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Converging Disciplines: A Transdisciplinary Research Approach to Urban Health Problems

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Abstract

Converging Disciplines: A Transdisciplinary Research Approach to Urban Health Problems Maritt Kirst, Nicole Schaefer-McDaniel, Stephen Hwang, and Patricia O’Campo Centre for Research on Inner City Health, Toronto, Canada As urban populations grow, new health problems evolve in tandem with longstanding issues. And as a welter of social, environmental, and access factors further complicate the picture, workable solutions require increasingly sophisticated understanding and innovative methods—generally beyond the scope of one professional field. Converging Disciplines introduces the concept of transdisciplinary research as a multidimensional, research-to-practice approach to urban health issues, not only bringing researchers together but also linking stakeholders, from practitioners to policymakers to community members. This immediately accessible volume differentiates transdisciplinary research from multi- and interdisciplinary strategies, as well as from popular community-based models, and brings a uniquely North American set of perspectives to the concept. Chapter authors explore the theory behind the methods as well as their application in meeting chronic problems (e.g., domestic violence, substance abuse) and working with vulnerable populations (e.g., homeless individuals, refugees) in ways that are ecologically based, ethically sound, and eminently practical. Key areas of coverage: • Benefits and challenges of transdisciplinary research in the urban health setting. • Transdisciplinary research process, including methodologies, collaboration, and information sharing. • Detailed case examples of transdisciplinary research used in addressing health issues among marginalized urban populations. • An overview of training programs in the U.S. and Canada. • The view from funding agencies. • Preparing the university, researchers, and the job market for a transdisciplinary future. Researchers and graduate students in urban and public health will find inspiring reading in Converging Disciplines: a bold framework for transforming their fields, and the tools for meeting the new generation of urban health challenges.

Chapters (12)

In the context of increased urbanization in the last century, public health research has evolved to explore the impact of urban environments on health (Galea & Vlahov, 2005). This relatively new body of research is referred to as urban health research and it seeks to explore determinants and outcomes of health as well as the interrelationships between them (Harpham, 2008). City living can affect health in multiple ways. Specifically, health in the urban context can be affected by such factors as the physical environment, the social environment, and access to health and social services (Galea & Vlahov, 2005).
The previous chapter outlined how transdisciplinary (TD) research, namely research that integrates divergent perspectives, frameworks, epistemologies, methods, and theories, enables urban health researchers to gather a more comprehensive understanding of social phenomena. In this chapter, we highlight the strengths TD research provides for urban health researchers as well as some of the challenges they can face. To illustrate our discussion, we will draw upon the following TD case study.
The urban environment has become an important determinant of health in the context of increased urbanization over the last century (Freudenberg, Galea, & Vlahov, 2006; Galea & Vlahov, 2005).
There is a growing recognition that social inequities in education, housing, employment, health care, safety, resources, money, and power contribute significantly to increasing health disparities globally, within countries, and even within specific urban environments. Thus, to promote health and well-being for all people, the World Health Organization recommends improving daily living conditions, measuring and understanding problems of health inequity, assessing the impact of action to address these problems, and ensuring equitable distribution of money, power, and resources (CSDH, 2008). Among the diverse populations that bear the burden of social inequities and health disparities are the increasing numbers of refugees and immigrants settling in urban areas.
Homelessness is a devastating social issue that affects a large number of people in Toronto, Canada’s largest city. According to a survey conducted by the City of Toronto, a minimum of 5,052 individuals were estimated to be literally homeless on one night in April 2006 (City of Toronto, 2006), and in 2007, at least 24,868 individuals stayed in a Toronto shelter at least once (City of Toronto, 2008).
This chapter revisits research carried out in the early 1990s in Scotland on child accidents – a key public health problem in rich and poor nations alike, and one where there are stark differences between better off and worse off children. The research (Roberts, Smith, & Bryce, 1995) was forged through a close collaboration with the residents of Corkerhill, a former railway village in Glasgow, Scotland.
Substance use and related problems are an important topic of transdisciplinary (TD) urban health research. This chapter reviews various multiple and responsive methods that were utilized with hard to reach adolescent populations such as delinquents, dropouts and street involved youth. Stories and example of practical applications contrasting a unidisciplinary with the TD approach are drawn from two recent Toronto studies. The Drugs, Alcohol and Violence International (DAVI) study is compared to the more TD Youth Pathways Project (YPP) to illustate 3 main issues. These include the impact on formulation of the research questions, methods of data collection, and stakeholder involvement. The importantance of conveying findings to a broad audience including policy makers is also considered. Although the advantages of a transdisciplinary over a unitary disciplinary approach are primarily considered, some cautionary comments will also be raised.
It has been widely acknowledged in recent years that if we are to achieve a coherent comprehension of the world and its enormous social, environmental, and public health problems we must make linkages between bodies of scientific knowledge and the social and political realities that generate them. Nearly eight decades after Spanish philosopher Ortega y Gasset noted the limits of specialization and the organization of knowledge into rigidly defined disciplinary boundaries, transdisciplinary (TD) collaboration is coming to be recognized as an essential strategy for understanding and resolving the complex urban public health challenges of our time (e.g., health disparities, AIDS, and heart disease).
