Co‐production in the epidemiological clinic: A decentred analysis of the tensions in community‐based,client‐facing risk work

Public health policies to prevent disease within populations are giving rise to shifting patterns of healthcare delivery in the late modern era. There is an inherent tension in modern medicine between evidence‐based standardisation, on the one hand, and patient‐centred specificity on the other. This tension manifests in recent policy narratives regarding public health risk (which we have characterised in terms of the epidemiological clinic) and co‐production. Drawing on co‐produced data with health trainers (lay health workers tasked with supporting behavioural change in patients at high risk of cardiovascular disease) in a deprived post‐industrial region of England, our decentred analysis focuses on three extended narratives from this data set. Our analysis builds on and develops emerging theories of risk work, informed by Habermas, and we explore the extent to which elite narratives of public health risk are resisted, absorbed, or bracketed off by client‐facing health workers—emphasising the heterogeneity of responses—and locate these responses within the context of the workers' employment conditions, their embodied experiences, and their wider beliefs and traditions. We argue that co‐production—albeit in a highly constrained form—is possible while delivering public health interventions. However, in the context of a community where health is so adversely affected by wider social problems and where task shifting has drawn lower status healthcare workers into these client‐facing roles, workers must find their own ways to negotiate and attempt to reconcile this context with the risk‐framed practices they are required to carry out.     

Co‐producing Approaches to the Management of Dementia through Social Prescribing

A promising approach to the management of dementia is ‘social prescribing’. Social prescribing is a form of ‘co‐production’ that involves linking patients with non‐clinical activities, typically delivered by voluntary and community groups, in an effort to improve their sense of well‐being. The success of social prescribing depends upon the ability of boundary‐spanning individuals within service delivery organizations to develop referral pathways and collaborative relationships through ‘networks’. This article examines the operation of a pilot social prescribing programme in the North East of England, targeted at older people with early onset dementia and depression, at risk of social isolation. It is argued that the scheme was not sustained, in part, because the institutional logics that governed the actions of key boundary‐spanning individuals militated against the collaboration necessary to support co‐production.     

Context and Age Differences in Same‐ and Other‐gender Peer Preferences

Age and gender differences in preferences for same‐ and other‐gender peers as partners for working on a school project and casual interactions at home were investigated. Participants were 82 students (19 sixth‐grade preadolescents; 29 eighth‐grade adolescents; 34 tenth‐ and eleventh‐grade older adolescents). Same‐gender preferences were assessed via peer nominations and ratings of expected enjoyment of interacting with same‐ and other‐gender peers. Preferences varied by context: individuals expected to enjoy same‐gender peers more than other‐gender peers when working on a project at school but not when interacting casually at home. Greater expected enjoyment of same‐gender peers over other‐gender peers was most pronounced for preadolescent boys and girls, and least pronounced for older adolescent males. Nominations of same‐gender peers for home and school activities decreased with age. Results are interpreted in light of a social‐contextual approach to gender segregation.     

Activation Reform and Inter‐Agency Co‐operation – Local Consequences of Mixed Modes of Governance in Sweden

Organizational reform has become a recurring solution to problems of social exclusion and unemployment. In Europe, and other parts of the world, there is a trend towards policies of ‘activation’ in employment and social policy. The idea of flexible, individualized and tailor‐made services is coupled with managerial and market‐based reforms as well as collaborative governance. In these complex structures of service provision, coordination and inter‐agency co‐operation have become key concerns. Based on a study of a recent reform of programmes for newly arrived refugees in Sweden (Etableringsreformen), this article seeks to contribute to the literature on governance of ‘activation’ by examining the consequences of mixed modes of governance (market and collaborative) on local inter‐agency co‐operation. Drawing on data from in‐depth case studies in two municipalities, it is demonstrated how the coupling of managerial practices and quasi‐markets with existing collaborative arrangements has created barriers for inter‐agency co‐operation. The results indicate that institutional tensions between governance forms represent an important factor for explaining governance failure in this policy area.     

