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Involving Users, Empowering Communities,

Understanding and tackling ethnic inequalities in health An ESRC Research Seminar Series: 5 Monday April 24th 2006 ‘Cultural Competence in Health & Social Research: Emic and Etic Perspectives (My View or Their View)’. Involving Users, Empowering Communities,

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Involving Users, Empowering Communities,

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  1. Understanding and tackling ethnic inequalities in health An ESRC Research Seminar Series: 5 Monday April 24th 2006 ‘Cultural Competence in Health & Social Research: Emic and Etic Perspectives (My View or Their View)’ Involving Users, Empowering Communities, Verifying Results Rhetta Moran on behalf of RAPAR, 2006

  2. Structure • Theoretical model • Overview of RAPAR • Researching in action: intervening, interrogating, • organising… • Reactions …. • Current situation Rhetta Moran on behalf of RAPAR, 2006

  3. Meta-theory: language creation from below (1) All research is communicated and interpreted through language-based Aims Text…… Methods Results Analyses 1 + 2 = 3 (Moran and Butler 2001:61) Rhetta Moran on behalf of RAPAR, 2006

  4. Meta-theory: language creation from below (2) • The importance of language in the research process, its impact upon the • Formation of research questions • Methods adopted • Resultant findings • Analysis • Dissemination • is rarely recognised or explored • (Moran and Butler 2001:61) Rhetta Moran on behalf of RAPAR, 2006

  5. Meta-theory: language creation from below (3) • Volosinov (1986 (1929)), disappeared in 1930’s Stalinist purges: Rhetta Moran on behalf of RAPAR, 2006

  6. Meta-theory: language creation from below (3) • Volosinov (1986 (1929)), disappeared in 1930’s Stalinist purges: - Experience of human reality is communicated through language Rhetta Moran on behalf of RAPAR, 2006

  7. Meta-theory: language creation from below (3) • Volosinov (1986 (1929)), disappeared in 1930’s Stalinist purges: - Experience of human reality is communicated through language - Critical purpose of language is to communicate Rhetta Moran on behalf of RAPAR, 2006

  8. Meta-theory: language creation from below (3) • Volosinov (1986 (1929)), disappeared in 1930’s Stalinist purges: - Experience of human reality is communicated through language - Critical purpose of language is to communicate - Reality is both objective and intersubjective Rhetta Moran on behalf of RAPAR, 2006

  9. Meta-theory: language creation from below (3) • Volosinov (1986 (1929)), disappeared in 1930’s Stalinist purges: - Experience of human reality is communicated through language - Critical purpose of language is to communicate - Reality is both objective and intersubjective - Intersubjective (between people) reality is fundamentally affected by socioeconomic[cultural] position Rhetta Moran on behalf of RAPAR, 2006

  10. Meta-theory: language creation from below (3) • Volosinov (1986 (1929)), disappeared in 1930’s Stalinist purges: • - Experience of human reality is communicated through language - Critical purpose of language is to communicate - Reality is both objective and intersubjective - Intersubjective reality is fundamentally affected by socioeconomic(cultural) position - Competing views of reality held by different population groups co-exist in space and time Rhetta Moran on behalf of RAPAR, 2006

  11. Meta-theory: language creation from below (3) • Volosinov (1986 (1929)), disappeared in 1930’s Stalinist purges: • - Experience of human reality is communicated through language - Critical purpose of language is to communicate - Reality is both objective and intersubjective - Intersubjective (between people) reality is fundamentally affected by socioeconomic[cultural] position - Competing views of reality held by different population groups co-exist in space and time - Continual process of struggle, ‘contest’, over what the dominant meaning of reality is, and over means of communicating reality Rhetta Moran on behalf of RAPAR, 2006

  12. Meta-theory: language creation from below (3) • Volosinov (1986 (1929)), disappeared in 1930’s Stalinist purges: - Experience of human reality is communicated through language - Critical purpose of language is to communicate - Reality is both objective and intersubjective - Intersubjective (between people) reality is fundamentally affected by socioeconomic[cultural] position - Competing views of reality held by different population groups co-exist in space and time - Continual process of struggle, ‘contest’, over what the dominant meaning of reality is, and over means of communicating reality - What comes to prominence results from the contest: it is a refraction, not reflection, of reality Rhetta Moran on behalf of RAPAR, 2006

