Lessons Learned From Co-Designing Educational Programs for Student and Practicing Healthcare Professionals in Nursing Homes: A Participatory Qualitative Study

Abstract

Our aim was to examine the co-design process of two educational programs based on scientific research, to investigate which factors influenced the co-design processes and which lessons we learned. Participatory qualitative research on multiple cases was conducted with representatives of the university, healthcare education (university of applied science), secondary vocational education and training and nursing home care practice. Data were analyzed using a critical creative hermeneutic analysis. Three themes influenced the co-design processes: (1) facilitation of the processes, (2) team members’ attributes and (3) diverse interests and structures. Participants’ diversity slowed down and deepened the collaboration. The positive climate and personal attributes enabled the processes. The complexity of the co-design processes, conflicting interests and making use of the full potential of the diversity were challenging aspects. These challenges can be overcome by organizing and facilitating co-design processes skillfully.

Full text

FULL-LENGTH ARTICLES
Lessons Learned From Co-Designing Educational Programs for Student
and Practicing Healthcare Professionals in Nursing Homes: A
Participatory Qualitative Study
Irene J.M. Muller-Schoof
1 , Marjolein E. A. Verbiest
1 , Miranda Snoeren
2 , Katrien G. Luijkx
1
1 Tranzo, Tilburg University, 2 School of People and Health Studies, Fontys University of Applied Sciences
Keywords: Critical Creative Hermeneutic Analysis, Co-design, Quality of care, Healthcare Education, Evidence-based practice
https://doi.org/10.35844/001c.57529
Journal of Participatory Research Methods
Vol. 4, Issue 1, 2023
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Muller-Schoof, I. J. M., Verbiest, M. E. A., Snoeren, M., & Luijkx, K. G. (2023). Lessons
Learned From Co-Designing Educational Programs for Student and Practicing
Healthcare Professionals in Nursing Homes: A Participatory Qualitative Study.
Journal
of Participatory Research Methods
,
4
(1). https://doi.org/10.35844/001c.57529

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Journal of Participatory Research Methods 2

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Journal of Participatory Research Methods 3

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JJJJ+ !*&))920&+! %!)2%0!$&6!0L7,0(&+$&+,2%! 32&,++ .02&!L7%,&1)!2,0!L2!%+ 0!1!0%U!&$%!2)NL
B@@EV
71 ,.&+$ 7&2% 2%! 1&232&,+N ,0 1!6!0) *,+2%1 U.0&) B@B@X!.2!*!0
B@B@VL2%!,Y !1&$+.0,!111),7!  ,7+!31!,#%&$%7,0(), &+,2%
0!+ ! 32&,+).02&!1,7&+$2,2%!.+ !*&+ 2%!13**!00!(N
30&+$ 2%! 13**!0 0!( U3)9 B@B@X3$312 B@B@VL 2%! ! 32&,+)
!6!),.*!+2!8.!02+ #&)&22,07,0(! ,+#,0*2#,0,2%! 32&,+)
.0,$0*1L 1!  ,+ 2%! +!! 1 +  0!120&2&,+1 ,# 2!* *!*!01 !8.0!11! 
!11,+1!0+! 0,*,Y!1&$+&+$ 32&,+)0,$0*1#,023 !+2+ 02&&+$!)2%0!0,#!11&,+)1&+301&+$NNN
Journal of Participatory Research Methods 4

&+ .0&,0 *!!2&+$1N !230+&+$ #0,* 13**!0 62&,+L 1,*! 2!* *!*!01
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,+)&+!6!01&,+1N%&171%!).#3)L)1,2,(!!.*,*!+23*&+2%!.0,!11N
,70 2%!!+ ,#2%!,Y !1&$+.0,'!21L+301!1% 1*))!00,)!U*,0!
1 6&1,02%+1,Y !1&$+!0VL12!%!012,,(2%!)! &+ !6!),.&+$13&2)!
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7,0(,6!0), N
The Six Co-Design Steps
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&+1!1A + BL #,)),7&+$2%!1&812!.1,# 2%!.02&&.2,09,Y !1&$+9)!
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Methods
Study Design
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Journal of Participatory Research Methods 5

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Journal of Participatory Research Methods 6

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Data analysis
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Journal of Participatory Research Methods 7

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Journal of Participatory Research Methods 8

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Journal of Participatory Research Methods 9

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Theme 1: Facilitation of the co-design process
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Journal of Participatory Research Methods 10

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Journal of Participatory Research Methods 11

