PAPER : Cultivating the power of partnerships in feminist participatory action research in women’s health

TITLE:

Cultivating the power of partnerships in feminist participatory action research in women’s health

REFERENCE: (FPAR)

Ponic, P, Reid, C and Frisby, W, 2010, Cultivating the power of partnerships in feminist participatory action research in women’s health, Nursing inquiry: 17 (4):324-335

JOURNAL

MY SUMMARY

As a novice FPAR researcher, the issue of “Power with” and “power-over” is negotiable and cultivation of the power of partnerships is a natural process during my field research. I learn from Ponic et al experience during their research.

In this paper, Ponic et al emphasize the importance of Feminist Participatory Action Research in women’s health which are combination of feminist theories and participatory action research methods. In women’s health, Ponic, Raid and Frisby (2010) added that by creating a space to share their individual and collective voices and experiences for their own health in all stages process of FPAR contribute to improving the quality of the women’s health. They added that cultivating ‘power with’ relationship or “finding ways to share power that are cumulative and expansive” is essential in every FPAR to “harness each partner’s resources, skills and knowledge” (p. 330) to address women’s health issues adequately and correctly in all their “messiness and complexity” (p. 333). We also should be aware of how to control or use ‘power over’ which refer to “the ability to control, dominate, and or impose ones’ will on others”.

Furthermore, three main things to cultivate and to sustain the partnership during FPAR research including:1) there is no doubt, the mutual relationship of ‘money’ and ‘time’ is necessary part of our project. “Building in adequate time and money” to maintain coordination or gatherings over the project, to provide honoraria for our team and others, and to maintain ‘mutually beneficial relationship’.; 2)”team building to develop ‘a strong foundation of trust’ and establish group agreement in order to create a space for less privileged positions”, “a safe space for all voices to be heard”, “mutual respect for diversity, caring and compassion, and egalitarian understanding of power” (pp. 331); 3) the value of conflict is a natural part of group process that indicated “differences are being embraced and negotiated and that power dynamics are being reformulated” (pp 332; ); 4) Individual and collective reflexivity, like a fieldnote, provides “useful strategy for managing the emotions, boundaries, and other relational complexities that can ‘plague’ academic researchers and partners working in the field” in order to create  “resolution or understanding within a broader social context” pp.332.

12 December, 2017, Najmah

ABSTRACT

Feminist participatory action research integrates feminist theories and participatory action research methods, often with the explicit intention of building community–academic partnerships to create new forms of knowledge to inform women's health. Despite the current pro-partnership agenda in health research and policy settings, a lack of attention has been paid to how to cultivate effective partnerships given limited resources, competing agendas, and inherent power differences. Based on our 10+ years individually and collectively conducting women's health and feminist participatory action research, we suggest that it is imperative to intentionally develop power-with strategies in order to avoid replicating the power imbalances that such projects seek to redress. By drawing on examples from three of our recent feminist participatory action projects we reflect on some of the tensions and complexities of attempting to cultivate power-with research partnerships. We then offer skills and resources needed by academic researchers to effectively harness the collective resources, agendas, and knowledge that each partner brings to the table. We suggest that investing in the process of cultivating power-with research partnerships ultimately improves our collective ability to understand and address women's health issues.

CONCLUSION

Deliberately creating strategies for cultivating power-with partnerships in FPAR and exploring the challenges in doing so have theoretical and methodological implications. Theoretically, it reveals the complexity of power relations in part- nerships when working against the flow of dominant and mutually-reinforcing ideologies and structural inequalities based on neoliberalism, patriarchy, classism, racism, homo- phobia, and other axes of power. It also calls into question the very value systems that partnerships are based upon and requires a deepening of theoretical perspectives to inform FPAR partnerships. As some researchers have argued, part- nership theory has focused on the economic and functional dimensions and under-theorizes the consequences of the power imbalances inherent in such relations (Coulson 2005). This has resulted in an assumption that partnerships in health research are ‘good’, which may not necessarily be the case if power differences are not adequately addressed. Partnership research has also focused more on the forma- tion stage and much less on the complexity of the manage- ment stage where power relations are played out (Babiak and Thibault 2009).

The power-over versus power-with framework is an important yet relatively simplistic one developed from long- standing feminist theorizing and practice. Participatory and community-based research partnering could be further informed by poststructural and intersectional theories that examine power as a relational force embedded in the con- struction, reproduction, and resistance of broader social structures (English 2006; Hankivsky and Christoffersen 2008; Kesby 2005). Additionally, examining theories of engagement and communities of practice could shed light on how people from diverse perspectives and locations work together towards mutually beneficial goals (e.g. Poole 2008). Doing so would deepen understandings of how FPAR partnerships can contribute to the work of social justice and improved women’s health.

