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Published in: Health Care Analysis 4/2010

Open Access 01-12-2010 | Original Article

The Role of Screenings Methods and Risk Profile Assessments in Prevention and Health Promotion Programmes: An Ethnographic Analysis

Authors: Yvonne J. F. M. Jansen, Antoinette A. de Bont

Published in: Health Care Analysis | Issue 4/2010

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Abstract

In prevention and health promotion interventions, screening methods and risk profile assessments are often used as tools for establishing the interventions’ effectiveness, for the selection and determination of the health status of participants. The role these instruments fulfil in the creation of effectiveness and the effects these instruments have themselves remain unexplored. In this paper, we have analysed the role screening methods and risk profile assessments fulfil as part of prevention and health promotion programmes in the selection, enrolment and participation of participants. Our analysis showed, that screening methods and health risk assessments create effects as they objectify health risks and/or the health status of individuals, i.e., they select the individuals ‘at risk’ and indicate the lifestyle modifications these people are required to make in order to improve their health. Yet, these instruments also reduce the group of participants thereby decreasing the possible effect of interventions, as they provide the legitimisation for people to make choices to whether they enrol or not and what lifestyle changes they incorporate into their lives. In other words, they present a space of interaction, in which agency is distributed across the practice nurses, the participants and the instruments. Decisions were not just made upon the projection of the outcomes of these instruments; decisions that were made by both the patients and practice nurses were the resultant of their opinions on these outcomes that were formed in interaction with the instruments.
Footnotes
1
For a more elaborate description of the intervention, study methods including its methodological justification and overviews of its results see: El Fakiri [8].
 
