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Strong Structuration Theory (SST) and Global Public Health

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Handbook of Social Sciences and Global Public Health

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Abstract

The examination of the interplay between people and their environment is a key focus for global public health research. Strong Structuration Theory focuses on the recursive process between the individual and society, holding great potential to explain the choices individuals make. Despite this explanatory potential, the theory has rarely been drawn upon as a frame of analysis in empirical work in global public health. This chapter consists of two sections. The first is comprised of a theoretical overview that situates Strong Structuration Theory within the broader context of social practice theories. Giddens’ articulation of Structuration Theory is introduced, followed by an outline of Stones’ Strong Structuration Theory, which sought to refine Giddens’ work. This outline includes a detailed description of the empirical application of Strong Structuration theory. The second section consists of a scoping review to identify research that has applied Strong Structuration Theory in global public health research. The review identified 12 articles. Two streams of literature have developed; one focused on theorizing change in health systems and delivery (focused on technology and policy), and the second on theorizing the social practices of persons (along with their caregivers) with various health conditions, including obesity and chronic conditions. There were relatively few articles focused on the second theme, representing a gap in the literature. Strong Structuration Theory provides a vantage point to comprehensively explore the impact and context of interventions, and the choices patients and their caregivers make within their social context.

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References

  • Archer M (1982) Morphogenesis versus structuration: on combining structure and action. Br J Sociol 33:455–483

    Article  Google Scholar 

  • Barley SR (1986) Technology as an occasion for structuring: evidence from observations of CT scanners and the social order of radiology departments. Adm Sci Q 31:78–108

    Article  CAS  Google Scholar 

  • Barrett AK, Stephens KK (2017) The pivotal role of change appropriation in the implementation of health care technology. Manag Commun Q 31:163–193

    Article  Google Scholar 

  • Beringer AJ, Fletcher ME, Taket AR (2006) Rules and resources: a structuration approach to understanding the coordination of children’s inpatient health care. J Adv Nurs 56:325–335

    Article  Google Scholar 

  • Blue S, Shove E, Carmona C, Kelly M (2016) Theories of practice and public health: understanding (un)healthy practices. Crit Public Health 26:36–50

    Article  Google Scholar 

  • Boonstra A, van Offenbeek M (2010) Towards consistent modes of e-health implementation: Structurational analysis of a telecare programme’s limited success. Inf Syst J 20:537–561

    Article  Google Scholar 

  • Bourdieu P (1977) Outline of a theory of practice. Cambridge University Press, Cambridge

    Book  Google Scholar 

  • Browne C (2017) Anthony giddens. In: Stones R (ed) Key sociological thinkers. Palgrave, London

    Google Scholar 

  • Butler J (1990) Gender trouble. Routledge, London

    Google Scholar 

  • Chan C, Deave T, Greenhalgh T (2010) Childhood obesity in transition zones: an analysis using structuration theory. Sociol Health Illn 32:711–729

    Article  Google Scholar 

  • Chu TH, Robey D (2008) Explaining changes in learning and work practice following the adoption of online learning: a human agency perspective. Eur J Inf Syst 17:79–98

    Article  Google Scholar 

  • Delormier T, Frohlich KL, Potvin L (2009) Food and eating as social practice – understanding eating patterns as social phenomena and implications for public health. Sociol Health Illn 31:215–228

    Article  Google Scholar 

  • DeSanctis G, Poole MS (1994) Capturing the complexity in advanced technology use: adaptive structuration theory. Organ Sci 5:121–147

    Article  Google Scholar 

  • Foucault M (1990 [1985]) The use of pleasure. Vintage Books, New York

    Google Scholar 

  • Foucault M. (1997 [1986]) The care of the self. Penguin, London

    Google Scholar 

  • Fraser A, Stewart E, Jones L (2019) Editorial: the importance of sociological approaches to the study of service change in health care. Sociol Health Illn 41:1215–1220

    Article  Google Scholar 

  • Frohlich KL, Corin E, Potvin L (2001) A theoretical proposal for the relationship between context and disease. Sociol Health Illn 23(6):776–797

    Article  Google Scholar 

  • Garfinkel H (1984 [1967]) Studies in ethnomethodology. Polity Press, Cambridge

    Google Scholar 

  • Geneau R, Lehoux P, Pineault R, Lamarche P (2008) Understanding the work of general practitioners: a social science perspective on the context of medical decision making in primary care. BMC Fam Pract 9(1):1–10

