208105 Reflecting on health promotion: The role of reflexivity

Monday, November 9, 2009

Stephanie A. C. Alexander, MSc , Department of Social and Preventive Medicine, University of Montréal, Montréal, QC, Canada
Katherine L. Frohlich, PhD , Department of Social and Preventive Medicine, University of Montréal, Montréal, QC, Canada
The central principles defining health promotion in the Ottawa Charter for Health Promotion (1986) include: an emphasis on equity in health matters; recognising people as social actors in health; and viewing participation and social engagement as central to health promotion processes. It has been argued that reflexive approaches are particularly well suited to support these health promotion values and principles. This presentation uses the example of a research project on tobacco control to demonstrate that reflexive approaches may be a means to return our research to health promotion's original values and principles. The example used in this presentation examines the disjuncture between the reasons why disadvantaged youth smoke and how tobacco control practitioners understand youth smoking. The project's aim was to encourage reflexivity among tobacco control practitioners and thereby encourage them to: a) apprehend the complexity inherent in smoking among disadvantaged youth; and b) acknowledge the important role of the social context for tobacco use. Reflexive approaches draw attention to power dynamics in research (i.e., the fact that tobacco control has “created” the notion of the disadvantaged youth smoker), question the assumptions and biases in research practice (e.g., those practitioners have about youth, as well as their smoking), and importantly recognize and value a diversity of ‘knowledges' in research (i.e., different ways of knowing and understanding youth smoking). Reflexivity is an important methodological tool that can improve our understanding of complex health issues and encourages multi-disciplinary work in health promotion.

Learning Objectives:
1. Describe the concept of reflexivity and its relevance for revisiting the priorities and guiding principles in health promotion research and practice. 2. Demonstrate using an example of a reflexive project how this approach can improve tobacco control practitioners understanding of youth tobacco use.

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been involved (academically and in the context of employment) in the area of Health Promotion and tobacco control for the past four years, with a particular focus on encouraging reflexivity within the tobacco control field. My Master's project entailed an examination of smoking, social context and gender, after which it became clear that reflexive approaches in tobacco control would benefit a better understanding of the social context of smoking (youth and adults). My PhD project will be an examination of reflexivity among tobacco control practitioners to better understand and reduce smoking among disadvantaged youth.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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