Methodologically, our reflections on the challenges associated with research partnerships help to uncover unexam- ined power relations amidst the myriad of stakeholders and illustrate the importance of refining participatory method- ologies to better gather knowledge to redress the inequities that compromise women’s health. Rather than simply toler- ating the challenges as an unfortunate side effect or a reason not to conduct FPAR, we argue that the uncomfortable dynamics that often unfold are necessary to meet the inten- tions behind the endeavour and give evidence to that fact that power relations are being destabilized in a way that can have positive consequences as a result.

Our journeys towards cultivating power-with partnerships have been riddled with discomfort and challenges. Destabiliz- ing longstanding systemic power relationships, creating and enacting new paradigms of knowledge construction, bridging social and cultural differences, and taking action toward improved health are not easily achieved, particularly when the values of partnerships and collaboration underpinning all stages of the research process itself are often insufficient

Cultivating the power of partnerships in feminist participatory action research in women’s health
Feminist participatory action research integrates feminist theories and participatory action research methods, often with the explicit intention of building community–academic partnerships to create new forms of knowledge to inform women’s health. Despite the current pro-partnership agenda in health research and policy settings, a lack of attention has been paid to how to cultivate effective partnerships given limited resources, competing agendas, and inherent power differences. Based on our 10+ years individually and collectively conducting women’s health and feminist participatory action research, we suggest that it is imperative to intentionally develop power-with strategies in order to avoid replicating the power imbalances that such projects seek to redress. By drawing on examples from three of our recent feminist participatory action projects we reflect on some of the tensions and complexities of attempting to cultivate power-with research partnerships. We then offer skills and resources needed by academic researchers to effectively harness the collective resources, agendas, and knowledge that each partner brings to the table. We suggest that investing in the process of cultivating power-with research partnerships ultimately improves our collective ability to understand and address women’s health issues.

IMPORTANT DIRECT QUOTATION

Feminist participatory action research (FPAR) integrates feminist theories and participatory action research methods, often with the explicit intention of building community– academic partnerships to create new forms of knowledge that lead to social justice (Frisby et al. 2009) –‘The ‘f’ word has everything to do with it; How feminist of action research’ p.324

Feminist partici- patory action research seeks to name and redress power inequities, reveal diverse women’s voices and experiences, critically examine the socioeconomic and political contexts shaping women’s lives, and facilitate action outcomes (Maguire 2001) –‘Uneven ground: Feminisms and Action research’ (in handbook of action research: Participative inquire and practice. P.324

From a feminist perspective, power can be a generative resource when used with, instead of over, each other (Lorde 1984). P..325

Power-with means finding ways to share power that are cumulative and expansive (Tett 2005), as opposed to traditional power-over approaches, which refer to the ability to control, dominate, and ⁄ or impose ones’ will on others (Tetreault and Teske 2000). In fact, challenging top down power-over strategies is a core ideal of FPAR and related feminist, participatory, and action research disciplines (Dominelli 2002; Greenwood and Levin 1998; Lykes and Coquillon 2006). P.325

Yet academic researchers embedded in traditional and often patriarchal settings receive little training in how to facilitate power-with approaches that culti- vate the collective resources that all partners bring to the table. P.325

Similar to other forms of participatory and action research, FPAR ultimately aims to democratize knowledge production as a precursor to taking action to improve the quality of people’s lives (Greenwood and Levin 1998; Stringer and Genat 2004). P.325

Feminist participatory action research emerged in response to critiques that participatory research and traditional research more broadly are gender-blind and fail to fully capture the reality of women’s lives (Maguire, 1996, 2001). P.325

Feminist participatory action research seeks to facilitate women’s participation in all stages of the research process (Frisby et al. 2005) p.325.’Putting ‘participatory’ into participatory forms of action research 

Feminist participatory action research seeks to facilitate women’s participation in all stages of the research process (Frisby et al. 2005), thus creating space for them to ask research questions that are meaningful to their own health while giving voice to their individual and collective experiences. p.325.--’Putting ‘participatory’ into participatory forms of action research

Reflexivity, a key FPAR tool, involves the systematic reflection of power relationships both within projects and broader social relations (Pillow 2003; Reid et al. In press; Williams and Brinton Lykes 2003). It encourages those involved in the research process to deeply consider how their power, social locations, biases, and assumptions implicate their roles, ethical judgments, and ability to share and translate knowledge (Reid et al. 2009). Most of the literature on reflexivity focuses on researcher roles vis-a`-vis participants, but under-examines what this means when brokering partnerships across differ-ent private, public, and not-for-profit sectors (Babiak and Thibault 2009). This paper helps to fill that gap. P.325

Similar to FPAR, the women’s health research movement has evolved over the past 25 years in response to women’s exclusion from traditional research settings (Greaves 2009).

