Social Impact of Participatory Health Research: Collaborative Non-Linear Processes of Knowledge Mobilization

Abma, T.A., Cook, T., Rämgård, M., Kleba, E., Harris, J. & Wallerstein, N. (2017) Social impact of participatory health research: Collaborative non-linear processes of knowledge mobilization. Educational Action Research, 25(4), 489-505.
Social impact, defined as an effect on society, culture, quality of life, community services, or public policy beyond academia, is widely considered as a relevant requirement for scientific research, especially in the field of health care. Traditionally, in health research, the process of knowledge transfer is rather linear and one-sided and has not recognized and integrated the expertise of practitioners and those who use services. This can lead to discrimination or disqualification of knowledge and epistemic injustice. Epistemic injustice is a situation wherein certain kinds of knowers and knowledge are not taken seriously into account to define a situation. The purpose of our article is to explore how health researchers can achieve social impact for a wide audience, involving them in a non-linear process of joint learning on urgent problems recognized by the various stakeholders in public health. In participatory health research impact is not preordained by one group of stakeholders, but the result of a process of reflection and dialog with multiple stakeholders on what counts as valuable outcomes. This knowledge mobilization and winding pathway embarked upon during such research have the potential for impact along the way as opposed to the expectation that impact will occur merely at the end of a research project. We will discuss and illustrate the merits of taking a negotiated, discursive and flexible pathway in the area of community-based health promotion.
Use this if you ever needed a reference about the importance of engaged scholarship (and the *very* many acronyms presented in this paper) over knowledge translation. This article complements a previous journal club entry from Bowen and Graham. The basic tenant (which isn’t news to any of us) is that iterative models of engaged scholarship are more powerful than linear models of knowledge translation to move beyond health research to outcomes (new health practices and policies) that will have a social impact. The authors prefer the iterative concept of knowledge mobilization than the linear concept of knowledge translation (personal commentary: SSHRC is grinning, CIHR not so much).
Traditional health (and other) research creates epistemic injustice. That’s an interesting new term. “Epistemic injustice arises when a person is not seen as credible as compared to providers, and this power differential is exacerbated when a patient doesn’t understand the language or comes from marginalized circumstances. This power inequity arises equally in health research when outsiders decide the research agenda and direct the process.”
Traditional scholarly production works in a reductionist manner, analyzing and describing complex phenomena by focusing on simple or fundamental constituents divorced from the complexity of contexts. Traditional research stands apart from and observes context. Engaged scholarship is embedded and engaged with the practices it is studying. It aims for joint understanding (not just the understanding of the researcher) and seeks to develop plans for action (i.e. observing and concluding without identifying action is not sufficient). And I would add that the most common of academic action items, “more research is needed”, is not a satisfactory action plan for non-academic participants.
If traditional research paradigms foster epistemic injustice then it follows that engaged scholarship fosters epistemic justice and can lead not just to “communicating research findings and delivering a ‘product’ or ‘service’ for society, it involves fostering social change within the wider complex social system in which the research is taking place”. Knowledge translation is predicated on disseminating knowledge. Knowledge mobilization and engaged scholarship seeks to support broader social impact.
There is an amusing moment in Figure 1 which is a conceptual model (yes, yet another conceptual model) of participatory research. It creates a framework which starts with 1) consideration of the context of research that moves to 2) partnership processes which proceed the 3) research and intervention function which creates 4) intermediate outcomes and long term impacts all connected by unidirectional arrows. The authors have created a linear conceptual framework after taking 10 pages to illustrate how linear models of knowledge translation are insufficient.
However, as I point out in our own paper on the co-produced pathway to impact, linear models are okay but only when they are describing a system of research. No individual engaged research project is linear but a system of engaged research projects seeks to progress from stakeholder engagement to impact, otherwise what’s the point of doing research?
Questions for brokers:
1. Traditional scholarship is reductionist. Engaged scholarship is embedded in multi-sectoral context and multidisciplinary complexity. Do we (and if so, how do we) maintain both traditional and engaged scholarship as complementary approaches?
2. Epistemic injustice. How is your practice working to counter epistemic injustice?
3. Linear models of impact are okay. Discuss.
Research Impact Canada is producing this journal club series as a way to make evidence on KMb more accessible to knowledge brokers and to create on line discussion about research on knowledge mobilization. It is designed for knowledge brokers and other knowledge mobilization stakeholders. Read this open access article. Then come back to this post and join the journal club by posting your comments.