Social Network Analysis

Process evaluation is an essential part of designing and testing complex interventions. New MRC guidance provides a framework for conducting and reporting process evaluation studies

https://www.bmj.com/content/bmj/350/bmj.h1258.full.pdf

Process evaluation of complex interventions: Medical Research Council guidance

Such diverse thinkers as Lao-Tze, Confucius, and U.S. Defense Secretary Donald Rumsfeld have all pointed out that we need to be able to tell the difference between real and assumed knowledge. The systematic review is a scientific tool that can help with this difficult task. It can help, for example, with appraising, summarising, and communicating the results and implications of otherwise unmanageable quantities of data. This is important because quite often there are so many studies, and their results are often so conflicting, that no policymaker or practitioner could possibly carry out this task themselves.Systematic review methods have been widely used in health care, and are becoming increasingly common in the social sciences (fostered, for example, by the work of the Campbell Collaboration). 

This book outlines the rationale and methods of systematic reviews, giving worked examples from social science and other fields. It requires no previous knowledge, but takes the reader through the process stage by stage. It draws on examples from such diverse fields as psychology, criminology, education, transport, social welfare, public health, and housing and urban policy, among others.The book includes detailed sections on assessing the quality of both quantitative, and qualitative research; searching for evidence in the social sciences;meta-analytic and other methods of evidence synthesis; publication bias; heterogeneity; and approaches to dissemination.

Systematic Reviews in the Social Sciences: A Practical Guide

Mind, Self and Society from the Standpoint of a Social Behaviorist

Qualitative research methods have a long history in the social sciences and deserve to be an essential component in health and health services research. Qualitative and quantitative approaches to research tend to be portrayed as antithetical; the aim of this series of papers is to show the value of a range of qualitative techniques and how they can complement quantitative research.

Medical advances, increasing specialisation, rising patient expectations, and the sheer size and diversity of health service provision mean that today's health professionals work in an increasingly complex arena. The wide range of research questions generated by this complexity has encouraged the search for new ways of conducting research. The rapid expansion of research on and about health and health services, and the relatively recent demarcation of a distinct field of “health services research” depend heavily on doctors and other health professionals being investigators, participants, and peer reviewers. Yet some of the most important questions in health services concern the organisation and culture of those who provide health care, such as why the findings of randomised controlled trials are often difficult to apply in day to day clinical practice. The social science methods appropriate to studying such phenomena are very different from the methods familiar to many health professionals.

Although the more qualitative approaches found in certain of the social sciences may seem alien alongside the experimental, quantitative methods used in clinical and biomedical research, they should be an essential component of health services research--not just because they enable us to access areas not amenable to quantitative research, such as lay and professional health beliefs, but also because qualitative description is a prerequisite of good quantitative research, particularly in areas that have received little previous investigation. A good example of this is the study of the social consequences of the …

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Reaching the parts other methods cannot reach: an introduction to qualitative methods in health and health services research.

Smoking prevalence is higher among disadvantaged groups, and disadvantaged smokers may face higher exposure to tobacco's harms. Uptake may also be higher among those with low socioeconomic status (SES), and quit attempts are less likely to be successful. Studies have suggested that this may be the result of reduced social support for quitting, low motivation to quit, stronger addiction to tobacco, increased likelihood of not completing courses of pharmacotherapy or behavioral support sessions, psychological differences such as lack of self-efficacy, and tobacco industry marketing. Evidence of interventions that work among lower socioeconomic groups is sparse. Raising the price of tobacco products appears to be the tobacco control intervention with the most potential to reduce health inequalities from tobacco. Targeted cessation programs and mass media interventions can also contribute to reducing inequalities. To tackle the high prevalence of smoking among disadvantaged groups, a combination of tobacco control measures is required, and these should be delivered in conjunction with wider attempts to address inequalities in health.

