REALITIES in Health Disparities: Researching Evidence-based Alternatives in Living, Imaginative, Traumatised, Integrated, Embodied Systems

“现实”（研究生活、想象、创伤、综合、具体化系统中的循证替代方案）是一个由生活和感受经验社区研究人员组成的团体，他们已经在苏格兰的三个地方（克拉克曼南郡、高地的复活节罗斯和北拉纳克郡）开展工作；地方议会代表；第三界别机构；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行政机构；来自不同学科的学者，包括卫生政策；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;环境社会学;设计创新与参与式设计；还有艺术。我们的生活经历、社区工作和研究让我们接受了这样一个事实：我们是一个支离破碎、伤痕累累的系统的一部分。在凯伦·特雷斯曼（Karen Treisman）关于组织创伤的思想的指导下，我们将系统视为“客户”、“弱势参与者”或“有生活经验的被剥夺者”。受到创伤的系统精疲力竭，遭受同情疲劳，使人、地方和过程两极分化。这是危机驱动的；在情感上回避或超然，以应对无法克服的全球不平等。这是混乱的;特异表达;断开连接。我们的多站点合作将共同设计和测试可扩展的现实模型——通过在超本地社区中有意识和协调的参与，将系统的碎片部分拼凑起来，带来综合的系统性变革——使用多方面的方法，将人、地点、流程和权力联系起来。我们会以不同的方式创造性地思考对现实的不同认知（本体论）；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列）；我们将探讨脆弱的伦理（谁决定谁是脆弱的，谁不是脆弱的，这个标签对所谓的脆弱意味着什么？）我们还联合了来自多个学科的学者，他们使用不同的方法方法来分析健康差异，并使他们就数据、方法、理论和分析进行深入、批判性的对话。现实模型将带我们走向方法论的融合（或帮助我们找到整合方法论分歧的方法），将参与性、艺术信息、创造性关系、（后）定性方法与实证主义、科学方法结合起来。总而言之，我们的团队将：i)促进三个地区的跨伙伴合作-克拉克曼南郡；复活节罗斯;北拉纳克郡(NL) -在这些社区建立多个明确定义的资产中心。这些中心的重点是创造性地将就业能力、健康和社会护理（特别是心理健康）、交通可达性、社区学习和发展以及环境联系起来。绘制和调查这些地方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、社会和创造性相关资产联系起来，以解决健康差距问题；iii)探索系统中被排斥的社区-“异类”-即囚犯，前罪犯，难民和无家可归者如何融入这些地方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的现实模型，以了解我们如何在苏格兰合作创建更健康的社区。

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.