The Social Ecology of Power in Participatory Health Research.

As increasing value is placed on community engagement, co-creation, and transdisciplinarity as essential ingredients to improve policies; participatory health research has gained popularity as a promising avenue for stakeholders to collaborate and solve problems in innovative ways. Participatory research has a history of success but important caveats caution against romanticizing the approach. The assumption that participation will empower participants overlooks potential feelings of disappointment or exploitation amid power imbalances, vested interest, and representativeness issues. This article outlines a multilevel conceptual framework that explicitly situates power dynamics within a wider system of bidirectional interconnections operating at the individual, interpersonal, and structural levels. It then provides a practical tool to examine and address these dynamics in a comprehensive and systematic way. This can be helpful for researchers and community practitioners working in contexts where democratic principles are not broadly endorsed and where power dynamics operate in subtle ways.