negative association between survey year and ‘overall rating’ as ‘good/excellent’. Over time, there was an increase in the number of students selecting the topic ‘consent’ as the most important. These findings demonstrate student support for the inclusion of a range of social health topics in relationships and sexual health education.

Social systems matter: Precision medicine, public health, and the medical model

Drawing on data from semi-structured interviews conducted in Singapore, Canada, and the United States, this paper shows that biomedical experts are deeply concerned about the shortcomings of the biomedical model of health. Precision public health, when anchored in genomics, can be considered a twenty-first century version of the medical model of health, which originated from nineteenth century germ theory. First, concerns regarding the adoption of genetic testing to identify disease susceptibility, and limitations of genome-based disease prevention exist. This includes limited evidence of the utility of screening measures in reducing mortality, lack of reimbursement for genetic screening, negative implications of genetic screening, and limitations of race/ethnicity-based genetic screening. Second, there are also concerns regarding the treatment of diseases, particularly the management of the costs of treatment and genetic testing in the context of national public health systems. Ultimately, it was found that healthcare-related inequities can be reduced in a universal, publicly funded, single-payer healthcare setting. These findings provide strong evidence supporting the social model of health by highlighting the key role of social systems and non-clinical interventions in precision public health to improve health outcomes for all.

Why Community Health Systems Have Not Flourished in High Income Countries: What the Australian Experience Tells Us.

Background: Despite the value of community health systems, they have not flourished in high income countries and there are no system-wide examples in high income countries where community health is regarded as the mainstream model. Those that do exist in Australia, Canada, the United States and the United Kingdom provide examples of comprehensive primary healthcare (PHC) but are marginal to bio-medical primary medical care. The aim of this paper is to examine the factors that account for the absence of strong community health systems in high income countries, using Australia as an example. Methods: Data are drawn from two Australian PHC studies led by the authors. One examined seven case studies of community health services over a five-year period which saw considerable health system change. The second examined regional PHC organisations. We conducted new analysis using the ‘three I’s’ framework (interests, institutions, ideas) to examine why community health systems have not flourished in high-income countries. Results: The elements of the community health services that provide insights on how they could become the basis of an effective community health system are: a focus on equity and accessibility, effective community participation/control; multidisciplinary teamwork; and strategies from care to health promotion. Key barriers identified were: when general practitioners (GPs) were seen to lead rather than be part of a team; funding models that encourage curative services rather than disease prevention and health promotion; and professional and medical dominance so that community voices are drowned out. Conclusion: Our study of the community health system in Australia indicates that instituting such a system in high income countries will require systematic ideological, political and institutional change to shift the overarching government policy environment, and health sector policies and practices towards a social model of health which allows community control, and multidisciplinary service provision.

Evidence for factors associated with diet and physical activity in African and Caribbean countries.

ObjectiveTo identify and describe summarized evidence on factors associated with diet and physical activity in low- and middle-income countries in Africa and the Caribbean by performing a scoping review of reviews.MethodsWe searched the Medline®, LILACS, Scopus, Global Health and Web of Science databases for reviews of factors associated with diet or physical activity published between 1998 and 2019. At least 25% of studies in reviews had to come from African or Caribbean countries. Factors were categorized using Dahlgren and Whitehead’s social model of health. There was no quality appraisal.FindingsWe identified 25 reviews: 13 on diet, four on physical activity and eight on both. Eighteen articles were quantitative systematic reviews. In 12 reviews, 25–50% of studies were from Africa or the Caribbean. Only three included evidence from the Caribbean. Together, the 25 reviews included primary evidence published between 1926 and 2018. Little of the summarized evidence concerned associations between international health or political factors and diet or associations between any factor and physical activity across all categories of the social model of health.ConclusionThe scoping review found a wide range of factors reported to be associated with diet and physical activity in Africa and the Caribbean, but summarized evidence that could help inform policies encouraging behaviours linked to healthy diets and physical activity in these regions were lacking. Further reviews are needed to inform policy where the evidence exists, and to establish whether additional primary research is needed.

Mergers may enhance the legitimacy of community health organisations in neoliberal environments

PurposeComprehensive primary health care (PHC) models are seldom implemented in high income countries, in part due to their contested legitimacy in neoliberal policy environments. This article explores how merging affected the perceived legitimacy of independent community health organisations in Victoria, Australia, in providing comprehensive PHC services.Design/methodology/approachA longitudinal follow-up study (2–3 years post-merger) of two amalgamations among independent community health organisations from the state of Victoria, Australia, was conducted. This article explores the perceived effects of merging on (1) the pragmatic, normative and cognitive legitimacy of studied organisations and (2) the collective legitimacy of these organisations in Victoria's health care system. Data were collected through 19 semi-structured interviews with key informants and subjected to template and thematic analyses.FindingsMerging enabled individual organisations to gain greater overall legitimacy as regional providers of comprehensive PHC services and thus retain some capacity to operationalise a social model of health. Normative legitimacy was most enhanced by merging, through acquisition of a large organisational size and adoption of business practices favoured by neoliberal norms. However, mergers may have destabilised the already contested cognitive legitimacy of community health services as a group of organisations and as a comprehensible state-wide platform of service delivery.Practical implicationsOver-reliance on individual organisational behaviour to maintain the legitimacy of comprehensive PHC as a model of organising health and social care could lead to inequities in access to such models across communities.Originality/valueThis study shows that organisations can manage their perceived legitimacy in order to ensure the survival of their preferred model of service delivery.

