Participatory Action Study Research Articles

Vulnerability and health promotion of Haitian immigrants: reflections based on Paulo Freire's dialogic práxis.

To understand the perceptions of Haitian immigrants about the possibilities to promote health, in the face of the vulnerabilities they experience. This is a qualitative, participatory action study, based on Paulo Freire's Research Itinerary, which has three phases: thematic investigation; encoding and decoding; critical unveiling. Ten Haitian immigrants, students of a public university in Brazil, participated in the Culture Circle. In the face of vulnerabilities, Haitian immigrants expressed the need to participate in university social groups, to have moments of integration with Brazilians, to know their rights, to master the Portuguese language, to adapt socially and culturally and to the food, to engage in the promotion of mental health and quality of life through physical activities and leisure. The discussions led to a process of action-reflection-action, in which immigrants reframed their reality, looking for strategies to promote health and empowering themselves in the search for a healthier life.

Determinantes sociais da saúde de mulheres imigrantes haitianas: repercussões no enfrentamento da COVID-19

Objetivos: Compreender as repercussões da COVID-19 no contexto dos determinantes sociais da saúde de mulheres imigrantes haitianas. Método: Estudo qualitativo, tipo ação-participante, fundamentado nos pressupostos de Freire, realizando-se um Círculo de Cultura Virtual, com a participação de 11 mulheres imigrantes haitianas. Foram percorridas as etapas do Itinerário de Pesquisa: Investigação Temática; Codificação e Descodificação; Desvelamento Crítico. Resultados: Nos diálogos emergiram o medo em relação à pandemia, escassos recursos econômicos, preconceito e racismo como aspectos dos determinantes sociais de saúde, que implicam na sua saúde mental das imigrantes, mas que referiram sentir-se acolhidas no Brasil. Conclusão: A partir dos determinantes sociais da saúde, apresentados pelas mulheres imigrantes haitianas no enfrentamento da pandemia mostra- se relevante a articulação entre ações de promoção da saúde, com ênfase na competência cultural, de forma a estimular o empoderamento das pessoas.

The Role of Creative Social Energy in Strengthening Ecological Adaptation Capacity Through Community Empowerment

Investments in large companies engaged in natural resource management have the potential to cause conflict, which requires an alternative model of conflict potential management. This study aims to analyze the development of creative social energy as an alternative to managing potential conflicts through empowering community food security. This study uses a participatory action study method for community empowerment and cybernetic triangulation methods in extracting data. Communities in the company's operational Ring1 area carried out community empowerment efforts by placing extension workers as community assistants. The results of the study show that community empowerment through a participatory extension approach is effective in supporting the realization of community welfare through increased income. Participatory community empowerment is effective in developing creative social energy. There is a close relationship between community empowerment and strengthening creative social energy and increasing the ecological adaptation capacity of society to the dynamics of environmental change. The ecological adaptation capacity of the community develops in line with the level of community empowerment. Community empowerment through effective participatory counseling is a model for managing potential conflicts in CSR programs. Extension workers with participatory community empowerment competencies are a key factor in the success of community empowerment.

A protocol study of participatory action research: integrated care pathway for pregnant women with heart disease in Indonesia

BackgroundHeart diseases are increasingly identified as an important indirect cause of maternal mortality in several cities in Indonesia. The management of pregnancy with heart diseases requires a multidisciplinary approach, and interprofessional collaboration practice (IPCP) is critical to improving the quality of patient care. To enable the effective implementation of IPCP, integrated care pathways (ICPs) are needed to define the roles and responsibilities of the health professionals involved. This study aims to examine the obstacles and enabling factors of IPCP, to develop and use ICPs in the implementation of IPCP in health care services for pregnant women with heart diseases.MethodsA participatory action study consisting of four stages (diagnostic, planning, implementation, and evaluation) will take approximately 2 years after consensus of ICPs are made. The primary data collection process will employ consensus, observations, focus group discussions, and in-depth interviews throughout the four stages, while secondary data from referral documents and medical records will be collected mainly during the diagnostic and evaluation stages. The findings are being analysed and will then be used to develop an ICPs through consensus building at the planning stage to be applied in the implementation stage. Finally, the implementation outcome, including acceptability, adoption, appropriateness, and feasibility of IPCP, will be assessed in the evaluation stage. All qualitative data will be analysed thematically by two coders using NVIVO 12 software.DiscussionThis research aims to assess the needs of IPCP, develop and use the ICPs in the implementation of IPCP in health care services for pregnant women with heart diseases. Findings from this study will be used for health service planning and policy making to strengthen practice of IPCP during the referral process. As a result, pregnant women with heart disease will have better access to high-quality services at every health care facility to reduce maternal mortality.Trial registrationRetrospectively registered in the ISRCTN registry with study ID ISRCTN82300061 on Feb 6, 2019.

