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UBC Theses and Dissertations

A constant comparative analysis of opposition campaign leaders’ experiences during a controversial referendum about alcohol sale initiated by a commercial interest Shoveller, Jean Anne


The Ottawa Charter For Health Promotion defines health promotion as "the process of enabling people to increase control over, and improve, their health" (World Health Organization, 1986, p. 1). Subsequently, health promotion policy-making, practice, and research promised a broader view of the concept of health and strategies to promote health, including an increased emphasis on decentralized participatory approaches and efforts to affect policies influencing health. The literature emphasizes the cooperative rather than the confrontational aspects of participation, offering limited knowledge about how participation relates to what citizens experience when they take on leadership roles during referendums. This study examines the history of opposition at the neighbourhood level during a controversial, health-related referendum. This study seeks to generate hypotheses about the experience of campaign leaders during such a process of participation and confrontation. Semi-structured interviews were conducted with three opposition campaign leaders and two key informants. Data were coded and organized into a theoretical framework, guided by the principles of the constant comparative method. Participating in a referendum is the core category around which all other concepts clustered and has three major stages. The first stage, becoming involved, has three phases: activating, anticipating, and structuring. The second stage, being involved, has five phases: bargaining, relinquishing, overcoming, concretizing, and elevating. Remaining involved, the final stage, has two phases: reconstituting and recovering. Implications for the literature regarding citizen participation, the incorporation of citizen participation in decision making in health promotion, and changes in the process of creating healthful public policy are discussed. The referendum under study polarized citizens according to their emotional responses to complex issues, rather than facilitating broad-based citizen participation in cooperative decision making. Three alternatives to conducting referendums are suggested: deliberative opinion polling, development of a sense of proactive agency within communities, and promotion of equitable power distribution among citizens.

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