Participatory co-design of science communication strategies for public engagement in the US and Ecuador around health behaviour change

Introduction

Over the last three decades, science communication scholars have shown that to promote a deeper engagement with audiences and the broader public, it is necessary to develop research that empowers and includes audiences’ voices and interests around different scientific disciplines (Bucchi and Trench, 2008; Holliman et al., 2009).

More frequently, science communication research and practice have used linear-communication theoretical models, such as diffusion of innovations (Rogers, 2010) and the transmission model (Leach et al., 2008). Similarly, the deficit model (Bucchi, 2008) has inspired research approaches that focus primarily, or even exclusively, on disseminating and transmitting, in a one-way fashion, scientific information from academia to the public. However, these models do not consider opening the discussion between academic researchers and members of the public. Thus, each of these research traditions has led to research and practice that explore unilateral communication of science, while ignoring the need to create deeper audience engagement.

Currently, science communication is defined as the use of appropriate communication skills, media and dialogue to produce audience awareness and practical responses around scientific information (Bowater and Yeoman, 2013). Yet, science communication needs to build sustainable science–society relationships, and it can benefit from exploring community engagement. More frequently, community engagement has been applied in health contexts, through communication and education to target populations, and it can be used alone or as part of larger strategies (O’Mara-Eves et al., 2013).

This article presents an alternative research design to establish an egalitarian research framework based on qualitative and participatory action research (PAR), decolonial epistemologies and media theories used in combination. Thus, such a framework can motivate collaboration among researchers and young audiences as co-researchers using egalitarian procedures to manage power relations. The overall goal of the study was to explore how to co-design engaging strategies around two already existing nutrition and physical activity programmes.

The evolution of science communication: from dissemination to public engagement

Science communication research movements have evolved from the deficit paradigm to dialogue models. In the 1990s, science communication was referred to as ‘scientific literacy’ (Gregory and Miller, 1998) or as ‘public understanding of science’ (Stilgoe et al., 2014), approaches using the deficit model as their theoretical foundation (Bucchi, 2008). The deficit model assumed that: (1) all scientifically relevant knowledge belongs to academics; (2) exposing people to scientific content will alone motivate its appreciation; and (3) the point of departure for science communication is the assumption that audiences do not have the knowledge or competencies to understand science (Bowater and Yeoman, 2013).

Consequently, science communication developed under the deficit model primarily were dissemination initiatives. Scientific findings were then passed along from researchers to communication practitioners at research institutes or universities, with the assumption that these communication co-workers would then relay the findings to the public – despite the fact that few practitioners had prior training in science communication (Friedman et al., 1999). Compounding the problem, researchers were involved minimally, if at all, in the communication strategy design or the actual content to be relayed to the public. As a result, not surprisingly, science content was frequently misreported by the media (Stilgoe and Wilsdon, 2009).

However, by the 1990s, the alternative theoretical paradigm of dialogic models emerged, emphasising dialogue between scientists and the public. Dialogic models proved to be so successful that the Royal Society proposed its members set aside deficit models and adopt dialogic approaches to successfully promote public engagement (Holliman et al., 2009). Since the turn of the twenty-first century, science communication studies have regularly suggested that scholars explore methodological alternatives to overcome the barriers that the deficit model erected between scientists and society.

Additionally, practitioners of science communication for public engagement (Bucchi and Trench, 2008; Bowater and Yeoman, 2013), the newest research movement, suggest that PAR as a methodological paradigm can support the development of more inclusive research and, in so doing, can overcome many contemporary science communication challenges. Over the last two decades, most enquiry has addressed introduction of dialogical practices among researchers and their target audiences (Brossard et al., 2005), for example, through citizen science (Cooper, 2016), by focusing on media reporting on science (Dunwoody, 2014), or by exploring the effects on audiences of using social media to communicate science, as well as such effects on scientific content itself (Brossard and Scheufele, 2013; Lee et al., 2018).

