Chapter 2: Ways of Knowing- Health Policy and Health Studies

Question 1

Four paradigms for understanding health

Answer 1

1. Medical
2. Behavioural/lifestyle
3. Socio-environmental
4. Structural/critical

Question 2

What is the most dominant health paradigm?

Answer 2

Medical

Question 3

What does the medical paradigm define health as?

Answer 3

Absence of disease and disability and defines health issues in terms of physiological risk factors and disease

Question 4

What is the medical paradigm rooted in?

Answer 4

Individualism

Question 5

What interventions does the medical paradigm include?

Answer 5

Medical intervention such as surgery, drugs provided by health care professionals

Question 6

What is health policy focused on regarding the medical paradigm?

Answer 6

Medical delivery

Question 7

How does the behavioural/lifestyle paradigm define health?

Answer 7

In terms of individual energy, functional ability and disease preventing lifestyles and defines health issues as behavioural risk factors such as smoking, diet etc.

Question 8

What interventions are implemented in behavioural/lifestyle paradigm?

Answer 8

Health promotion and social marketing to promote and support lifestyle changes

Question 9

Who is involved in the behavioural/lifestyle paradigm?

Answer 9

Individuals responsible for adopting healthy behaviours

Question 10

How does the socio-environmental paradigm define health?

Answer 10

Connectedness to family, friends and community and defines health problems in terms of social factors such as poverty, living or working conditions

Question 11

Interventions implemented with the socio-environmental paradigm

Answer 11

Community development, political action and advocacy

Question 12

What is a limitation to the socio-environmental paradigm?

Answer 12

Doesn’t direct attention to influence of larger, political, economic and social forces

Question 13

Who is involved in the socio-environmental paradigm?

Answer 13

Individuals

Question 14

What is the socio-environmental paradigm also called?

Answer 14

Materialistic

Question 15

What is the structural/critical paradigm also called?

Answer 15

Neo-materialistic

Question 16

How does the structural/critical paradigm define health?

Answer 16

In terms of unequal distributions and control of economic and social power within a society

Question 17

What is the structural/critical paradigm concerned with?

Answer 17

Focuses on ideology and the organization of society

Question 18

Who does the structural/critical paradigm focus on?

Answer 18

Collective/whole society, rejects individualism

Question 19

Interventions implemented with the structural/critical paradigm

Answer 19

Policy change to address inequalities

Question 20

What is a knowledge paradigm?

Answer 20

A set of beliefs or assumptions about knowledge and how it is created

Question 21

Ontology

Answer 21

Form in which reality and its objects are said to exist (nature of reality or what can be known)

Question 22

Epistemology

Answer 22

How the inquirer creates knowledge through research and experience; shapes how knowledge is believed to be acquired and understood (what is knowledge?)

Question 23

Methodology

Answer 23

What tools can be used to generate and acquire knowledge; scientific methods, interactive approaches (interviews)

Question 24

Social theories

Answer 24

1. Positivism/rationalism
2. Post positivism
3. Critical theory
4. Interpretivism

Question 25

Postitivism/rationalism

Answer 25

States that the only authentic knowledge is scientific knowledge and this can only come from positive affirmation of theories through the scientific method such as universal laws of natural phenomena and human behaviour

Question 26

Beliefs of positivism (ontology)

Answer 26

A natural world exists outside of human interpretation We can acquire objective knowledge about the world

Question 27

Epistemology of positivism

Answer 27

Physicial, biological and health sciences

Question 28

Methodology of positivism

Answer 28

Collection and analysis of quantitative data using hypothesis testing

Question 29

Limitations of positivism

Answer 29

Ignores social, economic and political factors Shifts focus to downstream factors such as pharmaceutical, medical etc.

Question 30

Post-positivism (critical realism)

Answer 30

A natural reality exists outside of human interpretation, but we cannot study it objectively due to researcher bias

Question 31

What type of research do post-positivists use?

Answer 31

Mixed

Question 32

What is the focus of interpretivism?

Answer 32

How people understand the world using the shared meanings we use to make sense of things All views are equal

Question 33

What type of research does interpretivism use?

Answer 33

Qualititative research based on lived experiences (ethnography, grounded theory)

Question 34

Examples of instruments interpretivists may use in their research

Answer 34

Open-ended interview questions Focus group questions Ethnographic field notes

Question 35

Limitations of interpretivism

Answer 35

Fails to take into account impact of social relations Fails to investigate structural systems Doesn't question what health and health problems are the first place

Question 36

Goals of the critical theory

Answer 36

Critique and transform society as a whole and describe structures and processes of power and hierarchy not considered by positivists or interpretivists

Question 37

What does the critical theory focus on?

Answer 37

Social, political and economic context

Question 38

What does the critical theory investigate?

Answer 38

Distribution of resources and lived experiences

Question 39

What research paradigm falls under the medical approach to health?

Answer 39

Positivism

Question 40

What research paradigm falls under the behavioural/lifestyle approach to health?

Answer 40

Positivism and post-positivism

Question 41

What research paradigm falls under the socio-environmental approach to health?

Answer 41

Interpretive

Question 42

What research paradigm falls under the structural/critical approach to health?

Answer 42

Critical theory