A participatory action research study of an intercultural communication strategy for improving the experience of cervical screening among minority ethnic women in the primary care setting

Concerns over low uptake of cervical screening among minority ethnic women have spurred much research and practical activity to address the problem. However, research in this area has tended to focus on the communication deficit of women, without addressing the social context. This has not only hindered a wider theoretical understanding of the problem, but it has perpetuated ineffective health promotion practice in this area. Using a Participatory Action Research (PAR) approach, the Real World project entitled Woman-to-Woman: promoting cervical screening to minority ethnic women in primary care, attempted to tackle the problem by involving both health professionals and women from the communities. This study examines in action the utility of PAR as a tool for intervention and its theoretical and methodological implications for research in primary care. Working in partnership, both professional and lay participants identified the problems from their own perspectives and generated solutions to resolve them. A communication strategy was formulated in which bi-lingual women from the communities were recruited as Community Health Educators to form an informed link between their respective communities and the primary care sector. The implementation of the strategy was evaluated by all the participants. This thesis presents the reflection on the research processes and key lessons learnt. Advantages and limitations of applying PAR in health promotion and health research are discussed. It concludes that the participation, action, and research are dynamic processes that are undergirded by power relationships. Changes are contingent upon personal, social and environmental conditions. The value of PAR as a research method in this case has led to meaningful discoveries and insights into the issue of minority ethnic women and cervical screening, which would be difficult to achieve using a conventional research model. As an intervention technique, this project has demonstrated the potential of PAR in building bridges between ideals and pragmatism, theory and practice, and professionals and communities. However, this study has also revealed major limitations of this approach, the development of PAR in the NHS requires these limitations to be address urgently.