Developing new community health roles: can reflective learning drive professional practice?

Lindsey Dugdill, Margaret Coffey, Anne Coufopoulos, Kate Byrne, Lorna Porcellato

Research output: Contribution to journalArticle

Abstract

A variety of new non-professional roles, such as health trainers and community food workers, have evolved from recent UK public health policy developments. These roles predominantly operate in communities characterised by extreme social deprivation. Their remit is to offer local people support to help change lifestyle ‘choices’, for example, healthy eating or drinking responsibly. However, encouraging people to change health-related behaviour often ignores the underlying social determinants of health related behaviour. Health trainers and community food workers have been identified as being able to bridge the gap between the health professional and lay person, because of their ability to identify with local people. The challenges faced by these non-professionals, working at the coal-face of communities, and in a new and evolving role, are as yet poorly understood and this paper details the mechanism of reflective learning adopted by these practitioners in order to explore the professional practices involved. Emergent issues faced by these new practitioners include: understanding the boundaries between the trainer role and other health services; and the issues raised by the community, for example, presenting with non-health reasons such as financial crisis, which the trainers were often unprepared to deal with, rather than ‘lack of health skills’ (e.g. cooking skills). This paper explores how reflective learning processes can deconstruct the experiences of this ‘new level of the health workforce’ who have on the one hand the sensibility and sensitivity to develop relationships with individuals and households in poorer communities, yet are ill equipped to deal with the wider structural factors often determining behaviour.
Original languageEnglish
Pages (from-to)121-130
JournalReflective Practice
Volume10
Issue number1
DOIs
Publication statusPublished - 2009

Fingerprint

Professional Practice
Reflective Learning
Health
Food
Workers
Health Professionals
Cooking
Financial Crisis
Drinking
Learning Process
Person
Public Health Policy
Workforce
Lifestyle
Deprivation
Household
Health Services
Sensibility

