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Canadian Journal of Public Health

, Volume 109, Issue 5–6, pp 643–652 | Cite as

Knowledge brokering: (mis)aligning population knowledge with care of fat bodies

  • Patricia ThilleEmail author
Special Section on Qualitative Research

Abstract

Objective

Two prominent Canadian knowledge brokers aim to influence how primary care clinicians address obesity, through the dissemination of texts: the Canadian Task Force on Preventive Health Care (guideline) and the Canadian Obesity Network (5As). While written for the same clinician and adult patient population, the recommendations differ. This analysis highlights active decisions that produced the difference.

Methods

Frame analysis of the guideline and 5As texts.

Results

The brokers both frame obesity as a chronic and pathological threat to health, at least to a point. The guideline texts frame obesity primarily as a sign of a behavioural problem, discrediting or ignoring many complicating sources of knowledge. In contrast, the 5As frames obesity as complex through diversifying the knowledge foundation embedded in the texts (e.g., including fat-related stigmatisation; health status differences among those classified as obese). Both de-emphasize social and environmental determinants of weight and health.

Conclusion

Frames of problems used by brokers are not neutral, nor are decisions about how knowledge is excluded and included. Knowledge brokering, no matter how scientific and systematic, is limited by its frame. Recognizing the limits of each frame supports reflexivity in knowledge brokering and interventions taken to enhance health.

Keywords

Obesity Fatness Primary care Knowledge brokering Stigma Critical weight studies 

Résumé

Objectif

Deux réputés courtiers de connaissances canadiens tentent d’influencer la façon dont les cliniciens de soins primaires abordent l’obésité, en diffusant des textes du Groupe d’étude canadien sur les soins de santé préventifs (Ligne directrice) et du Réseau canadien en obésité (« 5As »). Bien qu’ils aient été rédigés pour la même population clinicienne et adulte, leurs recommandations diffèrent. Cette analyse met en évidence les décisions qui ont mené à ces différences.

Méthodes

Analyser les cadres de la ligne directrice et des « 5As ».

Résultats

Les courtiers définissent tous les deux l’obésité comme une menace chronique et pathologique pour la santé, dans une certaine mesure du moins. Le texte de la ligne directrice considère l’obésité principalement comme un signe de problème comportemental, discréditant ou ignorant par le fait même de nombreuses sources de connaissances qui compliquent la question. Par contre, les « 5As » considèrent l’obésité comme un problème complexe en diversifiant les bases de connaissances employées dans le texte (p. ex., en incluant la stigmatisation reliée au poids et les différences d’état de santé parmi les gens considérés comme obèses). Les deux documents diminuent l’importance des déterminants sociaux et environnementaux du poids et de la santé.

Conclusion

Les cadres utilisés par les courtiers pour cerner les problèmes ne sont pas neutres, pas plus que ne le sont les décisions d’exclure ou d’inclure certaines connaissances. Le courtage de connaissances, si scientifique et systémique soit-il, est limité par son propre cadre. Accepter les limites de chaque cadre permet de soutenir la démarche réflexive dans le courtage de connaissances et dans les interventions entreprises pour améliorer la santé.

Mots-clés

Obésité Corpulence Soins primaires Courtage de connaissances Stigmatisation Études sur le poids critique 

Notes

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Copyright information

© The Canadian Public Health Association 2018

Authors and Affiliations

  1. 1.Department of Physical TherapyUniversity of ManitobaWinnipegCanada

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