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In my work I offer some reasons why we hang on to micro-level interventions even when the evidence is clear that they exert only modest, transient effects.
For one, macro- and meso- level work is challenging and often requires destabilizations of power.
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For one, macro- and meso- level work is challenging and often requires destabilizations of power.
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Yet, as I often argue, for our anti-stigma work we actually DO need micro-level interventions like educations and trainings. They DO have some effects and are easier to implement.
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The only problem is when micro-level interventions come to dominate the entire field of our anti-stigma work, which the evidence suggests happens, especially in public health spaces.
Instead, my teams and I advance a tripartite anti-stigma approach.
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Instead, my teams and I advance a tripartite anti-stigma approach.
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There's a lot in this thread, but one pt I'd like to extract is connected to something I've been arguing for years and #onhere quite a bit recently:
#MethodologicalIndividualism in public health occurs where we position the individual as the unit of change.
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#MethodologicalIndividualism in public health occurs where we position the individual as the unit of change.
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This is in comparison to structural interventions, which often alter upstream factors and institutions. My favorite example of the latter is laws and policies, but can also include infrastructure and built environmental changes, etc.
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But leading public health officials in the US have completely followed the #MethodologicalIndividualism that has dominated public health policy and priorities for much of the 20th c. until now. See:
pubmed.ncbi.nlm.nih.gov/19965565/
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pubmed.ncbi.nlm.nih.gov/19965565/
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