ABSTRACT
INTRODUCTION: Cultural safety, interculturality and antiracism are crucial concepts in addressing health disparities of minority and diverse groups. Measuring them is challenging, however, due to overlapping meanings and their highly contextual nature. Community engagement is essential for evaluating these concepts, yet the methods for social inclusion and protocols for participation remain unclear. This review identifies experimental studies that measure changes resulting from culturally safe, intercultural or antiracist healthcare. The review will describe outcomes and additional factors addressed in these studies. METHODS AND ANALYSIS: The study focuses on epidemiological experiments with counterfactual comparisons and explicit interventions involving culturally safe, intercultural or antiracist healthcare. The search strategy covers PubMed, CINAHL, Scopus, Web of Science, ProQuest, LILACS and WHO IRIS databases. We will use critical appraisal tools from the Joanna Briggs Institute to assess the quality of randomised and non-randomised experimental studies. Two researchers will screen references, select studies and extract data to summarise the main characteristics of the studies, their approach to the three concepts under study and the reported effect measures. We will use fuzzy cognitive mapping models based on the causal relationships reported in the literature. We will consider the strength of the relationships depicted in the maps as a function of the effect measure reported in the study. Measures of centrality will identify factors with higher contributions to the outcomes of interest. Illustrative intervention modelling will use what-if scenarios based on the maps. ETHICS AND DISSEMINATION: This review of published literature does not require ethical approval. We will publish the results in a peer-reviewed journal and present them at conferences. The maps emerging from the process will serve as evidence-based models to facilitate discussions with Indigenous communities to further the dialogue on the contributing factors and assessment of cultural safety, interculturality and antiracism. PROSPERO REGISTRATION NUMBER: CRD42023418459.
Subject(s)
Antiracism , Delivery of Health Care , Humans , Systematic Reviews as Topic , Health Facilities , Minority Groups , Review Literature as TopicABSTRACT
INTRODUCTION: Participatory research science deals with partnerships underlying research, governance and ownership of research products. It is concerned with relationships behind research objectives and methods. Participatory research has gained significant traction in design of health interventions, contextualising these to local settings and stakeholder groups. Despite a massive increase in participatory research exercises, the field remains undertheorised, and the mechanisms for improving health outcomes remain unclear. This realist review seeks to understand how and under what circumstances participatory research impacts health and social outcomes. METHODS AND ANALYSIS: The review will follow four steps: (1) searching for and selecting evidence, (2) assessing the quality of evidence, (3) extracting and categorising data and (4) synthesising the data in the form of context-mechanism-outcomes configurations. The review will follow the Realist And Meta Narrative Evidence Syntheses: Evolving Standards (RAMESES) II guidelines for reporting realist evaluations. We categorise and synthesise data in four steps: (1) identifying outcomes, (2) identifying contextual components of outcomes, (3) theoretical redescription (abduction) and (4) identifying mechanisms. A retroductive analysis will identify mechanisms by moving between empirical data and theories, using inductive and deductive reasoning to explain the outcomes-context matches. The output will generate middle-range theories on how participatory research works, for whom and under what circumstances. ETHICS AND DISSEMINATION: This study is a review of a published literature. It does not involve human participants. We will convene a workshop to share and discuss the preliminary results with partners and key stakeholders involved in participatory health research. We will publish the review results in peer-reviewed journals and academic conferences.
Subject(s)
Community-Based Participatory Research , Research Design , Humans , Narration , Review Literature as TopicABSTRACT
Antecedentes. El Estado como institución de poder tiene la capacidad de reconocer y garantizar los derechos y deberes de los ciudadanos. La relación entre Estado y ciudadanía permite a la población con discapacidad legitimar sus derechos y ser partícipes de la elaboración, decisión y ejecución de los asuntos que le conciernen. Objetivo. En este documento se presentan los hallazgos de las categorías Estado y ciudadanía derivados del estudio Análisis histórico de la construcción política de la categoría discapacidad en Colombia con el objetivo de reconstruir la historia de los acontecimientos sociales que determinaron las transformaciones sociopolíticas de la discapacidad entre los años 1986 y 2012. Materiales y métodos. Seis categorías fueron analizadas en 283 fuentes primarias y secundarias; el análisis se realizó en tres niveles: macro (políticas y lineamientos de nivel mundial), meso (políticas, jurisprudencia y legislación) y micro (sociedad civil organizada). Las orientaciones teóricas usadas fueron el concepto de campo social de Bourdieu y el concepto de biopoder de Foucault; las orientaciones metodológicas aquí empleadas están en la perspectiva de los estudios históricos críticos e históricos sociales de la discapacidad. Resultados. Se exponen tres periodos históricos que representan los puntos de giro en el concepto sociopolítico de la discapacidad en Colombia. Conclusión. Existe una constante tensión entre el Estado y los ciudadanos en situación de discapacidad: las políticas públicas sobre discapacidad en Colombia han favorecido, y son el resultado de la emergencia y configuración de, sujetos políticos conscientes de sus capitales sociales, de manera que su ejercicio político trasforma la configuración del poder. Sin embargo, estas acciones no se extienden homogéneamente a todas las regiones del país, de manera que las acciones políticas y ciudadanas de la discapacidad, dada la estructura del Estado colombiano, son disímiles en las regiones.
Background. The State as an institution of power has the ability to recognize and guarantee the rights and duties of citizens. The relationship between State and citizens allows people with disabilities to legitimize their rights and become partners in the development, decision and execution of the issues that concern them. Objective. This document presents the findings of the categories State and Citizenship, derived from the study "Historical Analysis of the Political Construction of the Disability Category in Colombia", in order to reconstruct the history of the social events that determined the political changes of disabled people between 1986 and 2012 . Materials and Methods. Six categories were analyzed in 283 primary and secondary sources. The analysis was performed at three levels: the macro one (politics and guidelines worldwide); the meso one (politics, jurisprudence and legislation), and the micro one (the organized civil society). The theoretical approaches used were the Bourdieu's concept of social field and the Foucault's concept of biopower. On the other hand, the methodological approaches used here were based on a critical-historical and social-historical studies perspective. Results. Three historical periods that represent turning points in the sociopolitical concept of disability in Colombia are exposed. Conclusion. There is a constant tension between the State and citizens with disabilities. Public policies on disability in Colombia have favored, and they are the result of the emergence and configuration of political subjects aware of their social capitals. So his political exercise transforms the configuration of power. However, these actions do not extend in the same way to all regions of the country, thus political and civic actions on disability, given the structure of the Colombian State, differ from region to region.
