PT - JOURNAL ARTICLE AU - Catherine Hudon AU - Maud-Christine Chouinard AU - Mathieu Bisson AU - Alya Danish AU - Marlène Karam AU - Ariane Girard AU - Pierre-Luc Bossé AU - Mireille Lambert TI - Case Study With a Participatory Approach: Rethinking Pragmatics of Stakeholder Engagement for Implementation Research AID - 10.1370/afm.2717 DP - 2021 Nov 01 TA - The Annals of Family Medicine PG - 540--546 VI - 19 IP - 6 4099 - http://www.annfammed.org/content/19/6/540.short 4100 - http://www.annfammed.org/content/19/6/540.full SO - Ann Fam Med2021 Nov 01; 19 AB - The case study design is particularly useful for implementation analysis of complex health care innovations in primary care that can be influenced by the context of dynamic environments. Case studies may be combined with participatory approaches where academics conduct joint research with nonacademic stakeholders, to foster translation of findings results into practice. The aim of this article is to clarify epistemological and methodological considerations of case studies with a participatory approach. It also aims to propose best practice recommendations when using this case study approach. We distinguish between the participatory case study with full co-construction and co-governance, and the case study with a participatory approach whereby stakeholders are consulted in certain phases of the research. We then compare the epistemological posture of 3 prominent case study methodologists, Yin, Stake, and Merriam, to present the epistemological posture of case studies with a participatory approach. The relevance, applications, and procedures of a case study with a participatory approach methodology are illustrated through a concrete example of a primary care research program (PriCARE). We propose 12 steps for designing and conducting a case study with a participatory approach that may help guide researchers in the implementation analysis of complex health care innovations in primary care.