Literature
1.
go back to reference Bartholomée, Y. (2004). Society as a Laboratory; Donald T. Campbell and the history of social experimentation. Psychologische, Pedagogische en Sociologische Wetenschappen. Groningen: Rijksuniversiteit Groningen. Bartholomée, Y. (2004). Society as a Laboratory; Donald T. Campbell and the history of social experimentation. Psychologische, Pedagogische en Sociologische Wetenschappen. Groningen: Rijksuniversiteit Groningen.
2.
go back to reference Blasinsky, M., Goldman, H. H., et al. (2006). Project IMPACT: A report on barriers and facilitators to sustainability. Administration and Policy in Mental Health and Mental Health Services Research, 33(6), 718–729.CrossRefPubMed Blasinsky, M., Goldman, H. H., et al. (2006). Project IMPACT: A report on barriers and facilitators to sustainability. Administration and Policy in Mental Health and Mental Health Services Research, 33(6), 718–729.CrossRefPubMed
3.
go back to reference Bodenheimer, T., Lorig, K., et al. (2002). Patient self-management of chronic disease in primary care. Journal of American Medical Association, 288(19), 2469–2475.CrossRef Bodenheimer, T., Lorig, K., et al. (2002). Patient self-management of chronic disease in primary care. Journal of American Medical Association, 288(19), 2469–2475.CrossRef
4.
go back to reference Childress, J. E., Faden, R. R., et al. (2002). Public health ethics: Mapping the terrain. Journal of Law, Medicine & Ethics, 30, 170–178.CrossRef Childress, J. E., Faden, R. R., et al. (2002). Public health ethics: Mapping the terrain. Journal of Law, Medicine & Ethics, 30, 170–178.CrossRef
6.
go back to reference Creswell, J. W. (2003). Research design; qualitative, quantitative, and mixed methods approaches. Thousand Oaks: SAGE Publications, Inc. Creswell, J. W. (2003). Research design; qualitative, quantitative, and mixed methods approaches. Thousand Oaks: SAGE Publications, Inc.
7.
go back to reference Edwards, N., Mill, J., et al. (2004). Multiple intervention research programs in community health. Canadian Journal of Nursing Research, 36(1), 40–54.PubMed Edwards, N., Mill, J., et al. (2004). Multiple intervention research programs in community health. Canadian Journal of Nursing Research, 36(1), 40–54.PubMed
8.
go back to reference El Fakiri, F. (2008). Prevention of cardiovascular diseases in deprived neighbourhoods. Rotterdam: Institute Health Policy and Management, Erasmus MC. El Fakiri, F. (2008). Prevention of cardiovascular diseases in deprived neighbourhoods. Rotterdam: Institute Health Policy and Management, Erasmus MC.
9.
go back to reference El Fakiri, F., Hoes, A. W., et al. (2008). Process evaluation of an intensified preventive intervention to reduce cardiovascular risk in a multiethnic patient population. European Journal of Cardiovascular Nursing, 7(4), 296–302.CrossRefPubMed El Fakiri, F., Hoes, A. W., et al. (2008). Process evaluation of an intensified preventive intervention to reduce cardiovascular risk in a multiethnic patient population. European Journal of Cardiovascular Nursing, 7(4), 296–302.CrossRefPubMed
10.
go back to reference Getrich, C., Heying, S., et al. (2007). An ethnography of clinic “noise” in a community-based, promotora-centered mental health intervention. Social Science and Medicine, 65(2), 319–330.CrossRefPubMed Getrich, C., Heying, S., et al. (2007). An ethnography of clinic “noise” in a community-based, promotora-centered mental health intervention. Social Science and Medicine, 65(2), 319–330.CrossRefPubMed
11.
go back to reference Horstman, K., & Houtepen, R. (2005). Worstelen met gezond leven: ethiek in de preventie van hart-en vaatziekten. Het Spinhuis: Amsterdam. Horstman, K., & Houtepen, R. (2005). Worstelen met gezond leven: ethiek in de preventie van hart-en vaatziekten. Het Spinhuis: Amsterdam.
12.
go back to reference Howson, A. (1998). Surveillance, knowledge and risk: The embodied experience of cervical screening. Health, 2(2), 195–215. Howson, A. (1998). Surveillance, knowledge and risk: The embodied experience of cervical screening. Health, 2(2), 195–215.
13.
go back to reference Hunter, D. J. (2003). Public health policy. Cambridge: Polity Press. Hunter, D. J. (2003). Public health policy. Cambridge: Polity Press.
14.
go back to reference Jansen, Y. J. F. M. (2010). The taming of chance and the actual practice of prevention; rationalised prevention and ‘the social’. In T. Mathar & Y. J. F. M. Jansen (Eds.), Health promotion and prevention programmes is practice; how patients’ health practices are rationalised, reconceptualised and reorganised (pp. 147–169). Bielefeld: Transcript Verlag. Jansen, Y. J. F. M. (2010). The taming of chance and the actual practice of prevention; rationalised prevention and ‘the social’. In T. Mathar & Y. J. F. M. Jansen (Eds.), Health promotion and prevention programmes is practice; how patients’ health practices are rationalised, reconceptualised and reorganised (pp. 147–169). Bielefeld: Transcript Verlag.
15.
go back to reference Jansen, Y. J. F. M., de Bont, A., et al. (2007). Tailoring intervention procedures to routine primary health care practice; an ethnographic process evaluation. BioMed Central Health Services Research, 7, 125. doi:10.1186/1472-6963-7-125. Jansen, Y. J. F. M., de Bont, A., et al. (2007). Tailoring intervention procedures to routine primary health care practice; an ethnographic process evaluation. BioMed Central Health Services Research, 7, 125. doi:10.​1186/​1472-6963-7-125.
16.
go back to reference Jansen, Y. J. F. M., & Foets, M. M. E., et al. (2009). The contribution of qualitative research to the development of tailor-made community-based interventions in primary care: A review. European Journal of Public Health, 1–7 [Epub ahead of print]. doi:10.1093/eurpub/ckp085. Jansen, Y. J. F. M., & Foets, M. M. E., et al. (2009). The contribution of qualitative research to the development of tailor-made community-based interventions in primary care: A review. European Journal of Public Health, 1–7 [Epub ahead of print]. doi:10.​1093/​eurpub/​ckp085.
17.
