Participatory Action Research Team Research Articles

A sandwich effect: Gentrification and Black residential displacement in the university-adjacent West Philadelphia Promise Zone

ABSTRACT This study examines the landscape of gentrification and Black residential displacement within the West Philadelphia Promise Zone (WPPZ). Our intergenerational community-driven participatory action research team conducted a comparative longitudinal spatial analysis between Census data from 2008 to 2012 and 2013 to 2017 investigating variables of both gentrification and displacement including changes in population, racial demographics, per capita income, and housing costs and value. Our findings demonstrate that targeted block groups within the WPPZ are exhibiting indicators of displacement; however, they are not progressing at the same rate. We found that Black residents are impacted by the neighborhood changes at the highest rates and are being displaced from the north and the south, being squeezed to the middle resulting in a racialized pattern of gentrification that we deem a sandwich effect. Recommendations to respond to the displacement of Black residents in the WPPZ and other university-adjacent urban communities are presented.

The dementia-inclusive choices in exercise project: Using participatory action research to improve physical activity supports for persons with dementia.

Persons with dementia have the right to equal inclusion in rehabilitation, including physical activity. However, the perspectives of persons with dementia are rarely integrated into decision-making related to physical activity programming, services, and supports. Here, we describe the participatory action research (PAR) approach used to develop the Dementia-Inclusive Choices for Exercise (DICE) toolkit, which aims to increase the quality and number of physical activity opportunities available to persons with dementia. The DICE Research Team included persons with dementia, a family care partner, exercise professionals, community and dementia service providers, health care professionals, and researchers who worked to: 1) Engage/maintain the Research Team; 2) Set/navigate ways of engagement; 3) Understand barriers to physical activity; 4) Prioritize the audience and actions; 5) Develop the toolkit; 6) Conduct usability testing; and 7) Implement and evaluate. Guided by the Behaviour Change Wheel, and informed by interviews, focus groups, and existing research, our PAR Team chose to prioritize training exercise providers; exercise providers can enable exercise for persons with dementia if they understand common changes with dementia and how to support persons with dementia in exercise. The content and format of the toolkit was co-developed: drafted by our Research Team, adapted through a stakeholder workshop, and refined through iterative development and usability testing. The product of our PAR process, the DICE toolkit, includes videos meant to destigmatize dementia, training modules and a training manual for exercise providers, a physical activity handout for persons with dementia, and wallet cards to help persons with dementia communicate their abilities, needs, and preferences. Our usability study indicated that the toolkit could be used by exercise providers and may improve attitudes about dementia. Our vision is that our co-developed DICE toolkit will empower exercise providers to improve physical activity opportunities and support for persons with dementia.

Autoethnographic engagement in participatory action research: Bearing witness to developmental transformations for college student activists

This article documents and analyzes autoethnographic engagement in participatory action research (PAR)—a reflective, irritative, and dialogic writing and team-discussion process which documents researcher-activist experiences and contextualizes them within the action research process. We document autoethnography as implemented in a research partnership between HMoob American college student activists and education researchers, to study the systems of oppression and inform advocacy to support HMoob American students at a predominantly white university. Autoethnography informs all aspects of the PAR project, from the development of research questions, to data collection, analysis, and writing, to the implementation of plans for action. We provide evidence from selections of the team’s autoethnographic journals, of the role of autoethnographic engagement as a PAR research technique that can facilitate and bear witness to the developmental transformations for emerging PAR activists—specifically, the cultivation of critical consciousness, the critical re-framing of issues of cultural-community identity, and the formation of an identity as a researcher-activist. We argue that autoethnography provides a practical technique for PAR teams for engaging in iterative cycles of critical self-reflective praxis (Freire, 2011), facilitating the development of critically-engaged researchers and the formation of analyses that are epistemologically grounded and action-oriented, addressing issues of power asymmetries within research.

Scaling-up digital follow-up care services: collaborative development and implementation of Remote Patient Monitoring pilot initiatives to increase access to follow-up care.

