Social Contexts of Interventions

Question 1

CORNISH & CAMPBELL (2009): IMPORTANCE OF SOCIAL CONTEXTS FOR INTERVENTIONS

Answer 1

• 3 contexts to consider:
  1. SYMBOLIC CONTEXT
  2. MATERIAL-POLITICAL CONTEXT
  3. RELATIONAL-INSTITUTIONAL

Question 2

CORNISH & CAMPBELL (2009): SYMBOLIC CONTEXT

Answer 2

• refers to social ideas/identities “floating” around in social world in which we inhabit; aka. valorised/supported forms of masculinity/femininity
• very hard not to conform to particular identities; need to think how this limits/enables to people to change dif behs
• also about ideas (ie. stigma; in-group/out-group)

Question 3

CORNISH & CAMPBELL (2009): MATERIAL-POLITICAL CONTEXT

Answer 3

• refers to:
  1. what nature of livelihoods/poverty is like
  2. opportunities available in terms of work
  3. political movements
  4. ways in which power can shape opportunities

Question 4

CORNISH & CAMPBELL (2009): RELATIONAL-INSTITUTIONAL

Answer 4

• aspects (ie. social networks) at individual/group lvl (ie. community groups/institutions incl. government)
• opportunities/constraints that they put in place

Question 5

IMPACT OF SOCIAL CONTEXTS ON SGIs

Answer 5

• 3 broad ways:
  1. translation of learning; ideas into wider social world (aka. critique of SGIs)
  2. impacts delivery of SGIs

Question 6

GIBBS ET AL. (2019): WOMEN FOR WOMEN INTERNATIONAL TRIAL (BACKGROUND)

Answer 6

• Afghanistan experienced 40+ years of war
• clear links between conflict experience/settings & IPV experience/perpetration
• conflicy settings = particularly hard to work in

Question 7

GIBBS ET AL. (2019): WOMEN FOR WOMEN INTERNATIONAL TRIAL (INTERVENTION)

Answer 7

• ran 12 month combined economic/social empowerment intervention for groups of 25 women:
  1. rights based training
  2. numeracy/literacy/business skills
  3. stipend of $10/month
  4. referrals to other support (ie. health/business training/etc.)
• sought to evaluate whether intervantion could reduce IPV experienced & depressive symptoms

Question 8

GIBBS ET AL. (2019): BARRIERS TO TRANSFORMATION IN WFWI TRIAL

Answer 8

1. MATERIAL-POLITICAL BARRIERS
2. INSTITUTIONAL BARRIERS
3. SYMBOLIC BARRIERS

Question 9

GIBBS ET AL. (2019): BARRIERS TO TRANSFORMATION IN WFWI TRIAL (MATERIAL-POLITICAL BARRIERS)

Answer 9

• improvements in economic position seen
• livelihood improvements = not as strong as needed:
  1. livelihoods WEREN’T always appropriate (ie. animal husbandry)
  2. access to materials limited (ie. mushroom growing/spores)
  3. livelihoods = oft mediated by husband/family

Question 10

GIBBS ET AL. (2019): BARRIERS TO TRANSFORMATION IN WFWI TRIAL (INSTITUTIONAL BARRIERS)

Answer 10

• understood women’s rights
• limits to changes
• divorce laws meant women had to accept violence
• required male guardian to leave house

Question 11

GIBBS ET AL. (2019): BARRIERS TO TRANSFORMATION IN WFWI TRIAL (SYMBOLIC BARRIERS)

Answer 11

• confidence/ability to discuss issues w/husband increased
• limits to change:
  1. when husband disagreed -> quickly backed down
  2. change only possible within household system

Question 12

REED ET AL. (2013): HIV & SUBSTANCE INTERVENTION

Answer 12

• Women’s Health CoOp (WHC)
• short 2-session group intervention focused on:
  1. HIV-risks associated w/substance abuse; taught sexual/condom negotiation skills
  2. relationship power; building communication/negotiation skills; strategies avoiding violent situations
• WHC seen reductions in alcohol/violence experience

Question 13

REED ET AL. (2013): SOCIAL CONTEXTS SHAPING IMPACTS

Answer 13

• importance of groups/group bonding
• institutions:
  1. social connections to family important
  2. ending social connections linked to drug abuse BUT challenges
  3. needing to leave bfs if drug users BUT not if supportive change
• material political; employment opportunities (ie. offered other opportunities)

Question 14

STERK ET AL. (2003): HIV RISK REDUCTION AMONG AFRICAN-AMERICAN WOMEN WHO INJECT DRUGS

Answer 14

• HIV-risk reduction intervention; focused on individual African-American female frug users (mainly crack users)
• interventions used theory of planned beh + gender; power focused on social context of women’s lives
  INTERVENTION
• 4-session enhanced motivation intervention
• 4-session enhanced negotiation intervantion
• control NIDA standard of care
  OUTCOMES
• reduced drug use/sex work

Question 15

STERK ET AL. (2007): INDIVIDUAL ACTION & COMMUNITY CONTEXT (HEALTH INTERVENTION PROJECT)

Answer 15

• 65 in-depth interviews over study period
• impact of community on ability to change
  RESULTS
• gave up crack BUT changed social connections/daily life structure (ie. isolating themselves/establishing social connections/12-step programmes)
• changing HIV risk (ie. getting high w/fewer people in safe setting)
• sex work for drugs (ie. where reduced drugs also reduced sex in exchange for money/drugs; where not, no change)
• as started to make change in own lives; more frustrated about context they live in (aka. change social roles; limited roles available (mothers/drug users/poor women)

