de Toledo Renata Ferraz, Giatti Leandro Luiz
School of Education, University of São Paulo, São Paulo, Brazil.
Department of Environmental Health, School of Public Health, University of São Paulo, São Paulo, Brazil.
Health Promot Int. 2015 Mar;30(1):162-73. doi: 10.1093/heapro/dau079. Epub 2014 Sep 19.
In order to understand and take action in complex health and environmental issues, we intend to analyse the conditions that are needed for those at risk to participate in research and intervention projects. In this study, we describe and discuss an action research experience carried out with an indigenous community in the Brazilian Amazon that suffers from serious sanitary problems, where cultural aspects in the relationship with the environment and health are particularly relevant. Different types of tools were deployed and combined and were subsequently classified according to their dialectic efficacy and ability to both conduct and steer the research and encourage the participation of social actors within a process of feedback. Even tools that were considered to be non-dialectic proved to be important sources of feedback. We present a research flow as a model of analysis and a framework for implementing action research, in which challenges to the participation of social actors are classified according to their priority through a critical review of the methodology developed. These challenges are social mobilization, co-operation, appropriation and a proactive stance. We conclude that a cyclic combination of dialectic and non-dialectic tools can increase participation, which though difficult to achieve is nevertheless necessary. During the development of this process, social mobilization is a prerequisite, whereas a proactive stance, the highest level of participation, requires continuous effort and the successive deployment of a variety of tools.
为了理解复杂的健康和环境问题并采取行动，我们打算分析风险人群参与研究和干预项目所需的条件。在本研究中，我们描述并讨论了与巴西亚马逊地区一个存在严重卫生问题的原住民社区开展的行动研究经验，在该社区，与环境和健康相关的文化层面尤为重要。我们部署并组合了不同类型的工具，随后根据其辩证功效、开展和引导研究的能力以及在反馈过程中鼓励社会行为者参与的能力进行了分类。即使是那些被认为不具有辩证性的工具，也被证明是重要的反馈来源。我们提出一种研究流程作为分析模型和实施行动研究的框架，在该框架中，通过对所开发方法的批判性审查，根据社会行为者参与的挑战的优先级对其进行分类。这些挑战包括社会动员、合作、认同和积极主动的态度。我们得出结论，辩证性和非辩证性工具的循环组合可以提高参与度，尽管这很难实现，但却是必要的。在这个过程的发展中，社会动员是前提条件，而积极主动的态度作为最高水平的参与，需要持续努力并相继部署各种工具。
