The Social Ecology of Power in Participatory Health Research

Abstract

As increasing value is placed on community engagement, co-creation, and transdisciplinarity as essential ingredients to improve policies; participatory health research has gained popularity as a promising avenue for stakeholders to collaborate and solve problems in innovative ways. Participatory research has a history of success but important caveats caution against romanticizing the approach. The assumption that participation will empower participants overlooks potential feelings of disappointment or exploitation amid power imbalances, vested interest, and representativeness issues. This article outlines a multilevel conceptual framework that explicitly situates power dynamics within a wider system of bidirectional interconnections operating at the individual, interpersonal, and structural levels. It then provides a practical tool to examine and address these dynamics in a comprehensive and systematic way. This can be helpful for researchers and community practitioners working in contexts where democratic principles are not broadly endorsed and where power dynamics operate in subtle ways.

Participatory health research with migrants: Opportunities, challenges, and way forwards

“…However, in practice, this is not always the case, and inequalities between negotiating actors may end up favouring those who are most powerful. 99,100 The above challenges illustrate the importance of maintaining a high standard of quality and building the empirical evidence about the value of PHR. In this process, it is important to avoid tokenistic approaches where participatory claims are used as a strategy to implement already designed policies rather than to provide spaces for populations to advocate for transformative initiatives.…”

“…Robust M&E frameworks are urgently needed to guide these processes, with particular attention to power dynamics that may hinder transformative participation dynamics. 100 In a decisive step in this direction, a M&E working group established within the ICPHR is already drawing from various conceptual frameworks and the views of global PHR practitioners to identify relevant domains, indicators and questions to be asked. 102 Second, guidance is needed on how to recruit, engage and create fruitful inter-stakeholder alliances in this particular field of research.…”

Participatory approaches in the development of health interventions for migrants: a systematic review

“…33 37 Challenges in ensuring equitability in research understanding, and balancing the participatory nature of a project, with the standards expected by the wider scientific community were also highlighted. 22 35 Furthermore, one study cited the difficulty of navigating acknowledgement and authorship of non-academics in published materials; 27 a scenario that serves to reiterate power imbalances that can often persist, 51 in that despite being 'equal partners' in research, migrants may still not be equally recognised. The lack of recognition of the requirements of participatory research in traditional academic circles is also cited as a challenge, with one set of authors stating the need for managerial, institutional and funder-level buy-in and commitment regarding participatory research.…”

Community‐engaged Research Approaches: Multiple Pathways To Health Equity

“…Neglect of these broader considerations reflects, we believe, a tendency to conflate the privilege held by academic researchers with actual social power. Despite the benefits and prestige associated with academic institutions and research, decisions in the sociopolitical domain are commonly based as much (or more) on the political realities in which decision makers find themselves as they are on scientific evidence (Roura, 2020;Speer & Christens, 2013). To assume that academic research has the power, on its own, to leverage transformative changes to the conditions in communities is an unfortunate underestimation of the broader social and political dynamics that shape those conditions.…”