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Failure of governments across the world to address climate change has fuelled social movements focused on climate-related policy and action. Research analysing these movements has focused mainly on the types of strategies employed including blockades and occupations, marches and petitions, divestment, boycotts and litigation as well as how groups are framing climate change as a problem. What has been largely missed are the ways these groups are framing the change they want to see, that is their demands to governments. Not all demands and actions have the same potential to create the changes needed to mitigate climate change. Used in public health and health promotion, the systems science Intervention Level Framework (ILF) is a tool that can help analyse to what extent different demands have the leverage to create change in a system. We use the ILF to analyse 131 demands from 35 different climate-related advocacy groups in Australia. Results show demands are more focused on lower system leverage points, such as stopping particular projects, rather than on more impactful leverage points, such as the governance structures that determine climate-related policy and decision-making mechanisms. Further, the results highlight the lack of attention on public health related topics of transport and food systems. This paper shows how a systems science framework used in health promotion, the ILF, could enable climate advocacy groups to more effectively target demands to achieve more impactful outcomes from governments, corporations and the public. [ABSTRACT FROM AUTHOR]

This paper offers a brief social history of the hospice movement in Russia. The author explains why the hospice movement has become so relevant over the last five years in modern Russia; who the people are who lead this movement; how their ideas collide with 'reality'; and what consequences of this collision can already be observed. The author presents the Russian hospice movement as a dynamic social process which arises in the particular context of the political protests of 2011–2012. The paper is based on the first results of ethnographic research conducted in several hospices in Siberia, as well as on data from in-depth interviews with hospice movement activists and archival materials. The author argues that the hospice movements in contemporary Russia serve a social function as grassroots mediation for social and economic care between local bureaucracy and patients. [ABSTRACT FROM AUTHOR]

This article provides results from interviews and a focus group conducted at two different points in time in the first year of the COVID-19 pandemic, which explored impacts of the pandemic and adaptation among water advocacy organizations in southern Ontario, Canada. Our findings show that despite the destabilizing and sometimes devastating impact of COVID-19 on grassroots organizations and their programs, by disrupting business as usual the pandemic also created the conditions for experimentation, innovation, the establishment of new capacities and strategic foci. In this paper, we share descriptive narratives from water activists in our geographic area about how they adapted and innovated their work despite the challenges of the pandemic. Our findings illustrate and add nuance to themes emerging in the literature about the impacts of the pandemic on environmental advocacy groups and other nonprofit organizations, and generate new themes for further exploration. [ABSTRACT FROM AUTHOR]

This paper reports on a long-term collaboration with a self-organised social clinic, within solidarity movements in Greece. The collaboration focused on the co-creation of an oral history group within the social clinic, aiming to record and make sense of a collection of digital oral histories from its volunteers and volunteers-doctors. The process aimed to support reflection and shape the future of the clinic's ongoing social innovation and to transform institutional public health services. Positioning the work of solidarity movement as designing social innovation, the work contributes to CSCW and 'infrastructuring' in Participatory Design aspiring to support social activism and social transformation processes. More specifically, through our empirical insights on the process of infrastructuring an oral history group within a social movement; and related insights about their ongoing participatory health service provision—we provide implications for CSCW concerned with its role in institutional healthcare service transformation. [ABSTRACT FROM AUTHOR]

How are changing times impacting on the possibility of collective agency by actors and agencies responding to domestic violence against women in London? The struggle against the domestic abuse of women was grounded in the 1970s women's liberation movement under the rallying cry of 'the personal is the political'. Over time, the domestic violence (DV) response has become professionalised and mainstreamed, located in public sector agencies and charities, with small feminist groups challenging gender inequalities in different settings. These combined efforts are having no impact on the incidence of DV, and recent years have seen dramatic cuts in DV services. A snowball sample of 25 professionals, policy makers and activists across the DV response engaged in semi-structured interviews exploring their work experiences, particularly experiences of 'multi-sectoral collaboration', the professional instantiation of collective agency. Thematic analysis depicted an exhausted and divided sector. Nearly all informants saw DV as rooted in gender inequalities, and viewed collaborative working as essential for tackling its interlocking individual and social drivers. However, contemporary feminism was seen as completely irrelevant to the daily realities of professionals' work. The paper explores how the current economic, political and cultural contexts of interviewees' work experiences were hostile to the practice of multi-sectoral collaboration. Such contexts actively militated against collaborator solidarity, the inclusion of survivor voices and a social change orientation – preconditions for effective collective agency in tackling such a complex and multi-level social problem. [ABSTRACT FROM AUTHOR]