Participatory action research in science communication research

PAR has its origins in two interrelated traditions: Kurt Lewin’s (1946) action research and Paulo Freire’s 1970s approach to co-learning processes (Freire, 2010). Lewin proposed a cyclical problem-solving process, through promoting people’s participation in planning, analysing and implementing different solutions (Minkler, 2004), while Freire (2010) proposed a process whereby the researcher acts as a facilitator of dialogue and capacity building for empowering people through interaction, interchange and mutual learning. Following these traditions, PAR studies unite experts and citizens around topics of mutual interest, with the two groups working as co-researchers participating in an egalitarian framework to find solutions to a given problem (Chevalier and Buckles, 2013; Hacker, 2013).

PAR methodologies, then, can bring new opportunities to science communication, allowing scholars and members of the public to jointly explore the perspectives of society around science. Science communication studies can, and must, also consider creating resources and learning spaces (Davies et al., 2009) and promoting dialogue among scientists and audiences of different ages, cultures and education (Van Dijck, 2003).

Decolonial research and community engagement

Developing a decolonial enquiry means designing and conducting research from a community/society standpoint (Denzin and Lincoln, 2008; Smith, 1999). Researchers must be open to sharing voice and agency with the people involved in research, doing so by facilitating the collaborative development of objectives, research questions, data collection and analysis.

In contrast to Western epistemologies, in decolonial research, people are not merely seen as human subjects of study from which to extract data but, rather, as equal co-researchers (Smith, 1999; Tuck, 2009). People participate in the research process by using their experiences, cultural history and local knowledge to discuss and address issues related to their needs and/or interests (Walsh, 2017). Here, the role of researchers is to facilitate and co-design along with the people a process whereby they dismantle their struggles and promote capacity building through tools to support participants (Smith, 2013).

In terms of epistemology, decolonial methodologies facilitate designing research procedures that reflect critically upon Western systems of knowledge and those systems’ tools, and that set as priorities the participation of society and researchers (Denzin and Lincoln, 2008). The tensions between researchers and vulnerable populations are the result of decades of unequal relations dictated by knowledge extraction and appropriation (Jojola, 2008; Tuck, 2009). Therefore, significant challenges exist in terms of establishing relationships of mutual trust and openness to collaboration for researchers who aim to work with culturally diverse populations.

Decolonial scholars in the Global North (Porter, 2010; Smith, 2013) have applied the principle of humanising the enquiry process in culturally diverse populations affected by oppressive power structures that relegate them to vulnerable positions. Also, science communication researchers must always acknowledge the contextual reality of ‘scientific rigour’ and ‘objectivity’ as they affect people, and become aware of the harms inflicted through the very process of scientific research, in order to correct for these unintended effects. Consequently, researchers are challenged not only to create knowledge, but also to suggest practical solutions leading to tangible actions that people can take to overcome their problems.

Regarding community engagement, Chambers (1994) describes the conundrum faced by all academics attempting to employ PAR and development paradigms. Participation has three uses and meanings: cosmetic labelling, to look good; co-opting practice, for securing local action and resources; and empowering process, to enable people to do things themselves.

PAR methodologies have been shifting from a top-down paradigm towards a diversified, bottom-up approach. This implies a transfer of power from ‘uppers’, who have been dominant, to ‘lowers’ (people, institutions and disciplines) who have been subordinate. Participatory approaches to research and development tend to hide underlying changes in philosophy and practice. Empowerment of marginalised people requires reversals and changes in an egalitarian fashion. Thus, PAR approaches face significant challenges to their use as they require changes to bureaucratic procedures and cultures, including more participatory management (Chambers, 1994).

Chambers’ (1994) work spotlights the shortcomings of traditional participatory research and development, and it sets the stage for an evolving PAR paradigm which seeks to eliminate the stark divisions between ‘uppers’ and ‘lowers’, to cast community members as co-researchers, and to bring PAR into the emergent realm of relational communication and relational dialectics 2.0; that is, placing PAR and health promotion squarely in the dialogic arena (Chambers, 1994; Halliwell, 2016).

