Community Needs Assessment and Development Using the Participatory Research Model

Participatory research is a collaborative model that promotes the development of critical partnerships and the application of research conclusions into the process of community development. It is a means by which the expertise of primary care researchers can produce new knowledge through developing research partnerships with the community. The knowledge, expertise, and resources of the involved community are frequently key to effective research and problem solving.

The participatory research model began as a movement for social justice in international development activities and has evolved into a tool for improving social and economic conditions, effecting change, and increasing trust for scientists and community development efforts among the members of the communities studied. Today, participatory research represents a methodology for partnering with communities to develop interventions that are acceptable to community members, for evaluating and demonstrating the effectiveness of the intervention with community members, and for sustaining the intervention beyond external funding.

There are three critical attributes of the participatory research model: collaboration throughout the research process, a mutually rewarding educational experience for researchers and community members, and tangible action based on research results. Collaborations promote sharing of decision making throughout the research process, from refining the question and undertaking the research to interpreting the data and jointly disseminating the results. A critical process goal is for the community to build its own capacity by developing skills, applying research results to improve the quality of life, and planning for future health needs. In addition, the participatory research model more effectively answers the questions that emerge from within communities, thereby increasing community capacity building and sustainability.

There is a growing recognition among researchers of the distinction and the importance of participatory research compared with the more historical model for community needs evaluation and development, often referred to as top-down research or derogatorily as “helicopter” or “safari” research. The participatory research model has gained prominence during the last decade through the community research accomplished in collaboration with indigenous peoples of North America and by an endorsement of NAPCRG in a 1998 policy statement, reproduced on the organization’s Web page, www.napcrg.org/exec.html.^1,2

The rationale and methodologies applied by researchers using the participatory research model bear a striking similarity to those of primary care researchers using practice-based research networks. In both cases, a genuine partnership must develop between researchers and the community to overcome historical animosities, define relevant questions, acquire data to answer questions, and ensure that research results are translated into reality, whether applicable to patient care or community development.

As with all primary care research, community-based research that uses the participatory concept requires a greater understanding among potential sponsors of the three critical attributes that define the model. Because of the need for negotiation and two-way education, participatory research calls for a longer start-up or developmental phase. Further, the purpose of this phase precludes researchers from clearly defining an a priori methodology. Research partnerships, like any partnership, require time to build trust and mutually rewarding relationships. Partnership building and the time required to negotiate process and outcomes, though lengthy, are clearly beneficial to the research process, producing research conclusions that are more relevant and more likely to be implemented.

Given the probability that researcher-community partnerships might not be able to adhere to the typical prerequisites of sponsors’ requests for funding applications, several institutes and centers within the National Institutes for Health and the Canadian Institutes of Health Research offer 6- to 12-month developmental grants to support the requirements of initial partnership building. Such vehicles offer an excellent opportunity to support the negotiation and development phase of participatory research.

As with any new methodology for expanding our body of knowledge, participatory research potentially raises new, ethical challenges, such as the extent to which the protection of the community might need to be considered in addition to the protection of the individual.³ Nevertheless, participatory research represents one more valuable methodology in the expanding toolbox of primary care research methodologies.

Ann C. Macaulay, MD, FCFP

McGill University

John G. Ryan, DrPH

University of Miami

• © 2003 Annals of Family Medicine, Inc.