Structural coercion in the context of community engagement in global health research conducted in a low resource setting in Africa.
Structural coercion in the context of community engagement in global health research conducted in a low resource setting in Africa.
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DOI：
10.1186/s12910-020-00530-1
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发表时间：
2020-09-21
影响因子：
2.7
通讯作者：
Desmond N
中科院分区：
文献类型：
--
作者：
Nyirenda D;Sariola S;Kingori P;Squire B;Bandawe C;Parker M;Desmond N
虽然在全球卫生研究中越来越多地促进社区参与，以改善伦理研究实践，但它有时会强迫参与，从而损害伦理研究。本文旨在讨论在低资源环境下社区参与所产生的一些伦理问题。一个定性的研究设计，重点是参与活动的三个生物医学研究项目的人种学案例研究，以深入了解社区参与经验丰富的多个利益相关者在马拉维。通过参与者观察，43次深入访谈和17次与社区领导人，研究人员，社区成员和研究参与者的焦点小组讨论收集数据。本研究采用主题分析法对研究结果进行分析和解释。结果表明，结构性胁迫的产生是由于社会经济背景，研究设计和研究利益相关者之间的权力关系等因素的相互作用。社区领袖、政府利益相关者的参与以及研究利益相关者之间的权力不平等影响了一些参与者对研究参与做出自主决定的能力。这些研究结果是在以下主题下提出的：将研究视为发展，研究参与者获得个人利益的动机，方言翻译对研究参与的影响力，以及领导者的强制力。该研究确定了与结构性胁迫有关的社区参与实践中的伦理问题。我们的结论是，社区参与本身并不能解决根本的结构性不平等，以确保社区得到充分的保护。这些结果提出了如何在社区参与以改善研究参与和确保自愿给予知情同意之间取得平衡的重要问题。
While community engagement is increasingly promoted in global health research to improve ethical research practice, it can sometimes coerce participation and thereby compromise ethical research. This paper seeks to discuss some of the ethical issues arising from community engagement in a low resource setting. A qualitative study design focusing on the engagement activities of three biomedical research projects as ethnographic case studies was used to gain in-depth understanding of community engagement as experienced by multiple stakeholders in Malawi. Data was collected through participant observation, 43 In-depth interviews and 17 focus group discussions with community leaders, research staff, community members and research participants. Thematic analysis was used to analyse and interpret the findings. The results showed that structural coercion arose due to an interplay of factors pertaining to social-economic context, study design and power relations among research stakeholders. The involvement of community leaders, government stakeholders, and power inequalities among research stakeholders affected some participants’ ability to make autonomous decisions about research participation. These results have been presented under the themes of perception of research as development, research participants’ motivation to access individual benefits, the power of vernacular translations to influence research participation, and coercive power of leaders. The study identified ethical issues in community engagement practices pertaining to structural coercion. We conclude that community engagement alone did not address underlying structural inequalities to ensure adequate protection of communities. These results raise important questions on how to balance between engaging communities to improve research participation and ensure that informed consent is voluntarily given.
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影响因子：
15.8
作者：
Farmer PE;Nizeye B;Stulac S;Keshavjee S
通讯作者：
Keshavjee S
“我们是研究人员和社区的眼睛和耳朵”：了解社区咨询小组在代表马拉维的研究人员和社区中的作用。
影响因子：
2.2
作者：
Nyirenda D;Sariola S;Gooding K;Phiri M;Sambakunsi R;Moyo E;Bandawe C;Squire B;Desmond N
通讯作者：
Desmond N
影响因子：
5.4
作者：
Sariola, Salla;Simpson, Bob
通讯作者：
Simpson, Bob
影响因子：
0.8
作者：
Mfutso-Bengo, Joseph;Ndebele, Paul;Molyneux, Malcolm
通讯作者：
Molyneux, Malcolm
影响因子：
4.1
作者：
Pickersgill, Martyn D.
通讯作者：
Pickersgill, Martyn D.