A typology of power in implementation: Building on the exploration, preparation, implementation, sustainment (EPIS) framework to advance mental health and HIV health equity

Background Persistent inequities in HIV health are due, in part, to barriers to successful HIV-related mental health intervention implementation with marginalized groups. Implementation Science (IS) has begun to examine how the field can promote health equity. Lacking is a clear method to analyze how power is generated and distributed through practical implementation processes and how this power can dismantle and/or reproduce health inequity through intervention implementation. The aims of this paper are to (1) propose a typology of power generated through implementation processes, (2) apply this power typology to expand on the Exploration, Preparation, Implementation, Sustainment (EPIS) framework to advance HIV and mental health equity and (3) articulate questions to guide the explicit examination and distribution of power throughout implementation. Methods This paper draws on the work of an Intermediary Purveyor organization implementing trauma-informed care and harm reduction organizational change with HIV service organizations. The expanded framework was developed through analyzing implementation coaching field notes, grant reporting, and evaluation documents, training feedback, partner evaluation interviews, and existing implementation literature. Results The authors identify three types of power working through implementation; (1) discursive power is enacted through defining health-related problems to be targeted by intervention implementation, as well as through health narratives that emerge through implementation; (2) epistemic power influences whose knowledge is valued in decision-making and is recreated through knowledge generation; and (3) material power is created through resource distribution and patterns of access to health resources and acquisition of health benefits provided by the intervention. Decisions across all phases and related to all factors of EPIS influence how these forms of power striate through intervention implementation and ultimately affect health equity outcomes. Conclusions The authors conclude with a set of concrete questions for researchers and practitioners to interrogate power throughout the implementation process. Plain language summary Over the past few years, Implementation Science researchers have committed increased attention to the ways in which the field can more effectively address health inequity. Lacking is a clear method to analyze how implementation processes themselves generate power that has the potential to contribute to health inequity. In this paper, the authors describe and define three types of power that are created and distributed through intervention implementation; discursive power, epistemic power, and material power. The authors then explain how these forms of power shape factors and phases of implementation, using the well-known EPIS (exploration, preparation, implementation, sustainment) framework. The authors draw from their experience working with and Intermediary Purveyor supporting HIV service organizations implementing trauma-informed care and harm reduction organizational change projects. This paper concludes with a set of critical questions that can be used by researchers and practitioners as a concrete tool to analyze the role of power in intervention implementation processes.

Normalizing a new language hierarchy: Event names in post-Soviet urban space

Naming practices not only reveal ideological contestation in a particular community, but also contribute to the discursive construction of a new social reality. However, the transformative role of naming practices as a semiotic resource for reimagining language hierarchy has been overlooked. This socio-onomastics study aims to explore shifting ideological premises and semiotic mechanisms of normalizing a new language hierarchy in post-Soviet urban space. In doing so, the study diachronically examines naming practices of choosing and using event names, which are more fluid and often short-lived in comparison to other names such as toponyms, anthroponyms or brand names. The study analyses 1246 unique event names mentioned in a local Russian-language newspaper Вечерний Алматы (Vechernii Almaty) over the period of time from 1989 to 2019. The results show a decrease in the use of Russian for name production. Further examination reveals a steady increase in non-integrated event names in Kazakh and English in Russian-language newspaper texts; there are few examples of translation and transliteration, no examples of transcription or loanwords in more recent texts. Our comparison shows that in the context of the multilingual Almaty transgressing the purist norms of standard Russian has become a new norm. We argue that these new local strategies of naming and using names are a semiotic mechanism of domination; they work to normalize a new language hierarchy where the Russian language is no longer the only dominant code of the public and official domain. Our account adds to the discussion of the discursive power of naming in challenging dominant language practices.

Trust, Standards of Public Office, and Corruption

The central contention of this chapter is that the legal and political history of trust is also a history of the development of public office. ‘Trust’ helped to define and restrain the abuse of office in the early modern period. Originally a Roman legal concept, fiduciary trust was designed in the sixteenth century to protect private property rights but came to be applied, in the mid-seventeenth century, to public (and commercial) office to help describe, but also tackle, the abuse of powers exercised by officeholders. By the nineteenth century its standards and criteria had become widely shared norms—so much so, that we have largely forgotten their origins and the cultural factors that shaped their genesis. Trust and ‘breach of trust’ had great discursive power but also had juridical reach.

