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The purpose of this paper is to present insights into the way in which system change can be activated around the provision of services and support for people experiencing multiple disadvantages in an urban setting.

This paper is informed by a thematic analysis of reflections, reports, learning logs, interviews and experiences of those “activating” system change in the Golden Key partnership in Bristol between 2014 and 2021.

Four themes are identified, including “creating the conditions for change”, “framing your involvement”, “investing in relationships” and “reflective practice and learning”. For each of these, an illustrative vignette is provided.

Practical recommendations and reflective questions are provided with suggestions of further considerations for applying this approach in different contexts.

This paper describes an original approach of activating and supporting people to do system change to improve the lives of people facing multiple disadvantages.

Privilege is often silent, invisible and not made explicit, and silence is a key question for theorizing on organizations. This paper examines interrelations between privilege and silence for relatively privileged professionals in high-intensity knowledge businesses (KIBs).

This paper draws on 112 interviews in two rounds of interviews using the collaborative interactive action research method. The analysis focuses on processes of recruitment, careers and negotiation of boundaries between work and nonwork in these KIBs. The authors study how relative privilege within social inequalities connects with silences in multiple ways, and how the invisibility of privilege operates at different levels: individual identities and interpersonal actions of privilege (micro), as organizational level phenomena (meso) or as societally constructed (macro).

At each level, privilege is reproduced in part through silence. The authors also examine how processes connecting silence, privilege and social inequalities operate differently in relation to both disadvantage and the disadvantaged, and privilege and the privileged.

This study is relevant for organization studies, especially in the kinds of “multi-privileged” contexts where inequalities, disadvantages and subordination may remain hidden and silenced, and, thus, are continuously reproduced.

The purpose of this paper is to present a case study tracking the development and engagement of a group of experts by experience (The Independent Futures (IF) Group) who provided a lived experience voice to the Bristol Golden Key (GK) partnership within the Fulfilling Lives programme. The case study reports the genesis and impact of the group, as well as the facilitators of impact and experiences of the group members and those they worked in partnership with.

The research adopted an iterative approach drawing on multiple data sources over an eight-year period. An inductive ethnographic analysis of stakeholder and partnership meetings was combined with documentary analysis and thematic analysis of interviews with experts by experience and service providers.

The voice of lived experience provided by the IF group contributed to the GK partnership through various channels. Evidence of this contribution and its impact was found at programme, city-wide and national levels of the service ecosystem. Furthermore, IF members recognised the value of the group in contributing to systems change and service improvement, but also for themselves.

This case study serves to illustrate the impact of the lived experience voice on services and systems change, specifically the provision of that voice from a formalised advisory group. The successes and challenges of the group and the experiences of its members are reported with a view to sharing learning that may influence future co-production initiatives with experts by experience and service provision for those experiencing multiple disadvantage.

The insights provided by the longitudinal observation of the group as it was formed and evolved, coupled with insights provided by the experts by experience, have important implications for facilitating and supporting sustainable lived experience input.

Work-life flexibility policies (e.g., flextime, telework, part-time, right-to-disconnect, and leaves) are increasingly important to employers as productivity and well-being strategies. However, policies have not lived up to their potential. In this chapter, the authors argue for increased research attention to implementation and work-life intersectionality considerations influencing effectiveness. Drawing on a typology that conceptualizes flexibility policies as offering employees control across five dimensions of the work role boundary (temporal, spatial, size, permeability, and continuity), the authors develop a model identifying the multilevel moderators and mechanisms of boundary control shaping relationships between using flexibility and work and home performance. Next, the authors review this model with an intersectional lens. The authors direct scholars’ attention to growing workforce diversity and increased variation in flexibility policy experiences, particularly for individuals with higher work-life intersectionality, which is defined as having multiple intersecting identities (e.g., gender, caregiving, and race), that are stigmatized, and link to having less access to and/or benefits from societal resources to support managing the work-life interface in a social context. Such an intersectional focus would address the important need to shift work-life and flexibility research from variable to person-centered approaches. The authors identify six research considerations on work-life intersectionality in order to illuminate how traditionally assumed work-life relationships need to be revisited to address growing variation in: access, needs, and preferences for work-life flexibility; work and nonwork experiences; and benefits from using flexibility policies. The authors hope that this chapter will spur a conversation on how the work-life interface and flexibility policy processes and outcomes may increasingly differ for individuals with higher work-life intersectionality compared to those with lower work-life intersectionality in the context of organizational and social systems that may perpetuate growing work-life and job inequality.

