Participatory Action Research With Older Adults: A Critical Interpretive Synthesis

Abstract

Background and Objectives Given population aging, the meaningful involvement of older adults in influencing policy and programs through participatory action research (PAR) is increasingly vital. PAR holds promise for equitable participation, co-learning, community mobilization, and personal and social transformation, however, little scholarly attention has been given to critically evaluating how PAR has been taken up with older adults. The objective of this review was to critically evaluate the use of PAR with older adults. Research Design and Methods A critical interpretive synthesis (CIS) of 40 PAR studies with older adults was conducted. Critical engagement with the articles identified dominant tendencies, limits of these tendencies, and proposed ways forward. Results Within the majority of articles reviewed, older adults were not prominent partners in PAR given their often limited involvement in designing the research questions, learning research skills and knowledge, and implementing findings for change. Furthermore, power differentials between researchers and older adults were evident, as older adults were often positioned as participants rather than partners. Finally, this article demonstrates various boundaries on the foci of studies related to inclusivity and sustainability. Discussion and Implications This study revealed that the promises PAR holds are often not fully realized in projects with older adults, given that they are rarely positioned as equitable partners, co-learners, or agents for change. The findings have the potential to stimulate further uptake of PAR research with an older adult population, highlighting areas for change in systems and research practices.

Employing Participatory Citizen Science Methods to Promote Age-Friendly Environments Worldwide

“…These examples are also intended to highlight how this community engagement model can be used across diverse locales and populations to facilitate scalable and sustainable local changes to promote healthy living. Consistent with the principles of participatory action research that emphasize involvement of older adult co-researchers in defining the problem and solutions [13], "success" related to environmental and policy changes targeted by the older adult citizen scientists in each project was defined based on whether the solutions implemented addressed identified problems and contributed to Age-Friendly communities, as defined by the WHO framework [33]. The environmental and policy changes occurring as part of the older adult citizen scientist efforts that are described in each project were verified via observation by the research and organizational partners facilitating each project.…”

“…The suite of projects presented in this paper contribute to the expanding evidence base supporting the use of participatory research methods to advance global activities promoting age-friendly communities. Although it has been noted frequently that older adults represent an important resource and can make valuable contributions in this area, they are often among the last to be included in local decision-making activities [8,13]. The WHO's Age-Friendly Cities initiative and other movements (e.g., the "village movement" in the United States) [72] have set the stage for an increased co-creation process between older residents and community stakeholders.…”

“…The Our Voice model combines key strengths of traditional forms of citizen science and community-based participatory research (CBPR) methods. These include greater standardization of resident data collection methods-a hallmark of citizen science-than what is often found in CBPR applications, and more complete involvement of residents in the full scientific endeavor relative to more frequently used citizen science methods [13,22]. (See Our Voice video overview in Supplementary Materials.…”

“…The intervention's effects can also be moderated by local factors, such as neighborhood socioeconomic status, local governance structures, and built environment features. Using the WHO Age-Friendly Cities guide (13) and checklist 14, we reviewed the fourteen Our Voice projects conducted with older adult populations. We categorized the key barriers and action steps identified and local changes proposed and carried out within each of the three major domains and related eight topic areas promoted by the WHO as essential to support healthy aging.…”

“…While much has been written about the important role that older adults themselves can play in contributing to building an age-friendly community [8][9][10], this area can continue to be advanced through systematically deploying and testing purposeful and sustained resident engagement models in developing, evaluating, monitoring, and implementing changes to improve the age-friendliness of their environments [11,12]. Notably, in what has been referred to as the "paradox of neighborhood participation", older adults typically spend a large amount of time in their neighborhoods but are often among the last to be included in local decision-making activities [8,13]. Involvement in such activities is strongly recommended by experts in the field as well as the WHO Global Age-Friendly Cities movement [8,14].…”