Is it possible to synthesise theory?
Many of you will be familiar with the idea of synthesising evidence – finding out what research exists, assessing which of it is good quality and then pulling it together – using methods such as meta-ethnography, meta-analysis or systematic review. But what about synthesising theories? Where a large body of theoretical work has accumulated, it is important to review and evaluate what currently exists. The reasons we synthesise evidence apply equally to theory: we need to avoid reinventing the wheel, prevent the continued use of unhelpful theories and review, evaluate and build those theories that appear useful. Since theory synthesis may be an important step in the process of developing theoretically informed interventions for use in public health, Rona Campbell and I decided to see what methods were out there and to attempt a theory synthesis.
Theory synthesisers or sociological monks?
We were interested in sociological theory so the first thing we did was find out whether any other sociologists had attempted to synthesise theory. That’s when we came across Jonathan Turner, prolific author and Professor of Sociology at University of California, Riverside. Jonathan Turner has been advocating theory synthesis for years, arguing that the process will help make sociological theories more relevant and useful, but his pleas have fallen on deaf ears. Some sociologists have criticised the idea of synthesising theories as ‘positivist’, since it could be seen to suggest that we can find the objective truth about society by combining diverse theories. Many also disapprove of removing theories from the intellectual context in which they were developed. Jonathan Turner’s response is that theory synthesis should be welcomed as it will help make sociological theory more applicable to real world social problems. He argues that if sociologists do not work to address these problems, they risk becoming ‘sociological monks’ who simply copy out the ‘sacred texts’.
Finding the theories
We decided to pilot Turner’s method using sociological theories that explain why people take risks that might impact on their health. We searched for theories in the journals ‘Social Science and Medicine’ and ‘Sociology of Health and Illness’, from when they were first published up until mid-2012. When we identified potentially relevant theories we checked the references to see if they led to any further theories. In the end we found sixteen theories that could be applied to health-related risk taking. Five of these seemed similar in that they each related risk taking to social isolation in some way. We felt that the theories had enough in common but were also sufficiently diverse – each analysing the phenomenon in markedly different ways – to provide a good test for a theory synthesis.
Three of these theories were developed by sociologists (Emile Durkheim, Howard Becker, Roni Factor and colleagues), one came from social anthropologists (Mary Douglas and Marcel Calvez) and another, by Cynthia Lightfoot, drew upon several disciplines, including sociology, anthropology, psychology and folklore. The risk taking activities considered by the theorists include self-harm (suicide), sexual risk taking, substance use, unhealthy eating, and low levels of physical activity.
Doing the synthesis
We followed Turner’s synthesis methodology, which consists of several clear stages, as follows: First clarify the concepts, models and propositions of the theories and extract what is plausible and useful for your purposes. State the theories simply and formally. Make them ‘abstract’ (relating to all times and places rather than a specific historical or empirical context), to make them easily comparable. Break down each theory into propositions (i.e. simple statements) and present them in a table to illustrate points of similarity and difference. Those appearing on the same row address a similar dynamic, while gaps show where theories diverge or examine different processes. This procedure builds the synthesis and produces a new set of propositions.
The synthesised theory
Our synthesis produced the following propositions:
- Risk taking is associated with detachment from the dominant social group.
- Risk taking may be associated with opposition to the dominant social group.
- Serious or sustained risk taking is associated with social isolation.
- Serious or sustained risk taking is associated with membership of a ‘deviant’ subculture or ‘marginal’ group.
- Such groups tend to be strongly bonded together yet have few connections to wider social networks.
We then looked for any further theoretical insights or causal processes. The refinement of the synthesis resulted in a further three propositions:
- Serious or sustained risk taking occurs outside the boundaries of mainstream society and is associated with powerlessness and liminality.
- The more detached a person becomes from mainstream society, the more likely they are to engage in serious or sustained risk taking and the harder it will be for them to re-join mainstream society.
- Reintegration into mainstream society will decrease the likelihood of engaging in serious or persistent risk taking.
The value of theory synthesis
While the concepts of social isolation and social exclusion are not new, their association with health-related risk taking is. A sociological approach to risk taking is necessary in the field of public health, where psychological theories of risk behaviour dominate, and consideration of how society influences health is often relegated to ‘environmental influences’. Theory synthesis can help make sociological theories more accessible, more robust, and easier to apply to real world problems. Our pilot study has confirmed that theory synthesis is feasible and has unearthed some valuable sociological theories that have contemporary relevance for public health.
The synthesis is published in the January 2015 issue of Social Science and Medicine in 2015,and is available online, open access, here: http://dx.doi.org/10.1016/j.socscimed.2014.11.029
A further paper describing our search for the theories and outlining their relevance to public health, is currently in press with Health Sociology Review.