As part of a planned series from Global Public Health aimed at exploring both the epistemological and political differences in diverse public health approaches across different geographic and cultural regions, this special issue assembles papers that consider the legacy of the Latin American Social Medicine and Collective Health (LASM-CH) movements, as well as additional examples of contemporary social action for collective health from the region. In this introduction, we review the historical roots of LASM-CH and the movement's primary contributions to research, activism and policy-making over the latter-half of the twentieth century. We also introduce the special issue's contents. Spanning 19 papers, the articles in this special issue offer critical insight into efforts to create more equitable, participatory health regimes in the context of significant social and political change that many of the countries in the region have experienced in recent decades. We argue that as global health worldwide has been pushed to adopt increasingly conservative agendas, recognition of and attention to the legacies of Latin America's epistemological innovations and social movement action in the domain of public health are especially warranted. [ABSTRACT FROM AUTHOR]

This paper is about the clinical principle of informed choice-the hallmark feature of the midwifery model of care in Ontario, Canada. Drawing on ethnographic history interviews with midwives, I trace the origins of the idea of informed choice to its roots in the social movement of midwifery in North America in the late 1960s and 1970s. At that time informed choice was not the distinctive feature of midwifery but was deeply embedded what I call midwifery's feminist experiment in care. But as midwifery in Ontario transitioned from a social movement to a full profession within the formal health care system, informed choice was strategically foregrounded in order to make the midwifery model of care legible and acceptable to a skeptical medical profession, conservative law makers, and a mainstream clientele. As mainstream biomedicine now takes up the rhetoric of patient empowerment and informed choice, this paper is at once a nuanced history of the making of the concept and also a critique of the ascendant 'regime of choice' in contemporary health care, inspired by the reflections of the midwives in my study for whom choice is impossible without care. [ABSTRACT FROM AUTHOR]

Civil society engagement around health care and population health improvement is an important driver towards Health for All. Research can improve the effectiveness of health activism by examining the resources, structures and strategies of civil society engagement. However, research to support such engagement faces epistemological and methodological challenges which call for specific research strategies. A four year multi-country study was undertaken by the People's Health Movement, a global network working for health for all. The research took place in six countries (Brazil, Colombia, DR Congo, India, Italy, South Africa) and globally, and was directed to understanding five domains of civil society engagement: movement building; campaigning and advocacy; capacity building; knowledge generation, access and use; and engaging with governance. The research plan and methods of data collection and analysis were tailored to address the objective of improving activist practice, while negotiating research challenges identified during the design phase. Results include insights into the practice of civil society engagement in relation to the five domains of activist practice, as well as experience gained in managing six methodological challenges which we describe as: making meaning, aligning research and action, managing power relations, valuing experiential knowledges, chaos and contingency, challenging preconceptions. Researching activism can produce useful insights into practice as well as support continuous improvement in the effectiveness of such activism. However, there are significant methodological challenges that can be addressed through appropriate strategies. More research, building on the approach described in this paper, can contribute to more effective civil society activism for health. [ABSTRACT FROM AUTHOR]

This paper seeks to explain the survival of the Treatment Action Campaign (TAC) and to identify lessons it may offer on how social movements may resist demobilisation. It considers the role the TAC plays in the creation of social accountability dynamics around primary health care but with broader implications for strengthening rights-based notions of citizenship. The paper examines the TAC’s relative success in democratising public health care provision and explores shifts in the relationship between this social movement organisation and the South African state. [ABSTRACT FROM AUTHOR]

