literature review action research

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3 Planning Your Research: Reviewing the Literature and Developing Questions

ESSENTIAL QUESTIONS

• What is relevant literature? What are the best ways to find it?
• What are the best ways to organize your relevant literature?
• What are the intended outcomes of reviewing your relevant literature?

Nearly all research begins with a review of literature that is relevant to the topic of research, even if it is only a casual review. Reviewing the available literature on your topic is a vital step in the research process. The literature review process provides an anchor for your inquiry. O’Leary (2004, p. 66) states, the “production of new knowledge is fundamentally dependent on past knowledge” because “it is virtually impossible for researchers to add to a body of literature if they are not conversant with it.” By reviewing the literature in the initial stages of the inquiry process, researchers are better able to:

• Understand their topic;
• Develop and focus a topic;
• Provide a clear rationale for, or better situate, their topic;
• Fine-tune their research questions.

In terms of thinking about methodology and the actual research process, reviewing the literature can help researchers:

• Identify well-vetted data collection and analysis methods on their topic;
• Determine whether to replicate a previous study, or develop a completely new study;
• Add rigor and validity to the research by validating the topic, methods, and significance.

Lastly, reviewing the literature also helps the researcher make sense of their findings, in both their field of study and in their educational context, by:

• Assessing whether the findings correlate with findings from another study;
• Determining which of the findings are different than previous studies;
• Determining which of the findings are unique to the researcher’s educational context. [1]

As you may see, the literature review is the backbone, anchor, or foundation of your research study. Overall the review of literature helps you answer three important questions that are the result of the bullet points outlined above. The literature review helps you answer the following:

• What do we know about your topic?
• What do we not know about your topic?
• How does your research address the gap between what we know and what we don’t about your topic?

After reviewing the literature, if you are able to answer those three questions, you will have a very clear and well-rationalized justification for your inquiry. If you cannot answer those questions, then you should probably keep reviewing the literature by looking for related topics or synonyms of major concepts.

While an extensive review of the literature about your topic of study is expected, you should also be realistic as to what you are able to manage. For topics that have a lot of research literature available, make sure you establish parameters for your research, such as:

• Temporal (e.g., only articles in the last 5 or 10 years)
• Content Area (e.g., only in science and math classrooms)
• Age or grade (e.g., only middle school classrooms)
• Research Subject (e.g., girls only, teachers, struggling readers)

These categories provide only a few examples, but parameters like these can make your review of literature much more manageable and your study much more focused.

What Types of Literature Should You Consider in Your Review?

It is helpful to consider the characteristics, purposes, and outcomes of different types of literature. Below are four broad categories I identify within educational research literature. I want to emphasize that my categories are in no way definitive, and only represent my own understanding.

Policy-Based Literature

Policy-based literature includes official documents that outline education policy with which the practitioner needs to be familiar. For example, the Common Core Standards or Content Standards are often refenced in articles to situate the need for research in relation to the standards; if my topic was on place-based education with middle school social studies students, I might have to look at national social studies standards. There also may be initiatives launched by organizations or researchers that become accepted practice. The documents that launch these initiatives (e.g., reports, articles, speeches) would also be useful to review. An example would be the Report of the National Reading Panel: Teaching Children to Read report from the National Reading Panel. These documents may provide rationale, based on the theories and concepts they utilize, and they may provide new ways of thinking about your topic. Similarly, if your topic is based on the local context, recent newspaper articles could also provide policy-type insights. All of these policy-based insights will be useful in providing the landscape or background for your work.

Theoretical Literature

Once you have identified your theoretical perspective, it is also important to locate your research within the appropriate theoretical literature. Many of you may be engaged in highly practice-based or small-scale research and wonder if you need a theoretical basis in your literature review. Regardless of the extent of your project, theoretical literature will help with the rigor and validity of your study and will help identify any theoretical views that underlie your topic. For example, if your study focuses on the place-based education in enhancing social studies students’ learning, it is highly probable that you would cite Kolb’s (1984/2014) work on Experiential Learning. By using Kolb’s work, you situate your research theoretically in the area of experiential learning.

Applicable Literature

Applicable literature will account for the bulk of your literature review. The previous two types of literature provide indication as to where your research is rationalized professionally and situated theoretically. Applicable literature will mainly come from journals related to your specific field of study. If I was doing a study in a social studies classroom, I would look at the journals The Social Studies, Social Education, and Social Studies Research and Practice . Use Google Scholar or your university library databases to examine literature in your specific area. When using these search engines and databases, start as specific as possible with your topic and related concepts. Using the example of place-based learning from above, I would search for “place-based learning” and “social studies” and “middle school” and “historic sites”. If I did not find many articles with this first search, then I would remove “historic sites” and search again. Books or handbooks on research may also have some useful studies to support your literature review section.

Methodological Literature

When sharing or reporting your work, you will want to review and cite research methodology literature to justify the methods you chose. When reading other research articles, pay attention to the research methods used by researchers. It is especially important to find articles that use and cite action research methodology. This type of literature will provide further support of your data gathering and analysis methods. Again, your methods should fit within your theoretical and epistemological stances. In addition, you’ll want to review data collection methods and potentially borrow or adapt rubrics or surveys from other studies.

Sources of Relevant Literature

When searching for these four types of literature, there are two ways to think about possible sources:

• primary sources include government publications, policy documents, research papers, dissertations, conference presentations and institutional occasional papers with accounts of research;
• secondary sources use primary sources as references, such as papers written for professional conferences and journals, books written for practicing professionals and book reviews. This is often called “reference mining” as you look through the reference lists of other studies and then return to the primary source that was cited.

Secondary sources are often just as valuable as primary sources, or potentially more valuable. When beginning your search, secondary sources can provide links to a wealth of primary sources that the secondary source author has already vetted for you, and likely with similar intentions. This is especially true of research handbooks. You will come across both types of literature wherever you search, and they both provide a landscape for your topic and add value to your literature review.

Regardless of being a primary or secondary source, you want to make sure the literature you review is peer-reviewed. Peer-reviewed simply means that the article was reviewed by two to three scholars in the field before it was published. Books, or edited books, would have also gone through a peer-review process. We often recommend teachers to look at professional books from reputable publishing companies and professional organizations, such as ASCD, NCTE, NCTM, or NCSS. This is a way for scholars to objectively review each other’s work to maintain a high level of quality and ethics in the publication of research. Most databases have mostly peer-reviewed journals, and often provide a filter to sort out the non-peer-reviewed journals.

Using the Internet

The internet is a valuable research tool and is becoming increasingly efficient and reliable in providing peer-reviewed literature. Sites like Google Scholar are especially useful. Often, and depending on the topic, the downside of internet-based searches is that it will generate thousands or millions of sources. This can be overwhelming, especially for new researchers, and you will have to develop ways to narrow down the results.

Professional organization websites will also have resources or links to sources that have typically been vetted. With all internet sources, you should evaluate the information for credibility and authority.

Evaluating sources from the Internet

Evaluating internet sources is a whole field of study and research within itself, and an in-depth discussion would take away from the focus of this book. However, O’ Dochartaigh (2007) provides a chapter to help guide the internet source evaluation process. Here is a brief summary, based on O’ Dochartaigh’s book, to give you a general idea of the task of evaluating sources:

• Examine if the material belongs to an advocacy group. Many times, these sources are fine, however, they require extra examination for bias or funding interests.
• As mentioned above, many academic papers are published in refereed journals which are subject to peer-review. Papers found on academic or university websites are typically refereed in some manner; however, some papers are posted by academics on their personal sites and have not been reviewed by other academics. Papers published solely by academics or other experts require further scrutiny before citing.
• When you are reviewing newspaper and magazine articles from the internet be weary of potential conflicts of interest based on the political stance of that periodical.

Therefore, it is wise to consider the objectivity of any source you find on the internet before you accept the literature.

We always recommend that students consider a few questions in their evaluation of sources, which are similar to the formal questions outlined by O’ Dochartaigh (2007):

• Is it clear who is responsible for the document?
• Is there any information about the person or organization responsible for the page?
• Is there a copyright statement?
• Does it have other publications that reinforce its authority?
• Are the sources clearly listed so they can be verified?
• Is there an editorial involvement?
• Are the spelling and grammar correct?
• Are biases and affiliations clearly stated?
• Are there dates for when the document was last updated or revised?

Organizing your Literature

When you begin, here are some things to think about as your read the literature. Again, these are not definitive, but merely provided for guidance. These questions are especially focused on other action research literature:

Questions to Think about as You Examine the Literature

• What was the context of their research?
• Who was involved? Was it a collaborative project?
• Was the choice of using action research as a method justified? Are any models discussed?
• What ‘actions’ actually took place?
• How was data gathered?
• How was data analyzed?
• Were ethical considerations addressed? How?
• What were the conclusions? Were they justified using appropriate evidence?
• Was the report accessible? Useful?
• Is it possible to replicate the study?

Regardless of the amount of literature you review, your challenge will be to organize the literature in way that is manageable and easy to reference. It is important to keep a record of what you read and how it relates conceptually to your topic. Some researchers even use the questions above to organize their literature. It is easy to read and think about the content of an article by making brief notes, however, this is often not enough to initially begin to develop your study or write about your findings. I will state the obvious here: organizing your literature search efficiently from the start is vital!

No matter how you choose to record or document the articles you read (e.g., paper, computer, photo), I would suggest thinking about the format in terms of index cards. Index cards are a very practical and simple model because the space limits you to be precise in recording vital information about each article. I typically create a document on my computer, allow each article the space of an index card, and focus on recording the following information:

• Journal/Book Chapter Title
• Main Arguments/Key findings
• Pertinent Quote(s)
• Implications
• Connective Points (how does it relate to my work and/or other articles)

I find that these aspects provide the information I need to be refreshed on the article and to be able to use it upon review.

There are also a lot of computer applications that are very useful and efficient in managing your literature. For example, Mendeley © provides comprehensive support for reviewing literature, even allowing you to store the article itself and make comments or highlights in text. There are also many citation apps that are helpful if you continue this research agenda and use roughly the same literature for each project.

Using the Literature

Think ahead to when you have collected and read a good amount of literature on your topic. You are now ready to use the literature to think about your topic, your research question, and the methods you plan to use. It might be helpful to peek ahead to Chapter 7 where I discuss writing the literature review for a report to give you an idea of the end goal. The primary purpose of engaging in a literature review is to provide knowledge to construct a framework for understanding the landscape of your topic. I often suggest for students to think of it as constructing an argument for your research decisions, or as if you are telling a story of how we got to this point in researching your topic. Either way you are situating your research in what we know and don’t know about your topic.

