1. UHI Millennium Institute and The University of Aberdeen working in partnership
“I don’t speak for everyone, but..”
Discourses and Power in Community Engagement
Amy Nimegeer – PhD Candidate

2. UHI Millennium Institute and The University of Aberdeen working in partnership
• Context
• Research Questions
• Research Process
• Answering the third research question

3. UHI Millennium Institute and The University of Aberdeen working in partnership
Context
• Rural areas face unique challenges
• Changing disease/treatment profile
• Rural services changing, often with retiral of a key
health care professional
• Rise of community engagement/co-planning as a
policy priority
• Previous engagement by NHS patchy, reactive,
problem based
• Guidance on engagement is not rural-specific

4. UHI Millennium Institute and The University of Aberdeen working in partnership
Research Questions
1. What are the most appropriate methods for
engaging with remote and rural Scottish
communities for health care service design?
2. Does this ‘ideal’ methodology work in context?
3. What are power relations like within a
particular stakeholder group and how does this
affect engagement?

5. UHI Millennium Institute and The University of Aberdeen working in partnership
Research Process
Research Q1
Literature
Review
Research Q2
Action Research
Project
Research Q3
Participant
Observation and
Foucauldian
Discourse
Analysis

6. UHI Millennium Institute and The University of Aberdeen working in partnership
Discourse and Power
Literature states that community engagement is, at
heart, about dialogue and power...
• Community engagement literature/theory: Dichotomous
power struggle whose ultimate aim is to transfer power from
one homogenous group to another (rings false?)
• Foucauldian theory: that ‘truth’ is not fixed but is a
construction of interpretations that are believed to be true,
therefore the discourses people use can illustrate the power
relations at work in a particular context
• Discourse: grouping of codified linguistic usages attached to a
type of social practices or way of thinking. Allows you to
‘create’ your truth..i.e. “terrorists” or “freedom fighters”

7. UHI Millennium Institute and The University of Aberdeen working in partnership
Research Question 3
What are power relations like within a
particular stakeholder group and how
does this affect engagement?
Aim: to highlight the complexities of power
relations within and between groups and
consider how this could be complicating
engagement activities.

8. UHI Millennium Institute and The University of Aberdeen working in partnership
Ageing
demographic
(population and
workforce)
Services often
fragile and
linked to social
capital
Mistrust and
confrontation
between
communities
and NHS
Structures not
always in place
to allow
managers to co-
plan services
Discourse Analysis
• Participant observation highlighted different power dynamics in
community – discourse analysis one step further
• Method of analysis based on linguistics, sociology, social psychology
that can be applied to any text
•A step by step process of identifying individual discourses in the text
(i.e. Medical discourse, rational, familial, etc) looking at when and how
they are used and comparing and contrasting between the different
texts (e.g. Using medical discourse to ‘legitimise’ statements)
• Next step is to apply this technique of analysis to selection of texts
including interview transcripts and website text

9. UHI Millennium Institute and The University of Aberdeen working in partnership
Questions? Supervisors:
Dr. Mags Currie
UHI, Centre for Rural
Health
Dr Rachel Tearse
UHI, Lews Castle College
Dr Elizabeth Thomson
University of Aberdeen
Amy Nimegeer
amy.nimegeer@uhi.ac.uk

10. UHI Millennium Institute and The University of Aberdeen working in partnership
Questions? Supervisors:
Dr. Mags Currie
UHI, Centre for Rural
Health
Dr Rachel Tearse
UHI, Lews Castle College
Dr Elizabeth Thomson
University of Aberdeen
Amy Nimegeer
amy.nimegeer@uhi.ac.uk