The controversy over packing therapy used in psychiatry was studied here to illustrate how leading associations can influence public health policies. The main French associations of parents with autistic children succeeded in obtaining the prohibition of packing, announced by the French Secretary of State to the Ministry of Health in April 2016. Parents and professionals who had observed the positive effects of packing when nothing else worked for their part wondered what could be done for self-harming patients. The political authorities followed the opinion of the main associations of parents with autistic children at the expense of that of professionals. In this paper, the actions and discourse of the associations against packing are explored, as are the arguments of the psychiatrists who defend packing therapy. The different phases in the controversy from the first opposition in 2005 and the role of opinion leaders in associations are analyzed. The strategies to discredit psychiatry and to promote behavioral methods are also studied to understand the shift in the balance of power from professionals to association leaders. The mobilization of the associations prompted some psychiatrists to conduct evidence-based research and to formalize their practice. The controversy over packing, involving political decision-making processes, ethical issues and clinical questions, enables us to illustrate a case of lobbying by associations. • The controversy over packing illustrates how associations can influence public policy. • This controversy involves a political decision, ethical issues and clinical questions. • A shift in the balance of power from professionals to association leaders has been shown. • A case of lobbying by associations has been described. [ABSTRACT FROM AUTHOR]

Drawing on ethnographic research conducted from 2011 to 2015 and the authors' long-term engagement in diverse aspects of HIV and human rights advocacy in Brazil, this paper explores key elements of the Brazilian sex workers' movement response to HIV and the broader political factors that profoundly influenced its trajectory. We argue that the movement has constantly challenged representations of prostitution by affirming sex workers' roles as political actors, not just peer educators, in fighting the HIV epidemic and highlight their development of a sex positive and pleasure centred response that fought stigma on multiple fronts. Moments of tension such as the censorship of an HIV prevention campaign and implementation of 'test and treat' projects are analysed, as are the complex questions that Brazil's 2016 political and economic crisis evokes in terms of how to develop and sustain responses to HIV driven by communities but with material commitment from the State. We conclude with what we see to be the unique, central components of Brazilian sex workers' approach to HIV prevention and what lessons can be learned from it for broader collective health movements in Latin America and beyond. [ABSTRACT FROM AUTHOR]

Highlights • We provide a graphical representation of the development of the comparator model for SoA. • We propose that a motor signal-model of SoA may be able to explain narrow SoA. • We show that standard experimental paradigms study only broad SoA. • We present results from two experiments, where we have failed to induce illusory narrow SoA in healthy participants. Abstract In this paper, we argue that the comparator model is not a satisfactory model of sense of agency (SoA). We present a theoretical argument and experimental studies. We show (1) most studies of SoA neglect a distinction between SoA associated with movements (narrow SoA) and SoA associated with environmental events (broad SoA); (2) the comparator model emerges from experimental studies of sensory consequences narrowly associated with movements; (3) narrow SoA can be explained by a comparator model, but a motor signal model is simpler and explain narrow SoA equally well; and (4) standard experimental paradigms study only broad SoA. Finally, we present results from two experiments, where we have failed to induce illusory narrow SoA in healthy participants. We believe our experimental approaches should have led to illusory SoA, if the comparator model of SoA was correct. The results challenge proponents of the comparator model of narrow SoA. [ABSTRACT FROM AUTHOR]

Policies governing the sale of raw milk-making the sales of raw milk more permissive-are gaining traction on the legislative agendas of dozens of states. This paper examines one contributor to this movement on the policy agenda: the role of competitive framing. By combining theoretical approaches from policy studies and political psychology theories of competitive framing, we offer evidence supporting the recent relative success of raw milk activists in several state legislatures. Using an Internet survey-based experiment with a sample size of 1,630 respondents from seven Midwestern states, we show that a frame emphasizing consumer choice and food freedom is more effective than the frame that dominates among the policy establishment, that emphasizing public health risks. This is true in both one-sided and competitive framing contexts. We further show that those previously aware of this issue were less influenced by the public health frame than those naïve to the issue. Our results suggest that the pro-raw milk movement may be making strides on the state policy agenda because their frames are more resonant among the public. We also highlight the advantages gained from considering psychological and policy processes simultaneously to understand policy change. [ABSTRACT FROM AUTHOR]

This paper advances the concept of path-prolonging critical junctures, a category used for eventful historical episodes marked by high levels of contingency that lock in path maintenance. It contributes to recent debates in comparative-historical social science, adding a pathway of continuity that is the product of agency and activism. The analysis is grounded in the 1985 interruption of Chile's long-standing state milk programme and argues that against a backdrop of economic, social and policy turmoil, expert and grassroots efforts combined to pressure the military regime to reverse retrenchment. The implications of this juncture help explain Chile's favourable infant malnutrition and mortality indices and the maintenance of a state-run infant-maternal primary healthcare network despite neoliberal reform. [ABSTRACT FROM AUTHOR]