COVID-19 increased the demand for Remote Patient Monitoring (RPM) services as a rapid solution for safe patient follow-up in a lockdown context. Time and resource constraints resulted in unplanned scaled-up RPM pilot initiatives posing risks to the access and quality of care. Scalability and rapid implementation of RPM services require social change and active collaboration between stakeholders. Therefore, a participatory action research (PAR) approach is needed to support the collaborative development of the technological component while simultaneously implementing and evaluating the RPM service through critical action-reflection cycles. This study aims to demonstrate how PAR can be used to guide the scalability design of RPM pilot initiatives and the implementation of RPM-based follow-up services. Using a case study strategy, we described the PAR team's (nurses, physicians, developers, and researchers) activities within and across the four phases of the research process (problem definition, planning, action, and reflection). Team meetings were analyzed through content analysis and descriptive statistics. The PAR team selected ex-ante pilot initiatives to reflect upon features feedback and participatory level assessment. Pilot initiatives were investigated using semi-structured interviews transcribed and coded into themes following the principles of grounded theory and pilot meetings minutes and reports through content analysis. The PAR team used the MoSCoW prioritization method to define the set of features and descriptive statistics to reflect on the performance of the PAR approach. The approach involved two action-reflection cycles. From the 15 features identified, the team classified 11 as must-haves in the scaled-up version. The participation was similar among researchers (52.9%), developers (47.5%), and physicians (46.7%), who focused on suggesting and planning actions. Nurses with the lowest participation (5.8%) focused on knowledge sharing and generation. The top three meeting outcomes were: improved research and development system (35.0%), socio-technical-economic constraints characterization (25.2%), and understanding of end-user technology utilization (22.0%). The scalability and implementation of RPM services must consider contextual factors, such as individuals' and organizations' interests and needs. The PAR approach supports simultaneously designing, developing, testing, and evaluating the RPM technological features, in a real-world context, with the participation of healthcare professionals, developers, and researchers.

Outcomes and challenges of successful clinical nurse specialist role implementation: Participatory action research.

To describe the clinical nurse specialist role and its outcomes and challenges. Participatory Action Research conducted in Finland between the fall of 2017 and the end of 2018. A core participatory action research team (n=10) led the design, implementation and evaluation of the research. Multiple data collection methods were used. The study is reported using the Enhancing the QUAlity and Transparency Of health Research (EQUATOR) guidelines for participatory action research. The clinical nurse specialist used most of the time in clinical patient care followed by clinical nursing leadership and scholarship activities. Outcomes of successful implementation led to increased visibility of nursing expertise, development, integration and quality assurance of nursing processes and practice, and promotion of knowledge translation and unit and collaborator cooperation. Furthermore, role challenges were also recognized.

Enhancing Farmers’ Seed Systems through Empowerment of Women: A Case Study from China

Maintaining farmer’s seed systems is important to secure the adaptive capacity both ecologically and socially for global food systems, and to secure genetic diversity. In a mountain village of southwest China, a Participatory Action Research Team has carried out action research for more than 20 years to support women's participation in participatory breeding and to enhance the farmers’ seed system. In this case study, the team assisted women in the conservation of local varieties and establishment of community seed banks to enhance farmers’ seed systems. The women-led agricultural cooperatives promoted the economic development of the community and improved the sustainability of farmers’ seed system through eco-circular agriculture and the community supported agriculture (CSA) model. In this participatory process, the empowerment of women improved women's comprehensive ability and provided the guarantee of human resources for enhancing farmers' seed system. Multi-stakeholder processes also extended important support to this model work.

