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Using a Participatory Research Process to Make a Difference in Policy on Aging

Published online by Cambridge University Press:  08 November 2023

Carol L. McWilliam*
Affiliation:
The University of Western Ontario
*
Requests for reprints should be sent to:/Les demandes de reproduction doivent être adressées à: Carol L. McWilliam, Centre for Studies in Family Medicine, Kresge Building, Room K1, The University of Western Ontario, London, ON N6A 5C1

Abstract

As policy emerges from the interplay of economic, political, and social forces, determining whether research has made a difference to policy choices on aging issues is extremely difficult. Such a determination demands attention to the "black box" of the policy process, and the setting within which policy ultimately operates. This paper presents a Seniors' Independence Research Program as a case illustration of how research has made a difference to policy choices by stakeholder involvement throughout the research process. Strategies ensure stakeholder collaboration in policy issue search, filtration, definition, and prioritization; involvement in the design, implementation, and evaluation of health services models; and participation in achieving long-term evidence-based changes in policy and practice.

Résumé

Résumé

Alors qu'une stratégic politique émerge de l'interaction des forces économiques, politiques et sociales, il reste qu'il est trés difficile à déterminer si la recherche a eu un impact favorable sur les choix politiques concernant des questions relatives au vieillissement. Afin de mesurer cet impact il faut porter son attention sur la «boîte noire» de la procédure politique, et sur le contexte dans lequel la politique opère en definitive. Cette communication présente un Programme de Recherche sur l'lndépendance des Personnes âgées, en guise d'illustration de la façon dont la recherche a eu un impact favorable sur les choix politiques, grace a l'engagement des principaux intéressés au cours de la procedure des recherches. Des strategies garantissent la collaboration des principaux intéressés dans les recherches sur la politique à suivre, et sur le rayonnement, la définition, les questions prioritaires; sur l'engagement dans la conception, la mise en vigueur et I'évaluation des modèles de services de santé; et garantissent la participation, a partir des faits établis, aux changements a long terme apportés à la politique à suivre et à sa mise en pratique.

Type
Research Article
Copyright
Copyright © Canadian Association on Gerontology 1997

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Footnotes

*

The author, a Career Scientist supported by the Ontario Ministry of Health, wishes to acknowledge the National Health Research and Development Program, and the Seniors' Directorate of Canada for their funding support of the projects undertaken in this collaborative research. The results and conclusions contained in this paper are those of the author. No official endorsement by either funding body is intended, nor should it be inferred. Additionally, the helpful assistance of Ms. Lynn Dunikowski, The Canadian Library of Family Physicians, and Ms. Carol Thompson, Centre for Studies in Family Medicine, is acknowledged.