In this paper, we offer a critical examination of Let's Move!, the comprehensive anti-obesity program initiated by the First Lady of the United States, Michelle Obama, that aims to solve the problem of childhood obesity within a generation. We argue that Let's Move! is not just a campaign against obesity but is emblematic of the nature of (and assumptions underpinning) the health education of children in the contemporary United States. Drawing on the concept of ‘governmentality,’ we examine how Let's Move! functions as a biopolitical strategy (a solution to the problem of childhood obesity), framed by the political rationalities of neoliberalism. In particular, we identify and explore three interrelated bio-techniques mobilized within, and through, the Let's Move! campaign. First, in an effort to ‘responsibilize’ citizens, the initiative is framed as a social movement whereby all segments of society can (and should) be empowered to take collective action against childhood obesity. Second, an array of multi-sectoral partnerships, including corporate sponsors and non-profit organizations, are being mobilized, resulting in a range of initiatives underpinned by the rhetoric of consumer choice and responsibility as well as the outsourcing of physical education to private entities. Third, the adoption of standardized fitness testing techniques based on the logic of chronic disease epidemiology, and related notions of ‘risk,’ aim to produce the disciplined child-citizen who monitors his/her health goals with the aid of Web 2.0 technologies. In contextualizing Let's Move! in this way, we illustrate how, in line with the soft authoritarian imperatives of the neoliberal enabling state, the campaign functions as a national biopedagogy, working to empower every citizen to be an ‘active partner’ in the fight against childhood obesity, so as to optimize the health of the next generation and allow them, in the words of Michelle Obama, to ‘pursue their dreams.’ [ABSTRACT FROM PUBLISHER]

The struggle for healthy eating is a nascent social movement that represents active resistance to the hostile food environments created by multinational food and beverage corporations. Using a political economy approach and leveraging Winson's [2013.The industrial diet: the degradation of food and the struggle for healthy eating. Vancouver: UBC Press] concepts of dietary regimes and the industrial diet, this paper will examine the strengths and limitations of Brazil's new dietary guidelines and discuss its role as a precursor to a new dietary regime that incorporates social justice and sustainability. [ABSTRACT FROM AUTHOR]

Although most research on the effect of tobacco warnings has been focused on attitude changes following the presentation of tobacco warnings, this paper takes a somewhat new perspective by investigating cognitive processing of tobacco warnings by adolescents of different ages (i.e., 14-, 16-, and 18-year-olds). More specifically, this paper investigates the way adolescents encode different textual elements presented in tobacco warnings. By means of a standard psycholinguist paradigm (i.e., sentence evaluation paradigm), we evaluated tobacco warnings differing along three variables: (1) severity, (2) time consequence and (3) target (health vs. others). Our main result demonstrated noticeable differences between the age groups and between smoking experiences in the cognitive processing of tobacco warnings. Our experimental paradigm represents an important step in identifying the mechanisms through which certain types of written warnings are cognitively processed, which in turn may well set a critical base for understanding decision makers' responses to risky behaviors such as smoking and for constructing adequate health warnings. [ABSTRACT FROM AUTHOR]

Abstract: In this paper I discuss the question of how we should understand the concept of “social movements”, particularly as applied to health related movements. My argument is that movements should be understood as “fields of contention”. This concept, as I develop it, emphasizes two key aspects of social movement mobilization. Firstly, departing from traditional models of movements, which tend to view them as unified “things”, it draws our attention to the numerous groups and agents who interact within the internal space of a “movement” and to the relations, alliances and conflicts between those various groups/agents as they unfold through time. Secondly, it draws our attention to the embedding of social movement struggles within multiple differentiated contexts of struggle, each of which affords different opportunities for struggle but each of which makes different demands upon activists if struggle is to prove effective. The model of fields of contention is explored within the paper using empirical data on a variety of “social movement organizations” (SMOs) which have formed around the mental health system in the UK over the last forty years. [Copyright &y& Elsevier]

