Abstract:Background: There is a need to unpack the empirical, practical, and personal challenges within participatory approaches advocated to optimize implementation. The unpredictable, chaotic nature of participatory approaches complicates application of implementation theories, methods, and strategies which do not address researchers' situatedness within participatory processes. As an implementation scientist, addressing one's own situatedness through critical reflection is important to unearth how conscious and unco… Show more
“…This approach leverages, examines, and makes inferences around the authors' lived experiences, which supports and facilitates transferability and contextualization of the authors' findings. 14,15 While the authors' experiences occurred within the U.S., the tactics, experiences, and lessons learned may be transferable to other settings.…”
COVID-19 has, and continues to, wreak havoc worldwide, and the healthcare system has been particularly challenged with personnel shortages, resource insecurity, mixed messages, and fear to name a few. At the outset, it was thought the pandemic would be short-lived, resulting in the enactment of disaster plans in hospitals. Such autocratic approaches are not always effective in the long-term; a servant leadership approach is more conducive to engaging teams, and this dyad structure supports effective leadership during challenging times. While there is not one right approach to leading through a pandemic, lessons learned from this pandemic are applicable when, not if, the next pandemic occurs.
“…This approach leverages, examines, and makes inferences around the authors' lived experiences, which supports and facilitates transferability and contextualization of the authors' findings. 14,15 While the authors' experiences occurred within the U.S., the tactics, experiences, and lessons learned may be transferable to other settings.…”
COVID-19 has, and continues to, wreak havoc worldwide, and the healthcare system has been particularly challenged with personnel shortages, resource insecurity, mixed messages, and fear to name a few. At the outset, it was thought the pandemic would be short-lived, resulting in the enactment of disaster plans in hospitals. Such autocratic approaches are not always effective in the long-term; a servant leadership approach is more conducive to engaging teams, and this dyad structure supports effective leadership during challenging times. While there is not one right approach to leading through a pandemic, lessons learned from this pandemic are applicable when, not if, the next pandemic occurs.
“…We challenge traditional perceptions of engagement, recognizing that involvement intersects with structural and systemic barriers [ 43 ]. Instead, we understand meaningful engagement as a spectrum of contributions where less visible but significant efforts are equally valued [ 57 ]. Fig.…”
Background
This manuscript is coauthored by 15 young adult Patient RESearch partners (PARES) with lived and living mental health experiences and three institutional researchers across Canada involved in a patient-oriented research (POR) study called the HEARTS Study: Helping Enable Access and Remove Barriers To Support for Young Adults with Mental Health-Related Disabilities. We share our reflections, experiences and lessons learned as we grapple with the field of POR for its lack of clarity, hierarchical structures, internalized ableism, and accessibility challenges, among others. To mitigate the difficulties of POR, we started by laying the groundwork for equality by embracing the principle of Primus Inter Pares: First Among Equals as the foundation of our approach. In this way, we began with what we know for certain: the inherent worth and dignity of young adults as equal partners, recognizing their expertise, worldviews, creativity, and capacity to contribute meaningfully and intentionally to the research that affects their lives and futures.
Main Body
The manuscript underscores the need to reconceptualize meaningful engagement in POR, advocating a shift from traditional, biased paradigms that fail to address the complexities faced by young adults with mental illness. It introduces what we have termed Adaptive and Differential Engagement, underscoring the necessity of tailoring participation to individual preferences and circumstances alongside a Tripartite Compensation model that promotes fair and holistic remuneration in research collaborations. Then we discuss the approaches we have conceptualized, such as Equitable Dialogue, Trust Architecture, Community Continuum, Unity in Diversity, Shared Stewardship, and Agile Frameworks that collectively aim to overcome barriers like language intimidation, power imbalances, framework fatigue, consultation burnout, trust deficits, and systemic discrimination and exclusion. The manuscript does not seek to prescribe any universal or standardized solutions; in fact, it seeks the opposite. Instead, it offers a thoughtful and transparent contribution to the POR canon, providing resources for young adults eager to engage in research and institutional researchers aspiring to collaborate with them.
Conclusion
This manuscript is a product of our collective learning and critical self-evaluation. By integrating theoretical insights with practical strategies, we present a justice-oriented blueprint for an inclusive and egalitarian approach to POR. We advocate for applications of POR that are responsive to the individualized contexts of young adult PARES, ensuring their perspectives are central to the research with the resources to take the lead should they choose.
“…Moreover, critical development theorists, like Escobar (1995), and participatory scholars, like Chambers (1997) have challenged how academics produce knowledge that reinforces existing power hierarchies and excludes disadvantaged groups (Mitlin et al, 2020: 549). Therefore, development studies has a more interpretivist or constructivist paradigm that emphasizes the subjective nature of knowledge, reflexivity, and iterative theorizing (Steketee et al, 2020: 2). These epistemological and ontological positions shape how research translation is conducted and, together with the profusion of these approaches, create a real challenge for generating research driven solutions for development challenges.…”
Many research-to-practice approaches exist, yet fundamental differences in interpretation and uneven application of research translation approaches create a real challenge in generating research-driven solutions for development challenges. In this review, we aim to clarify the plethora of approaches to increase research uptake into international development practice and policy. Through a qualitative analysis of 93 articles, we identified four interrelated factors that differentiate research translation approaches. Building off the variation expressed across these factors, we propose a conceptual framework called the Research Translation Continuum. This framework illustrates the range of ways to produce useful evidence and the range of ways that academics and practitioners can collaborate. Our study makes a unique contribution by providing a conceptual framework for guiding research translation efforts in international development. We conclude that critical reflexive engagement is needed to situate, use, and produce evidence for development policy and practice.
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