Background Power imbalances between researchers and underserved communities perpetuate health inequalities by excluding those most affected by poor health outcomes from research processes. Traditional engagement approaches maintain academic control while offering superficial participation, creating what Arnstein's ladder of participation describes as tokenism rather than genuine citizen power. We will explore how participatory modes of conceptualisation can transform power dynamics through the development of Community Research Link Worker (CRLW) roles, demonstrating authentic collaboration that moves beyond consultation toward delegated power and citizen control. Methods Using Participatory Action Research methodology, we developed and iteratively refined the IBISES model (Identify community, Build relationships, Investment in training, Support CRLWs, Empower through co-production, Sustain relationships) across six research projects with underserved communities over a three year cycle. Our approach embedded community voices throughout the research cycle, from priority-setting to dissemination, challenging traditional researcher-participant hierarchies. The interpretive analysis process itself became a site of power redistribution. Meaning was co-created through joint analysis sessions where CRLWs and academic researchers collaboratively identified themes, with CRLWs providing essential cultural context that would otherwise remain invisible to academic teams. This participatory conceptualisation process fundamentally altered both the research questions being asked and the interpretations being drawn. Findings Our work demonstrates that genuine participatory conceptualisation requires systematic attention to power dynamics throughout the analytical process. When CRLWs were involved in thematic analysis of focus groups about contraception experiences, their cultural insights revealed that women viewed contraception within broader reproductive health contexts—a finding that redirected the entire research focus and would have been missed through conventional analysis approaches. The CRLW model enabled authentic co-production of knowledge, with communities identifying research priorities that reflected lived experiences rather than academic assumptions. For example, Roma community members revealed that addressing specific lung health conditions was impossible without first confronting cultural trauma from healthcare encounters—an insight that emerged through participatory analysis sessions but would have been absent from researcher-led interpretations. Implications This work demonstrates that rigorous interpretive analysis requires acknowledging and addressing power dynamics as methodological considerations, not merely ethical ones. Participatory conceptualisation through models like IBISES creates more accurate and contextually grounded interpretations while building community research capacity. The creative methods employed—including photovoice exhibitions, visual scribing, and community-led priority-setting—enabled knowledge mobilisation that reached policymakers and practitioners while maintaining community ownership of findings. This approach challenges under-conceptualised qualitative research in public health by demonstrating how theoretical frameworks like Cultural Trauma can illuminate systemic barriers while participatory analysis methods can generate more nuanced and actionable insights. Moving forward, healthcare research must embrace complexity by recognising that interpretive analysis is never neutral. When communities become co-analysts rather than subjects of analysis, research produces more rigorous, relevant, and transformative knowledge that can meaningfully address health inequalities through genuine collaboration rather than academic extraction.

This paper draws on two complementary approaches, namely critical cartography and walking interviews, which seek to move away from dominant ways of looking at resources and spaces from the top down and create a better understanding of the view emanating from the less powerful and from below. Critical cartography has sought to erode dominant narratives and destabilise the monopoly of the powerful in map and city making (Pezzino 2020), while walking interviews, as a recent review of their global use (Sun and Zhu 2024) found, enabled researchers to directly engage with and experience the life- worlds of respondents, becoming deeply involved in the process of knowledge transfer, and how individuals impart knowledge to others. There has been a long tradition of walking in ethnographic and anthropological research and more recently walking interviews are being used widely in the arts and humanities, environmental studies and health sciences (King & Woodroffe, 2017). Co-creating asset and place-based approaches to tackling refugee and migrant health exclusion (2024-2027) project uses both critical cartography and walking interviews approaches for the identification of health-related community assets in 12 sites across London and the East of England. It focuses on specific migrant and refugee groups (Afghans, Hong Kongers Syrians, and Ukrainians) and relevant European and non-European migrant groups specific to each site. Most participants have arrived in recent years through different routes of entry. Peer researchers across the different project sites led 80 walking interviews where research participants had to identify their key community assets in relation to food/nutrition, housing and access to services (eg. advice, health, legal, sport), and take pictures as part of the photo-voice approach utilized during the walking interviews. In presenting an intertextual analysis of this set of data, we are also contributing to a counter-cartographic approach that uses bottom-up and peer research-led representations of city making and localized community assets as experienced by a number of migrants. Whilst walking interviews seek to readjust the dynamics of power, we also seek to use the bottom-up knowledge to identify the ways community assets are accessed and the resources required to do so in order to reduce levels of exclusion and improve health and well being of migrants, asylum seekers and refugees.

