Benefits and Drawbacks of Using Community-Based and Participatory Approaches with Refugees with Disabilities: A Scoping Review

Background: Worldwide, the number of forcibly displaced people surpassed 103 million in Spring 2022, among them 32.5 million refugees. Refugees face turbulent journeys while fleeing war and conflict, resulting in higher rates of physical and mental disabilities—of 25.4 million refugees, 9.3 million had at least one disability. Refugees with disabilities often experience higher levels of discrimination and exclusion, which lowers their trust in institutions. This increased marginalization often makes it difficult to engage this hard-to-reach population, especially through conventional research methods, which often overlook communities' unique needs and priorities. To fill this gap, participatory approaches (PAs) have gained attention in research and programming. This scoping review researched types of PA and community-based approaches that have been used with refugees with disabilities, looking at the benefits and drawbacks of these approaches. Our findings provide a comprehensive understanding of PAs.

Methods: This scoping review was based on the Arksey and O’Malley’s (2005) framework. We conducted a systematic search of Google Scholar and four other databases to identify peer-reviewed articles written in English that included refugees with disabilities and used PA methodology. Exclusion criteria included reviews, non-English, samples without refugees with disabilities, and non-PA methods.

Results: We located 543 articles (672 minus 129 duplicates), with 44 eligible for full review after the titles and abstracts were examined, and 18 met the inclusion criteria. The review showed that diverse PAs have been used with disabled refugees. Community-based participatory research (CBPR) was the most common. This approach built trust and improved the rigor of the study by engaging participants to generate cultural insights. Other approaches empowered participants to voice their needs and take ownership of participating in the study. Benefits such as mutual learning, improved cultural sensitivity, and strengthened collaboration with the community were reported. Multiple challenges with using CBPR were identified, such as ethical concerns, scheduling conflicts, and the risk of retraumatizing participants. The second most used was community-based system dynamics (CBSD), which helped researchers disentangle complex issues, helped participants visualize their issues, and helped build capacity. Through CBSD, participants were able to prioritize the most common issue, build consent, and identify durable solutions. Community–partner approaches were the third most commonly used, with the main rationale of building trust between the researchers and the community. Insight from participants allowed the development of action steps, such as the hiring of patient navigators, and to develop concrete steps to reduce stigma.

Implications: This scoping review demonstrated the need for innovative approaches to reach and engage refugees with disabilities. To bridge this gap, PAs showed promising results by allowing researchers and participants to learn and increase study credibility. Most importantly, PAs allowed capacity building and community ownership. Nonetheless, it is essential to use PAs with caution, particularly related to planning ethical issues, providing accommodations, flexibility with the timing of the study, and preparing for public health emergencies.