{"id":18,"date":"2014-06-27T14:56:37","date_gmt":"2014-06-27T14:56:37","guid":{"rendered":"http:\/\/www.researchunbound.org.uk\/bme\/?page_id=18"},"modified":"2019-04-10T16:00:15","modified_gmt":"2019-04-10T15:00:15","slug":"the-candidacy-framework","status":"publish","type":"page","link":"https:\/\/www.researchunbound.org.uk\/bme\/introduction\/the-candidacy-framework\/","title":{"rendered":"The Candidacy Framework"},"content":{"rendered":"

Candidacy is best understood as a conceptual framework, model or construct that identifies distinct factors \u2013 spheres of experience \u2013 that influence the behaviour of individuals, service professionals and systems at all points on the access route to services. This is an emerging concept and is still being refined through academic research (see Mackenzie et al). In order to arrive at a working model, the following construct is used in this report. This adheres to the dynamic Dixon-woods model but tries to anticipate more recently suggested refinements, whilst also taking into account the need to develop a workable model that can be applied to the research methodology.<\/p>\n

Candidacy can be considered from the following six dimensions:<\/p>\n

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  1. Identification \u2013 how people recognise themselves as needing a service \u201cPeople may be highly sensitive to perceptions of their behaviour by professionals and others. Many help\u00acseeking studies show that people\u2019s fear of identity threats influences their decisions to seek help for medical problems and their interaction with health services. Their need to protect their identity \u2013 as rational, non\u00acneurotic, non\u00achypochrondriacal, responsible users of health services \u2013 may mean that they delay help\u00acseeking\u201d Dixon Woods, 2006<\/li>\n
  2. Navigation \u2013 awareness of the services on offer and the practicalities of accessing those services (including transport and physical accessibility)<\/li>\n
  3. Permeability \u2013 the ease with which people can use services (Ie do people have to be referred? Is it a drop\u00acin service?)<\/li>\n
  4. Presentation \u2013 the ability to self\u00acpresent, communicate and articulate the \u2018need\u2019 or issue; relates also to the ability to voice concerns about the standard of service if those needs are not met. This category also makes provision for political rationing, which covers the ability of individuals and groups to use political or other mechanisms to increase their access to services when competing demands and claims on a service mean more likelihood of the rationing of that service.<\/li>\n
  5. Professional adjudication \u2013 professional perceptions that may disadvantage certain people. This refers to the construction of the individual as \u2018deserving\u2019 or \u2018undeserving\u2019 and involves moral and social judgements on the part of the \u00a0\u201cservice professional\u201d, or gatekeeper.<\/li>\n
  6. Operating Conditions \u2013 Candidacy is subject to multiple levels of influence at the societal and macro levels, depending on the political, economic and environmental context at the time of presentation.<\/li>\n<\/ol>\n

    According to Mackenzie et al, Candidacy should be seen as a cyclical process, with different interactions embedded in their meso and macro contexts, rather than as a dynamic journey where each part of the process is contingent on another. Attention is drawn by Mackenzie et al to the multiplicity of layers of complexity inherent in some of these dimensions. Specifically:<\/p>\n