Facing Power: Navigating Power Dynamics in a Youth Participatory Action Research Project Situated within a Healthcare Setting

Background and Purpose: Scholarship on Youth Participatory Action Research (YPAR) asserts that this method is guided by the following principles: power-sharing (researcher and participant; adult and youth), shared decision-making, legitimation of various forms of knowledge including community members’ lived experiences, and an orientation towards collective action and social change. However, research also suggests that community-engaged projects such as YPARs can reproduce and exacerbate existing power differentials between researchers and community members.

In order to uphold YPAR’s principles of equity, inclusion, and collaboration, additional research is needed to understand how YPAR participants –youth and adults alike–navigate, negotiate, and contest power differentials and emerging power dynamics during the course of a YPAR project. In this study, we examine these processes by conducting in depth semi-structured interviews with adult facilitators (n=6) and youth members (n=8) engaged in a YPAR project. We seek to answer the following research question: How do youth and adult participants perceive and negotiate power dynamics in a YPAR project situated within a healthcare setting?

Methods: We conducted in depth semi-structured interviews (n= 42) with YPAR adult facilitators and youth participants at three timepoints across the project; at baseline (August 2020), mid-point (December 2020), and exit (April 2021). Semi-structured interviews (62mins on average) covered topics including YPAR members’ motivations and expectations for the project, their experiences within the project, their reflections on youth-adult partnerships, and their perceptions of the challenges and successes, as well as power dynamics, within the project. Interviews were audio-recorded and transcribed verbatim. We then conducted thematic data analysis by 1) reading and rereading the transcripts to immerse ourselves in the data, 2) coding interview transcripts (n=10) to develop an initial codebook, 3) applying the codebook to the remaining interviews, 4) collating codes into themes, 5) exploring the relationship between codes and themes across levels, and 6) selecting illustrative quotes to demonstrate the themes.

Findings: Our analyses suggest that power dynamics in a YPAR project materialize both within (internal power dynamics) and outside of (external power dynamics) the YPAR project, especially if the project is interdisciplinary in nature. While most scholarship on YPAR training and preparation materials focuses on attending to age differentials or adultism, our findings suggest that other power dynamics (racial, economic) often take precedence over age-related differentials. As such, youth in particular emphasized the need to incorporate an intersectional lens when identifying and confronting YPAR power dynamics. Finally, as articulated by all YPAR members, the sustainability of equitable and inclusive YPAR projects depends on creating spaces to acknowledge and process power dynamics that manifest in community-engaged research.

Conclusions and Implications: This study provides an in depth analysis of youth participants’ and adult facilitators’ reflections on power within YPAR at three different timepoints. Our findings suggest that YPAR projects require significant investment in resources including 1) time to reflect on and process power, and 2) robust and ongoing training–especially for adult facilitators–on how to engage in dialogue on power in order to authentically uplift youth voices within academic and healthcare settings.