Brubacher Laura J, Lau Lincoln L, Bustos Monica, Kelly Mijares Melinda, Lim Mar Krisha, Dodd Warren
School of Public Health Sciences, University of Waterloo, Ontario, Canada.
International Care Ministries, Metro Manila, Philippines.
Community Health Equity Res Policy. 2025 Jul;45(4):351-363. doi: 10.1177/2752535X241280353. Epub 2024 Sep 6.
This study explored the use of three participatory tools within a Philippines-based case study with community health workers (CHWs) by comparing and contrasting the process and data generated across the tools, and critically reflecting on adaptations and facilitation considerations that affected the tools' use. Facilitator notes and audio-recordings of discussions were integrated and analyzed thematically. Tools differed by the type of data generated: program-specific data related to CHWs' roles and responsibilities or data on broader structural factors. A stepwise approach within each tool facilitated focused, in-depth sharing, as did initial paired discussions that allowed exchange of knowledge and experiences among CHWs. Facilitators required topic- and context-specific knowledge to guide discussion effectively. CHWs discussed challenges and successes in their roles; program recommendations; and broader challenges related to healthcare delivery in their communities. This study contributes critical insights on the use of participatory tools to promote the inclusion of implementer perspectives in health program co-design, implementation, and evaluation.
本研究通过比较和对比三种参与式工具在菲律宾社区卫生工作者（CHW）案例研究中的使用过程及产生的数据，并批判性地反思影响工具使用的调整和促进因素，探索了这三种参与式工具的使用情况。主持人笔记和讨论录音进行了整合，并进行了主题分析。工具所产生的数据类型有所不同：与社区卫生工作者的角色和职责相关的特定项目数据，或关于更广泛结构因素的数据。每种工具中的逐步方法促进了有重点、深入的分享，初始的配对讨论也起到了同样的作用，这种讨论允许社区卫生工作者之间交流知识和经验。主持人需要具备特定主题和背景的知识，以便有效地指导讨论。社区卫生工作者讨论了他们在角色中的挑战和成功；项目建议；以及与他们社区医疗服务提供相关的更广泛挑战。本研究为使用参与式工具以促进在卫生项目的共同设计、实施和评估中纳入实施者观点提供了重要见解。
