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The challenges of measuring social cohesion in public health research: A systematic review and ecometric meta-analysis

ABSTRACT: The relationship between social cohesion and health has been studied for decades. Yet, due to the contextual nature of this concept, measuring social cohesion remains challenging. Using a meta-analytical framework, this review's goal was to study the ecometric measurement properties of social cohesion in order to describe dissimilarities in its measurement as well as bring a new perspective on the empirical usefulness of the concept itself. To this end, we analysed if, and to what extent, contextual-level reliability and intersubjective agreement of 78 social cohesion measurements varied under different measurement conditions like measurement instrument, spatial unit, ecometric model specification, or region. We found consistent evidence for the contextual nature of social cohesion, however, most variation existed between individuals, not contexts. While contextual dependence in response behaviour was fairly insensitive to item choices, population size within chosen spatial units of social cohesion measurements mattered. Somewhat counterintuitively, using spatial units with, on average, fewer residents did not yield systematically superior ecometric properties. Instead, our results underline that precise theory about the relevant contextual units of causal relationships between social cohesion and health is vital and cannot be replaced by empirical analysis. Although adjustment for respondent's characteristics had only small effects on ecometric properties, potential pitfalls of this analytic strategy are discussed in this paper. Finally, acknowledging the sensitivity of measuring social cohesion, we derived recommendations for future studies investigating the effects of contextual-level social characteristics on health. Highlights • Social cohesion aims to describe aspects of the social environment we live in but its measurement remains challenging.• We meta-analysed the ecometric properties of 78 social cohesion measurements.• There is modest but consistent evidence for the contextual nature of social cohesion.• Contextual dependence in individual response behaviour is sensitive to the chosen spatial unit.• Meta-ecometrics studies the empirical usefulness of theoretical concepts aiming to describe social environments.

SUBMITTER: Oberndorfer M

PROVIDER: S-EPMC8790679 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:PurposeTo test the feasibility of introducing 'Free Time for Wellness' (FT4W) an intervention to increase healthy behaviours and reduce the risk of cancer.DesignFeasibility study; Setting: Washington Heights, New York, USA is a low socioeconomic status area.SubjectsMothers aged 18 and above with children under 12 years of age and living in Washington Heights were recruited.InterventionFT4W, a community-based intervention delivered through a neighbourhood-based app, offering weekly dance and yoga classes, food pantry visits and group playdates. Childcare professionals cared for participants' children during wellness activities.MeasuresA bespoke before and after survey was designed and tested for its ability to collect relevant data to assess the impact of FT4W. Outcomes included recruitment rates, participation, attrition, acceptability, and success of the community champion.AnalysisComparisons of proportions and means.ResultsTwenty-one mothers participated in the study of which 90% attended ≥ 1 FT4W activity; 65% ≥ 2; 52% ≥ 3. The survey was completed by a 100% of participants indicating it was easy to understand and not too burdensome. All measures detected change in constructs from baseline to follow-up. Availability of childcare was the most commonly (66%) reported reason participants were able to engage in the offered wellness activities.ConclusionConducting a larger-scale trial to assess the impact of FT4W is feasible considering 4 major lessons. (1) Recruitment, retention, and acceptability rates were high; however, moms need additional support to increase participation in wellness activities and improve tech literacy. (2) Research measures were sensitive enough to detect change, but the timing of assessments needs to be considered. (3) Participants greatly valued access to professional childcare. (4) The Community Champion is a necessary, but difficult role to fill that requires careful consideration by the Institutional Review Board (IRB).

Project description:BackgroundThere is increasing recognition of the importance of sharing research data within the international scientific community, but also of the ethical and social challenges this presents, particularly in the context of structural inequities and varied capacity in international research. Public involvement is essential to building locally responsive research policies, including on data sharing, but little research has involved stakeholders from low-to-middle income countries.MethodsBetween January and June 2014, a qualitative study was conducted in Kenya involving sixty stakeholders with varying experiences of research in a deliberative process to explore views on benefits and challenges in research data sharing. In-depth interviews and extended small group discussions based on information sharing and facilitated debate were used to collect data. Data were analysed using Framework Analysis, and charting flow and dynamics in debates.FindingsThe findings highlight both the opportunities and challenges of communicating about this complex and relatively novel topic for many stakeholders. For more and less research-experienced stakeholders, ethical research data sharing is likely to rest on the development and implementation of appropriate trust-building processes, linked to local perceptions of benefits and challenges. The central nature of trust is underpinned by uncertainties around who might request what data, for what purpose and when. Key benefits perceived in this consultation were concerned with the promotion of public health through science, with legitimate beneficiaries defined differently by different groups. Important challenges were risks to the interests of study participants, communities and originating researchers through stigmatisation, loss of privacy, impacting autonomy and unfair competition, including through forms of intentional and unintentional 'misuse' of data. Risks were also seen for science.DiscussionGiven background structural inequities in much international research, building trust in this low-to-middle income setting includes ensuring that the interests of study participants, primary communities and originating researchers will be promoted as far as possible, as well as protected. Important ways of building trust in data sharing include involving the public in policy development and implementation, promoting scientific collaborations around data sharing and building close partnerships between researchers and government health authorities to provide checks and balances on data sharing, and promote near and long-term translational benefits.

Project description:Integrating theory and research on persuasion, moralization, and intergroup relations, the present research aims to highlight the far-reaching impact of health-related persuasion on society. I propose that governments' health-related persuasion leads to the emergence of new social norms, and in particular moral norms. Importantly, moral norms provide strong behavioral imperatives and are seen as binding for group members. This suggests that moralized persuasion has a strong potential to divide society along the lines of citizens who conform to and citizens who deviate from health-related moral norms. Thus, departing from the traditional focus on targets of persuasion, the present research focuses on those holding a moralized view on health and lifestyle. Key aspects of social cohesion as defined by the OECD (2011) have been tested across four studies. The main hypothesis tested is that those conforming to the norm (e.g., non-smokers, normal weight people, people with healthy lifestyles) will stigmatize those deviating from the norm (e.g., smokers, overweight people, people with unhealthy lifestyles). Flowing from stigmatization, less inclusion, lower solidarity with and greater endorsement of unequal treatment of those deviating from the moral norm are predicted. Four survey studies (total N = 1568) examining the proposed associations among non-smokers, normal weight people, and employees with healthy lifestyles are presented. The studies provide unanimous support for the hypothesis, with meta-analysis providing further support for the reliability of the findings. Consistent across studies, social cohesion indicators were negatively affected by health moralization through stigmatization of those deviating from health-related moral norms. Findings highlight an under-acknowledged potential of moralized health-related persuasion to divide society, thereby undermining cohesion and the achievement of important societal goals. In the discussion, limitations and relevant routes for future research are highlighted. Recommendations are derived for policy makers, institutions, employers, and individuals.

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The challenges of measuring social cohesion in public health research: A systematic review and ecometric meta-analysis

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