Naturally we tend to think about, and potentially write about, the literature in relation to the article’s author (e.g. Clark and Porath (2016) found that…). However, more commonly today in educational research you will find that literature reviews are organized by themes. It can be a little more organic to think about literature in terms of themes because they emerge or become more defined as you read. Also thinking thematically allows the articles to naturally connect and build on each other, whereas thinking in terms of authors can fragment thinking about the topic. In terms of thinking thematically, here are some guidelines:

• Identify the significant themes that have emerged organically from the literature review. These themes would be concepts or ideas that you typed or wrote down in your note-taking or management system.
• Introduce the common concepts or ideas by themes, instead of by authors’ disjointed viewpoints. Paragraphs in a thematic literature review begin like: The research on teacher self-efficacy has identified several key factors that contribute to strong self-efficacy… .
• Lastly, once you have introduced each theme and explained it, then present evidence from your readings to demonstrate the parameters of the knowledge on the theme, including areas of agreement and disagreement among researchers. Using the evidence, explain what the evidence for the theme means to your topic and any of your own relational or critical commentary.

Another way to think about structuring a literature review is a funnel model. A funnel model goes from broad topic, to sub-topics, to link to the study being undertaken. You can think of a literature review as a broad argument using mini-arguments. To use the funnel model, list your topic and the related subtopics, then design questions to answer with the literature. For example if our topic was discussion-based online learning, we might ask the following questions before reading the literature:

• Why is discussion important in learning?
• How does discussion support the development of social, cognitive, and teacher presence in an online course?
• What does research say about the use of traditional discussion boards ?
• What does the research say about asynchronous, video-based discussion ?
• How have other researchers compared written and video responses?
• How does this literature review link to my study?

O’Leary (2004) provides an interesting representation and model of the purpose for the literature review in the research process, in Figure 3.1. We will leave this for you to think about before moving on to Chapter 4.

• We will talk about this aspect of literature reviews further in Chapters 6 and 7. ↵

Action Research Copyright © by J. Spencer Clark; Suzanne Porath; Julie Thiele; and Morgan Jobe is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License , except where otherwise noted.

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Methodology

• What Is Action Research? | Definition & Examples

What Is Action Research? | Definition & Examples

Published on January 27, 2023 by Tegan George . Revised on January 12, 2024.

Table of contents

Types of action research, action research models, examples of action research, action research vs. traditional research, advantages and disadvantages of action research, other interesting articles, frequently asked questions about action research.

There are 2 common types of action research: participatory action research and practical action research.

• Participatory action research emphasizes that participants should be members of the community being studied, empowering those directly affected by outcomes of said research. In this method, participants are effectively co-researchers, with their lived experiences considered formative to the research process.
• Practical action research focuses more on how research is conducted and is designed to address and solve specific issues.

Both types of action research are more focused on increasing the capacity and ability of future practitioners than contributing to a theoretical body of knowledge.

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Action research is often reflected in 3 action research models: operational (sometimes called technical), collaboration, and critical reflection.

• Operational (or technical) action research is usually visualized like a spiral following a series of steps, such as “planning → acting → observing → reflecting.”
• Collaboration action research is more community-based, focused on building a network of similar individuals (e.g., college professors in a given geographic area) and compiling learnings from iterated feedback cycles.
• Critical reflection action research serves to contextualize systemic processes that are already ongoing (e.g., working retroactively to analyze existing school systems by questioning why certain practices were put into place and developed the way they did).

Action research is often used in fields like education because of its iterative and flexible style.

After the information was collected, the students were asked where they thought ramps or other accessibility measures would be best utilized, and the suggestions were sent to school administrators. Example: Practical action research Science teachers at your city’s high school have been witnessing a year-over-year decline in standardized test scores in chemistry. In seeking the source of this issue, they studied how concepts are taught in depth, focusing on the methods, tools, and approaches used by each teacher.

Action research differs sharply from other types of research in that it seeks to produce actionable processes over the course of the research rather than contributing to existing knowledge or drawing conclusions from datasets. In this way, action research is formative , not summative , and is conducted in an ongoing, iterative way.

As such, action research is different in purpose, context, and significance and is a good fit for those seeking to implement systemic change.

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Action research comes with advantages and disadvantages.

• Action research is highly adaptable , allowing researchers to mold their analysis to their individual needs and implement practical individual-level changes.
• Action research provides an immediate and actionable path forward for solving entrenched issues, rather than suggesting complicated, longer-term solutions rooted in complex data.
• Done correctly, action research can be very empowering , informing social change and allowing participants to effect that change in ways meaningful to their communities.

Disadvantages

• Due to their flexibility, action research studies are plagued by very limited generalizability  and are very difficult to replicate . They are often not considered theoretically rigorous due to the power the researcher holds in drawing conclusions.
• Action research can be complicated to structure in an ethical manner . Participants may feel pressured to participate or to participate in a certain way.
• Action research is at high risk for research biases such as selection bias , social desirability bias , or other types of cognitive biases .

If you want to know more about statistics , methodology , or research bias , make sure to check out some of our other articles with explanations and examples.

• Normal distribution
• Degrees of freedom
• Null hypothesis
• Discourse analysis
• Control groups
• Mixed methods research
• Non-probability sampling
• Quantitative research
• Inclusion and exclusion criteria

Research bias

• Rosenthal effect
• Implicit bias
• Cognitive bias
• Selection bias
• Negativity bias
• Status quo bias

Action research is conducted in order to solve a particular issue immediately, while case studies are often conducted over a longer period of time and focus more on observing and analyzing a particular ongoing phenomenon.

Action research is focused on solving a problem or informing individual and community-based knowledge in a way that impacts teaching, learning, and other related processes. It is less focused on contributing theoretical input, instead producing actionable input.

Action research is particularly popular with educators as a form of systematic inquiry because it prioritizes reflection and bridges the gap between theory and practice. Educators are able to simultaneously investigate an issue as they solve it, and the method is very iterative and flexible.

A cycle of inquiry is another name for action research . It is usually visualized in a spiral shape following a series of steps, such as “planning → acting → observing → reflecting.”

Sources in this article

We strongly encourage students to use sources in their work. You can cite our article (APA Style) or take a deep dive into the articles below.

George, T. (2024, January 12). What Is Action Research? | Definition & Examples. Scribbr. Retrieved March 20, 2024, from https://www.scribbr.com/methodology/action-research/

Cohen, L., Manion, L., & Morrison, K. (2017). Research methods in education (8th edition). Routledge.

Naughton, G. M. (2001).  Action research (1st edition). Routledge.

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• Published: 27 April 2023

Participatory action research

• Flora Cornish   ORCID: orcid.org/0000-0002-3404-9385 1 ,
• Nancy Breton   ORCID: orcid.org/0000-0002-8388-0458 1 ,
• Ulises Moreno-Tabarez   ORCID: orcid.org/0000-0002-3504-8624 2 ,
• Jenna Delgado 3 ,
• Mohi Rua 4 ,
• Ama de-Graft Aikins 5 &
• Darrin Hodgetts 6  

Nature Reviews Methods Primers volume  3 , Article number:  34 ( 2023 ) Cite this article

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Participatory action research (PAR) is an approach to research that prioritizes the value of experiential knowledge for tackling problems caused by unequal and harmful social systems, and for envisioning and implementing alternatives. PAR involves the participation and leadership of those people experiencing issues, who take action to produce emancipatory social change, through conducting systematic research to generate new knowledge. This Primer sets out key considerations for the design of a PAR project. The core of the Primer introduces six building blocks for PAR project design: building relationships; establishing working practices; establishing a common understanding of the issue; observing, gathering and generating materials; collaborative analysis; and planning and taking action. We discuss key challenges faced by PAR projects, namely, mismatches with institutional research infrastructure; risks of co-option; power inequalities; and the decentralizing of control. To counter such challenges, PAR researchers may build PAR-friendly networks of people and infrastructures; cultivate a critical community to hold them to account; use critical reflexivity; redistribute powers; and learn to trust the process. PAR’s societal contribution and methodological development, we argue, can best be advanced by engaging with contemporary social movements that demand the redressingl of inequities and the recognition of situated expertise.

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Introduction

For the authors of this Primer, participatory action research (PAR) is a scholar–activist research approach that brings together community members, activists and scholars to co-create knowledge and social change in tandem 1 , 2 . PAR is a collaborative, iterative, often open-ended and unpredictable endeavour, which prioritizes the expertise of those experiencing a social issue and uses systematic research methodologies to generate new insights. Relationships are central. PAR typically involves collaboration between a  community with lived experience of a social issue and professional researchers, often based in universities, who contribute relevant knowledge, skills, resources and networks. PAR is not a research process driven by the imperative to generate knowledge for scientific progress, or knowledge for knowledge’s sake; it is a process for generating knowledge-for-action and knowledge-through-action, in service of goals of specific communities. The position of a PAR scholar is not easy and is constantly tested, as PAR projects and roles straddle university and community boundaries, involving unequal  power relations and multiple, sometimes conflicting interests. This Primer aims to support researchers in preparing a PAR project, by providing a scaffold to navigate the processes through which PAR can help us to collaboratively envisage and enact emancipatory futures.

We consider PAR an emancipatory form of scholarship 1 . Emancipatory scholarship is driven by interest in tackling injustices and building futures supportive of human thriving, rather than objectivity and neutrality. It uses research not primarily to communicate with academic experts but to inform grassroots collective action. Many users of PAR aspire to projects of liberation and/or transformation . Users are likely to be critical of research that perpetuates oppressive power relations, whether within the research relationships themselves or in a project’s messages or outcomes, often aiming to trouble or transform power relations. PAR projects are usually concerned with developments not only in knowledge but also in action and in participants’ capacities, capabilities and performances.

PAR does not follow a set research design or particular methodology, but constitutes a strategic rallying point for collaborative, impactful, contextually situated and inclusive efforts to document, interpret and address complex systemic problems 3 . The development of PAR is a product of intellectual and activist work bridging universities and communities, with separate genealogies in several Indigenous 4 , 5 , Latin American 6 , 7 , Indian 8 , African 9 , Black feminist 10 , 11 and Euro-American 12 , 13 traditions.