  13. Meta-theory: language creation from below (3) • Volosinov (1986 (1929)), disappeared in 1930’s Stalinist purges: - Experience of human reality is communicated through language - Critical purpose of language is to communicate - Reality is both objective and intersubjective - Intersubjective (between people) reality is fundamentally affected by socioeconomic[cultural] position - Competing views of reality held by different population groups co-exist in space and time - Continual process of struggle, ‘contest’, over what the dominant meaning of reality is, and over means of communicating reality - What comes to prominence results from the contest: it is a refraction, not reflection, of reality • How has this approach helped to shape the participatory • action research process? Rhetta Moran on behalf of RAPAR, 2006

  14. Physical Context: Social- economic- cultural- political Rhetta Moran on behalf of RAPAR, 2006 Material conditions, specifically situated in time and space: e.g. housing, employment, mix of people, form of government

  15. Physical Context: Social- economic- cultural- political Dominant Ideologies Rhetta Moran on behalf of RAPAR, 2006 Super-ordinate, refracted views about health/asylum seeking Material conditions, specifically situated in time and space: e.g. housing, employment, mix of people, form of government

  16. Physical Context: Social- economic- cultural- political Dominant Ideologies Contests over who is the person seeking asylum & why are they Rhetta Moran on behalf of RAPAR, 2006 Communicative action between people about health/asylum Super-ordinate, refracted views about health/asylum seeking Material conditions, specifically situated in time and space: e.g. housing, employment, mix of people, form of government

  17. Physical Context: Social- economic- cultural- political Dominant Ideologies Contests over who is the person seeking asylum & why are they PERSON SEEKING ASYLUM The ‘inner speech’ deriving from their lived experience RESEARCHER/PRACTITIONER Rhetta Moran on behalf of RAPAR, 2006 Communicative action between people about health/asylum Super-ordinate, refracted views about health/asylum seeking Material conditions, specifically situated in time and space: e.g. housing, employment, mix of people, form of government

  18. Physical Context: Social- economic- cultural- political Dominant Ideologies Contests over who is the person seeking asylum & why are they PERSON SEEKING ASYLUM Their ‘inner speech’, deriving from their lived experience RESEARCHER/PRACTITIONER PAR PAR Language/Action Action/Language Rhetta Moran on behalf of RAPAR, 2006 Communicative action between people about health/asylum Super-ordinate, refracted views bout health/asylum seeking Material conditions, specifically situated in time and space: e.g. housing, employment, mix of people, form of government

  19. RAPAR is: An acronym for Refugee and Asylum seeker Participatory Action Research • Spring 2001- RAPAR network forms in response to • introduction of forced dispersal, seedcorn funding follows • (Moran et al, 2002) • A collection of organisations and individuals well placed to create evidence bases about the needs of communities in the North West of England where people fleeing persecution have been dispersed by central government • An action network that begins to inductively develop constructive responses to evidence bases about need that derive from the lived experience of asylum Rhetta Moran on behalf of RAPAR, 2006

  20. Traditional maintenance of separation of researcher from both subject and subjects being studied… Researcher Practitioner Community member/ client/user Skills Experience Experience (work) (life) Explicit role/ Objectivity Objectivity Subjectivity position (about (about client) (about service/life) research Subjectivity issue) (about practice) Rhetta Moran on behalf of RAPAR, 2006

  21. Material Context: Social- economic- cultural- political Community Member/ Client/ User Practitioner Rhetta Moran on behalf of RAPAR, 2006 E.g. service delivery setting E.g. Public or private space Specific places/spaces/sites Researcher Material conditions, specifically situated in time and space: e.g. housing, employment, mix of people, form of government

  22. Material Context: Social- economic- cultural- political Community Member/ Client/ User Practitioner Interaction Rhetta Moran on behalf of RAPAR, 2006 E.g. Public or private space E.g. service delivery setting Researcher Material conditions, specifically situated in time and space: e.g. housing, employment, mix of people, form of government

  23. Material Context: Social- economic- cultural- political Community Member/ Client/ User Practitioner Rhetta Moran on behalf of RAPAR, 2006 RAPAR E.g. service delivery setting E.g. Public or private space Researcher Material conditions, specifically situated in time and space: e.g. housing, employment, mix of people, form of government

  24. What is PAR? • PAR is predicated on the democratic notion that oppressed and marginalized people can transform their social realities through education, research and action, while forwarding their own value system. People can empower themselves through examining their own situations… • Praxis as defined by Friere is a combination of action and reflection: Praxis without action is verbalism; while praxis without reflection is activism (Udas, 1998:603) Rhetta Moran on behalf of RAPAR, 2006

