Alice MacLean

Oh, what a tangled web we weave: experiences of doing ‘multiple perspectives’ research in families

It is not uncommon to explore the views of parents and children in qualitative research with families. Yet the implications and challenges of a multiple perspective approach often remain at a relatively taken‐for‐granted level. In this article we draw on our experience across a range of qualitative interview‐based projects, focusing in particular on two case studies, to illustrate the practical working out of the challenges posed by multiple perspective research in families. The implications of research with parents and children are discussed in relation to two themes – power and truth. This discussion reflects on the challenges and benefits of multiple perspective research at different points in the research process. It is not the intention of this article to try to provide definitive ‘answers’ to some of the challenges posed. Rather we aim to open up discussion by reflecting on a range of scenarios, offering suggestions based on our experience, and so, allow the reader to reflect on the particularities of their own research.

‘Coz football is what we all have’: masculinities, practice, performance and effervescence in a gender‐sensitised weight‐loss and healthy living programme for men

Abstract In this paper we use a social practice approach to explore mens experience of Football Fans in Training (FFIT), a group‐based weight management programme for men that harnesses mens symbolic attachment to professional football clubs to engage them in lifestyle change. FFIT is delivered by community coaches in clubs’ stadia and is gender‐sensitised in relation to context, content and style of delivery. Using a ‘toolkit’ of concepts from the work of Bourdieu, Goffman and Durkheim we analysed data from 13 focus group discussions with participants, and fieldwork notes from programme observations to investigate the appeal and success of FFIT, and how it worked to support change. Our analysis builds on our work on the importance of shared symbolic commitment to the football club and being with ‘men like me’ to understand how the interaction context facilitated ‘effervescent’ experiences. These experiences encouraged men to make changes to their diet and physical activity, talk about them, practice performing them and implement them in their lives. Thus a social practice approach illuminated the social processes through which lifestyle change was achieved, and we argue that it can deepen and enrich both intervention design and evaluation.

How robust is the evidence of an emerging or increasing female excess in physical morbidity between childhood and adolescence? Results of a systematic literature review and meta-analyses

For asthma and psychological morbidity, it is well established that higher prevalence among males in childhood is replaced by higher prevalence among females by adolescence. This review investigates whether there is evidence for a similar emerging female ‘excess’ in relation to a broad range of physical morbidity measures. Establishing whether this pattern is generalised or health outcome-specific will further understandings of the aetiology of gender differences in health. Databases (Medline; Embase; CINAHL; PsycINFO; ERIC) were searched for English language studies (published 1992–2010) presenting physical morbidity prevalence data for males and females, for at least two age-bands within the age-range 4–17 years. A three-stage screening process (initial sifting; detailed inspection; extraction of full papers), was followed by study quality appraisals. Of 11 245 identified studies, 41 met the inclusion criteria. Most (n = 31) presented self-report survey data (five longitudinal, 26 cross-sectional); 10 presented routinely collected data (GP/hospital statistics). Extracted data, supplemented by additional data obtained from authors of the included studies, were used to calculate odds ratios of a female excess, or female:male incident rate ratios as appropriate. To test whether these changed with age, the values were logged and regressed on age in random effects meta-regressions. These showed strongest evidence of an emerging/increasing female excess for self-reported measures of headache, abdominal pain, tiredness, migraine and self-assessed health. Type 1 diabetes and epilepsy, based on routinely collected data, did not show a significant emerging/increasing female excess. For most physical morbidity measures reviewed, the evidence broadly points towards an emerging/increasing female excess during the transition to adolescence, although results varied by morbidity measure and study design, and suggest that this may occur at a younger age than previously thought.

Symptoms of Mental Health Problems: Children's and Adolescents' Understandings and Implications for Gender Differences in Help Seeking.