ISelf-Help: a co-designed, culturally appropriate, online pain management programme in Aotearoa

IntroductionCurrent best practice recommends group-based pain management programmes for long-term improvements in persistent pain-related disability. However, there are barriers for people to access in-person delivered pain management programmes in Aotearoa.AimsTo develop a co-designed, culturally responsive, online group-based pain management programme (iSelf-help) for people with persistent pain.MethodsA modified participatory action research (PAR) framework was used to co-design contents and cultural-appropriateness of iSelf-help. The PAR team included: (1) seven end-users living with persistent pain, who had previously attended an in-person delivered group pain management programme, (2) two pain management clinicians, (3) two health researchers, (4) two digital health experts, and (5) a health literacy expert. Five meetings were held with the PAR group and a Nominal Group Technique was used to rank order the preferred features of content delivery. In parallel, to ensure cultural appropriateness of iSelf-help, three focus groups (n = 15) were held with Māori (the Indigenous population of Aotearoa) living with persistent pain in collaboration with a Māori community health trust. All contents were reviewed by a Māori Health literacy expert and core contents were translated into Te Reo (Māori language). All contents were finalised by iterative discussion among the PAR team and consultation with Māori stakeholders. The preliminary version of iSelf-help was pilot tested with the PAR group participants and Māori community members living with persistent pain and their feedback was included. The iterative co-design process occurred over a period of nine months.ResultsThe finalised version of iSelf-help included a total of 130 resources organised in to 12 content relevant online modules plus a dedicated welcoming page and an online community forum. Each module included: short videos, animations explaining main concepts, patient stories, written content to accompany visual content, podcasts of relaxation techniques, illustrated texts, and evidence-summaries. A dedicated module of videos demonstrating cardiovascular and strengthening exercises of varying intensity was also included.ConclusionsThis is the first co-created, culturally appropriate, on-line group pain management programme for people with persistent pain, developed in Aotearoa. The next step is to evaluate the clinical and cost-effectiveness of iSelf-help compared to in-person delivered pain management programme.

The Action Research Collective: Using Participatory Action Research to Support Graduate Student Development

The Action Research Collective:Using Participatory Action Research to Support Graduate Student Development Keneisha Harrington (bio) and Robin Phelps-Ward (bio) Within the last 20 years, graduate student enrollment in the U.S. has increased by 39% (NCES, 2019). Such a growing population of students pursuing postbaccalaureate degrees necessitates that institutional leaders direct more of their efforts and resources to graduate students and their development and socialization (Gardner & Barnes, 2007). The need grows increasingly important when we consider the experiences of graduate Students of Color (GSOC) at predominantly white institutions (PWIs). These students face added barriers throughout their graduate journeys given the legacy of racism embedded within US educational institutions (Brunsma et al., 2016; Gildersleeve et al., 2011; Wilder, 2013). From microaggressions and exclusionary practices to epistemic violence and racial battle fatigue (Clark et al., 2012; Levin et al., 2013), the social sciences literature has highlighted the multitude of ways GSOC experience racism. Further, scholars have continued to underscore the prevailing influence of campus racial climate in relation to GSOC recruitment and retention, noting programs, policies, and practices that acknowledge, address, and disrupt inequities (Griffin et al., 2012). However, the literature dedicated to researching specific diversity, inclusion, equity, and justice (DIEJ) initiatives and their associated effectiveness remains scant (Patton et al., 2010). Thus, in this paper, we focus on a particular student-led organization designed to support GSOC development—the Action Research Collective (ARC)—and briefly discuss the team's history, its research project, and outcomes for its graduate student members determined through an evaluation study. Ultimately, the purpose of this paper is to provide those who support graduate students (i.e., student affairs professionals, faculty) with a participatory action research team model to support graduate students' development and belonging, as well as their skills as emerging scholars. ARC is a team of graduate students (predominantly Students of Color) who organized during the fall of 2016 at Clemson University, a large, public research university in the South, to respond to the institution's racist campus climate. Although student-led activism against campus racism had been brewing for many years at the university, tensions reached a pinnacle during the #SikesSitIn sparked by a racist campus incident. The student sit-in lasted more than 12 days, garnered national attention, and led to an administrator's decision to arrest five students who resisted demands to end their protest inside a campus administrative building. [End Page 736] ARC formed in response to the racial tensions at Clemson and sought to address the racist campus climate while building community and professional development opportunities for GSOC at the university. With the guidance of a tenure-track, higher education faculty member (Robin Phelps-Ward) who secured financial support from the graduate school (to provide professional development funds up to $500 to involved students), a small group of nine graduate students mobilized as a team. While the initial goals of the team focused on the students' individual professional development through research, the group ultimately decided to form an action research collective to address inequities and improve the university's campus racial climate (Hurtado et al., 1998). Within the initial months of organizing, students shared their experiences at the university navigating racism—on campus, in the community, in classes, and in interactions with peers—as well as the challenges they encountered gaining access to their graduate programs. Additionally, the team engaged in reflective prompts, group storytelling, and scholarly reading about the experiences of GSOC to define the group's purpose and goals. Based on these activities, the team collaboratively decided to engage photovoice methodology (Latz, 2017; Wang, 1999) because of its ability to powerfully illustrate experiences and potential effectiveness in reaching graduate education leaders at the university with the power to provide additional resources for GSOC and change inequitable policies, practices, and processes. At the time of this manuscript's authorship, ARC includes 23 student members, four faculty members, and several alumni who now work as student affairs professionals at various universities across the country. During the first three years of ARC's existence, the team focused on designing a photovoice research project, collecting and analyzing data, and sharing findings with peers, colleagues, and the broader research community at...