A person-centred approach to implementation of psychosocial interventions with people who have an intellectual disability and dementia-A participatory action study.

Numbers of people with an intellectual disability and dementia present a global health and social challenge with associated need to reduce stress or agitation and improve quality of life in affected individuals. This study aimed to identify effectiveness of psychosocial interventions in social care settings and, uniquely, explore use of photovoice methodology to develop dialogue about dementia. This mixed-method participatory action study used individualised goal-setting theory with 16 participants with intellectual disability and dementia, and 22 social care staff across 11 sites. Five co-researchers with intellectual disability were part of an inclusive research team collecting data using existing and bespoke tools including photovoice. Analysis used descriptive and inferential statistics and framework analysis. Seventy four percentage of individual goals met or exceeded expectations with reduction in some "as required" medication. Qualitative findings include themes of enabling care and interventions as tools for practice. Photovoice provided insight into previously unreported fears about dementia. Individualized psychosocial interventions have potential to reduce distress or agitation.

The Role of Educational Spaces in Supporting Inuit Youth Resilience

ABSTRACT Indigenous youth in Canada grow up in communities shaped by the enduring political and economic legacies of settler colonialism. These legacies continue through systemic marginalisation, manifesting in strained sociocultural resources, intergenerational trauma, and poorer psychosocial outcomes for youth. To redress these outcomes, communities are drawing on traditional culture, together with life philosophies and frameworks, to identify relevant resources that better support young people and their development. Research findings support these approaches, demonstrating the importance of cultural continuity and related enculturation, in promoting improved psychosocial outcomes. The emerging question however, is how to foster increased engagement by children and youth. Spaces & Places, a participatory action study positioned within a resilience framework, responds to this question. In this article, we draw on findings from one of the three participating communities to highlight the complexities in understanding youth cultural engagement. We also explore ways in which communities can better support such engagement. In particular, findings highlight that youth perceptions of, and engagement with, resources is complex. Despite this complexity, socially embedded relationships and engagement with land-based, cultural activities are valued. While youth reflect a predominantly ambivalent attitude towards school, their narratives simultaneously suggest school as being a potential site within which to powerfully support their social and cultural engagement. Drawing on these findings, we recommend that schools and related educational systems adopt policies and service delivery practices that will facilitate the integration of external, community-based resources into the delivery of curriculum via more land-based and cultural activities.

Creating conditions for a sense of security during the evenings and nights among older persons receiving home health care in ordinary housing: a participatory appreciative action and reflection study

BackgroundToday many older persons in ordinary housing receive home health care. It is stipulated that the care is to provide security; however, deficiencies in home health care are reported in many countries. It may be difficult to implement a sense of security among older persons receiving home health care in ordinary housing, especially during the evenings and nights, due to a lack of knowledge.MethodsThis study is part of a larger project with a participatory appreciative action and reflection (PAAR) approach. We invited older persons, relatives, nurse assistants, registered nurses, and their managers to co-create knowledge with us on how conditions for a sense of security can be created during evenings and nights among older persons receiving home health care in ordinary housing. We performed thematic analysis of the data.ResultsFive subthemes were developed that gave structure to two main themes. The first main theme, To confirm the self-image, has the following subthemes: To see the home as a reflection of the person’s identity and To maintain self-determination. The second main theme, To create interaction in a sheltered place, has these subthemes: To undress the power, To create control and lifelines, and To create a good sleeping environment. The two themes interact and are each other’s conditions. The person’s self-image must be confirmed in order to create interaction in a sheltered place and through the interaction, the self-image is confirmed.ConclusionConditions necessary for older persons to have a sense of security are living in a familiar environment, having habits and routines maintained, and having self-determination. Other conditions are equality, the prevention of falls, and an individualized sleeping environment. Older people’s self-determination should be honored, and they should not being excluded from decision-making. We need to ask them if the conditions are sufficient and their sense of security is great enough to allow them to continue living in their ordinary housing.