In this chapter, we explore how the transdisciplinary (TD) approach can advance knowledge translation (KT) related to complex inner-city health problems. KT is an emerging discourse within health and social research communities. The overriding concern in KT is to increase the use of research evidence in practical decision-making contexts. A range of conceptual frameworks have been developed to better understand effective KT processes. However, little attention has been paid to KT opportunities that may arise through TD research.
The malaria and AIDS epidemics, rising cancer, diabetes, and obesity rates are but some of the tremendously complex global health challenges of the twenty-first century. Since these challenges do not lie in the domain of any one academic discipline, many scholars have recognized that if they are to be tackled effectively, a new generation of scientists and health promotion practitioners must be trained to ensure that they have the requisite conceptual, methodological, and interpersonal skills to enable them to bridge traditional discipline-based, regional, and cultural boundaries (Nash, 2008; Nash et al., 2003; National Academy of Sciences, 2003; von Ruschkowski, 2003).
As national health research funding agencies work to fund excellent and innovative research, the continual adaptation of programs and approaches is essential. In Canada, the mandate of the Canadian Institutes of Health Research (CIHR) is to create new knowledge that will benefit the health of Canadians. In the United States, the mission of the National Institutes of Health (NIH) is to support science in pursuit of fundamental knowledge about the nature and behaviour of living systems and the application of that knowledge to extend healthy life and reduce the burdens of illness and disability. Both agencies adapt programs and practices in order to maximize new technologies or strategies to most effectively develop knowledge to meet pressing health needs.
The chapters of this book paint a picture of urban health research today. As discussed in the introductory chapter, the field of urban health is still relatively new and can comprise myriad research agendas, for example, a focus on the lives and health of specific inner-city populations (e.g., homeless adults, people experiencing mental health problems), the well-being and problems of slum dwellers, exposure to health hazards common in urban areas (e.g., pollution), or access to sound housing and clean water.
... Um diese vielschichtigen Strukturen und Prozesse erkennen, analysieren und adäquat bewerten zu können, werden zunehmend inter-und transdisziplinäre Ko opera tions-und Forschungsdesigns angestrebt, in denen Akteure aus Wissenschaft und Praxis Fragestellungen gemeinschaftlich bearbeiten und -sofern möglich -auch beantworten (Bergmann et al. 2010;Kirst et al. 2011). Inzwischen werden trans disziplinäre Forschungsansätze -oftmals gepaart mit dem Anspruch von Transforma tions forschung bzw. ...
... Insofern könnte zukünftig eine Evaluation des potenziellen Mehrwertes transdisziplinärer Forschungsansätze von vornherein mitgedacht und mitgeplant werden. Dies setzt allerdings eine frühzeitige Einigung auf das zugrunde liegende Verständnis von Transdisziplinarität voraus (Kirst et al. 2011). Denn die unterschiedlichen Begrifflichkeiten und disziplinär verschiedenartigen Verständnisse zu Multi-, Inter-und Transdisziplinarität sorgen immer wieder für Verwirrung und Unsicherheiten in Wissenschaft und Praxis (vgl. ...
... Beitrag zu transdisziplinären Kooperations-und Forschungsansätzen im Kontext von Urban HealthInter-und transdisziplinäre Forschungsansätze spiegeln die Erkenntnis wider, dass Wissenschaft Antworten auf praxisrelevante Fragestellungen nur in angemessener Weise geben kann, wenn die Praxis in alle wesentlichen Prozesse des wissenschaftlichen Prozesses frühzeitig einbezogen wird (vgl. u. a.Bergmann et al. 2010;Kirst et al. 2011). Sie sind daher fester Bestandteil aktueller Forschungspolitik. ...
... This is because disciplines and sectors have historically evolved in silos and branched out as specialisations that have developed different standards of 'normal science' , or practices or empirical approaches that members of a certain discipline or sector take for granted [1]. The different standards are strongly rooted in the epistemological, ontological, methodological, and aetiological definitions of urban health of the diverse disciplines that often act as barriers to meaningful interdisciplinary or intersectoral collaboration [2][3][4]. ...