International research has shown that food insecurity is a cause and consequence of poor physical and mental health. Families with young children, people living with disabilities, households receiving Universal Credit and households from ethnic minority groups are more likely to experience food insecurity. In the wake of austerity policies since 2010, Covid-19 and the cost-of-living crisis, diverse community organisations have started or increased food support in the UK. Our NIHR-funded mixed-methods study ‘Fair Food Futures UK’ explores the role of community organisations in shaping families’ experiences of food insecurity in two cities in England. The study is led by a multidisciplinary team of academics in public health, sociology, social policy, business and food systems studies, as well as representatives from two local authorities and a panel of members of the public (PPI). In this paper, we reflect on how we have navigated the diverse analytical approaches of our multidisciplinary team, in the context of different norms in analysing data and writing about and sharing findings. We consider how, in working as part of a large team, and with PPI members and participants, we build interpretations of our findings whilst trying to balance a need to be inclusive with a need to not over-burden people. We also consider the importance of using accessible language while engaging in deep conceptual thinking. We discuss how we have involved our PPI members, and reflect on our decision (part-way through our fieldwork) to bring participants together for photography workshops, taking a more participatory approach in the visual part of our study in our efforts to share the power of interpreting people’s stories through their photos. We consider possible benefits and risks, including regarding ethics and confidentiality, of pushing the boundaries of participation beyond PPI involvement, mixing up the roles and blurring the separation between researchers, PPI and research participants.

This paper draws from an applied health research doctoral project, focused on disabled children’s participation in healthcare decision-making. The new sociology of childhood has been striving since the 90s for an epistemological shift in childhood research wherein children are regarded as competent social actors whose voices should be elicited directly rather than through parents as proxies. This trend in childhood research is complemented by developments in international human rights law, most notably the UN Convention on the Rights of the Child, adopted in 1989 and its Article 12 on children’s right to be heard in all matters that affect them. The study deployed socio-legal analysis with a view to identifying the factors that influence disabled children’s involvement or the lack of it in important individual healthcare decisions. Undertaking comparative analysis between England and Serbia, the qualitative arm of the study reported in this paper recruited 16 disabled young people with different types of impairments, aged between 11 and 21, from both countries, 15 parents and 5 healthcare professionals from two NHS sites in England, to take part in a semi-structured interview. This paper focuses on methodological issues inherent to qualitative research with young people with learning disabilities (out of 16 recruited young people, 5 had learning disabilities). It seeks to critically reflect on ethical challenges and methodological choices made in the research process to adapt the interview method to respond to the communication preferences of this group of young people. Moreover, it answers the research question of how the voice of young people with learning disabilities can be understood and supported to foster their effective participation in the research. Findings indicate that the ‘mosaic’ approach to methods of engagement works well, as one size does not fit all. ‘Mosaic’ approach combines different creative methods based on communication preferences and the style of a young person. In this research, a combination of methods was used, including Google Jam Board application, closed questions, emoticons and graphic images to aid the expression of young people who are non-verbal and photo-elicitation. Findings also indicate that parents can be instrumental as ‘interlocutors’ and interpreters of young persons’ non-verbal communication and cues. This opens up the question of ‘whose interpretation’ emerges through the research assemblage and how authentic young people’s voices are. The paper offers theoretical developments grounded in new materialism and assemblage theory that rethinks children’s ‘voice’ not as an essential characteristic of an articulate child but as a socially produced through research assemblage comprised of material and non-material components such as technology, photographs, graphic images, communication devices and similar.