    Article  Google Scholar 

  • Giddens A (1976) New rules of sociological method: a positive critique of interpretative sociologies. Hutchison, London

    Google Scholar 

  • Giddens A (1984) The constitution of society: outline of the theory of structuration. University of California Press, Oakland

    Google Scholar 

  • Giddens A (1989) A reply to my critics. In: Held D, Thompson J (eds) Social theory of modern societies: Anthony Giddens and his critics. Cambridge University Press, Cambridge

    Google Scholar 

  • Goh JM, Gao GD, Agarwal R (2011) Evolving work routines: adaptive routinization of information technology in healthcare. Inf Syst Res 22:565–585

    Article  Google Scholar 

  • Greenhalgh T, Stones R (2010) Theorising big IT programmes in healthcare: strong structuration theory meets actor-network theory. Soc Sci Med 70:1285–1294

    Article  Google Scholar 

  • Greenhalgh T, Wherton J, Sugarhood P, Hinder S, Procter R, Stones R (2013) What matters to older people with assisted living needs? A phenomenological analysis of the use and non-use of telehealth and telecare. Soc Sci Med 93:86–94

    Article  Google Scholar 

  • Greenhalgh T, Stones R, Swinglehurst D (2014a) Choose and book: a sociological analysis of ‘resistance’ to an expert system. Soc Sci Med 104:210–219

    Article  Google Scholar 

  • Greenhalgh T, Swinglehurst D, Stones R (2014b) Rethinking resistance to ‘big IT’: a sociological study of why and when healthcare staff do not use nationally mandated information and communication technologies. Health Serv Deliv Res 2(39):1–112

    Article  Google Scholar 

  • Greenhalgh T, Wherton J, Shaw S, Papoutsi C, Vijayaraghavan S, Stones R (2019) Infrastructure revisited: an ethnographic case study of how health information infrastructure shapes and constrains technological innovation. J Med Internet Res 21(12):e16093

    Article  Google Scholar 

  • Harris J (2005) The ordering of things: organization in Bruno Latour. Sociol Rev 53:163–167

    Article  Google Scholar 

  • Hinder S, Greenhalgh T (2012) This does my head in. Ethnographic study of self-management by people with diabetes. BMC Health Serv Res 12(1):1–16

    Article  Google Scholar 

  • Hughes G, Shaw SE, Greenhalgh T (2022) Why doesn’t integrated care work? Using strong structuration theory to explain the limitations of an English case. Sociol Health Illn 44:113–129

    Article  Google Scholar 

  • Hvidt EA, Grønning A, Brøgger MN, Møller JE, Antoinette A, Fage-Butler. (2021) Multilevel structures and human agency in relation to email consultations: a strong structuration theory analysis of the Danish general practice setting. Soc Sci Med 282:114155

    Article  Google Scholar 

  • Jarzabkowski P, Bednarek R, Lê JK (2014) Producing persuasive findings: demystifying ethnographic textwork in strategy and organization research. Strateg Organ 12:274–287

    Article  Google Scholar 

  • Jeffries M, Phipps D, Howard RL, Avery A, Rodgers S, Ashcroft D (2017) Understanding the implementation and adoption of an information technology intervention to support medicine optimisation in primary care: qualitative study using strong structuration theory. BMJ Open 7:e014810

    Article  Google Scholar 

  • Kairy D, Lehoux P, Vincent C (2014) Exploring routine use of telemedicine through a case study in rehabilitation. Pan Am J Public Health 35:337–344

    Google Scholar 

  • Koplan JP, Bond TC, Merson MH, Reddy KS, Rodriguez MH, Sewankambo NK, Wasserheit JN (2009) Towards a common definition of global health. Lancet 373:1993–1995

    Article  Google Scholar 

  • Maller CJ (2015) Understanding health through social practices: performance and materiality in everyday life. Sociol Health Illn 37:52–66

    Article  Google Scholar 

  • Moreira ECD, O’Dwyer G (2013) An analysis of actions to promote health in underprivileged urban areas: a case in Brazil. BMC Fam Pract 14(1):1–11

    Google Scholar 

  • Munn Z, Micah DJP, Stern C, Tufanaru C, McArthur A, Aromataris E (2018) Systematic review or scoping review? Guidance for authors when choosing between a systematic or scoping review approach. BMC Med Res Methodol 18(1):1–7

    Article  Google Scholar 

  • Mutch A (2002) Actors and networks or agents and structures: towards a realist view of information systems. Organization 9:477–496