PAR, as an authoritative form of enquiry, became established during the 1970s and 1980s in the context of anti-colonial movements in the Global South. As anti-colonial movements worked to overthrow territorial and economic domination, they also strived to overthrow symbolic and epistemic injustices , ousting the authority of Western science to author knowledge about dominated peoples 4 , 14 . For Indigenous scholars, the development of PAR approaches often comprised an extension of Indigenous traditions of knowledge production that value inclusion and community engagement, while enabling explicit engagements with matters of power, domination and representation 15 . At the same time, exchanges between Latin American and Indian popular education movements produced Orlando Fals Borda’s articulation of PAR as a paradigm in the 1980s. This orientation prioritized people’s participation in producing knowledge, instead of the positioning of local populations as the subject of knowledge production practices imposed by outside experts 16 . Meanwhile, PAR appealed to those inspired by Black and postcolonial feminists who challenged established knowledge hierarchies, arguing for the wisdom of people marginalized by centres of power, who, in the process of survivance, that is, surviving and resisting oppressive social structures, came to know and deconstruct those structures acutely 17 , 18 .

Some Euro-American approaches to PAR are less transformational and more reformist, in the action research paradigm, as developed by Kurt Lewin 19 to enhance organizational efficacy during and after World War II. Action research later gained currency as a popular approach for professionals such as teachers and nurses to develop their own practices, and it tended to focus on relatively small-scale adjustments within a given institutional structure, instead of challenging power relations as in anti-colonial PAR 13 , 20 . In the late twentieth century, participatory research gained currency in academic fields such as participatory development 21 , 22 , participatory health promotion 23 and creative methods 24 . Although participatory research includes participants in the conceptualization, design and conduct of a project, it may not prioritize action and social change to the extent that PAR does. In the early twenty-first century, the development of PAR is occurring through sustained scholarly engagements in anti-colonial 5 , 25 , abolitionist 26 , anti-racist 27 , 28 , gender-expansive 29 , climate activist 30 and other radical social movements.

This Primer bridges these traditions by looking across them for mutual learning but avoiding assimilating them. We hope that readers will bring their own activist and intellectual heritages to inform their use of PAR and adapt and adjust the suggestions we present to meet their needs.

Four key principles

Drawing across its diverse origins, we characterize PAR by four key principles. The first is the authority of direct experience. PAR values the expertise generated through experience, claiming that those who have been marginalized or harmed by current social relations have deep experiential knowledge of those systems and deserve to own and lead initiatives to change them 3 , 5 , 17 , 18 . The second is knowledge in action. Following the tradition of action research, it is through learning from the experience of making changes that PAR generates new knowledge 13 . The third key principle is research as a transformative process. For PAR, the research process is as important as the outcomes; projects aim to create empowering relationships and environments within the research process itself 31 . The final key principle is collaboration through dialogue. PAR’s power comes from harnessing the diverse sets of expertise and capacities of its collaborators through critical dialogues 7 , 8 , 32 .

Because PAR is often unfamiliar, misconstrued or mistrusted by dominant scientific 33 institutions, PAR practitioners may find themselves drawn into competitions and debates set on others’ terms, or into projects interested in securing communities’ participation but not their emancipation. Engaging communities and participants in participatory exercises for the primary purpose of advancing research aims prioritized by a university or others is not, we contend, PAR. We encourage PAR teams to articulate their intellectual and political heritage and aspirations, and agree their core principles, to which they can hold themselves accountable. Such agreements can serve as anchors for decision-making or counterweights to the pull towards inegalitarian or extractive research practices.

Aims of the Primer

The contents of the Primer are shaped by the authors’ commitment to emancipatory, engaged scholarship, and their own experience of PAR, stemming from their scholar-activism with marginalized communities to tackle issues including state neglect, impoverishment, infectious and non-communicable disease epidemics, homelessness, sexual violence, eviction, pollution, dispossession and post-disaster recovery. Collectively, our understanding of PAR is rooted in Indigenous, Black feminist and emancipatory education traditions and diverse personal experiences of privilege and marginalization across dimensions of race, class, gender, sexuality and disability. We use an inclusive understanding of PAR, to include engaging, emancipatory work that does not necessarily use the term PAR, and we aim to showcase some of the diversity of scholar-activism around the globe. The contents of this Primer are suggestions and reflections based on our own experience of PAR and of teaching research methodology. There are multiple ways of conceptualizing and conducting a PAR project. As context-sensitive social change processes, every project will pose new challenges.

This Primer is addressed primarily to university-based PAR researchers, who are likely to work in collaboration with members of communities or organizations or with activists, and are accountable to academic audiences as well as to community audiences. Much expertise in PAR originates outside universities, in community groups and organizations, from whom scholars have much to learn. The Primer aims to familiarize scholars new to PAR and others who may benefit with PAR’s key principles, decision points, practices, challenges, dilemmas, optimizations, limitations and work-arounds. Readers will be able to use our framework of ‘building blocks’ as a guide to designing their projects. We aim to support critical thinking about the challenges of PAR to enable readers to problem-solve independently. The Primer aims to inspire with examples, which we intersperse throughout. To illustrate some of the variety of positive achievements of PAR projects, Box  1 presents three examples.

Box 1 What does participatory action research do?

The Tsui Anaa Project 60 in Accra, Ghana, began as a series of interviews about diabetes experiences in one of Accra’s oldest indigenous communities, Ga Mashie. Over a 12-year period, a team of interdisciplinary researchers expanded the project to a multi-method engagement with a wide range of community members. University and community co-researchers worked to diagnose the burden of chronic conditions, to develop psychosocial interventions for cardiovascular and associated conditions and to critically reflect on long-term goals. A health support group of people living with diabetes and cardiovascular conditions, called Jamestown Health Club (JTHC), was formed, met monthly and contributed as patient advocates to community, city and national non-communicable disease policy. The project has supported graduate collaborators with mixed methods training, community engagement and postgraduate theses advancing the core project purposes.

Buckles, Khedkar and Ghevde 39 were approached by members of the Katkari tribal community in Maharashtra, India, who were concerned about landlords erecting fences around their villages. Using their institutional networks, the academics investigated the villagers’ legal rights to secure tenure and facilitated a series of participatory investigations, through which Katkari villagers developed their own understanding of the inequalities they faced and analysed potential action strategies. Subsequently, through legal challenges, engagement with local politics and emboldened local communities, more than 100 Katkari communities were more secure and better organized 5 years later.

The Morris Justice Project 74 in New York, USA, sought to address stop-and-frisk policing in a neighbourhood local to the City University of New York, where a predominantly Black population was subject to disproportionate and aggressive policing. Local residents surveyed their neighbours to gather evidence on experiences of stop and frisk, compiling their statistics and experiences and sharing them with the local community on the sidewalk, projecting their findings onto public buildings and joining a coalition ‘Communities United for Police Reform’, which successfully campaigned for changes to the city’s policing laws.

Experimentation

This section sets out the core considerations for designing a PAR project.

Owing to the intricacies of working within complex human systems in real time, PAR practitioners do not follow a highly proceduralized or linear set of steps 34 . In a cyclical process, teams work together to come to an initial definition of their social problem, design a suitable action, observe and gather information on the results, and then analyse and reflect on the action and its impact, in order to learn, modify their understanding and inform the next iteration of the research–action cycle 3 , 35 (Fig.  1 ). Teams remain open throughout the cycle to repeating or revising earlier steps in response to developments in the field. The fundamental process of building relationships occurs throughout the cycles. These spiral diagrams orient readers towards the central interdependence of processes of participation, action and research and the nonlinear, iterative process of learning by doing 3 , 36 .

Participatory action research develops through a series of cycles, with relationship building as a constant practice. Cycles of research text adapted from ref. 81 , and figure adapted with permission from ref. 82 , SAGE.

Building blocks for PAR research design

We present six building blocks to set out the key design considerations for conducting a PAR project. Each PAR team may address these building blocks in different ways and with different priorities. Table  1 proposes potential questions and indicative goals that are possible markers of progress for each building block. They are not prescriptive or exhaustive but may be a useful starting point, with examples, to prompt new PAR teams’ planning.

Building relationships

‘Relationships first, research second’ is our key principle for PAR project design 37 . Collaborative relationships usually extend beyond a particular PAR project, and it is rare that one PAR project finalizes a desired change. A researcher parachuting in and out may be able to complete a research article, with community cooperation, but will not be able to see through the hard graft of a programme of participatory research towards social change. Hence, individual PAR projects are often nested in long-term collaborations. Such collaborations are strengthened by institutional backing in the form of sustainable staff appointments, formal recognition of the value of university–community partnerships and provision of administrative support. In such a supportive context, opportunities can be created for achievable shorter-term projects to which collaborators or temporary researchers may contribute. The first step of PAR is sometimes described as the entry, but we term this foundational step building relationships to emphasize the longer-term nature of these relationships and their constitutive role throughout a project. PAR scholars may need to work hard with and against their institutions to protect those relationships, monitoring potential collaborations for community benefit rather than knowledge and resource extraction. Trustworthy relationships depend upon scholars being aware, open and honest about their own interests and perspectives.

The motivation for a PAR project may come from university-based or community-based researchers. When university researchers already have a relationship with marginalized communities, they may be approached by community leaders initiating a collaboration 38 , 39 . Alternatively, a university-based researcher may reach out to representatives of communities facing evident problems, to explore common interests and the potential for collaboration 40 . As Indigenous scholars have articulated, communities that have been treated as the subjects or passive objects of research, commodified for the scientific knowledge of distant elites, are suspicious of research and researchers 4 , 41 . Scholars need to be able to satisfy communities’ key questions: Who are you? Why should we trust you? What is in it for our community? Qualifications, scholarly achievements or verbal reassurances are less relevant in this context than past or present valued contributions, participation in a heritage of transformational action or evidence of solidarity with a community’s causes. Being vouched for by a respected community member or collaborator can be invaluable.

Without prior relationships one can start cold, as a stranger, perhaps attending public events, informal meeting places or identifying organizations in which the topic is of interest, and introducing oneself. Strong collaborative relationships are based on mutual trust, which must be earned. It is important to be transparent about our interests and to resist the temptation to over-promise. Good PAR practitioners do not raise unrealistic expectations. Box  2 presents key soft skills for PAR researchers.

