O35 Exploring narratives of physical activity and disability using story completion

Background Disabled people face a multitude of social barriers to leading a physically active lifestyle. These barriers include a lack of knowledge and understanding from healthcare professionals and exercise practitioners, and negative attitudes from others in sport and exercise settings. Thus, there is a need to explore constructions of physical activity and disability and the cultural narratives that operate within sport, exercise and health contexts. Aims To explore sport and exercise science students’ constructions of physical activity and disability using story completion and to examine the methodological opportunities and challenges of using story completion to identify cultural narratives. Methods Story completion is a radically different approach to collecting qualitative data to explore social constructions concerning a certain topic and the socio-cultural discourses and dominant meanings available to participants. Story completion research involves participants being provided with the opening sentences of a hypothetical scenario – or story stem – and asked to write what happens next. Four story stems were designed and refined based upon a pilot study and feedback from experts in qualitative methods and disability. Ninety UK-based undergraduate sport and exercise science students wrote a story in response to one of the stems, randomly allocated. The stories were subject to a thematic and structural narrative analysis. Results Analysis is underway. The supercrip narrative was the most dominant narrative type drawn upon, with interwoven elements of tragedy and romance from a fairy-tale narrative. The less prescriptive story stems elicited the more diverse and creative stories in terms of length and detail. Conclusions The need for alternative stories of physical activity and disability that challenge the underlying ableist assumptions of the dominant supercrip narrative will be discussed. Reflections of story completion will be provided with recommendations for future use.

Background Story completion asks the participant to produce a story, in response to an open, sometimes ambiguous, scenario. As a method for qualitative research, it is relatively unknown. Yet the method has deep roots, with origins in psychotherapy practice (projective techniques, such as Rorschach) and (quantitative) developmental psychology research (such as the doll play story completion test); in those domains, it offers a method to access information inaccessible through self-report. As a qualitative method, story completion has usually been used to research the meaning-worlds people occupy, exploring everyday sense-making in relation to topics such as infidelity 1 and health and weight loss. 2 Aims/Objectives This paper provides an overview and introduction to story completion as a qualitative technique for health research, including a brief signal of key design concerns. It demonstrates the exciting potential this method has for tapping collective sense-making, making git potentially very use for health researchers. Discussion/Conclusions We believe story completion has untapped, exciting potential for qualitative health research, offering something quite different to many of the more popular methods used (e.g. interviews, focus groups). Through highlighting conceptual and design considerations for story completion, this paper both introduces the method and sets the scene for the three empirical symposium papers that followeach of which demonstrates the application of story completion within a different area of health (healthy eating; disability and physical activity; mental health in the workplace).  Background The ways people eat is of interest to many, from government level instruction to the populace on 'healthy eating' (e.g. through guidelines, such as the UK's Eatwell Guide; eatwell.gov.uk), to the individuals who may be making choices around their food practice. Foodwhat and how we eatis deeply implicated in health and wellbeing, and the last decade or so has seen a diversification and intensification of what we might characterise as health maximisation dietary 'guidelines'such as gluten-free, sugar-free or ketogenic diets. Often based around exclusion or restriction, these diets go far beyond what public health messages promote. Yet they have high profile via (social) media, and appear to be popular beyond their evidence base, at least among privileged individuals, and those seeking to maximise health and wellness. Aims This research aims to explore how do everyday individuals (in Aotearoa New Zealand) understand decisions around, and the practice of, 'healthy eating'? Are dietary guidelines or more restrictive modes of eating evident in common-sense about 'healthy eating'? Method Using an innovative approach called story completion, I collected a sample of approximately 100 stories. Stories were written in response to a cue which read: 'Chris has decided to eat healthily, but needs clear guidelines to do this. After some online research, and talking to friends, Chris is ready to start…' Other aspects were left open.

