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Standard Involvement Is Not Enough: A Mixed Method Study of Enablers and Barriers in Research Meetings with Forced Migrants
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social medicine/CHAP.ORCID iD: 0000-0002-5467-5850
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social medicine/CHAP.ORCID iD: 0000-0001-6594-2291
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social medicine/CHAP.ORCID iD: 0000-0003-2885-0931
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social medicine/CHAP.ORCID iD: 0000-0002-7850-9136
2024 (English)In: The Journal of Refugee Studies, ISSN 0951-6328, E-ISSN 1471-6925, Vol. 37, no 1, p. 157-180Article in journal (Refereed) Published
Abstract [en]

Although participatory approaches in health research are increasingly used, critical voices are being raised around lack of diversity among the public contributors involved. This article explores enabling and hindering factors in participatory meetings with forced migrants involved as public contributors in health research, using a convergent parallel mixed methods design including behavioural observations and questionnaires, with the aim of contributing to practices of meaningful and inclusive involvement in research. Our findings indicated that relationship-building and adapting to team development over time were key. Additionally, researcher responsivity and transparency enabled relevant contributions, but few decisions were taken. Although linguistic barriers existed and were rated higher by the researchers, engaging interpreters as co-facilitators of the meetings enabled nuanced discussions. In addition to following PPI recommendations, involving public contributors with experience of forced migration requires considering relationship-focused factors; inclusive communication, relationships and trust, and process-focused factors: where and how decisions are taken.

Place, publisher, year, edition, pages
Oxford University Press, 2024. Vol. 37, no 1, p. 157-180
Keywords [en]
patient and public involvement, forced migrants, health research, mixed methods, observations
National Category
Public Health, Global Health and Social Medicine
Identifiers
URN: urn:nbn:se:uu:diva-511736DOI: 10.1093/jrs/fead062ISI: 001059166300001Scopus ID: 2-s2.0-85189481334OAI: oai:DiVA.org:uu-511736DiVA, id: diva2:1797452
Funder
Kavli Trust, A-321629Available from: 2023-09-14 Created: 2023-09-14 Last updated: 2026-04-20Bibliographically approved
In thesis
1. Patient and public involvement with forced migrants: Exploring communication, ethics and public contributor experiences
Open this publication in new window or tab >>Patient and public involvement with forced migrants: Exploring communication, ethics and public contributor experiences
2024 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The topic of this thesis is patient and public involvement (PPI) in health research. Here, PPI is defined as the active involvement in key research decisions of people whose lives are at the centre of the research. Currently, there is an increased interest in and development of participatory methods. In Sweden, PPI has acquired growing attention in health research. However, the use of PPI in Sweden, as well as the structures supporting researchers and public contributors, are not yet established. The PPI field has been criticised for lacking diversity and fair representation of the researched groups. One group rarely involved as public contributors in PPI is forced migrants. Doing research with rather than about forced migrants, has the potential to alleviate asymmetries of power and knowledge, and reduce health inequities – if conducted in a meaningful way. 

The overall aim was to explore patient and public involvement with forced migrants in health research. Four studies were conducted. The study designs built on and complemented each other in terms of data, analysis methods and level of detail. Study I used a longitudinal qualitative approach to track the experiences of refugee parents during their involvement in a three-year child mental health trial. In Study II, enablers and barriers to PPI meetings with forced migrant public contributors were identified using a mixed methods approach. Study III evaluated the communication strategies in a research project with refugee youth coresearchers, with a focus on epistemic injustice. In Study IV, ethical issues in PPI with forced migrants were empirically investigated and analysed using relational ethics.

The findings show similar patterns from different perspectives. PPI with forced migrants required considerations around inclusive communication, relationship-building and trust, as well as considerations around where and how decisions were made. For these processes to develop, time and a focus on relationships is required. Using relational ethics and a reflexive approach can help researchers navigate ethical PPI with forced migrants. In the Swedish setting, PPI needs to be acknowledged on an institutional level, to create conditions to work with PPI in meaningful and ethical ways.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2024. p. 103
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 2052
Keywords
Patient and public involvement, forced migration, ethics, communication, epistemic injustice, empirical ethics, relational ethics, mixed methods, longitudinal research
National Category
Public Health, Global Health and Social Medicine Medical Ethics
Research subject
Health Care Research; Bioethics
Identifiers
urn:nbn:se:uu:diva-526848 (URN)978-91-513-2134-9 (ISBN)
Public defence
2024-06-11, The Humanities Theatre, Engelska parken, Thunbergsvägen 3C, Uppsala, 09:15 (English)
Opponent
Supervisors
Available from: 2024-05-20 Created: 2024-04-19 Last updated: 2025-02-20

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Inge, ElinSarkadi, AnnaTökés, AntóniaWarner, Georgina

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