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Community based
Participatory Research
Dr Venkatesh Karthikeyan
Department of Community and Family Medicine
AIIMS Patna
www.drvenkateshkarthikeyan.com
t.me/drvkspm
Contents
ā€¢ What is Community based participatory research?
ā€¢ Principles of Community based participatory research
ā€¢ Advantages of Community based participatory research
ā€¢ What is Focus Group Discussion?
ā€¢ Why Focus Group Discussion?
ā€¢ Steps in Focus Group Discussion
ā€¢ Advantages and limitations of Focus Group Discussion
ā€¢ Conclusion
10-11-2021 Community Based Participatory Research 2
What is Community based Participatory
Research?
ā€¢ It is a collaborative process that equitably involves all partners in the
research process and recognizes the unique strengths that each brings.
ā€¢ It begins with a research topic of importance to the community with
the aim of combining knowledge and action for social change to
improve community health and eliminate health disparities.
10-11-2021 Community Based Participatory Research 3
ā€¢ It focuses on social, structural, and physical environmental inequities
through active involvement of community members, organizational
representatives, and researchers in all aspects of the research process.
ā€¢ Partners contribute their expertise to enhance understanding of a
given phenomenon and integrate the knowledge gained with action to
benefit the community involved
10-11-2021 Community Based Participatory Research 4
Why should it be promoted?
ā€¢ It is a process that helps in building healthy communities because of
its emphasis on building trust and genuine collaborative partnerships.
ā€¢ The study findings can be used to help bring about changes in
programs, practices and policies that in turn can help improve health
outcomes.
10-11-2021 Community Based Participatory Research 5
Principles
ā€¢ Recognizes community as a unit of identity
ā€¢ Builds on strengths and resources within the community
ā€¢ Facilitates a collaborative, equitable partnership in all phases of
research, involving empowering and power ā€“ sharing process that
attends to social inequalities
ā€¢ Fosters co-learning and capacity building among all partners.
ā€¢ Integrates and achieves a balance between knowledge generation and
intervention for the mutual benefit of all partners
10-11-2021 Community Based Participatory Research 6
ā€¢ Focuses on the local relevance of public health problems and on
ecological perspectives that attend to the multiple determinants of
health.
ā€¢ Involves system development using a cyclical and iterative process
ā€¢ Disseminate results to all partners and involves them in the wider
dissemination of results.
ā€¢ Involves a long term process and commitment to sustainability
ā€¢ Openly addresses issues of race, ethnicity, racism and social class, and
embodies ā€œcultural humilityā€
ā€¢ Works to ensure research rigor and validity but also seeks to
ā€œbroaden the bandwidth of validityā€ with respect to research
relevance.
10-11-2021 Community Based Participatory Research 7
Advantages
ā€¢ Allows for the innovative adaptation of existing resources
ā€¢ Explores local knowledge and perceptions
ā€¢ Empowers people by considering them agents who can
investigate their own situations
ā€¢ Community input ā€“ making the project credible
10-11-2021 Community Based Participatory Research 8
ā€¢ Brings together the research participants who have varied
skills, knowledge and expertise to address complex problems
in complex situations
ā€¢ Provides resources for the involved communities
ā€¢ Provides a forum that can bridge across cultural differences
among the participants
ā€¢ Helps dismantle the lack of trust communities may exhibit in
relation to research
10-11-2021 Community Based Participatory Research 9
Types of interviews
ā€¢ Ethnographic interviews
ā€¢ Key informant interviews
ā€¢ In-depth interviews
ā€¢ Cultural domain analysis
ā€¢ Free list
ā€¢ Pile sorts
ā€¢ Surveys with questionnaire having close or open ended questions
ā€¢ Focus group
ā€¢ Group interviews
ā€¢ Nominal group technique
ā€¢ Delphi technique
10-11-2021 Community Based Participatory Research 10
What is Focus Group Discussion?
ā€¢ It is a research methodology in which a small group of participants
gather to discuss a specific topic/issue to generate data.
ā€¢ The main characteristic of a focus group is the interaction between
the moderator and the group, as well between group members.
ā€¢ The objective is to give the researcher an understanding of the
participantā€™s perspective on the topic in discussion.
10-11-2021 Community Based Participatory Research 11
Why Focus Group Discussion?
