Inside an Occupational Therapy–Disability Community Partnership to Promote Health Management: Ethnography of a Research Collaboration
Tóm tắt
Importance: Disability studies–informed occupational therapy is predicated on full and equal partnerships among occupational therapy practitioners, researchers, and disability communities. Community-based participatory research (CBPR) is an approach to research that aligns with this vision yet is not without challenges. Understanding the tensions that arise from stakeholders’ perspectives and priorities is critical for promoting collaboration between occupational therapy professionals and disability community partners.
Objective: To understand the group dynamics and relational processes of a CPBR team in the context of an intervention development study focused on health management for people with disabilities (PWD).
Design: This 9-mo ethnographic study included semistructured interviews and participant observation. Data were analyzed thematically.
Setting: Community-based multiagency collaborative.
Participants: Nine participants (6 academic team members, 4 of whom were trained as occupational therapists; 2 disability partners; and 1 managed-care organization representative) took part. Three participants self-identified as PWD.
Findings: CBPR processes, although productive, were fraught with challenges. Team members navigated competing priorities, varying power dynamics, and multifaceted roles and identities. Flexibility was needed to address diverse priorities, respond to unexpected challenges, and facilitate the project’s success.
Conclusions and Relevance: Deep commitment to a shared goal of health care justice for PWD and team members’ willingness to address tensions promoted successful collaboration. Intentional relationship building is needed for occupational therapy researchers to collaborate with members of disability communities as equal partners.
What This Article Adds: Disability studies–informed occupational therapy research demands that team members intentionally nurture equitable relationships through shared governance, clear communication, and recognition of the fluid nature of power dynamics.
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Tài liệu tham khảo
Ahmed, 2016, Opening the black box: Conceptualizing community engagement from 109 community–academic partnership programs, Progress in Community Health Partnerships, 10, 51, 10.1353/cpr.2016.0019
American Occupational Therapy Association. (2016). AOTA unveils Vision 2025. https://www.aota.org/AboutAOTA/vision-2025.aspx
Belone, 2016, Community-based participatory research conceptual model: Community partner consultation and face validity, Qualitative Health Research, 26, 117, 10.1177/1049732314557084
Braun, 2006, Using thematic analysis in psychology, Qualitative Research in Psychology, 3, 77, 10.1191/1478088706qp063oa
Braun, 2013
Camden, 2015, Engaging stakeholders in rehabilitation research: A scoping review of strategies used in partnerships and evaluation of impacts, Disability and Rehabilitation, 37, 1390, 10.3109/09638288.2014.963705
Creswell, 2000, Determining validity in qualitative inquiry, Theory Into Practice, 39, 124, 10.1207/s15430421tip3903_2
Curry-Stevens, 2012, The end of the honeymoon: CBPR, positional privilege and working with community coalitions, American International Journal of Contemporary Research, 2, 92–101.
Danieli, 2005, Emancipatory research methodology and disability: A critique, International Journal of Social Research Methodology, 8, 281, 10.1080/1364557042000232853
Frank, 2008, Occupational therapy foundations for political engagement and social transformation, A political practice of occupational therapy, 111
Frerichs, 2017, Stakeholder perspectives on creating and maintaining trust in community–academic research partnerships, Health Education and Behavior, 44, 182, 10.1177/1090198116648291
Green, 2017, Challenging hierarchy in healthcare teams—Ways to flatten gradients to improve teamwork and patient care, British Journal of Oral and Maxillofacial Surgery, 55, 449, 10.1016/j.bjoms.2017.02.010
Gustafson, 2014, Ethics, “vulnerability,” and feminist participatory action research with a disability community, Qualitative Health Research, 24, 997, 10.1177/1049732314538122
Hart, 2011, The “elephant in the room”: Using emotion management to uncover hidden discourses in interprofessional collaboration and teamwork, Journal of Interprofessional Care, 25, 373, 10.3109/13561820.2011.578224
Heffron, 2019, “The bigger picture”: Occupational therapy practitioners’ perspectives on disability studies, American Journal of Occupational Therapy, 73, 7302205100, 10.5014/ajot.2019.030163
Heffron, 2018, Room for change? Experiences of occupational therapy practitioners with disabilities, American Journal of Occupational Therapy, 72, 7211505085, 10.5014/ajot.2018.72S1-PO1016
Israel, 2013, Methods for community-based participatory research for health, 2nd ed.