  25. RAPAR • Feb- Mar 2002 - RAPAR limited company and charity in process of development • May 2002 - RAPAR’s bid to lead SRB5 project in Salford • approved: • “to develop evidence about needs and action in • services with refugee people seeking asylum” • (Private Eye 2005) • Oct 2002 – First destitution presentation (Moran, 2003) Rhetta Moran on behalf of RAPAR, 2006

  26. RAPAR and the SALFORD RAPAR SRB5 PROJECT • Oct 2002 – Disseminates about destitution to Accommodator • Oct 2002 – Destitute man imprisoned: When people come to this country, applied for asylum, been refused and have gone right through the appeals system, they can end up in the situation of the man I visited….without the right to work, without support and without accommodation: i.e. destitute. It should be no surprise that a person in such a situation resorts to crime in order to live. My view is that in a civilized society, no-one should be left in that situation: support should be maintained until either the individual leaves the country or his status here is resolved.” Email correspondence from Reverend to author, 31.10.02 17:58:52 Rhetta Moran on behalf of RAPAR, 2006

  27. Learning Opportunity with RAPAR hosted by the Revans Institute for Action Learning and Research, University of Salford, Thursday 5th June, 2003 Mother facing eviction into destitution: “after everyone has tried to help me I am feeling better. My GP visited me he told me he would try to help me. The assessment people came and told me, 2 or 3 times ‘we believe you’. I told them: ‘I have 2 arms and 2 eyes and think about me… what I have left…think about me… I am not a piece of paper’.” Rhetta Moran on behalf of RAPAR, 2006

  28. Overview of case example: All the persons involved in the case – service users, service providers, community members – have been anonymised and the real- time framework within which the events occurred has been removed. Our purpose being: To create a constructive atmosphere, free from the drive to find one – or some – to blame, within which we can all learn for the future. Rhetta Moran on behalf of RAPAR, 2006

  29. Rhetta Moran on behalf of RAPAR, 2006

  30. What is participatory action research? Research that captures what is going on in the world and understands what is happening to the selves involved in the research as moments of intersection between their biography and history within society. (Building on from Wright Mills, 1959) Research conducted by a mutually respectful collective interested in ‘the practical application of ideas to material reality so that incomplete and inexact knowledge becomes more complete and more exact’ (Building on from Lenin, 1972: 111) Rhetta Moran on behalf of RAPAR, 2006

  31. What is the purpose of participatory action research? To understand an idea one must be able to apply it in practice, and to understand a situation one must be able to change it. Verbal description is not command enough. [We describe successful theory] as consistently replicated and successful practice that distil[s] and concentrate[s] the knowledge. (Building on from Revans 1982:494) The process by which one is transformed into the other is the scientific method and the essence of the scientific method is the experimental test. (Revans 1982:494) Rhetta Moran on behalf of RAPAR, 2006

  32. The super-ordinate reaction to this experimental test has been to seek to stop the experiment: • Requisition the laboratory – occupy the place of safety (Private Eye, January 2005) • Silence the researching practitioners/clients inside of it (Miwanda Bagenda, (2006)) • Dis-locate the researching practitioners/clients outside of it (Greenham and Moran (2006), Temple and Moran (2006)) BUT The outcome of the experimental test is - as yet - unknown…. (Baty, 2005: Times Higher Educational Supplement, 21st October) (Asthana, 2006: Observer Newspaper, 19th February) Rhetta Moran on behalf of RAPAR, 2006

  33. The issues dealt with on a day-to-day basis included people with compounded problems, many of which arose from the forced dispersal programme. The city had other support groups dotted about and doing bits and pieces with people seeking asylum but ours was the first project to operate at a citywide level and in a very different way: by including the refugee people seeking asylum in the development of the project from the outset and by seeking to understand, document and communicate how the individual issues that presented related to the wider social context and networks within which they were located. (Miwanda Bagenda, 2006) Rhetta Moran on behalf of RAPAR, 2006

  34. Participatory action research with refugee and asylum seeking people in Manchester (Moran et al, 2006) RAPAR, 2006

  35. Contact details: RAPAR The Congolese Centre Cobden House Cobden Street Salford Greater Manchester M6 Email: BigRapar@yahoo.co.uk Rhetta.moran@ntlworld.com FREEPHONE: 0800 458 7598 Registered Charity 1095961 Company Limited by Guarantee 04387010

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