The 130th Annual Meeting of APHA

Abstract #40699

Rene I. Jahiel, MDPhD, President, International Health Policy Research, 250 Main Street(#732), Hartford, CT 06106, 860-547-1202, jahiel@nso2.uchc.edu

Discourse analysis provides interpretations based on descriptions of power relations in historically specific contexts. It includes 1) historical basis of present power relations; 2) structural analysis of a) privileged access to the “discourse”; b) types of objectives of one group over another; c) means of exerting power; d) power structures; and e) rationalization to support power arrangements (Penny Powers. The Methodology of Discourse Analysis. Sudbury, MA: Jones & Bartlett, 2001, pp. 53-56). I used it to plan and evaluate alcohol screening and brief intervention (ASBE) and screening for homelessness risk factors (SHRF) in a teaching hospital-based clinic staffed by 80 internal medicine residents under supervision of university faculty, supported by a community action grant. The power groups are: 1) the university that provides the teaching; 2) the hospital that provides the clinic; 3) the medical residents; 4) a multidisciplinary community action group; 5) a lone, highly articulate consumer; and 6) the program coordinator. Analyses of minutes of planning meetings and encounters were used to help develop programs in context of power relationships and barriers thereof. Within a year, ASBE (an innovation congruent with clinic practice) and SHRF (an innovation that deviates from past clinic practice) were adopted and implemented. The systematic analysis of power relationships provided by discourse analysis is a useful complement to needs-based planning and evaluation

Learning Objectives:

• The method of discourse analysis is described. Participants will learn to apply it to health planning. At the conclusion of the session, the participants will be able to list the 5 steps of discourse analysis and to explain how each may contribute to community health planning and evaluation.

Keywords: Community Health Planning, Hospitals

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.