Article
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Background Urban health is a field of research and practice that has attracted the interest of various disciplines. While it is encouraged for diverse disciplines to contribute to a multidisciplinary field of study such as urban health, this often results in tensions, conflicts or competition between the different traditions that stem from different epistemological backgrounds. This meta-narrative review aims to identify and describe the multiple paradigms and articulate the underlying epistemological, ontological, methodological, and aetiological differences in their approaches. Articulating the paradigms not only contributes to the advancement of research, but also provides a framework for understanding the different policy beliefs and ideas policy actors hold and apply in the policy process. Methods We apply the meta-narrative method to systematic literature review which includes the following six iterative phases. The planning phase includes the finalisation of the review protocol and assembly of review team. The search phase includes a comprehensive literature search in key databases and a double-sided systematic snowballing method. We will search multidisciplinary databases including Web of Science, Scopus and ProQuest, and topic-specific databases including Urban Studies Abstracts (EBSCO), MEDLINE, and EMBASE from their inception onwards. Bibliometric analyses of this literature will be used to triangulate the mapping of the paradigms. The mapping phase includes identifying the dominant paradigms and landmark publications through agreement with the review team. In the appraisal phase, the literature will be assessed by their respective quality standards, followed by data extraction to identify the individual narratives in the conceptual, theoretical, methodological, and instrumental dimensions of each paradigm. The synthesis phase will review the data to compare and contrast and identify the overarching meta-narratives. The recommendation phase will include dissemination of the findings from the review. Discussion The meta-narrative review will reveal the how the different paradigms conceptualise, frame and prioritise urban health issues, their preferred methodologies to study the phenomenon, and the nature of the solutions to improve human health. This review will assist researchers and practitioners in understanding and interpreting evidence produced by other traditions that study urban health. Through this, urban health researchers and practitioners will be able to seek coherence in understanding, explaining, and exploring the urban health phenomenon. Systematic review registration Open Science Framework ( https://osf/io/tn8vk )
... Bien qu'il n'existe pas de consensus reconnu concernant la définition exacte du concept de supradisciplinarité, les analyses de certains auteurs s'accordent à dire qu'il s'agit d'un modèle de production du savoir basé sur trois formes principales de transgression disciplinaire : la multidisciplinarité, l'interdisciplinarité et la transdisciplinarité (Balsiger, 2004 ;Bellemare et Tremblay, 2007 ;Bruun et al., 2005 ;Fourez, 2002 ;Frodeman, 2014 ;Kötter et Balsiger, 1999 ;Lemay, 2011 ;O'Campo et al., 2011 ;Osborne, 2015 ;Petrisor, 2013 ;Pivot et Leroy, 2001 ;Resweber, 1981Resweber, , 2000. Sans prétendre que ces formes constituent une représentation exhaustive des phénomènes de transgression disciplinaire, il est suggéré dans cette étude qu'elles méritent une attention particulière car elles sont suffisamment distinctes pour couvrir une variété de phénomènes de transgression disciplinaire documentés dans la littérature et pour informer les études futures. ...
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L’inclusion des défis du développement durable en tant que thème de recherche dans le « champ » du management a mis en lumière certaines sources d’incohérences dans les postulats ontologiques et épistémologiques qui y sont associés. Inspiré de l’expérience de l’auteur dans un programme de recherche et de formation « Marie Curie » fondé sur la collaboration entre universitaires et acteurs d’entreprises et une volonté de stimuler le progrès social (« Innovating for Sustainability », 2013-2016), cet article appelle à un effort « supradisciplinaire » de production des savoirs pour permettre la construction d’un paradigme de management (mieux) adapté aux défis du développement durable. Trois formes principales de supradisciplinarité sont identifiées : la multidisciplinarité, l’interdisciplinarité et la transdisciplinarité. Si toutes ces formes ont le potentiel de stimuler le progrès vers le développement durable, le processus de « transdisciplinarité » est présenté comme la forme d’engagement la plus avancée, mais aussi la plus exigeante.
... This is because disciplines and sectors have historically evolved in silos and branched out as specialisations that have developed different standards of 'normal science', or practices or empirical approaches members of a certain discipline or sector take for granted (1). The different standards are strongly rooted in the epistemological, ontological, methodological and aetiological de nitions of urban health of the diverse disciplines that often act as barriers to meaningful interdisciplinary or intersectoral collaboration (2)(3)(4). ...
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Full-text available
Background Urban health is a field of research and practice that has attracted the interest of various disciplines. While it is encouraged for diverse disciplines to contribute to a multidisciplinary field of study such as urban health, this often results in tensions, conflicts or competition between the different traditions that stem from different epistemological backgrounds.This meta-narrative review aims to identify and describe the multiple paradigms and articulate the underlying epistemological, ontological, methodological and aetiological differences in their approaches. Articulating the paradigms not only contributes to the advancement of research, but also provides a framework for understanding the different policy beliefs and ideas policy actors hold and apply in the policy process.Methods We apply the meta-narrative method to systematic literature review which includes the following six iterative phases. The planning phase includes the finalisation of the review protocol and assembly of review team. The search phase includes a comprehensive literature search in key databases and a double-sided systematic snowballing method. Bibliometric analyses of this literature will be used to triangulate the mapping of the paradigms. The mapping phase includes identifying the dominant paradigms and landmark publications through agreement with the review team. In the appraisal phase, the literature will be assessed by their respective quality standards, followed by data extraction to identify the individual narratives in the conceptual, theoretical, methodological and instrumental dimensions of each paradigm. The synthesis phase will review the data to compare and contrast and identify the overarching meta-narratives. The recommendation phase will include dissemination of the findings from the review. DiscussionThe meta-narrative review will reveal the how the different paradigms conceptualise, frame and prioritise urban health issues, their preferred methodologies to study the phenomenon, and the nature of the solutions to improve human health. This review will assist researchers and practitioners in understanding and interpreting evidence produced by other traditions that study urban health. Through this, urban health researchers and practitioners will be able to seek coherence in understanding, explaining and exploring the urban health phenomenon.Systematic review registrationPROSPERO CRD42020192992
... Examples of transdisciplinary project implementation abound, especially in pragmatic responses to urban situations that involve non-academic actors and institutions (Kirst et al. 2011). Such efforts challenge the way to the others. ...
