Browsing by Author "Smith, Stephanie L."

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    Civil society priorities for global health: concepts and measurement
    Smith, Stephanie L. (Oxford University Press, 2023-05-22)
    The global health agenda--a high stakes process in which problems are defined and compete for the kind of serious attention that promises to help alleviate inequities in the burden of disease--is comprised of priorities set within and among a host of interacting stakeholder arenas. This study informs crucial and unanswered conceptual and measurement questions with respect to civil society priorities in global health. The exploratory two-stage inquiry probes insights from experts based in four world regions and pilots a new measurement approach, analysing nearly 20 000 Tweets straddling the COVID-19 pandemic onset from a set of civil society organizations (CSOs) engaged in global health. Expert informants discerned civil society priorities principally on the basis of observed trends in CSO and social movement action, including advocacy, program, and monitoring and accountability activities-all of which are widely documented by CSOs active on Twitter. Systematic analysis of a subset of CSO Tweets shows how their attention to COVID-19 soared amidst mostly small shifts in attention to a wide range of other issues between 2019 and 2020, reflecting impacts of a focusing event and other dynamics. The approach holds promise for advancing measurement of emergent, sustained and evolving civil society priorities in global health.
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    Making Sense of Networks: Exploring How Network Participants Understand and Use Information From Social Network Analysis
    Moore, John (Virginia Tech, 2021-05-28)
    Many of today's complex public issues are best addressed by multi-sectoral multi-organizational responses that include different types of organizations working together (Kettl, 2008; O'Toole, 1997). Social network analysis (SNA) of interorganizational networks has emerged as a useful tool for network managers to understand the structure and function of the complex networks in which they seek to manage (Human and Provan, 1997, 2000; Provan and Milward, 1995; Provan, Sebastian, and Milward, 1996; Provan, Veazie, Staten, and Teufel-Shone, 2005). The output of an interorganizational SNA typically provides a range of information to network managers including network plots. The network plots provide visual representations of different aspects of the network by showing the kinds of ties between the actors in the network. The information from network analyses can help network managers encourage systems thinking, see the different roles played by organizations, or identify links to outside resources among many other uses, but "will only have practical value to communities if it can be effectively presented, discussed, accepted, and acted on by community leaders and network participants [emphasis added]." (Provan et al., 2005, p. 610). However, little is currently known about if or how the information embedded in network plots is accepted or acted on by network participants. The visual representations of the network (network plots) provided to network participants following a SNA are often open to a range of interpretations that may or may not align with the findings of the analyst or the intended use by network managers, raising many interesting questions. Little is currently known about how differently situated network participants might interpret the same network plots differently. Nor do we understand what factors might influence different individuals or organizations to come up with different interpretations. After conducting a SNA and presenting it to network participants, I conducted interviews with a range of different representatives from participating organizations. I used a particular form of semi-structured interview, a situated micro-element interview from Dervin's Sense Making Methodology (SMM) (Dervin, Foreman-Wernet, and Lauterbach, 2003). I then analyzed the interview transcripts using standard qualitative coding methods (Bailey, 2007) to see if themes emerged that addressed the research questions. I found that most informants had trouble extracting information and meaning from their examination of the plots without that meaning and interpretation being provided by the expert analyst. I posit some potential explanations for why that might be so in the case I studied. I then turn to some interesting methodological considerations that emerged from taking the perspectives of network participants seriously. Finally, I synthesize the subject area and methodological findings into a refined framework for sense-making around network plots and offer propositions and potential approaches for future research.
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    The rise and fall of global health issues: an arenas model applied to the COVID-19 pandemic shock
    Smith, Stephanie L.; Shiffman, Jeremy; Shawar, Yusra R.; Shroff, Zubin C. (2021-03-29)
    Background The global health agenda is ill-defined as an analytical construct, complicating attempts by scholars and proponents to make claims about the agenda status of issues. We draw on Kingdon’s definition of the agenda and Hilgartner and Bosk’s public arenas model to conceptualize the global health agenda as those subjects or problems to which collectivities of actors operating nationally and globally are paying serious attention at any given time. We propose an arenas model for global health agenda setting and illustrate its potential utility by assessing priority indicators in five arenas, including international aid, pharmaceutical industry, scientific research, news media and civil society. We then apply the model to illustrate how the status of established (HIV/AIDS), emergent (diabetes) and rising (Alzheimer’s disease) issues might be measured, compared and change in light of a pandemic shock (COVID-19). Results Coronavirus priority indicators rose precipitously in all five arenas in 2020, reflecting the kind of punctuation often caused by focusing events. The magnitude of change varied somewhat by arena, with the most pronounced shift in the global news media arena. Priority indicators for the other issues showed decreases of up to 21% and increases of up to 41% between 2019 and 2020, with increases suggesting that the agenda for global health issues expanded in some arenas in 2020— COVID-19 did not consistently displace priority for HIV/AIDS, diabetes or Alzheimer’s disease, though it might have for other issues. Conclusions We advance an arenas model as a novel means of addressing conceptual and measurement challenges that often undermine the validity of claims concerning the global health agenda status of problems and contributing causal factors. Our presentation of the model and illustrative analysis lays the groundwork for more systematic investigation of trends in global health agenda setting. Further specification of the model is needed to ensure accurate representation of vital national and transnational arenas and their interactions, applicability to a range of disease-specific, health systems, governance and policy issues, and sensitivity to subtler influences on global health agenda setting than pandemic shocks.