Israel, 1998, Review of community-based research: Assessing partnership approaches to improve public health, Annual Review of Public Health, 19, 173, 10.1146/annurev.publhealth.19.1.173
Kielhofner, 2005, Rethinking disability and what to do about it: Disability studies and its implications for occupational therapy, American Journal of Occupational Therapy, 59, 487, 10.5014/ajot.59.5.487
Kitchin, 2000, The researched opinions on research: Disabled people and disability research, Disability and Society, 15, 25, 10.1080/09687590025757
Krahn, 2015, Persons with disabilities as an unrecognized health disparity population, American Journal of Public Health, 105, S198, 10.2105/AJPH.2014.302182
Kwon, 2018, Applying a community-based participatory research framework to patient and family engagement in the development of patient-centered outcomes research and practice, Translational Behavioral Medicine, 8, 683, 10.1093/tbm/ibx026
Lassiter, 2005, The Chicago guide to collaborative ethnography, 10.7208/chicago/9780226467016.001.0001
Lewis, 2011, Being embedded: A way forward for ethnographic research, Ethnography, 12, 398, 10.1177/1466138110393786
Magasi, 2008, Disability studies in practice: A work in progress, Topics in Stroke Rehabilitation, 15, 611, 10.1310/tsr1506-611
Magasi, 2008, Infusing disability studies into the rehabilitation sciences, Topics in Stroke Rehabilitation, 15, 283, 10.1310/tsr1503-283
Magasi, 2012, Negotiating the social service systems: A vital yet frequently invisible occupation, OTJR: Occupation, Participation and Health, 32(1, Suppl.), S25, 10.3928/15394492-20110906-03
Magasi, 2019, Our Peers—Empowerment and Navigational Support (OP–ENS): Development of a peer health navigator intervention to support Medicaid beneficiaries with physical disabilities, Rehabilitation Process and Outcome, 8, 117957271984475, 10.1177/1179572719844759
Mayan, 2016, Worth the risk? Muddled relationships in community-based participatory research, Qualitative Health Research, 26, 69, 10.1177/1049732315618660
McDonald, 2016, You say you want a revolution: An empirical study of community-based participatory research with people with developmental disabilities, Disability and Health Journal, 9, 201, 10.1016/j.dhjo.2015.12.006
Minkler, 2005, Community-based research partnerships: Challenges and opportunities, Journal of Urban Health, 82, ii3, 10.1093/jurban/jti034
Mirza, 2016, Soul searching occupations: Critical reflections on occupational therapy’s commitment to social justice, disability rights, and participation, Occupying disability: Critical approaches to community, justice, and decolonizing disability, 159, 10.1007/978-94-017-9984-3_11
Newman, 2014, A community-based participatory research approach to the development of a Peer Navigator health promotion intervention for people with spinal cord injury, Disability and Health Journal, 7, 478, 10.1016/j.dhjo.2014.04.006
Okpala, 2020, Addressing power dynamics in interprofessional health care teams, International Journal of Healthcare Management, 10.1080/20479700.2020.1758894
Oliver, 1997, Emancipatory research: Realistic goal or impossible dream?, Doing disability research, 15
Paradiso de Sayu, 2016, Perceptions of empowerment within and across partnerships in community-based participatory research: A dyadic interview analysis, Qualitative Health Research, 26, 105, 10.1177/1049732315577606
Rhodes, 2018, Community-engaged research as an approach to expedite advances in HIV prevention, care, and treatment: A call to action, AIDS Education and Prevention, 30, 243, 10.1521/aeap.2018.30.3.243
Saldaña, 2015, The coding manual for qualitative researchers, Sage.
VanPuymbrouck, 2020, Explicit and implicit disability attitudes of healthcare providers, Rehabilitation Psychology, 65, 101, 10.1037/rep0000317
Wilson, 2018, Ethical challenges in community-based participatory research: A scoping review, Qualitative Health Research, 28, 189, 10.1177/1049732317690721