The mainstreaming of par in health care final version

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  • Not sure what else to say, hard act to follow…You know everything you need to know about PAR
  • Continuum exercise
  • Action Research is often visualised as a cycle in which a team of researchers and stakeholders identify desired outcomes, pilot approaches, evaluate their impact, suggest improvements, pilot the improved approach, and so on. The cycle aims to achieve a spiralling up of both theory and practice, as theory informs practice and practice continually refines theory.Key dimensions of Action Research are Involvement (of community or organisation members) and Improvement (development of practical solutions to improve their situation). As suggested by the name, Action Research has twin aims: to study a system (research), while collaborating with members of the system to improve it (action).
  • Alma FlorAda and Paulo Freire share ideas about Participatory Research as developed based on Paulo's principals of Critical Education.
  • This community-based, participatory action research project was facilitated by Robin R. R. Gray (Tsimshian/Mikisew Cree), a master's and doctoral student in socio-cultural anthropology at the University of Massachusetts at Amherst. Using the Photovoice methodology, urban Native youth were provided with an opportunity to answer the question: How do urban Native youth interpret, and experience, the inter-generational affects of the Indian Residential School System in Canada? Responding to the concerns of their urban Native community and the greater Indigenous community at large, three youth participants--Herb Varley (Nuu-chah-nulth), Billie-Jeanne Sinclair (Nisga'a), and Daniel Cook (Nuu-chah-nulth/Nisga'a)--engaged in critical consciousness, educated the greater Vancouver community, and interrogated the intersection between pedagogy and power with their photos and in their presentation of them. The Photovoice exhibit and the results of the project, "," will be made available via the partnering organization, the Urban Native Youth Association, in the coming months.
  • The mainstreaming of par in health care final version