Socioeconomic status and smoking: a review

Nice girls don't smoke 





When the Irish born American femme fatale Lola Montez had her photograph taken at a Boston studio in 1851, neither she nor anyone else could foresee the future symbolic value of the cigarette as a sign of emancipation for women and the tragic development that we are now facing with women as the next wave of the tobacco epidemic. With the dress and hairstyle that she was wearing in the photograph Lola Montez could have passed for a lady, if it wasn't for the cigarette which stood out so effectively against her black gloved hand (fig 1). Used as the focal point of this picture, the cigarette was intended to be provocative. Ladies in 1851 did not smoke, and the very notion that women and girls might be experimenting with cigarettes was certainly not acknowledged publicly. Indeed smoking by women in North America and Europe had long been associated with loose morals and dubious sexual behaviour. As far back as the 17th century Dutch painters had used tobacco and smoking to symbolise human folly. The only women shown smoking in these paintings were either whores or procuresses.1 Similarly in the 19th century women smokers were viewed as fallen women, with smoking the occupational symbol of prostitution.2 Indeed cigarettes became a common prop in Victorian erotic photography.3 Only rebellious, bohemian intellectuals and artists such as George Sands dared challenge these social mores. So widespread was the social stigma attached to women smoking that as late as 1908 a woman in New York was arrested for smoking a cigarette in public,2 and in 1921 a bill was proposed in the US Congress to ban women from smoking in the District of Columbia.4



Figure 1 
Lola Montez.



It is therefore remarkable that within 50 years of …

https://tobaccocontrol.bmj.com/content/tobaccocontrol/9/1/3.full.pdf

From social taboo to “torch of freedom”: the marketing of cigarettes to women

Objective We updated and expanded a previous systematic literature review examining the impact of tobacco control interventions on socioeconomic inequalities in smoking. Methods We searched the academic literature for reviews and primary research articles published between January 2006 and November 2010 that examined the socioeconomic impact of six tobacco control interventions in adults: that is, price increases, smokefree policies, advertising bans, mass media campaigns, warning labels, smoking cessation support and community-based programmes combining several interventions. We included English-language articles from countries at an advanced stage of the tobacco epidemic that examined the differential impact of tobacco control interventions by socioeconomic status or the effectiveness of interventions among disadvantaged socioeconomic groups. All articles were appraised by two authors and details recorded using a standardised approach. Data from 77 primary studies and seven reviews were synthesised via narrative review. Results We found strong evidence that increases in tobacco price have a pro-equity effect on socioeconomic disparities in smoking. Evidence on the equity impact of other interventions is inconclusive, with the exception of non-targeted smoking cessation programmes which have a negative equity impact due to higher quit rates among more advantaged smokers. Conclusions Increased tobacco price via tax is the intervention with the greatest potential to reduce socioeconomic inequalities in smoking. Other measures studied appear unlikely to reduce inequalities in smoking without specific efforts to reach disadvantaged smokers. There is a need for more research evaluating the equity impact of tobacco control measures, and development of more effective approaches for reducing tobacco use in disadvantaged groups and communities.

https://tobaccocontrol.bmj.com/content/tobaccocontrol/23/e2/e89.full.pdf

Impact of tobacco control interventions on socioeconomic inequalities in smoking: review of the evidence

Smoking kills over half a million women each year and is the most important preventable cause of female premature death in several developed countries. However, in many countries, cigarette smoking still tends to be regarded as a mainly male problem.This paper explores the reasons why more attention needs to be paid to issues around smoking and women, even in countries which currently have low levels of female cigarette smoking.The article includes an overview of current patterns and trends of smoking among women, and the factors which influence smoking uptake and cessation in women compared to men.The experience of countries with the longest history of widespread female smoking is used to identify some of the key challenges facing developed and developing countries.Tobacco companies have identified women as a key target group, therefore particular attention is given to the ways in which they have attempted to reach women through advertising and other marketing strategies. It is concluded that in order to halt and ultimately reverse the tobacco epidemic among women, tobacco control policies need to encompass both gender-specific and gender-sensitive approaches. Examples are given of the types of action that are needed in relation to research, public policy and legislation, and education.

Amanda Amos

Papers

Socioeconomic status and smoking: a review

From social taboo to “torch of freedom”: the marketing of cigarettes to women

Impact of tobacco control interventions on socioeconomic inequalities in smoking: review of the evidence

Women and smoking

Impact of Tobacco Control Interventions on Socioeconomic Inequalities in Smoking