Inclusive public participation in health: Policy, practice and theoretical contributions to promote the involvement of marginalised groups in healthcare
Inclusive public participation in health: Policy, practice and theoretical contributions to promote the involvement of marginalised groups in healthcare
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DOI：
10.1016/j.socscimed.2015.04.019
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发表时间：
2015-06-01
影响因子：
5.4
通讯作者：
Martin, Graham
中科院分区：
文献类型：
--
作者：
de Freitas, Claudia;Martin, Graham
在为让公民在医疗保健治理中发声而创建的空间中，移民和少数民族的代表性不足。将少数群体排除在卫生参与领域之外，可能会削弱公众参与的变革潜力，(重新)造成卫生不平等。然而，很少有研究关注是什么让被边缘化的群体参与到参与性空间中来。本文以参与链模型(PCM)为概念框架，以荷兰一个涉及佛得角移民的心理健康倡导项目的用户参与为例，探讨了这一问题。数据收集需要观察、书面证据和与受心理社会问题影响的佛得角人(n=20)和机构利益攸关方(n=30)进行面谈。我们提供实践、政策和理论贡献。实际上，我们强调必须采取积极主动的做法，为少数群体和其他被边缘化群体提供机会和奖励，吸引、留住并使他们能够通过参与建设和释放能力。在政策方面，我们建议卫生当局和民间社会组织在创造“混合”空间方面发挥作用，以促进被边缘化群体实质性地参与医疗决策。理论上，我们强调了PCM的缺点及其对用户资源的概念化，建议对其进行调整，以提高其概念性和实用性。(C)2015爱思唯尔有限公司。保留所有权利。
Migrants and ethnic minorities are under-represented in spaces created to give citizens voice in healthcare governance. Excluding minority groups from the health participatory sphere may weaken the transformative potential of public participation, (re)producing health inequities. Yet few studies have focused on what enables involvement of marginalised groups in participatory spaces. This paper addresses this issue, using the Participation Chain Model (PCM) as a conceptual framework, and drawing on a case study of user participation in a Dutch mental health advocacy project involving Cape Verdean migrants. Data collection entailed observation, documentary evidence and interviews with Cape Verdeans affected by psychosocial problems (n = 20) and institutional stakeholders (n = 30). We offer practice, policy and theoretical contributions. Practically, we highlight the importance of a proactive approach providing minorities and other marginalised groups with opportunities and incentives that attract, retain and enable them to build and release capacity through involvement. In policy terms, we suggest that both health authorities and civil society organisations have a role in creating 'hybrid' spaces that promote the substantive inclusion of marginalised groups in healthcare decision-making. Theoretically, we highlight shortcomings of PCM and its conceptualisation of users' resources, suggesting adaptations to improve its conceptual and practical utility. (C) 2015 Elsevier Ltd. All rights reserved.