\u201cA coalition of the willing\u201d: experiences of co-designing an online pain management programme (iSelf-help) for people with persistent pain

BackgroundParticipatory approaches to developing health interventions with end-users are recommended to improve uptake and use. We aimed to explore the experiences of co-designing an online-delivered pain management programme (iSelf-help) for people with persistent pain.MethodsA modified participatory action research (PAR) framework was used to co-design contents and delivery of iSelf-help. The PAR team included: (1) a patient advisory group consisting of people living with persistent pain (n = 8), (2) pain management service clinicians (n = 2), (3) health researchers (n = 3), (4) digital health experts (n = 2), (5) a health literacy expert, and (6) two Māori health researchers and our community partner who led the cultural appropriateness of iSelf-help for Māori (the Indigenous population of New Zealand). The iSelf-help co-design processes and activities of the ‘PAR’ team is reported in another paper. In this paper, all PAR team members were invited to share their experiences of the co-design process. Individual interviews were held with 12 PAR team members. Interview transcripts were analysed using the General Inductive Approach.ResultsFive common themes were identified from the interviews: (1) Shared understanding and values of the co-design process, (2) Mismatched expectations with content creation, (3) Flexibility to share power and decision making, (4) Common thread of knowledge, and (5) Shared determination. Sustaining these themes was an overarching theme of “A coalition of the willing”.ConclusionsPAR team members valued the shared determination and responsibility to co-design iSelf-help. They also acknowledged the complexities and challenges during the process related to mismatched expectations, power sharing and establishing a common thread of knowledge. Successful co-design requires a shared commitment and responsibility as a coalition to meet the aspirations of end-users, within the boundaries of time and budget.

Use of participatory action research approach to develop a self-management resource for persons living with dementia.

This article describes the use of a participatory action research (PAR) approach to developing a self-management resource for persons living with dementia and care partners. Despite growing evidence that persons with dementia are able to contribute in meaningful ways to decision-making about their care and life preferences, few opportunities exist for them to participate in the design of resources and services meant for them. There is also a need to support the self-management of persons living with dementia with the provision of accurate, high quality, user-friendly information. The Living Well with Dementia resource was developed through a partnership with persons with dementia, family members, Alzheimer Society representatives, primary care providers, and researchers. The methods used in the development of this resource are outlined in six steps employed in this process, from establishment of a PAR team to final resource creation. Informed by a whole systems approach, the resource brings together essential components of self-management into a comprehensive system of care and support for living. It empowers users to be active participants in the application of new knowledge to their lives. Better self-management has important implications for access to health care and quality of life for persons with dementia and care partners.

Clinical and cost-effectiveness of an online-delivered group-based pain management programme in improving pain-related disability for people with persistent pain—protocol for a non-inferiority randomised controlled trial (iSelf-help trial)

IntroductionPersistent non-cancer pain affects one in five adults and is more common in Māori—the Indigenous population of New Zealand (NZ), adults over 65 years, and people living in areas of...

