Uncovering the Benefits of Participatory Research: Implications of a Realist Review for Health Research and Practice
Open Access
- 18 June 2012
- journal article
- review article
- Published by Wiley in The Milbank Quarterly
- Vol. 90 (2), 311-346
- https://doi.org/10.1111/j.1468-0009.2012.00665.x
Abstract
Context: Participatory 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. Methods: Our 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. Findings: From 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. Conclusions: We 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.Keywords
This publication has 45 references indexed in Scilit:
- Assessing the outcomes of participatory research: protocol for identifying, selecting, appraising and synthesizing the literature for realist reviewImplementation Science, 2011
- Individual determinants of research utilization by nurses: a systematic review updateImplementation Science, 2011
- Building and Maintaining Trust in a Community-Based Participatory Research PartnershipAmerican Journal of Public Health, 2008
- Project VIVA: A Multilevel Community-Based Intervention to Increase Influenza Vaccination Rates Among Hard-to-Reach Populations in New York CityAmerican Journal of Public Health, 2008
- A Socioecological Approach to Improving Mammography Rates in a Tribal CommunityHealth Education & Behavior, 2007
- The WORD (Wholeness, Oneness, Righteousness, Deliverance): A Faith-Based Weight-Loss Program Utilizing a Community-Based Participatory Research ApproachHealth Education & Behavior, 2006
- Application of Community-Based Participatory Research Methods to a Study of Complementary Medicine Interventions at End of LifeComplementary health practice review, 2005
- Impact of a Diabetes Prevention Program on Body Size, Physical Activity, and Diet Among Kanien'kehá:ka (Mohawk) Children 6 to 11 Years Old: 8-Year Results From the Kahnawake Schools Diabetes Prevention ProjectPEDIATRICS, 2005
- Caveats on Coalitions: In Praise of PartnershipsHealth Promotion Practice, 2000
- Conducting a Participatory Community-Based Survey for a Community Health Intervention on Detroitʼs East SideJournal of Public Health Management and Practice, 1998