REALITIES in Health Disparities: Researching Evidence-based Alternatives in Living, Imaginative, Traumatised, Integrated, Embodied Systems

健康差异的现实：研究生活、想象力、创伤性、综合性、具体化系统中基于证据的替代方案

• 批准号: AH/X006131/1
• 负责人: Marisa De Andrade
• 金额: $ 26.78万
• 依托单位: University of Edinburgh
• 依托单位国家: 英国
• 项目类别: Research Grant
• 财政年份: 2022
• 资助国家: 英国
• 起止时间: 2022 至 无数据
• 项目状态: 已结题
• 来源: https://gtr.ukri.org/projects?ref=AH%2FX006131%2F1
• 关键词: REALITIES; Health; Disparities; Researching; Evidence

REALITIES (Researching Evidence-based Alternatives in Living, Imaginative, Traumatised, Integrated, Embodied Systems) is a collective of lived and felt experience community researchers already embedded within three localities in Scotland (Clackmannanshire; Easter Ross in the Highland; and North Lanarkshire); local council representatives; third sector organisations; artists; environmentalists; Scottish national dance, theatre and singing bodies; an executive non-departmental public body of the Scottish Government; and academics from diverse disciplines including health policy; health economics; mental health nursing; counselling, psychotherapy and applied social sciences; new public management; human geography; environmental sociology; design innovation and participatory design; and the arts. Our life experiences, work in communities and research has made us accept that we're part of a fragmented, traumatised system. Guided by Karen Treisman's thinking on organisational trauma, we're seeing the system as the 'client' or 'vulnerable participant' or 'deprived person' with 'lived experience'. Burnt out and suffering from compassion fatigue, the traumatised system polarises people, places and processes. It's crisis driven; avoidant or detached emotionally to cope with insurmountable global inequities. It's chaotic; dysregulated; disconnected. Our multi-site collaboration will co-design and test the scalable REALITIES model - to piece together the fragmented parts of the system to bring about integrated systemic change through conscious and co-ordinated engagement in hyper-local communities - using a multi-faceted approach that connects people, places, processes and power. We'll think differently and creatively about divergent perceptions of reality (ontology); different types of knowledge and evidence (epistemology) in the system (for example, how dance movement can sit alongside a statistical analysis); and we'll explore the ethics of vulnerability (who decides who is and isn't vulnerable and what does this label mean for the so-called vulnerable?). We're also uniting academics from multiple disciplines, who use diverse methodological approaches to analyse health disparities, and bringing them into deep, critical conversations about data, methods, theories and analysis. The REALITIES model will take us towards methodological convergence (or help us find ways to integrate methodological divergence) that situates participatory, arts-informed, creative-relational, (post)-qualitative approaches alongside positivist, scientific approaches in the evidence-base. In summary, our team will:i) facilitate cross-partner collaborations in three localities - Clackmannanshire; Easter Ross; and North Lanarkshire (NL) - to establish multiple, clearly defined asset hubs in these neighbourhoods. The hubs have focus on creatively connecting employability, health and social care (particularly mental health), transport accessibility, community learning and development, and the environment. ii) map and investigate how Integrated Joint Boards in these localities work with non-statutory community groups to connect cultural, natural, social and creative-relational assets to address health disparities;iii) explore how excluded communities in the system - 'The Outliers' - namely prisoners, ex-offenders, refugees and those experiencing homelessness are integrated within statutory and non-statutory services and partnerships in these localities; iv) co-design and explore the new scalable REALITIES model across emergent asset hubs in the three localities to understand how we can collaboratively create healthier communities across Scotland.

现实（研究基于循证的生活，想象力，创伤，综合，具体系统的替代方案）是生活和感觉的集体，经验丰富的社区研究人员已经嵌入了苏格兰三个地区（Clackmannanshire; Clackmannanshire; Easter Ross; Easter Ross in Highland in the Highland; North Lanarkshire; North Lanarkshire; north Lanarkshire;;地方议会代表；第三部门组织；艺术家；环保主义者；苏格兰国家舞蹈，戏剧和唱歌的身体；苏格兰政府的执行非部门公共机构；以及包括卫生政策在内的各种学科的学者；卫生经济学；心理健康护理；咨询，心理治疗和应用社会科学；新的公共管理；人地理；环境社会学；设计创新和参与设计；和艺术。我们的生活经验，在社区和研究中的工作使我们接受了我们是一个破碎的，受创伤的系统的一部分。在凯伦·特里斯曼（Karen Treisman）对组织创伤的思考的指导下，我们将系统视为“客户”或“弱势参与者”或“剥夺的人”，具有“生活经验”。烧毁并遭受了同情疲劳的痛苦，受创伤的系统使人，地方和过程两极分化。这是危机驱动的；在情感上避免或超脱，以应对无法克服的全球不平等。这很混乱；失调；断开连接。我们的多站点协作将共同设计和测试可扩展的现实模型 - 将系统的零散部分组合在一起，以使用多方面的方法通过有意识和协调的互动来实现系统性变化。这将连接人员，地方，过程和权力联系起来。我们将对对现实的不同看法（本体论）的不同思考；系统中不同类型的知识和证据（认识论）（例如，舞蹈运动如何与统计分析一起坐下）；我们将探索脆弱性的伦理（谁决定谁是和不脆弱的，此标签对所谓的脆弱性意味着什么？）。我们还将来自多个学科的学者团结起来，他们使用多种方法学方法来分析健康差异，并将其带入有关数据，方法，理论和分析的深入，批判性的对话中。现实模型将使我们走向方法论上的融合（或帮助我们找到将方法论差异整合的方法），以将参与性，艺术知识，创造性地关联，（后）的质量方法与证据基础的积极实证主义，科学的方法一起。总而言之，我们的团队将：i）促进在克拉克曼郡三个地区的跨派对合作；复活节罗斯；和北拉纳克郡（NL） - 在这些社区中建立多个明确定义的资产枢纽。枢纽专注于创造性地联系就业能力，健康和社会护理（尤其是心理健康），运输可及性，社区学习和发展以及环境。 ii）绘制并调查这些地方的综合联合委员会如何与非遗产社区团体合作，以连接文化，自然，社会和创造性的资产以解决健康差异； iii）探索如何排除系统中的社区 - “异常值” - 即囚犯，前罪犯，难民和经历无家可归的人都融入了这些地区的法定和非遗产服务以及伙伴关系中； iv）共同设计并探索三个地区的新兴资产中心的新可扩展现实模型，以了解我们如何在苏格兰各地建立更健康的社区。