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Reference: Shaw, SE and Greenhalgh, T, (2008). Best research--for what? Best health--for whom? A critical exploration of primary care research using discourse analysis. Social science and medicine (1982), 66 (12), 2506-2519.Citable link to this page:

 

Best research--for what? Best health--for whom? A critical exploration of primary care research using discourse analysis.

Abstract: Health research is fundamental to the development of improved health and healthcare. Despite its importance, and the role of policy in guiding the kind of research that gets addressed, there are very few empirical studies of health research policy. This paper redresses this, exploring the means by which one area of health research policy is shaped, enabled and constrained. We ask: what are the historical, social and political origins of research policy in primary care in England? What are the key discourses that have dominated debate; and what are the tensions between discourses and the implications this raises for practitioners and policymakers? To answer these questions we employed a Foucauldian approach to discourse analysis to explicitly recognise the historical, social and ideological origins of policy texts; and the role of power and knowledge in policy development. We adapted Parker's framework for distinguishing discourses as a means of selecting and analysing 29 key policy documents; 16 narrative interviews with historical and contemporary policy stakeholders; and additional contextual documents. Our analysis involved detailed deconstruction and linking across texts to reveal prevailing storylines, ideologies, power relations, and tensions. Findings show how powerful policy discourses shaped by historical and social forces influence the type of research undertaken, by whom and how. For instance, recent policy has been shaped by discourse associated with the knowledge-based economy that emphasises microscopic 'discovery', exploitation of information and the contribution of highly technological activities to 'UK plc' and has re-positioned primary care research as a strategic resource and 'population laboratory' for clinical research. Such insights challenge apolitical accounts of health research and reveal how health research serves particular interests.

Peer Review status:Peer reviewedPublication status:PublishedVersion:Accepted Manuscript Funder: Economic and Social Research Council   Funder: Medical Research Council   Notes:Copyright © 2008 Elsevier Ltd. This manuscript version is made available under the CC-BY-NC-ND 4.0 license http://creativecommons.org/licenses/by-nc-nd/4.0/

Bibliographic Details

Publisher: Elsevier

Publisher Website: http://www.elsevier.com/

Journal: Social science and medicine (1982)see more from them

Publication Website: http://www.journals.elsevier.com/social-science-and-medicine/?testing=a

Issue Date: 2008-06

pages:2506-2519Identifiers

Urn: uuid:83db10aa-fe52-4417-a741-7cd5f6387613

Source identifier: 504206

Eissn: 1873-5347

Doi: https://doi.org/10.1016/j.socscimed.2008.02.014

Issn: 0277-9536 Item Description

Type: Journal article;

Language: eng

Version: Accepted ManuscriptKeywords: health research policy primary care knowledge-based economy discourse analysis UK biomedical research Tiny URL: pubs:504206

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Author: Shaw, SE - institutionUniversity of Oxford Oxford, MSD, Primary Care Health Sciences - - - Greenhalgh, T - institutionUniversity

Source: https://ora.ox.ac.uk/objects/uuid:83db10aa-fe52-4417-a741-7cd5f6387613



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