Tackling inequalities in health and social wellbeing: Evidence of ‘good practice’ by nurses, midwives and health visitors

Abstract

This paper details a project which assessed the contribution made by nurses, midwives and health visitors to Targeting Health and Social Need (THSN). Targeting Health and Social Need is an important theme within the Northern Ireland Regional Strategy entitled Health and Wellbeing into the Next Millennium: A Regional Strategy for Health and Social Wellbeing 1997-2002 which is concerned with addressing inequalities in health status and social wellbeing. While there is a considerable body of research and information on variations in health and social wellbeing there is a paucity of corresponding research on those interventions which may improve the health of disadvantaged groups. Health professionals are addressing such inequalities so it is appropriate that their efforts should be recorded and assessed. The project was conducted jointly by the departments of nursing at The Queen's University of Belfast and the University of Ulster, funded by the Department of Health and Social Services and had a timetable that covered three phases. Phase 1 entailed the distribution of a survey questionnaire to all nurses, including those professionals working with community and voluntary groups, to assess their contribution to THSN. The paper describes the results from the 392 questionnaires identified (a response rate of almost 40%) and the work in phase 2 of analysing the responses by selection criteria devised by the Project Advisory Board to allow further investigation. The resulting interventions were reduced to 22 and in an overview of each of these a number of characteristics kept recurring that could serve to define aspects of 'good practice'. These 22 case studies demonstrate the efforts made by nurses and health professionals to change behaviour, practice, the community and the environment. Also highlighted are the nursing competencies gained through working, the lessons learnt and the problems and difficulties encountered. The paper concludes that the use of qualitative research opens the door to measures of social position that reflect the ways in which people define themselves and the relationships that sustain them. Although there is still some way to go in understanding the different approaches to evaluation, an environment that fosters the monitoring and assessment of practice might be created in the future within the nursing community.

‘Health and well-being’: questioning the use of health concepts in public health policy and practice

“…Since then, 'well-being' has featured increasingly as part of the language of health, from nursing to health promotion (Lazenbatt et al 2000, DoH 2003b), typically as a tag to 'health'. However, well-being seems to be used in a curiously unconsidered way, involving assumptions and with little systematic attention (for example DoH 1997, HDA 2002a, 2002b.…”

Tackling inequalities through partnership working: the development of a neighbourhood project

“…The challenge of working in disadvantaged areas shapes practice and different approaches have been proposed (Kai and Drinkwater, 2004). Lazenbatt et al (2000) reviewed nursing interventions to tackle health and social inequalities and identified eight aspects of good practice: 1) Holistic view of health and social need; 2) Health alliances and inter-agency working;…”

Dietary Interventions for Healthy Pregnant Women: A Systematic Review of Tools to Promote a Healthy Antenatal Dietary Intake

“…The main barriers include limited self-perceived nutrition expertise and self-efficacy by providers, and a lack of time [ 10 , 11 , 12 ]. Considering the communication with low SES pregnant women, specifically, providers might experience language barriers, and complex needs within and outside the scope of antenatal care (e.g., housing, welfare) might be prioritized over discussing a healthy diet [ 13 , 14 ].…”