ā€¢ It can be used to obtain knowledge, perspective and attitudes of
people about issues and seek explanations for behavior in a way that
would be less accessible in responses to direct questions like one ā€“ to
ā€“ one interview.
ā€¢ Many different forms of communication can be used (jokes,
anecdotes, teasing and arguments)
ā€¢ It shows dimensions of understanding that often remain untapped or
inaccessible by other forms of data collection
ā€¢ Exceptionally effective for study of sensitive issues as well as issues
that are difficult to access.
10-11-2021 Community Based Participatory Research 12
Steps of conducting Focus Group Discussion
ā€¢ Formulate research question
ā€¢ Preparing Discussion guide
ā€¢ Recruiting participants
ā€¢ Determining size of the group
ā€¢ Number of focus group sessions
ā€¢ Group composition
ā€¢ Group settings
ā€¢ Role of moderator and note-taker
ā€¢ Conduct discussion
ā€¢ Analysing the data and reporting findings
10-11-2021 Community Based Participatory Research 13
Formulate research questions
ā€¢ Clear and specific purpose statement is needed to develop the right
question
ā€¢ Focus groups are better used to explore specific/narrowly ā€“ focused
topics
ā€¢ If not, data obtained will be diffused and data analysis would become
difficult.
10-11-2021 Community Based Participatory Research 14
Discussion Guide
ā€¢ It is to provide framework for the moderator to ask and probe questions
ā€¢ It increases the comprehensiveness of data collection and makes data
collection more efficient
ā€¢ It is not equivalent to survey instrument ā€“ not be followed in detail
ā€¢ Guide should proceed logically and from general to specific
ā€¢ Questions should be open ended, simple, unbiased and non-threatening.
ā€¢ The guide should sallow the flexibility to pursue unanticipated issues that
are generated during discussion
ā€¢ Pretesting should be done
10-11-2021 Community Based Participatory Research 15
Recruiting participants
ā€¢ Recruited based on their experience or involvement related to the
research topic.
ā€¢ E.g. Caretaker who is familiar with the patient.
ā€¢ Participants can be recruited by snowball sampling.
10-11-2021 Community Based Participatory Research 16
Size of the group
ā€¢ Ideal size : 6 to 12 people
ā€¢ Small size:
ā€¢ Easily dominated by one or two members
ā€¢ Discussion may fall silent if too few people contribute
ā€¢ Large size
ā€¢ Discussion may lack cohesion
ā€¢ Participants may become frustrated if they have to wait for their turn
10-11-2021 Community Based Participatory Research 17
Number of focus group sessions
ā€¢ Depends of purpose and scale of research
ā€¢ Depends on heterogeneity of participants
ā€¢ Diverse range of participants ā€“ need large number of sessions.
ā€¢ Depends on reaching saturation point, where there is repetition of
themes and no new information is shared.
10-11-2021 Community Based Participatory Research 18
Group composition
ā€¢ Some diversity ā€“ enhances discussion
ā€¢ Very heterogenous group ā€“ can be threatening to participants and can
inhibit disclosure
ā€¢ Composition should be in such a way that that the group members
feel that everyone is in the same boat.
ā€¢ They can talk freely and share experiences if they feel that way.
ā€¢ Hence, point of balance between both extremes of homogeneity and
heterogeneity
10-11-2021 Community Based Participatory Research 19
ā€¢ When data is to be collected from different group, conduct series of
focus groups using homogenous participants.
ā€¢ For example, if a studyā€™s aim is to explore publicā€™s view on HIV/AIDS,
one might conduct separate focus groups with healthy people, PLHIV
and family members of PLHIV.
