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

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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.