The literature of community engagement privileges the role of those impacted by particular issues in the solution of those same problems. Proceeding from theories of marginalisation and its consequences, Aday et al. (2015) designed and implemented collaborative community health interventions in Central America, engaging undergraduate university students and community members to identify emergent health issues and their solutions. Having employed participatory and community action methodologies, Aday et al. (2015: 22–3) wrote:

we believe that the theory of marginalization and alienation helps us to better understand the context in which we find the observed problems of health and health care. This theoretical understanding prepares us to ask better, more focused questions about our own role in the communities in which we work.

The efforts of Aday and colleagues (2015) increased communication among community residents, facilitated the development of co-researchers’ construction of community-endorsed five-year plans, and established partnerships with regional and international groups. This approach informed our own work with young students from marginalised communities as co-researchers.

Our work also comports with the Ottawa Charter for Health Promotion (World Health Organization – Europe, 1986: n.p.), which lists as prerequisites for health ‘peace, shelter, education, food, income, a stable ecosystem, sustainable resources, social justice, and equity’. The two case studies described in this article sought to base their work in social justice and equity through the recruitment of co-researchers from the ecosystem being studied and by granting those co-researchers roles in all aspects of the studies, including the definitions of research questions and intervention methodologies.

Methods

Here we describe two case studies, including their functions and goals. We also discuss the methodological design for the study, and its research procedures, as guided by several decolonial theories, along with data collection tools and analysis.

PAR and qualitative research adapted to science communication

For this study, PAR and qualitative research were combined. The qualitative research framework used multiple case-study designs (Yin, 2012, 2017) with embedded units of analysis. This approach is regarded as more robust than that taken in single case studies because its results can be compared and thus can provide more generalisable data in two or more different scenarios (Herriott and Firestone, 1983). Consequently, the multiple case study enabled the researchers and co-researchers to identify differences, similarities and cultural considerations, and to develop science communication strategies, in two research programmes – one in the US and one in Ecuador – which have similar goals. The embedded units of analysis respond to each of the research questions. It is important to clarify that the design of the study was developed by the researchers. To follow the criteria of PAR studies developed using decolonial guidelines, the researchers and co-researchers initiated their collaboration after their recruitment to discuss research questions and procedures for the co-design participatory workshops and data analysis.

Self-reflexivity practices and designing a participatory science communication study

This study was designed as a collaboration among researchers and young audiences; for this reason, it was crucial to incorporate self-reflexivity practices for the researchers. As the PAR framework promotes egalitarian agency and participation of audiences, researchers were required to acknowledge their privilege and power, and how they would position themselves in the study in relation to the audiences for the health programmes. For this purpose, we combined guidelines suggesting decolonial considerations by Andrea Smith (2013) in order to develop a practice of self-reflexivity prior to finalising the overall research design and approach to audiences. Decolonial guidelines were crucial in managing possible power imbalances among the interests of the researchers and the needs and interests of co-researchers. Consequently, the researchers developed a self-reflexivity exercise before the first contact with the co-researchers of each case study.

The self-reflexivity exercise was conducted by one of the researchers of this study as a one-hour session with the researchers at ESPH in Albuquerque, and later separately with the researchers of ACTIVITAL in Cuenca. We combined the notions of co-learning processes (Freire, 2010) and the critical approach of self-reflexivity (Smith, 2016) for balancing power and agency. Before the session, the researchers were asked to bring a clear written statement acknowledging their privilege in terms of socio-economic characteristics, and describing their personal identifications in terms of gender, race, culture and ideology. During the session, the researchers were asked to disclose how they would use the emerging data to ensure mutually beneficial outcomes for the co-researchers and their programmes, focusing not only on scientific outcomes, but also on activities that would promote healthy habits with young audiences, and provide voice and agency to the co-researchers in the co-design process.

