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Week 9 Mind Map: Reflective Health Promotion Practice / Community…
Week 9 Mind Map: Reflective Health Promotion Practice / Community Organizing and Advocacy
Participatory health promotion practice goes beyond individualistic thinking, and involves
both
practitioners and community members thinking and acting participatively,.
3.2 A utilitarian approach to participatory practice is often insincere and unproductive
3.2.1 Looking at participation as a means to an end to achieve predetermined health outcomes - not truly collaborating with community
3.2.1.1 It seems somewhat ironic that what some consider to be a participatory approach is actually somewhat the opposite
3.2.2 Can be considered a practical rarther than transformational appraoch - real decisions are made by project staff, whereas truly participatory approaches take direction from the participants (Community members)
3.3 A truly participatory approach to health promotion practice involves a cyclical process of reflection and action that highlights and addresses conditions that negatively influence health outcomes and equity.
3.3.1 starting where people are, rather than with where they need to be
3.3.2 Listening to where community members feel the current state of affairs is, then reflecting on social action required to change the conditions that prevent improved health outcomes
3.3.2.1 salutogenic model of health
3.3.2.2 Again, requires going beyond the individual - definitely a theme here
3.1 Participation should be thought of as a mindset rather than just a process
3.1.2 rather than focusing only on individual health issues and their direct causes, questioning why society has created the conditions under which this can occur, and starting with community members to uncover reality
3.1.1 philosophy for being and acting organically and holistically with ultimate aim of improving conditions for heath and social justice - not merely cause and effects, rather, a relational and cyclical process
3.1.1.1 Inspiration from Indigenous world views - this textbook time and time again demonstrates the knowledge and wisdom of Indigenous ways of knowing and thinking - so much to be learned from Indigenous peoples in regard to health promotion
Neoliberal ideology and its emphasis on individualism pose the biggest challenge to participatory health promotion practice.
5.2 healthcare is an elite-dominated policy space - as such, engaging equity-deserving groups in health promotion often results in structural issues being incorrectly reframed as individual or community ones
5.2.1 burden of change is often placed on the targets of health health promotion activities rather than promoters/practitioners themselves
5.2.2 limited appetite for change at the top - this necessitates bottom-up action, which can be most effective when done correctly
5.3 neoliberalism encourages maintenance of the status quo when it comes to health promotion
5.3.1 the ideology often defines individuals as consumers even in the context of health - if people are already consuming, then no need to change anything
5.3.1.1 yet another example of the negative impacts of neoliberal ideology on health promotion - seems to affect all aspects of the discipline (e.g., points of entry, healthy campuses, anti-racism, immigrant health promo, etc.)
5.3.1.2 connection to my honours thesis topic - the way in which adherence to neoliberal ideology is associated with covid-19 denial mirrors this concept that it seeks to maintain status qu
5.3.2 fuelling competition between individuals maintains social strata
5.1 health promoters have been working in a 'non-participatory' world since the proliferation of neoliberal individualism in the 80s and 90s
5.1.2 Participatory approaches are often used to satisfy funding requirements (tokenistically), not often used in a meaningful and transformative way
5.1.1 emphasis on competition even among practitioners places focus on short term outcomes rather than long-term, upstream change
5.1.1.1 Prevents meaningful reflection
Story, dialogue and reflection are essential elements of transformative participatory health promotion practice (TPHPP).
4.2 Dialogue can be built on a foundation of respect for and meaningful consideration of the stories and lived experiences of community members
4.2.1 'the heart' of participatory practice
4.2.2 practicioner mediates between dialogue and deliberation, helping people to co-create meanings
4.2.2.1 also important for practitioner and participants to recognize how existing agendas and social conditions contribute to challenges
4.2.2.2 key distinction here between listening to stories and dialogue is that the former involves simply listening - no back and forth - this seems to be an important takeaway
4.3 Critical reflexivity is the third essential element of TPHPP, and can be achieved by engaging in respectful dialogue (as a starting point)
4.3.1 questioning assumptions that emerge through dialogue based on a story
4.3.2 changing practitioner and participant 'meaning schemes' and their embodiment through critical questioning
4.3.2.1 can help expose meta-narratives - again, bringing it back to the 'big picture'
4.1 Listening to community members' stories is the first step toward TPHPP, often most critical
4.1.1 stories highlight assumptions, contradictions and paradoxes that emerge in every day life, many which may be impactful in terms of health or lifestyle outcomes
4.1.2 Highlighting similarities and differences between community members through their stories and lived experiences can help to shape a collective vision for the future
Reflective health promotion practice (RHPP) can be defined in terms of its relations to power and collaboration.
1.2 Reflection often involves collaborating with others (often a team) to collectively consider issues, actions and group interactions
1.2.1 Effectiveness requires time, energy and trust
1.2.2 Should strive to engage in reflection during action, not just after the fact
1.3 The collaborative nature of reflection in a team setting involves complex relationships with differences of power, skillsets and experience
1.3.1 Reflective practice helps team members to become wiser at working within complex power structures and dynamics
1.3.2 Can be uncomfortable, but all are better off for it if done meaningfully
1.1 Broadly, reflection involves a cycle of questioning and experimenting with strategies until change occurs
1.1.1 Involves problem-solving, self-development, decision-making and empowerment
1.1.2 Can also be thought of as a preventative process
1.1.2.1 the preventative lens on reflection is an outlook that not many people talk about, but seems like a critical point
1.1.2.2 Avoids futile processes
1.1.3 Always a risk that reflexivity becomes too focused on the individual reflecting - always needs to come back to the bigger picture
Becoming a reflective health promotion practitioner requires engagement with reflective tools.
2.2 New tools for reflective practice are emerging, such as photography, drawing-based journals, weblogs, and more.
2.2.1 Visual modes of reflection often more appropriate when reflection is necessary but community members are reluctant to write (or unable to due to lack of access to supplies)
2.2.2 In certain cultural contexts, images articulate reflections better than writing and thus are more impactful
2.2.2.1 This could be a good idea to introduce the concept of reflection to younger age groups - could be helpful for normalizing the process across disciplines over time
2.3 Boutilier and Mason offer real world examples of their own experiences journalling and creating diagrams for reflection, highlighting the effectiveness of reflection in practice.
2.3.1 Mason's journal reflection excerpts demonstrate just how useful of a tool it can be for highlighting political context of health promotion activities and subsequently reflecting on what aspects of this context are holding the program back.
2.3.2 Boutlier's reflective diagram offers a glimpse of a seemingly less structured form of reflection that benefits from its unique ability to illustrate the complex networks, hierarchies and relationships that often define health promotion practice
2.3.2.1 seems to be more immersive than journalling in some ways but could be harder to reflect on
2.1 Writing is a critical tool for reflective health promotion practitioners
2.1.1 slows down thoughts, allows for careful reflection
2.1.2 Journals are an effective form of reflective writing
2.1.2.1 Factual description of events can help facilitate subsequent reflection
2.1.2.2 Often include critical analyses of political context surrounding events, which is greatly beneficial to taking a 'big picture view' while reflecting