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%!2%!*![#&)&22&,+\#,31! +,2,+)9,+21(Y0!)2! .0,!11!132)1,
,+0!)2&,+).0,!11!1N%!0!)2&,+)1.!2,#,Y !1&$+71&+?3!+! 92%!
1%&#22,,+)&+!*!!2&+$1 3!2,2%!YAI.+ !*&*!130!1N10!13)2L
2%! #!!)&+$ ,# 2,$!2%!0+!11 $0!7L 1 2!* *!*!01 2,,( 0! ,# !% ,2%!0
*,0!!8.)&&2)991202&+$!6!09*!!2&+$7&2%%!(Y&+2,%!0,32 %,7
!6!09,+!71,.&+$7&2%2%!1&232&,+N%!0!7!0!.,1&2&6!$0,3.)&*2!1L
7&2%&+Y !.2%3+ !012+ &+$,#!%,2%!0]1.0&,0&2&!1N+2%!,2%!0%+ L&2
71 &<3)22,129#,31!  30&+$27,Y%,30,+)&+!*!!2&+$+ 2,,++!2
+ ,**3+&2!,+)&+!N%!&+1.&02&,+)+ 0!)2&,+)1.!21,##!Y2,Y
#!*!!2&+$17!0!*&11! K
[M23))9L&+,Y !1&$+9,3%6!2,,*!2,$!2%!0N+ !31!
,# 2%!  2%2 %1 !!+ ,*.0,*&1!   &2N\ Y &+)
&+2!06&!7HL)!230!0Y.02&2&,+!0
Theme 2: Team members’ attributes
,)),02&,+!27!!+2!**!*!017&2% &6!01!($0,3+ 1L!8.!0&!+!
+  60&,31 .!01,+) 20&21 7!0! ,2% 1),7&+$ ,7++  !!.!+&+$ 2%! ,Y
!1&$+.0,!11N %! &6!01&29,# 2!* *!*!01 !+)! 2%!* 2, )!0+ #0,*
!%,2%!0]1!8.!02&1!+ .!01.!2&6!N%!*3)2&.)!.!01.!2&6!1!+0&%! 2%!
,Y !1&$+! *2!0&)K
[NN6!096)3)!2,%6!1,*!,+!#0,*0!.02&!7%,)!0)9
&+ &2!1 7%2 7,0(1 +  7%2 ,!1+]2 7,0( &+ .02&!N\ Y
)#79&+2!06&!7BL)!230!0
&;!0!+2.!01,+) 20&21 7!0!&+?3!+&+$ 2%! ,Y !1&$+ .0,!11N)) 2!*
*!*!017!0!$,,  )&12!+!01+  ',&+! 2%! &),$3!1+  !&1&,+Y*(&+$N
%&1 )!  2, )!0+&+$ +   !22!0 3+ !012+ &+$ ,# !% ,2%!0]1 ,*&+1N
!)&+$ 7&2% 3+!02&+29L %,7!6!0L 1,*!2&*!1 71  %))!+$! #,0 2!*
*!*!01N,*!2!**!*!01#!)2 &1,*#,02 3!2,2%!3+!02&+29,#2%!
,Y !1&$+.0,!11+ !8.0!11! 2%!&0.!01,+)+!! #,0,+0!2!+!11N%!+2%!
.0, 321!*!0$! + !*!2+$&)!L2%!9#!)2*,0!,*#,02)!K
[%!+ 2%&+$1 !*! ,+0!2!L &2 )*!  *! ,7+\N Y &+)
&+2!06&!7A@L2!%!0
2%!01 7!0! *,12)9 ,*#,02)! 7&2% 2%! 3+!02&+29 ,# 2%! ,Y !1&$+
.0,!11L!8.0!11!  2%2 2%!9 !+',9! &2L +  32&)&:!  &2 92(&+$ 2%! )!  ,0
13..,02&+$ ,2%!01N %! &+6,)6!*!+2 ,# 3+ !0$0 32! 123 !+21 &+ ,+! ,Y
!1&$+2!*71&+1.&0&+$2,2%!2!**!*!01!31!,#2%!&0.,1&2&6!!+!0$9
+ ?!8&)!*&+ 1!2K
!11,+1!0+! 0,*,Y!1&$+&+$ 32&,+)0,$0*1#,023 !+2+ 02&&+$!)2%0!0,#!11&,+)1&+301&+$NNN
Journal of Participatory Research Methods 12

[ #,3+ &2 &+1&$%2#3) 2%2 2%! 123 !+21 2%!*1!)6!17!0! $,&+$
2,$&6!2%!1! !8!0&1!12,,2%!0 123 !+21N%2 2%!91!! ),2 ,#
,..,023+&2&!12, ,2%&+$1 &$&2))9L7%&%2%,3$%2!#,0!%+ 
9!1L *9! 9,3 1%,3)  , 2%&1 #!Y2,Y#!N !))L  &1
,*&+$L!6!092%&+$%12,! &$&2)L+ 2%,1!123 !+21'312*!!2
7&2%*&+ 1!2,#L7!))L2%!+7!7&))'312,+6!02&2&+13%79
2%2&2+)1,! ,+! &$&2))9N,+,2,*!3.7&2%!831!1L,0
&2&1)) &<3)2L+,L2%!90!&+6!+2&6!L),,(#,01,)32&,+1L2%&+(
&2]1)!6!0L )1, 2%2 ?!8&)!*&+ 1!2N  #,3+ 2%2 &+1.&0&+$N\ Y
&+)&+2!06&!7AAL! 32&,+) !6!),.*!+2!8.!02
%!,Y !1&$+.0,!11!+)! 2!**!*!012,7,0(,+&+ &6& 3)+!! 1
+ *&2&,+1L !8.0!11!  2 2%!!$&++&+$ ,# 2%! ,Y !1&$+ .0,!11L13% 1
0, !+&+$,+!]1 +!27,0(L7%&% 71&+1.&0&+$ 2,2%!*L +  )!0+&+$#0,*
,2%!01+ 2%!&0 ,*&+1N+2%&1 79,30,Y !1&$+&+$710!&.0,)+ 
*,2&62&,+) .0,!11N ,*! 2!* *!*!01 !8.0!11!  2%2 2%!9 130.0&1! 
2%!*1!)6!1&+!8.),0&+$+!70,)!1+ 2%!0!#,0!)!0+! ,322%!*1!)6!1K
[,#2!+#!!)2%2,2%!01(+,7),2*,0!2%+ ,N+ 2%2 ,
+,20!))9%6!2%2*3%2,,+20&32!N%2%6!/3&2!,#2!+N
UMV+ &+2%&1.0,'!2L71)!2,!8.!0&!+!6!09+&!)92%2
2%2&1'312 70,+$113*.2&,+N\Y&+) &+2!06&!7HL)!230!0
.02&2&,+!0
271%))!+$!#,0*3)2&+$2%!+!! 1#,02%! &;!0!+2 ,*&+1!31!
2%!20$!2 $0,3.1#,0 7%,*2%! ! 32&,+).0,$0* 71 !1&$+!  &;!0! K
,2% 3+ !0$0 32! +301!1 +   20&+!  1%,,)Y1!  +  7,0(Y1! 
%!)2%0! .0,#!11&,+)1N  #3)) +  &+?!8&)! 300&3)3* )1, %&+ !0!  2%!
#,0*3)2&,+,#+!! 1#,02%! ,*&+1,#! 32&,+!31!2%!9 & +]2
1!!+91.!N!!!),722%!*!CN
+,2%2!*1L2%! !*&Y20&+! *!*!017!0!&+2%!*',0&29N%&1)! 
2,+3+&+2!+ ! .,7!0&*)+! 3!2,)(,#!8.!0&!+!&+,Y !1&$+&+$
! 32&,+) .0,$0*1L 7%&% %&+ !0!  1,*! 2!* *!*!01N 30&+$ 2%!
%)#79 &+2!06&!71 *,12  2!* *!*!01 *!+2&,+!  2%2 %6&+$ *,0!
.02&&.+21&+2%!2!*7,3) %6!%!).! 2%!*1!06!2%!*3)2&.)!
)!6!)1!22!0L!+%+!2%!&0&+ &6& 3)6,&!+ 2%!0!9%&!6!*,0!!/3)
&120&32&,+,#.,7!0K
[27,3) !+&!2,!)!2,1.07&2%1,*!,+!#0,**9,7+
)!6!)N!31!+,2&!2%22%!1!(&+ 1,#.0,'!210!*,0!
7& !)913..,02! &+ %&$%!0.0,#!11&,+) ! 32&,+N%&1&1 12&))
&23+(+,7+7&2%31+ &2&11,*!2&*!1 &<3)22,>+ 2%!
0&$%2.!,.)!#,0*!2,1.07&2%N\X)#79&+2!06&!7DL
2!%!0
!11,+1!0+! 0,*,Y!1&$+&+$ 32&,+)0,$0*1#,023 !+2+ 02&&+$!)2%0!0,#!11&,+)1&+301&+$NNN
Journal of Participatory Research Methods 13

