CHAIR IN COMMUNITY APPROACHES AND HEALTH INEQUALITIES CHSRF/CIHR Reflective practices in participatory public health research Yan Sénéchal, Julie Bradette and Stéphane Vibert Presentation plan Preamble: The theorization of partnership practices in public health 1. The work of ÉRIRIS 1.1 The research team on Interventions to reduce social health inequalities 1.2 Cases under study 1.3 Stages completed 2. The relationship between research and practice 2.1 Develop research projects that respond to practical concerns 2.2 Regularly inform partners on research progress and results 2.3 Establish clear rules for establishing partnerships 3. Mediation between partners 3.1 The mediation function 3.2 Liaison mechanisms Conclusion: Theorizing liaison mechanisms that support partnership practices 1

CHAIR IN COMMUNITY APPROACHES AND HEALTH INEQUALITIES CHSRF/CIHR Reflective practices in participatory public health research Yan Sénéchal, Julie Bradette and Stéphane Vibert Preamble: The theorization of partnership practices in public health Although seldom discussed, theorization is a central aspect of participatory public health. It clarifies past experiences and guides future experiences. In this sense, a particularly important issue is the theorization of the practices actually used by the research partners. This issue, which concerns reflection, is present in at least three levels: Understanding effective practices Identifying innovative practices Generalizing these practices in order to develop guidance tools. This three-pronged issue is presented in three parts, as a preliminary report on the initial phases of an ongoing project: 1.The work of ÉRIRIS 2.The relationship between research and practice 3.Mediation between partners 2

CHAIR IN COMMUNITY APPROACHES AND HEALTH INEQUALITIES CHSRF/CIHR Reflective practices in participatory public health research Yan Sénéchal, Julie Bradette and Stéphane Vibert 1. The work of ÉRIRIS 1.1 The Research Team on Interventions to Reduce Public Health Inequalities Under the responsibility of Louise Potvin, the Research Team on Interventions to Reduce Public Health Inequalities (ÉRIRIS) is a research subgroup under the Chair in Community Approaches and Health Inequalities (CACIS) at the University of Montreal, Québec. One of the Team’s projects is to theorize effective, participatory research practices. One question, although undefined, was raised throughout the entire initial development phase of this project: How should these practices be theorized? And what theoretical approach should be used? After much lively discussion, a multi-case study and a grounded theoretical analysis was deemed the most appropriate approach. This approach allowed us to consider all the different interests and objectives of the partners (researchers, practitioners, managers, financial backers, etc.). The starting point for this approach would be the actual practices of those involved, and it consisted of a systematic confrontation between these practices and the theoretical analysis. 3

CHAIR IN COMMUNITY APPROACHES AND HEALTH INEQUALITIES CHSRF/CIHR Reflective practices in participatory public health research Yan Sénéchal, Julie Bradette and Stéphane Vibert 1. The work of ÉRIRIS (continued) 1.2 Cases under study Five intervention projects in Montreal, Québec make up the cases that allow theorization of the prevailing partnership practices in the ongoing participatory research. They involve various intervention types, because they are conducted at various levels (local, regional and national) and are at various stages of completion: Assessment of a nutritional education project in schools in disadvantaged communities (Petits cuistots – Parents en réseaux) (Little cooks – parental network); Principal researcher: Johanne Bédard Le quartier comme espace transactionnel (The neighbourhood as a transactional space); Principal researcher: Gilles Sénécal Assessment of the Démarche-action (Action approach) project in Montreal-North; Principal researcher: André Bergeron; Associate researcher: Louise Potvin Assessment of a support program for young parents (SIPPE); Principal researchers: Céline Goulet and Sylvie Gendron A research-intervention partnership called Un milieu ouvert sur ses écoles in Bordeaux-Cartierville; Principal researcher: Angèle Bilodeau 4

CHAIR IN COMMUNITY APPROACHES AND HEALTH INEQUALITIES CHSRF/CIHR Reflective practices in participatory public health research Yan Sénéchal, Julie Bradette and Stéphane Vibert 1. The work of ÉRIRIS (continued) 1.3 Stages completed To date, two stages have been completed in the time horizon for the theorization of the practices involved in these participatory research projects. These stages aimed at a preliminary documentation of the experiences of the researchers, managers, practitioners and the public. Semi-directed interviews were held in summer 2007 on the following four general themes: a) the expectations of everyone involved; b) relationships between research and practice; c) mediation between the partners; and d) research benefits. Analysis of these interviews revealed that most of the practitioners concerns were connected with the relationship between research and practice, as well as mediation between the partners. Based on this preliminary analysis, a Partnership Workshop was organized in January 2008 to address these two important aspects of partnership practices. Here are some of the comments and questions offered by the Workshop participants. 5