As a result, researchers agreed to the following procedure:

• In the first of the four co-design workshops, dedicate time to set the rules with the co-researchers to enhance egalitarian agency and decision making.

• Include the co-researchers in refining the research procedures, in order to promote their agency in the co-design process.

• Respect the opinions, needs and interests of co-researchers by supporting their ideas and suggestions for replacing specific interventions with new ones oriented to improving the audience´s engagement around the scientific content.

• Promote capacity building by teaching co-researchers about the use of participatory data collection tools, addressing co-researchers’ concerns, and countering any emerging misinformation about healthy habits with scientifically validated information.

Research procedures

Here we describe the methodological considerations that research procedures followed.

Co-researcher recruitment and trust building for creating a safe space for co-design

After developing an initial understanding of the audience contexts, we approached each programme in order to request access to the participants. In the case of ESPH, this involved writing to the principals of several Albuquerque high schools; ultimately, we were granted approval for research participation of the students of the Health Leadership High School, a charter school oriented to promoting health sciences careers. During our first visit, we explained the study and made clear to the students that our goal was to promote science communication around health programmes. At the conclusion of our visit, we provided informed consent/assent forms to the students who expressed interest and explained that, since they were underage at the time of the study, they would need the permission of their parents or legal guardians to participate as co-researchers. In the case of ACTIVITAL, the participants were already at least 18 years old. Consequently, we approached them through email; in our initial message, we presented information about the goals of the study, and we invited them to participate voluntarily.

We recruited 10 co-researchers for each health programme. From that point on, all decision making was participatory, to create trust. Together, co-researchers and researchers were guided by the authors of this study to work together to refine the research questions, select the dates and locations for the participatory co-design workshops, and create the policies that would guide the co-design process, as described in Figure 1. The co-researchers were invited to also provide the researchers with their questions of interest about healthy habits and about the scientific content of the study (that is, concepts, data collection methods, and any other doubts that they had). Responsibilities for the facilitation of the workshops were shared among the researchers and co-researchers.

Figure 1.

Rules for teamwork for Eat Smart to Play Hard (Source: Authors, 2022)

Compensation for co-researchers

This study compensated each co-researcher with US$40 in cash, as well as healthy snacks and materials for co-designing strategies.

Research questions

To develop the research questions, the researchers consulted with the co-researchers of both health programmes to agree on questions that addressed their interests. This practice was crucial to ensure a PAR design, reinforce collaboration and put in practice the decolonial guidelines created in the self-reflexivity sessions. The resulting research questions were:

• RQ1: How can researchers/scientists of health behaviour studies develop better science communication strategies for public engagement from the perspective of teenage/young-adult audiences?

• RQ2: How can teen audience engagement with science/health communication be improved?

RQ1 addresses how to create and develop science communication for public engagement. In this study, we had two focuses related to audience engagement: to evaluate the current communication engagement of the programmes, and to improve teen audiences’ engagement in science and health communication. We analysed collectively whether the suggested activities were effective in engaging young audiences, and how those activities could be improved or changed. RQ2 concerns how to create spaces and opportunities for collaboration among researchers and young people around healthy habits, and how researchers can develop strategies to motivate the audience’s engagement.

Data collection tools

As decolonial epistemologies suggest incorporating participatory methodologies to overcome power imbalances, finding suitable data collection tools was crucial. As Western data collection tools are seen as extracting information from research participants (Tuck, 2009), instead we used participatory data collection tools that use iterative processes for co-constructing knowledge (see Table 1).

Table 1.