Theme 3: Diverse Interests and Structures
,2% .!01,+) &+2!0!121 +  2%! &+2!0!121 ,# 2!* *!*!01] ,0$+&:2&,+
&+?3!+! 2%!,Y !1&$+.0,!11&+0!)2&,+2,2%!&07,0(), L9.0&,0&2&:&+$
2%! .0&*09 ',1 ,6!0 2%! ,Y !1&$+ .0,'!21N %&1 ,+?&2 ,# .0&,0&29 71
*,12)9#!)29&+6,)6! 2!%!01+ +301!1N9,+2012L2!**!*!01#0,*
2%! 3+&6!01&29 .0&,0&2&:!  2%! ,Y !1&$+ .0,'!21 1 2%!9 %   &0!2
0!1.,+1&&)&292,70 2%!$0+2.0,6& !0K
[NN)1,2%&+(2%27!0!,)&$! 2, ,1,2,2%!$0+2.0,6& !0
M&#7!,+2&+3!&+2%!,*&+$*,+2%1L2%213&2)!.0, 32
+ ! !)&6!0! N\ X )#79 &+2!06&!7 AAL ! 32&,+)
!6!),.*!+2!8.!02
!%!01.0&,0&2&:! 2(&+$0!,#123 !+21&+,+6!02&+$,=&+!! 32&,+
2,,+)&+!! 32&,+ 3!2,YAI.+ !*&*!130!1N17!0!),1! 
30&+$2%!),( ,7++ %!)2%0!12;% 2, !)7&2%!8207,0(), + 
!820120!110&+$#,00!1& !+21+ 0!1& !+21]0!)2&6!1K
[S!T0!))9L0!))9L0!))9% 2,7,0(0!))9%0 SMT0!))9'312
7,0(!  7&2% 0!1& !+21N &  +,2 0!))9 %6! 2&*! #,0 ,2%!0
2%&+$1X\Y)#79&+2!06&!7FL+301!
!31! 2!* *!*!01 7!0! 1, 1,0!  &+ 2%!&0 .0&*09 7,0(L &2 71
&<3)2 2, $!2 !6!09,+! 2, ',&+ !6!09 *!!2&+$ +  ,+20&32! 2, ,Y !1&$+
!27!!+ *!!2&+$1N %! %,1!+ ,Y !1&$+ 1203230! ,# #,30 %,301 .!0 7!!(
#,0 AF *,+2%1 71 2%!0!#,0! &+!<&!+2 +  %&+ !0&+$L 1 2%! 2!*1 ),12
*,*!+23* &+Y!27!!+N )1,L !8&12&+$ +  >8!  1203230!1 )&*&2!  2%! ,Y
!1&$+.0,!11&+,2%2!*1L&+)3 &+$! 32&,+)1203230!1U!N$NL1%! 3)!1L
300&3)L62&,+1L !+  2!0*1V +  0! 1203230!1 U!N$NL #3))9 .)++! 
7,0(1%! 3)!1VL7%&%%&+ !0! 2%!?!8&&)&29,#2!**!*!01N,0!8*.)!L
!8&12&+$62&,+1203230!1 ,#2%!! 32&,+)&+12&232&,+1* !.)++&+$,#
*!!2&+$1 &<3)2 &+ 1,*! .!0&, 1 +  1),7!  ,7+2%! .0,!11 30&+$ 2%!
13**!0+ %0&12*11!1,+1K
[%&%'312#,3+ 6!09 &<3)2&+2%!13**!0UMV7%!+2%!
2!%!0123))9%6!E7!!(1]62&,+N%271)1,2%!1!
7&2%2%!%0&12*1 0!(N+  2%22%2 712%!*&+ 0!1,+N
+ 1,*!2&*!1% 2%!& !2%2&22,,(2%!1.!! ,32,#2%!
7%,)!.0,!11X\Y&+)&+2!06&!7CL+301!
(,# 2&*!+  .0!1!+! 3!2, ,+1!/3!+!1,#YAI.+ !*&
*!130!1 7!0! #2,01 %&+ !0&+$ &+)31&,+ ,# !6!09 6,&! 30&+$ 2%! 7%,)!
.0,!11K
[2 2(!1 2&*! 2, &1311 2%! .0&+&.)!1 ,# ,Y !1&$+L 2, $!2 2,
(+,7!%,2%!0L %,79,3+,0*))9 .!0#,0*L7%20,)!,3) 
9,3%6!%!0!L%,70!7!$,&+$2,1%.!2%2,Y !1&$+N%&%
!11,+1!0+! 0,*,Y!1&$+&+$ 32&,+)0,$0*1#,023 !+2+ 02&&+$!)2%0!0,#!11&,+)1&+301&+$NNN
Journal of Participatory Research Methods 14