CHAIR IN COMMUNITY APPROACHES AND HEALTH INEQUALITIES CHSRF/CIHR Reflective practices in participatory public health research Yan Sénéchal, Julie Bradette and Stéphane Vibert 2. The relationship between research and practice 2.1 Develop research projects that respond to practical concerns According to the practitioners, researchers should engage in research that meets the quality standards in force and is peer-recognized. However, given the time spent conducting the participatory research, the practitioners wanted to see tangible benefits of the interventions. Some partners doubted that the divergent interests of research and intervention could be reconciled. Participants’ questions: 1)What reasons would researchers and practitioners have to develop partnerships? 2)What are the benefits for the partners who participate in the research? 3)How can common goals be set? 6

CHAIR IN COMMUNITY APPROACHES AND HEALTH INEQUALITIES CHSRF/CIHR Reflective practices in participatory public health research Yan Sénéchal, Julie Bradette and Stéphane Vibert 2. The relationship between research and practice (continued) 2.2 Regularly inform partners on research progress and results Research time differs from intervention time. Nevertheless, the partners feel it is important to receive regular follow-ups on research developments. However, some researchers are reluctant to release partial or preliminary results. Participants’ questions: 1)Can research inform practice on a regular basis? 2)Is it up to research alone to organize and support these encounters? 3)How can the financial backers be made aware of the time that researchers and practitioners spend on these activities? 7

CHAIR IN COMMUNITY APPROACHES AND HEALTH INEQUALITIES CHSRF/CIHR Reflective practices in participatory public health research Yan Sénéchal, Julie Bradette and Stéphane Vibert 2. The relationship between research and practice (continued) 2.3 Establish clear rules for establishing partnerships. Clear rules must be defined for participatory research, so that all the partners benefit. Among other things, these rules should clarify the respective areas of action. They could also help to conciliate the separate requirements of researchers and practitioners. Participants’ questions: 1)How can scientific production practices be integrated with intervention practices? 2)What is the role of a representative or spokesperson in the partnership? 3)Who owns the research results? 8

CHAIR IN COMMUNITY APPROACHES AND HEALTH INEQUALITIES CHSRF/CIHR Reflective practices in participatory public health research Yan Sénéchal, Julie Bradette and Stéphane Vibert 3. Mediation between partners 3.1 The mediation function The mediation function aims at more than just information management. It must stimulate and “energize” the partnership. It must succeed in clarifying ambiguities and grey areas. Participants’ questions: 1)Does the mediation function improve the synergy between researchers and workers on the ground? 2)Should the mediation function be fulfilled by a single person? 3)How can we make sure that the mediators have a global vision of the partnership, and the direction it is headed ? 9

CHAIR IN COMMUNITY APPROACHES AND HEALTH INEQUALITIES CHSRF/CIHR Reflective practices in participatory public health research Yan Sénéchal, Julie Bradette and Stéphane Vibert 3. Mediation between partners (continued) 3.2 Liaison mechanisms Partnership practices alone are not enough to ensure coherent, large-scale participatory research. Hence the need to put in place liaison mechanisms on which all those involved in the project can agree. These mechanisms can be more or less formal, for example, a steering committee, and would serve as the “memory” for the research, among other things. These mechanisms ensure continuity between the existing research partners and new partners that join the research along the way. Participants’ questions: 1)How do these mechanisms affect the practices of the partners? 2)How can these mechanisms be justified to financial backers? 10

CHAIR IN COMMUNITY APPROACHES AND HEALTH INEQUALITIES CHSRF/CIHR Reflective practices in participatory public health research Yan Sénéchal, Julie Bradette and Stéphane Vibert Conclusion: Theorizing the liaison mechanisms that support partnership practices Next year, we will focus our attention more on mediation between research and practice, and more particularly on the mediation mechanisms between partners. We must gain a better understanding of the nature of these mechanisms that accompany the conduct of participatory research involving multiple partners. We must better understand the effects of the presence or absence of these mechanisms on partnership practices. Do the mechanisms foster reflective practices? Can they be applied to other settings? Finally, can the study of these liaison mechanisms shed new light on issues affecting participatory public health research? These are a few of the questions that our ongoing project is attempting to answer. Thank you! 11