Cameron, J., Kothari, A. & Fiolet, R. (2025) Addressing power imbalance in research: exploring power in integrated knowledge translation health research. Research Involvement and Engagement 11, 35. https://doi.org/10.1186/s40900-025-00706-2.
Abstract
Introduction: Integrated knowledge translation (IKT) is a knowledge translation framework that focuses collaboration between researchers and knowledge users (KUs) to generate research findings. KUs can be policymakers, clinicians, or those with lived experience who partner with researchers. While advocated as an approach that democratizes research and reduces power imbalance between researchers and KUs, it is not known if the implementation of IKT by health researchers actively addresses power imbalances. The aim of this study was to review research using an integrated knowledge translation approach to explore how power is addressed within these research studies. By looking broadly at how the studies addressed / described / discussed / dismantled power we explored examples of when this was done well and not so well, exposing the assumptions sometimes made by researchers.
Methods: We drew from systematic review procedures combined with a modified critical discourse analysis (CDA) lens. We searched Medline, PsycINFO, CINAHL, Scopus, Social Science Database, SocIndex and Google Scholar for English language studies that focused on IKT and power. Data were extracted on study characteristics and a modified CDA which included questions in relation to power (e.g., description of power, phrases used to describe power, evidence of power dynamics, strategies for addressing power imbalances) and end user engagement (e.g., Did they ask KUs how they wanted to be involved? Did they engage in reflection with KUs? Did they discuss dissemination strategies with KUs).
Results: Eleven studies were eligible after screening 381 titles and reviewing 40 full-text studies. The use of IKT to address power varied significantly, revealing both positive examples as well as some missed opportunities to address power imbalances from study inception to dissemination.
Conclusion: Revisiting the use of IKT to examine how power is defined, shared, and managed in relationships with KUs could provide valuable insights. Using a CDA framework to explore these dynamics would indeed address the nuances of power in research contexts. Future research should focus on developing strategies to effectively implement IKT to address power imbalances, leading to research that has a better chance of being useful, usable and used in practice.
This article is about power. Power between partners in integrated knowledge translation (iKT) which is where academics and non-academics (policy makers, community groups, people with lived expertise such as patients) collaborate on research. Who holds the power? How might we balance power? What happens if we do? What happens if we don’t?
First off, they offer a Plain English Summary. That’s great. It helps make the article accessible to a non-specialist audience. But how non-specialist? I put their Plain English Summary into Co-Pilot and it turned out to be between a grade 10-12 level English. That’s good. I then asked Co-Pilot to write it in grade 8 English. Try it for yourselves.
This was a lit review. Of 381 study titles and 40 full text reading they found only 11 articles that fit the inclusion criteria. One conclusion is there isn’t much out there on this important topic. Conclusion #1: more empirical studies are needed but we will make the most of these 11 articles.
Way back in 2007 Sandra Nutley mentioned power in her seminal book, Using Evidence. Why is power important? The article states, Power can be wielded for benevolent purposes or for dominance. When one population dominates another, especially if the dominant group holds a higher social status or is seen as the knowledge authority, significant societal issues can arise. Some examples of academics (maybe unknowingly) holding power include being the grant recipient and not sharing funding, benefitting from formal research training and not building community capacity, having time for research built into work schedules, holding meetings on campus not in community, publishing in peer reviewed literature behind a paywall. There are lots of ways academics wield power. Not in a megalomaniac way, possibly unconscious, but power nonetheless.
iKT without sharing power risks research that is not or never will be ready for use, data/samples/outputs extracted from knowledge users, recapitulation of trauma on knowledge users, reputational damage. One example in the article cites patient engagement in healthcare research, while often framed as empowering, can be constrained by institutional norms that prioritize biomedical expertise over experiential knowledge.
Kudos to the authors who write about their own positionalities. I am seeing this occasionally in peer reviewed literature where authors cite their institutional affiliations but not what else they bring to the table. One observation: they mention how they practice iKT and bring their own lived expertise to their research but all four are housed at academic institutions. Just sayin’…
One approach cited engagement of advisory bodies, Engagement with KUs regarding the dissemination strategies was variable; again, some studies use their advisory group or committees to assist with this task. Advisory bodies. At best they can give advice. There is no power in advice. Give them power to make decisions not just provide advice.
One approach to sharing power in iKT was cited as an institutional need. Until researchers are supported by a system that provided opportunity, time, resources and capacity to address power (through IKT and other mechanisms) from the beginning of the research process, there will still
be gaps in capacity to do this effectively. Researchers work in a system that is used to holding onto power. See an 11 year old post about trying to change a 600 year old academic model.
Finally, the authors suggest six approaches to address power imbalances between academic and non-academic research partners. None of them are building capacity for non-academics to become authentic, equal partners in research even though capacity building was mentioned in the article.
Questions for brokers:
- Being the grant recipient and not sharing funding, benefitting from formal research training and not building community capacity, having time for research built into work schedules, holding meetings on campus not in community, publishing in peer reviewed literature behind a paywall. What other ways might academics hold onto power?
- What might a non-academic voice have brought to this paper if invited to collaborate and power was shared in decisions about the questions asked, methods used and forms of forms of dissemination?
- What is your institution doing to support researchers’ iKT? If you are working at a Research Impact Canada (RIC) member institution how is RIC helping?
Research Impact Canada is producing this journal club series to make evidence on KMb more accessible to knowledge brokers and to create online discussion about research on knowledge mobilization. It is designed for knowledge brokers and other people interested in knowledge mobilization. Read this open access article. Then come back to this post and join the journal club by posting your comments on our LinkedIn.