Question 16

CORNISH & CAMPBELL (2009): SOCIAL CONDITIONS FOR SUCCESSFUL PEER EDUCATION (SUMMERTOWN, SA)

Answer 16

• HIV-transmission among sex workers around mines
• peer group process led by nurse w/peer outreach workers
• multi-stakeholder group
• no impact on HIV-incidence
• peers never fully integrated

Question 17

CORNISH & CAMPBELL (2009): SOCIAL CONDITIONS FOR SUCCESSFUL PEER EDUCATION (SONAGACHI, INDIA)

Answer 17

• HIV-transmission in red-light area, Kolkata
• 12 sex worker peer educators
• moved beyond sex work peer groups to support everyday struggles w/clients/brothel owners
• sex worker led management group
• HIV-incidence/violence reduced

Question 18

CORNISH & CAMPBELL (2009): SUMMERTOWN V SONAGACH SUMMARY

Answer 18

• context = more supportive in Sonagachi (ie. relations stable; political precedents of empowerment)
• approach beyond biomedical (ie. community development & addressing wider social needs; narrowly biomedical approach)
• strategies for effective SGIs (address social factors driving disadvantage/poor health; involve communities; devise strategies & commit to social empowerment; engage stakeholders carefully)

Question 19

SUMMARY (SOCIAL CONTEXTS)

Answer 19

• positive individual change = hard to sustain outside of groups
• change requires sig shifts in identities:
  1. social relations need to change
  2. identities available to individuals = limited
  3. political-economic contexts = challenges
• strengthening SGIs may mean working explicitly to strengthen/address social contexts interventions work in

Question 20

CHRISTOFIDES ET AL. (2020): SONKE CHANGE TRIAL

Answer 20

• in urban informal settlements in South Africa; similar context as for SSCF
• Sonke Gender Justice (Sonke) focused on engaging men/boys:
  1. One Man Can: small group workshops
  2. advocacy/social mobilisation
• implemented 18+ months:
  1. core team implementing (7 people)
• small group workshops
  2. community action teams (CATs) volunteers
• discussion w/peers; mini-workshops; door-to-door activities
  3. local lvl advocacy

Question 21

INTERVENTION THEORY OF CHANGE

Answer 21

• SONKE workshops & outreach/community action teams/local advocacy ->
• enhanced critical consciousness + better social cohesion/trust + collective efficacy/action ->
• self-efficacy to take action + reduced adherence to harmful masculinity norms ->
• improbed mental health + better partner communication + reduction in harmful alcohol ->
• decreased IPV

Question 22

HATCHER ET AL. (2020): BARRIERS TO INTERVENTION IMPLEMENTATION

Answer 22

1. PHYSICAL SPACE IN URBAN INFORMAL SETTLEMENTS
2. WORKSHOPS CHALLENGING TO DELIVER
3. UNABLE TO BUILD CRITICAL CONSCIOUSNESS
4. VOLUNTEERS NOT AN OPTION
5. ADVOCACY WAS CO-OPTED

Question 23

HATCHER ET AL. (2020): BARRIERS TO INTERVENTION IMPLEMENTATION (PHYSICAL SPACE IN URBAN INFORMAL SETTLEMENTS)

Answer 23

• digital stories = aimed to promote/support people to change; DIDN’T occur
• street soccer = used to bring communities together; NOT possible
• open house = friends/family invited to discuss project themes together; NOT option

Question 24

HATCHER ET AL. (2020): BARRIERS TO INTERVENTION IMPLEMENTATION (WORKSHOPS CHALLENGING TO DELIVER)

Answer 24

• ended up using taverns
• limited private spaces for workshops
• pps = hungry

Question 25

HATCHER ET AL. (2020): BARRIERS TO INTERVENTION IMPLEMENTATION (UNABLE TO BUILD CRITICAL CONSCIOUSNESS)

Answer 25

- workshops = too short; few attended many - awareness raising achieved

Question 26

HATCHER ET AL. (2020): BARRIERS TO INTERVENTION IMPLEMENTATION (VOLUNTEERS NOT AN OPTION)

Answer 26

- high turnover as people migrated a lot - stipend not payment

Question 27

HATCHER ET AL. (2020): BARRIERS TO INTERVENTION IMPLEMENTATION (ADVOCACY = CO-OPTED)

Answer 27

- got involved in local government responses - hard to challenge & "make waves" - back-lash from identifying community

Question 28

GIBBS ET AL. (2015): SSCF

Answer 28

JOBS - people attended thinking it'd lead to jobs - attendence = challenge as people looked for jobs FOOD - provided during intervention - arguments about distribution of left-over food - food for children who attended sessions TAXIS - intervention in central town; public taxi ride away - though reimbused hard to borrow from neighbours to travel in - male partners' worried why women travelling in town JOURNALS - for self-reflection/notes - literacy; privacy (male partners)

Question 29

PAWSON & TILLEY (1997): CONTEXT-MECHANISM-OUTCOME

Answer 29

- realistic evaluation - suggest whether interventions work OR not need to focus on: 1. conceptualising conditions under which mechanisms may (not) work 2. interventions may work within given/positive conditions 3. interventions may not work if context does not support change - BUT... who does intervention work for? under what conditions? why?