Lessons learned: MPCER “Community-Engaged Research Design: Feedback Session”

This MPCER feedback session addressed specific questions from our community on designing Community-Engaged Research (CER). A number of researchers presented  case studies and questions to a panel of experts consisting of three professors: Klasien Horstman, Onno van Schayck and Rob Ruiter and to the audience of participants. The panel members were chosen for their experience and expertise in community-engaged research projects.

• Case 1: community-engagement in intervention studies, presented by Esther Boudewijns, FHML

Today, 2.8 billion people globally still cook with unsafe and polluting fuels. This practice has severe impacts on health, gender equality, economic and environmental outcomes and costs the world 2.4 trillion dollars each year. Interventions to promote access to cleaner solid fuel cook stoves and clean fuels have existed for decades; the first models came on the market in the 1950s. However, real-world outcomes of interventions that promoted the switch to cleaner cook stoves or clean fuels have often not been fruitful. Many of the programmes ran into hurdles and failed. Adoption rates are often not reported in the literature, and if they are, rates vary between 4-10%. One of the reasons for the low adoption rates has been a low understanding of the culture and how to design stoves in accordance with end-users’ wishes. It appeared that users were modifying the stove, compromising the efficiency of the stove, or that they even disavowed the stove.

“We, as researchers, sometimes want to easily solve the problem, while this approach does not always fit the wishes of the actual users, even if we involve our research community. What are we doing wrong?”

Question 1: The easy answer to this problem would be to involve your research community in your study. But apparently this is not as easy as it sound (cookstove dissemination has already been an issue since the 1950s, so for more than 70 years!). What are we doing wrong? And what could we learn from this example?

Feedback highlights:

- Do the researchers really understand the needs and health risk behaviour of the end-users? I would advise to use interviews, observations etc. of current and wanted behaviour. You might also want to think about the environmental context of cook stove use. Adoption of the correct stove is made difficult because of the environmental factors (access to fuel, pricing, weather conditions, social relations and cultural aspects). Try to ask yourself the question: “Why does the intervention not motivate people to accept the ‘new’ stove?” Maybe the focus of the research has too much been on the solution instead of on really understanding the needs of the community. Change needs understanding.

If you do community-engaged research you cannot do an intervention. Instead you have to engage in a dialogue with your target community, much like in a relationship.

- A different approach could be to focus the research more on understanding why the end-users are using the stoves the way they are. The book An ethic of health promotion. Rethinking the sources of human well-being might provide useful insights. Also, an intervention usually isn’t the best option when you want to do community-engaged research (CER). Implementing a new behaviour is something that takes time. CER should care about other outcomes than evidence-based implementation.

“A relationship with your research participants is like your relationship with your partner. It’s about dialogue and conversations, not about interventions.”

- Maybe focus on dialogue and conversations. It’s about understanding your partner. Most solutions in this specific research were developed together with the community, but the researchers might need to address and have more insights for other needs like food.

- Try to find a local partner who is aware of the health risk behaviour and who wants to work with you to improve these cooking conditions.

- Try bottom-up implementation

- Collaborate with environmental groups that are present in the region, even if these groups sometimes only have a small budget.

- Involve the community to make this an important issue. Try to add another product/service to your offer (make it a package deal) so the main solution will also be accepted. For example, add something they need more like food in this case. Another example mentioned was a project where people are getting medicines during a praying session. By adding the faith, the medicines are accepted better.

- Try to train people in the slums in teaching others how to use the stove and give them some financial compensation for this job. Also cook together with the community so they can enjoy a decent meal while learning how to use the stove.

- Always be honest about what you are doing. Don’t try to trick people, but go for a win-win situation where the autonomy of the end-users is respected. This is very important.

• Case 2: Community-engagement in conflict studies, presented by Marieke Hopman (FL)

In a future study on children’s development rights in Palestine, we want to recruit and train local researchers to collect data on the children’s rights situation in Palestine. During phase 1 of the study, we aim to ask children about what we should focus on if we’re studying children’s rights in their area. We want to find out what is the most important issue in their opinion. Their answers will determine the further focus of the case study. However, I’m worried about the influence that the local focus on the Israeli-Palestinian conflict may have on our study. I would like to develop a collaboration with local researchers that ensures that external personal opinions do not influence the children’s voices and that the children feel free to discuss anything.

Question 2: (How) can you motivate local researchers to collect “objective” data in a conflict situation?

Feedback highlights:

- It is difficult to delete the context of people’s problems. Do you need to see this issue as a separate concern or can you accept the situation as it is?

- Discuss your concerns with the local researchers. Also, consider not to talk to children, but ask them to draft a picture. This fits the imagination of the children better than verbal conversations.

- Bias-prevention is important: from the researchers, responders, children and others. Maybe try ‘source triangulation’. Not only talk to children, but also to parents, teachers, nurses, and social workers. Try to have an ‘objective’ research output.

“Is it really necessary to separate the (conflict) context from your data collection?”

The two case presentations were followed by additional questions from the MPCER community:

• Question 3: When you are observinga community, can you become a member of the community and participate in their activities or do you need to stick to the observer’s role? I found that being a member of the community could yield rich data. (Yan Lia)

“The idea of community-engaged research is to do the research together, in an open way. When researching a group of people, in most cases you become part of their community”

Reactions:

- The idea of community-engagement is to work together, in an open way. When researching a group of people, in most cases you become part of their community. You need to be open about your position to other members: tell them that you are participating as a researcher. Be careful how to proceed in these communities, because your participation might influence your results.

• Question 4: How do you deal with language barriers between you and the community with whom you would like to engage? (Vanessa Tünsmeyer).

Reactions:

- It is more important in my opinion to be knowledgeable about the community and to be a partner, instead of speaking the community’s language.

- Make sure that you present the results of your research in the local language. If you organise a translation service and have local people involved, the language issue can be overcome.

For more information about MPCER, please see the website.

Our next event will take place on 3 December 2020. More information can be found here