Use this URL to cite or link to this record in EThOS:
Title: Complementarity of individual-level and community-level health promotion programmes : a longitudinal and qualitative study of empowerment
Author: Romeo-Velilla, María
ISNI:       0000 0004 6424 6827
Awarding Body: Staffordshire University
Current Institution: Staffordshire University
Date of Award: 2017
Availability of Full Text:
Access from EThOS:
Access from Institution:
Health inequalities are the result of social inequalities and a major concern in the UK. In 1986 the Ottawa Charter for Health Promotion committed to tackling such health inequalities and defined health promotion as ‘the process of enabling people to increase control over, and to improve, their health’, with the concept of empowerment at the centre. Health promotion approaches can be broadly categorised into top-down and bottom-up programmes. Tensions between these exist and the value of a balanced approach has been recognised. However, it is not well understood if and how participants of programmes that take such different approaches experience empowerment and, if they could complement one another. This research was set in Stoke-on-Trent, a city with considerable health challenges and inequalities. Two ‘real world’ health promotion programmes were considered: (i) The Lifestyle Service (LS), a top-down individual-level programme; and (ii) My Community Matters (MCM), a bottom-up, community-level programme. Each was studied using longitudinal qualitative methods. Baseline interviews (n=23, LS; n=28, MCM) were analysed using thematic analysis. At one year, follow-up interviews were analysed using comparative analysis and following constructivist grounded theory (n=13, LS; n=17, MCM). For the LS, the thematic analysis revealed three master themes at baseline (past experiences, expectations, and barriers), and a model with three categories at follow-up (identification, planning, and action). The LS was primarily experienced with a providing role similar to person-centred approaches. For MCM, the thematic analysis revealed two master themes at baseline (community deterioration and perspectives towards community improvement), and at follow-up a model with four categories (power influences, community deciding, acting, and consequences). This programme was experienced with a providing role by ‘disengaged’ residents, but with a role of enabling action by ‘engaged’ residents. This provides novel insight into participant experiences of empowerment through individual- and community-level health programmes with recommendations of how such approaches can better collaborate and complement one another as part of an overall effort to improve health and reduce health inequalities.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available