10-11-2021 Community Based Participatory Research 20
Setting
ā€¢ Venue has to be comfortable and conducive to discussion
ā€¢ It should be geographically convenient for the participants
ā€¢ Discussion should be free from outside distractions ā€“ background
noise might affect quality of recording
ā€¢ Participants should be arranged to sit around the table (to see and
hear one another)
10-11-2021 Community Based Participatory Research 21
Role of moderator and note taker
ā€¢ Moderator serve as discussion leaders
ā€¢ They guide the participants through the discussion
ā€¢ They look after group dynamics ā€“ to ensure equal participation by all
participants
ā€¢ Note taker captures whatever is being said, tone of discussion and the
order in which participants spke
ā€¢ Phrases , statements, non verbal expressions like facial expressions
should also be noted
10-11-2021 Community Based Participatory Research 22
ā€¢ Note taker should also sketch the seating arrangement
10-11-2021 Community Based Participatory Research 23
Conduct discussion
ā€¢ Introduce self
ā€¢ Brief overview of topic of discussion and objectives of research
ā€¢ Ground rules
ā€¢ Explains how session is recorded
ā€¢ Conveys the expectation that everyone should contribute
ā€¢ Assure confidentially
ā€¢ Asks for introduction of group members (pseudonym)
ā€¢ Brief the participants
10-11-2021 Community Based Participatory Research 24
ā€¢ Summarize each time before moving from one topic to another
ā€¢ Curb dominant participant
ā€¢ Encourage silent participant
ā€¢ Encourage in depth exploration
ā€¢ Be unbiased, respectful and listen patiently
ā€¢ Should not pass judgement
ā€¢ Not to be too actively involved in discussion
ā€¢ Summarize all important points at the end.
10-11-2021 Community Based Participatory Research 25
Analyzing the data and reporting findings
ā€¢ Produce verbatim transcript of entire discussion
ā€¢ Translation (if applicable)
ā€¢ Compare transcript with handwritten notes to fill the gap.
ā€¢ Code the data in transcript
ā€¢ Basic level of analysis ā€“ descriptive account of data
ā€¢ Second level of analysis ā€“ interpretative ā€“ involves the comprehension
of themes, creating links between the themes, demonstrate how
those themes emerged and generated a theory grounded in the data
10-11-2021 Community Based Participatory Research 26
Advantages of Focus Group Discussions
ā€¢ Focus groups, unlike individual interviews, provide the added
dimension of the interactions among members.
ā€¢ Participants are able to build upon otherā€™s comments ā€“
stimulate thinking and discussion ā€“ generate ideas
ā€¢ Yields high quality data - participants can respond to
questions and probing for clarification is possible
ā€¢ May aid in conceptualization and generation of hypothesis if
new area is being explored
10-11-2021 Community Based Participatory Research 27
Limitations of Focus Group Discussions
ā€¢ Data obtained is not necessarily representative of the general
population, unlike in a survey
ā€¢ Susceptible to bias ā€“ opinions can be swayed by dominant
participants/moderator
ā€¢ Control over group
ā€¢ Time can be lost on irrelevant issues
ā€¢ Difficult to assemble and response rate could be a problem
10-11-2021 Community Based Participatory Research 28
Conclusion
ā€¢ The interactive element makes focus groups ideally suited to explore
issues related to medical and health research.
ā€¢ It provides high quality data.
* Although it requires careful and tedious planning, followed by
intricate analyses, focus groups remain an invaluable research tool in
health and medical perspective.
10-11-2021 Community Based Participatory Research 29
References
ā€¢ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2774214/
ā€¢ CBPR guide by school of public health, California
ā€¢ CBPAR - A SHORT GUIDE TO COMMUNITY BASED PARTICIPATORY
ACTION RESEARCH
ā€¢ Community-Campus Partnerships for Health - http://www.ccph.info/
ā€¢ https://jprm.scholasticahq.com/article/13244-participatory-research-
methods-choice-points-in-the-research-process
ā€¢ Singapore Medical Journal - http://www.smj.org.sg/article/focus-
group-discussion-tool-health-and-medical-research
10-11-2021 Community Based Participatory Research 30
Thank you!