The tree of community knowledge and engagement

Deep-seated educational discourses have blamed low-income communities for their youth’s lack of high school completion. These deficit discourses reflect top–down knowledge hierarchies and a lack of knowledge democracy in education (de Sousa Santos 2007; Hall & Tandon 2017; Visvanathan 2009), and they are in need of critical and diverse knowledge reckoning by low-income communities themselves. This article relays how a community-university participatory action research (PAR) partnership became a dynamic site of knowledge democracy from which to counter and transform deficit-based knowledge systems imposed on economically disadvantaged communities. Steeped in the generative enactments of PAR, storytelling, ecological metaphor, strength-based approaches and the arts, this article explores a low-income/social housing community’s knowledge practices that are energising and growing its community power to support the success of their youth in school. These seven knowledge practices are narrated through the ecological metaphor of trees, specifically via a co-constructed PAR team narrative called the Tree of Community Knowledge and Engagement.
 In the telling and retelling of this counternarrative-in-the-making, this article embodies knowledge democracy. Here, community members’ energising knowledge practices are recognised as invaluable forms of everyday educational knowing and leadership for their youth. This article further explores three broad ways of knowing that reside within and across community members’ seven knowledge practices: lived knowing, interconnected knowing and participatory/power-in-relation knowing. The three community ways of knowing illustrate how the community is growing its power to support youth’s success via a transformative educational worldview, from which other schools and universities could learn and, indeed, thrive.

Developing outcome, process and balancing measures for an emergency department longitudinal patient monitoring system using a modified Delphi

BackgroundEarly warning score systems have been widely recommended for use to detect clinical deterioration in patients. The Irish National Emergency Medicine Programme has developed and piloted an emergency department specific early warning score system. The objective of this study was to develop a consensus among frontline healthcare staff, quality and safety staff and health systems researchers regarding evaluation measures for an early warning score system in the Emergency Department.MethodsParticipatory action research including a modified Delphi consensus building technique with frontline hospital staff, quality and safety staff, health systems researchers, local and national emergency medicine stakeholders was the method employed in this study. In Stage One, a workshop was held with the participatory action research team including frontline hospital staff, quality and safety staff and health systems researchers to gather suggestions regarding the evaluation measures. In Stage Two, an electronic modified-Delphi study was undertaken with a panel consisting of the workshop participants, key local and national emergency medicine stakeholders. Descriptive statistics were used to summarise the characteristics of the panellists who completed the questionnaires in each round. The mean Likert rating, standard deviation and 95% bias-corrected bootstrapped confidence interval for each variable was calculated. Bonferroni corrections were applied to take account of multiple testing. Data were analysed using Stata 14.0 SE.ResultsUsing the Institute for Healthcare Improvement framework, 12 process, outcome and balancing metrics for measuring the effectiveness of an ED-specific early warning score system were developed.ConclusionThere are currently no published measures for evaluating the effectiveness of an ED early warning score system. It was possible in this study to develop a suite of evaluation measures using a modified Delphi consensus approach. Using the collective expertise of frontline hospital staff, quality and safety staff and health systems researchers to develop and categorise the initial set of potential measures was an innovative and unique element of this study.

A Toolkit for Enhancing End-of-Life Care: An Examination of Implementation and Impact

The purpose of this study was to examine the infusion of a Toolkit for Enhancing End-of-Life Care in prisons, as well as the outcome and impact on the quality of prison end-of-life care. A total of 74 front-line staff and administrators were in attendance across two post-Toolkit-infusion evaluation visits. Applying qualitative analysis, co-researcher outcome findings were related to activities, community outreach and relations, multidisciplinary team, quality improvement approach, and participatory action research team effects. Organizational outcomes included barriers and challenges, cost, organizational features, sphere of influence, readiness (for change), and sustainability.