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Complexity is the hallmark of our habitats, our livelihoods and our health. These objects of analysis, understanding and intervention extend from our homes to our streets and neighbourhoods, to the cities and regions beyond our immediate surroundings. They are inscribed in ecological and geopolitical systems that span international and planetary levels. Over two millennia ago in Classical Greece, Hippocrates wrote about the complex web of interconnections that influence health and well-being. To achieve desired outcomes in the cities of today and tomorrow, we must transcend purely biomedical models and apply the principles of ecological public health. Collaborative systems thinking involving different disciplines and professions is essential for the implementation of this new approach, which adopts an integrated conceptual framework drawn from human ecology. This framework can underpin a shared understanding of the interdisciplinary concepts that must be applied during the transdisciplinary processes needed to address urban health challenges. This new approach is particularly important for the implementation of the United Nations’ 2030 Agenda for Sustainable Development, the New Urban Agenda and related global agreements, as we strive for effective promotion of urban health and well-being in a rapidly changing world.
... This knowledge should be applied to implement a significant change from conventional disciplinary and multidisciplinary research to innovative interdisciplinary and transdisciplinary contributions using a range of quantitative and qualitative research methods. This shift can provide the foundation for participative research and professional practice as some innovative contributions have shown [22]. ...
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The low impact of scientific research on the relations between housing and health during the last 30 years can be attributed to a number of reasons. First, statistical analyses have meant to improve understanding of the relations between what are interpreted and measured as causal factors. However, any single statistical approach fails to account for the dynamic non-linear relations between multiple factors and therefore cannot analyze systemic complexity. Second, there has been too little accumulation and validation of knowledge from scientific research owing to the dominance of cross-sectional studies, and the lack of coordinated research agendas using these approaches in order to confirm empirical findings. Hence, there is little evidence indicating that public policies in both the housing and the public health sectors in specific localities have benefited from the accumulated evidence of empirical research. Third, the findings from empirical studies have been published in academic journals and monographs but rarely disseminated to actors and institutions in the public and private sectors. Hence housing and health research and policy formulation have not been consolidated during the last three decades. The author of this communication argues for a radical shift from conventional disciplinary and multi-disciplinary contributions to transdisciplinary research programmes and projects that formulate and apply innovative approaches founded on conceptual frameworks that apply systems thinking for the integration of knowledge and know-how of researchers, policy makers, and professional practitioners in precise localities.
... Transdisciplinarity needs to be flexible, responsive, sustainable and democratic (Novy 2012;Russell, Wickson and Carew 2008). Despite being complex, it is clear that the transdisciplinary approach is the key to holistic problem solving at a local level (O'Campo et al. 2011). Because it is system-oriented and not object-oriented, transdisciplinarity is a positive move toward better methods of capacity building and community engagement (Russell et al. 2008). ...
Chapter
This chapter proposes an ethnographic and collaborative model of inquiry for executing community scale architectural projects that facilitate capacity building opportunities for all stakeholders involved in the process. Taking on the role of an ethnographer, the designer/architect/researcher is able to locate her- or himself within the time and space of the community. In the process he/she is able to form an insider’s perspective on issues and challenges. Working collaboratively, the intention is to create a horizontal power relation between different stakeholders. The model is described in general terms, then illustrated by a case-study—an Activity Centre project for an Indian slum settlement—then discussed in terms of its capacity building outcomes. The Activity Centre project was initiated by a non-government organization, and involved the local architect, the academic researcher and architecture students, residents of a slum settlement, and skilled labour. Although each stakeholder entered into the project with different objectives, the project outcomes were able to provide benefit to all in a tangible or intangible manner. The chapter reflects on the methods employed in the project and the role of stakeholders at each stage of the process. The importance of the local context is underscored—local people, local resources, local tools and techniques—during the design and construction process, to achieve an outcome that is innovative and engenders reciprocity and learning amongst the stakeholders.
... Transdisciplinarity needs to be flexible, responsive, sustainable and democratic (Novy 2012;Russell, Wickson and Carew 2008). Despite being complex, it is clear that the transdisciplinary approach is the key to holistic problem solving at a local level (O'Campo et al. 2011). Because it is system-oriented and not object-oriented, transdisciplinarity is a positive move toward better methods of capacity building and community engagement (Russell et al. 2008). ...
... ebola) and non-communicable diseases (e.g. cancers and cardiovascular illness) (Kirst, Schaefer-McDaniel, Hwang, & O'Campo, 2011). ...
Article
There has been a proliferation of contributions about transdisciplinarity during the last decade. Today transdisciplinarity is known and referenced in the natural and social sciences, and the humanities, as well as numerous professions. Hence it is appropriate to take stock of what has been achieved in both education and research during the last ten years. These achievements include development of conceptual and analytical frameworks, a diversification of methods and approaches in precise localities, specific cases showing the creative, reflexive and transformative capacity of transdisciplinary inquiry, and concerns about the asymmetries of power and control of participants during processes of the co-production of knowledge. However, conceptual and institutional barriers for transdisciplinary inquiry are still common whereas incentives remain rare. This is not only due to the skepticism of decision makers in academic institutions, in conventional funding agencies and in policy decision making but also to the formal education and personal motives of scientific researchers in academic institutions.
... Transdisciplinarity needs to be flexible, responsive, sustainable and democratic (Novy 2012;Russell, Wickson and Carew 2008). Despite being complex, it is clear that the transdisciplinary approach is the key to holistic problem solving at a local level (O'Campo et al. 2011). Because it is system-oriented and not object-oriented, transdisciplinarity is a positive move toward better methods of capacity building and community engagement (Russell et al. 2008). ...
