Public Health Action Research
by
Jennifer Mullett, Sarah Fletcher
  • LAST REVIEWED: 07 January 2022
  • LAST MODIFIED: 23 February 2011
  • DOI: 10.1093/obo/9780199756797-0018

Introduction

Action research is research for societal change that progresses through cyclical stages of planning, acting, reflecting, and evaluating. It is used in the field of public health to alleviate adverse conditions in communities by addressing the determinants of health, community-wide interventions, and health promotion. A renewed interest in action research has led to a number of articles and books focused on the articulation of principles for conducting this research. Indeed, action research is less a methodology and more a set of guidelines for the roles of the researcher and collaborators, interweaving theory and action and the function of the research knowledge. There are many subtle variations and iterations of action research, but a gross distinction could be made between action research that is conducted by a researcher implementing an intervention at a community level for the dual purposes of change and knowledge outcomes versus community based participatory action research where those affected by the change and other important stakeholders participate in all stages of the research from design, implementation, and data gathering to analysis. Participatory action research approaches often have the additional goal of promoting critical consciousness where through cyclical stages of dialogue participants attain a greater understanding of their situation, which in turn may result in political or major social change. These approaches are more common in public health initiatives in underdeveloped countries but have been adapted for interventions with marginalized populations in developed countries. Because of the emphasis on research as an instrument of change there are several versions of how-to books and articles, some referred to as handbooks, that articulate the nonpositivist philosophy and offer a detailed description of the research process with examples. Included here are seminal articles in the general area of action research that articulate these principles followed by those specific to health promotion and public health initiatives. Online resources such as those edited by Ian Hughes and Bob Dick are included as they provide easy access to basic definitions and discussions of theory, but other fields outside of public health that rely heavily on action research such as education are not covered.

Origins and Development

Lewin 1946 is generally regarded as the first discussion of and therefore the origin of action research. Lewin provides the rationale for the necessity of action research and lays out the procedures for its practice. In Lewin’s later article, Lewin 1952, he articulates and illustrates with a frequently cited or commonly modified diagram the iterative approach of action research that has been adopted by many disciplines, particularly the fields of quality assurance and quality improvement. In the field of pubic health, Israel, et al. 1998, is a meta-analysis of action research papers from which the authors derived critical elements of collaborative action research that have become standards in the field. In addition, critical thinking and partnership approaches in community-based research are identified for the interaction of knowledge and action in public health. In Israel, et al. 2001, the authors introduce the policy recommendations necessary to advance community-based research in order to benefit communities.

  • Israel, B. A., A. J. Schulz, E. A. Parker, and A. B. Becker. 1998. Review of community-based research: Assessing partnership approaches to improve public health. Annual Review of Public Health 19:173–202.

    DOI: 10.1146/annurev.publhealth.19.1.173

    The authors review the rationale for community-based research and then trace the evolution of thinking about the determinants of health and the methodologies best suited to the topic. Eight key principles for conducting community-based research aimed at improving the public’s health are listed, followed by examples of both challenges and facilitators. Very useful for teaching and grant writing.

  • Israel, B. A., A. J. Schulz, E. A. Parker, and A. B. Becker. 2001. Community-based participatory research: Policy recommendations for promoting a partnership approach in health research. Education for Health 14.2: 182–197.

    DOI: 10.1080/13576280110051055

    The authors suggest that if community members and practitioners are to be equal partners, capacity building has to be the first step. Grants, review processes, training programs, and infrastructures need changing to facilitate engagement for practitioners, community members, and academics—for example, building capacity by providing training programs in historically marginalized communities.

  • Lewin, K. 1946. Action research and minority problems. Journal of Social Issues 2:34–46.

    DOI: 10.1111/j.1540-4560.1946.tb02295.x

    Lewin argues that being able to judge whether an action has led forward or backward is prerequisite for any learning. He then describes the stages of the fact-finding process—plan, act, reflect—which results in gaining new insights for the next action. He also argues for an integrated, interdisciplinary approach to inform social practice.

  • Lewin, K. 1952. Group decision and social change. In Readings in social psychology. Edited by G. E Swanson, T. M. Newcomb, and E. L. Hartley, 459–473. New York: Henry Holt.

    Through an original diagram, Lewin outlines the iterative processes of action research that create social change. This article provides an introduction to motivation; the ideas of “unfreezing” entrenched behavior and “freezing” new behavior; examples of action research in nutrition, healthy eating, or managerial fields; and the different outcomes achieved with a lecture format versus group decision making about change.

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