Evidence and causality in health promotion practice - the view from anthropology Morten Hulvej...

Evidence and causality in health promotion practice

- the view from anthropology

Morten Hulvej Jørgensen

The 5th Nordic Health Promotion Research ConferenceEsbjerg 2006

An anthropological analysis of health promotion practice

- complementing causal evidence

Morten Hulvej Jørgensen

The 5th Nordic Health Promotion Research ConferenceEsbjerg 2006


Esbjerg 2006 | Morten Hulvej Jørgensen Slide 3

Background

Intervention Outcome

What works?



Background

Intervention ? Outcome

How does it work in practice?



Aim of presentation

•Case: Health promoting activities and alcohol use among teenagers in a Danish rural community

•Health promotion seen as a social practice•Focus on interaction between actors

•Theoretical distinction between • Strategic action• Tactical action



Methods

•Ethnographic fieldwork in a Danish rural community• Approximately 2,000 inhabitants

•Participant observation among 13 to 16-year-olds (n=93)• 2 two-month periods• In school, at leisure activities, private parties, soda pop discos

•Semi-structured interviews• Self-selected friendship pairs or small groups• Interviews with 32 boys and girls in the 15-16 age group• 4 interviews with teachers and municipal staff



The soda pop disco

Rules:•Age limit: 12-15 years•No alcohol inside• Intoxicated persons are not allowed to enter

Control by adults:•Municipal street worker•Door men•Front desk•Surveillance inside



Warm-up sessions

•Get-togethers in private homes•Small groups of teenagers•Eating, drinking alcohol, socialising

Getting in the right mood

Anticipating adult control

Timing of alcohol intake and intoxication



What happens?

•Soda pop disco ~ health promotion practice• Salutogenetic approach• Preventive approach

• Interaction between adults and teenagers

•Different positions in intergenerational social space (power)



Strategic versus tactical action

Michel de Certeau, The Practice of Everyday Life. University of California Press, London, 1984

Strategic action (adults)

- presupposes a position of power - defining, surveilling and ruling a social space

Tactical action (teenagers)

- ”must vigilantly make use of the cracks that particular conjunctions open in the surveillance of the proprietary powers” (p. 37)



Conclusion

Intervention ? Outcome

How does it work in practice?



Conclusion

Soda pop disco? Reduction of

alcohol use



Conclusion

Soda pop discoTiming of

alcohol use

Strategies Tactics



Collaborators

Julie Bredenfeld ThomsenMette Riegels Morten GrønbækNina LyngPia Haudrup ChristensenTine Curtis

Evidence and causality in health promotion practice - the view from anthropology Morten Hulvej...

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