Jinks et al. BMC Public Health 2010, 10:148 http://www.biomedcentral.com/1471-2458/10/148 Table 1 Profile of Interviewees Gender Age Knee Pain Status Male Female Male Female Female Male Male Female Male Male Male Male Female Male Male Female Male Male Female Male Male Male Male Male Male Female Male Male 58 61 64 64 59 63 75 70 86 59 61 78 66 69 60 63 72 62 79 68 68 53 69 62 66 61 59 69 Resolved pain Pain Pain No Pain No Pain Pain Pain Pain No pain Pain No Pain No Pain No Pain Pain Pain Pain Pain Pain Pain Pain No Pain Resolved Pain No Pain No Pain No Pain No Pain No pain No Pain ID 539 668 669 957 968 1148 1417 1633 2241 2390 2411 3641 4237 4477 4575 4713 5217 5228 5248 5300 5456 5969 6028 6150 6545 6598 6894 6900 Qualitative computer software package NVivo 2 was used to manage the data. A thematic analysis approach was adopted. The codes were grouped in relation to the Rainbow model, and team analysis of the coding groups allowed relationships between the elements of the model to be drawn out that could then be ordered into themes. TO and CJ also wrote memos in order to develop ideas about the data and codes. This is an important process as it enables the researcher to com- mence data analysis early and capture comparisons and directions to pursue [18]. The main themes to emerge from the data were in relation to individual responsibil- ity for health, barriers and facilitators to prevention activity and social context. Figure 2 outlines the devel- opment of the coding framework and the integration of memos within this. Results Whose responsibility is it? The interview started with asking people about their general health, followed by exploring their knee pain history. This then led to talking about the factors that Page 4 of 9 contributed to their knee pain and their thoughts about preventing this, using the rainbow model as a guide. While nearly all respondents alluded to the issue of responsibility for maintaining health, eight people elabo- rated on this concept in greater depth. Each person emphasised that individuals are responsible for their own health using phrases such as: “Well, it’s nobody’s responsibility but my own.” (4575) or “I think you have to be prepared to help yourself.” (5300) These statements became more nuanced through con- sidering the factors that allowed people to live responsi- bly, and professional advice was seen as important, or more broadly, organisations should take a pro-active approach to individuals: “With the National Health, you know, the lessons I’ve learned is that, if it’s a great expense for them to react to a condition that I’ve had, whereas it might have been cheaper had the resources been there to have taken the preventative.” (6028) and “I suppose, in the first instance, it’s the individual, but people, being individuals, are all different. So I think there should be some sort of ‘gee-up’ from authorities [...] somebody could come round from the [city] council or some gym or something. Just do a few basic exercises with residents.” (6900) The role of health and other statutory services with respect to prevention were explicitly recognised by these individuals: the NHS was seen as focusing on treating acute problems which may have been prevented if invest- ments were aimed at prevention rather than cure. The importance of organisations outside of health was high- lighted in the second quote where it was suggested that city councils could create the conditions that helped peo- ple to improve their health. As an extension of organisa- tional facilitators the professionals working within health and social care were seen to be important in advising people on healthy lifestyles and who should act as educa- tors and sources of information. At the same time, their influence was dependent on individual receptivity: “I think it’s got to come from within, hasn’t it really? I mean, when we, you can listen to advice, but you’ve got to either put that advice into practice or be determined enough, in your own mind, that, you know, you will either lose the weight or stop smok- ing, or stop drinking, or whatever.” (4713)