Promoting Participatory Research by Family Physicians

Abstract

In the past, researchers have inadvertently caused stigmatization of various populations, fi rst by not involving community members and then through publishing negative fi ndings. In contrast, participatory research, which is based on a partnership between researchers and those affected by the issue being studied, promotes the voice of those being researched. This essay highlights key principles, processes, complexities, and challenges of participatory research and outlines when participatory research is not appropriate. It also refl ects on the training and skills of family physicians that make them especially suited to participatory research. Family physicians have established clinical partnerships with their patients and sometimes entire communities, are trained in patient-centered care-a good basis for community centered research-and are accustomed to working with uncertainty. In addition, they are frequently pragmatic, interested in questions arising from their patients and communities, and likely to respond well to community requests. The main challenges to participatory research are lack of funding, expertise, and time, which may improve as more funding agencies and universities support this approach to research. INTRODUCTION Family physicians work in a wide variety of settings, including communities identifi able by geography or ethnicity, private offi ces, managed care practices, and academic teaching centers. They take care of patients from all walks of life, including those from poor, vulnerable, and minority populations. Some family physicians-both practice-and university-based-are also engaged in primary care research. If they are already engaged in research or thinking of becoming so engaged, I would like to advocate that they consider using participatory research. Participatory research is defi ned as researchers working in partnership with "those affected by the issue under study" 1 and is increasingly recognized as a highly effective method of adding relevance and value to primary health care research.2 The equally important goals of participatory research are to undertake high-quality research, benefi t the community or group where the research is occurring, and develop knowledge applicable to other settings. This essay highlights the key points and challenges of participatory research, shows how this approach to research can be applied in different settings and with different populations, and describes why I believe family physicians are ideally suited to succeed in this type of research. Need for Participatory ResearchCommunities, especially of poor, vulnerable, and minority populations, are often stigmatized by those who conduct research on or in or about communities. Community has been defi ned as "a group of people sharing 1 Communities can be geographic entities, organizations (eg, health care organizations), or groups of individuals. Individuals may not necessarily belong to a community with social interactions, but they can become a community of convenience for a research proje...

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