References

Abelson, J., Lomas, J., Eyles, J., Birch, S., & Veenstra, G. (1995). Does the community want devolved authority? Results of deliberative polling in Ontario. Canadian Medical Association Journal, 153(4), 403-412.Google ScholarPubMed
Alberta Ministry of Health. (1993). Self-managed care pilot project. Technical report. Manitoba, Canada: Alberta Ministry of Health.Google Scholar
Argyris, C., & Schon, D. (1991). Participatory action research and action science compared. In Whyte, W.F. (Ed.), Participatory Action Research (pp. 85-96). Newbury Park: Sage.CrossRefGoogle Scholar
Brown, J.B., McWilliam, C.L., & Mai, V. (In press). Barriers and facilitators to seniors' independence: Seniors', caregivers' and health care providers' perceptions. Canadian Family Physician.Google Scholar
Canadian Home Care Association. (1995). At Home: Official Newsletter of the Canadian Home Care Association, Spring 1995. Ottawa.Google Scholar
Charles, C., Schalm, C., & Semradek, J. (1994). Involving stakeholders in health services research: Developing Alberta's resident classification system for longterm care facilities. International Journal of Health Services, 24(4), 749-761.CrossRefGoogle ScholarPubMed
Durning, D. (1993). Participatory policy analysis in a social service agency: A case study. Journal of Policy Analysis and Management, 12, 297-322.CrossRefGoogle Scholar
Elmore, R.F. (1979-1980). Backward mapping: Implementation research and policy decisions. Political Science Quarterly, 94(4), 601-616.Google Scholar
Feldman, C., Olberding, L., Shortridge, L., Toole, K., & Zappin, P. (1993). Decision-making in case management of home health care clients. Journal of Nursing Administration, 23(1), 33-38.CrossRefGoogle Scholar
Foster, B., Susman, J., Mueller, K., Bowman, A., & Lunt, K. (1994). Delivering services to the rural elderly: A study of policy implementation. Journal of Case Management, 3(1), 13-20.Google Scholar
Freire, P. (1970). Pedagogy of the Oppressed. New York: Herder and Herder.Google Scholar
Freire, P. (1973). Education for Critical Consciousness. New York: Seabury Press.Google Scholar
Freire, P. (1978). Pedagogy in Process. New York: Seabury Press.Google Scholar
Freire, P. (1985). The Politics of Education: Culture, Power and Liberation. South Hadley: Bergin and Garvey.CrossRefGoogle Scholar
George, S. (1991). Measures of dependency. Their use in assessing the need for residential care for the elderly. Journal of Public Health Medicine, 13(3), 178-181.CrossRefGoogle ScholarPubMed
Goeppinger, J. (1993). Health promotion for rural populations: Partnership interventions. Family and Community Health, 16(11), 1-10.CrossRefGoogle Scholar
Gray, B.H., & Phillips, S.R. (1995). Medical sociology and health policy: Where are the connections? Journal of Health and Social Behavior, Spec. No., 170-182.Google Scholar
Green, L.W., George, M.A., Daniel M., Frankish, C.J., Herbert, C.J., Bowie, W.R., & O'Neill, M. (1995). Study of participatory research in health promotion: Review and recommendations for the development of participatory research in health promotion in Canada. Ottawa: The Royal Society of Canada. ISBN 0-920064-55-8.Google Scholar
Haines, A., & Jones, R. (1994). Implementing findings of research. British Medical Journal, 308(6942), 1488-1492.CrossRefGoogle ScholarPubMed
Hogwood, B.W., & Gunn, L.A. (1984). Policy Analysis for the Real World. Oxford: Oxford University Press.Google Scholar
Holter, I.M., & Schwartz-Barcott, D. (1993). Action research: What is it? How has it been used and how can it be used in Nursing? Journal of Advanced Nursing, 18(2), 298-304.CrossRefGoogle Scholar
Joshi, A., & Pedlar, D. (1992). Case managers for seniors: Educational needs and opportunities. Educational Gerontology, 18, 567-586.CrossRefGoogle Scholar
Kane, R.A. (1988). Case management: Ethical pitfalls on the road to high-quality managed care. Quality Review Bulletin, May, 161-166.CrossRefGoogle Scholar
Karlsen, J.I. (1991). Action research as method: Reflections from a program for developing methods and competence. In Whyte, W.F. (Ed.), Participatory Action Research (pp. 143-158). Newbury Park, CA: Sage.CrossRefGoogle Scholar
King, A. (1975). On studying the impacts of public policies: The role of the political scientist. In M. Holden & D. Dresang (Eds.), What Government Does, Sage Yearbooks in Politics and Public Policy. Volume 1 (pp. 298-316). Beverley Hills: Sage.Google Scholar
Labonte, R. (1993). Community development and partnerships. Canadian Journal of Public Health, 84(4), 237-240.Google ScholarPubMed
Lomas, J. (1990). Finding audiences, changing beliefs: The structure of research use in Canadian health policy. Journal of Health Politics, Policy and Law, 15(3), 525-542.CrossRefGoogle ScholarPubMed
Lomas, J. (1991). Words without action? The production, dissemination, and impact of consensus recommendations. Annual Review of Public Health, 12, 41-65.CrossRefGoogle ScholarPubMed
Lomas, J. (1993). Retailing research: Increasing the role of evidence in clinical services for childbirth. Milbank Quarterly, 71(3), 439-475.CrossRefGoogle ScholarPubMed
Lomas, J., Sisk, J.E., & Stocking, B. (1993). From evidence to practice in the United States, The United Kingdom, and Canada. Milbank Quarterly, 71(3), 405-410.CrossRefGoogle Scholar
