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Personal Responsibility for Health: Exploring Together with Lay Persons.

ABSTRACT: Emerging parallel to long-standing, academic and policy inquiries on personal responsibility for health is the empirical assessment of lay persons' views. Yet, previous studies rarely explored personal responsibility for health among lay persons as dynamic societal values. We sought to explore lay persons' views on personal responsibility for health using the Fairness Dialogues, a method for lay persons to deliberate equity issues in health and health care through a small group dialogue using a hypothetical scenario. We conducted two 2-h Fairness Dialogues sessions (n = 15 in total) in Nova Scotia, Canada. We analyzed data using thematic analysis. Our analysis showed that personal choice played an important role in participants' thinking about health. Underlying the concept of personal choice was considerations of freedom and societal debt. In participants' minds, personal and social responsibilities co-existed and they were unwilling to determine health care priority based on personal responsibility. The Fairness Dialogues is a promising deliberative method to explore lay persons' views as dynamic values to be developed through group dialogues as opposed to static, already-formed values waiting to be elicited.

SUBMITTER: Asada Y

PROVIDER: S-EPMC9719321 | biostudies-literature | 2022 Jul

REPOSITORIES: biostudies-literature

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Personal Responsibility for Health: Exploring Together with Lay Persons.

Asada Yukiko Y Brown Marion M McNally Mary M Murphy Andrea A Urquhart Robin R Warner Grace G

Public health ethics 20220725 2

Emerging parallel to long-standing, academic and policy inquiries on personal responsibility for health is the empirical assessment of lay persons' views. Yet, previous studies rarely explored personal responsibility for health among lay persons as dynamic societal values. We sought to explore lay persons' views on personal responsibility for health using the Fairness Dialogues, a method for lay persons to deliberate equity issues in health and health care through a small group dialogue using a ...[more]

PMID: 36483293

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Project description:BackgroundHypertension is a major health risk factor for mortality globally, resulting in about 13% of deaths worldwide. In Nigeria, the high burden of hypertension remains an issue for urgent attention. The control of hypertension, among other factors, is strongly determined by personal beliefs about the illness and recommended treatment.ObjectiveThe aim of this review is to systematically synthesize available data from all types of studies on beliefs of the Nigerian populace about hypertension.MethodsWe searched the following electronic databases; Medline, EMBase, PsycInfo, AMED from their inception till date for all relevant articles. A modified Kleinman's explanatory model for hypertension was used as a framework for extraction of data on beliefs about hypertension.ResultsThe search yielded a total of 3,794 hits from which 16 relevant studies (2 qualitative, 11 quantitative and 3 mixed methods studies) met the inclusion criteria for the review. Overall, most health care providers (HCPs) believe that stress is a major cause of hypertension. Furthermore, reported cut-off point for uncomplicated hypertension differed widely among HCPs. Lay Health Care Providers such as Patent Medicine Vendors' beliefs about hypertension seem to be relatively similar to health care professionals in areas of risk factors for hypertension, course of hypertension and methods of treatment. Among Lay persons, misconception about hypertension was quite high. Although some Nigerians believed that life style habits such as alcohol intake, exercise levels, cigarette smoking were risk factors for developing hypertension, there was discordance between belief and practice of control of risk factors. However, beliefs across numerous ethnic groups and settings (urban/rural) in Nigeria have not been explored.ConclusionIn order to achieve control of hypertension in Nigeria, interventions should be informed, among other factors, by adequate knowledge of beliefs regarding hypertension across the numerous ethnic groups in Nigeria, settings (rural/urban), age and sex.

Project description:BackgroundFactors that could potentially act as facilitators and barriers to successful recruitment strategies in perinatal clinical trials are not well documented. The objective was to assess lay persons' understanding of the informed consent for randomized clinical trial in emergency obstetric and newborn care.MethodsThis was a qualitative study conducted among survivors of severe obstetric complications who were attending the post-natal clinic of Kawempe National Referral Hospital, Uganda, 6-8 weeks after surviving severe obstetric complications during pregnancy or childbirth. The study that involved 18 in-depth interviews was conducted from June 1, 2019 to July 6, 2019. The issues explored included perceptions of the purpose and necessity to conduct such research how research-related information would be disclosed, and what could be the potential benefits and risks of participation. The data was analyzed by thematic analysis.ResultsRespondents felt that research was necessary to investigate the cause, prevention or complications of an illness, especially as much was known about some pregnancy and newborn complications. Most believed that the emergency contexts affects whether and what prospective participants may understand if information about research was disclosed. Whereas they did not see the value of procedures like randomization, they felt that if these and any other procedures necessary should be done transparently and fairly. The decisions to participate would significantly be influenced by possibility of risk to the unborn baby or the newborn. Solidarity was an important influence on decision-making.ConclusionsRespondents valued participation in RCTs in emergency obstetric and newborn care. However, they expressed concerns and valued openness, transparency and accountability with regard to how clinical trials information is disclosed and the decision-making process for clinical trial participation. While autonomy and solidarity are contradictory values, they complement each other during decision-making for informed consent.

Project description:BackgroundThe increased digitalisation of health records has resulted in increased opportunities for the secondary use of health information for advancing healthcare. Understanding how patients want their health information used is vital to ensure health services use it in an appropriate and patient-informed manner. The aim of this study was to explore patient perceptions of the use of their health information beyond their immediate care.MethodsSemi-structured in-depth interviews were conducted with current users of health services in Aotearoa New Zealand. Different scenarios formed the basis of the discussions in the interviews covering different types of information use (current practice, artificial intelligence and machine learning, clinical calculators, research, registries, and public health surveillance). Transcripts were analysed using thematic analysis.ResultsTwelve interviews were conducted with individual's representative of key ethnicity groups and rural/urban populations, and at the time of recruitment, had been accessing a diverse range of health services. Participants ranged from high users of health care (e.g., weekly dialysis) through to low users (e.g., one-off presentation to the emergency department). Four interrelated overarching themes were identified from the transcripts describing the main issues for participants: helping others, sharing of data is important, trust, and respect.ConclusionsPeople currently engaging with health services are supportive of their health information being used to help others, advance science, and contribute to the greater good but their support is conditional. People need to be able to trust the health service to protect, care for, and respect their health information and ensure no harm comes from its use. This study has identified key considerations for services and researchers to reflect on when using patient health information for secondary purposes to ensure they use it in a patient-informed way.Trial registrationNA.

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Personal Responsibility for Health: Exploring Together with Lay Persons.

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Personal Responsibility for Health: Exploring Together with Lay Persons.

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