Co-designing Integrated Care Using Participatory Action Research [PAR]: The Epilepsy Partnership in Care [EPiC] Project

Introduction: Concepts of “Co-design”, “Co-creation”, “Co-production” are currently used by those promoting innovation to improve integration of healthcare services. They each reflect a practice where both the consumer and the provider of a service/product work together, in partnership, to make something happen. In response to the fragmentation of traditional health services Integrated Care has become a core value of current and emerging health service reforms worldwide. Models of Integrated Care are promoting enhanced co-ordination of care for individuals, better continuity across organisational boundaries and healthcare sectors and improved efficiencies and use of limited health care resources. While Integrated Care is high on the health reform agenda, this does not mean it is actually happening. Using epilepsy as a probe, the National Clinical Care Programme for Epilepsy in collaboration with academic partners from RCSI, Maynooth and Dublin City Universities is conducting a project entitled “Epilepsy Partnership in Care (EPiC)” to explore and advance the integration of care and services provided. Aim: The EPiC Project aims to: realise the promise of Integrated Care for people with epilepsy in Ireland. develop a fine-grained understanding of the provision of services and the experience(s) of living with epilepsy. identify and act on opportunities for promoting better integration of epilepsy services and care. Methods: Ethnographic field work (in-depth interviews, observational field work and focus groups) initially explored Integrated Care in the Irish epilepsy domain. This involved engagement with people with epilepsy (PWE), families, carers, community resource officers, healthcare providers from multiple health services (epileptologists, epilepsy specialist nurses, health service managers, general practitioners, community nurses) at various sites across Ireland ranging from the patient living room to the hospital ward. From this field word, four contexts for creating participatory action research (PAR) teams were identified. Results: 32 people with epilepsy, 6 community resource officers, 4 consultant epileptologists, 13 epilepsy specialist nurses, 3 intellectual disability sector nurses, 3 general practitioners, 2 health service managers and 1 epilepsy service manager have participated in the project. The exploration has elucidated the full range of actors involved in the epilepsy ecosystem, and the nature of their interactions with each other and their surroundings. Evidence of (expert epilepsy clinicians), gaps in (role confusion), and challenges to (competing priorities) integration of epilepsy care have emerged as have opportunities for advancing it through PAR research. Four PAR teams (Community Care; Education; Adolescent Transition; Telephone Advice) were formed into collaborative partnerships between people who receive and deliver epilepsy care and iteratively explored the meaning of Integrated Care while simultaneously identifying both opportunities for and challenges to achieving sustainable integrated care. Conclusion: The EPiC project recognises people with epilepsy in the context of their whole lives not just their medical condition. It is collaboratively observing and cataloguing the diversity of needs, and experiences within the epilepsy care domain in Ireland from the day-to-day life of the person with epilepsy to the experiences of those who deliver services and care. EPiC will create the conditions for intelligently designing and implementing integrated care.

Rethinking Urban Refugee Resettlement: A Case Study of One Karen Community in Rural Georgia, USA.

AbstractWhile refugee resettlements in urban areas have historically had negative outcomes, alternatives have not been adequately discussed. This study aims to shed light on refugee's rural resettlement via an ethnographic case study. The participatory action research team consisting of refugee youth and outside academics investigated two rural Karen communities in Georgia and three urban communities via semi‐structured interviews and participant observation. Interview transcripts, field notes, video recordings of observations, and dialogues among researchers served as rich data for thematic analysis. We found refugees like the Karen, who came from rural agricultural backgrounds, benefitted from the familiar lifestyle of rural living. We discuss the advantages and disadvantages of rural resettlement for refugees regarding community support, insecurity, inter‐ethnic conflict, housing, employment, and cultural heritage and language maintenance. Community leaders and policymakers of refuge resettlement may use the findings in making decisions about the potential for rural resettlement.

Police Abuse and Sex Workers The Two Wings of the Butterfly: Negotiating Ethical Dilemmas in Participatory Action Research (PAR) in Bogott, Colombia

