PT  - JOURNAL ARTICLE
AU  - Nixon, Lara
AU  - Gray, Mandi
AU  - Kelly, Martina
AU  - Dhanota, Navi
AU  - Feasby, Claire
TI  - ‘It takes a lot of twisting’: doing research in structurally vulnerable spaces
AID  - 10.1370/afm.22.s1.6701
DP  - 2024 Nov 20
TA  - The Annals of Family Medicine
PG  - 6701
VI  - 22
IP  - Supplement 1
4099  - http://www.annfammed.org/content/22/Supplement_1/6701.short
4100  - http://www.annfammed.org/content/22/Supplement_1/6701.full
SO  - Ann Fam Med2024 Nov 20; 22
AB  - Context: Addressing structural vulnerability is an increasing focus for primary care researchers.This work can be demanding in terms of professional skills required and personal capacity and even risk secondary trauma. Few institutions offer specific supports or training for conducting research in this domain.Objective: To inform researcher training and education, this study explored the experiences of researchers conducting participatory research with people experiencing structural vulnerability.Study Design and Analysis: Exploratory qualitative study. Reflexive thematic analysis. The research team comprised experienced (2), midcareer (2) and junior researchers (2) working with structurally vulnerable populations across a range of communities.Setting: Community based researchers from a Canadian academic setting. Population Studied: 15 researchers working with people who have experience of structural vulnerability (homelessness, substance use, trauma) who self-identified: 4 male, 9 female; 5 black, indigenous or persons of colour; 8 senior researchers (PI or Associate professor or higher), 3 mid-experience researchers (early post-doctorate/completing PhD), and 4 junior researchers (working as research assistant/Master’s level).Results: From 4 sequential focus groups and 15 individual interviews, three themes emerged: personal motivation – a source of energy and distress; navigating institutional rules and power structures; supports and training. Participants engaged in research based on personal lived experience or following frontline work experience. This ‘insider’ perspective provided understanding and promoted rapport, to promote trusting relationships with community participants. Circumnavigating institutional policies; paying participants, respecting community customs and expectations at odds with institutional ethics requirements; and responding to timelines set by external bodies, tested researchers’ emotional and moral resources. Participants identified a lack of formal training and support. Help when accessed was ad hoc, often consisting of collegial support.Conclusions: To develop and sustain research with people experiencing structural vulnerability, greater institutional reflexivity and flexibility is required. Formal training for researchers in this field could help to prevent burnout and disillusionment.