Previous research has focused on the outcomes of telework, investigating the advantages and disadvantages of teleworking for employees. However, these investigations do not examine whether there are differences between teleworkers when evaluating the advantages and disadvantages of teleworking. The aim of this study is to identify of distinct classes of teleworkers based on the advantages and disadvantages that teleworking has for them.

This study used secondary survey data collected by the Spanish National Statistics Institute (INE). A sample of 842 people was used for this study. To identify the distinct classes of teleworkers, their perceived advantages and disadvantages of teleworking were analyzed using latent class analysis.

Three different classes of teleworkers were distinguished. Furthermore, sociodemographic covariates were incorporated into the latent class model, revealing that the composition of the classes varied in terms of education level, household income, and the amount of time spent on teleworking per week. This study also examined the influence of these emergent classes on employees’ experience of teleworking.

This study contributes to previous research investigating if telework is advantageous or disadvantageous for teleworkers, acknowledging that teleworkers are not identical and may respond differently to teleworking.

This article draws upon our perspective as academic-practitioners working in the fields of food insecurity, food systems, and inequality to comment, in the early stages of the pandemic and associated lockdown, on the empirical and ethical implications of COVID-19 for socio-economic inequalities in access to food in the UK. The COVID-19 pandemic has sharpened the profound insecurity of large segments of the UK population, an insecurity itself the product of a decade of “austerity” policies. Increased unemployment, reduced hours, and enforced self-isolation for multiple vulnerable groups is likely to lead to an increase in UK food insecurity, exacerbating diet-related health inequalities. The social and economic crisis associated with the pandemic has exposed the fragility of the system of food charity which, at present, is a key response to growing poverty. A vulnerable food system, with just-in-time supply chains, has been challenged by stockpiling. Resultant food supply issues at food banks, alongside rapidly increasing demand and reduced volunteer numbers, has undermined many food charities, especially independent food banks. In the light of this analysis, we make a series of recommendations. We call for an immediate end to the five week wait for Universal Credit and cash grants for low income households. We ask central and local government to recognise that many food aid providers are already at capacity and unable to adopt additional responsibilities. The government's – significant – response to the economic crisis associated with COVID-19 has underscored a key principle: it is the government's responsibility to protect population health, to guarantee household incomes, and to safeguard the economy. Millions of households were in poverty before the pandemic, and millions more will be so unless the government continues to protect household incomes through policy change.

This study aims to examine the emotional and cognitive responses of frontline homelessness service support staff to the highly insecure attachment styles (AS) exhibited by people experiencing multiple exclusion homelessness (MEH), that is, a combination of homelessness and other forms of deep social exclusion.

Focus groups were conducted with frontline staff (N = 19) in four homelessness support services in Scotland. Hypothetical case vignettes depicting four insecure AS (enmeshed, fearful, withdrawn and angry-dismissive) were used to facilitate discussions. Data is analysed thematically.

Service users with AS characterised by high anxiety (enmeshed or fearful) often evoked feelings of compassion in staff. Their openness to accepting help led to more effective interactions between staff and service users. However, the high ambivalence and at times overdependence associated with these AS placed staff at risk of study-related stress and exhaustion. Avoidant service users (withdrawn or angry-dismissive) evoked feelings of frustration in staff. Their high need for self-reliance and defensive attitudes were experienced as hostile and dismissing. This often led to job dissatisfaction and acted as a barrier to staff engagement, leaving this group more likely to “fall through the net” of support.