Positionality is crucial to PAR relationships. A university-based researcher’s positionalities (including, for example, their gender, race, ethnicity, class, politics, skills, age, life stage, life experiences, assumptions about the problem, experience in research, activism and relationship to the topic) interact with the positionalities of community co-researchers, shaping the collective definition of the problem and appropriate solutions. Positionalities are not fixed, but can be changing, multiple and even contradictory 42 . We have framed categories of university-based and community-based researchers here, but in practice these positionings of ‘insiders’ and ‘outsiders’ are often more complex and shifting 43 . Consideration of diversity is important when building a team to avoid  tokenism . For example, identifying which perspectives are included initially and why, and whether members of the team or gatekeepers have privileged access owing to their race, ethnicity, class, gender and/or able-bodiedness.

The centring of community expertise in PAR does not mean that a community is ‘taken for granted’. Communities are sites of the production of similarity and difference, equality and inequalities, and politics. Knowledge that has the status of common sense may itself reproduce inequalities or perpetuate harm. Relatedly, strong PAR projects cultivate  reflexivity 44 among both university-based and community-based researchers, to enable a critical engagement with the diversity of points of view, positions of power and stakes in a project. Developing reflexivity may be uncomfortable and challenging, and good PAR projects create a supportive culture for processing such discomfort. Supplementary files  1 and   2 present example exercises that build critical reflexivity.

Box 2 Soft skills of a participatory action researcher

Respect for others’ knowledge and the expertise of experience

Humility and genuine kindness

Ability to be comfortable with discomfort

Sharing power; ceding control

Trusting the process

Acceptance of uncertainty and tensions

Openness to learning from collaborators

Self-awareness and the ability to listen and be confronted

Willingness to take responsibility and to be held accountable

Confidence to identify and challenge power relations

Establishing working practices

Partnerships bring together people with different sets of norms, assumptions, interests, resources, time frames and working practices, all nested in institutional structures and infrastructures that cement those assumptions. University-based researchers often take their own working practices for granted, but partnership working calls for negotiation. Academics often work with very extended time frames for analysis, writing and review before publication, hoping to contribute to gradually shifting agendas, discourses and politics 45 . The urgency of problems that face a community often calls for faster responsiveness. Research and management practices that are normal in a university may not be accessible to people historically marginalized through dimensions that include disability, language, racialization, gender, literacy practices and their intersections 46 . Disrupting historically entrenched power dynamics associated with these concerns can raise discomfort and calls for skilful negotiation. In short, partnership working is a complex art, calling for thoughtful design of joint working practices and a willingness to invest the necessary time.

Making working practices and areas of tension explicit is one useful starting point. Not all issues need to be fully set out and decided at the outset of a project. A foundation of trust, through building relationships in building block 1, allows work to move ahead without every element being pinned down in advance. Supplementary file  1 presents an exercise designed to build working relationships and communicative practices.

Establishing a common understanding of the issue

Co-researchers identify a common issue or problem to address. University-based researchers tend to justify the selection of the research topic with reference to a literature review, whereas in PAR, the topic must be a priority for the community. Problem definition is a key step for PAR teams, where problem does not necessarily mean something negative or a deficit, but refers to the identification of an important issue at stake for a community. The definition of a problem, however, is not always self-evident, and producing a problem definition can be a valid outcome of PAR. In the example of risks of eviction from Buckles, Khedkar and Ghevde 39 (Box  1 ), a small number of Katkari people first experienced the problem in terms of landlords erecting barbed wire fences. Other villages did not perceive the risk of eviction as a big problem compared with their other needs. Facilitating dialogues across villages about their felt problems revealed how land tenure was at the root of several issues, thus mobilizing interest. Problem definitions are political; they imply some forms of action and not others. Discussion and reflexivity about the problem definition are crucial. Compared with other methodologies, the PAR research process is much more public from the outset, and so practices of making key steps explicit, shareable, communicable and negotiable are essential. Supplementary file  3 introduces two participatory tools for collective problem definition.

Consideration of who should be involved in problem definition is important. It may be enough that a small project team works closely together at this stage. Alternatively, group or public meetings may be held, with careful facilitation 5 . Out of dialogue, a PAR team aims to agree on an actionable problem definition, responding to the team’s combination of skills, capacities and priorities. A PAR scholar works across the university–community boundary and thus is accountable to both university values and grassroots communities’ values. PAR scholars should not deny or hide the multiple demands of the role because communities with experience of marginalization are attuned to being manipulated. Surfacing interests and constraints and discussing these reflexively is often a better strategy. Creativity may be required to design projects that meet both academic goals (such as when a project is funded to produce certain outcomes) and the community’s goals.

For example, in the context of a PAR project with residents of a public housing neighbourhood scheduled for demolition and redevelopment, Thurber and colleagues 47 describe how they overcame differences between resident and academic researchers regarding the purposes of their initial survey. The academic team members preferred the data to be anonymous, to maximize the scientific legitimacy of their project (considered valuable for their credibility to policymakers), whereas the resident team wanted to use the opportunity to recruit residents to their cause, by collecting contact details. The team discussed their different objectives and produced the solution of two-person survey teams, one person gathering anonymous data for the research and a second person gathering contact details for the campaign’s contact list.

Articulating research questions is an early milestone. PAR questions prioritize community concerns, so they may differ from academic-driven research questions. For example, Buckles, Khedkar and Ghevde 39 facilitated a participatory process that developed questions along the lines of: What are the impacts of not having a land title for Katkari people? How will stakeholders respond to Katkari organizing, and what steps can Katkari communities take towards the goal of securing tenure? In another case, incarcerated women in New York state, USA, invited university academics to evaluate a local college in prison in the interest of building an empirical argument for the value of educational opportunities in prisons 38 , 48 Like other evaluations, it asked: “What is the impact of college on women in prison?” But instead of looking narrowly at the impact on re-offending as the relevant impact (as prioritized by politicians and policymakers), based on the incarcerated women’s advice, the evaluation tracked other outcomes: women’s well-being within the prison; their relationships with each other and the staff; their children; their sense of achievement; and their agency in their lives after incarceration.

As a PAR project develops, the problem definition and research questions are often refined through the iterative cycles. This evolution does not undermine the value of writing problem definitions and research questions in the early stages, as a collaboration benefits from having a common reference point to build from and from which to negotiate.

Observing, gathering and generating materials

With a common understanding of the problem, PAR teams design ways of observing the details and workings of this problem. PAR is not prescriptive about the methods used to gather or generate observations. Projects often use qualitative methods, such as storytelling, interviewing or ethnography, or participatory methods, such as body mapping, problem trees, guided walks, timelines, diaries, participatory photography and video or participatory theatre. Gathering quantitative data is an option, particularly in the tradition of participatory statistics 49 . Chilisa 5 distinguishes sources of spatial data, time-related data, social data and technical data. The selected methods should be engaging to the community and the co-researchers, suited to answering the research questions and supported by available professional skills. Means of recording the process or products, and of storing those records, need to be agreed, as well as ethical principles. Developing community members’ research skills for data collection and analysis can be a valued contribution to a PAR project, potentially generating longer-term capacities for local research and change-making 50 .

Our selection of data generation methods and their details depends upon the questions we ask. In some cases, methods to explore problem definitions and then to brainstorm potential actions, their risks and benefits will be useful (Supplementary file  3 ). Others may be less prescriptive about problems and solutions, seeking to explore experience in an open-ended way, as a basis for generating new understandings (see Supplementary file  2 for an example reflective participatory exercise).

Less-experienced practitioners may take a naive approach to PAR, which assumes that knowledge should emerge solely from an authentic community devoid of outside ideas. More established PAR researchers, however, work consciously to combine and exchange skills and knowledge through dialogue. Together with communities, we want to produce effective products, and we recognize that doing so may require specific skills. In Marzi’s 51 participatory video project with migrant women in Colombia, she engaged professional film-makers to provide the women with training in filming, editing and professional film production vocabulary. The women were given the role of directors, with the decision-making power over what to include and exclude in their film. In a Photovoice project with Black and Indigenous youth in Toronto, Canada, Tuck and Habtom 25 drew on their prior scholar–activist experience and their critical analysis of scholarship of marginalization, which often uses tropes of victimhood, passivity and sadness. Instead of repeating narratives of damage, they intended to encourage desire-based narratives. They supported their young participants to critically consider which photographs they wanted to include or exclude from public representations. Training participants to be expert users of research techniques does not devalue their existing expertise and skills, but takes seriously their role in co-producing valid, critical knowledge. University-based researchers equally benefit from training in facilitation methods, team development and the history and context of the community.

Data generation is relational, mediated by the positionalities of the researchers involved. As such, researchers position themselves across boundaries, and need to have, or to develop, skills in interpreting across boundaries. In the Tsui Anaa Project (Box  1 ) in Ghana, the project recruited Ga-speaking graduate students as researchers; Ga is the language most widely spoken in the community. The students were recruited not only for their language skills, but also for their Ga cultural sensibilities, reflected in their sense of humour and their intergenerational communicative styles, enabling fluid communication and mutual understanding with the community. In turn, two community representatives were recruited as advocates to represent patient perspectives across university and community boundaries.

University-based researchers trained in methodological rigour may need reminders that the process of a PAR project is as important as the outcome, and is part of the outcome. Facilitation skills are the most crucial skills for PAR practitioners at this stage. Productive facilitation skills encourage open conversation and collective understandings of the problem at hand and how to address it. More specifically, good facilitation requires a sensitivity to the ongoing and competing social context, such as power relations, within the group to help shift power imbalances and enable participation by all 52 . Box  3 presents a PAR project that exemplifies the importance of relationship building in a community arts project.

Box 3 Case study of the BRIDGE Project: relationship building and collective art making as social change

The BRIDGE Project was a 3-week long mosaic-making and dialogue programme for youth aged 14–18 years, in Southern California. For several summers, the project brought together students from different campuses to discuss inclusion, bullying and community. The goal was to help build enduring relationships among young people who otherwise would not have met or interacted, thereby mitigating the racial tensions that existed in their local high schools.

Youth were taught how to make broken tile mosaic artworks, facilitated through community-building exercises. After the first days, as relationships grew, so did the riskiness of the discussion topics. Youth explored ideas and beliefs that contribute to one’s individual sense of identity, followed by discussion of wider social identities around race, class, sex, gender, class, sexual orientation and finally their identities in relationship to others.

