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Ameliorating epistemic injustice in practice: Communication strategies in a research project with refugee youth coresearchers
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social medicine/CHAP. (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.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social medicine/CHAP.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social medicine/CHAP.
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2023 (English)In: Health Expectations, ISSN 1369-6513, E-ISSN 1369-7625, Vol. 27, no 1, article id e13926Article in journal (Refereed) Published
Abstract [en]

IntroductionMany researchers want to include seldom involved groups, such as refugees and youth, in patient and public involvement (PPI), but experience a number of barriers. The PPI research community calls for critical evaluations that are prospective, data-based and conducted by researchers and public contributors together. In this study, we conducted a longitudinal evaluation of a core activity in all collaborations: communication strategies. The aim was to evaluate the communication strategies adopted throughout a research project with refugee youth coresearchers.MethodsThis article is based on the evaluation of a project where refugee youth were involved in the online adaptation of a group-based programme for youth with posttraumatic stress. Behavioural observations and field notes collected during the project were analysed with qualitative content analysis and a readability index, and discussed through the lens of epistemic injustice. The article was cowritten by researchers and refugee youth.FindingsFour manifest categories were identified: Facilitating engagement through coplanning and circumstantial flexibility; Different needs require different channels; It's not just about the channel—facilitation skills matter; Finding a common language opens a communicative flow. In addition, a latent underlying theme reflecting the role of trust was identified: Interactive moments facilitate trust—trust facilitates richer involvement.ConclusionAt the core of the identified communication strategies were strengthening relationship-building and actively facilitating involvement. Establishing trusting relationships enabled refugee youth to share input. The communication strategies increased hermeneutical justice by contributing to a common understanding; thus, taking a step towards ameliorating epistemic injustice.

Place, publisher, year, edition, pages
John Wiley & Sons, 2023. Vol. 27, no 1, article id e13926
National Category
Media and Communication Studies Other Health Sciences
Research subject
Health Care Research
Identifiers
URN: urn:nbn:se:uu:diva-518705DOI: 10.1111/hex.13926ISI: 001110512600001PubMedID: 38031659OAI: oai:DiVA.org:uu-518705DiVA, id: diva2:1822200
Available from: 2023-12-21 Created: 2023-12-21 Last updated: 2025-02-17Bibliographically 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)
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Supervisors
Available from: 2024-05-20 Created: 2024-04-19 Last updated: 2025-02-20

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Inge, ElinPérez-Aronsson, AnnaSarkadi, AnnaWarner, Georgina

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