$&6!19,3&2,##!!)&+$22%!!+ K&271+,20!))97%,)!,Y
!1&$+L*,0!,Y !1&$+,##!7.!,.)!X\Y&+)&+2!06&!7EL
)!230!0
+!+)&+$#2,0,#2%!,Y !1&$+.0,!1171L%,7!6!0L2%2,30,+)&+!
*!!2&+$1% *,0!1203230!+ 2!**!*!0116! 206!)2&*!P2%!0!#,0!L
2%!2!*17,0(! *,0!!<&!+2)9&+2%!)12.02,#,30,Y !1&$+.0,!11K
[%! ,+)&+! *!!2&+$1 %  2%!  6+2$! 2%2 .!,.)! 0! 6!09
2, 2%! .,&+2L 7&2%  )!0 $!+ L &2 &1 6!09 !<&!+2X\ Y &+)
&+2!06&!7HL)!230!0.02&2&,+!0
2 71 &<3)2 2, !*!  2%! +!7 ! 32&,+) .0,$0*1 &+2, !8&12&+$
300&3)N  300&3) 7!0! !1.!&))9 ,6!00,7 ! L 7%&% &1 )0$!)9
!2!0*&+! 9+2&,+)! 32&,+)&+12&232&,+1K
[ %6! ,+!0+1 ,32 2%! 1203230) &+20, 32&,+ &+2, 2%!
300&3),#..)&! 1&!+!! 32&,++ ! 32&,+L+ 
7%!2%!02!%!01 7&)),+)9 31! 1*)) .02,# &2&+12!  ,#2%!
!+2&0! .0,$0*L !31! 300&3) 0! '*.(! X\ Y )#79
&+2!06&!7BL)!230!0
%!! 32&,+).0,$0*17!0!* !1?!8&)!1.,11&)!&+,0 !02,*!!2
)) +!! 1 +  !1&0!1N + 2%&1 79L2%! >8! 1203230!1 !+)! 31 2, !1&$+
?!8&)9+ 0!2&6!)9N>+),+1!/3!+!,#2%!.+ !*&*!130!1
71 2%2 ,Y !1&$+!  ! 32&,+) .0,$0*1 ,3)  +,2 ! 2!12!  &+
*3)2& &1&.)&+09UV2!*1!31!2!*1 & +,2%6!,+13)22&,+1
2,$!2%!0,07!0!+,2.0!1!+2+ 7,0(! #0,*%,*!K
[M2%!&+1203*!+2S!6)32&,+ 2,,)T7%&%7!%6! .2! 2,
),+$Y2!0*0!2,2!12&2M7!7!0!+,2)),7! 2,*!!22>012
3!2,  + 2%!+L 30&+$ 2%! %,)& 9 .!0&, L)) 2%,1!
 ,+13)22&,+1 %+$! N 13))9 6!09 #!7 &1&.)&+!1 7!0!
.0!1!+2X\Y)#79&+2!06&!7FL+301!N
Discussion
!,+ 32! .02&&.2,09/3)&22&6!123 9,+27,1!12,!8.),0!2%!
!8.!0&!+! !+)&+$+  %&+ !0&+$ #2,01,# ,Y !1&$+&+$ 27,! 32&,+)
.0,$0*1 7&2% &6!01! $0,3.1 ,# .02&&.+21K 0!1!0%!01L ! 32,01 #0,*
&;!0!+2)!6!)1,#0!! 32&,+L+301!1#0,*.02&!+ +! 32&,+)
!6!),.*!+2 !8.!02N ! #,3+  2%2 ,Y !1&$+&+$ 7&2% 2%&1 ,*.,1&2&,+ ,#
.02&&.+2171,*.)!8.0,!112%2++,2!#3))9,+20,))! + 7%!0!
&6!01&29 .)9!   0,)!N %! .02&&.2&+$ &+ &6& 3)1L 2!* .0,!11!1 + 
&+2!0!121,#2!**!*!01],0$+&:2&,+&+?3!+! 2%!,Y !1&$+N.,1&2&6!
2*,1.%!0!17!))1.!01,+)/3)&2&!113%1)&12!+&+$+ .9&+$22!+2&,+
2,,2%!01!+)! ,)),02&,++ ,%!1&,+,#2%!2!*1N!01,+)!8.!02&1!
+  &6!01&29,#.!01.!2&6!1)1, !!.!+! 2%!,)),02&,+L7%&%&10!?!2! 
&+ 2%! 0!13)21N %! 60&!  1203230!1 ,# 2%! ,0$+&:2&,+1L ,*&+!  7&2%
!11,+1!0+! 0,*,Y!1&$+&+$ 32&,+)0,$0*1#,023 !+2+ 02&&+$!)2%0!0,#!11&,+)1&+301&+$NNN
Journal of Participatory Research Methods 15

