What is the 'problem' that outreach work seeks to address and how might it be tackled? Seeking theory in a primary health prevention programme

Mackenzie, M. , Turner, F., Platt, S., Reid, M., Wang, Y., Clark, J., Sridharan, S. and O'Donnell, C.A. (2011) What is the 'problem' that outreach work seeks to address and how might it be tackled? Seeking theory in a primary health prevention programme. BMC Health Services Research, 11(Dec), p. 350. (doi:10.1186/1472-6963-11-350)

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Publisher's URL: http://dx.doi.org/10.1186/1472-6963-11-350

Abstract

<b>Background</b> Preventive approaches to health are disproportionately accessed by the more affluent and recent health improvement policy advocates the use of targeted preventive primary care to reduce risk factors in poorer individuals and communities. Outreach has become part of the health service response. Outreach has a long history of engaging those who do not otherwise access services. It has, however, been described as eclectic in its purpose, clientele and mode of practice; its effectiveness is unproven. Using a primary prevention programme in the UK as a case, this paper addresses two research questions: what are the perceived problems of non-engagement that outreach aims to address; and, what specific mechanisms of outreach are hypothesised to tackle these.<p></p> <b>Methods</b> Drawing on a wider programme evaluation, the study undertook qualitative interviews with strategically selected health-care professionals. The analysis was thematically guided by the concept of 'candidacy' which theorises the dynamic process through which services and individuals negotiate appropriate service use.<p></p> <b>Results</b> The study identified seven types of engagement 'problem' and corresponding solutions. These 'problems' lie on a continuum of complexity in terms of the challenges they present to primary care. Reasons for non-engagement are congruent with the concept of 'candidacy' but point to ways in which it can be expanded.<p></p> <b>Conclusions</b> The paper draws conclusions about the role of outreach in contributing to the implementation of inequalities focused primary prevention and identifies further research needed in the theoretical development of both outreach as an approach and candidacy as a conceptual framework.

Item Type:Articles
Additional Information:This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Turner, Ms Fiona and MacKenzie, Professor Mhairi and O'Donnell, Professor Catherine
Authors: Mackenzie, M., Turner, F., Platt, S., Reid, M., Wang, Y., Clark, J., Sridharan, S., and O'Donnell, C.A.
College/School:College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > Social Scientists working in Health and Wellbeing
College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > General Practice and Primary Care
College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > Mental Health and Wellbeing
College of Social Sciences > School of Social and Political Sciences > Urban Studies
Journal Name:BMC Health Services Research
ISSN:1472-6963
Published Online:28 December 2011
Copyright Holders:Copyright © 2011 Mackenzie et al; licensee BioMed Central Ltd.
First Published:First published in BMC Health Services Research 2011 11(Dec): 350
Publisher Policy:Reproduced in accordance with the copyright policy of the publisher

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