Co-construction and exchange of dental service-related knowledge in a Merseyside neighbourhood: an ethnography and visual methods study of inter-gener

摘要：介绍和背景：牙科服务的利用显示出强烈的社会经济梯度，最贫穷的人最不可能定期使用服务（Reda et al 2018; Wu 2007）。存在地域差异，以及当地的社会模式（Reda等人2018；Exley 2009）。关于牙科服务的知识可以发挥作用，这可以分为1)保健专业人员和支持个人或社区使他们能够获得护理的其他人的科学知识和2)当地知识，包括当地社区拥有的各种形式的知识、文化信仰和规范；从家庭、朋友和几代人之间的社会交往、生活经历或各种信息来源（Samerski 2019; WHO 2022）中获得。本文以贫困地区的利物浦当地社区群体为视角，探讨了第二种类型的知识。几项研究（Kirkegaard 2022; Schaefer et al 2013; Woudstra 2019; Gage et al 2013）报告说，通过社会互动进行医疗保健知识交流对医疗保健服务利用的影响研究有限。信息进一步限制了牙科服务的利用，这是本文所要解决的差距。目的：探讨不同代际社区牙科服务利用的地方知识实践。目的:(1)。探索当地知识实践如何在影响贫困社区牙科服务利用的人群中趋同、分化和相互作用；(2）.探讨代际医疗保健知识实践；（3.) 使用视觉参与式方法来激发对话，创造新的见解，鼓励包容，并通过其他定性方法辅助三角测量。方法：首先，对知识和信念在当地社区如何构建、交换和适应影响人们帮助自己、家人和社区成员获得医疗保健服务的决策的文献进行范围审查和绘制。其次，实证工作将涉及使用并整合在一起的几种定性方法：人种学，包括观察、访谈、文献分析和视觉方法（例如研究人员和社区参与者拍摄的照片），以及参与性讲习班。会议将在内瑟顿感觉良好工厂举行，这是一个社区组织。看门人（在监督小组）将方便进入研究领域。工作坊和面试的参与者将采用有目的抽样和滚雪球式的方式进行招募。(一)。数据收集：人种学（Hammersley和Atkinson 2007）和参与性研讨会，为期1年（2023- 2024年）。人种学之后将有5个参与性研讨会，这些研讨会将以不同的方式组织（Watson等人2023）作为小组讨论，并结合使用参与观察中获得的图像的照片启发过程。(B)数据分析：主题分析与数据收集并行（Braun and Clark, 2006）。将反复分析现场记录、笔录和图像。视觉数据分析将包括选择相关图像并解释图像附带的叙事（Close 2007; Thorne 2000; Wang et al . 1998）。结果（预期）：本研究将报告知识实践的动态，各种来源和潜在参与者在内瑟顿感觉良好工厂和周边地区从事牙科服务利用方面的知识交流或合作生产；特别关注代际知识实践。

Title: Co-construction and exchange of dental service-related knowledge in a Merseyside neighbourhood: an ethnography and visual methods study of inter-generational knowledge practices in a community settingAbstract:Introduction and background: Dental service utilization shows a strong socioeconomic gradient with the poorest least likely to use services regularly (Reda et al 2018; Wu 2007). There are geographical differences, as well as a social patterning in local areas (Reda et al 2018; Exley 2009). Knowledge about dental services has a role to play and this can be divided into 1) scientific knowledge of healthcare professionals and others who support individuals or communities to enable them to access care and 2) Local knowledge, encompassing various forms of knowledge, cultural beliefs and norms possessed by the local communities; gained from diverse sources either from social interactions between families, friends and others across generations, lived experiences or from various sources of information-online, electronic or print media (Samerski 2019; WHO 2022). This thesis explores the second type of knowledge with a lens on a local Liverpool community group in a deprived area. Several studies (Kirkegaard 2022; Schaefer et al 2013, Woudstra 2019; Gage et al 2013) report that there is limited study on the role of healthcare knowledge exchange through social interactions influencing healthcare service utilization. The information is further limited on dental service utilization which is the gap this thesis addresses.Aim: To explore local knowledge practices relating to dental service utilization in a community across different generations.Objectives: (1). To explore how local knowledge practices converge, diverge and interact among people influencing dental service utilization in a deprived community; (2).To explore inter-generational healthcare knowledge practices; (3.) To use visual participatory methods to stimulate conversation, create new insights, encourage inclusion and aid triangulation with other qualitative approaches.Methods: First, a scoping review mapping literature on how knowledge and beliefs are constructed, exchanged and adapted in local communities influencing the decision-making of people to help themselves, their families and community members to access healthcare services. Second, empirical work will then involve several qualitative methods used and integrated together: ethnography including observation, interviews, documentary analysis and visual methods (e.g. photographs taken by the researcher and community participants), and participatory workshops. The setting will be Netherton Feelgood Factory, a community group. The gatekeeper (on the supervisory panel) will facilitate access to the study field. Participants for workshops and interviews will be recruited by purposive sampling coupled with snowballing. (A). Data collection: Ethnography (Hammersley and Atkinson 2007) and participatory workshops for 1 year (2023-24). Ethnography will be followed by 5 participatory workshops which will be organised in different ways (Watson et al 2023) as group discussions, combined with the photo-elicitation process using images obtained in participant observation. (B) Data analysis: Thematic analysis, concurrent with data collection (Braun and Clark, 2006). Field-notes, transcripts and images will be analysed iteratively. Visual data analysis will involve selecting relevant images and interpreting the narrative attached to the images (Close 2007; Thorne 2000; Wang et al 1998). Results (anticipated): This study will report the dynamics of knowledge practices, various sources and potential actors engaged in knowledge exchange or co-production around dental service utilisation in Netherton feelgood factory and surrounding localities; focusing particularly on intergenerational knowledge practices.