In this paper, we discuss the discourses about the health privatization from the analysis of interviews and manifests of three Catalan movements: Centre d'Anàlisis i Programes Sanitaris (Caps), Grup de Defensa de Sanitat Pública (15MBCNSalut) and Plataforma Pel Dret a la Salut (PDS). The content analysis has been adopted as methodology. The analysis has evidenced a dichotomy between public and private systems as a duality that structures discourses favoring the public model and the great efforts made by the movements to guarantee that model. This has shaped the movements as a revolutionary force that defends the public system from private threats by assuming that it essentially represents the people's ideals. The debate between the traditional and the new in social action has been central to the analysis, as well as the problem of coexistence of different models of action. [ABSTRACT FROM AUTHOR]

This paper examines consumerism in public health policy and focuses on a specific strategy to make Irish hospital services more consumer-oriented, namely, patients' charters. The first part of the paper examines different conceptualisations of the ‘new consumerism’ in the social policy literature and locates its emergence within the broader context of the ‘marketisation’ of the welfare state. A brief review of the literature on the merits and limitations of public sector consumerism is then presented. The second part of the paper concentrates on the emergence of the new consumerism in Irish public health policy, and the results of a study that examined the implementation of the Charter of Rights for Hospital Patients are presented. A key finding of the study was that none of the hospitals in the study area had fully implemented the provisions of the Charter. Furthermore, only 26 per cent of a sample of one hundred hospital patients had heard of the Charter and only 10 per cent could recall any of the rights that it conferred on patients. The paper concludes by suggesting that the Charter of Rights for Hospital Patients is less concerned with empowering patients than it is with other agendas, such as creating a semblance of closeness to the users of health services and counterbalancing medical authority. [ABSTRACT FROM AUTHOR]

Abstract: In the past two decades, research on the sociology of diagnosis has attained considerable influence within medical sociology. Analyzing the process and factors that contribute to making a diagnosis amidst uncertainty and contestation, as well as the diagnostic encounter itself, are topics rich for sociological investigation. This paper provides a reformulation of the sociology of diagnosis by proposing the concept of ‘social diagnosis’ which helps us recognize the interplay between larger social structures and individual or community illness manifestations. By outlining a conceptual frame, exploring how social scientists, medical professionals and laypeople contribute to social diagnosis, and providing a case study of how the North American Mohawk Akwesasne reservation dealt with rising obesity prevalence to further illustrate the social diagnosis idea, we embark on developing a cohesive and updated framework for a sociology of diagnosis. This approach is useful not just for sociological research, but has direct implications for the fields of medicine and public health. Approaching diagnosis from this integrated perspective potentially provides a broader context for practitioners and researchers to understand extra-medical factors, which in turn has consequences for patient care and health outcomes. [Copyright &y& Elsevier]

This paper briefly outlines how the political scenario and the mobilization of different actors have contributed to the construction of a public health policy in response to the AIDS epidemics in Brazil. Three factors are presented and discussed: the political context of the 1980s, characterized by redemocratization, growth of social movements, and consolidation of the Brazilian health care reform; the socio-cultural context of the 1970s and 1980s, characterized by achievement of individual freedom, which was key to the organization of the AIDS movement; and finally the actions carried out in the international scenario to support the sustainability of the Brazilian domestic policy and the reinforcement of a global response to face the epidemics in lower-middle income economies. [ABSTRACT FROM AUTHOR]

This paper assesses the evolving "facilitated consumerism" model of health care at the community level using data from the Community Tracking Study (CTS). We find that in a relatively short time, large employers and health plans have made notable progress in putting the building blocks in place to support their vision of consumerism. However, developments in the CTS communities suggest that the consumerism strategy evolving in local markets is more nuanced than implied by some descriptions of health care consumerism. [ABSTRACT FROM AUTHOR]

The effects of powerlessness and depleted levels of social capital in coalfield communities make community organizing a particularly daunting task. Any organizing effort, if it is to be successful, must overcome these two major barriers to mobilization. In this paper, I present the participatory action research method of "Photovoice" as an underutilized strategy for community organizing that has the potential to both address the consequences of long-term powerlessness and low social capital within the coalfields of Central Appalachia. Photovoice is a method, most notably used in public health, which involves using participant-produced photography as a means of giving voice to marginalized persons in the community. Community member participants receive cameras to record images that "tell the story" of their community and then come together for regular group reflection sessions to discuss their photographs and the underlying issues represented in the images. At these reflection sessions, participants write short narratives to accompany the pictures they deem most important, creating "photostories." Outcomes from the Cabin Creek Photovoice Project are presented as evidence of the possibilities that this method holds as a tool for organizing for change in Central Appalachia. [ABSTRACT FROM AUTHOR]

