Practice Theory and Public Health, September 2017

This week – 7th and 8th September 2017 – Ros went to Lancaster University for a two-day workshop called “Practice Theory and Public Health – a workshop on scale, matter, method and challenges”. The event was attended by people with an interest in the possible intersections of social practice theory and methodology, and the broad scope of work in the area of public health.

The organisers of the event, Cecily Maller and Stanley Blue gave an initial overview. They used the opportunity to raise an interesting point: the labels of “healthy”  and “unhealthy” may be more usefully understood as meanings associated with people’s practices and, though one doesn’t always think of practices as being un/healthy, perhaps most practices can be said to have some kind of ‘health outcome’.

The two days threw up a lot of thought-provoking discussion around language. The notion of an public health ‘intervention’, for example, sparked some debate about whether practice theory can change, as well as trace, what people do. Underlying this was a question of whether users of practice theory ought to be attempting to produce changes in the dynamics of practice. Unsurprisingly, this issue remained unresolved!

Ros presented work from phase 1 of Tracking Ourselves, exploring the ways that commercial actors understand self-monitoring practices. You can read the abstract from the paper below.

 

Our paper was one in a wide range of topics. To name only a handful, Cecily Maller gave a presentation on designing  a residential estate in Mebourne for residents’ wellbeing. Maller showed survey and interview data revealing how people made (sometimes unexpected) use of the built environment – an outdoor gym was used by children for play, for example. Stanley Blue’s paper on understanding obesogenic environments prompted really exciting discussion about what constitutes a practice. For example, where does it begin and end, and what’s the starting point for studying its dynamics? Does eating including snacking, drinking? Or are we concerned with ‘meal’-ing!

A fantastic presentation on British women’s alcohol drinking practices from Kat Jackson offered insights into alcohol’s enfolding into how interviewees cared for family, partners, and themselves. It brought into relief the complexity of describing drinking alcohol as unhealthy – accounts from some of her informants suggested drinking was an important and enriching part of their lives.

A different empirical site drew out similarly interesting questions around how we can glean information about people’s practices; a two-way radio programme in Cape Verde during the Zika outbreak (presented by Laurie Denyer Willis) allowed people to text in descriptions of their practices, revealing problems in the assumptions of public health advice about putting lids on water containers – water infrastructures in Cape Verde made lidding bottles challenging, a point revealed through considering elements of practice.

Altogether, the event offered a valuable opportunity to think about how the Tracking Ourselves studies could contribute to public health understandings of health self-monitoring. In parsing some of the heterogeneity of self-monitoring practices, as phases and 1 and 2 are revealing, we can contribute to a richer grasp of how self-monitoring practices are currently  being undertaken by individuals.

Below is the title and abstract of our talk at the above event.

Everyday Practices of Health Self-Monitoring: Exploring Commercial Imaginaries of Self-Monitoring

Self-monitoring, using products including apps, blood pressure monitors and weighing scales, is increasingly invoked in policy as a tool for promoting healthy lifestyles. It is anticipated that measurements previously done in clinics will be undertaken at home by individuals using devices they acquire themselves, saving the NHS time/money and reducing obesity and heart disease. We report on a study of these newly emerging or proto practices – framed as a public health salve rather than problem – suggesting that they offer useful insights for practice theory’s application to public health, which has so far focussed more on the ‘usual suspects’ of problematic health behaviour including eating and smoking.

In our paper we start from the work done by commercial actors seeking to reinvent products associated with the clinic as consumer goods that can be integrated into ordinary life. While aware that these commercial imaginaries cannot be assumed to determine the actual use of products, we engage with these arguments in work by Shove and Pantzar (2005) to discuss how commercial actors attempt to shift the meanings of monitoring along with new materials (products) emphasising the playful, relaxing and sociable elements of the practice. Contrasting commercial versions of self-monitoring with those in public health we suggest that our understanding of these practices can be improved if we consider the efforts of commercial actors to reinvent self-monitoring, suggest ways in which this alters our understanding of the category of ‘health practice’ and of the health implications of shared nature of activities in the home.