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Silence, Awkwardness and Discomfort: Understanding How Health Interventions Fail-An Ethnographic Study of a Peer
Astrid Andrea Anesen1,2, Bryan Cleal2, Tine M Gammeltoft1
1Department of Anthropology, University of Copenhagen, Copenhagen, Denmark.
Abstract:
Unsuccessful peer support interventions rarely receive detailed ethnographic attention. The article examines a peer support intervention part of a randomised controlled trial designed to provide people with type 2 diabetes socio-emotional support while adopting self-care technology. The trial concluded that the intervention yielded no benefits. This article insists on 'failure' as an analytical opening with potential for intervention research. Ethnographic fieldwork was conducted in Denmark between January 2020 and June 2022. The ethnographic material comprises intervention audio recordings and observations involving 15 participants, as well as follow-up interviews. Using the concept of 'lifeworld' to understand participants' perspectives and 'the will to improve' to interpret the intervention's framework, we unpack the tensions and awkwardness that permeated meetings. Comprehending why the intervention's activities failed to engage participants meaningfully, we highlight how it framed diabetes as a socio-emotional problem in need of fixing, thereby problematising living with the illness, contrasting participants' shared endeavours to de-problematise the experience within the intervention. The intervention offered a version of their lives with values and priorities that did not resonate and was thereby unsuccessful in bringing the aimed-for outcomes. Challenging the will to improve, we propose the 'lifeworlding' of future health interventions, prioritising lived experiences in the very framing of interventions.
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