Book
What it is about community involvement that attracts some professionals to adopt ways of working that embrace the community members as partners? Which aspects make community work rewarding for a professional, and more importantly, successful from a community member’s perspective? The theoretical constructs—community engagement, capacity building, and community empowerment—will be discussed in order to demonstrate how theory and practice are relevant to the development of ways to be involved in communities. A framework that we consider is of value has evolved that enables us to map or describe the attributes of community based projects; that is, an approach which aims to move beyond simply bringing people together from a variety of disciplines, to one which is transdisciplinary and applicable across cultures and genres of projects. Although a transdisciplinary approach is not new in itself, by making it explicit as an aspiration, we highlight the possible limitation of those projects that only bring together differing contributors at core moments for their expertise, without reflecting or planning for the potentially new ways of conceptualizing and of actioning what needs to be done. Such interactions are discussed in relation to participation and engagement. By constructing a project as transdisciplinary, all people—including the community—are ongoing contributors, who are able to wander into others’ discipline-specific arenas and vice versa.
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Synergies between urban planning and public health were synthesized a decade ago by the Lancet Commission's article "Shaping Cities for Health: Complexity and the Planning of Urban Environments in the 21st Century." Since then, innovative research projects, urban planning projects, and accumulated experience from the World Health Organization Healthy Cities project confirm that transdisciplinary contributions enable the achievement of core principles of healthy cities. This article clarifies important differences between the content, scope, and outcomes of interdisciplinary and transdisciplinary projects about public health and urban planning. It explains why transdisciplinary contributions are more likely to bridge the applicability gap between knowledge and practice in response to persistent urban health challenges; notably, they transgress the boundaries of public health and medical science; they prioritize political action in both the formal and informal construction sectors; and they include citizens, community associations, and private enterprises as partners in consortia for concerted action. This article proposes a radical shift from incremental, reactive, and corrective approaches in planning for urban health to proactive and anticipative contributions using backcasting and alternative scenarios that prioritize health. The article uses the case of public green spaces in planning for urban health. It identifies the shortcomings of many empirical studies that are meant to promote and sustain health before describing and illustrating an alternative way forward.
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Resumen El presente artículo examina un enfoque psicoambiental para el estudio de las ciudades. En una primera sección, se analizan las raíces históricas relacionadas con los orígenes de la psicología ambiental y su participación en temáticas urbanas. Posteriormente, se expone una revisión de algunas conceptualizaciones teóricas sobre psicología ambiental y la ciudad. En un tercer plano, se emplea el modelo de Stokols (1978) sobre las tipologías transaccionales ambiente-persona para ilustrar los temas urbanos de interés en el área psicoambiental. Por último, se exponen algunos métodos cuantitativos y cualitativos empleados en el campo de la psicología ambiental para el estudio de los problemas urbanos. Palabras clave: psicología ambiental, urbanización, percepción ambiental. Abstract The present paper examines a psycho environmental approach to the study of cities. In a first section the historical roots related to the origins of environmental psychology and its participation in urban issues are analyzed. Subsequently, a review of some theoretical conceptualizations about environmental psychology and the city is presented. In a third plane, the Stokols model (1978) of transactional typologies environment-person is used in order to illustrate the urban themes of interest in the psycho-environmental area. Finally, some quantitative and qualitative methods used in the field of environmental psychology for the study of urban problems are exposed.
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Narrative writing was used to critically reflect on the reasons for the success and failure of two research partnerships: one between the authors and a community group, the other between the authors and academic colleagues. The reflections relate to a vignette constructed on the experiences of the authors and somewhat fictionalised, but brought together to highlight the contrasts, whereby one research partnership was successful in producing outcomes while the other was not. An analysis of these reflections was informed by Wenger’s Communities of Practice framework. This helped draw out issues around power and participation as fundamental for successful research partnerships, particularly multidisciplinary partnerships, intent on the co-creation of knowledge. Such issues related to recognising partnerships and the underlying assumptions when these partnerships cross boundaries include transparent communication, power and decision-making processes, critical self-awareness, and negotiated meaning and identity.
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An increase in cross-disciplinary, collaborative team science initiatives over the last few decades has spurred interest by multiple stakeholder groups in empirical research on scientific teams, giving rise to an emergent field referred to as the science of team science (SciTS). This study employed a collaborative team science concept-mapping evaluation methodology to develop a comprehensive research agenda for the SciTS field. Its integrative mixed-methods approach combined group process with statistical analysis to derive a conceptual framework that identifies research areas of team science and their relative importance to the emerging SciTS field. The findings from this concept-mapping project constitute a lever for moving SciTS forward at theoretical, empirical, and translational levels.
Chapter
Social epidemiologists are undertaking research to understand an ­increasingly complex set of social factors and processes given the complicated health problems encountered today. Systematic reviews are powerful tools to assess the effectiveness of interventions by utilizing a transparent and rigorous method for summarizing and synthesizing the existing research literature. In light of the increasing complexity of health problems and interventions to address these problems, their subsequent evaluation must not only explore the magnitude of the interventions’ impact but must also include an examination of underlying intervention ­theory in order to fully assess effectiveness. Drawing on an example from our work synthesizing evidence on intimate partner violence screening programs, we argue in this chapter for greater adoption of systematic review methods informed by realist philosophy in the field of social epidemiology. Such research methods are important tools for the identification of key intervention mechanisms and contextual effects in the comprehensive evaluation of interventions that will inform the development of solutions to complex health problems.
