4. 4.1
Overall Evaluation of VOICES through Situational Analysis Introduction
The study of multi-faceted interventions like VOICES, that aim to intervene on various aspects of already complex systems, such as the provision of health and social care for people experiencing multiple disadvantage, requires advanced methodologies to understand the potential impact on the target population’s health, well-being, and on health equity [8]. Situational Analysis is a methodology designed to unpick the knowledge from complex inquiries, where methodologies grounded in linear models of cause and effect are inappropriate [6]. It is well-suited to this purpose for several reasons. First, data can be gathered using various methods, such as reports, interviews, field notes and minutes [7]. Second, emerged from Grounded Theory, it is an iterative and data driven methodology, where data collection in each phase depends on the findings from the previous phase. This is appropriate as we are not testing predefined hypotheses but are being guided by the data [9]. Third, Situational Analysis is one of the few complex systems methodologies that places the importance of context at the heart of its investigation [9].
4.2
Method
Specifically, Situational Analysis involves a three-stage methodology of conceptual maps, which aims to provide a detailed picture of non-linear interlinkage of complex systems structures and processes that shape the experiences of those within a specific environment [7]. The three stages are: Micro level analysis on situational maps is implemented where all important human, nonhuman, elements of the situation under concern unfold (reported in section 4.3). Meso level analysis involves the production of social worlds/arenas maps, where all collective actors (humans) and actants (non-humans) are analysed in relation to the arena in which they are engaged and negotiated the related to situation discourses (reported in section 4.4). Macro level analysis uses positional maps to unpack all positions that have emerged from data around key discourses or issues. These positions are presented on a Cartesian map in which axes present the issues of concern or controversy [8, 27] (reported in section 4.5).
Through this bottom-up, data driven methodology, Situational Analysis produces a higher and abstract level of explanation of non-linear relationships within the context (or situation) of interest. The Situational Analysis process is iterative. There are no fixed boundaries between the three analytical stages. Data collection of each phase depends on the findings of the previous one, but there is a constant recursive analytical loop (where earlier stages can be amended based findings from subsequent stages) until the saturation of evidence is achieved. For the overall exploration of VOICES’ impact and legacy, Situational Analysis was chosen as linearity, universality and generalisability are not relevant. Rather, post-modern ideas that embrace fragmentation, instability, diversity, context, and positionalities (all accepted by Situational Analysis) are necessary. When taking this approach, nothing was taken for granted; especially on issues that seem ‘normal’ within the situation and, therefore, have become invisible. Minor discourses or issues are given equal consideration as those that appear to be major or more prominent, because they may be indicative of power imbalances. Similarly, deviations from the norm are not treated as exceptions but as the boundaries 31