Towards an agency-based model of intersex, variations of sex characteristics (VSC) and DSD/dsd health

Agency-based approaches to the health of intersex people and those with DSD focus on bodily autonomy and the cessation of normalising medical interventions until an under-age person can exercise fully informed choice regarding treatment. Discussions regarding intersex agency and health care can be inspired by the social model of health that emerged from disability theory. However, a purely social model is insufficient to address the harms that has been caused by DSD medical interventions, and the healthcare needs that some intersex people have. Drawing on original empirical research conducted in Italy, Switzerland and the UK, this article explores agency-based approaches to intersex and DSD, incorporating the social model’s critique of the pathologisation of bodily diversities, whilst supporting the provision of effective healthcare where needed. The article addresses healthcare deficits and their cultural underpinnings. It identifies key impediments to intersex agency, including body normativity and sex and gender binarism. While there has been slight movement towards an agency-based approach to intersex in some national medical settings in the last ten years, there is still a need for change to the conceptualisation of intersex/DSD and subsequent revisions to healthcare provision.

COVID-19 and the role of health promoters and educators

The role of health promoters and educators in the current and future response to COVID-19 is critical, but, to date, under explored. This opinion paper offers a number of important contributions that this professional group may offer both in the immediate and future strategy of global public health. While the importance of a medical model of health cannot be underplayed, the social model of health suggests that some groups in society are being more disproportionately impacted than others. Health promotion has been committed to reducing inequalities and therefore offers “a voice” to those most marginalised. The paper suggests that bottom-up approaches focusing on building individual and community control is essential and, moreover, the concepts of a settings approach in health promotion, the fostering of critical health literacy and “salutogenesis” may be worthy of further debate and discussion.

COVID-19 and the role of health promoters and educators

The role of health promoters and educators in the current and future response to COVID-19 is critical, but, to date, under explored. This opinion paper offers a number of important contributions that this professional group may offer both in the immediate and future strategy of global public health. While the importance of a medical model of health cannot be underplayed, the social model of health suggests that some groups in society are being more disproportionately impacted than others. Health promotion has been committed to reducing inequalities and therefore offers ‘a voice’ to those most marginalised. The paper suggests that bottom-up approaches focusing on building individual and community control is essential and, moreover, the concepts of a settings approach in health promotion, the fostering of critical health literacy and ‘salutogenesis’ may be worthy of further debate and discussion.

COVID-19 and the role of health promoters and educators

The role of health promoters and educators in the current and future response to COVID-19 is critical, but, to date, under explored. This opinion paper offers a number of important contributions that this professional group may offer both in the immediate and future strategy of global public health. While the importance of a medical model of health cannot be underplayed, the social model of health suggests that some groups in society are being more disproportionately impacted than others. Health promotion has been committed to reducing inequalities and therefore offers ‘a voice’ to those most marginalised. The paper suggests that bottom-up approaches focusing on building individual and community control is essential and, moreover, the concepts of a settings approach in health promotion, the fostering of critical health literacy and ‘salutogenesis’ may be worthy of further debate and discussion.

The prevention of tobacco smoking and development of skills of healthy life-style in students of professional educational institutions

The purpose of the study is to analyze issues of prevention of smoking among college students and to reveal influence of social environment including influence of healthy lifestyle to development addiction. The study was based on value social model of health. The study covered student survey (n = 495, proportional selection by gender, age, year of study) and standardized interview with youth professionals (n = 21) to analyze in the youth the main motives for smoking, attitudes to healthy lifestyle and preventive social work methods that are implemented in colleges. The comparative analysis of data was carried out in subgroups of smoking and non-smoking students and experts. The results of study demonstrated the unformed negative attitudes to smoking. Among 25% of smoking students and 39% of non-smoking students smoking itself is considered as mean of communication and integration in youth community. Among 45.6% of respondents the exposure to and conformal behavior as reasons for starting smoking were declared. The analysis of results of the study concerning assessing attitude to smoking from the perspective of fashion and social recognition occurred to be unexpected: the number of non-smoking students who assume smoking is fashionable is 17 times higher than the number of smokers who share these beliefs. The comparison of the data permitted to establish possible causes of such a distribution of answers: in everyday life, smokers are faced with various legislative restrictions and social censure, while their non-smoking peers focus on social communicative and recreational effects of this habit. There are particular contradictions in the interpretation by students and youth professionals of causes of smoking. This testifies certain unawareness of professionals about age-related psychological characteristics and emotional conditions of students.