.0&,0&2&:&+$#,0.0&*097,0(&+3192&*!1L%&+ !0! 2%!,Y !1&$+&+$N)(
,#)0&290,3+ 2%!0,)!+ )(,#0!$3)0!6)32&,+17!0!+,2%!).#3)2,
2%!,Y !1&$+&+$.0,!11!&2%!0N,7!6!0L.02&&.+21% +2&6!0,)!&+2%!
0&2&)0!2&6!%!0*!+!32& 2Y+)91&1 1,2%2 2%! 0!13)21 0!?!2 &;!0!+2
.!01.!2&6!1N!0!,**!+ 2%!31!,#2%!.02&&.2,09,Y !1&$+#,02%!,Y
!1&$+,#! 32&,+).0,$0*1U022!2!&$!2)NLB@ABVN
%&)!7!!8.!0&!+! %))!+$!1 30&+$2%! ,Y !1&$+&+$.0,!11!1U)!
EVL !)&+$7&2% &6!01&29712%!,6!00%&+$,12)!N+)&+!7&2%2%&10!13)2
0! >+ &+$1 #0,* .0!6&,31 123 &!1 2%2 122! 2%2 ,)),02&+$ &+ $0,3.1
,+1&12&+$,#&+ &6& 3)10!.0!1!+2&+$ &;!0!+2,0$+&:2&,+10!2!1%))!+$!1
2%2 + ! &<3)2 2, !) 7&2% U((!0*+ ^ ((!0L B@AAP 305!3 ^
%03&'!0LB@AGP%03&'!0LB@BAVN!*&$%2!.22%2,Y !1&$+,*!17&2%
%))!+$!1,+ 2%! ,+! %+ N + 2%! ,2%!0 %+ L ((!0*+^ ((!0 122!
2%22,7%2!82!+22!*113!! &+,6!0,*&+$%))!+$!19)!0+&+$0,11
2%!&0,3+ 0&!17&)),+20&32!2,*(&+$31!,#2%!!+2&0!.,2!+2&) ,#2%!
&6!01&29,#2%! 2!*1U((!0*+ ^ ((!0LB@AAVN , 2%2!+ L 7!1%,3) 
%6!!6)32! 2%!.0,!11*,0!,#2!+N
!  0!11 2%! %))!+$!1 7!!+,3+2!0!  +  &1311 %,7 2, ,6!0,*!
2%!*K %&!6&+$ 1%0!  3+ !012+ &+$L %&!6&+$ !/3) .,7!0 &120&32&,+L
!)&+$7&2%,Y)! !01%&.L !& &+$,322%! !$0!!,#.02&&.2&,+L !)&+$
7&2%3+!02&+2&!1L !)&+$ 7&2% ,+?&21 ,# .0&,0&2&!1L +  !)&+$ 7&2% 2%!
,+1!/3!+!1 ,# 2%! *!130!1 ,# YAIN , 6,&  3.)&2&,+1L 2%!
%))!+$!1[*!!2&+$&+ &6& 3)1]+!! 1\+ [2%!,+1!/3!+!1,#2%!*!130!1
,#YAI\0!7,6!+&+2,2%! &1311&,+,#2%!,2%!0%))!+$!1N
&012L1%0! 3+ !012+ &+$,#,**,+$,)1230+! ,322,! &<3)22,
%&!6!22%!!$&++&+$N1%0! 3+ !012+ &+$&1&*.,02+21&2!+,30$!1
2%!!8%+$!,#0!)!6+2&+#,0*2&,+U!0!3!2)NLB@@HP&+1:!2)NLAIIGVN
&!+2&> )&2!0230! ,+ 0,11Y1!2,0,)),02&,+ 0! 1 2%2 [2 *9 ! 7&1!
9! 32&+$.02&&.+21,322%!,+!.21L&+#,0*2&,+L+ 2,,)12%20!
(!9\U091,+!2)NLB@@FP!12!2)NLB@@DVN%&1*!+12%2)).02&&.+21
+!!  2, ! &+#,0*! L ! )! 2, #,0* + ,.&+&,+ +  ! $&6!+ 2%! .,7!0
2, &+?3!+! U022!2!&$ !2 )NL B@ABVN 6!+ 2%,3$% 2%! #&)&22,0 .0!1!+2! 
2%! ,+!.2 +  12!.1 ,# ,Y !1&$+ +  .0,'!2 $,)1 ,# 2%! .0,'!2 2, 2%!
2!* *!*!01 2 2%! !$&++&+$L 2%!9 7!0! +,2 ,*.)!2!)9 3+ !012,,  9
!6!09,+!N+0!20,1.!2L2%!)+$3$! + #,0*2,# 2%!.0!1!+22&,+ 1%,3) 
%6!!!+*,0!2&),0! 2,2%! &6!01&29,#2%!2!*N(,#0!$3)0!6)32&,+
,#2%!.0,!1131! )2! &1,6!09N%!+&271 &1,6!0!  30&+$ 2%!%)#Y
79&+2!06&!71L*,0!&+ &6& 3)13..,0271,;!0! N!13$$!12 &1311&+$&+
,Y !1&$+2!*17%!2%!0 + %,7 1%0! $,)10! 3+ !012,, N+ )&+!7&2%
2%&1L&+ ),*!2)NUB@BAV !10&!2%! +!! #,031&+$60&! 00+$!*!+21
2%2[)),7! #,01!6!0)*, !1,# !8.0!11&,++ *!22%!+!! 1,# &;!0!+2
&+ &6& 3)1N\,*!!22%! &6!01!+!! 1+ 2,0!%1%0! 3+ !012+ &+$L
7! 13$$!12 312,*&:&+$ ,**3+&2&,+1 2, 2%! 2!* *!*!01L 13% 1 +
+&*2&,+,06& !,,32,Y !1&$+,01%,02L&))31202! 0! !0,+2%22,.&N
)1,L *,0! 1&232&,+) &+ &6& 3) 13..,02 ,3)  ! ,;!0! N ,0 &+12+!L
!11,+1!0+! 0,*,Y!1&$+&+$ 32&,+)0,$0*1#,023 !+2+ 02&&+$!)2%0!0,#!11&,+)1&+301&+$NNN
Journal of Participatory Research Methods 16

