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首页> 外文学位 >Reconciling concept and context: A grounded theory study of implementing school-based health promotion.
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Reconciling concept and context: A grounded theory study of implementing school-based health promotion.

机译：调和概念和背景：实施基于学校的健康促进的扎根理论研究。

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摘要

In response to high prevalence rates of alcohol and other drug use by adolescents in British Columbia (BC), the BC Ministry of Health initiated a pilot project in secondary schools aimed at preventing alcohol and drug misuse among students. The School-Based Prevention Project involved placement of a Prevention Worker (PW) in selected secondary schools. The PW was expected to engage the school community in a collaborative process to develop and implement a comprehensive prevention program in the school using the School-Based Prevention Model (SBPM), an adaptation of the Precede-Proceed Model for health promotion planning.; This grounded theory study explored the process by which the PWs implemented a PW role and the SBPM in the schools. Initial data collection involved one hour telephone interviews with 28 of 31 eligible PWs from across the province, conducted 4 to 6 months after the second annual training session. On the basis of the theoretical conceptualizations emerging from analysis of the PW interviews, 6 schools with varied implementation experiences were selected to conduct one week site visits to explore implementation in context. Field notes were kept on all interactions with PWs and schools over the four year study period. Over 100 interviews were conducted in the 6 sites with various members of the school community. Data analysis was conducted using the constant comparative method of grounded theory.; Analysis yielded the core category of Reconciling Concept and Context. The core category is composed of three sub-categories, Entering the Field, Confronting the Model and "Doing" the Model. Before implementation of the SBPM could begin, PWs had to gain entry to the school by establishing program legitimacy and personal credibility, and by learning the ropes. This was often a challenging and lengthy process. As part of Entering the Field, PWs created a role by finding a focus that was acceptable to all concerned, and by striking a balance between: (a){A0}the schools' demand for intervention and the program focus on prevention, and (b){A0}the schools' propensity for crisis management and the program focus on pro-active planning. Many schools were not "ready" to implement the prevention program as intended, so PWs also had to enhance school readiness to develop and implement the program in the school. Before PWs could begin "Doing" the Model, they went through a personal Confrontation with the Model, which involved reacting to, learning and contemplating it. When PWs ultimately tried to "Do" the Model, conditions in the school context led them to reinvent, retrofit, reframe, approximate, or abandon the model rather than implement it as intended.; Thus, in Reconciling Concept and Context, PWs had to facilitate changes in the school context to accommodate the concept. The concept, in turn, did not fit with the schools' goals and ways of doing things. The challenge for PWs was to modify the concept to fit the context, while retaining the integrity of the concept. In most instances, the concept was modified to a much greater extent than the context and was therefore coopted by the status quo.
机译：为了应对不列颠哥伦比亚省（BC）青少年的酗酒和滥用其他毒品的高发生率，卑诗省卫生部在中学发起了一项试点项目，旨在防止学生滥用酒精和毒品。以学校为基础的预防项目包括在选定的中学安置一名预防工作者。预期PW会通过使用基于学校的预防模型（SBPM）来在学校中参与学校社区的协作过程，以制定和实施全面的预防计划，该模型是对健康促进计划的先行模式的改编。这项扎根的理论研究探索了PW在学校中扮演PW角色和SBPM的过程。最初的数据收集涉及在第二次年度培训课程后的4至6个月内，对全省31个合格的PW进行了1小时的电话采访。根据对PW访谈的分析得出的理论概念，选择了6家具有不同实施经验的学校进行为期一周的实地考察，以探索在环境中的实施情况。在为期四年的学习期内，对与PW和学校的所有互动进行了现场记录。在6个地点对学校社区的各个成员进行了100多次采访。使用扎根理论的恒定比较方法进行数据分析。分析得出了“协调概念与环境”的核心类别。核心类别由三个子类别组成：进入字段，与模型对接和“执行”模型。在开始实施SBPM之前，PW必须通过建立计划的合法性和个人信誉以及学习绳索来进入学校。这通常是一个艰巨而漫长的过程。作为“进入该领域”的一部分，PW通过找到所有人都可以接受的重点并在以下方面取得平衡来建立角色：（a）{A0}学校的干预需求与该计划的重点在于预防，以及（ b）{A0}学校的危机管理倾向和该计划侧重于主动计划。许多学校还没有“准备好”按计划实施预防计划，因此，PW也必须提高学校的准备水平，以便在学校制定和实施该预防计划。在PW可以开始“执行”模型之前，他们与模型进行了个人对抗，包括对模型的反应，学习和思考。当PW最终尝试“执行”模型时，学校环境中的条件导致他们重新发明，改造，重新设计，近似或放弃了模型，而不是按预期实施。因此，在兼顾概念和情境的过程中，PW必须促进学校情境的变化以适应该概念。反过来，这一概念不符合学校的目标和做事方式。 PW面临的挑战是修改概念以适合上下文，同时保留概念的完整性。在大多数情况下，对该概念的修改程度远大于上下文，因此被现状所采用。

著录项

  • 作者

    MacDonald, Marjorie Anne.;

  • 作者单位

    The University of British Columbia (Canada).;

  • 授予单位 The University of British Columbia (Canada).;
  • 学科 Health Sciences Public Health.; Education Health.
  • 学位 Ph.D.
  • 年度 1998
  • 页码 368 p.
  • 总页数 368
  • 原文格式 PDF
  • 正文语种 eng
  • 中图分类 预防医学、卫生学;教育;
  • 关键词

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