Predicting Children's Prosocial and Co‐operative Behavior from Their Temperamental Profiles: A Person‐centered Approach

The goal of this study was to examine how aspects of self‐regulation and negative emotionality predicted children's co‐operative and prosocial behavior concurrently and longitudinally using the National Institute of Child Health and Human Development (NICHD) Study of Early Child Care and Youth Development. Mothers completed measures of children's temperamental proneness to negative emotionality and self‐regulation at 54 months. Teachers and parents completed measures of children's co‐operative and prosocial behavior at 54 months, first grade, and third grade. A latent profile analysis of the temperamental variables revealed four profiles of children: those high in regulation and low in negative emotionality, those moderate in regulation and moderate in negative emotionality, those low in regulation and high in negative emotionality, and finally those who were very low in regulation but high in anger emotionality. Generally, children with profiles that were high or moderate in terms of regulation and low or moderate in terms of negative emotionality were rated as the most prosocial and co‐operative. Children with profiles that were less well regulated and who were high in negative emotionality (particularly anger proneness) were rated as less co‐operative and prosocial by parents and teachers.     

Co‐occurrence of and cross‐informant agreement on shyness,unsociability, and social avoidance during early adolescence

We investigated the co‐occurrence of and cross‐informant agreement on early adolescents’ shyness, unsociability, and avoidance measured by self‐ and peer reports for fifth to eighth graders (N = 383; 51% male) in the United States. Avoidance was significantly and positively associated with shyness and unsociability based on peer reports and self‐reports. Furthermore, 45% and 30% of peer‐ and self‐reported withdrawn adolescents had multiple motivations for withdrawal, suggesting prevalent co‐occurrence of withdrawal subtypes. Cross‐informant agreement was moderate for shyness and weak for unsociability and avoidance. We draw attention to the complexity of motivations underlying withdrawal, theorize about subtype co‐occurrence, and discuss challenges and opportunities related to peer‐reported unsociability and avoidance.     

Co‐production,governance and practice: The dynamics and effects of User Voice Prison Councils

Drawing on Bevir's (2013) decentered theory of governance, and Donati's (2016) theory of the relational subject, this article explores how User Voice Prison Councils in England have contributed to shifts in aspects of prison governance and practice. It discusses the cultural and policy context in which the Councils emerged and operate before exploring their perceived purposes, dynamics, and effects. User Voice Prison Councils represent an important example of different actors co‐producing alternative patterns of governance through innovations in democratic participation. Interviews with Prison Council participants, User Voice and prison staff revealed that the development of such “bottom–up” participatory governance practices require and restore interpersonal trust, the mechanisms of which are interactions underpinned by a distinct manner of relating and the establishment of a network of relations oriented to the common good. The effects include enhanced institutional legitimacy; improvements in prison officer‐prisoner relations; and greater quality of life for prisoners. Revealing the “how” of co‐production, from the “inside”, the argument advanced here is that while the effects of co‐production may be more ameliorative than transformative, such collaborative and dialogic approaches can enable differently situated people to forge new norms of interactions and forms of democratic participation to achieve collective goals.     

How I am Constructing Culture‐inclusive Theories of Social‐psychological Process in our Age of Globalization

Accepting Cole's the premise that, “cultural‐inclusive psychology has been … an elusive goal” (1996, pp. 7–8) but one worth striving to attain, I first set out to identify my domain of interest and competence as an intellectual. Deciding it to be social interaction between individuals, I then searched out theoretical approaches to this domain that encompassed as many approaches to this trans‐historical concern that have emerged from cultural traditions bequeathing us their legacies. Doing this search comprehensively required me to move outside my Judeo‐Christian, Greco‐Roman, Renaissance heritage and its international diffusion via the European Empires since the 1500's, embodied most recently the American dominance of intellectual discourse since the Second World War. In my case, this journey has taken me in to Chinese culture and psychology where I have worked towards integrating the Chinese worldview and its psychological measures into the discipline of social psychology. Striving for a more inclusive culture‐view, I am now using multi‐cultural data bases to transcend this two‐cultural focus and incorporate wider measures of cultural variation into our theorizing and empirical validation of universal models for social interaction. This paper describes my current procedures for such culture‐mapping.