10-11-2021 Community Based Participatory Research 31

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Community Based Participatory Research - Focus Group discussion

  • 1. Community based Participatory Research Dr Venkatesh Karthikeyan Department of Community and Family Medicine AIIMS Patna www.drvenkateshkarthikeyan.com t.me/drvkspm
  • 2. Contents ā€¢ What is Community based participatory research? ā€¢ Principles of Community based participatory research ā€¢ Advantages of Community based participatory research ā€¢ What is Focus Group Discussion? ā€¢ Why Focus Group Discussion? ā€¢ Steps in Focus Group Discussion ā€¢ Advantages and limitations of Focus Group Discussion ā€¢ Conclusion 10-11-2021 Community Based Participatory Research 2
  • 3. What is Community based Participatory Research? ā€¢ It is a collaborative process that equitably involves all partners in the research process and recognizes the unique strengths that each brings. ā€¢ It begins with a research topic of importance to the community with the aim of combining knowledge and action for social change to improve community health and eliminate health disparities. 10-11-2021 Community Based Participatory Research 3
  • 4. ā€¢ It focuses on social, structural, and physical environmental inequities through active involvement of community members, organizational representatives, and researchers in all aspects of the research process. ā€¢ Partners contribute their expertise to enhance understanding of a given phenomenon and integrate the knowledge gained with action to benefit the community involved 10-11-2021 Community Based Participatory Research 4
  • 5. Why should it be promoted? ā€¢ It is a process that helps in building healthy communities because of its emphasis on building trust and genuine collaborative partnerships. ā€¢ The study findings can be used to help bring about changes in programs, practices and policies that in turn can help improve health outcomes. 10-11-2021 Community Based Participatory Research 5
  • 6. Principles ā€¢ Recognizes community as a unit of identity ā€¢ Builds on strengths and resources within the community ā€¢ Facilitates a collaborative, equitable partnership in all phases of research, involving empowering and power ā€“ sharing process that attends to social inequalities ā€¢ Fosters co-learning and capacity building among all partners. ā€¢ Integrates and achieves a balance between knowledge generation and intervention for the mutual benefit of all partners 10-11-2021 Community Based Participatory Research 6
  • 7. ā€¢ Focuses on the local relevance of public health problems and on ecological perspectives that attend to the multiple determinants of health. ā€¢ Involves system development using a cyclical and iterative process ā€¢ Disseminate results to all partners and involves them in the wider dissemination of results. ā€¢ Involves a long term process and commitment to sustainability ā€¢ Openly addresses issues of race, ethnicity, racism and social class, and embodies ā€œcultural humilityā€ ā€¢ Works to ensure research rigor and validity but also seeks to ā€œbroaden the bandwidth of validityā€ with respect to research relevance. 10-11-2021 Community Based Participatory Research 7
  • 8. Advantages ā€¢ Allows for the innovative adaptation of existing resources ā€¢ Explores local knowledge and perceptions ā€¢ Empowers people by considering them agents who can investigate their own situations ā€¢ Community input ā€“ making the project credible 10-11-2021 Community Based Participatory Research 8
  • 9. ā€¢ Brings together the research participants who have varied skills, knowledge and expertise to address complex problems in complex situations ā€¢ Provides resources for the involved communities ā€¢ Provides a forum that can bridge across cultural differences among the participants ā€¢ Helps dismantle the lack of trust communities may exhibit in relation to research 10-11-2021 Community Based Participatory Research 9
  • 10. Types of interviews ā€¢ Ethnographic interviews ā€¢ Key informant interviews ā€¢ In-depth interviews ā€¢ Cultural domain analysis ā€¢ Free list ā€¢ Pile sorts ā€¢ Surveys with questionnaire having close or open ended questions ā€¢ Focus group ā€¢ Group interviews ā€¢ Nominal group technique ā€¢ Delphi technique 10-11-2021 Community Based Participatory Research 10
  • 11. What is Focus Group Discussion? ā€¢ It is a research methodology in which a small group of participants gather to discuss a specific topic/issue to generate data. ā€¢ The main characteristic of a focus group is the interaction between the moderator and the group, as well between group members. ā€¢ The objective is to give the researcher an understanding of the participantā€™s perspective on the topic in discussion. 10-11-2021 Community Based Participatory Research 11
