The Value and Challenges of Participatory Research: Strengthening Its Practice

Department of Psychiatry and Douglas Mental Health University Institute, McGill University, Verdun, Quebec, Canada.
Annual Review of Public Health (Impact Factor: 6.47). 02/2008; 29(1):325-50. DOI: 10.1146/annurev.publhealth.29.091307.083824
Source: PubMed

ABSTRACT

The increasing use of participatory research (PR) approaches to address pressing public health issues reflects PR's potential for bridging gaps between research and practice, addressing social and environmental justice and enabling people to gain control over determinants of their health. Our critical review of the PR literature culminates in the development of an integrative practice framework that features five essential domains and provides a structured process for developing and maintaining PR partnerships, designing and implementing PR efforts, and evaluating the intermediate and long-term outcomes of descriptive, etiological, and intervention PR studies. We review the empirical and nonempirical literature in the context of this practice framework to distill the key challenges and added value of PR. Advances to the practice of PR over the next decade will require establishing the effectiveness of PR in achieving health outcomes and linking PR practices, processes, and core elements to health outcomes.

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    • "Developing a partnership with participants, although critical to extract insider insights, can be especially challenging if a sense of trust and respect is not effectively established between participants and research or evaluation teams (Muhammad et al., 2015). In addition, given the integral involvement of participants during each phase, the overall direction and scope of the study can vary; this may lead to difficulties in governing and managing the direction of the study (Cargo & Mercer, 2008). Furthermore, local contextual regulations around conducting research or QI projects may also pose challenges. "
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    ABSTRACT: In this methodological article, we examine participatory methods in depth to demonstrate how these methods can be adopted for quality improvement (QI) projects in health care. We draw on existing literature and our QI initiatives in the Department of Veterans Affairs to discuss the application of photovoice and guided tours in QI efforts. We highlight lessons learned and several benefits of using participatory methods in this area. Using participatory methods, evaluators can engage patients, providers, and other stakeholders as partners to enhance care. Participant involvement helps yield actionable data that can be translated into improved care practices. Use of these methods also helps generate key insights to inform improvements that truly resonate with stakeholders. Using participatory methods is a valuable strategy to harness participant engagement and drive improvements that address individual needs. In applying these innovative methodologies, evaluators can transcend traditional approaches to uniquely support evaluations and improvements in health care.
    No preview · Article · Dec 2015 · Qualitative Health Research
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    • "In fact, the inclusion of all key stakeholders' perspectives[12,13]is central to the development of relevant 'bottom-up' health initiatives14151617. Participatory research (PR)181920, participatory action research (PAR)212223and community-based participatory research (CBPR)24252627are used to engage stakeholders in 'bottom-up' primary healthcare research[15,18,2829303132. However, within this, we could not locate a detailed practical description of how to develop a guideline in partnership with migrant service-users. "
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    ABSTRACT: Background: Communication problems occur in general practice consultations when migrants and general practitioners do not share a common language and culture. Migrants' perspectives have rarely been included in the development of guidelines designed to ameliorate this. Considered 'hard-to-reach' on the basis of inaccessibility, language discordance and cultural difference, migrants have been consistently excluded from participation in primary healthcare research. The purpose of this qualitative study was to address this gap. Methods: The study was conducted in the Republic of Ireland, 2009 - 2011. We developed a multi-lingual community-university research team that included seven established migrants from local communities. They completed training in Participatory Learning & Action (PLA) - a qualitative research methodology. Then, as trained service-user peer researchers (SUPERs) they used their access routes, language skills, cultural knowledge and innovative PLA techniques to recruit and engage in research with fifty-one hard-to-reach migrant service-users (MSUs). Results & discussion: In terms of access, university researchers successfully accessed SUPERs, who, in turn, successfully accessed, recruited and retained MSUs in the study. In terms of meaningful engagement, SUPERs facilitated a complex PLA research process in a language-concordant manner, enabling inclusion and active participation by MSUs. This ensured that MSUs' perspectives were included in the development of a guideline for improving communication between healthcare providers and MSUs in Ireland. SUPERs evaluated their experiences of capacity-building, training, research fieldwork and dissemination as positively meaningful for them. MSUs evaluated their experiences of engagement in PLA fieldwork and research as positively meaningful for them. Conclusions: Given the need to build primary healthcare 'from the ground up', the perspectives of diverse groups, especially the hard-to-reach, must become a normative part of primary healthcare research. PLA is a powerful, practical 'fit-for-purpose' methodology for achieving this: enabling hard-to-reach groups to engage meaningfully and contribute with ease to academic research. PLA has significant potential to become a 'standard' or generic approach in building community-based primary health care. Community-university partnerships have a significant role to play in this, with capacity to radically influence the shape of healthcare research, expanding the research agenda to incorporate the views and needs of hard-to-reach and vulnerable populations.
    Preview · Article · Dec 2015 · BMC Health Services Research
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    • "PE is a participatory research technique with the potential to provide such rich in-depth information as well as to generate new insights about physical activity and eating behavior in underserved groups. Participatory research is defined as a type of research method in which participants take action upon phases of the research study, rather than be included only as subjects of the research (Cargo and Mercer 2008). Participatory visual and digital methods help to include participants as active participants in the research process (Gubrium and Harper 2013). "
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    ABSTRACT: Aim A healthier America depends on the development of strategies and interventions that are inclusive of and attentive to the needs of at-risk groups. This commentary seeks to contribute to the discussion of such interventions by advocating for the use of photo-elicitation (PE) as a research tool that can enhance the impact of studies targeting health behaviors such as physical activity and diet. Subject and Methods This commentary discusses the extent to which PE may enhance the quality and outcomes of research studies that aim to understand health behavior in underserved groups. We describe some of the advantages and disadvantages of the application of PE in public health research. This analysis is timely because public health researchers and practitioners are currently engaged in efforts to better understand health behaviors in specific racial and ethnic groups in an attempt to mitigate health disparities. Results Participatory research techniques (PRTs) such as PE are promising tools for elucidating an individual’s knowledge and perceptions of his or her socio-cultural context. As a participant-centered method, it can directly benefit individuals and their communities. Within the behavioral health sciences, it has the potential to advance knowledge of the determinants of physical activity and healthy eating habits as well as of the enablers and deterrents of these key health behaviors. Conclusion The new insights that investigators can acquire by employing PRTs such as PE may help public health researchers to develop culturally sensitive strategies and culturally meaningful intervention programs that have a better chance of reaching and benefiting at-risk populations.
    Full-text · Article · Nov 2015
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