The art-making process was structured in a manner that mirrored the building of their relationships. Youth learned mosaic-making skills while creating individual pieces. They were discouraged from collaborating with anyone else until after the individual pieces were completed and they had achieved some proficiency. When discussions transitioned to focus on the relationship their identities had to each other, the facilitators assisted them in creating collaborative mosaics with small groups.

Staff facilitation modelled the relationship-building goal of the project. The collaborative art making was built upon the rule that no one could make any changes without asking for and receiving permission from the person or people who had placed the piece (or pieces) down. To encourage participants to engage with each other it was vital that they each felt comfortable to voice their opinions while simultaneously learning how to be accountable to their collaborators and respectful of others’ relationships to the art making.

The process culminated in the collective creation of a tile mosaic wall mural, which is permanently installed in the host site.

Collaborative analysis

In PAR projects, data collection and analysis are not typically isolated to different phases of research. Instead, a tried and tested approach to collaborative analysis 53 is to use generated data as a basis for reflection on commonalities, patterns, differences, underlying causes or potentials on an ongoing basis. For instance, body mapping, photography, or video projects often proceed through a series of workshops, with small-scale training–data collection–data analysis cycles in each workshop. Participants gather or produce materials in response to a prompt, and then come together to critically discuss the meaning of their productions.

Simultaneously, or later, a more formal data analysis may be employed, using established social science analytical tools such as grounded theory, thematic, content or discourse analysis, or other forms of visual or ethnographic analysis, with options for facilitated co-researcher involvement. The selection of a specific orientation or approach to analysis is often a low priority for community-based co-researchers. It may be appropriate for university-based researchers to take the lead on comprehensive analysis and the derivation of initial messages. Fine and Torre 29 describe the university-based researchers producing a “best bad draft” so that there is something on the table to react to and discuss. Given the multiple iterations of participants’ expressions of experiences and analyses by this stage, the university-based researchers should be in a position that their best bad draft is grounded in a good understanding of local perspectives and should not appear outlandish, one-sided or an imposition of outside ideas.

For the results and recommendations to reflect community interests, it is important to incorporate a step whereby community representatives can critically examine and contribute to emerging findings and core messages for the public, stakeholders or academic audiences.

Planning and taking action

Taking action is an integral part of a PAR process. What counts as action and change is different for each PAR project. Actions could be targeted at a wide range of scales and different stakeholders, with differing intended outcomes. Valid intended outcomes include creating supportive networks to share resources through mutual aid; empowering participants through sharing experiences and making sense of them collectively; using the emotional impact of artistic works to influence policymakers and journalists; mobilizing collective action to build community power; forging a coalition with other activist and advocacy groups; and many others. Selection between the options depends on underlying priorities, values, theories of how social change happens and, crucially, feasibility.

Articulating a theory of change is one way to demonstrate how we intend to bring about changes through designing an action plan. A theory of change identifies an action and a mechanism, directed at producing outcomes, for a target group, in a context. This device has often been used in donor-driven health and development contexts in a rather prescriptive way, but PAR teams can adapt the tool as a scaffolding for being explicit about action plans and as a basis for further discussions and development of those plans. Many health and development organizations (such as Better Evaluation ) have frameworks to help design a theory of change.

Alternatively, a community action plan 5 can serve as a tangible roadmap to produce change, by setting out objectives, strategies, timeline, key actors, required resources and the monitoring and evaluation framework.

Social change is not easy, and existing social systems benefit, some at the expense of others, and are maintained by power relations. In planning for action, analysis of the power relations at stake, the beneficiaries of existing systems and their potential resistance to change is crucial. It is often wise to assess various options for actions, their potential benefits, risks and ways of mitigating those risks. Sometimes a group may collectively decide to settle for relatively secure, and less-risky, small wins but with the building of sufficient power, a group may take on a bigger challenge 54 .

Ethical considerations are fundamental to every aspect of PAR. They include standard research ethics considerations traditionally addressed by research ethics committees or institutional review boards (IRBs), including key principles of avoidance of harm, anonymity and confidentiality, and voluntary informed consent, although these issues may become much more complex than traditionally presented, when working within a PAR framework 55 . PAR studies typically benefit from IRBs that can engage with the relational specificities of a case, with a flexible and iterative approach to research design with communities, instead of being beholden to very strict and narrow procedures. Wilson and colleagues 56 provide a comprehensive review of ethical challenges in PAR.

Beyond procedural research ethics perspectives, relational ethics are important to PAR projects and raise crucial questions regarding the purpose and conduct of knowledge production and application 37 , 57 , 58 . Relational ethics encourage an emphasis on inclusive practices, dialogue, mutual respect and care, collective decision-making and collaborative action 57 . Questions posed by Indigenous scholars seeking to decolonize Western knowledge production practices are pertinent to a relational ethics approach 4 , 28 . These include: Who designs and manages the research process? Whose purposes does the research serve? Whose worldviews are reproduced? Who decides what counts as knowledge? Why is this knowledge produced? Who benefits from this knowledge? Who determines which aspects of the research will be written up, disseminated and used, and how? Addressing such questions requires scholars to attend to the ethical practices of cultivating trusting and reciprocal relationships with participants and ensuring that the organizations, communities and persons involved co-govern and benefit from the project.

Reflecting on the ethics of her PAR project with young undocumented students in the USA, Cahill 55 highlights some of the intensely complex ethical issues of representation that arose and that will face many related projects. Determining what should be shared with which audiences is intensely political and ethical. Cahill’s team considered editing out stories of dropping out to avoid feeding negative stereotypes. They confronted the dilemma of framing a critique of a discriminatory educational system, while simultaneously advocating that this flawed system should include undocumented students. They faced another common dilemma of how to stay true to their structural analysis of the sources of harms, while engaging decision-makers invested in the current status quo. These complex ethical–political issues arise in different forms in many PAR projects. No answer can be prescribed, but scholar–activists can prepare themselves by reading past case studies and being open to challenging debates with co-researchers.

The knowledge built by PAR is explicitly knowledge-for-action, informed by the relational ethical considerations of who and what the knowledge is for. PAR builds both  local knowledge and conceptual knowledge. As a first step, PAR can help us to reflect locally, collectively, on our circumstances, priorities, diverse identities, causes of problems and potential routes to tackle them.

Such local knowledge might be represented in the form of statistical findings from a community survey, analyses of participants’ verbal or visual data, or analyses of workshop discussions. Findings may include elements such as an articulation of the status quo of a community issue; a participatory analysis of root causes and/or actionable elements of the problem; a power analysis of stakeholders; asset mapping; assessment of local needs and priorities. Analysis goes beyond the surface problems, to identify underlying roots of problems to inform potential lines of action.

Simultaneously, PAR also advances more global conceptual knowledge. As liberation theorists have noted, developments in societal understandings of inequalities, marginalization and liberation are often led by those battling such processes daily. For example, the young Black and Indigenous participants working with Tuck and Habtom 25 in Toronto, Canada, engaged as co-theorists in their project about the significance of social movements to young people and their post-secondary school futures. Through their photography project, they expressed how place, and its history, particularly histories of settler colonialism, matters in cities — against a more standard view that treated the urban as somehow interchangeable, modern or neutral. The authors argue for altered conceptions of urban and urban education scholarly literatures, in response to this youth-led knowledge.

A key skill in the art of PAR is in creating achievable actions by choosing a project that is engaging and ambitious with achievable elements, even where structures are resistant to change. PAR projects can produce actions across a wide range of scales (from ‘small, local’ to ‘large, structural’) and across different temporal scales. Some PAR projects are part of decades-long programmes. Within those programmes, an individual PAR project, taking place over 12 or 24 months, might make one small step in the process towards long-term change.

For example, an educational project with young people living in communities vulnerable to flooding in Brazil developed a portfolio of actions, including a seminar, a native seeds fair, support to an individual family affected by a landslide, a campaign for a safe environment for a children’s pre-school, a tree nursery at school and influencing the city’s mayor to extend the environmental project to all schools in the area 30 .

Often the ideal scenario is that such actions lead to material changes in the power of a community. Over the course of a 5-year journey, the Katkari community (Box  1 ) worked with PAR researchers to build community power to resist eviction. The community team compiled households’ proof of residence; documented the history of land use and housing; engaged local government about their situations and plans; and participated more actively in village life to cultivate support 39 . The university-based researchers collected land deeds and taught sessions on land rights, local government and how to acquire formal papers. They opened conversations with the local government on legal, ethical and practical issues. Collectively, their legal knowledge and groundwork gave them confidence to remove fencing erected by landlords and to take legal action to regularize their land rights, ultimately leading to 70 applications being made for formal village sites. This comprised a tangible change in the power relation between landlords and the communities. Even here, however, the authors do not simply celebrate their achievements, but recognize that power struggles are ongoing, landlords would continue to aggressively pursue their interests, and, thus, their achievements were provisional and would require vigilance and continued action.

Most crucially, PAR projects aim to develop university-based and community-based researchers’ collective agency, by building their capacities for collaboration, analysis and action. More specifically, collaborators develop multiple transferable skills, which include skills in conducting research, operating technology, designing outputs, leadership, facilitation, budgeting, networking and public speaking 31 , 59 , 60 .

University-based researchers build their own key capacities through exercising and developing skills, including those for collaboration, facilitation, public engagement and impact. Strong PAR projects may build capacities within the university to sustain long-term relationships with community projects, such as modified and improved infrastructures that work well with PAR modalities, appreciation of the value of long-term sustained reciprocal relations and personal and organizational relationships with communities outside the university.

Applications

PAR disrupts the traditional theory–application binary, which usually assumes that abstract knowledge is developed through basic science, to then be interpreted and applied in professional or community contexts. PAR projects are always applied in the sense that they are situated in concrete human and social problems and aim to produce workable local actions. PAR is a very flexible approach. A version of a PAR project could be devised to tackle almost any real-world problem — where the researchers are committed to an emancipatory and participatory epistemology. If one can identify a group of people interested in collectively generating knowledge-for-action in their own context or about their own practices, and as long as the researchers are willing and able to share power, the methods set out in this Primer could be applied to devise a PAR project.

