All sectors in health care are being asked to focus on the knowledge-to-practice gap, or knowledge translation, to increase service effectiveness. A social interaction approach to knowledge ...translation assumes that research evidence becomes integrated with previously held knowledge, and practitioners build on and co-create knowledge through mutual interactions. Knowledge translation strategies for public health have not provided anticipated positive changes in evidence-based practice, possibly due in part to a narrow conceptualization of knowledge. More work is needed to understand the role of tacit knowledge in decision-making and practice. This pilot study examined how health practitioners applied tacit knowledge in public health program planning and implementation.
This study used a narrative approach, where teams from two public health units in Ontario, Canada were conveniently selected. Respondents participated in individual interviews and focus groups at each site. Questions were designed to understand the role of tacit knowledge as it related to the program planning process. Data were analyzed through a combination of content analysis and thematic comparison.
The findings highlighted two major aspects of knowledge that arose: the use of tacit knowledge and the integration of tacit and explicit knowledge. Tacit knowledge included: past experiences, organization-specific knowledge, community contextual knowledge, and the recognition of the tacit knowledge of others. Explicit knowledge included: research literature, the Internet, popular magazines, formal assessments (surveys and interviews), legislation and regulations. Participants sometimes deliberately combined tacit and explicit knowledge sources in planning.
This pilot demonstrated that front-line public health workers draw upon both tacit knowledge and explicit knowledge in their everyday lived reality. Further, tacit knowledge plays an important role in practitioners' interpretation and implementation of explicit research findings. This indicates a need to broaden the scope of knowledge translation to include other forms of knowledge beyond explicit knowledge acquired through research. Strategies that recognize and support the use of tacit knowledge, such as communities of practice or networks, may be important components of a comprehensive approach to knowledge translation. This study provides support for further investigation of the role of tacit knowledge in the planning and delivery of effective public health services.
Everyone who has worked with qualitative interview data has run into problems with transcription error, even if they do the transcribing themselves. A thoughtful, accurate, reliable, multilingual ...transcriptionist with a quick turnaround time is worth her or his weight in gold. In this article, the authors examine some transcription circumstances that seem to bring about their own consistent set of problems. Based on their experiences, the authors examine the following issues: use of voice recognition systems; notation choices; processing and active listening versus touch typing; transcriptionist effect; emotionally loaded audiotaped material; class and/or cultural differences among interviewee, interviewer, and transcriptionist; and some errors that arise when working in a second language. The authors offer suggestions for working with transcriptionists as part of the qualitative research team.
Few studies on women's health include immigrant women as participants, and fewer are conducted by immigrant women themselves. In this article, the authors present a model that allowed their full ...participation as researchers and authors. They describe their experiences using participatory research methods with Hispanic women in multiple ways to reach out to isolated women, collect data about community needs, and provide health education. They explore the advantages and challenges of being trained for both researcher and health educator roles, describe opportunities to use this approach to assess service needs, and discuss the potential for personal empowerment. They also report on the time commitment that such a bilingual project requires. In the process of interviewing marginalized women, they realized how much health promotion and participatory research complement each other. The authors conclude that combining participatory research with health promotion activities has promise to contribute toward increased empowerment of immigrant communities.
Social network analysis is a potentially useful reflective tool that could be used by public health practitioners to assess the overall composition of their networks, strengthen collaborations with ...other community partners, and evaluate network function. The purpose of this paper is to report on public health practitioners’ experiences with social network analysis. Thirteen public health practitioners, each associated with their own advocacy-oriented community collaboration, participated in the study. Specifically, the intervention consisted of social network analysis output (social network analysis measures and sociograms) and a facilitated discussion to stimulate reflection on the respondents’ professional networks. Semi-structured interviews were conducted two weeks later to solicit participants’ reactions to the sociograms and the accompanying measures, and elicit thoughts about how social network analysis might have an impact on their work. Participants commented on ways in which social network analysis could be applied in practice, such as using sociograms to raise awareness of the nature of current networks, as a planning and evaluation tool, to identify gaps, and to assess the degree of sustainability of current networks.
As the focus of health promotion moves from individuals to organizations, communities and broader social policy, the models that guide public health program planning and development need ...reexamination. Public health nurses are gaining experience in strengthening and supporting the ability of communities to grow and change. This study aimed to illuminate the process. Data, gathered as part of an action research project to develop individual and community‐based strategies to decrease isolation in frail older adults, provided a rich source of qualitative data. Analysis was directed toward identifying the factors and processes of capacity‐building. The emerging model was clarified and partially validated with academics and practitioners from health promotion programs across the age span. Four stages of building collective capacity were identified: identifying common ground, working cooperatively, working in partnership, and working across the community. At each stage, processes of relationship building, project management and capacity‐building resulted in stage specific products. A model of building collective capacity, grounded in community health practice and supported by the literature provides a base for developing practice indicators, and practice guidelines which will strengthen the ability to reach health goals.
