scholarly journals The power-trust cycle in global health: Trust as belonging in relations of dependency

2021 ◽  
pp. 1-21
Author(s):  
Emma-Louise Anderson ◽  
Laura Considine ◽  
Amy S. Patterson

Abstract Trust between actors is vital to delivering positive health outcomes, while relationships of power determine health agendas, whose voices are heard and who benefits from global health initiatives. However, the relationship between trust and power has been neglected in the literatures on both international politics and global health. We examine this relationship through a study of relations between faith based organisations (FBO) and donors in Malawi and Zambia, drawing on 66 key informant interviews with actors central to delivering health care. From these two cases we develop an understanding of ‘trust as belonging’, which we define as the exercise of discretion accompanied by the expression of shared identities. Trust as belonging interacts with power in what we term the ‘power-trust cycle’, in which various forms of power undergird trust, and trust augments these forms of power. The power-trust cycle has a critical bearing on global health outcomes, affecting the space within which both local and international actors jockey to influence the ideologies that underpin global health, and the distribution of crucial resources. We illustrate how the power-trust cycle can work in both positive and negative ways to affect possible cooperation, with significant implications for collective responses to global health challenges.

2021 ◽  
pp. 000312242199668
Author(s):  
Patricia Homan ◽  
Amy Burdette

An emerging line of research has begun to document the relationship between structural sexism and health. This work shows that structural sexism—defined as systematic gender inequality in power and resources—within U.S. state-level institutions and within marriages can shape individuals’ physical health. In the present study, we use a novel dataset created by linking two nationally representative surveys (the General Social Survey and the National Congregations Study) to explore the health consequences of structural sexism within another setting: religious institutions. Although religious participation is generally associated with positive health outcomes, many religious institutions create and reinforce a high degree of structural sexism, which is harmful for health. Prior research has not reconciled these seemingly conflicting patterns. We find that among religious participants, women who attend sexist religious institutions report significantly worse self-rated health than do those who attend more inclusive congregations. Furthermore, only women who attend inclusive religious institutions exhibit a health advantage relative to non-participants. We observe marginal to no statistically significant effects among men. Our results suggest the health benefits of religious participation do not extend to groups that are systematically excluded from power and status within their religious institutions.


2021 ◽  
pp. 001789692110164
Author(s):  
Rachel E Riggs

Objective: Sexual assault victims often do not disclose their assaults or seek positive health outcomes. The RAINN Survivor Stories project shares testimonials in the form of online blogs from sexual assault survivors to motivate and encourage others to come forward and disclose their assaults. This study aimed to better understand the themes present in the survivor stories to motivate victims to disclose their assaults and seek positive health outcomes. Design: A theoretical thematic analysis was conducted on blog posts created for the project to identify (a) how the posts tell survivor stories and (b) how the posts model positive health outcomes using social cognitive theory and the disclosure processes model as a guide. Setting: Online setting linked to the rainn.org website. Method: Blog posts were collected for inductive thematic analysis. Themes were identified based on their prevalence in the data and their pertinence to the research questions. Results: Emerging themes included (a) overcoming initial disclosure, (b) overcoming the lasting effects of victimisation, (c) utilising support and (d) advocating for others after assault. Conclusion: Findings offer insight to researchers and practitioners creating media messages for sexual assault victims and other stigmatised groups by expanding understanding of modelled positive health outcomes in media and the disclosure process of victims.


Author(s):  
Wendell C. Taylor

The study of sedentary behaviors requires taxonomies (classification schemes) to standardize data collection, measurements, and outcomes. Three taxonomies of sedentary behaviors have been identified, but none address an important challenge in sedentary behavior research, which is to distinguish between beneficial and detrimental health effects of various sedentary behaviors. Some sedentary behaviors (e.g., reading) are associated with positive health outcomes, whereas other sedentary behaviors (e.g., television viewing) are associated with adverse health outcomes. To address directly this complexity and present a different conception and understanding of discrepant findings related to health outcomes, a new taxonomy is needed. The development of the new taxonomy is guided by analysis of literature and selection of a relevant and informative behavioral sciences theoretical framework (i.e., self-determination theory). Because older adults are an increasing percentage of the population and report a high prevalence of sedentary behaviors, the new taxonomy was designed for older adults with potential application to all age groups. Taylor’s taxonomy of sedentary behaviors is parsimonious with four domains: social interaction (i.e., not solitary, companionship, interacting, and connecting with others); novelty (i.e., refreshingly new, unusual, or different); choice (i.e., volition, preferred option or alternative, the power, freedom, or decision to choose); and cognition (i.e., mentally stimulating and engaging).


Author(s):  
Agnes Binagwaho ◽  
Miriam F. Frisch ◽  
Kelechi Udoh ◽  
Laura Drown ◽  
Jovial Thomas Ntawukuriryayo ◽  
...  

Success in the implementation of evidence-based interventions (EBIs) in different settings has had variable success. Implementation research offers the approach needed to understand the variability of health outcomes from implementation strategies in different settings and why interventions were successful in some countries and failed in others. When mastered and embedded into a policy and implementation framework, the application of implementation research by countries can provide policy-makers and implementers with the knowledge necessary to work towards universal health coverage (UHC) with the effectiveness, efficiency, sustainability, and fidelity needed to achieve sustainable positive health outcomes for all. To achieve this goal however, work is needed by the communities of research producers and consumers to create more clarity on implementation research methodologies and to build capacity to apply them as a critical tool for countries on their path to achieving UHC.


2007 ◽  
Vol 59 (4) ◽  
pp. 272-285 ◽  
Author(s):  
Chris Alappat ◽  
Gary Siu ◽  
Aaron Penfold ◽  
Brendan McGovern ◽  
Jennifer McFarland ◽  
...  

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