PAR is consonant with participatory movements across multiple disciplines and sectors, and thus finds many intellectual homes. Its application is supported by social movements for inclusion, equity, representation of multiple voices, empowerment and emancipation. For instance, PAR responds to the value “nothing about us without us”, which has become a central tenet of disability studies. In youth studies, PAR is used to enhance the power of young people’s voices. In development studies, PAR has a long foundation as part of the demand for greater participation, to support locally appropriate, equitable and locally owned changes. In health-care research, PAR is used by communities of health professionals to reflect and improve on their own practices. PAR is used by groups of health-care service users or survivors to give a greater collective power to the voices of those at the sharp end of health care, often delegitimized by medical power. In environmental sciences, PAR can support local communities to take action to protect their environments. In community psychology, PAR is valued for its ability to nurture supportive and inclusive processes. In summary, PAR can be applied in a huge variety of contexts in which local ownership of research is valued.

Limitations to PAR’s application often stem from the institutional context. In certain (often dominant) academic circles, local knowledge is not valued, and contextually situated, problem-focused, research may be considered niche, applied or not generalizable. Hence, research institutions may not be set up to be responsive to a community’s situation or needs or to support scholar–activists working at the research–action boundary. Further, those who benefit from, or are comfortable with, the status quo of a community may actively resist attempts at change from below and may undermine PAR projects. In other cases, where a community is very divided or dispersed, PAR may not be the right approach. There are plenty of examples of PAR projects floundering, failing to create an active group or to achieve change, or completely falling through. Even such failures, however, shed light on the conditions of communities and the power relations they inhabit and offer lessons on ways of working and not working with groups in those situations.

Reproducibility and data deposition

Certain aspects of the open science movement can be productively engaged from within a PAR framework, whereas others are incompatible. A key issue is that PAR researchers do not strive for reproducibility, and many would contest the applicability of this construct. Nonetheless, there may be resonances between the open science principle of making information publicly available for re-use and those PAR projects that aim to render visible and audible the experience of a historically under-represented or mis-represented community. PAR projects that seek to represent previously hidden realities of, for example, environmental degradation, discriminatory experiences at the hands of public services, the social history of a traditionally marginalized group, or their neglected achievements, may consider creating and making public robust databases of information, or social history archives, with explicit informed permission of the relevant communities. For such projects, making knowledge accessible is an essential part of the action. Publicly relevant information should not be sequestered behind paywalls. PAR practitioners should thus plan carefully for cataloguing, storing and archiving information, and maintaining archives.

On the other hand, however, a blanket assumption that all data should be made freely available is rarely appropriate in a PAR project and may come into conflict with ethical priorities. Protecting participants’ confidentiality can mean that data cannot be made public. Protecting a community from reputational harm, in the context of widespread dehumanization, criminalization or stigmatization of dispossessed groups, may require protection of their privacy, especially if their lives or coping strategies are already pathologized 25 . Empirical materials do not belong to university-based researchers as data and cannot be treated as an academic commodity to be opened to other researchers. Open science practices should not extend to the opening of marginalized communities to knowledge exploitation by university researchers.

The principle of reproducibility is not intuitively meaningful to PAR projects, given their situated nature, that is, the fact that PAR is inherently embedded in particular concrete contexts and relationships 61 . Beyond reproducibility, other forms of mutual learning and cross-case learning are vitally important. We see increasing research fatigue in communities used, extractively, for research that does not benefit them. PAR teams should assess what research has been done in a setting to avoid duplication and wasting people’s time and should clearly prioritize community benefit. At the same time, PAR projects also aspire to produce knowledge with wider implications, typically discussed under the term generalizability or transferability. They do so by articulating how the project speaks to social, political, theoretical and methodological debates taking place in wider knowledge communities, in a form of “communicative generalisation” 62 . Collaborating and sharing experiences across PAR sites through visits, exchanges and joint analysis can help to generalize experiences 30 , 61 .

Limitations and optimizations

PAR projects often challenge the social structures that reproduce established power relations. In this section, we outline common challenges to PAR projects, to prompt early reflection. When to apply a workaround, compromise, concede, refuse or regroup and change strategy are decisions that each PAR team should make collectively. We do not have answers to all the concerns raised but offer mitigations that have been found useful.

Institutional infrastructure

Universities’ interests in partnerships with communities, local relevance, being outward-facing, public engagement and achieving social impact can help to create a supportive environment for PAR research. Simultaneously, university bureaucracies and knowledge hierarchies that prize their scientists as individuals rather than collaborators and that prioritize the methods of dominant science can undermine PAR projects 63 . When Cowan, Kühlbrandt and Riazuddin 45 proposed using gaming, drama, fiction and film-making for a project engaging young people in thinking about scientific futures, a grants manager responded “But this project can’t just be about having fun activities for kids — where is the research in what you’re proposing?” Research infrastructures are often slow and reluctant to adapt to innovations in creative research approaches.

Research institutions’ funding time frames are also often out of sync with those of communities — being too extended in some ways and too short in others 45 , 64 . Securing funding takes months and years, especially if there are initial rejections or setbacks. Publishing findings takes further years. For community-based partners, a year is a long time to wait and to maintain people’s interest. On the other hand, grant funding for one-off projects over a year or two (or even five) is rarely sufficient to create anything sustainable, reasserting precarity and short-termism. Institutions can better support PAR through infrastructure such as bridging funds between grants, secure staff appointments and institutional recognition and resources for community partners.

University infrastructures can value the long-term partnership working of PAR scholars by recognizing partnership-building as a respected element of an academic career and recognizing collaborative research as much as individual academic celebrity. Where research infrastructures are unsupportive, building relationships within the university with like-minded professional and academic colleagues, to share work-arounds and advocate collectively, can be very helpful. Other colleagues might have developed mechanisms to pay co-researchers, or to pay in advance for refreshments, speed up disbursement of funds, or deal with an ethics committee, IRB, finance office or thesis examiner who misunderstands participatory research. PAR scholars can find support in university structures beyond the research infrastructure, such as those concerned with knowledge exchange and impact, campus–community partnerships, extension activities, public engagement or diversity and inclusion 64 . If PAR is institutionally marginalized, exploring and identifying these work-arounds is extremely labour intensive and depends on the cultivation of human, social and cultural capital over many years, which is not normally available to graduate students or precariously employed researchers. Thus, for PAR to be realized, institutional commitment is vital.

Co-option by powerful structures

When PAR takes place in collaboration or engagement with powerful institutions such as government departments, health services, religious organizations, charities or private companies, co-option is a significant risk. Such organizations experience social pressure to be inclusive, diverse, responsive to communities and participatory, so they may be tempted to engage communities in consultation, without redistributing power. For instance, when ‘photovoice’ projects invite politicians to exhibitions of photographs, their activity may be co-opted to serving the politician’s interest in being seen to express support, but result in no further action. There is a risk that using PAR in such a setting risks tokenizing marginalized voices 65 . In one of our current projects, co-researchers explore the framing of sexual violence interventions in Zambia, aiming to promote greater community agency and reduce the centrality of approaches dominated by the Global North 66 . One of the most challenging dilemmas is the need to involve current policymakers in discussions without alienating them. The advice to ‘be realistic’, ‘be reasonable’ or ‘play the game’ to keep existing power brokers at the table creates one of the most difficult tensions for PAR scholars 48 .

We also caution against scholars idealizing PAR as an ideal, egalitarian, inclusive or perfect process. The term ‘participation’ has become a policy buzzword, invoked in a vaguely positive way to strengthen an organization’s case that they have listened to people. It can equally be used by researchers to claim a moral high ground without disrupting power relations. Depriving words of their associated actions, Freire 7 warns us, leads to ‘empty blah’, because words gain their meaning in being harnessed to action. Labelling our work PAR does not make it emancipatory, without emancipatory action. Equally, Freire cautions against acting without the necessary critical reflection.

To avoid romanticization or co-option, PAR practitioners benefit from being held accountable to their shared principles and commitments by their critical networks and collaborators. Our commitments to community colleagues and to action should be as real for us as any institutional pressures on us. Creating an environment for that accountability is vital. Box  4 offers a project exemplar featuring key considerations regarding power concerns.

Box 4 Case study: participatory power and its vulnerability

Júba Wajiín is a pueblo in a rural mountainous region in the lands now called Guerrero, Mexico, long inhabited by the Me’phaa people, who have fiercely resisted precolonial, colonial and postcolonial displacement and dispossession. Using collective participatory action methods, this small pueblo launched and won a long legal battle that now challenges extractive mining practices.

Between 2001 and 2012, the Mexican government awarded massive mining concessions to mining companies. The people of Júba Wajiín discovered in mid-2013 that, unbeknown to them, concessions for mining exploration of their lands had been awarded to the British-based mining company Horschild Mexico. They engaged human rights activists who used participatory action research methods to create awareness and to launch a legal battle. Tlachinollan, a regional human rights organization, held legal counselling workshops and meetings with local authorities and community elders.

The courts initially rejected the case by denying that residents could be identified as Indigenous because they practised Catholicism and spoke Spanish. A media organization, La Sandia Digital , supported the community to collectively document their syncretic religious and spiritual practices, their ability to speak Mhe’paa language and their longstanding agrarian use of the territory. They produced a documentary film Juba Wajiin: Resistencia en la Montaña , providing visual legal evidence.

After winning in the District court, they took the case to the Supreme Court, asking it to review the legality and validity of the mining concessions. Horschild, along with other mining companies, stopped contesting the case, which led to the concessions being null and void.

The broader question of Indigenous peoples’ territorial rights continued in the courts until mid-2022 when the Supreme Court ruled that Indigenous peoples had the constitutional right to be consulted before any mining activities in their territory. This was a win, but a partial one. ‘Consultations’ are often manipulated by state and private sectors, particularly among groups experiencing dire impoverishment. Júba Wajiín’s strategies proved successful but the struggle against displacement and dispossession is continual.

Power inequalities within PAR

Power inequalities also affect PAR teams and communities. For all the emphasis on egalitarian relationships and dialogue, communities and PAR teams are typically composed of actors with unequal capacities and powers, introducing highly complex challenges for PAR teams.