go back to reference Kooiker, S., & van der Velden, K. (2007). Een nuchtere kijk op gezond gedrag; Vier thema’s voor gezondheidsbevordering. Sociaal en Cultureel Planbureau: Den Haag. Kooiker, S., & van der Velden, K. (2007). Een nuchtere kijk op gezond gedrag; Vier thema’s voor gezondheidsbevordering. Sociaal en Cultureel Planbureau: Den Haag.
18.
go back to reference Lupton, D. (1993). The construction of patienthood in medical advertising. International Journal of Health Services, 23(4), 805–819.CrossRefPubMed Lupton, D. (1993). The construction of patienthood in medical advertising. International Journal of Health Services, 23(4), 805–819.CrossRefPubMed
19.
go back to reference Lupton, D. (1993). Risk as moral danger: The social and political functions of risk discourse in public health. International Journal of Health Services, 23(3), 425–435.CrossRefPubMed Lupton, D. (1993). Risk as moral danger: The social and political functions of risk discourse in public health. International Journal of Health Services, 23(3), 425–435.CrossRefPubMed
20.
go back to reference Lupton, D. (1997). Consumerism, reflexivity and the medical encounter. Social Science and Medicine, 45(3), 373–381.CrossRefPubMed Lupton, D. (1997). Consumerism, reflexivity and the medical encounter. Social Science and Medicine, 45(3), 373–381.CrossRefPubMed
21.
go back to reference Mackenbach, J. P., & Stronks, K. (2002). A strategy for tackling health inequalities in the Netherlands. British Medical Journal, 325(7371), 1029–1032.CrossRefPubMed Mackenbach, J. P., & Stronks, K. (2002). A strategy for tackling health inequalities in the Netherlands. British Medical Journal, 325(7371), 1029–1032.CrossRefPubMed
23.
go back to reference Mathar, T. & Jansen, Y. J. F. M. (Eds.) (2010). Health promotion and prevention programmes is practice; how patients’ health practices are rationalised, reconceptualised and reorganised. VerKörperungen/MatteRealities—Perspektiven empirischer Wissenschaftsforschung. Bielefeld, Transcript Verlag. Mathar, T. & Jansen, Y. J. F. M. (Eds.) (2010). Health promotion and prevention programmes is practice; how patients’ health practices are rationalised, reconceptualised and reorganised. VerKörperungen/MatteRealities—Perspektiven empirischer Wissenschaftsforschung. Bielefeld, Transcript Verlag.
24.
go back to reference May, C. (2009). Mundane medicine, therapeutic relationships, and the clinical encounter: Current and future agendas for sociology. In B. Pescosolido, J. K. Martin, J. D. McLeod, & A. Roggers (Eds.), Handbook of the sociology of health, illness, & healing: A blueprint for the 21st century. New York: Springer. May, C. (2009). Mundane medicine, therapeutic relationships, and the clinical encounter: Current and future agendas for sociology. In B. Pescosolido, J. K. Martin, J. D. McLeod, & A. Roggers (Eds.), Handbook of the sociology of health, illness, & healing: A blueprint for the 21st century. New York: Springer.
25.
go back to reference Nutbeam, D. (1998). Evaluating health promotion—Progress, problems and solutions. Health Promotion International, 13(1), 27–44.CrossRef Nutbeam, D. (1998). Evaluating health promotion—Progress, problems and solutions. Health Promotion International, 13(1), 27–44.CrossRef
26.
go back to reference Porter, T. M. (1995). Trust in numbers; the pursuit of objectivity in science and public life. Princeton: Princeton University Press. Porter, T. M. (1995). Trust in numbers; the pursuit of objectivity in science and public life. Princeton: Princeton University Press.
27.
go back to reference Rousseau, N., McColl, E., et al. (2003). Practice based, longitudinal, qualitative interview study of computerised evidence based guidelines in primary care. British Medical Journal, 326(7384), 314.CrossRefPubMed Rousseau, N., McColl, E., et al. (2003). Practice based, longitudinal, qualitative interview study of computerised evidence based guidelines in primary care. British Medical Journal, 326(7384), 314.CrossRefPubMed
28.
go back to reference Shim, J. K. (2005). Constructing ‘Race’ across the science-lay divide: Racial formation in the epidemiology and experience of cardiovascular disease. Social Studies of Science, 35(3), 405–436.CrossRef Shim, J. K. (2005). Constructing ‘Race’ across the science-lay divide: Racial formation in the epidemiology and experience of cardiovascular disease. Social Studies of Science, 35(3), 405–436.CrossRef
29.
go back to reference Spratley, J. P. (1980). Participant observation. Fort Worth: Harcourt Brace College Publishers. Spratley, J. P. (1980). Participant observation. Fort Worth: Harcourt Brace College Publishers.
30.
go back to reference Timmermans, S., & Berg, M. (2003). The gold standard; the challenge of evidence-based medicine and standardization in health care. Philadelphia: Temple University Press. Timmermans, S., & Berg, M. (2003). The gold standard; the challenge of evidence-based medicine and standardization in health care. Philadelphia: Temple University Press.
31.
go back to reference Timmermans, S., & Haas, S. (2008). Towards a sociology of disease. Sociology of Health & Illness, 30(5), 659–676.CrossRef Timmermans, S., & Haas, S. (2008). Towards a sociology of disease. Sociology of Health & Illness, 30(5), 659–676.CrossRef
32.
go back to reference Tones, K. (2000). Evaluating health promotion: A tale of three errors. Patient Education and Counseling, 39(2–3), 227–236.CrossRefPubMed Tones, K. (2000). Evaluating health promotion: A tale of three errors. Patient Education and Counseling, 39(2–3), 227–236.CrossRefPubMed
33.
go back to reference Uitewaal, P. J. M. (2003). Type 2 diabetes mellitus and Turkish immigrants: An educational experiment in general practice. Rotterdam: Institute Health Policy and Management, Erasmus MC. Uitewaal, P. J. M. (2003). Type 2 diabetes mellitus and Turkish immigrants: An educational experiment in general practice. Rotterdam: Institute Health Policy and Management, Erasmus MC.
Metadata
Title
The Role of Screenings Methods and Risk Profile Assessments in Prevention and Health Promotion Programmes: An Ethnographic Analysis
Authors
Yvonne J. F. M. Jansen
Antoinette A. de Bont
Publication date
01-12-2010
Publisher
Springer US
Published in
Health Care Analysis / Issue 4/2010
Print ISSN: 1065-3058
Electronic ISSN: 1573-3394
DOI
https://doi.org/10.1007/s10728-009-0141-0

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