scholarly journals Evaluating a novel Integrated Community of Care (ICoC) for patients from an urbanised low-income community in Singapore using the participatory action research (PAR) methodology: a study protocol

BMJ Open ◽  
2017 ◽  
Vol 7 (10) ◽  
pp. e017839 ◽  
Author(s):  
Lian Leng Low ◽  
Adlina Maulod ◽  
Kheng Hock Lee
Keyword(s):  
Mixed Methods ◽  
Action Research ◽  
High Risk ◽  
Participatory Action Research ◽  
Low Income ◽  
Acute Hospital ◽  
Participatory Action ◽  
Health And Social Care ◽  
The Impact ◽  
Hospital Use

IntroductionPoorer health outcomes and disproportionate healthcare use in socioeconomically disadvantaged patients is well established. However, there is sparse literature on effective integrated care interventions that specifically target these high-risk individuals. The Integrated Community of Care (ICoC) is a novel care model that integrates hospital-based transitional care with health and social care in the community for high-risk individuals living in socially deprived communities. This study aims to evaluate the effectiveness of the ICoC in reducing acute hospital use and investigate the implementation process and its effects on clinical outcomes using a mixed-methods participatory action research (PAR) approach.Methods and analysisThis is a single-centre prospective, controlled, observational study performed in the SingHealth Regional Health System. A total of 250 eligible patients from an urbanised low-income community in Singapore will be enrolled during their index hospitalisation. Our PAR model combines two research components: quantitative and qualitative, at different phases of the intervention. Outcomes of acute hospital use and health-related quality of life are compared with controls, at 30 days and 1 year. The qualitative study aims at developing a more context-specific social ecological model of health behaviour. This model will identify how influences within one’s social environment: individual, interpersonal, organisational, community and policy factors affect people’s experiences and behaviours during care transitions from hospital to home. Knowledge on the operational aspects of ICoC will enrich our evidence-based strategies to understand the impact of the ICoC. The blending of qualitative and quantitative mixed methods recognises the dynamic implementation processes as well as the complex and evolving needs of community stakeholders in shaping outcomes.Ethics and disseminationEthics approval was granted by the SingHealth Centralised Institutional Review Board (CIRB 2015/2277). The findings from this study will be disseminated by publications in peer-reviewed journals, scientific meetings and presentations to government policy-makers.Trial registration numberNCT02678273

Predicting trust in police: the impact of instrumental and expressive concerns in street-identified Black-American men and women

2020 ◽  
Vol 43 (6) ◽  
pp. 917-933
Author(s):  
Darryl L. Chambers ◽  
Yasser A. Payne ◽  
Ivan Sun
Keyword(s):  
Action Research ◽  
Participatory Action Research ◽  
Black Men ◽  
Low Income ◽  
Participatory Action ◽  
Men And Women ◽  
Content Type ◽  
Original Manuscript ◽  
The Impact ◽  
Trust In Police

PurposeWhile the past few decades have witnessed a substantial number of studies on public attitudes toward the police, a relatively thin line of inquiry has focused exclusively on low income urban Black-Americans, and especially street-identified Black populations. The purpose of this paper, however, is to examine trust in police amongst street-identified Black men and women.Design/methodology/approachRelying on a street participatory action research methodological approach, the authors collected survey data (N = 520) from two low-income unban Black neighborhoods, to examine the effects of an instrumental model versus an expressive model on procedural- and outcome-based trust in police.FindingsThe findings suggested a community sample of street-identified Black men and women were able to differentiate between procedural- and outcome-based trust. The instrumental model was better in predicting procedural-based trust in police, while the expressive model accounted better for outcome-based trust in police.Research limitations/implicationsImplications for street participatory action research methodology, future research and policy are also discussed.Originality/valueThis paper is an original manuscript.

scholarly journals Adapting the Community-based Health Planning and Services (CHPS) to engage poor urban communities in Ghana: protocol for a participatory action research study

BMJ Open ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. e049564
Author(s):  
Mary Abboah-Offei ◽  
Akosua Gyasi Darkwa ◽  
Andrews Ayim ◽  
Adelaide Maria Ansah-Ofei ◽  
Delanyo Dovlo ◽  
...  
Keyword(s):  
Action Research ◽  
Participatory Action Research ◽  
Urban Communities ◽  
Low Income ◽  
Urban Areas ◽  
Health Planning ◽  
Phase 1 ◽  
Participatory Action ◽  
Community Based ◽  
Key Stakeholders