Changing nursing practice: Implementation challenges of intentional rounding on three rehabilitation units.

The purpose of this article is to critically examine the process and results of a participatory action study designed to implement intentional rounding on a rehabilitation inpatient service. As a change initiative, this brief case study highlights the successes and challenges of implementing a practice intervention. Intentional rounding is a nursing intervention whereby hourly contact and support is provided to patients and families to strengthen the therapeutic relationship and proactively address their needs. Three units implemented rounding, and pre- and post-data were collected on four indicators: patient falls, call bell frequencies, satisfaction with care, and the nurses' practice environment. The results demonstrated small, positive changes in all indicators, but the level of rounding was lower than expected. Focus groups revealed the complexities of integrating rounding into established routines. Three factors were identified that contributed to the findings.

Hotel internal branding: A participatory action study with a case hotel

Successful hotel branding requires the management of both external and internal branding. External branding has been widely studied to understand how hotel brands connect with customers; however, internal branding targets internal employees, and the practice is not well understood by hoteliers. For that reason, this study proposes a framework for implementing internal branding in hotel organizations. We analyzed an internal branding project for three consecutive years using a participatory action study. The findings of this study support a six dimensions framework for implementing internal branding strategies: (1) corporate support; (2) leadership of managers; (3) reciprocal learning; (4) being proactive at the personal level; (5) characteristics of departments; and (6) performance evaluation. In the proposed framework, we applied a combined social identity and social exchange approach to identify how these approaches function in different paths which contributes new theoretical insights to the understanding of internal branding.

Using Facebook to reduce smoking among Australian Aboriginal and Torres Strait Islander people: a participatory grounded action study

BackgroundThere is limited evidence for the effectiveness of social media to promote healthy behaviour among Indigenous Australians, including to reduce smoking. Social media has significant potential to stimulate interpersonal influence to quit, however an important knowledge gap is how and what content people choose to share with friends and family. This paper explores the decision making processes of community members for sharing tobacco control content with family and friends on Facebook.MethodsCommunity researchers were paid to choose and share at least one tobacco control post per week for a period of 6 months on their personal Facebook page. They documented reasons for their choices, which were coded and analysed to determine features of messages most likely to be shared, and salient considerations in the decision-making process.ResultsPosts which are child-focused, feature Indigenous content, and are perceived as practical, relevant and credible, with a direct and unambiguous message, were most likely to be shared. Posts which included disgusting imagery about health impacts, were focused on the environment, or were ambiguous or sarcastic were less likely to be shared. Decisions were also based on whether content was perceived to contain new information, to be helpful for their friends, and to be consistent with the participant’s online identity, as well as the perceived sensitivity of content. The potential impact on expensive mobile data for videos was also a factor.ConclusionsWhen designing tobacco control messages to be shared on social media, health promoters should take into account how information will align with positive self-image and can contribute to social capital among the intended audience, and generate interpersonal engagement. Content should complement, rather than attempt to replicate, some message features that are effective on traditional broadcast media. This study shows the potential for health services to incorporate a strategy of using paid local social media ‘champions’ or ‘ambassadors’ to disseminate tobacco control messages on Facebook through community networks.

L’accès aux milieux de loisir pour les aînés ayant des incapacités : démarche d’élaboration d’un guide pratique

The article describes the process of developing a practical guide rooted in a participatory action study conducted at the Compagnie des jeunes retraités du Plateau to promote the inclusion of members with disabilities. The four phases were carried out by a committee made up of members of the organizations as well as researchers: (1) documentation of personal and environmental factors that may affect the participation of seniors with disabilities; (2) the design of inclusive measures concerning orientations, awareness, reception, and organization of activities; (3) conducting pilot projects to test these inclusive measures; and (4) the development of a practical handbook. The result combines knowledge, know-how, and skills to equip leaders and members of organizations that deal with seniors so that they may work toward the full participation of not only people with disabilities, but also those who are likely to be ostracized for other reasons.