Detail of data collection tools and co-design sessions (Source: Authors, 2022)

Research questions		Session	PAR data collection tools
RQ1	How can researchers/scientists of health behaviour studies develop better science communication strategies for public engagement, from the perspective of teenage/young-adult audiences?	1	PAR diagramming
		2	PAR diagramming
			Asset mapping
RQ2	How can teen audience engagement with science/health communication be improved?	3	Zines
		4	PAR diagramming

Participatory dialogue was an essential tool, focusing on the value of co-researchers’ knowledge and ‘real-life’ problems (Coburn, 2005) to develop activities, resources and messages that would support healthy habits. We used action-reflection cycles (McNiff, 2014) to facilitate discussions and to organise collective participation, analysis and proposed actions, and thus we were able to more productively identify crucial factors that could influence the implementation of strategies to promote audience engagement (see Figure 2).

Figure 2.

The action-reflection cycle process (Source: McNiff, 2014)

Among other PAR data collection tools, we applied participatory diagramming (see Table 1), which uses available materials (for example, paper, boards, colour-coded cards) to create charts that connect responses of participants with prompt questions that have the purpose to guide the discussion of co-design workshops guided by a facilitator (Kesby, 2000). PAR diagramming was used to organise the ideas to analyse the current programme’s strategies to connect them to suggestions for improving engagement or to propose new strategies.

We also used asset mapping (Chapin and Threlkeld, 2001), a participatory tool that uses maps to locate specific places that provide resources, and which allows several people to work simultaneously by using online platforms such as Google Maps. To this end, we focused on identifying each city’s information resources, as well as places we could use to organise events and activities to promote physical activity.

Finally, we used Zines (Chidgey, 2014), an arts-based tool that can combine drawings, collage and writing, and which uses simple materials such as paper and magazine cut-outs. Zines served to organise the overall strategies and their corresponding communication conduits and messages in order to motivate the creativity of the researchers and co-researchers.

Results

Regarding the demographics of the overall co-design teams, the three main researchers are a semi-diverse group. The first author is a Latinx female researcher with a PhD who is an assistant professor; the second author is a White male associate professor; and the third author is a White female associate professor. The ages of the researchers range from their 30s to their 70s.

Co-researchers of ESPH were the programme scientists and the children. Most individuals were Latin-Hispanic who were immigrants from Latin America (two programme scientists); there was also one White female scientist. The co-researchers were first-generation Latinos born in the US (three females and three males) ranging in age from 13 to 16; 4 of them were low-income DACA students. (Deferred Action for Childhood Arrivals is a programme of the US Citizenship and Immigration Service that provides youth with a work permit and protects them from deportation as they arrive and stay in the United States; Center for Diversity and Inclusion, Washington University in St. Louis [2018].)

The ACTIVITAL researchers were two Latinx female scientists who are professors and researchers. The co-researchers were all Latinx (three males and three females) ranging from 18 to 20 years old; they were first-year college students from middle- and low-income families who accessed higher education through government-funded merit scholarships.

Our study evidenced two important streams of findings in each programme: first, specific contextual considerations that influenced audience engagement and the development of co-designed strategies oriented towards improving such engagement; and, second, a set of useful guidelines for science communication for public engagement around health programmes.

In the case of ESPH (see Figure 3), we found that the current strategies and tactics were interesting and attractive to audiences. However, some of those tactics did not take into consideration certain limitations within some participants’ households; for example, many New Mexican families lack access to safe public parks or playgrounds. Another chronic limitation is that certain foods, such as fresh vegetables and some protein sources, are prohibitively expensive for low-income families.

Figure 3.

Contextual considerations of Eat Smart to Play Hard (Source: Authors, 2022)

We found ACTIVITAL’s programme strategy to be well thought out at the time of its implementation. However, to implement the programme during a time in which social media and other newer communication conduits are increasingly prevalent, it was crucial to create an interactive strategy approach, focused on developing learning for children, teenagers, their families and their teachers. Specifically, a hybrid online–offline approach was suggested which would combine activities and resources that are useful and interesting to ACTIVITAL’s audiences (see Figure 4).