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Globally, health and social inequities are growing and are created, actively maintained, and aggravated by existing policies and practices. The call for evidence-based policy making to address this injustice seems a promising strategy to facilitate a reversal of existing strategies and the design of new effective programming. Acting on evidence to address inequities requires congruence between identifying the major drivers of disparities and the study of their causes and solutions. Yet, current research on inequities tends to focus on documenting disparities among individuals or subpopulations with little focus on identifying the macro-social causes of adverse population health. Moreover, the research base falls far short of a focus on the solutions to the complex multilevel drivers of disparities. This paper focuses upon recommendations to refocus and improve the public health research evidence generated to inform and create strong evidence-based recommendations for improving population health.
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Transdisciplinarity is a word a` la mode. However, few of us are aware of the context of its origins, of what it meant at that time, and how it has evolved as aconcept in recent decades. In what ways do transdisciplinary contributions differfrom the more familiar interdisciplinary and multidisciplinary ones? Is transdisciplinarity applied frequently, and if so by whom? For what reasons and types of problemscan it be used? Last, but not the least, how is transdisciplinarity operationalized in research and professional practice? This special issue is an attempt to answer these kinds of questions. Collectively, the contributions provide a picture of what transdisciplinaryresearch is, as well as why and how it is being conducted in Europeanand North American countries.
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Peer Reviewed http://deepblue.lib.umich.edu/bitstream/2027.42/48749/2/galea_urban health_2005.pdf http://deepblue.lib.umich.edu/bitstream/2027.42/48749/1/galea_urban health_2005.pdf
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Domestic violence results in long-term and immediate health problems. This study compared selected physical health problems of abused and never abused women with similar access to health care. A case-control study of enrollees in a multisite metropolitan health maintenance organization sampled 2535 women enrollees aged 21 to 55 years who responded to an invitation to participate; 447 (18%) could not be contacted, 7 (0.3%) were ineligible, and 76 (3%) refused, yielding a sample of 2005. The Abuse Assessment Screen identified women physically and/or sexually abused between January 1, 1989, and December 31, 1997, resulting in 201 cases. The 240 controls were a random sample of never abused women. The general health perceptions subscale of the Medical Outcomes Study 36-Item Short-Form Health Survey measured general health. The Miller Abuse Physical Symptom and Injury Scale measured abuse-specific health problems. Cases and controls differed in ethnicity, marital status, educational level, and income. Direct weights were used to standardize for comparisons. Significance was tested using logistic and negative binomial regressions. Abused women had more (P<.05) headaches, back pain, sexually transmitted diseases, vaginal bleeding, vaginal infections, pelvic pain, painful intercourse, urinary tract infections, appetite loss, abdominal pain, and digestive problems. Abused women also had more (P< or =.001) gynecological, chronic stress-related, central nervous system, and total health problems. Abused women have a 50% to 70% increase in gynecological, central nervous system, and stress-related problems, with women sexually and physically abused most likely to report problems. Routine universal screening and sensitive in-depth assessment of women presenting with frequent gynecological, chronic stress-related, or central nervous system complaints are needed to support disclosure of domestic violence.
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Intimate partner violence is one health-related outcome that has received growing attention from those interested in the role of neighborhood context. A limitation of existing contextual health research is its' failure to look beyond urban settings. Because suburban and rural areas have received so little attention, it is not clear whether data generated from urban samples can be generalized to non-urban geographic settings. We began to explore this issue using concept mapping, a participatory, mixed method approach. Data from 37 urban and 24 suburban women are used to explore and compare perceptions of neighborhood characteristics related to intimate partner violence. While several similarities exist between the perceptions of participants residing in urban and suburban areas, some differences were uncovered. These results provide valuable information regarding the perceived relationship between neighborhood context and intimate partner violence and suggest future avenues for research interested in examining the role of geographic setting.
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This paper offers a conceptual framework for establishing a science of transdisciplinary action research. Lewin's (1951) concept of action research highlights the scientific and societal value of translating psychological research into community problem-solving strategies. Implicit in Lewin's formulation is the importance of achieving effective collaboration among behavioral researchers, community members and policy makers. The present analysis builds on Lewin's analysis by outlining programmatic directions for the scientific study of transdisciplinary research and community action. Three types of collaboration, and the contextual circumstances that facilitate or hinder them, are examined: (1) collaboration among scholars representing different disciplines; (2) collaboration among researchers from multiple fields and community practitioners representing diverse professional and lay perspectives; and (3) collaboration among community organizations across local, state, national, and international levels. In the present analysis, transdisciplinary action research is viewed as a topic of scientific study in its own right to achieve a more complete understanding of prior collaborations and to identify strategies for refining and sustaining future collaborations (and their intended outcomes) among researchers, community members and organizations.
Book
The essays commissioned for this book analyze the impact of city living on health, focusing primarily on conditions in the United States. With 16 chapters by 24 internationally recognized experts, the book introduces an ecological approach to the study of the health of urban populations. This book assesses the primary determinants of well-being in cities, including the social and physical environments, diet, and health care and social services. The book includes chapters on the history of public health in cities, the impact of urban sprawl and urban renewal on health, and the challenges facing cities in the developing world. It also examines conditions such as infectious diseases, violence and disasters, and mental illness.