Amidst concerns that young people’s mental health is deteriorating, it is important to explore their understandings of symptoms of mental health problems and beliefs around help seeking. Drawing on focus group data from Scottish school pupils, we demonstrate how they understood symptoms of mental health problems and how their characterisations of these symptoms as ‘rare’ and ‘weird’ informed participants’ perceptions that peers, teachers and parents would respond to disclosure in stigmatising ways. Consequently, participants suggested that they would delay or avoid disclosing symptoms of mental health problems. We highlight subtle gender and age differences and outline implications for policy and practice.

Hopes for the Future: Parents' and Children's Narratives of Children's Future Employment Orientations

‘What do you want to be when you grow up?’ is a question often asked of children yet little is known about how children and their parents think about their future in terms of employment. This paper, based on qualitative longitudinal research with 14 families, explores childrens and parents’ narratives about childrens employment futures, illuminating the values, social relations and structures through which such narratives are formed. The paper reflects on the extent to which childrens present lives are future orientated and the ways this future orientation manifests itself in everyday life. The findings highlight the hopes expressed by parents and the nature of parental influence in shaping their childrens futures. While childrens futures were not developed as precise plans, there were many ways in which they were being ‘planned’. Choices were expanded or narrowed and trajectories mapped out through parents’ and childrens hopes, dreams and assumptions for what the future would hold. This ‘planning’ was framed by the families’ individualised biographies and their socio-economic position.

Comparing the effectiveness of using generic and specific search terms in electronic databases to identify health outcomes for a systematic review: a prospective comparative study of literature search methods

Objective To compare the effectiveness of systematic review literature searches that use either generic or specific terms for health outcomes. Design Prospective comparative study of two electronic literature search strategies. The ‘generic’ search included general terms for health such as ‘adolescent health’, ‘health status’, ‘morbidity’, etc. The ‘specific’ search focused on terms for a range of specific illnesses, such as ‘headache’, ‘epilepsy’, ‘diabetes mellitus’, etc. Data sources The authors searched Medline, Embase, the Cumulative Index to Nursing and Allied Health Literature, PsycINFO and the Education Resources Information Center for studies published in English between 1992 and April 2010. Main outcome measures Number and proportion of studies included in the systematic review that were identified from each search. Results The two searches tended to identify different studies. Of 41 studies included in the final review, only three (7%) were identified by both search strategies, 21 (51%) were identified by the generic search only and 17 (41%) were identified by the specific search only. 5 of the 41 studies were also identified through manual searching methods. Studies identified by the two ELS differed in terms of reported health outcomes, while each ELS uniquely identified some of the reviews higher quality studies. Conclusions Electronic literature searches (ELS) are a vital stage in conducting systematic reviews and therefore have an important role in attempts to inform and improve policy and practice with the best available evidence. While the use of both generic and specific health terms is conventional for many reviewers and information scientists, there are also reviews that rely solely on either generic or specific terms. Based on the findings, reliance on only the generic or specific approach could increase the risk of systematic reviews missing important evidence and, consequently, misinforming decision makers. However, future research should test the generalisability of these findings.

Financial trajectories: how parents and children discussed the impact of the recession.

This paper presents findings from a qualitative longitudinal study which investigated processes of negotiation between parents and their primary school-aged children in addressing issues raised by working parenthood. Three waves of fieldwork were conducted with 14 families living in Scotland under differing socio-economic and labour market conditions. Individual interviews were conducted with parents and children at waves 1 and 3, while wave 2 entailed family interviews. Experiences of unfolding conditions of economic uncertainty and recession were explored with a focus on how families were making sense of these changes in terms of their personal projects, aims and challenges. The data revealed three types of recession experience and showed how, within each, notions of economising or adapting to changing economic circumstances were articulated and incorporated into everyday family practices to differing extents. The findings also demonstrate the importance of understanding families’ reactions to the recession against the backdrop of their financial histories and anticipated futures.