Determinants of pesticide concentrations in silicone wristbands worn by Latina adolescent girls in a California farmworker community: The COSECHA youth participatory action study

Personal exposure to pesticides has not been well characterized, especially among adolescents. We used silicone wristbands to assess pesticide exposure in 14 to 16 year old Latina girls (N = 97) living in the agricultural Salinas Valley, California, USA and enrolled in the COSECHA (CHAMACOS of Salinas Examining Chemicals in Homes and Agriculture) Study, a youth participatory action study in an agricultural region of California. We determined pesticide concentrations (ng/g/day) in silicone wristbands worn for one week using gas chromatography electron capture detection and employed gas chromatography mass spectrometry to determine the presence or absence of over 1500 chemicals. Predictors of pesticide detections and concentrations were identified using logistic regression, Wilcoxon rank sum tests, and Tobit regression models. The most frequently detected pesticides in wristbands were fipronil sulfide (87%), cypermethrin (56%), dichlorodiphenyldichloroethylene (DDE) (56%), dacthal (53%), and trans-permethrin (52%). Living within 100 m of active agricultural fields, having carpeting in the home, and having an exterminator treat the home in the past six months were associated with higher odds of detecting certain pesticides. Permethrin concentrations were lower for participants who cleaned their homes daily (GM: 1.9 vs. 6.8 ng/g/day, p = 0.01). In multivariable regression models, participants with doormats in the entryway of their home had lower concentrations (p < 0.05) of cypermethrin (87%), permethrin (99%), fipronil sulfide (69%) and DDE (75%). The results suggest that both nearby agricultural pesticide use and individual behaviors are associated with pesticide exposures.

Stress and coping among university students in Sierra Leone: Implications for social work practice to promote development through higher education

This participatory action study involved interviews with 80 Sierra Leonean university students. Participants reported stress caused by personal challenges (financial, access to transportation, peer pressure, lack of emotional support), university resources (lack of accommodation, water, toilets, learning materials, technology), and issues with instructors (sexual harassment, bribery). Also, the students described their coping strategies, including ‘staying quiet’, seeking external support, turning toward God, engaging in recreation, and ‘encouraging myself’. Implications for social work interventions on the micro level, organizational level, and policy level are discussed in order to take a holistic, systems approach to promoting quality tertiary education in developing countries.

Perceptions of sexual abstinence among Muslim adolescent girls in southern Thailand.

Background Sex before marriage among Muslim adolescents is becoming a serious issue in Muslim societies exemplified by an increasing incidence of teenage pregnancy. Sexual abstinence is an optimal goal for adolescent health from an Islamic perspective. Muslim adolescent girls' perceptions have not been investigated, therefore, we lack understanding of their strengths and the risks that may contribute to outcomes such as pregnancy or sexually transmitted infections. Objective The purpose of this investigation was to characterize Muslim adolescent girls' perceptions of sexual abstinence. Methodology This participatory action study was conducted at an Islamic school in southern Thailand. Twenty-five girls, ages 12-14 years old, were purposively selected to participate in the study. Content analysis was used for data analysis. Results Two salient themes were discovered that characterize Muslim adolescent girls' perceptions about sexual abstinence: sexual abstinence is a means of self-protection and sex outside marriage is restricted by Islam, but it seems to be difficult to adhere to. Conclusions Religious values, family and peers play a central role in shaping thoughts and decisions about abstaining from sex. The integration of religious principles with building practical refusal skills, is needed to promote Muslim adolescent health.

A Righteous Undocumented Economy

The academic literature commonly exposes large components of informal economies housed in developed countries as nefarious systems designed to help people evade taxes or carry on other illegal activities. However, our community-based participatory action study uncovered a significant element of a social and economic system that was largely undocumented, but was viewed as far more righteous than dishonorable and immoral. Our research involved approximately 375 participants from seven communities spread across a large and sparsely populated geographic region in the northern part of the Canadian province of Saskatchewan. The purpose for the research was to explore how entrepreneurship contributes to the good life, well-being, and prosperity by building social and economic capacity across a rural business ecosystem. We found that an important, yet undocumented part of the business ecosystem was grounded in history, culture, and tradition. When considered through a legitimacy theory lens, this perspective challenges the implication drawn from some of the academic literature that those who participate in informal business systems in developed countries usually do so for immoral reasons that might warrant a legal penalty. Further, we propose that researchers, policy makers, and community development professionals use the term undocumented economy rather than expressions like informal, hidden and underground economy to distinguish components of economic systems based on righteous motivations and activities from those founded on iniquitous practices and non-existent or unofficial record keeping. We begin this article with a definition for the undocumented economy in which we describe why we consider it to be righteous.