Most frequently, university-based researchers engaging with marginalized communities do not themselves share many aspects of the identities or life experiences of those communities. They often occupy different, often more privileged, social networks, income brackets, racialized identities, skill sets and access to resources. Evidently, the premise of PAR is that people with different lives can productively collaborate, but gulfs in life experience and privilege can yield difficult tensions and challenges. Expressions of discomfort, dissatisfaction or anger in PAR projects are often indicative of power inequalities and an opportunity to interrogate and challenge hierarchies. Scholars must work hard to undo their assumptions about where expertise and insights may lie. A first step can be to develop an analysis of a scholar’s own participation in the perpetuation of inequalities. Projects can be designed to intentionally redistribute power, by redistributing skills, responsibilities and authority, or by redesigning core activities to be more widely accessible. For instance, Marzi 51 in a participatory video project, used role swapping to distribute the leadership roles of chairing meetings, choosing themes for focus and editing, among all the participants.

Within communities, there are also power asymmetries. The term ‘community participation’ itself risks homogenizing a community, such that one or a small number of representatives are taken to qualify as the community. Yet, communities are characterized by diversity as much as by commonality, with differences across sociological lines such as class, race, gender, age, occupation, housing tenure and health status. Having the time, resources and ability to participate is unlikely to be evenly distributed. Some people need to devote their limited time to survival and care of others. For some, the embodied realities of health conditions and disabilities make participation in research projects difficult or undesirable 67 . If there are benefits attached to participation, careful attention to the distribution of such benefits is needed, as well as critical awareness of the positionality of those involved and those excluded. Active efforts to maximize accessibility are important, including paying participants for their valued time; providing accommodations for people with health conditions, disabilities, caring responsibilities or other specific needs; and designing participatory activities that are intuitive to a community’s typical modes of communication.

Lack of control and unpredictability

For researchers accustomed to leading research by taking responsibility to drive a project to completion, using the most rigorous methods possible, to achieve stated objectives, the collaborative, iterative nature of PAR can raise personal challenges. Sense 68 likens the facilitative role of a PAR practitioner to “trying to drive the bus from the rear passenger seat—wanting to genuinely participate as a passenger but still wanting some degree of control over the destination”. PAR works best with collaborative approaches to leadership and identities among co-researchers as active team members, facilitators and participants in a research setting, prepared to be flexible and responsive to provocations from the situation and from co-researchers and to adjust project plans accordingly 28 , 68 , 69 . The complexities involved in balancing control issues foreground the importance of reflexive practice for all team members to learn together through dialogue 70 . Training and socialization into collaborative approaches to leadership and partnership are crucial supports. Well-functioning collaborative ways of working are also vital, as their trusted structure can allow co-researchers to ‘trust the process’, and accept uncertainties, differing perspectives, changes of emphasis and disruptions of assumptions. We often want surprises in PAR projects, as they show that we are learning something new, and so we need to be prepared to accept disruption.

The PAR outlook is caught up in the ongoing history of the push and pull of popular movements for the recognition of local knowledge and elite movements to centralize authority and power in frameworks such as universal science, professional ownership of expertise, government authority or evidence-based policy. As a named methodological paradigm, PAR gained legitimacy and recognition during the 1980s, with origins in popular education for development, led by scholars from the Global South 16 , 32 , and taken up in the more Global-North-dominated field of international development, where the failings of externally imposed, contextually insensitive development solutions had become undeniable 21 . Over the decades, PAR has both participated in radical social movements and risked co-option and depoliticization as it became championed by powerful institutions, and it is in this light that we consider PAR’s relation to three contemporary societal movements.

Decolonizing or re-powering

The development of PAR took place in tandem with anti-colonial movements and discourses during the 1970s and 1980s, in which the colonization of land, people and knowledge were all at stake. During the mid-2010s, calls for decolonization of the university were forced onto the agenda of the powerful by various groups, including African students and youth leading the ‘Rhodes Must Fall’, ‘Fees must Fall’ and ‘Gandhi must Fall’ movements 71 , followed by the eruption of Black Lives Matter protests in 2020 (ref. 72 ). PAR is a methodology that stands to contribute to decolonization-colonization through the development of alternatives to centralizing knowledge and power. As such, the vitality of local and global movements demanding recognition of grassroots knowledge and the dismantling of oppressive historical power–knowledge systems heralds many openings and exciting potential collaborations and causes for PAR practitioners 73 , 74 . As these demands make themselves felt in powerful institutions, they create openings for PAR.

Yet, just as PAR has been subject to co-option and depoliticization, the concept of decolonization too is at risk of appropriation by dominant groups and further tokenization of Indigenous groups, as universities, government departments and global health institutions absorb the concept, fitting it into their existing power structures 41 , 75 . In this context, Indigenous theorists in Aotearoa/New Zealand are working on an alternative concept of ‘re-powering Indigenous knowledge’ instead of ‘decolonizing knowledge’. By doing so, they centre Indigenous people and their knowledge, instead of the knowledge or actions of colonizers, and foreground the necessity of changes to power relations. African and African American scholars working on African heritage and political agency have drawn on the Akan philosophy of Sankofa for a similar purpose 76 . Sankofa derives from a Twi proverb Se wo were fi na wosan kofa a yenkyiri (It is not taboo to fetch what is at risk of being left behind). Going back to fetch what is lost is a self-grounded act that draws on the riches of Indigenous history to re-imagine and restructure the future 77 . It is also an act independent of the colonial and colonizing gaze. Contributing to a mid-twenty-first century re-powering community knowledge is a promising vision for PAR. More broadly, the loud voices and visionary leadership of contemporary anti-racist, anti-colonial, Indigenous, intersectional feminist and other emancipatory movements provide a vibrant context to re-invent and renew PAR.

Co-production

In fields concerned with health and public service provision, a renewed discourse of respectful engagement with communities and service users has centred in recent years on the concept of  co-production 78 . In past iterations, concepts such as citizen engagement, patient participation, community participation and community mobilization had a similar role. Participatory methods have proved their relevance within such contexts, for example, providing actionable and wise insights to clinicians seeking to learn from patients, or to providers of social services seeking to target their services better. Thus, the introduction of co-production may create a receptive environment for PAR in public services. Yet again, if users are participating in something, critical PAR scholars should question in which structures they are participating, instantiating which power relations and to whose benefit. PAR scholars can find themselves compromised by institutional requirements. Identifying potential compromises, lines that cannot be crossed and areas where compromises can be made; negotiating with institutional orders; and navigating discomfort and even conflict are key skills for practitioners of PAR within institutional settings.

One approach to engaging with institutional structures has been to gather evidence for the value of PAR, according to the measures and methods of dominant science. Anyon and colleagues 59 systematically reviewed the Youth PAR literature in the United States. They found emerging evidence that PAR produces positive outcomes for youth and argued for further research using experimental designs to provide harder evidence. They make the pragmatic argument that funding bodies require certain forms of evidence to justify funding, and so PAR would benefit by playing by those rules.

A different approach, grounded in politics rather than the academy, situates co-production as sustained by democratic struggles. In the context of sustainability research in the Amazon, for instance, Perz and colleagues 79 argue that the days of externally driven research are past. Mobilization by community associations, Indigenous federations, producer cooperatives and labour unions to demand influence over the governance of natural resources goes hand in hand with expectations of local leadership and ownership of research, often implemented through PAR. These approaches critically question the desirability of institutional, external funding or even non-monetary support for a particular PAR project.

Global–local inequality and solidarity

Insufferable global and local inequalities continue to grow, intensified by climate catastrophes, the coronavirus disease 2019 (COVID-19) pandemic and extreme concentrations of wealth and political influence, and contested by increasingly impactful analyses, protests and refusals by those disadvantaged and discriminated against. Considering the impact of the COVID-19 pandemic on PAR projects, Auerbach and colleagues 64 identify increasing marketization and austerity in some universities, and the material context of growing pressure on marginalized communities to simply meet their needs for survival, leaving little capacity for participating in and building long-term partnerships. They describe university-based researchers relying on their own capacities to invent new modes of digital collaboration and nourish their partnerships with communities, often despite limited institutional support.

We suggest that building solidaristic networks, and thus building collective power, within and beyond universities offers the most promising grounding for a fruitful outlook for PAR. PAR scholars can find solidarity across a range of disciplines, traditions, social movements, topics and geographical locations. Doing so offers to bridge traditions, share strategies and resonances, build methodologies and politics, and crucially, build power. In global health research, Abimbola and colleagues 80 call for the building of Southern networks to break away from the dominance of North–South partnerships. They conceptualize the South not only as a geographical location, as there are of course knowledge elites in the South, but as the communities traditionally marginalized from centres of authority and power. We suggest that PAR can best maximize its societal contribution and its own development and renewal by harnessing the diverse wisdom of knowledge generation and participatory methods across Southern regions and communities, using that wisdom to participate in global solidarities and demands for redistribution of knowledge, wealth and power.

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Acknowledgements

The authors thank their PAR collaborators and teachers, who have shown us how to take care of each other, our communities and environments. They thank each other for generating such a productive critical thinking space and extending care during challenging times.

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Flora Cornish & Nancy Breton

Departmento de Gestion para el Desarrollo Sustentable, CONACyT–Universidad Autonoma de Guerrero, Acapulco, Guerrero, Mexico

Ulises Moreno-Tabarez

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Jenna Delgado

Māori Studies, University of Auckland, Auckland, Aotearoa, New Zealand

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Supplementary information

Supplementary information.

Involving multiple team members in the analysis and interpretation of materials generated, typically in iterative cycles of individual or pair work and group discussion.

Both a structure and a process, community refers to a network of often diverse and unequal persons engaged in common tasks or actions, stakes or interests that lead them to form social ties or commune with one another.

A process through which a person or group’s activities are altered or appropriated to serve another group’s interests.

A term typically used in service provision to describe partnership working between service providers and service users, to jointly produce decisions or designs.

A call to recognize and dismantle the destructive legacies of colonialism in societal institutions, to re-power indigenous groups and to construct alternative relationships between peoples and knowledges that liberate knowers and doers from colonial extraction and centralization of power.

Scholarship that creates knowledge of the conditions that limit or oppress us to liberate ourselves from those conditions and to support others in their own transformations.

Injustices in relation to knowledge, including whose knowledge counts and which knowledge is deemed valid or not.

Research that extracts information and exploits relationships, places and peoples, producing benefit for scholars or institutions elsewhere, and depleting resources at the sites of the research.

Knowledge that is rooted in experience in a particular social context, often devalued by social science perspectives that make claims to generalizability or universality.

The relationships of domination, subordination and resistance between individuals or social groups, allowing some to advance their perspectives and interests more than others.