  • 12. Why Focus Group Discussion? ā€¢ It can be used to obtain knowledge, perspective and attitudes of people about issues and seek explanations for behavior in a way that would be less accessible in responses to direct questions like one ā€“ to ā€“ one interview. ā€¢ Many different forms of communication can be used (jokes, anecdotes, teasing and arguments) ā€¢ It shows dimensions of understanding that often remain untapped or inaccessible by other forms of data collection ā€¢ Exceptionally effective for study of sensitive issues as well as issues that are difficult to access. 10-11-2021 Community Based Participatory Research 12
  • 13. Steps of conducting Focus Group Discussion ā€¢ Formulate research question ā€¢ Preparing Discussion guide ā€¢ Recruiting participants ā€¢ Determining size of the group ā€¢ Number of focus group sessions ā€¢ Group composition ā€¢ Group settings ā€¢ Role of moderator and note-taker ā€¢ Conduct discussion ā€¢ Analysing the data and reporting findings 10-11-2021 Community Based Participatory Research 13
  • 14. Formulate research questions ā€¢ Clear and specific purpose statement is needed to develop the right question ā€¢ Focus groups are better used to explore specific/narrowly ā€“ focused topics ā€¢ If not, data obtained will be diffused and data analysis would become difficult. 10-11-2021 Community Based Participatory Research 14
  • 15. Discussion Guide ā€¢ It is to provide framework for the moderator to ask and probe questions ā€¢ It increases the comprehensiveness of data collection and makes data collection more efficient ā€¢ It is not equivalent to survey instrument ā€“ not be followed in detail ā€¢ Guide should proceed logically and from general to specific ā€¢ Questions should be open ended, simple, unbiased and non-threatening. ā€¢ The guide should sallow the flexibility to pursue unanticipated issues that are generated during discussion ā€¢ Pretesting should be done 10-11-2021 Community Based Participatory Research 15
  • 16. Recruiting participants ā€¢ Recruited based on their experience or involvement related to the research topic. ā€¢ E.g. Caretaker who is familiar with the patient. ā€¢ Participants can be recruited by snowball sampling. 10-11-2021 Community Based Participatory Research 16
  • 17. Size of the group ā€¢ Ideal size : 6 to 12 people ā€¢ Small size: ā€¢ Easily dominated by one or two members ā€¢ Discussion may fall silent if too few people contribute ā€¢ Large size ā€¢ Discussion may lack cohesion ā€¢ Participants may become frustrated if they have to wait for their turn 10-11-2021 Community Based Participatory Research 17
  • 18. Number of focus group sessions ā€¢ Depends of purpose and scale of research ā€¢ Depends on heterogeneity of participants ā€¢ Diverse range of participants ā€“ need large number of sessions. ā€¢ Depends on reaching saturation point, where there is repetition of themes and no new information is shared. 10-11-2021 Community Based Participatory Research 18
  • 19. Group composition ā€¢ Some diversity ā€“ enhances discussion ā€¢ Very heterogenous group ā€“ can be threatening to participants and can inhibit disclosure ā€¢ Composition should be in such a way that that the group members feel that everyone is in the same boat. ā€¢ They can talk freely and share experiences if they feel that way. ā€¢ Hence, point of balance between both extremes of homogeneity and heterogeneity 10-11-2021 Community Based Participatory Research 19
  • 20. ā€¢ When data is to be collected from different group, conduct series of focus groups using homogenous participants. ā€¢ For example, if a studyā€™s aim is to explore publicā€™s view on HIV/AIDS, one might conduct separate focus groups with healthy people, PLHIV and family members of PLHIV. 10-11-2021 Community Based Participatory Research 20
  • 21. Setting ā€¢ Venue has to be comfortable and conducive to discussion ā€¢ It should be geographically convenient for the participants ā€¢ Discussion should be free from outside distractions ā€“ background noise might affect quality of recording ā€¢ Participants should be arranged to sit around the table (to see and hear one another) 10-11-2021 Community Based Participatory Research 21
  • 22. Role of moderator and note taker ā€¢ Moderator serve as discussion leaders ā€¢ They guide the participants through the discussion ā€¢ They look after group dynamics ā€“ to ensure equal participation by all participants ā€¢ Note taker captures whatever is being said, tone of discussion and the order in which participants spke ā€¢ Phrases , statements, non verbal expressions like facial expressions should also be noted 10-11-2021 Community Based Participatory Research 22
  • 23. ā€¢ Note taker should also sketch the seating arrangement 10-11-2021 Community Based Participatory Research 23
  • 24. Conduct discussion ā€¢ Introduce self ā€¢ Brief overview of topic of discussion and objectives of research ā€¢ Ground rules ā€¢ Explains how session is recorded ā€¢ Conveys the expectation that everyone should contribute ā€¢ Assure confidentially ā€¢ Asks for introduction of group members (pseudonym) ā€¢ Brief the participants 10-11-2021 Community Based Participatory Research 24
