3 - (SYM 16) “A Problem Shared Is a Problem solved:” Lay Counselor Perspectives on the Participatory Research Process

Background: Qualitative, mixed-method and other participatory research methods are increasingly used to center stakeholder voices in mental health research. While it is generally acknowledged that these methods are critical to advance mental health equity, little is known about stakeholders’ experiences with them. Given the power dynamics inherent in research, it is critical to examine the perspectives of participatory research partners and identify ways to improve these methods. 

Methods: This study builds from a stepped-wedge cluster-randomized-trial in Western Kenya, wherein teachers and community health volunteers were trained to provide trauma-focused cognitive behavioral therapy. Mobile phones emerged as a tool to supervise counselors from afar; however, their use was characterized by unique challenges. Informed by human-centered design, we first engaged counselors (n=24) and supervisors (n=3) in individual semi-structured interviews then hosted an in person participatory workshop to “co-design” solutions to optimize the use of mobile phone supervision. Led by experienced Kenyan supervisors, the workshop included a review of qualitative interview results as well as large and small group “co-creation” sessions. At the conclusion of the workshop, counselors participated in one of two focus group discussions regarding experiences in the workshop. Focus group transcripts were analyzed using thematic analysis. 

Findings: Overall, counselors expressed positive sentiments regarding the participatory research process. They enjoyed participating in semi-structured interviews and appreciated that their results were presented back for member-checking. Particularly with regard to the participatory workshop, counselors enjoyed working alongside other counselors. They felt it was a valuable experience to learn new strategies from their colleagues, and they enjoyed the “collaborative spirit” that emerged as they worked together to develop solutions. Counselors felt that varying small and large group discussions fostered participation by creating opportunities for more people to engage and share their thoughts. They suggested the approach be improved by providing more tangible materials (e.g., hand-outs) and more closely following a schedule of activities.

Conclusion: It is important to also center stakeholders’ experiences as partners in the research process. Though counselors mostly expressed positive sentiments, they also shared valuable suggestions for how to improve participatory research practices.