THE MAINSTREAMING OF PARTICIPATORY RESEARCH IN HEALTH CARE
Gonzalo Bacigalupe, EdD, MPHAssociate Professor
University of Massachusetts Boston
Ikerbasque Research Professor
University of Deusto, Bilbao
http://bacigalupe.wordpress.com
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Why do we do/need research?
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Why do we do/need research?
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Why do we do/need research?
“Common sense” is not enough Gathering Information (for decision-
making) Advancing knowledge To resolve specific problems To account for and learn from our
practices (Reflexive-Action)
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The Taken for Granted
Wadsworth, Y. (1998) What is Participatory Action Research? Action Research International, Paper 2. www.scu.edu.au/schools/gcm/ar/ari/p-ywadsworth98.html
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Instead… in PAR
Wadsworth, Y. (1998) What is Participatory Action Research? Action Research International, Paper 2. www.scu.edu.au/schools/gcm/ar/ari/p-ywadsworth98.html
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Note:
All science involves cyclical processes Who drives the process/content? Someone reflects and concludes Inquiry leads somewhere
It’s inevitable: researchers are value-driven
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Why do we do/need research?
“Common sense” is not enough Gathering Information (for decision-making) Advancing knowledge To resolve specific problems To account for and learn from our practices (Reflexive-Action)
What’s missing in this equation? )
(p + e + J)
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Partnerships
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PAR Definition
A group, community, or network jointly: Diagnose a situation Works towards improving it Evaluate effectiveness Critically reflect
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PAR Definition
A group, community, or network jointly: Diagnose a situation Works towards improving it Evaluate effectiveness Critically reflect
Participation is Key (period)It is action which is researched, changed and re-researched, within the research process by participants. (Wadsworth, 1998)
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Nina Wallerstein
http://www.youtube.com/watch?v=mJnWmL3YeIA
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The Action Research Dimension
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PAR Cycle (s)
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Whitehead, D. (2005). Project management and action research: two sides of the same coin? Journal of Health Organization and Management, 19, 519-531.
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History
Action-Research (AR) Lewin 1940s Study things to change them
PAR begins in L.A. late 1950s - 1960s, 1970s and on
Franz Fanon (1960s): Trauma/Inersectionality Fals Borda (1959) in Colombia
dominant knowledge (science) Reproduces status quo
emergent knowledge (alternative/resistant) Transform
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Paulo Freire
Participatory Research is an intrinsic piece in Popular Education (1970s)
Guided by principles of Liberation and Transformation Acknowledges that all human beings are capable of
knowledge PR challenges belief that research should be
conducted only by specialists; research should be part of everyone's life
Praxis: The philosophers have only interpreted the world, in
various ways; the point is to change it. Karl Marx (1845), Theses on Feuerbach (Thesis XI)
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PAR in Latin America
Participants (the “subjects”) …. Research problem Define; Analyze; Resolve
Goal of Research: to transform social reality It’s a permanent process of research and
action It’s part of an educational experience
Aids in accessing needs Consciousness raising
Collective organization is core Note: Ignacio Martin-Baro & Maritza MonteroDe Witt, T., & Gianotten, V. (1988). Investigacion participativa en America Latina. Mexico DF:
CENAPRO
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1984-1986
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Anglo Discoveries and Memories Peter Reason (AR/PAR Seminal Book) Michelle Fine (youth empowerment/intersectionality)
(and many in the world of social and critical psychology) Brinton Lykes (trauma/voice)
but (because some of us are not so “grounded” and don’t write in the dominant lingua franca)
Core is part of postcolonial developments in Asia and Africa and of transformative efforts in Latin America
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PAR Example
VOYCE
Youth-led project with high school students using PAR
Addresses drop out rate in Public High Schools
7 different community organizations Chicago area.
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VOYCE
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CBPR & Health Disparities
CBPR is not a research method but an orientation to research that emphasizes ‘‘equitable’’ engagement of all partners throughout the research process, from problem definition through data collection and analysis to the dissemination and use of findings to help affect change. Minkler (2010, p. S81)
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The Benefits according to AHQRDone properly, CBPR should benefit community participants, practitioners, and researchers alike. CBPR creates bridges between scientists and communities, allowing both to gain in knowledge and experience. This collaboration assists in developing culturally appropriate measurement instruments, thus making projects more effective and efficient.
Finally, CBPR establishes a level of trust that enhances both the quantity and the quality of data collected. The ultimate benefit is the prospect of examining the community's own unique circumstances to test and adapt best practices to its own needs.
Viswanathan M, Ammerman A, Eng E, Gartlehner G, Lohr KN, Griffith D, Rhodes S, Samuel-Hodge C, Maty S, Lux, L, Webb L, Sutton SF, Swinson T, Jackman A, Whitener L. Community-Based Participatory Research: Assessing the Evidence. Evidence Report/Technology Assessment No. 99 (Prepared by RTI—University of North Carolina Evidence-based Practice Center under Contract No. 290-02-0016). AHRQ Publication 04-E022-2. Rockville, MD: Agency for Healthcare Research and Quality. July 2004.
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http://www.ncbi.nlm.nih.gov/bookshelf/br.fcgi?book=hserta&part=A148846&rendertype=table&id=A148983
Critical elements in CBPR (AHQR)
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AssAssessing the Evi
Viswanathan M, Ammerman A, Eng E, Gartlehner G, Lohr KN, Griffith D, Rhodes S, Samuel-Hodge C, Maty S, Lux, L, Webb L, Sutton SF, Swinson T, Jackman A, Whitener L. Community-Based Participatory Research: Assessing the Evidence. Evidence Report/Technology Assessment No. 99 (Prepared by RTI—University of North Carolina Evidence-based Practice Center under Contract No. 290-02-0016). AHRQ Publication 04-E022-2. Rockville, MD: AHRQ. July 2004.
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Dis
trib
uti
ve &
Pro
ced
ura
l Ju
stic
e
Minkler, M. (2010). Linking science and policy through community-based participatory research to study and address health disparities. American Journal of Public Health, 100 Suppl 1, S81-87.
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http://www.youtube.com/watch?v=G4zEncKHKdA (April 2010)
Literacy for Environmental Justice
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CBPR Lessons: Addressing Health Disparities
Policy changes and implementation require multiple stakeholders
CBPR processes may create more policy momentums and thus we need to evaluate them for their ability to improve this environment and/or for scaffolding.
Social technologies offer great opportunities for collaboration and all the requirements of organizing and researching (besides better ways of documenting)
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Challenges
PAR demands relationships and trust (real) Academic timing versus community’s Diverse policy needs among stakeholders Financial rewards:
equity, inequity, control funding venues create competition
Academic versus communities deliverables Data triangulation is key Mass media likes “single individuals” and not
communities to report success Collaborations exist in a gradient
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The P
art
icip
ati
on
Conti
nuum
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What can academic types do?
Learn knowledge/skills relevant to the task at hand
Develop relationships of solidarity Engage in actions that win victories &
build self-sufficiency
DOING RESEARCH IS NOT, IN ITSELF, A GOAL
Stoecker, R. (2008). Are academics irrelevant? Approaches and roles for scholars in CBPR. In M. Minkler & N. Wallerstein (Eds.), Community-based participatory research for health: From process to outcomes. New York, Joseey-Bass
THE MAINSTREAMING OF PARTICIPATORY RESEARCH IN HEALTH CARE
Gonzalo Bacigalupe, EdD, MPHAssociate Professor
University of Massachusetts Boston
Ikerbasque Research Professor
University of Deusto, Bilbao
http://bacigalupe.wordpress.com
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