Maclure, R. (1990). The challenge of participatory research and its implications for funding agencies. International Journal of Sociology and Social Policy, 10(3), 1-21.CrossRefGoogle Scholar
Manitoba Ministry of Health. (1994). Impact on self-managed care participants. Technical Report. Manitoba, Canada: Manitoba Ministry of Health.Google Scholar
McWilliam, C.L. (1992). From hospital to home: Elderly patients' discharge experiences. Family Medicine, 24(6), 256-267.Google ScholarPubMed
McWilliam, C.L., Brown, J.B., Carmichael, J.L., & Lehman, J. (1994). A new perspective on threatened autonomy in elderly persons: The disempowering process. Social Science and Medicine, 38(2), 327-338.CrossRefGoogle Scholar
McWilliam, C.L., Coderre, P., & Desai, K. (1995). Using action research to enhance geriatric case management. Geriatric Care Management Journal, Winter, 13-19.Google Scholar
McWilliam, C.L., Stewart, M., Brown, J.B., Desai, K., & Coderre, P. (1996). Creating health with chronic illness. Advances in Nursing Science, 18(3), 1-15.CrossRefGoogle ScholarPubMed
McWilliam, C.L., Stewart, M., Brown, J.B., McNair, S., Desai, K., Patterson, M.L., Del Maestro, N., & Pittman, B. (In press). Creating empowering meaning: An interactive process of promoting health with chronically ill older persons. Health Promotion International.Google Scholar
McWilliam, C.L., Stewart, M., Sangster, J.F., Brown, J., & Wong, C. (1993). Achieving the transition from hospital to home: How older patients and their caregivers experience the discharge process. Working Paper series, Paper #93-1. London, ON: Centre for Studies in Family Medicine, The University of Western Ontario.Google Scholar
Minkler, M., & Cox, K. (1980). Creating critical consciousness in health: Applications of Freire's philosophy and methods to the health care setting. International Journal of Health Services, 10(2), 311-322.CrossRefGoogle Scholar
Morgan, D.L. (1988). Focus Groups as Qualitative Research. Newbury Park, CA: Sage Publications.Google Scholar
Morgan, D.L. (1993). Successful Focus Groups: Advancing the State of the Art. Newbury Park, CA: Sage Publications.CrossRefGoogle Scholar
New Brunswick Ministry of Health. (1991). The New Brunswick Extra-Mural Hospital: A response to the future. Fredericton, NB.Google Scholar
Ontario Ministry of Health, Ministry of Community and Social Services, and Ministry of Citizenship. (1993). Partnerships in Long Term Care: A New Way to Plan, Manage and Deliver Services and Community Support: An Implementation Framework. Toronto: Queen's Printer for Ontario.Google Scholar
Orosz, E. (1994). The impact of social science research on health policy. Social Science and Medicine, 39(9), 1287-1293.CrossRefGoogle ScholarPubMed
Prochaska, J., & DiClemente, C.C. (1992). Stages of change in the modification of problem-behaviours. In M. Hersen, Eisler, R.M. & Miller, P.M. (Eds.), Progress in Behaviour Modification (pp. 184-214). Sycamore: Sycamore.Google Scholar
Rapp, C.A. (1986). The outcomes of case management services. Unpublished Presentation. Columbus, OH: The Ohio Department of Mental Health. Spring, 1986.Google Scholar
Rose, S.M. (1992a). Empowering case management clients. Ageing International, XIX(3), 1-4.CrossRefGoogle Scholar
Rose, S.M. (Ed.). (1992b). Case Management and Social Work Practice. New York: Longman.Google Scholar
Sabatier, P.A. (1987). Knowledge, policy-oriented learning, and policy change. Knowledge: Creation, Diffusion, Utilization, 8(4), 649-692.CrossRefGoogle Scholar
Sabatier, P.A. (1988). An advocacy coalition framework of policy change and the role of policy-oriented learning therein. Policy Science, 21(2-3), 129-168.CrossRefGoogle Scholar
Schon, D. (1987). Educating the Reflective Practitioner. San Francisco: Jossey-Bass.Google Scholar
Sharkansky, I. (1970). Environment, policy, output, and impact. In I. Sharkansky (Ed.), Policy Analysis in Political Science (pp. 61-79). Chicago: Markham Publishing.Google Scholar
Sheehan, J. (1990). Investigating change in a nursing context. Journal of Advanced Nursing, 15, 819-824.CrossRefGoogle Scholar
Simeon, R. (1976). Studying public policy. Canadian Journal of Political Science/Revue canadienne de science politique, 9(4), 449-580.CrossRefGoogle Scholar
Torres-Gil, F.M., & Wray, L.A. (1993). Funding and policies affecting geriatric rehabilitation. Clinics in Geriatric Medicine, 9(4), 831-840.CrossRefGoogle ScholarPubMed
Veatch, R.M. (1991). Consensus of expertise: The role of consensus of experts in formulating public policy and estimating facts. Journal of Medicine and Philosophy, 16(4), 427^45.CrossRefGoogle Scholar
Weatherly, R., & Lipsky, M. (1977). Street-level bureaucrats and institutional innovation: Implementing special education reform. Harvard Educational Review, 47, May, 172-196.CrossRefGoogle Scholar
Whyte, W.F. (1991). Participatory Action Research. London: Sage.CrossRefGoogle Scholar
Wortman, P.M., Vinokur, A., & Sechrest, L. (1988). Do consensus conferences work? A process evaluation of the NIH Consensus Development Program. Journal of Health Politics, Policy, and Law, 13(3), 469-498.CrossRefGoogle Scholar
Zawadski, R.T., & Eng, C. (1988). Case management in capitated long-term care. Health Care Financing Review, Annual Supplement, 75-81.Google Scholar