Since September of 2012, we have been conducting Participatory Action Research (PAR) in the center of Bogota with sex workers regarding their right to the public space known as 'La Mariposa' (The Butterfly), an open‐air plaza where they often face discriminatory urban praxis and frequent abuse by police officers. While our PAR team has conducted research in 'The Butterfly' for over five years, the objectives, motivation and design of this PAR project were defined by community‐based peer leaders and driven by their concerns and testimonies about the abuse and discrimination they have experienced from police in the plaza. Sex workers in the plaza have described these experiences in terms of unjustified detention, physical and verbal abuse, discrimination and abuse due to sexual orientation, and urban displacement. In this paper, we will discuss our PAR team's action research agenda and our collective work promoting sex worker's re‐appropriation of their right to public space and the city. We will provide concrete examples of ethical dilemmas we have faced in the field and the corresponding praxis our PAR team developed to negotiate and overcome these dilemmas through our 'PARCES' (Translated Acronym: Peers in Action Reaction Against Social Exclusion) methodology. The principles of 'PARCES' and 'action‐reaction' guide our decision‐making process with research actors throughout the construction of the action research design, implementation and analysis in order to incorporate participatory relations and the consideration of research actors' safety, health, and rights within the ethical framework of the project.

The Mothers on Respect (MOR) index: measuring quality, safety, and human rights in childbirth

BackgroundAbuse of human rights in childbirth are documented in low, middle and high resource countries. A systematic review across 34 countries by the WHO Research Group on the Treatment of Women During Childbirth concluded that there is no consensus at a global level on how disrespectful maternity care is measured. In British Columbia, a community-led participatory action research team developed a survey tool that assesses women's experiences with maternity care, including disrespect and discrimination. MethodsA cross-sectional survey was completed by women of childbearing age from diverse communities across British Columbia. Several items (31/130) assessed characteristics of their communication with care providers. We assessed the psychometric properties of two versions of a scale (7 and 14 items), among women who described experiences with a single maternity provider (n=2514 experiences among 1672 women). We also calculated the proportion and selected characteristics of women who scored in the bottom 10th percentile (those who experienced the least respectful care). ResultsTo demonstrate replicability, we report psychometric results separately for three samples of women (S1 and S2) (n=2271), (S3, n=1613). Analysis of item-to-total correlations and factor loadings indicated a single construct 14-item scale, which we named the Mothers on Respect index (MORi). Items in MORi assess the nature of respectful patient-provider interactions and their impact on a person's sense of comfort, behavior, and perceptions of racism or discrimination. The scale exhibited good internal consistency reliability. MORi- scores among these samples differed by socio-demographic profile, health status, experience with interventions and mode of birth, planned and actual place of birth, and type of provider. ConclusionThe MOR index is a reliable, patient-informed quality and safety indicator that can be applied across jurisdictions to assess the nature of provider-patient relationships, and access to person-centered maternity care.

FEELING LIKE RESEARCH PARTNERS AS A YOUTH-ADULT TEAM

Participatory action research (PAR) lacks concerted attention to what makes youth-adult teams feel like genuine partners. This paper explores our youth-adult PAR team’s experience of what made us feel like partners during our five-year study of youth voice in educational change. Our findings reveal that we felt like research partners when our partnership was rooted in 1) real relationship; 2) shared power, responsibility and passion; 3) a culture of flexibility, creativity and unfolding; and 4) transformation. By conceptualizing partnership in a manner that incorporates both youth and adult felt experiences and shared understandings, notions of youth-adult partnership become more inclusive. These findings (re)orient current emphases placed on the partnering benefits to youth, research and social change.

Community and Public Arena Advocacy Training Challenges, Supports, and Recommendations in Counseling Psychology: A Participatory Qualitative Inquiry

Despite a continuing need for clinicians to engage in socially-­‐just practice that addresses systemic factors impacting the mental health of clients through advocacy, there are often limited formalized opportunities for doctoral counseling psychology students to be exposed to and to engage in community or public arena advocacy. Two counseling psychology faculty members initiated and supervised a Participatory Action Research (PAR) team comprised of six advanced counseling psychology doctoral students and three early career counseling psychologists with experience conducting community and public arena advocacy. The nine PAR team members explored the doctoral students’ experiences conducting advocacy during their doctoral training and the resulting qualitative data was analyzed using a content analysis methodology. The study results highlight the challenges inherent in facilitating and conducting these types of advocacy training activities, discuss essential supports provided by their doctoral programs, and offer recommendations to counseling psychology faculty interested in preparing their students to engage in this work.