Article
This paper presents a participatory research and planned change effort to develop a coordinated community response system to domestic violence in a United States culturally diverse community with a large immigrant population. This work grew out of an international, interdisciplinary project that was designed to establish ongoing collaborative relationships between university and community practitioners in the United States, Honduras, and Costa Rica around the theme of intra-familial violence, particularly gender-based violence against women. The paper analytically describes the international collaborative project, the local community-based participatory research and community development project, and lessons learned from both the local and international interdisciplinary collaboration. Examination of differences across disciplinary and cultural contexts generated critical reflection on the need to consider reframing domestic violence in the context of fundamental human rights, as is the case in Central America. at the same time, challenges around developing a coordinated community response, addressing inadequacies in the legal system, and implementing education and trainingwere echoed across boundaries, demonstrating the need for continued international collaboration.
Article
The mental health consequences for women who have experienced intimate partner violence (IPV), such as major depressive disorder (MDD) and posttraumatic stress disorder (PTSD) and especially their comorbidity, have received little attention in large-scale studies and treatment protocols for affected populations. We compared the association of PTSD, MDD, and PTSD/MDD comorbidity to IPV in two large cohorts, one of military and the other of civilian women. The adjusted prevalence of mental health symptoms, especially PTSD, was higher among abused than nonabused women in both samples. Mental health symptoms were also higher among the civilian sample compared to the military sample. Approximately one-third (34%) of the abused civilian women and one-fourth (25%) of the abused military women had symptoms that met criteria for at least one of the three diagnostic categories employed in this study, compared to 18% and 15% of nonabused women in the two groups. Comorbidity of PTSD and depression affected 19.7% of the civilian abused women versus 4.5% of nonabused civilian women, whereas for active duty military women, the prevalence was 4.6% and 4.2% for abused and nonabused, respectively. To better understand the mental health consequences of IPV and to design the most effective treatment and prevention programs, it is important to examine the presence of comorbidities between mental health disorders.
Article
The past 15 years have seen a growing interest in transdisciplinary research approaches across academic disciplines. This approach is starting to infiltrate work and health research. Some suggest that a transdisciplinary approach may overcome some of the obstacles in understanding complex pathways between working conditions and health, and may overcome some of the barriers in translating research evidence into action. However, a greater understanding of exactly what transdisciplinary research is (and what it is not) is needed so that the term ‘transdisciplinary’ is not abused or misused. In this paper the author outline the key tenants of a transdisciplinary approach as it applies to research on work and health. He then outlines some of the challenges and benefits of engaging in such an approach across three broad areas: integrating academic disciplinary perspectives; partnering with non-academic groups; and moving research into sustainable solutions. It is hoped that on reading this paper researchers, research participants and funding bodies can weigh up the benefits and challenges of engaging in truly transdisciplinary approaches to different work and health research questions. It is suggested that a truly transdisciplinary approach has both considerable benefits and considerable challenges for the people involved. As such, a transdisciplinary approach might not be the best approach to every research question or situation.
Article
Using data collected during a 4year ethnography, this paper examines how the 1996 Personal Responsibility and Work Opportunity Reconciliation Act (PRWORA) has impacted homeless women in San Francisco who are also victims of domestic violence. Specifically this paper looks at how the behavior of abusive men prevents homeless women from successfully navigating the new welfare-to-work requirements and maintaining stable employment. Findings indicate that despite the discourse touting the success of welfare reform, the 1996 PRWORA has further disenfranchised an already devastated population systematically forcing them further onto the margins of society.
Article
There is a shifting landscape for knowledge generation in contemporary societies that suggests a bright future for transdisciplinary (TD) research. Interestingly, however, there is currently no clear consensus on what transdisciplinarity is or how its quality can be evaluated. This paper uses three avenues to advance and clarify our understanding of transdisciplinarity. Firstly, we survey the theoretical literature and identify key characteristics used by authors in the field to distinguish transdisciplinarity from related research approaches. These characteristics are problem focus, evolving methodology and collaboration. In our discussion of these we highlight variations in description that have significance for practice. Secondly, we explore three interesting quandaries that transdisciplinary researchers face (integration, reflection and paradox) discussing how these quandaries manifest in different dimensions and their potential as both challenge and opportunity for practice. Finally, we use our synthesised characteristics and challenges to shape two alternative frameworks for evaluating the quality of TD endeavours. Our first framework is based on strategic questioning and is potentially useful to individuals seeking to improve the quality of their work. Our second framework adapts an existing quality schema to the unique challenges of transdisciplinarity and may be more appealing to those seeking to compare TD research projects.
Article
The world became mainly urban in 2007. It is thus timely to review the state of knowledge about urban health and the current priorities for research and action. This article considers both health determinants and outcomes in low-income urban areas of developing countries. The need to study urban health in a multi-level and multi-sectoral way is highlighted and priorities for research are identified. Interventions such as the Healthy Cities project are considered and obstacles to the effective implementation of urban health programmes are discussed. Concepts such as the double burden of ill health and the urban penalty are re-visited. Finally, a call for a shift from ‘vulnerability’ to ‘resilience’ is presented.
