This paper outlines the characteristics of PAR, participatory action research, so that interested investigators can determine if their project fits the criteria. The author introduces some key concepts in critical theory that drive the political analysis dimension of PAR and lay to rest concerns about validity and legitimacy. Types of PAR are reviewed according to the brand of knowledge focused on in the research, and some examples are given. An emerging critique of PAR is offered and some abuses of PAR are described. The major ethical principles of social justice that guide PAR are outlined. References to epistemology and specific methodological demonstration projects are included. Suggestions for future use in chronic disease research are offered.

Key words: Critical theory; empowerment; ethics; oppressed groups; participatory action research; research design; research outcomes; research utilization; social environment

Participatory action research (PAR) is the gloss for a number of research traditions that emerged in the latter half of the 20th century. Researchers such as Paulo Freire¹ broke with conventional approaches to gathering data "on" oppressed people. Phrases such as "hit and run" and "fly in fly out" research indicate that communities are astute as to how research is used to manage them. In many quarters, distrust is still expressed. "Research for the empire strikes back" is a droll observation about one extreme of abuse, while "dead reports on dusty shelves" refers to the needs assessment or prevalence study that is done to be seen to be doing something, when in fact the political agenda is not to respond to the need. By contrast, "participatory research is a means of putting research capabilities in the hands of the deprived and disenfranchised people so that they can transform their lives for themselves."²

Characteristics of PAR

Hall³ outlines seven characteristics of participatory research that bear repeating here so researchers can evaluate their proposals or projects using these criteria.

• The "problem" originates within the community or workplace itself.
  
• The research goal is to fundamentally improve the lives of those involved, through structural transformation.
  
• The people in the community or workplace are involved in controlling the entire research process.
  
• The focus of PAR is on oppressed groups whose issues include inaccessibility, colonization, marginalization, exploitation, racism, sexism, cultural disaffection, etc.
  
• Participatory research plays a role in enabling by strengthening people's awareness of their own capabilities.
  
• The people themselves are researchers, as are those involved who have specialized research training.
  
• The researchers with specialized training may be outsiders to the community, but are committed learners in a process that leads to militancy (fighting for change) rather than detachment.⁴

Critical Theory and Political Analysis

PAR requires doing a political analysis and having a shared understanding of the authority and power relations of all parties involved, be they individuals or bureaucratic offices. In the traditions of PAR this analysis has been critical, informed by one of several critical theory traditions. These theories grew out of movements that analyzed political events and attacks on democratic process, such as those in Germany and Italy before the Second World War. See the work of Stevens and Hall 5 for references to the major critical theories in the context of introducing some key concepts.

An important concept that is more easily described than applied is that of demystification. Newcomers to the field balk at this concept because it sounds like Marx's famous notion of getting rid of false consciousness. In today's milieu, this might smack of "political correctness." The intent is for an honest assessment of where the power lies and where there is systematic disadvantage, failure to advocate or merit not being recognized or acknowledged. Demystification is uncovering the "truth" that is predicted to be hidden or denied by those in power resisting change, wishing to keep control. This process is a beginning point for Freire's method of "conscientization."⁶ However, Freire's approach includes belief in the freedom to change relations and in learning to do it by doing it.⁷

A related concept is that of hegemony, formulated by Antonio Gramsci,⁸ who saw that fascism rose to dominance in prewar Italy by enlisting the co-operation of the people in their own domination, in conformity to fascism and in managing their own complicity. The concept of hegemony is central to PAR because it is only through awareness of how they contribute to their own oppression that the (community) researchers themselves can begin an empowerment process. The Gramscian tradition considers every person to have the capacity to be an intellectual, able to peel off the layers of mystification in "common sense" or what feels normal, embarking instead on what makes "good sense" informed by knowledge gained in the participatory research process.⁹

The concept of reflexivity¹⁰ invites clarifying power relations by locating oneself within the authority and power relations. Foucault¹¹ has confirmed for PAR advocates that knowledge is power, and discourse is the means of negotiating knowledge/power.¹² One type of discourse, research, is acknowledged as one means of regulating society and is therefore political. PAR challenges the ideal of seeing researchers as neutral and unbiased, without vested interests, etc., because it purposely champions the community engaging in its own research. PAR studies are accorded success because they achieve goals and outcomes. Research utilization is both process and product in participatory action research.

Types of PAR According to Knowledge Focus

Brydon-Miller⁴ lists three types of focus in the projects that have been successfully transformative using PAR.

• Technical knowledge and empirical analytic techniques as required, for example, in clean water systems, reforestation, sewer systems, reallocation of food sources and mapping of traditional hunting, trapping and land use

• Dialogue and human interaction techniques to generate knowledge, understanding and new relationships and roles (See Tandon's work with villagers in India;¹³ see also the research of Stevens and Hall 5 for efforts to shift from routine harassment by police and a high rate of sexual assault in a community, to a reduction of sexual assaults in that community related to better relations with police.)

• Social action, which can use empirical and interpretive techniques directed at generating joint program development (Examples here include women's health programs, birth control programs, street patrol assistance for homeless people and community kitchens for co-operative, low-cost nutrition. For the women's health example, see Chand and Soni's work.¹⁴ )

A fifth type of PAR can be seen in the Appalachian Land Ownership Study, undertaken as citizens' research in three states in the US. Coalitions were organized to teach the citizens about tax law and investigative methods; because multitudes of citizens volunteered their time, absentee landlords were brought to accountability.¹⁷

Critical theories inform the analysis of how institutions are regulated by various forms of discourse and of how discourse can be counter-managed by those subject to hegemony. Critical theory situates PAR in the camp of qualitative research with a rigorous theory base. Yet PAR is also able to incorporate quantitative methods that may be useful. See the research by Oquist¹⁸ and Fals Borda¹⁹ for elaborations on epistemology and methods for conducting PAR, i.e. transforming reality.