Facts of (Financial) Life: Political Power and Re-Visualization Strategies

Digital visualizations have seen an exponential rise in use by politicians, candidates, and other political actors. Digital visualizations are an informative and engaging genre, but when applied by political candidates, they may also be used to persuade or mislead. However, the ways in which different actors utilize them have yet to receive systematic scholarly attention. Informed by a comprehensive theoretical framework related to political power, digital visualizations, and social media campaigns, I perform grounded qualitative content analysis of all cost-of-living visualizations posted to Facebook during the 2015 Israeli election period, by both peripheral and primary political actors. I define two main argumentation strategies ( Progress Makers & Hinderers and Re-Visualized Economy) reliant on different narrative, visual, and information-oriented strategies by different actors. An overview of the findings reveals digital visualizations as a meeting ground between the political power of actors, the rhetorical power of emotionality, and the cultural-political power of numbers. I conclude with a reflection on re-visualization as a means of expanding a fourth type of power, discursive power, wherein visualizations are used as a tool for resistance by weaker actors, against the narrative of reality promoted by stronger actors, relying on the rhetorical affordances of the digital political visualization genre to increase their political power. Digital visualizations thus offer a uniquely agile tool for political actors of all types to utilize in gaining discursive power in the competition over election narratives in the digital arena of social media.

Discursive Institutionalism and Food Policy Research: The Case Study of Canada’s National Food Policy

“Food” and “policy” are ambiguous concepts. In turn, the study of food policy has resulted in varying approaches by different disciplines. However, the power behind the discursive effects of these concepts in policymaking—how food policy is understood and shaped by different actors as well as how those ideas are shared in different settings—requires a rigorous yet flexible research approach. This paper will introduce the contours of discursive institutionalism and demonstrate methodological application using the case study example of Canada’s national food policy, Food Policy for Canada: Everyone at the Table! Selected examples of communicative and coordination efforts and the discursive power they carry in defining priorities and policy boundaries are used to demonstrate how discursive institutionalism is used for revealing the causal and material consequences of food policy discourses.

Refuser d’être l’aveugle des autres Dynamiques et pratiques de l’écriture de soi, à l’encontre des représentations sociales de la cécité

This paper aims at exploring the autobiographical writing of blind, deaf-blind or partially sighted people from a sociopoetical perspective. It contends the following idea: for the authors to be considered, the first-person text opens up a space which allows them to refuse and deconstruct the conception of blindness shared by sighted persons. This literary process, from which the construction of a counter-discourse that can even go as far as subversion emerges, gives the author the opportunity to reappropriate his or her blindness beyond the imaginary, the myths and the fancies deriving from what is commonly understood and depicted as an impairment and a deprivation. Focusing on the fundamental concept of “préjugé de la cécité” (“prejudice of blindness”) developed by the French blind intellectual Pierre Villey, the article shall furthermore demonstrate that this common imaginary and these collective social representations are deeply rooted in culture and literature: They turn out to be an archetype one cannot easily avoid, inhabiting autobiographical texts and taking the form of stereotyped associations. This archetype is nevertheless swiftly challenged and deconstructed by the autobiographer’s writing, therefore leaving room for a representation of blindness from an internal point of view, based on individual experience and nurtured by everyday life. This paper thus argues that autobiographical space and textuality display a discursive power that the author can use as he or she wishes, in order to dismantle stereotypes and transform collective and social representations of blind people and blindness.

THE DYNAMIC IMAGE OF CHINA PRESENTED IN GERMAN MAINSTREAM MEDIA REPORTS --THE CHINA-RELATED REPORTS OF GERMAN MAINSTREAM MEDIA FROM JANUARY 2020 TO JANUARY 2021 WERE USED AS EXAMPLES

The impact of the COVID-19 pandemic, which began to spread globally in early 2020, has attracted a great deal of attention from global society on the world's politics, economy, public security and global development. The mass media played an important role in promoting it, making international relations and the construction of national images during COVID-19 pandemic an important and urgent issue of national interest in the international political arena. During this period, China also became the ‘centre of public opinion’. As the most inuential country in the European Union, Germany's foreign policy and the China policy under its presidency has attracted a great deal of global attention. While Sino-German cooperation remained at a ‘high level’ during the pandemic, Germany also sought to position itself between the great powers of China and the US. Therefore, the image of China presented by the German mainstream media in their coverage of China during the COVID-19 pandemic, their positions, the constraints behind them, and their development trends are worthy of attention and study by academics. This study attempts to research the generation of Chinese images in the German mainstream media, including both an analysis of "Germany" and a reection on "China", and to investigate what cognitive models and knowledge structures the German mainstream media use in their discourse construction, how they use their discursive power, and what kind of Chinese national image they construct

A Critical Analysis on the Non-equivalence Between Bertha’s Identity and Discursive Power

Bliss is one of Katherine Mansfield’s masterpieces, which is a short story containing a large number of discourses, i.e. speeches. Previous scholars analyzed this classical novel from many perspectives, among them the discursive power is less mentioned and is worth discussing. This paper applying critical discourse analysis theory on discursive power and the interrelation between discourse and power, discusses the non-equivalence between the identity and discursive power of the heroine, Bertha, aiming to provide a new perspective to appreciate the novel and unveil the power in discourse of the novel.