“It's not healthy and it's decidedly not masculine”: a media analysis of UK newspaper representations of eating disorders in males

Objectives Recent qualitative research found young men reporting that an expectation that eating disorders (EDs) mainly affect young women led them, and others, to only recognise their symptoms when their ED had become entrenched. This raises questions about how these stereotypes persist. We therefore explored how EDs in males were represented in articles published in UK newspapers over a 10-year period (7.12.2002–7.12.2012), specifically attending to whether newsprint media represent EDs in males as ‘gender appropriate’, ‘gender anomalous’ or ‘gender neutral’. Design A qualitative thematic analysis of UK newspaper articles. Methods We searched two databases, Newsbank and LexisNexis, for newspaper articles including ED and male terms in the lead/first paragraph. Following de-duplication, 420 articles were scrutinised; 138 met inclusion criteria for detailed textual analysis and were imported into NVivo10. Findings The number of articles peaked in 2008 when a UK politician announced that he had experienced bulimia nervosa. Analysis of how the articles portrayed male ED-related characterisations and experiences revealed that they conveyed ambiguous messages about EDs in males. Despite apparently aiming to dispel stereotypes that only young women experience EDs and to address stigma surrounding EDs in males, many aspects of the articles, including repetition of phrases such as ‘a young womans illness’, serve to reinforce messages that EDs are inherently ‘female’ and so ‘anomalous’ for men. Conclusions Newspaper articles represent men with EDs as atypical of men, as a result of having an ED (and any feminising or demasculinising characteristics associated with this), and as atypical of people with EDs, who are still usually portrayed as teenage girls. Such media representations frame a cultural paradigm in which there is an expectation that men may feel shame about or strive to conceal EDs, potentially contributing to men with EDs delaying help-seeking, gaining late access to treatments and reducing chances of successful outcomes.

Group-based healthy lifestyle workplace interventions for shift-workers: a systematic review

Objective Shift work is a risk factor for many chronic diseases and has been associated with unhealthy lifestyle behaviors. Workplaces have great potential for promoting and supporting behavior change. We conducted a systematic review of group-based lifestyle workplace interventions for shift workers to (i) identify adaptations and intervention components that accommodate shift working and (ii) assess their impact on weight, physical activity, sedentary behavior and healthy eating. Methods A systematic search was conducted in Scopus, Web of Knowledge, EBSCO and Ovid databases. Using pre-established criteria, independent pairs of researchers conducted the study selection, quality appraisal and data extraction. Results In total, 22 studies on group-based workplace interventions for shift workers were included. Many demonstrated organizational level adaptations, such as flexible delivery times and paying employees’ time for their involvement. Delivery locations near the workplace and management support were other key features. Common intervention components included competitive group activities, individualized goal setting, self-monitoring and feedback, staff involvement in intervention delivery, and incentives. There was moderate evidence for effectiveness on weight and physical activity outcomes, but insufficient evidence for healthy eating outcomes. No interventions focusing on sedentary behavior among shift workers were found. Conclusion Current evidence demonstrates that group-based workplace interventions can be effective for supporting shift workers to lose weight and increase physical activity, while further research is needed to change healthy eating and sedentary behaviors. Our findings offer decision support on organizational-level adaptations and intervention components that are important to make interventions that promote healthy lifestyles more accessible to shift workers.

Responsibility, Work and Family Life: Children’s and Parents’ Experiences of Working Parenthood

In the UK, more children than ever before are being brought up by parents who are engaged in some form of paid employment outside the home (Philo et al. 2008). This change has been met with interest by academics, policy-makers and indeed employers, with particular concern about how the demands of work and family are managed by parents and the impact this has on children’s lives. The challenges of reconciling the competing demands of paid work and family life on parents’ time have been acknowledged at a political level (OECD 2007) and research has offered insights into how the competing frameworks of work and family are constructed and managed by parents (Daly 2001, Cunningham-Burley et al. 2006, Backett-Milburn et al. 2008, Ba 2010). In particular it has been noted that working parents express a feeling of being ‘harried’ (Southerton and Tomlinson 2005), of being constantly busy (Brannen 2005) and of their time being ‘squeezed’ (Southerton 2003).