Centre for Social and Health Outcomes Research and Evaluation (SHORE) and Te Ropu Whariki http://hdl.handle.net/10179/1791 2018-01-23T17:18:48Z 2018-01-23T17:18:48Z Wall, Martin Hayes, Richard Moore, Derek Petticrew, Mark Clow, Angela Schmidt, Elena Draper, Alizon Lock, Karen Lynch, Rebecca Renton, Adrian http://hdl.handle.net/10179/1884 2012-07-28T22:51:56Z 2009-06-28T00:00:00Z

Evaluation of community level interventions to address social and structural determinants of health: a cluster randomised controlled trial Wall, Martin; Hayes, Richard; Moore, Derek; Petticrew, Mark; Clow, Angela; Schmidt, Elena; Draper, Alizon; Lock, Karen; Lynch, Rebecca; Renton, Adrian Background: In London and the rest of the UK, diseases associated with poor diet, inadequate physical activity and mental illness account for a large proportion of area based health inequality. There is a lack of evidence on interventions promoting healthier behaviours especially in marginalised populations, at a structural or ecological level and utilising a community development approach. The Well London project financed by the Big Lottery 'Wellbeing' Fund and implemented by a consortium of London based agencies led by the Greater London Authority and the London Health Commission is implementing a set of complex interventions across 20 deprived areas of London. The interventions focus on healthy eating, healthy physical activity and mental health and wellbeing and are designed and executed with community participation complementing existing facilities and services. Methods/Design: The programme will be evaluated through a cluster randomised controlled trial. Forty areas across London were chosen based on deprivation scores. Areas were characterised by high proportion of Black and Minority Ethnic residents, worklessness, ill-health and poor physical environments. Twenty areas were randomly assigned to the intervention arm of Well London project and twenty 'matched' areas assigned as controls. Measures of physical activity, diet and mental health are collected at start and end of the project and compared to assess impact. The quantitative element will be complemented by a longitudinal qualitative study elucidating pathways of influence between intervention activities and health outcomes. A related element of the study investigates the health-related aspects of the structural and ecological characteristics of the project areas. The project 'process' will also be evaluated. Discussion: The size of the project and the fact that the interventions are 'complex' in the sense that firstly, there are a number of interacting components with a wide range of groups and organisational levels targeted by the intervention, and secondly, a degree of flexibility or tailoring of the intervention, makes this trial potentially very useful in providing evidence of the types of activities that can be used to address chronic health problems in communities suffering from multiple deprivation. Trial Registration: Current Controlled Trials ISRCTN68175121

2009-06-28T00:00:00Z McCreanor, Tim Nairn, Raymond http://hdl.handle.net/10179/1882 2012-07-28T21:57:39Z 2002-09-01T00:00:00Z

Tauiwi general practitioners explanations of Maori health: Colonial relations in primary healthcare in Aotearoa/New Zealand? McCreanor, Tim; Nairn, Raymond This paper reports initial findings from qualitative research investigating how general practitioners talk about Maori health. Transcripts of semi-structured interviews with 25 general practitioners from urban Auckland were subjected to critical discursive analyses. Through this process of intensive, analytic reading, interpretative repertoires – patterns of words and images about a particular topic – were identified. This paper presents the main features of one such repertoire, termed Maori Morbidity, that the general practitioners used in accounting for poor Maori health status. Our participants were drawing upon a circumscribed pool of ideas and explaining the inequalities in health between Maori and Tauiwi in ways that gave primacy to characteristics of Maori and their culture. We discuss the implications of this conclusion for relations between Maori patients and Tauiwi doctors in primary healthcare settings.

2002-09-01T00:00:00Z Nairn, Raymond Pega, Frank McCreanor, Tim Rankine, Jenny Barnes, Angela http://hdl.handle.net/10179/1880 2012-07-28T21:58:38Z 2006-03-01T00:00:00Z

Media, racism and public health psychology Nairn, Raymond; Pega, Frank; McCreanor, Tim; Rankine, Jenny; Barnes, Angela A growing literature has established that racism contributes to ill-health of migrants, minority group members and indigenous peoples. Racial discrimination has been shown to act at personal, institutional and societal levels, negatively affecting physical health as evidenced by heart disease and other stress related conditions and generally negating wellbeing, signalled by psychological and psychiatric disorders including depression. In our highly mediatized world, mass communications in diverse forms are decisive for people’s knowledge and understandings of the world and their place in it. From critical studies we know that the media consistently marginalize, denigrate and neglect particular ethnic and cultural groups. Where media do focus on such groups much of the reporting is negative and stereotyping. Achievements are ignored or minimized while representations of those groups as problems for and threats to the dominant are highlighted. In this paper we consider the particular case of media representations of the indigenous Maori of Aotearoa New Zealand. We review extant studies to argue that detailed and systematic study is necessary for the development of critical, local media scholarship. Such scholarship is necessary if the current media impact on Maori health and wellbeing is to be mitigated. While such considerations may not have been traditional concerns of health psychology we, following George Albee (2003), argue for them as affirming the need for critical public health psychology.

2006-03-01T00:00:00Z McCreanor, Tim Moewaka Barnes, Helen Kaiwai, Hector Borell, Suaree Gregory, Amanda http://hdl.handle.net/10179/1858 2012-07-28T21:06:58Z 2008-09-01T00:00:00Z

Creating intoxigenic environments: Marketing alcohol to young people in Aotearoa New Zealand McCreanor, Tim; Moewaka Barnes, Helen; Kaiwai, Hector; Borell, Suaree; Gregory, Amanda Alcohol consumption among young people in New Zealand is on the rise. Given the broad array of acute and chronic harms that arise from this trend, it is a major cause for alarm and it is imperative that we improve our knowledge of key drivers of youth drinking. Changes wrought by the neoliberal political climate of deregulation that characterised the last two decades in many countries including Aotearoa New Zealand have transformed the availability of alcohol to young people. Commercial development of youth alcohol markets has seen the emergence of new environments, cultures and practices around drinking and intoxication but the ways in which these changes are interpreted and taken up is not well understood. This paper reports findings from a qualitative research project investigating the meaning-making practices of young people in New Zealand in response to alcohol marketing. Research data included group interviews with a range of Maori and Pakeha young people at three time periods. Thematic analyses of the youth data on usages of marketing materials indicate naturalisation of tropes of alcohol intoxication. We show how marketing is used and enjoyed in youth discourses creating and maintaining what we refer to as intoxigenic social environments. The implications are considered in light of the growing exposure of young people to alcohol marketing in a discussion of strategies to manage and mitigate its impacts on behaviour and consumption.

2008-09-01T00:00:00Z