Nick Emmel

Accessing Socially Excluded People — Trust and the Gatekeeper in the Researcher-Participant Relationship

This paper describes methodological findings from research to recruit and research hard-to-reach socially excluded people. We review the ways in which researchers have used particular strategies to access hard-to-reach individuals and groups and note that little attention has been given to understanding the implications of the nature of the trust relationship between researcher and participant. Gatekeepers invariably play a role in accessing socially excluded people in research, yet discussion to date invariably focuses on the instrumental role gatekeepers play in facilitating researchers’ access. In this paper we explore the possibilities for analysing relationships in terms of trust and distrust between gatekeeper and socially excluded participant. Our analysis considers the different kinds of relationships that exist between gatekeepers and socially excluded people and, in particular, the relationships of power between gatekeepers and socially excluded people. Insights into the nature of trust among socially excluded people will also be considered. Finally, we discuss how size and use of social networks among socially excluded groups and perceptions of risk in interactions with gatekeepers are important to understanding the possibilities for trustful relationships, and for meaningful and successful access for researchers to socially excluded individuals and groups.

‘Recession, it's all the same to us son’: the longitudinal experience (1999–2010) of deprivation

This paper reports on qualitative longitudinal research exploring deprivation in a low-income estate between 1999 and 2010. It draws on data from three studies and a continued engagement with participants between these studies. The paper explores the lived experience of deprivation in households, the interdependencies between households, and the experience of service provision to address basic need. A longitudinal social space of vulnerability is described that considers the effects of multiple deprivation, limited resilience, and (in)appropriate service provision. It further considers the impact of the most recent recession (from 2008 onwards) and concludes that its effects are eclipsed by earlier recessions.

Can “realist” randomised controlled trials be genuinely realist?

In this paper, we respond to a paper by Jamal and colleagues published in Trials in October 2015 and take an opportunity to continue the much-needed debate about what applied scientific realism is. The paper by Jamal et al. is useful because it exposes the challenges of combining a realist evaluation approach (as developed by Pawson and Tilley) with the randomised controlled trial (RCT) design.We identified three fundamental differences that are related to paradigmatic differences in the treatment of causation between post-positivist and realist logic: (1) the construct of mechanism, (2) the relation between mediators and moderators on one hand and mechanisms and contexts on the other hand, and (3) the variable-oriented approach to analysis of causation versus the configurational approach.We show how Jamal et al. consider mechanisms as observable, external treatments and how their approach reduces complex causal processes to variables. We argue that their proposed RCT design cannot provide a truly realist understanding. Not only does the proposed realist RCT design not deal with the RCT’s inherent inability to “unpack” complex interventions, it also does not enable the identification of the dynamic interplay among the intervention, actors, context, mechanisms and outcomes, which is at the core of realist research. As a result, the proposed realist RCT design is not, as we understand it, genuinely realist in nature.

Themes, variables, and the limits to calculating sample size in qualitative research: a response to Fugard and Potts

Andrew Fugard and Henry Potts’ paper joins a small number of papers that seek to justify sample size through counting themes. Unlike the other two papers I can think of, Guest and colleagues and Fr...

Health system decentralisation in Nepal: identifying the issues

PURPOSE The purpose of this paper is to describe and discuss policy analysis in Nepal and review the wide range of choices feasible in decentralisation decision making. DESIGN/METHODOLOGY/APPROACH In this paper an iterative qualitative method was developed and used in the research, which consisted of focus group interviews, key informant interviews, document analysis, including descriptive statistics, and analysis of the policy context. Participants in the research reflected the urban/rural mix of districts and the geography of Nepal. Analysis combined transcribed interviews with findings from document searches and analysis of the policy context. Coding was pre-determined during the training workshop and further codes were generated during and after the fieldwork. FINDINGS The paper finds that Nepal is in the process of decentralising public services from the central level to the local level, particularly to local bodies: District Development Committees (DDCs), Village Development Committees (VDCs) and Municipalities. Key contextual factors referred to are the overall structure of decentralisation, the social context of poverty and the political instability leading to a fluid political situation characterised by political tension, armed conflict, controversies and agreements while carrying out the research. The key issues identified and discussed in the paper are the policy process leading to decentralisation, the organisational structure and tension in the proposed system, the systems of resource generation, allocation, planning and management and lastly the forms of accountability, participation, public-private relations and collaborative strategies. ORIGINALITY/VALUE The paper discusses the challenges faced in conducting such a policy analysis, the broad ranging and unremitting nature of the decentralisation process, and the contextual setting of the process of change.

Using indigenous proverbs to understand social knowledge and attitudes to leprosy among the Yoruba of southwest Nigeria

Following a systematic analysis of 23 proverbs obtained from ethnographic research and from literature searches, this article presents the cultural knowledge and attitudes about leprosy in Yorubaland, southwest Nigeria. Our analysis indicates that contrary to fragmentary evidence portraying Yoruba attitudes to leprosy as entirely negative, there is a mixed pattern of social responses to leprosy which range from drastic exclusion to empathy and acceptance of people affected by leprosy. We show that there is sufficient evidence to demonstrate that leprosy related proverbs are used both as channels of social control and as mediums of knowledge production about leprosy. The fact that social interactions are saturated with metaphorical language in Yoruba culture makes the analysis of proverbs a valuable tool for identifying aspects of social discourse that influence stigmatization of disabled people. An interesting discovery of this research is that modern technology and social networking sites such as Facebook provide a new forum for the dissemination and preservation of proverbs and this article shows that proverbs are not part of an unchanging past but instead part of contemporary understandings of the world.

Vulnerability, Intergenerational Exchange and the Conscience of Generations

In this chapter, we are concerned with grandparents between 35 and 55 years old. The grandparents’ experiences reported here are all firmly positioned in a group recently labelled the precariat (Standing 2011); a group churning between low-paid low-skilled employment, underemployment and unemployment (Shildrick et al. 2012) and characterized by high levels of insecurity on all measures of economic, social and cultural capital (Savage et al. 2013). This is a relatively large social class and our focus in this chapter is an important minority of excluded low-income grandparents and their families. Grandparents in the UK are getting older, reflecting increasing life expectancies. There are, however, approximately 1.5 million grandparents under the age of 50 years. Furthermore, investigation by Grandparents Plus (2009) of the difference in age of grandparents reveals important divergence between socioeconomic groups. Women from a working-class background are four times more likely to become a grandmother before their 50th birthday when compared with middle-class groups.