IntroductionWith rapid urbanisation in low-income and middle-income countries, health systems are struggling to meet the needs of their growing populations. Community-based Health Planning and Services (CHPS) in Ghana have been effective in improving maternal and child health in rural areas; however, implementation in urban areas has proven challenging. This study aims to engage key stakeholders in urban communities to understand how the CHPS model can be adapted to reach poor urban communities.Methods and analysisA Participatory Action Research (PAR) will be used to develop an urban CHPS model with stakeholders in three selected CHPS zones: (a) Old Fadama (Yam and Onion Market community), (b) Adedenkpo and (c) Adotrom 2, representing three categories of poor urban neighbourhoods in Accra, Ghana. Two phases will be implemented: phase 1 (‘reconnaissance phase) will engage and establish PAR research groups in the selected zones, conduct focus groups and individual interviews with urban residents, households vulnerable to ill-health and CHPS staff and key stakeholders. A desk review of preceding efforts to implement CHPS will be conducted to understand what worked (or not), how and why. Findings from phase 1 will be used to inform and co-create an urban CHPS model in phase 2, where PAR groups will be involved in multiple recurrent stages (cycles) of community-based planning, observation, action and reflection to develop and refine the urban CHPS model. Data will be managed using NVivo software and coded using the domains of community engagement as a framework to understand community assets and potential for engagement.Ethics and disseminationThis study has been approved by the University of York’s Health Sciences Research Governance Committee and the Ghana Health Service Ethics Review Committee. The results of this study will guide the scale-up of CHPS across urban areas in Ghana, which will be disseminated through journal publications, community and government stakeholder workshops, policy briefs and social media content. This study is also funded by the Medical Research Council, UK.

scholarly journals Supporting family carers in home-based end-of-life care: using participatory action research to develop a training programme for support workers and volunteers

2017 ◽  
Vol 9 (1) ◽  
pp. e4-e4 ◽  
Author(s):  
Glenys Caswell ◽  
Beth Hardy ◽  
Gail Ewing ◽  
Sheila Kennedy ◽  
Jane Seymour
Keyword(s):  
Action Research ◽  
Participatory Action Research ◽  
End Of Life ◽  
Third Sector ◽  
Training Programme ◽  
Family Carers ◽  
Participatory Action ◽  
Health And Social Care ◽  
Carer Support ◽  
Support Family

BackgroundFamily carers are crucial in enabling dying people to stay at home, but are often not prepared for their caring role, receiving little support from formal health and social care services. It is increasingly likely that any help or support family carers receive will be provided by a third sector organisation on either a voluntary basis or by untrained carer support workers.ObjectivesTo produce a training programme designed to equip carer support workers and volunteers with the basic skills and knowledge needed to support family carers.Process of developmentParticipatory action research, a collaborative form of working in which those who are affected by an issue take a lead role in the research, was used. Bereaved carers acting as research partners, support workers and representatives of third sector organisations took an active part in designing, developing, piloting and refining the programme in a number of interlinked stages. During development, the programme was piloted on four occasions and evaluated by 36 trainees and 3 trainers.Final training programmeThe outcome of the project is an innovative, 1-day training programme, offering an introduction to supporting family carers who are looking after someone approaching the end of life. The use of participatory action research methods enabled the development of a programme that addresses support needs identified by bereaved carers and training needs identified by carer support workers.The finished programme includes all the materials necessary to run a training day for support workers and volunteers: facilitator’s notes, trainee workbook, slides, promotional poster and pre-course reading for trainees. Knowledge of issues involved in end-of-life and palliative care is not required, although some experience in delivering training is advisable.ConclusionThe programme evaluated well during development, but further research is required to examine the transfer of learning into the workplace.

Spaces and places for popular education and participatory action research

2020 ◽  
pp. 41-56
Author(s):  
Marjorie Mayo
Keyword(s):  
Action Research ◽  
Participatory Action Research ◽  
Lifelong Learning ◽  
Public Services ◽  
Popular Education ◽  
Participatory Action ◽  
Community Based ◽  
Community Based Education ◽  
The Impact ◽  
Informal Settings

Governments have supported popular education initiatives in the past. And so have community organisations and social movements. But the spaces for popular education have been shrinking in recent times, as part of the impact of neo-liberal globalisation. Public services have been increasingly subjected to pressures from market forces, pressures that have impacted on community-based education and lifelong learning. Despite these wider pressures, educators have continued to find spaces and places for popular education and participatory action research, however, working across sectors in a variety of contexts. The chapter includes examples of innovatory approaches in both formal settings and informal settings (such as libraries and community centres) including examples from both Northern and Southern American contexts.

scholarly journals Reflections From Co-Researchers With Intellectual Disability: Benefits to Inclusion in a Research Study Team

2018 ◽  
Vol 56 (4) ◽  
pp. 251-262 ◽  
Author(s):  
Brittany St. John ◽  
Iulia Mihaila ◽  
Katelyn Dorrance ◽  
Leann Smith DaWalt ◽  
Karla K. Ausderau
Keyword(s):  
Intellectual Disability ◽  
Action Research ◽  
Participatory Action Research ◽  
Research Participation ◽  
Research Process ◽  
Participatory Action ◽  
Research Staff ◽  
Study Team ◽  
Academic Faculty ◽  
The Impact

Abstract Participatory action research methodologies may empower and protect marginalized individuals; however, they remain underutilized. Limited studies have investigated the impact of participatory action research, specifically on individuals with intellectual disability (ID). This study examines (1) the perspectives of co-researchers with ID on their involvement in the research process and (2) the feasibility of their inclusion based on perspectives of research staff (academic faculty and graduate students without ID). Three co-researchers with ID were interviewed regarding their research participation. Thematic analysis of interviews identified four themes: (1) Shared Experience of Disability, (2) Teaching and Guidance, (3) Acquisition of Skills and Knowledge, and (4) Value of Participation. Research staff reviewed field notes and identified benefits and challenges to feasibility of including co-researchers with ID. Inclusion of co-researchers with ID was found to be both meaningful and feasible.

