Action Research in Health

9780130985781

0130985783

Introduction Action research is a rigorous and systematic approach to investigation that integrates the expertise of professionals and the local wisdom of the people they serve. This book provides step-by-step procedures for enacting research processes that, to some extent, run across the grain of the carefully prescribed, objective routines of experimental research that historically have been the hallmark of medical research. The purpose of this book is to show how health professionals can make more effective use of their expertise by ensuring that it "makes sense" to their clients, while providing the basis for health care that is easily integrated into the home, work, and/or community life of the individuals concerned. This book represents the outcome of twenty years of experience working with each other and like-minded associates. Our task has been to find ways to ensure that the collective wisdom and insight of local people informs the programs and services meant to enhance their health and well-being. Over the years, both of us have witnessed caring and committed professionals who, in managing the multiple demands on their time, often paid little heed to client perspectives. One example of the often futile interventions of the all-knowing health professional is provided by the story of one of our colleagues. A wonderfully passionate doctor, he went to Yemen as a very young man, and became absorbed in the task of working to enhance the health status of the local people. With an eye to the preventive side of public health, in particular, nutrition and income support, Peter imported a herd of goats for the benefit of the locals. Years later, he now recounts the story of how the whole herd was lost to altitude sickness. Such tales emphasize the way unaccounted subtleties of local circumstances, culture, or geography may undermine the good intentions of those working in the health arena. The effects of globalization and the multicultural nature of many urban and suburban contexts challenge health professionals to find ways of ensuring that their carefully prescribed programs of care can be implemented effectively in the lives of their clients. One of the central premises of this book, therefore, is that local people themselves must participate in the investigations and plans that provide the basis for health care. Our collective experience enacting action research covers a wide range of contexts and includes projects undertaken in university, institutional, and community settings. They include urban, rural, and remote locations in both developed and lesser developed nations and frequently incorporate multidisciplinary teams. A key feature of all these action research projects has been not only the learning gained by the participants themselves but also our learning about methods of practice. In these pages we seek to share the gift bestowed upon us by others we have worked with. Our experience suggests that the enactment of action research has placed us in uniquely special and privileged positions. In bringing together diverse groups of participants, we often find ourselves creating a special kind of social space where people feel safe and comfortable enough to share stories about their lives. The experience is sometimes quite emotional, sometimes even exciting and liberating for the storyteller, and often extremely informative for both speaker and listener. It is this rich kind of engagement that we both have been privileged to experience within our work. The Nature of the Book Action research differs from the forms of experimental and quasi-experimental research that have historically dominated the health arena. While action research will continue to contribute to the general body of objective knowledge that informs the practice of health professionals, its major purpose is to seek practical solutions to problems in particular contexts. In doing so, it engages participants in