MigRefHealth is a multi-site, participatory work which aims to uncover, bottom-up, hyper-local community assets and to weave them into an accessible network of support for migrants, refugees and asylums seekers. Coherently with its UKRI-AHRC programme of funding ‘Mobilising community assets to tackle health inequalities’, MigRefHealth looks into making a contribution to level up inequalities focussing on three key social determinants of health – housing, food, and access to services – and among a number of pre-identified migrant and refugee groups. To respond to this goal, MigRegHealth adopts a community-based participatory action research approach which, against extractive methodologies, unfolds in several community forums, blurring the boundaries between data collection, consultation, and intervention activities. Each forum is co-designed with community partners and leverages on site-specific assets. It employs an ad hoc qualitative and creative method to explore and more inclusively capture the practices, experiences, and sentiments of migrant participants. Rooted in social justice and action research (Lewin, 1946), and conscientisation (Freire, 1978), MigRefHealth challenges power imbalances by privileging community and hyper-localised expertise from a multi-stakeholder perspective: lived-experience, lived-experience/researcher/practitioner, practitioner, health system, local authority decision maker, academia. It resonates with critical and decolonial approaches, addressing structural and epistemic inequalities by validating community expertise and resisting unidirectional knowledge transfer (Wallerstein et al., 2020). In this paper, we concentrate on the preliminary work done in the four urban fieldsites of London during the first two years of the study – where methods included photovoices, traditional storytelling, community cooking, and music making. Aligned with interpretive inquiry, MigRefHealth CBPAR co-constructs meaning through shared analysis, ongoing reflexivity, and experiential knowledge (Cornwall & Jewkes, 1995; Guba & Lincoln, 2005) – afforded by the study stakeholders. We untangle synergies and divergencies in the collaboration, teasing out different experiential knowledges, positions and interests within the team, and how these have impacted the iterative co-development of the project activities, including decision making on the different methods, data interpretation, and impact generation. We critically reflect on the processes behind each community forum, looking at power dynamics, pragmatic factors, rigour, adaptability, decision on what counted as data in the different creative methods and how these were to be interpreted. We also aim to draw broader reflections on the overall, complex methodology of MigRefHealth and how it advances the field of participatory, creative epistemologies and methodologies in health. Bio Dr Runa Lazzarino is a socio-cultural and medical anthropologist working at the intersection of migration/marginalised groups, global (mental) health, and advanced technologies in healthcare. Currently a Research Fellow in Migration and Health at Middlesex University London, she has held positions at UCL, Nottingham, and Oxford University. With a specialisation in human trafficking and modern slavery, Runa has been involved in research projects on vulnerable migrants' and refugees' mental health and parenting wellbeing, gender migrant domestic work, cultural competence in nursing care, computerised clinical decision support systems in hospitals and socially assistive robots in healthcare, spiritual and religious care needs during major health disasters. She has been integrating anthropological ethnography with critical, qualitative and creative methods for social and policy impact. Professor Erminia Colucci is a Professor of Visual Psychology and Cultural & Global Mental Health at Middlesex University London and Adjunct Professor at Gadjah Mada University (Indonesia). She specializes in suicide and suicide prevention, human rights in mental healthcare, domestic violence, spirituality and faith-based/traditional healing, and lived experiences of ‘mental illness’ and suicidal behaviour, focusing on low-and-middle-income countries, ethnic minorities, and refugee/displaced populations. With a background in Cultural Psychiatry, Visual Anthropology and Clinical and Community Psychology, she is an applied activist researcher employing arts-based and visual methodologies, particularly photography and ethnographic film-documentary and participatory creative methods, in her research, teaching/training and advocacy activities. Erminia founded Movie-ment and co-chairs the World Association of Cultural Psychiatry SIG on Arts, Mental Health, and Human Rights. She also co-founded and chairs the Middlesex University Visual and Creative Methods Research Group. Her arts-based/visual projects can also be found on https://movie-ment.org/.

This paper offers a reflexive account of my positionality as a Chinese anthropologist based in the UK, working on global health research in low- and middle-income countries (LMICs), particularly in Africa. Drawing on over a decade of experience in gender and health research as an early career researcher, I examine the tensions between critical engagement and the practical constraints shaped by political surveillance, racialised health systems, career progression, and the need to maintain professional relationships. My intersecting positionalities, being Chinese, trained in the West, and working on British-funded global health projects, have provided me with unique insights into the decolonising global health initiative. These positionalities allow for plural interpretations of data and context-sensitive reflections. However, they also impose layered limitations on how I interpret and critique power structures, particularly in relation to China’s and UK’s roles in LMIC health landscapes and the expectations of collaborators, funders, and host institutions. For example, my Chinese identity not only informs how I analyse China’s increasing investments in local health systems, but also shapes how local collaborators perceive and engage with me. Furthermore, political censorship in China can influence the extent to which I can critically reflect on China’s global health role. Working on UK-based projects offers valuable platforms and spaces for open debate, but also exposes me to racialised structures in academia and global health, where Asian researchers remain underrepresented. This raises important questions about how to sustain a critical, decolonial perspective while navigating institutional expectations, power dynamics, and the pursuit of career development. Finally, this paper discusses the tensions between maintaining professional relationships with local collaborators and the need to produce critical, ethically sound research. By reflecting on the intersections of identity, race, gender, funder affiliation, and research politics, I explore how we might uphold both critique and care in global health research. This paper aims to contribute to ongoing conversations about equity, positionality, and epistemic justice in decolonising global health.