Time to ask and tell: Voices of older gay and bisexual male veterans regarding community services

ABSTRACTThis participatory action study involved lesbian, gay, bisexual, transgender, and queer (LGBTQ) veterans in determining community-based service needs for health and wellness, illuminating perspectives of older LGBTQ veterans regarding community services. This study explored veterans' perceptions of being LGBTQ later in life. The study included data from interviews with gay and bisexual male veterans ages 51 to 87. Participants valued engagement as part of community. Their recommendations for action included communal meals, transportation, housing, and the coming-out process. Community services facilitated community engagement to support health and wellness for LGBTQ older veterans. The authors used participatory action research (PAR), a method of systematic inquiry integrating the perspective of persons living the experience, to organize the study. Further PAR is recommended to implement community services to meeting health and wellness needs of participants.

In-service teacher training to provide psychosocial support and care in high-risk and high-need schools: school-based intervention partnerships

This article uses a South African case study to argue that postcolonial, emerging economy societies in transition often contain schools characterised as high risk and high need. Such schools require teachers to adapt to roles other than facilitating learning, such as psychosocial support and care, and which requires additional professional development. In the absence of structured teacher professional development programmes, alternatives are required to assist teachers. The paper describes a nine-year partnership between higher education researchers and teachers in high-risk and high-need schools in three South African provinces. The participatory reflection and action (PRA) study served as platform for a school-based intervention to assist in-service teachers to adapt to their additional responsibilities. Thematic analysis was used to identify the ways in which teachers’ adaptation to high risk benefitted from the programme, and self-determination theory is used to argue for a dynamic and interconnected relationship between the teachers’ demonstrated pathways to psychosocial support and care. The article argues that in socio-politically transforming societies where need is high for in-service teacher training and formal structures for teacher professional development may be limited, partnerships between researchers and teachers appear to be useful platforms for school-based interventions to support teacher resilience.

Empowering Homeless Youth: Building Capacity through the Development of Mobile Technology

Information-communication technologies, like computers and cell phones, are popular among young people. This article details a youth-centered participatory action study in which 12 homeless youth designed and developed a mobile application for other homeless youth. We frame our analysis through a theory of critical youth empowerment and discuss the steps taken to develop the application, as informed by the method of spiral technology action research. Developing the application allowed these young people to express their opinions and frustrations, while also providing an opportunity for them to make the lives of their peers better through improved access to supports and services.

Very low food security in the USA is linked with exposure to violence.

To investigate characteristics of exposure to violence in relation to food security status among female-headed households. Ongoing mixed-method participatory action study. Questions addressed food insecurity, public assistance, and maternal and child health. Grounded theory analysis of qualitative themes related to violence was performed. These themes were then categorized by food security status. Homes of low-income families in Philadelphia, PA, USA. Forty-four mothers of children under 3 years of age participating in public assistance programmes. Forty women described exposure to violence ranging from fear of violence to personal experiences with rape. Exposure to violence affected mental health, ability to continue school and obtain work with living wages, and subsequently the ability to afford food. Exposure to violence during childhood and being a perpetrator of violence were both linked to very low food security status and depressive symptoms. Ten of seventeen (59%) participants reporting very low food security described life-changing violence, compared with three of fifteen (20%) participants reporting low food security and four of twelve (33%) reporting food security. Examples of violent experiences among the very low food secure group included exposure to child abuse, neglect and rape that suggest exposure to violence is an important factor in the experience of very low food security. Descriptions of childhood trauma and life-changing violence are linked with severe food security. Policy makers and clinicians should incorporate violence prevention efforts when addressing hunger.

Stories of women involved in a postpartum depression peer support group

Living through postpartum depression (PPD) might lead women to seek a variety of support to re-establish their well-being, including a hybrid of traditional and non-traditional services. Within this mix, some women participate in peer groups; however, there is a paucity of research regarding their subjective experiences of engaging in this type of support. The purpose of this study was to describe how women talked about living through PPD in the context of a peer support group. This focused ethnography was a component of a larger participatory action study in northern Ontario, Canada. The seven members of a 5-week peer support group described their postpartum experiences through written, visual, and spoken stories. Using structural narrative analysis, stories about recovery were identified across the data. Three groups of recovery stories were labelled as illness, mothering wisdom, and mobilizing. The findings suggested that women actively sought and established a therapeutic space for PPD recovery with peers. As such, health-care providers are encouraged to acknowledge the merits and advocate for the multiple and diverse alliances women might require to actualize recovery.