Woodward Eva N, Ball Irenia A
Department of Psychiatry, University of Arkansas for Medical Sciences, Little Rock, AR, United States.
VA Center for Mental Healthcare and Outcomes Research, Central Arkansas Veterans Healthcare System, North Little Rock, AR, United States.
Front Health Serv. 2023 Jan 16;2:1070444. doi: 10.3389/frhs.2022.1070444. eCollection 2022.
As implementation scientists and practitioners engage community members and service users, reflexivity rises as a critical approach for managing power imbalances and effective collaborative work to promote equity. Reflexivity is an approach for acknowledging scientists' own positions, including their understanding and limits of how they view their phenomena of inquiry. We describe our perspective practicing reflexivity as an implementation science team new to community engagement.
We spent over two years learning principles of Community-Based Participatory Research (CBPR) to inform implementation science and practice, then applied CPBR principles into a new community-academic partnership in August 2020 for and with veterans of the United States Military living in rural Arkansas. We used five methods to practice reflexivity for the first time: identifying positionality, writing fieldnotes, obtaining mentorship on technical aspects, comparing head notes, and consulting reference materials.
We found multiple methods for practicing reflexivity to be feasible, although difficult to stay consistent with busy schedules. Fieldnotes especially required commitment and were important not to minimize. Written fieldnotes enabled us to reflect on successes and missteps, funneling into action planning. Head notes allowed emotional catharsis and to generate insights based on each other's perspectives. Referencing books or course modules reminded us of ideal CBPR principles. Discussion with mentors helped us with technical aspects and balancing real-world challenges with ideal CBPR principles. Our methods to practice reflexivity were valuable and directly impacted process and research outcomes. Future training for implementation science and practice might consider reflexivity practice as a core competency.
随着实施科学家和从业者与社区成员及服务使用者的接触，反思性成为管理权力不平衡以及开展有效协作工作以促进公平的关键方法。反思性是一种承认科学家自身立场的方法，包括他们对所研究现象的理解以及认知局限。我们将描述作为初次参与社区参与的实施科学团队，我们在实践反思性方面的观点。
我们花了两年多时间学习基于社区的参与式研究（CBPR）原则，以为实施科学和实践提供参考，然后于2020年8月将CBPR原则应用于与居住在阿肯色州农村的美国退伍军人建立的新社区 - 学术伙伴关系中。我们首次使用了五种方法来实践反思性：确定位置性、撰写实地记录、在技术方面获取指导、比较要点以及查阅参考资料。
我们发现多种实践反思性的方法是可行的，尽管要在繁忙的日程中保持一致很困难。实地记录尤其需要投入精力，且不能轻视其重要性。书面实地记录使我们能够反思成功与失误，进而用于行动计划。要点记录有助于情感宣泄，并基于彼此的观点产生见解。参考书籍或课程模块使我们想起理想的CBPR原则。与导师的讨论帮助我们解决技术方面的问题，并在现实世界的挑战与理想的CBPR原则之间取得平衡。我们实践反思性的方法很有价值，直接影响了过程和研究结果。未来实施科学和实践的培训可能会将反思性实践视为一项核心能力。
