University Centre for Rural Health, The University of Sydney, Lismore, New South Wales, Australia
The School of Public Health, The University of Sydney, Sydney, New South Wales, Australia.
BMJ Glob Health. 2021 Jan;6(1). doi: 10.1136/bmjgh-2020-003852.
Indigenous communities worldwide are leading calls for all research involving Indigenous people to be underpinned by values and principles articulated by them. Many researchers are explicitly adopting these principles to guide what, where, how and when research is undertaken with Indigenous people. With critical reflection to support the implementation of such principles largely absent from published literature, this paper explores both the implementation of, and the outcomes from a set of guiding principles used in a large-scale Australian research collaboration to improve Indigenous health.
In this inductive qualitative study, we adopted a principles-focused evaluation approach. Based on interviews with 35 actors in the collaboration and a review of project documents, we generated themes that were then iteratively discussed, refined and categorised into (1) 'strategies'-activities by which implementation of our guiding principles were recognised; (2) 'outcomes'-results seen from implementing the principles and (3) 'conditions'-aspects of the context that facilitated and constrained implementation of the principles.
Respondents found it difficult to articulate how the guiding principles were actually implemented, and frequently referred to them as part of the fabric of the collaboration. They viewed the set of principles as mutually reinforcing, and as providing a rudder for navigating complexity and conflict. Implementation of the principles occurred through five strategies-honouring the principles; being dynamic and adaptable; sharing and dispersing leadership; collaborating purposefully and adopting a culture of mutual learning. Outcomes included increased Indigenous leadership and participation; the ability to attract principled and values-driven researchers and stakeholders, and the development of trusting and respectful relationships. The conditions that facilitated the implementation of the principles were collaborating over time; an increasing number of Indigenous researchers and taking an 'innovation platform' approach.
Our findings show that principles guiding collaborations are valuable in providing a focus, direction and a way of working together when they are collaboratively developed, hold genuine meaning for all members and are implemented within a culture of continuous critical reflection, learning and adaptation, with ongoing reinterpretation of the principles over time.
世界各地的土著社区正在呼吁所有涉及土著人民的研究都以他们阐述的价值观和原则为基础。许多研究人员明确采用这些原则来指导与土著人民一起进行研究的内容、地点、方式和时间。由于发表的文献中基本上缺乏对这些原则实施情况的批判性反思，本文探讨了一套在澳大利亚大型研究合作中使用的指导原则的实施情况及其结果，以改善土著人民的健康。
在这项归纳性定性研究中，我们采用了以原则为重点的评估方法。基于对合作中 35 名参与者的访谈和对项目文件的审查，我们生成了主题，然后对这些主题进行了反复讨论、改进和分类，分为（1）“策略”-实施我们的指导原则的活动；（2）“结果”-从实施原则中看到的结果和（3）“条件”-促进和限制原则实施的背景方面。
受访者发现很难具体说明指导原则是如何实际实施的，并且经常将其作为合作的一部分来提及。他们认为这组原则是相互加强的，并且为应对复杂性和冲突提供了一个指导方针。原则的实施通过五种策略来实现：尊重原则；保持动态和适应性；分享和分散领导力；有目的地合作并采用相互学习的文化。实施原则的结果包括增加了土著领导人和参与；有能力吸引有原则和价值观驱动的研究人员和利益相关者，并发展出信任和相互尊重的关系。促进原则实施的条件是随着时间的推移进行合作；增加土著研究人员的数量并采用“创新平台”方法。
我们的研究结果表明，当合作制定、对所有成员具有真正意义并在持续批判性反思、学习和适应的文化中实施、并随着时间的推移对原则进行不断重新解释时，指导合作的原则对于提供重点、方向和合作方式是有价值的。