Results/Discussion
The study is underway. Data will be analysed thematically and discursively, and this paper will report key patterns in sense-making around healthy eating. Initial analysis suggests 'healthy eating' is constructed in various ways, and as good but effortful, and hard to persist with. I will also discuss how useful story completion is for understanding the everyday worlds people navigate and negotiate around 'eating healthily', and thus for thinking about healthoriented food interventions. Background Disabled people face a multitude of social barriers to leading a physically active lifestyle. These barriers include a lack of knowledge and understanding from healthcare professionals and exercise practitioners, and negative attitudes from others in sport and exercise settings. Thus, there is a need to explore constructions of physical activity and disability and the cultural narratives that operate within sport, exercise and health contexts. Aims 1. To explore sport and exercise science students' constructions of physical activity and disability using story completion and 2. to examine the methodological opportunities and challenges of using story completion to identify cultural narratives.
Methods Story completion is a radically different approach to collecting qualitative data to explore social constructions concerning a certain topic and the socio-cultural discourses and dominant meanings available to participants. Story completion research involves participants being provided with the opening sentences of a hypothetical scenarioor story stemand asked to write what happens next. Four story stems were designed and refined based upon a pilot study and feedback from experts in qualitative methods and disability. Ninety UKbased undergraduate sport and exercise science students wrote a story in response to one of the stems, randomly allocated. The stories were subject to a thematic and structural narrative analysis.
Results Analysis is underway. The supercrip narrative was the most dominant narrative type drawn upon, with interwoven elements of tragedy and romance from a fairy-tale narrative. The less prescriptive story stems elicited the more diverse and creative stories in terms of length and detail.
Conclusions The need for alternative stories of physical activity and disability that challenge the underlying ableist assumptions of the dominant supercrip narrative will be discussed. Reflections of story completion will be provided with recommendations for future use. Background Increasing numbers of people struggle with mental health issues in western industrial nations, including the UK and Germany, with about a quarter of the population experiencing mental health problems in the space of a year (WHO/ Europe, 2018). In neoliberal cultures, individuals are often positioned as responsible for their psychological (and physical) health. This is evidenced, in part, by the proliferation of resilience, stress management, and similar self-help courses. Such courses and resources focus on teaching individuals how to cope with mental health issues, disregarding potential social, cultural and environmental causes for psychological distress. Aims/Objectives Considering this, we explored how this individualising of mental health plays out in the context of the work place, in particular in the discourses drawn on in narratives about colleagues who experience psychological illness or distress.

USING STORY COMPLETION TASKS TO EXPLORE PERCEPTIONS ABOUT MENTAL HEALTH IN A WORK CONTEXT
Methods We collected data using the method of story completion tasks (Clarke et al., 2017), asking participants to complete the following story stem, with half of participants receiving the stem with a female and half with a male protagonist: 'Michael/a returns to work after 3 weeks off. In the meantime word had got around that s/he hadn't been on annual leave, but signed off sick with mental health issues. Please continue Michael/a's story.' Participants were individuals working in either Germany or the UK, who completed the task via an online survey platform.

Results and conclusion
The study is still in the early stages. We will report thematic/discursive analysis around constructions of mental health issues in general, the social perceptions about individuals with mental health issues, as well as their positioning in the context of the workplace reflected in the narratives told. We also reflect on the value of story completion for exploring understandings around workplace mental health. Aims Demonstrate how QHR can deepen understanding of safety and risk in palliative care. Showcase use of social research methods to identify implications for professional learning by integrating incident analysis with multi-voiced constructions of interpersonal safety work. 4,7 Methods We developed innovative mixed method combinations of systematic review techniques with cross-sectional quantitative descriptive analysis and interpretative qualitative meta-syntheses of data from UK National incident reporting systems, stakeholder perspectives and published literature. 8,9 Details will be given with each case study presented. Results QHR enables professional learning about insights into everyday safety challenges and realities for patients, informal carers and professional working practices. Patients are vulnerable not only to generic safety risks but also additional risks specific to the last phase of life. For example, many harms are mediated through medication work with problematic consequences. Advance care planning (ACP) is often postulated as a solution to care challenges. Our qualitative analysis of ACP incidents demonstrates safe ACP requires not simply theoretical knowledge but acceptance of socially constructed roles and responsibilities with applied metacognitive skills and emotional intelligence. We present a new analysis of intersectionality between enactment of patient, carer and professional