Abuse of PAR

The most common abuse of PAR is using its good reputation, gained from its ethical relations and practices, while conducting research within the conventional sets of relations. The obvious motivation is to retain control of research and to be accountable to one's bureaucracy, which calls for efficiency in research. PAR, being in community control, may not appear to be efficient and may ignore institutional deadlines. Researchers may be uninformed about the community's history and oblivious to signs of oppression, and they may be incompetent at doing the political analysis necessary to remain accountable to the community, which may be composed of several conflicting traditions.

Since there is a growing stable of PAR facilitators in the growing private research market, principal investigators can hire a facilitator who may come through with adequate results in the conventional research spectrum. In such cases, the principal investigator can passively be an agent for powers interested in managing the community. A close reading of their reports sometimes reveals infantalization of community leaders or belittling of the community's problem-solving abilities and political institutions. Principal investigators may exploit capable young people who can speak the local language, using them as research assistants. These possible abuses of PAR indicate no concept of who should own the research process and no critique of how or whether any of the information will further take advantage of the community. No mention is made of how the researchers have befriended the community in order to gain the privilege of truncating and controlling the research process.

Principal investigators, facilitators and community research assistants may believe they are grooming community members to be researchers so that, in the long run, the community will have its own research base. However, numerous excuses abound for putting off recognition of the community's own research base. These excuses might include that the community is fractionalized, it does not have the expertise required or the research process is muddied by conflictual politics. These realities have been transformed in PAR, which refuses to accept any excuse to ignore the community's rights to self-determination. Within PAR, one is asked to resist being a pawn for the bureaucracy or company that merely infiltrates the community to get the community to comply with its interests. Beware of research that uses the facilitator and the community members as puppets.

Ethical Principles

Social justice principles of equity, restitution and procedural justice²⁰ are important concepts in PAR. Equity embodies ideas that are qualitatively different from those of multiculturalism. The latter promotes equality but does not recognize that there is systemic disadvantage that requires counteraction and compensation. Restitution acknowledges institutional responsibility in creating conditions that must now be rectified. The concept of procedural justice values how relationships are lived, how interactions exclude or refrain from including, how particular elite individuals holding office practise dominance and perpetuate systemic disadvantage, how racism hurts and humiliates and is denied, how its perpetrators are unwilling to examine their own practices and how resistance to change is manifested, for example, when institutions have righteous sounding policies that they do not put into daily practice.

A fourth ethical principle of PAR is autonomy. The facilitator respects the autonomy of the people, avoiding speaking on their behalf, and he or she reports to the community when asked to play a mediator or interpreter role, always accountable to the people. In PAR, autonomy is complex because conflicts may arise between individuals and groups, and between groups.

Credibility of PAR

A social "fact" gaining credence through PAR is that one's position in structures of subordination shapes one's ability to see the whole.²¹ PAR is a way of galvanizing this holistic perspective among the participants. By honouring the extent to which the research process is actually a political process and by always working out the terms of relations as the process goes along, PAR is gaining credibility in the research community as a research process as opposed to just an everyday political process. PAR relies on honesty and veracity both in declaring agendas (reflexivity) and in carrying out the research and implementing its goals. On this foundation, both validity and legitimacy are grounded.

Since the usual rituals for determining validity are often not in the repertoire of PAR, the research community has looked askance at how old issues such as representativeness, generalizability and reliability are handled. The communities wanting to use PAR ask such questions as "Whose problem is it?" and "How much of the total budget for research and development actually accomplishes the developmental goal or implements recommendations?" To get a sense of whose interests are accomplished, read Norman's²² work on the global budget of research and development.

Receiving funding for PAR requires the same procedures as in traditional research for arguing the importance of the problem and the fit of the method with the nature of the problem and for reviewing the responsibility of the funding body to the population and to the problem as well as to competing populations or groups.

Emerging Critiques of PAR

Communities in a process of empowerment, notably First Nations, are questioning the need for outside facilitators of research, saying PAR does not go far enough in bringing their communities into the research and development arena. They are developing their own theory base and research programs.²³ This challenges the romantic idea of "partnering with communities" to do research and advocacy. It asserts the power of the community to find its own research consultants and hold them accountable. Counter-management is a different idea than partnering. When group autonomy is respected, counter-management is transformed into management under self-determination.

The Future Use of PAR

Participatory action research, accepting the politics of research, requires a good emotional intelligence quotient (or EQ),²⁴ a high tolerance of conflict and excellent group process skills. By definition, PAR is a research method that employs group process to generate and utilize research. PAR offers families and communities an approach to enlightened decision making that values the knowledge of practitioners and of persons with disabilities or those experiencing the effects of chronic disease.

Pedersen and Fernandes²⁵ describe decisional remodelling of those with decision-making powers. Such innovations can be used in future adaptations of PAR offering methods for balancing self-interest with collective interests and dominant interests with subordinate interests. It can offer those with chronic illnesses a way of empowering themselves, deliberating as researchers and creating new communities for living with chronic disease. PAR could help to uncover the truth about environmental causes of chronic diseases and where responsibilities for restitution lie. Let us value and explore this frontier for fruitful research.

Rebecca S Hagey, Associate Professor, University of Toronto, Faculty of Nursing, 50 St George Street, Toronto, Ontario M5S 3H4

Rebecca Hagey is a founding member of Anishnawbe Health Toronto, Canada's first urban aboriginal community health centre. She received the Praxis Award from the Washington Association of Professional Anthropologists for participatory action research on diabetes in the native community, which led to the establishment of the centre. The award recognizes the synthesis of research, theory and practice toward real world problem solving.

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