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,Y !1&$+.0,'!2#,0 2!**!*!01] ,7+,**3+&29N ! 2%!0!#,0!13$$!12
31&+$*2!0&)1+ 7,0(*!2%, 12%2!+,30$!!6!09,+!2,,+20&32!L#,0
&+12+! 9 )!0)9 !8.)&+&+$ 1202 ,+!.21 2%0,3$% *,0! 0!2&6!
&+2!02&6!7,0(1%,.1+ 9.0,6& &+$!820&+ &6& 3)13..,02N
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.0,'!22,%&!6!#3+2&,+) &6!01&29N!!8.!0&!+! +3+&+2!+ ! .,7!0
&120&32&,+ 3! 2, 2%! 2!* ,*.,1&2&,+L 7&2%  *&+,0&29 ,# 
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0!,**!+ ! 2%22%!#,0*,#)! !01%&.!0!#3))9%,1!+L &1311! L+ 
.,2!+2&))920&+! &+,Y !1&$+.0,'!211&+!+,2)).!,.)!>22%!0,)!,#,Y
)! !0U,%^3)!,%+LB@ACP!0!^+:LB@@EVN%&1&1+1.!22%2
,3) ! 1.!&>!  &+ 2%! 0!/3&0!  .0,>)! ,# )) 2!* *!*!01 +  11!11! 
30&+$2%!.0!.02&,+,#,Y !1&$+.0,'!2N
%! !$0!!,#.02&&.2&,+1%,3) !13'!2,# &1311&,+7&2%2%!2!*
*!*!01 2, *+$! !8.!22&,+1N ! !8.!2!  )) 2!* *!*!01 2, #3))9
.02&&.2! 30&+$2%!7%,)!.0,'!2L32&+0!20,1.!22%&171+,2+!!1109L1
#,0&+12+! !1&$+&+$)!11,+171+,2!6!09, 9]1!8.!02&1!N%&1>+ &+$71
)1, 0!11! 9022!2!&$!2)N UB@ABVK[%!0!*9 ! &;!0!+2 !.2%1,#
.02&&.2&,+N\!13$$!12 &1311&+$&+7%&%12!.1.02&&.2&,+,#!6!092!*
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Journal of Participatory Research Methods 17

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,#2%!,.!+Y!+ ! .0,!11+ 1(! #,0*,0!$3& +!N%!+!! #,0*,0!
$3& +!)&$+1 .,,0)97&2% ,Y)! !01%&.N&!+2&> )&2!0230! !10&!1 2%2
2%! +230! ,# ,Y !1&$+ &1 ,*.)!8 +  ,.!+Y!+ !  U%$3!0L B@BAP
%03&'!0LB@BAP+,7 !+^,,+!LB@@GVN6&+$,+6!012&,+,322%!
&1,*#,02L2%!.,2!+2&)!+!>21L+ !+6&1&,+&+$.,1&2&6!!*!0$&+$#3230!
,3)  %6!%!).!  2!* *!*!01 ,.! 7&2% 2%&1 3+!02&+29 U!+$!L AIIIP
!+$! !2 )NL B@@DP 0&1%)!0 !2 )NL B@AHVN + ,+! %+ L ,Y !1&$+ +  ,Y
)! !01%&. 0! !8.!2!  2, ! 0!&.0,) U&1%,. !2 )NL B@@@P ,% ^
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.0,'!2L 1, 1,*! 1(&)) &+ !)&+$ 7&2% &2 &1 31!#3)N ,)!0+!#,0 3+!02&+29
,3)  ! 1.!&>!  &+ 2%! 0!/3&0!  .0,>)! ,# .,2!+2&) 2!* *!*!01L + 
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.0,!11L1,Y !1&$+&+$&1 9+*&L+ 3+!02&+2&!1*90&1!),+$2%!79N
%! ,+1!/3!+!1 ,#  AI]1 *!130!1 )!  2,  &2&,+) 7,0(), 
&+2%!.0&*097,0(,#.02&&.+21#0,*0!+ ! 32&,+L1,.02&&.+21
$6!)!11.0&,0&292,2%!,Y !1&$+.0,'!2N2&1(+,7+#0,*)&2!0230!2%2,Y
!1&$+1!17&2%*3)2&.)!12(!%,) !01*(!,+?&21,#.0&,0&2&!1&+!6&2)!
U091,+ !2 )NL B@@FL B@AEVN 0,6+ ^ !+&1 !10&! 2%! 2!+1&,+ !27!!+
[.02&&.2&,+,#))\+ [#,31,+2%!0!13)2\1,+!,#2%!&+%!0!+22!+1&,+1
2%2!8&12&+*3)2&Y12(!%,) !0,)),02&,+U0,6+^!+&1LB@@HVN+,30
,)),02&,+L[.02&&.2&,+,# ))\71 ,6!02(!+9[#,31 ,+ 2%!0!13)21\
&+2%! !+ L 1 0!13)21 7!0! +!! ! 2, .0,!! 7&2% 2%! .0,'!2 ,0 &+$2,
1,*!2!**!*!01N+,302!*1L2%!1!,+?&211%,3) %6!!!+!8.)&&2)9
+!$,2&)!2,,*!2,,)),02&6!..0,%N6&+$1(&))! #&)&22,0+ 
0!$3)0)92(&+$2&*!2,!6)32!,+?&2&+$&+2!0!1210!13$$!12! N
Lessons Learned
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$0,3+ + 1%0! .0,)!*2,7,0(,+ 30&+$2%!.0!.02&,+,#,Y !1&$+
.0,'!2L7!13$$!12,0$+&:!01>+ 1(&))! #&)&22,0N30!8.!0&!+!&+ &2! 
2%&10,)!71,*.)!8L12%!#&)&22,0 !)17&2%)) 0!11! %))!+$!1+ 
*31212&*3)2!2%!2!**!*!012,31!2%!.,2!+2&),#2%!&0 &6!01&29N%!
,0$+&:!01 1%,3)  )1, 2%&+( ,32 0!/3&0!  .0,>)!1 ,# 2%! 2!* *!*!01L
17!)!0+! 2%22%!&+ &6& 3)/3)&2&!1 7!0!,2%!+)&+$+ &*.! &+$
#2,01N!)!0+! &2!+)!12%!.0,!112,,*.,1!2!*2%2&1#3+2&,+))9
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(+,7)! $! .,2!+2&) .,7!0 &*)+!1 &+  6+!N ,0!1!!+ .,7!0
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Journal of Participatory Research Methods 18

