Participatory practices and participant observation together in action research: novel approaches to building capacity for health equity?

Health equity and the capacity to build it may be better achieved when the approaches of participatory practice and participant observation are more intentionally implemented together in applied, action research. An exploration of the literature compared results from a title and abstract search for the phrases participatory and participant observation. When searched for together, the number of articles that was retrieved was very low, flagging an issue worth consideration. A comparison of the approaches’ historical development, theoretical foundations, and practical applications sheds light on their similarities and differences. Participatory practices lean on teaching community members how to conduct action research; plan and implement projects, and advocate for themselves. Participant observation leans on researchers and evaluators being taught about different communities through processes of immersion and deep reflection. Both have positive and negative connections to health equity, capacity building, empowerment, and engagement. Revisiting these approaches as separate strategies for learning provides an opportunity to adapt and reinvigorate their coordinated and robust use, which could lead to novel approaches to action research and more successful treatment of power-imbalances that thwart health equity. Such a revisitation should include consideration of action projects that conceptualize the approaches side by side, actual versus intended use of coordinated approaches, methods for more leveraging of health infrastructure and healthcare education; and potential new approaches to participant observation. Woven throughout this article are the author’s perspectives and examples from 25 years of work on community-based, participatory action, ethnographic, and qualitative research, implementation, and evaluation projects.