Figure 4.

Creation of an interactive strategy for ACTIVITAL (Source: Authors, 2022)

Engagement activities for audiences

A specific activity co-designed by the ESPH participants was to create a cooking contest promoted with the hashtag #ESPHcooking (see Figure 5). In this activity, participants would be invited to upload to social media a picture of themselves cooking a healthy meal with their families and featuring the hashtag on their photographs. The winners would be those who generated the most ‘likes’, and they would win a gift card from grocery stores or sports venues.

Figure 5.

Co-designed strategy artwork for the #ESPHcooking contest (Source: Artwork developed by ESPH participants)

Additionally, considering the ESPH participatory co-design team’s confirmation that some low-income families cannot afford healthy food (vegetables, grains and proteins), the team agreed to involve food gardens and food pantries at local schools. To do so, they developed activities soliciting donations of seeds and canned foods, and recruited teachers and parents as volunteers. The team’s main goal was to provide free vegetables and other healthy foods often excluded from families’ grocery shopping due to limited budgets.

In the case of ACTIVITAL, the participatory co-design research team recommended developing a strategy that would combine online resources and outdoor activities. Through asset mapping, the co-design teams located public parks and recreation areas in which free monthly events could be offered. A crucial factor was to bring together children, teenagers, their families and researchers to participate in these fun physical activities, as well as in healthy habits discussion groups.

Discussion

Science communication for public engagement suggests two avenues for research. One would create spaces for interaction among scientists and the public as a first step towards establishing sustainable relationships that can lead to science–society partnerships (Bowater and Yeoman, 2013). The other suggests a new methodological design for future studies that prioritises dialogue. To this suggestion, several scholars agree that PAR methods are well suited for facilitating an egalitarian framework among scientists and members of the public for mutual collaboration (Stilgoe et al., 2014). The research design of the present study addresses these suggested avenues. Also, in each case study, the findings respond directly to each of the research questions and its units of analysis regarding how to create strategies that promote audience interest and engagement with scientific research about children’s and teenagers’ healthy habits.

At the same time, we found some significant differences and some similarities related to the cultures and contextual factors of the countries. These led us to various implications for the future planning and execution of science communication for healthy habits promotion with young audiences. These are discussed in the following sections.

Conclusions

Co-designing science communication strategies leads not only to creating resources that are useful for society, but also to new opportunities for strengthening the relationships between scientists and the general public.

Regarding RQ1, which focuses on how science communication can be improved from the perspective of young audiences, strategies to enhance engagement must combine online and offline tactics. While social media, as we have shown, can provide important platforms for achieving collaboration and public engagement, there is still a way to go. The present study shows that audiences want to dialogue with scientists and learn from them through in-person activities and by using digital conduits such as social media. Social media can also serve as strategic conduits for sharing interactive activities that can simultaneously motivate scientists and audiences to engage and enhance all parties’ understanding. Regarding RQ2, we can suggest that PAR methodologies provide opportunities to develop partnerships that can lead to future collaborative research that attends to the needs of local communities with initiatives for social change.

Indeed, PAR research opens opportunities to explore in depth the issues that people face, such as to adopt healthy behaviours, and it can also help to create feasible solutions. This is possible when researchers and their target audiences share an egalitarian space for research. Moreover, the co-design participatory approach facilitates processes in which scientists and members of the public can experience mutual learning around topics of common interest. In order to achieve participation, scientists need to open their studies to public dialogue, and to explore – with the collaboration of audiences – how to create initiatives that provide useful information and resources.

Finally, the willingness of researchers to participate and share their research with the public is a key component for engaging science communication. As this study shows, researchers’ involvement in dialoguing with their audiences and co-designing initiatives are the crucial factors motivating audience engagement.

Funding

This project was fully funded by the PhD Fellow Award (2018–19) of the Latin American and Iberian Institute of the University of New Mexico.

Declarations and conflicts of interest