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,32,Y !1&$+&+$L 1%0! $,)1L +  ,Y)! !01%&.0! 3+ !012,,  2, 6,& 
!8.)&+&+$2%&+$12,,1202)9,03+)!0)9N#+!!1109L,;!013..,02,0!820
&+#,0*2&,+&+792%2 &13+ !012,,  9))2!**!*!01N ,0&+12+!L
!6!),.  7,0(1%,. ,32 ,Y !1&$+&+$ 7&2% &+2!02&6! !8!0&1!1 7&2% +
!8.!02L,0 *(! + +&*2&,+ ,32 ,Y)! !01%&.#,)),7! 9  &1311&,+
,0 &),$3!N+!+)&+$#2,0713&) &+$.,1&2&6!)&*2!7%&%%!).! 
2!**!*!01#!!)1#!,+20&32&+$2,2%!2!*N!0!,**!+ $&6&+$2%&1
#2,022!+2&,+N&+))9L7!13$$!122(&+$2&*!2, &1311,+?&2&+$$!+ 1
+  &+2!0!121 #0,* 2%! 1202 +   0!11 2%! !8.!2! ,0 +!!1109)!6!)1 ,#
.02&&.2&,+N!#,3+ ,322%2+,2!6!09, 9+!! ! 2,.02&&.2!&+2%!
7%,)!.0,!11N)(&+$,322%!.0,!11*(!1&2)!02,!6!09,+!N
%!*&+)!11,+7!)!0+!  30&+$,30.0,!11712%2!6)32&,+,#2%!
.0,!11&1&*.,02+2 2,& !+2&#9 + %+ )! 2%!%))!+$!1 *!+2&,+! ,6!
!0)9,+N+,30.0,!11L7!+!$)!2! !6)32&,+#,0),+$2&*!!31!7!
!11,+1!0+! 0,*,Y!1&$+&+$ 32&,+)0,$0*1#,023 !+2+ 02&&+$!)2%0!0,#!11&,+)1&+301&+$NNN
Journal of Participatory Research Methods 19

