Involving Users,

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
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• Structure
• Theoretical model
• Overview of RAPAR
• Researching in action intervening,
  interrogating,
• organising
• Reactions .
• Current situation

Rhetta Moran on behalf of RAPAR, 2006
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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 200161)
Rhetta Moran on behalf of RAPAR, 2006
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• 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 200161)

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

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

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

Rhetta Moran on behalf of RAPAR, 2006
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• Meta-theory language creation from below (3)
• Volosinov (1986 (1929)), disappeared in 1930s
  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
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• Meta-theory language creation from below (3)
• Volosinov (1986 (1929)), disappeared in 1930s
  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 socioeconomiccultural position

Rhetta Moran on behalf of RAPAR, 2006
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• Meta-theory language creation from below (3)
• Volosinov (1986 (1929)), disappeared in 1930s
  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
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• Meta-theory language creation from below (3)
• Volosinov (1986 (1929)), disappeared in 1930s
  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 socioeconomiccultural 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
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• Meta-theory language creation from below (3)
• Volosinov (1986 (1929)), disappeared in 1930s
  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 socioeconomiccultural 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
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• Meta-theory language creation from below (3)
• Volosinov (1986 (1929)), disappeared in 1930s
  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 socioeconomiccultural 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
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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
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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
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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/P
RACTITIONER
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
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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/P
RACTITIONER
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
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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
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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
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Material Context Social- economic- cultural-
political
Community Member/ Client/ User
Practitioner
Rhetta Moran on behalf of RAPAR, 2006
E.g. service delivery setting
Specific places/spaces/sites
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
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Material Context Social- economic- cultural-
political
Community Member/ Client/ User
Practitioner
Interaction
Rhetta Moran on behalf of RAPAR, 2006
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
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
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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, 1998603)

Rhetta Moran on behalf of RAPAR, 2006
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RAPAR

• Feb- Mar 2002 - RAPAR limited company and
  charity in
• process of development
• May 2002 - RAPARs 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
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(No Transcript)
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(No Transcript)
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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 175852

Rhetta Moran on behalf of RAPAR, 2006
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• 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 leftthink about me I am not a piece
  of paper.

Rhetta Moran on behalf of RAPAR, 2006
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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
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Rhetta Moran on behalf of RAPAR, 2006
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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
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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 distils and
concentrates the knowledge. (Building on from
Revans 1982494) 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 1982494)
Rhetta Moran on behalf of RAPAR, 2006
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• 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
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• 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
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Participatory action research with refugee and
asylum seeking people in Manchester (Moran et
al, 2006)
RAPAR, 2006
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Contact details RAPAR The Congolese
Centre Cobden House Cobden Street Salford Greater
Manchester M6 Email BigRapar_at_yahoo.co.uk Rhetta.
moran_at_ntlworld.com FREEPHONE 0800 458
7598 Registered Charity 1095961 Company
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