Participatory research in health intervention studies involving migrants: a systematic review

Objective To analyse the use of participatory approaches in research of health interventions for migrants, and how utilised approaches embody core participatory principles of democracy and power-distribution. Design A systematic review of original articles. Electronic searchers were carried out in the databases MEDLINE, Embase, Global Health and PsychINFO (from inception – Nov 2020). Eligibility criteria for study selection The analysis included original peer-reviewed research which reported on attempts to develop and implement a health intervention for migrants using participatory approaches. We defined migrants as foreign-born individuals; studies using definitions demonstrably outside of this were excluded. Only articles reporting the full research cycle (inception, design, implementation, analysis, evaluation, dissemination) were included. Data extraction Information related to who was involved in research (migrants or other non-academic stakeholders), the research stage at which they were involved (inception, design, implementation, analysis, evaluation, dissemination), and how this involvement aligned with the core principles of participatory research – categorising studies as exhibiting active, pseudo, or indirect participation of migrants. Results 1793 publication were screened of which 28 were included in our analysis. We found substantial variation in the application of participatory research approaches: across 168 individual research stages analysed across the 28 studies, we recorded 46 instances of active participation of migrants; 30 instances of proxy participation; and 24 instances of indirect participation. Whilst all studies involved at least one non-academic stakeholder group in at least one stage of the research, just two studies exhibited evidence of active participation of migrants across all research stages. Conclusions These data highlight important shortfalls in the inclusion of migrant groups in developing health interventions that affect their lives and suggest a more rigorous and standardised approach to defining and delivering participatory research is urgently needed to improve the quality of participatory research. Registration This review followed PRISMA guidelines and is registered on the Open Science Framework (osf.io/2bnz5) Strengths and Limitations This systematic review represents a robust and novel assessment of the applications of participatory approaches and principles to health intervention research with migrants. This review casts a critical lens over the application and outcomes of participatory approaches, conceptually focusing on the relationship between the methods used and the populations involved, and how this all relates to participatory principles. This review is limited by the varied and interchangeable use of participatory research terms within this field. The categorisations and terms we introduce may therefore be defined differently by others. This review is limited by the lack of clear and consistent reporting of participatory methods utilised; guidelines must be prepared and consistently adopted to improve transparency in all participatory research. This does not analyse or consider associations between participatory methods, and health or research outcomes; future research to understand any such associations is needed.