With the increasing pressure on the Welfare State in the UK and other European countries, policy makers are increasingly looking to Self-Care as a means to empower individuals to live longer and healthier lives, whilst helping curb unnecessary spending and over-reliance on health systems. Yet self-care remains a broad and somewhat nebulous concept to most as it covers a wide spectrum of ideas and activities ranging from cognition and health literacy, to empowerment and evidence-based decision making and rationing of resources. This makes self-care an exciting but also a challenging area to study.
Self-care has been extensively defined and considered by various academic groups and conceptualised from several different perspectives. Paradoxically, the academic exercise of understanding self-care as a broad concept has not as yet resulted in a definitive canon of evidence that makes the absolute case for self-care and its realised benefits in the real-world setting. It is therefore necessary to move away from self-care as a purist academic pursuit to an applied field of research.
Research into self-care necessarily implies a mixed methods approach that takes into account the study of contextual factors and microdata using a combination of qualitative and quantitative research methods, whereas the multidisciplinary nature of self-care illustrates many levers that could be used to affect change. However, pilot initiatives proposing a change in more than one variable at a time are not recommended because this confounds real scientific study, resulting in weak or non-generalizable conclusions. How, then, can we consolidate these challenges between theory and practice to advance our understanding and application of self-care in the contemporary setting?
This paradox, coupled to existing gaps in our knowledge, illustrates some R&D priorities for self-care in four broad categories:
3. Identification of extant barriers and drivers to the widespread adoption of evidence-based self-care praxis. This could be done by investigating the role of digital health, eHealth and mobile health interventions on individual lifestyle choices and behaviours tenable to improve health literacy, and the practice of self-care for improved mental health and wellbeing for example. Dissolving extant barriers will support the folding of self-care into the culture and fabric of society such that its application becomes a legitimate and conscious lifestyle choice we feel empowered to make as active and cognizant members of the community.
4. Policy research and realignment of incentives to support self-care initiatives that are considered from the perspective of funding of outcomes as opposed to activities. Research streams could potentially focus on how best to consider self-care holistically to promote a ‘health in all policies’ approach by configuring and investing in the right infrastructure, including urban design factors that promote effective self-ca
Addressing these research priorities will ensure that self-care can shift away from purist academic thinking to a translational research model where it is tested as an applied concept. However, for this to happen the prevailing attitude and conceptions of health commissioners and policy makers needs to shift to enable a sustained investment into complex self-care interventions and proof of concept pilots to determine how best theoretical self-care approaches could posit in the real-world setting.
Austen El-Osta is Acting Director of the Self Care Academic Research Unit (SCARU), Imperial College London School of Public Health.
This letter was first published on the ISFglobal website: http://isfglobal.org/self-care-rd-priorities/