Keywords

  • health trainers
  • community food workers
  • professional practice

Cite this

Dugdill, Lindsey ; Coffey, Margaret ; Coufopoulos, Anne ; Byrne, Kate ; Porcellato, Lorna. / Developing new community health roles: can reflective learning drive professional practice?. In: Reflective Practice. 2009 ; Vol. 10, No. 1. pp. 121-130.
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abstract = "A variety of new non-professional roles, such as health trainers and community food workers, have evolved from recent UK public health policy developments. These roles predominantly operate in communities characterised by extreme social deprivation. Their remit is to offer local people support to help change lifestyle ‘choices’, for example, healthy eating or drinking responsibly. However, encouraging people to change health-related behaviour often ignores the underlying social determinants of health related behaviour. Health trainers and community food workers have been identified as being able to bridge the gap between the health professional and lay person, because of their ability to identify with local people. The challenges faced by these non-professionals, working at the coal-face of communities, and in a new and evolving role, are as yet poorly understood and this paper details the mechanism of reflective learning adopted by these practitioners in order to explore the professional practices involved. Emergent issues faced by these new practitioners include: understanding the boundaries between the trainer role and other health services; and the issues raised by the community, for example, presenting with non-health reasons such as financial crisis, which the trainers were often unprepared to deal with, rather than ‘lack of health skills’ (e.g. cooking skills). This paper explores how reflective learning processes can deconstruct the experiences of this ‘new level of the health workforce’ who have on the one hand the sensibility and sensitivity to develop relationships with individuals and households in poorer communities, yet are ill equipped to deal with the wider structural factors often determining behaviour.",
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author = "Lindsey Dugdill and Margaret Coffey and Anne Coufopoulos and Kate Byrne and Lorna Porcellato",
note = "Birmingham Community Nutrition and Dietetic Department. (2005). Birmingham Food Net evaluation report. Birmingham: Birmingham Community Nutrition and Dietetic Department. British Psychological Society Health Psychology Team. (2008). Improving health: Changing behaviour, NHS health trainer handbook. London: Department of Health. Chivers, G. (2003). Utilising reflective practice interviews in professional development. Journal of European Industrial Training, 27(1), 5–15. Department of Health. (2004). Choosing health: Making healthy choices easier. Norwich: The Stationary Office. Department of Health. (2006). Our health, our care, our say: A new direction for community services. Norwich: The Stationary Office. Department of Health. (2008). High quality care for all. Norwich: The Stationary Office. Fleming, P. (2007). Reflection – a neglected art in health promotion. Health Education Research, 22(5), 658–664. Ghaye, T. (2005). Developing the reflective healthcare team. Oxford: Blackwell Publishing. Gomm, R., Needham, G., & Bullman, A. (2000). Evaluating research in health and social care. London: The Open University, published in association with Sage Publications. H{\o}yrup, S. (2004) Reflection as a core process in organisational learning. The Journal of Workplace Learning, 16(8), 442–454. Jivan, S., Horsley, K., & Bayliss, E. (2005). Engaging hard-to-reach groups in primary health care. London: Social Action for Health. Kennedy, L.A., Milton, B., & Bundred, P. (2008). Lay food and health worker involvement in community nutrition and dietetics in England: Roles, responsibilities and relationships with professionals. Journal of Human Nutrition and Dietetics, 21, 210–224. Kenny, L.J., Dugdill, L., & Springett, J. (1998). Doing evaluation: A framework for action. Liverpool John Moores University: Institute of Health. Downloaded By: [A E Cross] At: 16:57 13 February 2009 130 L. Dugdill et al. Marks, D.F. (2002). Perspectives on evidence-based practice. Retrieved 15 May 2008 from http://www.nice.org.uk/niceMedia/pdf/persp_evid_dmarks.pdf Marmot, M., (2001). A social view of health and disease. In T. Heller, R. Muston, M. Sidell & C. Lloyd (Eds), Working for Health (pp. 55–68). London: The Open University/Sage. Netherwood, M. (2007) Will health trainers reduce inequalities in health? British Journal of Community Nursing, 12(10), 463–468. South, J., Woodward, J., & Lowcock, D. (2007). New beginnings: Stakeholder perspectives on the role of health trainers. The Journal of the Royal Society for the Promotion of Health, 127(5), 225–230. Springett, J. (2001). Appropriate approaches to the evaluation of health promotion. Critical Public Health, 11(2), 139–151. Tashakkori, A., & Teddlie, C. (1998). Mixed methodology – combining qualitative and quantitative approaches. London: Sage Publications. Visram, S., & Drinkwater, C. (2005). Health trainers: A review of the evidence. Newcastle: Northumbria University. Wimbush, E., & Watson, J. (2000). An evaluation framework for health promotion: Theory, quality and effectiveness. Evaluation, 6, 301–321. Whitehead, M. (1996). Tackling inequalities: A review of policy initiatives. In M. Benzeval, K. Judge & M. Whitehead, (Eds.), Tackling inequalities for health: An agenda for action (pp. 22–52). London: Kings Fund. Zwarenstein, M., & Reeves, S. (2006). Knowledge translation and interprofessional collaboration: Where the rubber of evidence-based care hits the road of teamwork. Journal of Continuing Education in the Health Professions, 26(1), 46–54.",
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Dugdill, L, Coffey, M, Coufopoulos, A, Byrne, K & Porcellato, L 2009, 'Developing new community health roles: can reflective learning drive professional practice?', Reflective Practice, vol. 10, no. 1, pp. 121-130. https://doi.org/10.1080/14623940802652979

Developing new community health roles: can reflective learning drive professional practice? / Dugdill, Lindsey; Coffey, Margaret; Coufopoulos, Anne; Byrne, Kate; Porcellato, Lorna.

In: Reflective Practice, Vol. 10, No. 1, 2009, p. 121-130.

Research output: Contribution to journalArticle

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T1 - Developing new community health roles: can reflective learning drive professional practice?

AU - Dugdill, Lindsey

AU - Coffey, Margaret

AU - Coufopoulos, Anne

AU - Byrne, Kate

AU - Porcellato, Lorna

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