Uncovering the Benefits of Participatory Research: Implications of a Realist Review for Health Research and Practice

Abstract

ContextParticipatory research (PR) is the co-construction of research through partnerships between researchers and people affected by and/or responsible for action on the issues under study. Evaluating the benefits of PR is challenging for a number of reasons: the research topics, methods, and study designs are heterogeneous; the extent of collaborative involvement may vary over the duration of a project and from one project to the next; and partnership activities may generate a complex array of both short- and long-term outcomes.MethodsOur review team consisted of a collaboration among researchers and decision makers in public health, research funding, ethics review, and community-engaged scholarship. We identified, selected, and appraised a large-variety sample of primary studies describing PR partnerships, and in each stage, two team members independently reviewed and coded the literature. We used key realist review concepts (middle-range theory, demi-regularity, and context-mechanism-outcome configurations [CMO]) to analyze and synthesize the data, using the PR partnership as the main unit of analysis.FindingsFrom 7,167 abstracts and 591 full-text papers, we distilled for synthesis a final sample of twenty-three PR partnerships described in 276 publications. The link between process and outcome in these partnerships was best explained using the middle-range theory of partnership synergy, which demonstrates how PR can (1) ensure culturally and logistically appropriate research, (2) enhance recruitment capacity, (3) generate professional capacity and competence in stakeholder groups, (4) result in productive conflicts followed by useful negotiation, (5) increase the quality of outputs and outcomes over time, (6) increase the sustainability of project goals beyond funded time frames and during gaps in external funding, and (7) create system changes and new unanticipated projects and activities. Negative examples illustrated why these outcomes were not a guaranteed product of PR partnerships but were contingent on key aspects of context.ConclusionsWe used a realist approach to embrace the heterogeneity and complexity of the PR literature. This theory-driven synthesis identified mechanisms by which PR may add value to the research process. Using the middle-range theory of partnership synergy, our review confirmed findings from previous PR reviews, documented and explained some negative outcomes, and generated new insights into the benefits of PR regarding conflicts and negotiation between stakeholders, program sustainability and advancement, unanticipated project activity, and the generation of systemic change.

Collective action for knowledge mobilisation: a realist evaluation of the Collaborations for Leadership in Applied Health Research and Care

“…As Jagosh et al 127 remind us, collaborations are not de facto synergistic but their success is predicated on some effort to align values, goals and purpose. More successful and impactful attempts at collective action in implementation were determined by the alignment of a number of features, including foundational relationships, vision, values, structures and processes (including the potential for greater learning and meta-learning), purpose and thoughts about the nature of the collaboration and knowledge mobilisation (including theory and approaches).…”

“…Additionally, alignment has the potential to develop over time where there is attention to learning and evaluation with appropriate adaptation. 127 However, it is unclear if some degree of misalignment or tension within the implementation 'system' could potentially act as a form of catalyst for action, which could minimise the potential for entrenchment, habitual thinking and behaviour. 128 It is conceivable, for example, that alignment may stop being a catalytic mechanism if consensus and groupthink develop.…”

ReseArch with Patient and Public invOlvement: a RealisT evaluation – the RAPPORT study

“…Jagosh et al 103 addressed the complexity of PPI by utilising a realist review design. 104 Focusing on participatory research, which they define as the 'co-construction of research between researchers and people affected by the issues under study .…”

Can we Build on Social Movement Theories to Develop and Improve Community‐Based Participatory Research? A Framework Synthesis Review

“…In so doing, CBPR also implies balancing research with positive and tangible social change for the mutual benefit of all partners (Castleden et al., 2012; Israel et al., 2003; Mohatt, 2014). Recent reviews point to benefits of CBPR, including increased sustainability of project goals, the creation of unanticipated and spin‐off projects, and the generation of policy changes and systemic transformations (Jagosh et al., 2012, 2015). …”

“…A long‐standing challenge of CBPR has been to anchor practice and evaluation in a relevant and comprehensive theoretical framework of community change, one that links the processes of action and intervention to targeted changes across multiple levels of influence, including the broader social context (Cargo & Mercer, 2008; Fawcett, Schultz, Watson‐Thompson, Fox & Bremby, 2010; Jagosh et al., 2012; Merzel & D'Afflitti, 2003; Wallerstein et al., 2008). Typically, conceptual frameworks for CBPR have focused on developing practical implementation and outcome benchmarks (Fawcett et al., 1995) or describing group dynamics (inside the partnership itself) that lead to successful collaborations (Schulz, Israel & Lantz, 2003; Wallerstein et al., 2008).…”