7!0!#,31! ,+2%!0!13)2N%!0!#,0!L7!13$$!12.322&+$2%!13'!2,+2%!
$!+ 10!$3)0&2!*+  0!11&+$#0&2&,+112%!90&1!L!N$NL,+!/3)&29L
)0&29L !*,2&,+1L.0&,0&2&!1L,+?&2&+$&+2!0!121N%!31! ,# &),$3!102%!0
2%+ &1311&,+1!+)! 312,!8.),0!2%! &6!01!.,2!+2&),#,302!*1N271
1%0! !;,022,12&*3)2!!6!096,&!!&+$%!0 N!2%310!,**!+ 31&+$
&),$3!1 2, !8.),0! &+12!  ,# &1311&,+1N 302%!0L 7! ,3)  %6! ,;!0! 
 $0!2!0 60&!29 ,# 7,0(&+$*!2%, 1 2, *!!2 2%! &;!0!+!1!27!!+2!*
*!*!01N ! 13$$!12 %,,1&+$ 7,0(&+$*!2%, 1 2%2 0!,+0!2!L &6!01!L
+  2%2 &+6&2!2!* *!*!01 2, .02&&.2!L.0!#!0)9,=&+!L 2, .0,*,2!
0!)2&,+1%&.Y3&) &+$ +  0!2&6&29N +6,)6&+$ 3+ !0$0 32! 123 !+21
*,2&62!  +  ,+20&32!  2, !!.!+&+$ 2%! 0!13)2N ! 0!,**!+  )1,
&+6,)6&+$123 !+21&+#3230!.0,'!21L12%!91%,3) %6!!!+&+)3 ! 
17!))N)2%,3$%7!#,31! *,0!,+2%!%))!+$!12%+,+2%!!+)!01L,+
.!01,+))!6!)7!% $,, 0!)2&,+1L1,7!13$$!1212&*3)2&+$0!)2&,+1 30&+$
2%!.0,!11N! )!0+! 2%20!)2&,+ 3&) &+$71 !1&!0,=&+!2%+ ,+)&+!N
&+))9L7!!+',9! 7,0(&+$2,$!2%!0L7%&%)),7! 312,!+',92%!.0,!11N
Strengths and Limitations
, 2%! !12 ,# ,30 (+,7)! $!L 2%&1 71 2%! >012 123 9 2, ,3*!+2 2%!
&+?3!+&+$#2,01,#2%!,Y !1&$+.0,!117&2% &6!01!$0,3.1,#12(!%,) !01
#0,*  .02&!L ! 32&,+L +  0!1!0% 7&2% 2%! &* ,# 20+1)2&+$
1&!+2&>>+ &+$1&+2,! 32&,+N%!,Y !1&$+,+1&12! ,#27, &6!01!2!*1
2%2 !6!),.!  $,,  0!)2&,+1%&.1 +  .32 $0!2 !;,02 &+2, &),$3!1 2,
3+ !012+ !%,2%!0]11&232&,+1N!**!*!01)1,2&6!)9.02&&.2! &+
+)9:&+$2%! 2L!+130&+$2%22%! &;!0!+2.!01.!2&6!10!.0!1!+2&+2%!
0!13)21N,*!)&*&22&,+1%6!2,!2(!+&+2,,3+2N3!2,2%!YAI
.+ !*&*!130!1L7!17&2%! 2,,+)&+!,**3+&2&,+#2!01&8*,+2%1N
!(+,7#0,*0!!+20!1!0%2%2,+)&+!*!!2&+$10! 3!0!2&6&29U03(1
^!66L B@BBVL1, ,+)&+!*!!2&+$1 7&))%6!;!2! ,300!2&6&29 2,,N!
)&(!7&1! *&11!  &+#,0*) ,**3+&2&,+L !8.!0&!+!  #!7!0 0!)2&,+1%&.Y
3&) &+$ ,..,023+&2&!1L +  ,3)  +,2 6&1&2 !% ,2%!0]1 7,0(.)!N 2 &1
&<3)22,.0! &2&+7%2792%!0!13)217,3) %6!!!+ &;!0!+27&2%,Y
!1&$+&+$2,2))9,=&+!N302%!0L)2%,3$%,+)91&8,32,#2!+2!**!*!01
',&+!  2%! L &2 71  $,,  0!.0!1!+22&,+ ,# 2%! 27, 2!*1 +  ))
2%! ,*&+1N + )&+! 7&2% 2%&1L )2%,3$% 2%! 0!1!0%!0 %   *',0 0,)! &+
0!1!0%&+$L#&)&22&+$L+ ,Y !1&$+&+$L2!**!*!01.02&&.2! ,2%&+
,Y !1&$+9,Y)! !01%&.+ &+2%! 2+)91&12%0,3$%2%!N)1,L
2%!,Y32%,01 0&2&))9,+2!12! 2%! >+)  12!.L7%&% 0! 3! 2%!
,*&++9,#2%!0!1!0%!0N! & +,2&+)3 !123 !+21131!0$0,3.&+
,30,Y !1&$+&+$2!*1#0,*2%!!$&++&+$W2%&171+]2.,11&)!1&271+,2
(+,7+ #0,* 2%! 1202 &+ 7%2 9!0 2%! ! 32&,+ 7,3)  ! 13&2)!N 2!0
&+ 2%! .0,!11L 2%! .)+ 2, %,)  #,31 $0,3.1 7&2% 123 !+21 71 ))!  ,;
3!2,2%!.+ !*&N)2%,3$%3+ !0$0 32!123 !+217!0!&+6,)6! &+,+!
,# 2%! 2!*1L 7! 0!,**!+  &+6,)6&+$123 !+21 ,# )) ! 32&,+) )!6!)1 &+
#3230!,Y !1&$+&+$.0,'!211!0)91.,11&)!N6!+2%,3$%7!,+ 32! 2%!
&+6!12&$2&,+&+2%!!2%!0)+ 1L7!,+1& !02%!32%,+2!821,*.0)!
!11,+1!0+! 0,*,Y!1&$+&+$ 32&,+)0,$0*1#,023 !+2+ 02&&+$!)2%0!0,#!11&,+)1&+301&+$NNN
Journal of Participatory Research Methods 20

7&2% &+2!0+2&,+) ,+2!821 &+ 2%! !12!0+ 7,0) N &+,0 !6&2&,+1 7&2%
#,0!&$+1&232&,+1*9!8&12U#,0&+12+!2%!62&,+.!0&, 1,#! 32&,+)
&+12&232&,+1VL32 7! !8.!213% !6&2&,+1 2, %6! *&+,0 &*.2 ,+ 2%!
0!13)21N &+))9L 2%&1 0!1!0% &1 )&*&2!  2, 2%!  ,+2!82N ! 13$$!12
,+ 32&+$0!1!0% &+ ,2%!0 ,+2!82113% 10! #,0 ,**3+&29Y 7!))&+$
,) !0 3)21L 0!#,0 .!,.)!)&6&+$ 7&2% +&+2!))!23) &1&)&29L+ 9,32%
0!Q%!)2%0!N
Conclusions
%!&+?3!+&+$#2,01,#,Y !1&$+&+$! 32&,+).0,$0*1L2,$!2%!07&2%
0!.0!1!+22&6!1,#2%!3+&6!01&29L0!! 32&,+L+ 0!.02&!L2,20+1)2!
1&!+2&>(+,7)! $! &+2,2%! .02&! ,#0! #,0,) !0  3)21 7!0!+)9:! 
.02&&.2&6!)9N %! .,1&2&6! )&*2! +  .!01,+) 220&32!1 !+)!  2%!
.0,!11N %! ,*.)!8&29 ,# 2%! ,Y !1&$+ .0,!11L ,+?&2&+$ &+2!0!121 + 
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Acknowledgements
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Con%icts of Interest
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Journal of Participatory Research Methods 21

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,)),02&,+1K!! ! and%))!+$&+$NPublic Administration ReviewL75UEVLFDGXFFCN
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Journal of Participatory Research Methods 23

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Journal of Participatory Research Methods 24