  • 25. ā€¢ Summarize each time before moving from one topic to another ā€¢ Curb dominant participant ā€¢ Encourage silent participant ā€¢ Encourage in depth exploration ā€¢ Be unbiased, respectful and listen patiently ā€¢ Should not pass judgement ā€¢ Not to be too actively involved in discussion ā€¢ Summarize all important points at the end. 10-11-2021 Community Based Participatory Research 25
  • 26. Analyzing the data and reporting findings ā€¢ Produce verbatim transcript of entire discussion ā€¢ Translation (if applicable) ā€¢ Compare transcript with handwritten notes to fill the gap. ā€¢ Code the data in transcript ā€¢ Basic level of analysis ā€“ descriptive account of data ā€¢ Second level of analysis ā€“ interpretative ā€“ involves the comprehension of themes, creating links between the themes, demonstrate how those themes emerged and generated a theory grounded in the data 10-11-2021 Community Based Participatory Research 26
  • 27. Advantages of Focus Group Discussions ā€¢ Focus groups, unlike individual interviews, provide the added dimension of the interactions among members. ā€¢ Participants are able to build upon otherā€™s comments ā€“ stimulate thinking and discussion ā€“ generate ideas ā€¢ Yields high quality data - participants can respond to questions and probing for clarification is possible ā€¢ May aid in conceptualization and generation of hypothesis if new area is being explored 10-11-2021 Community Based Participatory Research 27
  • 28. Limitations of Focus Group Discussions ā€¢ Data obtained is not necessarily representative of the general population, unlike in a survey ā€¢ Susceptible to bias ā€“ opinions can be swayed by dominant participants/moderator ā€¢ Control over group ā€¢ Time can be lost on irrelevant issues ā€¢ Difficult to assemble and response rate could be a problem 10-11-2021 Community Based Participatory Research 28
  • 29. Conclusion ā€¢ The interactive element makes focus groups ideally suited to explore issues related to medical and health research. ā€¢ It provides high quality data. * Although it requires careful and tedious planning, followed by intricate analyses, focus groups remain an invaluable research tool in health and medical perspective. 10-11-2021 Community Based Participatory Research 29
  • 30. References ā€¢ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2774214/ ā€¢ CBPR guide by school of public health, California ā€¢ CBPAR - A SHORT GUIDE TO COMMUNITY BASED PARTICIPATORY ACTION RESEARCH ā€¢ Community-Campus Partnerships for Health - http://www.ccph.info/ ā€¢ https://jprm.scholasticahq.com/article/13244-participatory-research- methods-choice-points-in-the-research-process ā€¢ Singapore Medical Journal - http://www.smj.org.sg/article/focus- group-discussion-tool-health-and-medical-research 10-11-2021 Community Based Participatory Research 30
  • 31. Thank you! 10-11-2021 Community Based Participatory Research 31

Editor's Notes

  1. Regardless of the particular research methods used, what is unique about this orientation to research is the way in which the research is conceptualized and carried out; the heavy accent placed on genuine community engagement throughout the process; and the use of findings to help bring about change
  2. 11 principles
  3. Free listing isĀ a technique for gathering data about a specific domain or topic by asking people to list all the items they can think of that relate to the topic . In a pile sort, individualsĀ make a list of topics relevant to a particular subject, and then they group these topics into related piles. This study investigated whether there was consistency in the ways in which participants grouped behaviors related to having a healthful lifestyle.
  4. In the context of healthcare and medical research, focus groups are particularly apt due to the fact that most health related conditions are created by social environments and made within the social context. Thus, focus groups are a popular method for assessing public experience and understanding of illness, identifying ideas concerning health-risk behaviours and danger and discovering the publicā€™s perception of causes of diseases.
  5. Only 2 points in eacj
  6. Third point ā€“ oresle background noise in tape recorder
  7. retain
  8. Speak one at a time ā€“ orelse garbling will be present in recording. There is no correct or wrong.Probe as neede
  9. Dominant - There are a few people who wish to add to this point, we will come back to that idea if we have timeā€, Silent - Do you have anything you would like to add to on this
  10. Remember that data obtained is not necessarily representative of the
  11. retain
  12. Last point ā€“ hence over recruit by atleast 20%
  13. Social movement theory - https://onlinelibrary.wiley.com/doi/10.1002/ajcp.12142