Evaluating multiple-member partnerships is always a challenging task. This article is based on our experiences using a participatory approach to evaluating a community-based health promotion research ...project. “Mujer Sana, Comunidad Sana—Healthy Women, Healthy Communities” was partnership-based, multi-sector, multicultural, and participatory. We describe our experiences working with participatory methods to evaluate the partnership per se. Three evaluation frameworks were applied sequentially by the authors and provided insight into the functioning of the partnership in a complex and changing environment. Our experiences suggest that, through the process of participatory evaluation, the partnership itself also changed in ways that were not fully captured at the time of the original project evaluation. We reflect on the process with questions that might help other groups to consider ways to evaluate partnerships in community-based, participatory health research projects with minority and majority community partners.
We employed stimulated recall and content analysis to examine relations among counselor and client cognitions, behaviors, and ratings in 29 counseling sessions involving 10 different counselor-client ...pairs. The design of the study permitted assessments of the impact of counselor experience (novice vs. experienced) and stage of counseling (early, middle, and end) on these variables. Consistency in various parts of the sequential chain of counselor intention - counselor behavior - client perceptions of counselor intention and behavior - client cognitive processing - client behavior was lower for interpersonal cognitive than for interpersonal behavioral or intrapersonal cognitive-behavioral links. Consistency across different elements in this chain was observed to account for a significant proportion of the variance in counselor ratings of session effectiveness. Several consistent, interpretable patterns were observed across counselor intentions, counselor behaviors, and client cognitive processing. Relatively few effects of stage of counseling or of counselor experience were observed.
Applications of mindfulness during the perinatal period have recently been explored and appear to offer a decrease in stress, anxiety and depression during this period. However, it still remains ...unclear what practical use women make of mindfulness during the postpartum period and the mechanisms through which it works. The subjective experience of mindfulness practice by mothers is not fully understood. The aim of the present study was to explore how women enrolled in a "Mindfulness-Based Childbirth and Parenting programme" experienced mindfulness practice during the postpartum period.
Ten pregnant women over 18 years of age with singleton pregnancies, no diagnoses of mental illness and participation in a "Mindfulness-Based Childbirth and Parenting programme" were recruited to take part in a postpartum interview. Audio recordings of the interviews were transcribed and analysed thematically based on a phenomenological approach. The transcripts of nine interviews were submitted to a coding process consisting of the identification of words, sentences or paragraphs expressing common ideas. These ideas were classified in codes, each code representing a specific description, function or action (e.g. self-perception, personal organization, formal/informal meditation practice). Progressively, a framework of thematic ideas was extracted from the transcripts, allowing the interviews to be systematically organized and their content analysed in depth.
Five themes emerged from the descriptions of practices of mindfulness during the postpartum period: perception of the present moment, breathing, acceptance, self-compassion and the perception of mindfulness as a shelter.
Mindfulness practices during the postpartum period may contribute to a mother's psychological wellbeing. The perception of mindfulness as a shelter had not previously been reported. Future research could address whether this role is specific to the postpartum period.
The Mother-Generated Index (MGI) assesses postnatal quality of life (QoL) without providing a predefined checklist, thus offering mothers the opportunity to identify areas of life affected by having ...a baby.
To identify: (a) details and particularities of areas of life affected after childbirth and thus specific domains defining postnatal quality of life; (b) changes in the importance of domains specifying QoL within the first weeks postpartum; and (c) the potential role of cultural differences with regard to the nature of QoL definitions.
Prospective, cross-cultural, longitudinal survey. We applied a qualitative content analysis to Mother-Generated Index data collected in Switzerland and Germany using combined deductively and inductively category building.
Women participated at three days (n=124) and six and a half weeks (n=82) postpartum. Eleven domains were identified, each with several subdomains: ‘physical well-being’ (e.g. fatigue), ‘psychological well-being’ (e.g. happiness, emotional confusion), ‘general well-being’, ‘motherhood’ (e.g. bonding with the baby), ‘family and partnership’ (e.g. time for partner and children), ‘social life’ (e.g. friends, being isolated), ‘everyday life’ (e.g. organisation daily routine), ‘leisure’ (e.g. less time), ‘work life’ (e.g. worries about job), ‘financial issues’ (e.g. less money), and further aspects. The most frequently indicated domains were ‘motherhood’ and ‘family and partnership’. Differences between the stages of assessment and countries were identified.
Mothers faced challenges in defining their new role but welcomed the slowdown in the rhythm of life and experienced overwhelming maternal feelings.
Our findings suggest that postnatal quality of life is a concept that changes over time and differs between countries.
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