Public involvement in healthcare is a prominent policy in countries across the economically developed world. A growing body of academic literature has focused on public participation, often presenting dichotomies between good and bad practice: between initiatives that offer empowerment and those constrained by consumerism, or between those which rely for recruitment on self-selecting members of the public, and those including a more broad-based, statistically representative group. In this paper I discuss the apparent tensions between differing rationales for participation, relating recent discussions about the nature of representation in public involvement to parallel writings about the contribution of laypeople's expertise and experience. In the academic literature, there is, I suggest, a thin line between democratic justifications for involvement, suggesting a representative role for involved publics, and technocratic ideas about the potential ‘expert’ contributions of particular subgroups of the public. Analysing recent policy documents on participation in healthcare in England, I seek moreover to show how contemporary policy transcends both categories, demanding complex roles of involved publics which invoke various qualities seen as important in governing the interface between state and society. I relate this to social-theoretical perspectives on the relationship between governmental authority and citizens in late-modern society. [ABSTRACT FROM AUTHOR]

The potential of social movements to accomplish change relevant to people's health, longevity and empowerment has received little sustained attention in medical sociology outside the USA. In the current era of global or disorganized capitalism the most discussed movements in Europe have been the new social movements (NSMs). In this paper the NSMs are defined and discussed in terms of their actual and potential impact in the health domain. Within a broadly Habermasian framework, a series of rhetorics associated with, and intermittently enacted through, NSMs are identified. This leads to a provisional typology of 'mobilizing potentials' characteristic of NSMs. It is suggested that it is the organic bases and flexibility of health-related NSMs, together with their potential to comprise a 'culture of challenge' in the public sphere of the lifeworld, which makes them serious political agents for lifeworld de-colonization. [ABSTRACT FROM AUTHOR]

This paper addresses the impact on midwifery of its recent integration into the provincial health care system in Ontario, Canada. Data are derived from participant-observation, primary and secondary source documents, and key informant interviews. Based on these data. I argue that midwifery has changed throughout the integration process but it has also successfully resisted change Specifically, the organisation of the midwifery community evolved from an amorphous social movement to a more bureaucratically organised professor The regulation of midwifery also shifted from direct-regulation by clients to professional self-regulation. The educational model of midwifery also changed from an eclectic apprentice-based approach to a more standardised baccalaureate degree programme. The midwifery model of practice, however, was sustained. Although these changes occurred at the hands of key members of the midwifery community, they were made in response to the structural context of the health care system into which they were attempting to become integrated. [ABSTRACT FROM AUTHOR]

Abstract: The tobacco industry has lobbied successfully to obtain the support of the United States government for opening Asian Markets to American tobacco products. This paper comments on two issues arising from these efforts: the development of an atmosphere of invasion and resistance to invasion in Asia; and the change in the image of the United States in Asian nations from that of a leader in health to that of an exporter of death. The threat of sanctions and the effects of the open market and United States tobacco company advertising in Japan, Taiwan, and South Korea are noted. Parallels are drawn between the opium wars a century and a half ago in China and the current threat of trade sanctions. Reacting to American policy, an Asia-Pacific Association for Control of Tobacco has been formed and linked with the US Coalition Against Smoking. (Am J Public Health 1990;80:659-662.) [ABSTRACT FROM AUTHOR]

The absence of universally available language services is a national healthcare system failure, the burden of which is suffered by patients with limited English proficiency and their healthcare providers. Conceptualizing mandatory provision of language access as an unfair, unfunded mandate ignores massive and fundamental social changes taking place. Overcoming language barriers is essential to safe, quality health care. This paper, informed by the experience of Hablamos Juntos, a national demonstration project funded by the Robert Wood Johnson Foundation, argues that national and health industry investments are needed to develop population-based approaches supported by communication and information technology, and that these investments may prove useful to improving healthcare communication for English-speaking patients as well. [ABSTRACT FROM AUTHOR]