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.

REALITIES（研究生活、想象、创伤、综合、体现系统中基于证据的替代方案）是一个由生活和感受经验社区研究人员组成的集体，已经扎根于苏格兰的三个地区（克拉克曼南郡、高地的复活节罗斯和北拉纳克郡）；地方议会代表；第三部门组织；艺术家；环保主义者；苏格兰民族舞蹈、戏剧和歌唱团体；苏格兰政府的非部门公共执行机构；以及来自不同学科（包括卫生政策）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；新公共管理；人文地理学；环境社会学；设计创新和参与式设计；和艺术。我们的生活经历、社区工作和研究使我们承认我们是一个支离破碎、饱受创伤的系统的一部分。在凯伦·特雷斯曼（Karen Treisman）对组织创伤的思考的指导下，我们将系统视为具有“生活经验”的“客户”或“弱势参与者”或“被剥夺者”。饱受创伤的系统精疲力尽，并遭受同情疲劳，使人员、地点和流程两极分化。这是危机驱动的；在情感上回避或超然，以应对难以克服的全球不平等。很混乱；失调；已断开连接。我们的多站点协作将共同设计和测试可扩展的 REALITIES 模型 - 将系统的碎片部分拼凑在一起，通过超本地社区的有意识和协调的参与来实现集成的系统变革 - 使用连接人员、地点、流程和权力的多方面方法。我们将对现实（本体论）的不同看法进行不同的、创造性的思考；系统中不同类型的知识和证据（认识论）（例如，舞蹈动作如何与统计分析并存）；我们将探讨脆弱性的伦理（谁决定谁是脆弱的，谁不是脆弱的，这个标签对所谓的脆弱者意味着什么？）。我们还联合来自多个学科的学者，他们使用不同的方法来分析健康差异，并让他们就数据、方法、理论和分析进行深入、批判性的对话。 REALITIES 模型将带我们走向方法论趋同（或帮助我们找到整合方法论分歧的方法），将参与性、艺术知识、创造性关系、（后）定性方法与实证主义、科学方法放在证据基础上。总之，我们的团队将：i) 促进克拉克曼南郡三个地区的跨合作伙伴合作；复活节罗斯；和北拉纳克郡（NL）——在这些社区建立多个、明确界定的资产中心。这些中心致力于创造性地将就业能力、健康和社会关怀（特别是心理健康）、交通便利性、社区学习和发展以及环境联系起来。 ii) 规划和调查这些地区的综合联合委员会如何与非法定社区团体合作，将文化、自然、社会和创意关系资产联系起来，以解决健康差距问题；iii) 探索系统中被排除在外的社区（“离群者”，即囚犯、刑满释放人员、难民和无家可归者）如何融入这些地区的法定和非法定服务和伙伴关系； iv) 在三个地区的新兴资产中心共同设计和探索新的可扩展 REALITIES 模型，以了解我们如何在苏格兰合作创建更健康的社区。