Theories of practice and public health: understanding (un)healthy practices
Theories of practice and public health: understanding (un)healthy practices
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DOI：
10.1080/09581596.2014.980396
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发表时间：
2016-01-01
影响因子：
2.8
通讯作者：
Kelly, Michael P.
中科院分区：
文献类型：
--
作者：
Blue, Stanley;Shove, Elizabeth;Kelly, Michael P.
对人类行为和行为变化的心理学理解和个人主义理论主导了公共卫生领域的学术研究和干预措施。与此同时，为理解健康方面持续存在的不平等现象所做的努力指向了结构性因素，但未能确切表明这些因素如何转化为不同人口阶层的日常生活（从而影响健康）。在本文中，我们认为，社会理论的实践提供了一个替代范式，这两种方法，通知显着的新方法的概念化和应对一些最紧迫的当代公共卫生挑战。我们介绍和讨论的相关性，这种方法与吸烟，重点是吸烟的生活过程作为一种做法，而不是个人吸烟者的特点或广泛的社会健康决定因素。这一举动迫使我们考虑吸烟的物质和象征性元素，并遵循这些元素随着时间的推移而变化的方式。其中一些发展与吸烟和其他行为（如饮酒、放松和社交）之间的关系有关。我们认为，干预吸烟的未来，部分取决于了解这些联盟的性质，以及如何共同发展的做法。最后，我们反思的影响，以社会实践为中心的公共卫生政策的重点，评论这样一个范式的转变的好处，并对挑战，这对既定的方法，政策和方案。
Psychological understandings and individualistic theories of human behaviour and behaviour change have dominated both academic research and interventions at the coalface' of public health. Meanwhile, efforts to understand persistent inequalities in health point to structural factors, but fail to show exactly how these translate into the daily lives (and hence health) of different sectors of the population. In this paper, we suggest that social theories of practice provide an alternative paradigm to both approaches, informing significantly new ways of conceptualising and responding to some of the most pressing contemporary challenges in public health. We introduce and discuss the relevance of such an approach with reference to tobacco smoking, focusing on the life course of smoking as a practice, rather than on the characteristics of individual smokers or on broad social determinants of health. This move forces us to consider the material and symbolic elements of which smoking is comprised, and to follow the ways in which these elements have changed over time. Some of these developments have to do with the relation between smoking and other practices such as drinking alcohol, relaxing and socialising. We suggest that intervening in the future of smoking depends, in part, on understanding the nature of these alliances, and how sets of practices co-evolve. We conclude by reflecting on the implications of taking social practices as the central focus of public health policy, commenting on the benefits of such a paradigmatic turn, and on the challenges that this presents for established methods, policies and programmes.