Gender is now understood to be a core health determinant and research illustrates that women are disproportionately affected by social determinants of health such as low income, inadequate housing, and social exclusion (Bryant 2004; Moss 2002; Reid 2004). Further, poor women, Aboriginal woman and women of colour, migrant women, lesbians, and women who are dis- abled are especially vulnerable to their social conditions and face disproportionately higher rates of mortality and morbid- ity (Morrow, Hankivsky, and Varcoe 2008).

Feminist participatory action research researchers in women’s health have exemplified the importance of partner- ships and contributed to the broader literature on the chal- lenges and potential arising from such collaborative efforts. We build on this work by further articulating some of these tensions and offering recommendations on the explicit skills and resources required to cultivate power-with strategies to maximize partnership potential. P.326

Cultivating ‘Power-with’Partnerships:Learning from three FPAR projects

Attention to the process of navigating and cultivating partner- ships is important precisely because the success of FPAR pro- jects relies on effective and sustainable partnerships. The richness of FPAR in part results from the diverse agendas, worldviews, skills, resources, and social contexts that each partner brings to the table. P.328

For example, participants bring the power of their life experiences, community researchers add their knowledge of local contexts and connection to par- ticipants, organizational and government workers contribute their access to resources, ability to take action, and influence policy, and researchers supply their ability to generate funds and evidence. Yet traditionally these various forms of power are not equally valued in research or in broader social set- tings. The need for efficiency and control – two dominant val- ues held in traditional academic research and bureaucratic service systems – have led to a masking of power imbalances.  P.328

Sheeding light-P Ponic

A unique power difference exists in this research partner- ship because one of the lead organizations had initiated the grant and was responsible for its administration, and thus had power typically held by academic researchers. While this is a positive way through which community organizations can have greater control in projects than they traditionally do, it also resulted in a tendency to privilege that organization’s agenda, and limited my ability as lead researcher to facilitate power-with strategies. That is not to say that doing so was impossible. Rather, because we did not have the resources to create a venue where all of our various interests and objectives could be stated upfront and agreements could be made these power differences were masked. This experience confirmed my learning from past projects, which is the need for collective reflexivity so all perspectives are considered and potential misunderstandings can be avoided. Yet this type of process is often what gets sidestepped when funding is tight, especially in the under-resourced health and social sectors. Although we did not manage to gather all partners at the onset of the project, we have received a knowledge translation grant that will allow us to do so as we move forward towards action.

Women’s employability and health project-C.Reid

Yet the distance was not the only obstacle; the very struc-ture of the project compounded what some felt were embedded power inequities. Project timelines, deliverables, and budgets were managed by what some partners referred to as ‘project headquarters’ and ‘big sister’. While my intention was to make decisions collaboratively, it was not always feasible to do so. Most project documentation required my signature, I managed the project funding, and, ultimately, I was accountable to the funders for the appropriate and timely use of our grant monies. Although the researcher partners acknowledged that it was necessary for me to be in a leadership role, they also felt the control I wielded as project lead reflected power differences that were more typical in traditional power-over approaches to research. p.329

The external pressures imposed by my academic institution and the funders contravened our ethic of power-with part- nerships. In some instances I felt forced, rightly or wrongly, to exert power-over my research partners. The pressure to make decisions quickly and efficiently, and to be the one accountable for them, limited our capacity to develop power-with partnerships. P.329

Immigration and physical activity-W.Frisby

“When I presented some of our preliminary findings at the conference, one of the federal policy-makers made com- ments to the audience that appeared to discredit our work. He asked how he was supposed to make policy in the area of multiculturalism and physical activity after hearing about only 50 Chinese immigrant women from only one Canadian city. He also asked why we had used a qualitative approach instead of a quantitative approach which would have enhanced the generalizability of the findings. At first I was quite angry with his response and lack of knowledge about our approach to research, but I realized that like me, he is a product of his own background and education and he will have difficulty justifying policy based on one FPAR study. I did try to explain the values of our approach, but he certainly did not seem to be convinced. (W Frisby, field- notes, November 2008) “ p.330

POWER-WITH PARTNERSHIPS: IMPLICATIONS FOR WOMEN’S HEALTH RESEARCH

While partnerships are necessary for lever- aging limited resources, they are also essential for under- standing and addressing the range of overlapping factors that shape women’s health. p.330

