‘We have the time to listen’: community Health Trainers, identity work and boundaries

ABSTRACT

This article contributes empirical findings and sociological theoretical perspectives to discussions of the role of community lay health workers, including in improving the health of individuals and communities. We focus on the role of the Health Trainer (HT), at its inception described as one of the most innovative developments in UK Public Health policy. As lay health workers, HTs are tasked with reducing health inequalities in disadvantaged communities by supporting clients to engage in healthier lifestyles. HTs are currently sociologically under-researched, particularly in relation to occupational identity work, and the boundary work undertaken inter-occupationally with other health workers. To address this research lacuna, a qualitative study was undertaken with 25 HTs based in the Midlands region of the UK. In theorising our findings, we employ a novel combination of symbolic interactionist conceptualisation of 1) identity work, and of 2) boundary work. The article advances knowledge in the field of health and exercise by investigating and theorising how HTs construct, work at, manage, and communicate about professional/occupational boundaries, in order to provide personalised support to their clients in achieving and sustaining healthy behaviour change within the constraints of clients’ lifeworlds.

KEYWORDS:

• Behaviour change
• community lay health workers
• Health Trainers
• occupational identity work
• boundary work

Disclosure statement

No potential conflict of interest was reported by the authors.

Notes

1 Some Health Trainers are termed Health and Wellbeing Workers; we employ the generic term ‘Health Trainer’.

2 Drug and Alcohol Recovery Team.

Additional information

Funding

This work was supported by the College of Social Science, University of Lincoln.

Notes on contributors

Jacquelyn Allen-Collinson

Jacquelyn Allen-Collinson is Professor in Sociology and Physical Culture, and Director of the Health Advancement Research Team (HART), University of Lincoln, UK. Currently pursuing her interest in combining sociology and phenomenology, her research interests include the lived experience of health and illness conditions in sport and physical cultures, together with the sociology of the senses, identity and identity work. ORCID: 0000-0003-2146-8000.

Rachel Williams

Rachel Williams is the Learning and Evaluation Officer for the Talk, Eat, Drink (T.E.D) Ageing Better programme, Community Lincs, UK. Often framed by qualitative approaches, her research focuses upon studies of health and wellbeing, ageing, social isolation and loneliness, identity, gender, physical activity and embodied experiences. ORCID: 0000-0003-0477-2182.

Geoff Middleton

Geoff Middleton is Principal Lecturer in the School of Sport and Exercise Science at the University of Lincoln, UK. His research interests include nutrition, health promotion and evaluation theory, with a particular focus on complex multi-level and site interventions in the policy and practice domain. ORCID: 0000-0003-4696-0659.

Hannah Henderson

Hannah Henderson is Senior Lecturer in Physical Activity, Exercise and Health at the University of Lincoln, UK. Her research focuses on the evaluation of community-based projects, with a particular interest in complex, multi-level interventions. ORCID: 0000-0002-2742-4909.

Lee Crust

Lee Crust is a Chartered Sport and Exercise Psychologist, Chartered Scientist, and Senior Lecturer at the University of Lincoln, UK, where he also directs the Mental Toughness Research Group (MTOUGH). His current research interests are aligned with positive psychology and the study of human strengths that underpin optimal performance in sport. ORCID: 0000-0002-3092-3143.

Adam Evans

Adam Evans is Assistant Professor in Sociology of Sport in the Department of Nutrition, Exercise and Sport, University of Copenhagen, Denmark. His research coheres around the sociology of health, sport, and Physical Activity, as well as programme evaluation of community-based projects. ORCID: 0000-0002-8232-9912.