Each year in the UK, cities host running events attracting thousands of athletes and spectators. To support the capacity at these events, roads and transport links are temporarily closed and onsite medical facilities are set-up for any injuries or illnesses (field hospitals, first aid posts, ambulances and tents) with a mixture of voluntary (St John’s Ambulance and the British Red Cross), public (National Health Service) and private providers (independent organisations such as Lakes First Aid). This paper draws attention to the organisation of temporary medical provision at these events, with a particular focus on the coordination of first aid volunteering teams when athletes or spectators need urgent medical attention. Drawing on ethnographic fieldwork, the paper focuses on the work of the British Red Cross Event First Aid Service at the Great North Run. This included twelve hours of observation and ten follow-up interviews with volunteers after the event, as well as analysis of five supporting materials. It became clear while shadowing volunteers at the event, that multiple classification schemes guided first aid response. These three classification schemes (The British Red Cross Priority Guideline Tool, NEWS2 and Patient Report Form) intertwined at different spatial temporalities throughout the patient’s first aid journey. This observation informed my research question: How are care and responsibility organised across different spaces and times during first aid treatment, and what organisational structures are in place to ensure patient treatment adheres to specific spatial and temporal boundaries? This ethnographic study highlights the work of first aid volunteers in organising medical treatment at temporary public settings – skilled volunteers are an under researched ‘profession’ in public health research. My research is interpretive as it became clear when shadowing volunteers that there were multiple boundaries that matter for the organisation of first aid response when requiring immediate medical attention at temporary public event settings. It was also evident when talking to volunteers that different first aid roles interpreted standardisation tools differently. For example, paramedics assumed they could use guidelines much more effectively compared to junior first aiders. I used this data and put it into dialogue with Science and Technology Studies frameworks around standardisation tools (Bowker and Star, 1999; Berg, 1997) and medical sociological literature on the role of triage infrastructures when organising care provision (Hillman et al., 2014; van Pijkeren, 2021). This analytical approach allowed me to develop my research around the work of triage infrastructures in guiding first aiders' responses at temporary events. My research is participatory, involving close collaboration with the British Red Cross Event First Aid Service to understand the situated nature of first aid provision. I was invited to a number of events with a regional volunteering team (small half-marathon events; large half-marathon events; 2-day festivals and an arena show) to observe first aid practice. This group also invited me to group training sessions and team-building events. This participatory ethnography revealed multiple 'invisible' boundaries involved when providing help. For example, first aid volunteering group dynamics (social), the trajectories of first aid careers (organisational), roles and responsibilities (professional) and the organisation of response (spatial and temporal).

This interpretative analysis explores the lived experiences of individuals seeking to access public health services in communities characterised by high levels of organised crime violence. Families enrolled in Mexico’s conditional cash transfer programme, Prospera, are required to attend regular public health checkups as a pre-requisite of their enrolment in the programme. However their access can be severely compromised by direct threats, intimidation, violent interactions, and a breakdown of public infrastructure. Fifteen semi-structured interviews with residents, healthcare provides, and community leaders in selected municipalities in Chihuahua, Mexico were conducted. The study examined how participants make sense of their precarious situations, how they interpret risk, and how they develop pathways to accessing care. Responses were analysed using descriptive and interpretative analysis. Key themes included: Calculating Risk; the continuous assessment of personal safety against health urgency; Ambiguity in trust; the reliance on familial and community networks with fluctuating trustworthiness; Navigation; pursuing healthcare use during incidents of situational violence. The analysis demonstrates how the pervasive presence of violence pushes individuals to become increasingly active interpreters of their environment, constantly adjusting their understanding of ‘safety’ and ‘possible’ healthcare access. Understanding this interpretative dimension is crucial for designing more resilient accessible public health in conflict-affected communities.