It is necessary to generate power-with strategies to harness each partner’s resources, skills, and knowledge because power-over strategies will likely alienate research partners and ⁄ or participants. P.330

For Hibbert and Huxham (2005) it is through ‘process learning’ (a notion similar to collective reflexivity) where power dynamics are openly addressed so that effective collaborations evolve and have the potential to achieve multiple goals. A key feature of power-with strategies is that trust is developed, which according to Vangen and Huxham (2003), requires a proactive information exchange to deal with expectations and concerns over risk taking and the vulnerabilities that characterize the interdependencies in partnership relations. P.330

A failure to develop such strategies collaboratively will likely result in partners defaulting into traditional power-over relationships that mask differences, recreate power imbalances, and increase the likelihood of disappointing outcomes (Vangen and Huxham 2003)

Power-over partnerships can readily and unwittingly dismantle even the best-intentioned research project. If partners cannot find effective ways to collaborate, many women’s health issues will remain invisible, misunder- stood, and unaddressed – a situation that ultimately affects the women most vulnerable to poor health. p.330

CULTIVATING PARTNERSHIP RESEARCHER SKILLS AND RESOURCES

2.     Dedicated partnership-building resources-time and money

As each of our examples illustrates, the foremost practical strategy for managing partnerships in FPAR is building resources for it into project planning. We recognize that when either (or both) time and money are limited, attention to the process of cultivating and sustaining partnerships is often abandoned. This is understandable when competition for research funding is high and those working in the health and social services are chronically over-worked. Building in adequate time and money to engage in partnership building is the key first step. P.331

·      This would involve going beyond identifying partners to bringing them together for substantive conversations about how to cultivate mutually beneficial relationships.

·      It is also important to maintain these types of gatherings over the course of the project.

·      Honoraria for service providers are helpful for alleviating the cost of their time away from their workplace, especially non-profits that are consistently under- funded.

·      Funding for staff well-trained in group facilitation and communication is another option, so that all team mem- bers are kept informed and engaged as the project develops.

3.     Team building-establishing group agreements

Team building is a necessary first step in FPAR process in order to develop a strong relational foundation of trust from which the project can be launched (Vangen and Huxham 2003). This is especially important when cultivating power- with partnerships with varying interests, agendas, and skills (Frisby et al., 2004). P.331

Co-creating values statements, vision documents, and group agreements for how team members will work together can provide heightened clarity amongst team members. P.331

For example, community-based and anti-oppressive group work involves the active negotiation of social and power dynamics within groups, whereby group members learn how to develop a safe space for all voices to be heard, a mutual respect for diversity, caring and compassion, and egalitarian understandings of power (Dominelli 2002; Nelson and Prilleltensky 2005). Engaging in this type of relational group work from the outset of FPAR projects is necessary in order to find common ground among partners, especially those who are in less privileged positions or those who have less familiarity with FPAR processes (Dominelli 1995). P.331 

4.     The value of conflict

Conflict within groups may confirm that differences are being embraced and negotiated and that power dynamics are being reformulated (Shakir 2005)-dangers of a new dogma:Social inclusion or else....!-p.332

To work effectively with conflict, FPAR teams need to openly name it as a natural part of group process, agree to approaches for working with conflict, and be willing to go into the messy territory of managing it as a means for individ- ual and collective growth. P.332

While we stumbled into con- flict early in the WEHP, through our project coordinator who had advanced facilitation skills, we were able to use it constructively to build our partnerships, acknowledge what was at play, and find ways to feel heard and valued in the research. Managing conflict is another area where a well-- trained facilitator would be very useful to assist partners in finding an appropriate approach. P.332

5.     Individual and collective reflexivity

Reflexivity is useful strategy for managing the emotions, boundaries, and other relational complexities that can ‘plague’ academic researchers and partners working in the field (Davis and Gremmen 1998; Ponic et al. 2002) p.332 

As the excerpts from our fieldnotes demonstrate, they provided researchers with an outlet to vent and capture our emotions (e.g. frustration, anger, guilt), and to work towards resolution or understanding within a broader social context (Coy 2006; Reid et al. In press; Wolf 1996). Although fieldnotes are seldom included as sources of data, they should be taken seriously as an inte- gral part of FPAR because they help illuminate and resolve tensions that result from power differences observed in partnerships. W Frisby’s fieldnote on her encounter with the policy-maker in the Immigration and Physical Activity project exemplifies how her reflexive process helped her understand her anger as being a result of the differing epistemologies underlying FPAR and federal policy-making. It allowed her to deepen her analysis, which was an important finding in the project as well as an insight for her own learning. p.332