scholarly journals Verbal Autopsy with Participatory Action Research (VAPAR) programme in Mpumalanga, South Africa: protocol for evaluation

BMJ Open ◽  
2020 ◽  
Vol 10 (2) ◽  
pp. e036597
Author(s):  
Sophie Witter ◽  
Maria Van Der Merwe ◽  
Rhian Twine ◽  
Denny Mabetha ◽  
Jennifer Hove ◽  
...  
Keyword(s):  
Action Research ◽  
Participatory Action Research ◽  
Low Income ◽  
Verbal Autopsy ◽  
Secondary Data ◽  
Health Indicators ◽  
Theory Of Change ◽  
Local Health ◽  
Participatory Action ◽  
Middle Income

IntroductionThere is a growing recognition of the importance of developing learning health systems which can engage all stakeholders in cycles of evidence generation, reflection, action and learning from action to deal with adaptive problems. There is however limited evaluative evidence of approaches to developing or strengthening such systems, particularly in low-income and middle-income settings. In this protocol, we aim to contribute to developing and sharing knowledge on models of building collaborative learning platforms through our evaluation of the Verbal Autopsy with Participatory Action Research (VAPAR) programme.Methods and analysisThe evaluation takes a participatory approach, focussed on joint learning on whether and how VAPAR contributes to its aims, and what can be learnt for this and similar settings. A realist-informed theory of change was developed by the research team as part of a broader collaboration with other stakeholders. The evaluation will draw on a wide variety of perspectives and data, including programme data and secondary data. This will be supplemented by in-depth interviews and workshops at the end of each cycle to probe the different domains, understand changes to the positions of different actors within the local health system and feedback into improved learning and action in the next cycle. Quantitative data such as verbal autopsy will be analysed for significant trends in health indicators for different population groups. However, the bulk of the data will be qualitative and will be analysed thematically.Ethics and disseminationEthics in participatory approaches include a careful focus on the power relationships within the group, such that all groups are given voice and influence, in addition to the usual considerations of informed participation. Within the programme, we will focus on reflexivity, relationship building, two-way learning and learning from failure to reduce power imbalances and mitigate against a blame culture. Local engagement and change will be prioritised in dissemination.

Reflections on Participatory Action Research: The Case of Low-Income Women Accessing Local Physical Activity services

1997 ◽  
Vol 11 (1) ◽  
pp. 8-28 ◽  
Author(s):  
Wendy Frisby ◽  
Susan Crawford ◽  
Therese Dorer
Keyword(s):  
Physical Activity ◽  
Action Research ◽  
Participatory Action Research ◽  
Low Income ◽  
Resistance To Change ◽  
Poverty Line ◽  
Power Structures ◽  
Participatory Action ◽  
Action Research Project ◽  
Active Involvement

In contrast to traditional approaches to research, participatory action research calls for the active involvement of the community—including both the beneficiaries and providers of sport services—in defining research problems, executing interventions, interpreting results, and designing strategies to change existing power structures. The purpose of this paper was to analyze a participatory action research project designed to increase the access of women living below the poverty line and their families to local physical activity services. A framework developed by Green et al. (1995) formed the basis of the analysis. To place the analysis in context, the historical origins and theoretical assumptions underlying participatory action research were addressed. The case of the Women's Action Project demonstrated how the process can result in a more inclusive local sport system and, at the same time, provide a rich setting for examining organizational dynamics including collaborative decision-making, community partnerships, power imbalances, resource control, resistance to change, and nonhierarchical structures.

scholarly journals Methodological Challenges in Participatory Action Research with Undocumented Central American Migrants

2011 ◽  
Vol 3 (2) ◽  
pp. 22-35 ◽  
Author(s):  
M. Brinton Lykes ◽  
Rachel M. Hershberg ◽  
Kalina M. Brabeck
Keyword(s):  
Action Research ◽  
Participatory Action Research ◽  
Immigrant Families ◽  
Assistant Professor ◽  
Central American ◽  
Participatory Action ◽  
Early Stages ◽  
Senior Scholar ◽  
Methodological Challenges ◽  
The Impact

An interdisciplinary participatory action research (PAR) project was designed in collaboration with local immigrant organizations to document the impact of deportation policy on Central American immigrant families living in the northeastern U.S. This paper reports on selected methodological challenges of university-based co-researchers in this community-university PAR process which is currently concluding its fourth year. The paper discusses the iterative action-reflection processes focusing on: (1) an overview of the PAR project and its multiple phases within the U.S. and in Guatemala; (2) select challenges and contributions of the PAR approach for participating immigrant families “living in the shadows” and, (3) methodological concerns from the three coauthors, who include a graduate student who joined the early stages of partnership-building; an assistant professor in the early stages of her career; and a senior scholar with many years of experience in activist scholarship. We conclude with thoughts on why, despite these challenges, PAR is “worth the trouble”.

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