    Article  Google Scholar 

  • Omilion-Hodges LM, Swords NM (2017) The grim reaper, hounds of hell, and Dr. Death: the role of storytelling for palliative care in competing medical meaning systems. Health Commun 32:1272–1283

    Article  Google Scholar 

  • Orlikowski WJ (1992) The duality of technology: rethinking the concept of technology in organizations. Organ Sci 3:398–427

    Article  Google Scholar 

  • Payton FC, Kiwanuka-Tondo J (2009) Contemplating public policy in HIV/AIDS online content, then where is the technology spirit? Eur J Inf Syst 18:192–204

    Article  Google Scholar 

  • Porter A, Dale J, Foster T, Logan P, Wells B, Snooks H (2018) Implementation and use of computerised clinical decision support (CCDS) in emergency pre-hospital care: a qualitative study of paramedic views and experience using strong structuration theory. Implement Sci 13(1):1–10

    Article  Google Scholar 

  • Reckwitz A (2002) Toward a theory of social practices: a development in culturalist theorizing. Eur J Soc Theory 5:243–263

    Article  Google Scholar 

  • Rushforth A, Greenhalgh T (2020) Personalized medicine, disruptive innovation, and “trailblazer” guidelines: case study and theorization of an unsuccessful change effort. Milbank Q 98:581–617

    Article  Google Scholar 

  • Salm M, Ali M, Minihane M, Conrad P (2021) Defining global health: findings from a systematic review and thematic analysis of the literature. BMJ Glob Health 6:e005292

    Article  Google Scholar 

  • Schatzki TR (2001) Introduction: practice theory. In: Schatzki TR, Knorr-Cetina K, von Savigny E (eds) The practice turn in contemporary theory. Routledge, London

    Google Scholar 

  • Seguin M, Mendoza J, Lasco G, Palileo-Villanueva LM, Palafox B, Renedo A, McKee M, Balabanova D (2022) Strong structuration analysis of adherence patterns to hypertensive medication. Soc Sci Med Qual Res 2:100104

    Google Scholar 

  • Shaw S, Wherton J, Vijayaraghavan S, Morris J, Bhattacharya S, Hanson P, Campbell-Richards D, Ramoutar S, Collard A, Hodkinson I, Greenhalgh T (2018) Advantages and limitations of virtual online consultations in a NHS acute trust: the VOCAL mixed-methods study. Health Serv Deliv Res 6(21).

    Google Scholar 

  • Shaw S, Hughes G, Hinder S, Carolan S, Greenhalgh T (2020) Care organising technologies and the post-phenomenology of care: an ethnographic case study. Soc Sci Med 255:112984

    Article  Google Scholar 

  • Stones R (2005) Structuration theory. Palgrave Macmillan, Basingstoke

    Book  Google Scholar 

  • Wang J, Xiao LD, He GP, De Bellis A (2014) Family caregiver challenges in dementia care in a country with undeveloped dementia services. J Adv Nurs 70:1369–1380

    Article  Google Scholar 

  • Wheeler RM, Foster JW, Hepburn KW (2014) The experience of discrimination by US and internationally educated nurses in hospital practice in the USA: a qualitative study. J Adv Nurs 70:350–359

    Article  Google Scholar 

  • Williams G (2003) The determinants of health: structure, context and agency. Sociol Health Illn 25:131–154

    Article  Google Scholar 

  • Xiao LD (2010) Continuing nursing education policy in China and its impact on health equity. Nurs Inq 17:208–220

    Article  Google Scholar 

  • Xiao LD, Willis E, Jeffers L (2014) Factors affecting the integration of immigrant nurses into the nursing workforce: a double hermeneutic study. Int J Nurs Stud 51:640–653

    Article  Google Scholar 

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Authors and Affiliations

  1. Department of Health Services Research and Policy, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK

    Maureen Seguin

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  1. Maureen Seguin
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Correspondence to Maureen Seguin .

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Editors and Affiliations

  1. School of Health Sciences, Western Sydney University, Camberwell, VIC, Australia

    Pranee Liamputtong

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Seguin, M. (2023). Strong Structuration Theory (SST) and Global Public Health. In: Liamputtong, P. (eds) Handbook of Social Sciences and Global Public Health. Springer, Cham. https://doi.org/10.1007/978-3-030-96778-9_19-1

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  • DOI: https://doi.org/10.1007/978-3-030-96778-9_19-1

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  • Print ISBN: 978-3-030-96778-9

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