    1. 1. The Mainstreaming of Participatory Research in Health Care<br />Gonzalo Bacigalupe, EdD, MPH<br />Associate Professor<br />University of Massachusetts Boston<br />gonzalo.bacigalupe@umb.edu<br />&<br />Ikerbasque Research Professor<br />University of Deusto, Bilbao<br />http://bacigalupe.wordpress.com<br />
    2. 2. Why do we do/need research?<br />2<br />
    3. 3. Why do we do/need research?<br />3<br />
    4. 4. Why do we do/need research?<br />“Common sense” is not enough<br />Gathering Information (for decision-making)<br />Advancing knowledge<br />To resolve specific problems<br />To account for and learn from our practices (Reflexive-Action)<br />4<br />
    5. 5. The Taken for Granted<br />Wadsworth, Y.  (1998) What is Participatory Action Research? Action Research International, Paper 2.  www.scu.edu.au/schools/gcm/ar/ari/p-ywadsworth98.html<br />5<br />
    6. 6. Instead… in PAR <br />Wadsworth, Y.  (1998) What is Participatory Action Research? Action Research International, Paper 2.  www.scu.edu.au/schools/gcm/ar/ari/p-ywadsworth98.html<br />6<br />
    7. 7. Note:<br />All science involves cyclical processes<br />Who drives the process/content?<br />Someone reflects and concludes<br />Inquiry leads somewhere<br /> It’s inevitable: researchers are value-driven<br />7<br />
    8. 8. Why do we do/need research?<br />“Common sense” is not enough<br />Gathering Information (for decision-making)<br />Advancing knowledge<br />To resolve specific problems<br />To account for and learn from our practices (Reflexive-Action)<br />What’s missing in this equation? )<br />(p + e + J)<br />8<br />
    9. 9. Partnerships<br />9<br />
    10. 10. PAR Definition<br />A group, community, or network jointly:<br />Diagnose a situation<br />Works towards improving it<br />Evaluate effectiveness<br />Critically reflect<br />10<br />
    11. 11. 11<br />
    12. 12. PAR Definition<br />A group, community, or network jointly:<br />Diagnose a situation<br />Works towards improving it<br />Evaluate effectiveness<br />Critically reflect<br />Participation is Key (period)<br />It is action which is researched, changed and re-researched, within the research process by participants. (Wadsworth, 1998)<br />12<br />
    13. 13. Nina Wallerstein<br />13<br />http://www.youtube.com/watch?v=mJnWmL3YeIA<br />
    14. 14. The Action Research Dimension<br />14<br />
    15. 15. PAR Cycle (s)<br />15<br />
    16. 16. Whitehead, D. (2005). Project management and action research: two sides of the same coin? Journal of Health Organization and Management, 19, 519-531.<br />16<br />
    17. 17. History<br />17<br />Action-Research (AR) Lewin 1940s <br />Study things to change them<br />PAR begins in L.A. late 1950s - 1960s, 1970s and on<br />Franz Fanon (1960s): Trauma/Inersectionality<br />FalsBorda (1959) in Colombia <br />dominant knowledge (science) <br />Reproduces status quo<br />emergent knowledge (alternative/resistant)<br />Transform<br />
    18. 18. Paulo Freire<br />Participatory Research is an intrinsic piece in Popular Education (1970s) <br />Guided by principles of Liberation and Transformation <br />Acknowledges that all human beings are capable of knowledge <br />PR challenges belief that research should be conducted only by specialists; research should be part of everyone's life<br />Praxis: <br />The philosophers have only interpreted the world, in various ways; the point is to change it. <br />Karl Marx (1845), Theses on Feuerbach (Thesis XI) <br />18<br />
    19. 19. PAR in Latin America<br />19<br />Participants (the “subjects”) …. Research problem <br />Define; Analyze; Resolve<br />Goal of Research: to transform social reality<br />It’s a permanent process of research and action<br />It’s part of an educational experience<br />Aids in accessing needs<br />Consciousness raising<br />Collective organization is core<br />Note: Ignacio Martin-Baro & Maritza Montero<br />De Witt, T., & Gianotten, V. (1988). Investigacion participativa en America Latina. Mexico DF: CENAPRO<br />
    20. 20. 1984-1986<br />20<br />
    21. 21. Anglo DiscoveriesandMemories<br />21<br />Peter Reason (AR/PAR Seminal Book) <br />Michelle Fine (youth empowerment/intersectionality)<br />(and many in the world of social and critical psychology)<br />Brinton Lykes (trauma/voice)<br />but (because some of us are not so “grounded” and don’t write in the dominant lingua franca)<br />Core is part of postcolonial developments in Asia and Africa and of transformative efforts in Latin America<br />
    22. 22. PAR Example<br />VOYCE<br />Youth-led project with high school students using PAR<br />Addresses drop out rate in Public High Schools <br />7 different community organizations Chicago area.<br />22<br />
    23. 23. VOYCE<br />23<br />
    24. 24. 24<br />
    25. 25. CBPR & Health Disparities<br />25<br />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)<br />
    26. 26. The Benefits according to AHQR<br />26<br />Done 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.<br />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.<br />
    27. 27. 27<br />Critical elements in CBPR (AHQR) <br />http://www.ncbi.nlm.nih.gov/bookshelf/br.fcgi?book=hserta&part=A148846&rendertype=table&id=A148983<br />
    28. 28. AssAssessing the Evi<br />28<br />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.<br />
    29. 29. Distributive & Procedural Justice<br />29<br />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.<br />
    30. 30. 30<br />Literacy for Environmental Justice<br />http://www.youtube.com/watch?v=G4zEncKHKdA (April 2010)<br />
    31. 31. CBPR Lessons: Addressing Health Disparities<br />31<br />Policy changes and implementation require multiple stakeholders<br />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.<br />Social technologies offer great opportunities for collaboration and all the requirements of organizing and researching (besides better ways of documenting)<br />
    32. 32. Challenges<br />32<br />PAR demands relationships and trust (real)<br />Academic timing versus community’s<br />Diverse policy needs among stakeholders<br />Financial rewards: <br />equity, inequity, control<br />funding venues create competition<br />Academic versus communities deliverables <br />Data triangulation is key<br /> Mass media likes “single individuals” and not communities to report success<br />Collaborations exist in a gradient<br />
    33. 33. The Participation Continuum<br />33<br />
    34. 34. What can academic types do?<br />34<br />Learn knowledge/skills relevant to the task at hand<br />Develop relationships of solidarity<br />Engage in actions that win victories & build self-sufficiency<br />DOING RESEARCH IS NOT, IN ITSELF, A GOAL<br />Stoecker, R. (2008). Are academics irrelevant? Approaches and roles for scholars in CBPR. In M. Minkler & N. Wallerstein (Eds.), <br />Community-based participatory research for health: From process to outcomes. New York, Joseey-Bass<br />
    35. 35. The Mainstreaming of Participatory Research in Health Care<br />Gonzalo Bacigalupe, EdD, MPH<br />Associate Professor<br />University of Massachusetts Boston<br />gonzalo.bacigalupe@umb.edu<br />&<br />Ikerbasque Research Professor<br />University of Deusto, Bilbao<br />http://bacigalupe.wordpress.com<br />
    36. 36. 36<br />gonzalo.bacigalupe@umb.edu<br />

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