Using participatory research to challenge the status quo for women's cardiovascular health

Uncovering social and psychosocial health factors through participatory qualitative research with low-income adults in a suburb of Montreal, Quebec

OBJECTIVES

The association between social status and health is well established, but the psychosocial factors and mechanisms underlying this association are not fully understood. This study aims to identify and describe social and psychosocial factors that may harm the health of low-income adults.

DESIGN

Participatory qualitative research using a problem-posing method based on Freire's pedagogy.

SETTING

Community organisation in a low-income district in the metropolitan area of Montreal, in the province of Quebec, Canada.

PARTICIPANTS

Eight low-income adults using food bank services provided by the community organisation. Participants had to reside in the community organisation's service area, have insufficient income to cover living expenses, be aged 18 years or older, and be able to participate in group sessions.

METHODS

Eight weekly group sessions (average of 2.5 hours per session) were held using problem-posing method, which included activities such as presentation of representative stories or images and role-playing. Five additional sessions were held for thematic data analysis with participants.

RESULTS

A main factor identified as harming the health of participants was the dissonance between perceived current circumstances and the ideal of circumstances conceived early in life. This dissonance follows a loss or a failure to achieve the ideal of circumstances and generates profound malaise. Other main factors identified were the current circumstances as a social trap and the lack of love and support from an early age.

CONCLUSIONS

This study identifies a new psychosocial factor, namely, the dissonance between perceived current circumstances and the ideal of circumstances conceived early in life. Larger studies should examine the influence of this factor on health.

Applying mixed methods in community-based participatory action research: a framework for engaging stakeholders with research as a means for promoting patient-centredness

An increased focus on patient-centred care in response to national efforts of improving the quality of health care calls for effective approaches to engaging patients and other stakeholders with research and its outcomes. Mixed methods research can provide a rigorous methodological foundation for community-based participatory action research (CBPAR) by synergistically combining qualitative stakeholder engagement methods with quantitative outcome-based oriented approaches for developing evidence-based, scientifically sound and patient-centred plans for improvement. CBPAR has long been applied in nursing research as a tool to engage patients and other stakeholders as co-researchers. When combined with mixed methods, CBPAR can assist stakeholders in developing better appreciation for a data-driven decision-making process by capitalising on the advantages of integrating quantitative and qualitative methods. This paper describes a mixed methods methodological framework for CBPAR as a means for promoting patient-centredness and enhancing stakeholder engagement with research outcomes. It follows the action research methodological steps and captures the synergetic combination of the two approaches by integrating mixed methods into each step in the CBPAR process. This framework is one illustration of using mixed methods to facilitate patient-centred research. It can provide a framework for developing stakeholder engagement plans and facilitating the process of translation of generated evidence into nursing practice.