Existing literature describes challenges that support staff encounter when attempting to engage with people experiencing MEH, but provides little insight into the causes or consequences of “difficult” interactions. This study suggests that an attachment-informed approach to care can promote more constructive engagement between staff and service users in the homelessness sector.

Equity is an issue that pervades all aspects of primary care provision for children and as such is a recurring theme in the Models of Child Health Appraised project. All European Union member states agree to address inequalities in health outcomes and include policies to address the gradient of health across society and target particularly vulnerable population groups. The project sought to understand the contribution of primary care services to reducing inequity in health outcomes for children. We focused on some key features of inequity as they affect children, such as the importance of good health services in early childhood, and the effects of inequity on children, such as the higher health needs of underprivileged groups, but their generally lower access to health services. This indicates that health services have an important role in buffering the effects of social determinants of health by providing effective treatment that can improve the health and quality of life for children with chronic disorders. We identified common risk factors for inequity, such as gender, family situation, socio-economic status (SES), migrant or minority status and regional differences in healthcare provision, and attempted to measure inequity of service provision. We did this by analysing routine data of universal primary care procedures, such as vaccination, age at diagnosis of autism or emergency hospital admission for conditions that can be generally treated in primary care, against variables of inequity, such as indicators of SES, migrant/ethnicity or urban/rural residency. In addition, we focused on the experiences of child population groups particularly at risk of inequity of primary care provision: migrant children and children in the state care system.

The purpose of this paper is to explore the emergence of “Roma health and wellbeing” as a focus of attention in European research and in policy and the possible detrimental consequences of action founded on a generic representation of “Roma health.”

Based on discussions with and research conducted by scholars who work directly with Roma communities across European regions from a wide range of academic disciplines it suggests how future research might inform: a more nuanced understanding of the causes of poor health and wellbeing among diverse Roma populations and; actions that may have greater potential to improve the health and wellbeing among these populations.

In summary, the authors promote three types of research: first critical analyses that unpick the implications of current and past representations of “Roma” and “Roma health.” Second, applied participatory research that meaningfully involves people from specific self-defined Roma populations to identify important issues for their health and wellbeing. Third, learning about processes that might impact on the health and wellbeing of Roma populations from research with other populations in similarly excluded situations.

The authors provide a multidisciplinary perspective to inform research that does not perpetuate further alienation and prejudice, but promotes urgent action to redress the social and health injustices experienced by diverse Roma populations across Europe.

Global evidence indicates that multiple structural, biological, and behavioural mechanisms link gender-based violence (GBV), HIV/HCV, and substance misuse among women and adolescent girls. The aim of this chapter is to briefly summarise and synthesise recent literature that examines the complex and bi-directional relationships among these epidemics in different populations of adolescent girls and women around the world. To inform this chapter, a selective search strategy was conducted, prioritising use of meta-analytic epidemiological studies and research on interventions and policies that address different aspects of the syndemic among women and girls who use drugs worldwide. The search targeted publications from 2015 to 2019 using PubMed, MEDLINE, and Google Scholar. The chapter highlights methodological and geographic gaps in existing policy, intervention, and implementation research and makes recommendations for strategies to tackle these gaps. It also identifies a continuum of multilevel evidence-based interventions that target the risk environments and key syndemic mechanisms linking these intersecting epidemics that have been found to be effective in reducing intimate partner violence and other forms of GBV, substance use, and HIV/HCV risks. This chapter also assesses inclusiveness of existing research and interventions for underserved and disproportionately affected populations, affecting adolescent girls, sexual minority women, and racial/ethnic minority women and identifies strategies to target gaps or disparities for these key affected populations. Finally, this chapter describes the gaps and opportunities that harm reduction programmes, medical settings, and other community organisations experience in implementing gender-responsive programmes and policies to redress these intersecting epidemics.