Article
This article clarifies the distinction between unidisciplinary, multidisciplinary, interdisciplinary and transdisciplinary research about environment and human behaviour. One objective is to consider the challenges and opportunities transdisciplinarity offers in terms of the emergence of new ideas for theory and application. The costs and benefits, as well as the advantages and constraints of a transdisciplinary approach in the field of urban studies are then considered, and compared with multidisciplinary and interdisciplinary approaches. First, a brief history of the concept of transdisciplinarity is presented. Second, the scientific context (the unit of analysis, application and theoretical goal) is identified. Third, conclusions are drawn about the perspective that researchers need to adopt if a transdisciplinary approach is to be effective (looking for coherence versus paradoxes). All of these reflections on transdisciplinarity are supported by the research experience gained in studies on Canadian (Quebec) and French (Strasbourg) suburbs. The paper focuses on the representation and perception of urban space.
Article
Over the past two decades a variety of national and international efforts has sought to bring together health and social scientists to address complex health issues. This paper reviews how the notion of transdisciplinary research has emerged; discusses research programs that have successfully traversed discipline boundaries in sustained fashion; considers facilitating and constraining factors that have emerged from the analyses of this process; and suggests next steps for conceptualizing, organizing, and assessing transdisciplinary research based on the notion of heterarchy.
Article
The South African population is exposed to multiple forms of violence. Using nationally representative data from 4351 South African adults, this study examined the relative risk for post-traumatic stress disorder (PTSD) associated with political, domestic, criminal, sexual and other (miscellaneous) forms of assault in the South African population. Violence exposure was assessed using the 'worst event' list from the WHO's Composite International Diagnostic Interview (CIDI) and a separate questionnaire assessing experiences of human rights abuses, and lifetime PTSD was assessed according to the APA's Diagnostic and Statistical Manual of Mental Disorders criteria using the CIDI. Findings indicated that over a third of the South African population has been exposed to some form of violence. The most common forms of violence experienced by men were criminal and miscellaneous assaults, while physical abuse by an intimate partner, childhood physical abuse and criminal assaults were most common for women. Among men, political detention and torture were the forms of violence most strongly associated with a lifetime diagnosis of PTSD, while rape had the strongest association with PTSD among women. At a population level, criminal assault and childhood abuse were associated with the greatest number of PTSD cases among men, while intimate partner violence was associated with the greatest number of PTSD cases among women. Recommendations for mental health service provision in South Africa and for future research on the relative risk for PTSD are offered.
Article
The last decade of the twentieth century is witnessing a profusion of projects drawing together social and health scientists to study and recommend solutions for a wide range of health problems. The process--practiced in both developed and developing countries--is usually called multidisciplinary or interdisciplinary research. Its historical precedents are briefly reviewed in this paper along with the types of problems addressed. From a review and discussion of a sample of projects selected from two major proponents of this approach to research, the Social and Economic Research Component of the UNDP/World Bank/WHO Special Programme for Research and Training in Tropical Diseases and the Applied Diarrheal Disease Research Project, conclusions are drawn about the nature of contributions from such efforts--very useful for short-term problem solving, less so for longer-term programmatic changes, especially beyond the health sector, and even more limited in impact on theory building for coping with the changing human condition. The recognition of such limitations is now widespread in the social and natural sciences beyond the health sector, in population, ecology, and the humanities. Following these observations, I argue for a new approach to transcend the disciplinary bounds inherent in multi- and interdisciplinary research. A transdisciplinary approach can provide a systematic, comprehensive theoretical framework for the definition and analysis of the social, economic, political, environmental, and institutional factors influencing human health and well-being. The academic and career challenges for such researchers, while considerable, may be overcome since there is now a new flexibility in research-supporting organizations to encourage new ideas in international health, such as that of essential national health research.
Article
Women experiencing intimate partner violence may use a variety of help-seeking resources and coping strategies. The purpose of this study was to examine rural (n = 378) and urban (n = 379) women's help seeking, coping, and perceptions of the helpfulness of resources used in dealing with partner violence. Overall, results suggest that women from both areas utilized a variety of help-seeking resources and coping strategies in significantly different ways. Urban women used more help-seeking resources than rural women. Urban and rural women used different types of resources. Rural women perceived the justice system services as less helpful than urban women. Coping strategies and help seeking are related, with problem-focused coping associated with the use of more formalized help-seeking resources. Implications for research and practice are discussed.
Romantic attachment, emotional and instrumental aggressiveness in batterers
  • L Carrud
  • P D Jaffe
  • F Sillitti-Dokic
Carrud, L., Jaffe, P. D., & Sillitti-Dokic, F. (2008). Romantic attachment, emotional and instrumental aggressiveness in batterers. Practiques Psychologiques, 14, 481-490.
Domestic violence: A multi-professional approach for healthcare practitioners
  • P O'campo
  • F Ahmad
  • A Cyriac
O'Campo, P., Ahmad, F., & Cyriac, A. (2008). Role of healthcare professionals in preventing and intervening on IPV. In J. Keeling & T. Mason (Eds.), Domestic violence: A multi-professional approach for healthcare practitioners (pp. 107-115). Maidenhead: Open University Press.
Is intimate partner violence associated with unintended pregnancy? A review of the literature
  • C C Pallitto
  • J C Campbell
  • P Campo
Pallitto, C. C., Campbell, J. C., & O'Campo, P. (2005). Is intimate partner violence associated with unintended pregnancy? A review of the literature. Trauma Violence Abuse, 6(3), 217-235.