A methodological practice through which scholars critically reflect on their own positionality and how it impacts on participants and co-researchers, understanding of the topic and the knowledge produced.

An approach to ethical conduct that situates ethics as ongoingly negotiated within the context of respectful relationships, beyond following the procedural rules often set out by ethics committees.

A dual role in which scholars use their knowledge (scholarship) to tackle injustices and instigate changes (activism) in collaboration with marginalized communities and/or organizations.

Doing something or appointing a person for reasons other than in the interest of enabling meaningful change.

A systemic change in which relationships and structures are fundamentally altered, often contrasted with smaller-scale changes such as varying or refining existing relations.

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Cornish, F., Breton, N., Moreno-Tabarez, U. et al. Participatory action research. Nat Rev Methods Primers 3 , 34 (2023). https://doi.org/10.1038/s43586-023-00214-1

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"The purpose of a literature review is to help you explain how the question to be investigated fits into the larger picture and why you have approached the topic the way you have. This section of a scholarly report allows the reader to be brought up to date regarding the state of research in the field and familiarizes him or her to any contrasting perspectives and viewpoints on the topic."

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• Strategy: Literature Reviews

What is a literature review?

Typically, a literature review is a written discussion that examines publications about  a particular subject area or topic. 

A Literature Review provides an overview of selected sources on a topic.

Depending on disciplines, publications, or authors a literature review may be:  

a summary of sources an organized presentation of sources a synthesis or interpretation of sources an evaluative analysis of sources

A Literature Review may be part of a process or a product . 

It may be: 

a part of your research process a part of your final research publication an independent publication

Why do a literature review?

The Literature Review will place your research in context . 

It will help you and your readers: 

Locate   patterns, relationships, connections, agreements, disagreements, & gaps in understanding Identify methodological and theoretical foundations Identify landmark and exemplary works Situate your voice in a broader conversation with other writers, thinkers, and scholars

The Literature Review will aid your research process. 

It will help you to: 

establish your knowledge understand what has been said define your questions establish a relevant methodology refine your voice situate your voice in the conversation

What does a literature review look like?

The Literature Review structure and organization . 

an introduction or overview a body or organizational sub-divisions a conclusion or an explanation of significance

The body of a literature review may be organized: 

chronologically: organized by date of publication  methodologically: organized by type of research method used  thematically: organized by concept, trend, or theme  ideologically: organized by belief, ideology, or school of thought

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Literature review on the use of action research in higher education

2016, Educational Action Research

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Psychology lecturers are well-qualified to carry out action research which would contribute to the theoretical understanding of learning as well as having practical benefits for students. Researchers are urged to collect evidence to influence policy where higher education is facing new challenges, whether from changing economic conditions, technological developments, globalisation, student diversity, or greater expectations for personalised, engaging, and flexible learning. Five specific areas within the teaching of psychology are identified as offering rich opportunities for collaborative action research: study abroad, study skills for transition to university, engaging students with statistics, gamification, and teaching psychology to students from other disciplines. Pedagogical action research demonstrates how knowledge and skills in psychology can be applied to solve practical problems, providing role models of psychological literacy to students, who can also beneficially be involved as participant researchers. Pedagogical research is particularly desirable when students are learning a new way of thinking.

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Literature review

A general guide on how to conduct and write a literature review.

Please check course or programme information and materials provided by teaching staff, including your project supervisor, for subject-specific guidance.

What is a literature review?

A literature review is a piece of academic writing demonstrating knowledge and understanding of the academic literature on a specific topic placed in context.  A literature review also includes a critical evaluation of the material; this is why it is called a literature review rather than a literature report. It is a process of reviewing the literature, as well as a form of writing.

To illustrate the difference between reporting and reviewing, think about television or film review articles.  These articles include content such as a brief synopsis or the key points of the film or programme plus the critic’s own evaluation.  Similarly the two main objectives of a literature review are firstly the content covering existing research, theories and evidence, and secondly your own critical evaluation and discussion of this content. 

Usually a literature review forms a section or part of a dissertation, research project or long essay.  However, it can also be set and assessed as a standalone piece of work.

What is the purpose of a literature review?

…your task is to build an argument, not a library. Rudestam, K.E. and Newton, R.R. (1992) Surviving your dissertation: A comprehensive guide to content and process. California: Sage, p49.

In a larger piece of written work, such as a dissertation or project, a literature review is usually one of the first tasks carried out after deciding on a topic.  Reading combined with critical analysis can help to refine a topic and frame research questions.  Conducting a literature review establishes your familiarity with and understanding of current research in a particular field before carrying out a new investigation. After doing a literature review, you should know what research has already been done and be able to identify what is unknown within your topic.

When doing and writing a literature review, it is good practice to:

• summarise and analyse previous research and theories;
• identify areas of controversy and contested claims;
• highlight any gaps that may exist in research to date.

Conducting a literature review

Focusing on different aspects of your literature review can be useful to help plan, develop, refine and write it.  You can use and adapt the prompt questions in our worksheet below at different points in the process of researching and writing your review.  These are suggestions to get you thinking and writing.

Developing and refining your literature review (pdf)

Developing and refining your literature review (Word)

Developing and refining your literature review (Word rtf)

Writing a literature review has a lot in common with other assignment tasks.  There is advice on our other pages about thinking critically, reading strategies and academic writing.  Our literature review top tips suggest some specific things you can do to help you submit a successful review.

Literature review top tips (pdf)

Literature review top tips (Word rtf)

Our reading page includes strategies and advice on using books and articles and a notes record sheet grid you can use.

Reading at university

The Academic writing page suggests ways to organise and structure information from a range of sources and how you can develop your argument as you read and write.

Academic writing

The Critical thinking page has advice on how to be a more critical researcher and a form you can use to help you think and break down the stages of developing your argument.

Critical thinking

As with other forms of academic writing, your literature review needs to demonstrate good academic practice by following the Code of Student Conduct and acknowledging the work of others through citing and referencing your sources.  

Good academic practice

As with any writing task, you will need to review, edit and rewrite sections of your literature review.  The Editing and proofreading page includes tips on how to do this and strategies for standing back and thinking about your structure and checking the flow of your argument.

Editing and proofreading

Guidance on literature searching from the University Library

The Academic Support Librarians have developed LibSmart I and II, Learn courses to help you develop and enhance your digital research skills and capabilities; from getting started with the Library to managing data for your dissertation.

Searching using the library’s DiscoverEd tool: DiscoverEd

Finding resources in your subject: Subject guides

The Academic Support Librarians also provide one-to-one appointments to help you develop your research strategies.

1 to 1 support for literature searching and systematic reviews

Advice to help you optimise use of Google Scholar, Google Books and Google for your research and study: Using Google

Managing and curating your references

A referencing management tool can help you to collect and organise and your source material to produce a bibliography or reference list. 

Referencing and reference management

Information Services provide access to Cite them right online which is a guide to the main referencing systems and tells you how to reference just about any source (EASE log-in may be required).

Cite them right

Published study guides

There are a number of scholarship skills books and guides available which can help with writing a literature review.  Our Resource List of study skills guides includes sections on Referencing, Dissertation and project writing and Literature reviews.

Study skills guides

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Lau F, Kuziemsky C, editors. Handbook of eHealth Evaluation: An Evidence-based Approach [Internet]. Victoria (BC): University of Victoria; 2017 Feb 27.

Handbook of eHealth Evaluation: An Evidence-based Approach [Internet].

Chapter 9 methods for literature reviews.

Guy Paré and Spyros Kitsiou .

9.1. Introduction

Literature reviews play a critical role in scholarship because science remains, first and foremost, a cumulative endeavour ( vom Brocke et al., 2009 ). As in any academic discipline, rigorous knowledge syntheses are becoming indispensable in keeping up with an exponentially growing eHealth literature, assisting practitioners, academics, and graduate students in finding, evaluating, and synthesizing the contents of many empirical and conceptual papers. Among other methods, literature reviews are essential for: (a) identifying what has been written on a subject or topic; (b) determining the extent to which a specific research area reveals any interpretable trends or patterns; (c) aggregating empirical findings related to a narrow research question to support evidence-based practice; (d) generating new frameworks and theories; and (e) identifying topics or questions requiring more investigation ( Paré, Trudel, Jaana, & Kitsiou, 2015 ).

Literature reviews can take two major forms. The most prevalent one is the “literature review” or “background” section within a journal paper or a chapter in a graduate thesis. This section synthesizes the extant literature and usually identifies the gaps in knowledge that the empirical study addresses ( Sylvester, Tate, & Johnstone, 2013 ). It may also provide a theoretical foundation for the proposed study, substantiate the presence of the research problem, justify the research as one that contributes something new to the cumulated knowledge, or validate the methods and approaches for the proposed study ( Hart, 1998 ; Levy & Ellis, 2006 ).

The second form of literature review, which is the focus of this chapter, constitutes an original and valuable work of research in and of itself ( Paré et al., 2015 ). Rather than providing a base for a researcher’s own work, it creates a solid starting point for all members of the community interested in a particular area or topic ( Mulrow, 1987 ). The so-called “review article” is a journal-length paper which has an overarching purpose to synthesize the literature in a field, without collecting or analyzing any primary data ( Green, Johnson, & Adams, 2006 ).

When appropriately conducted, review articles represent powerful information sources for practitioners looking for state-of-the art evidence to guide their decision-making and work practices ( Paré et al., 2015 ). Further, high-quality reviews become frequently cited pieces of work which researchers seek out as a first clear outline of the literature when undertaking empirical studies ( Cooper, 1988 ; Rowe, 2014 ). Scholars who track and gauge the impact of articles have found that review papers are cited and downloaded more often than any other type of published article ( Cronin, Ryan, & Coughlan, 2008 ; Montori, Wilczynski, Morgan, Haynes, & Hedges, 2003 ; Patsopoulos, Analatos, & Ioannidis, 2005 ). The reason for their popularity may be the fact that reading the review enables one to have an overview, if not a detailed knowledge of the area in question, as well as references to the most useful primary sources ( Cronin et al., 2008 ). Although they are not easy to conduct, the commitment to complete a review article provides a tremendous service to one’s academic community ( Paré et al., 2015 ; Petticrew & Roberts, 2006 ). Most, if not all, peer-reviewed journals in the fields of medical informatics publish review articles of some type.

The main objectives of this chapter are fourfold: (a) to provide an overview of the major steps and activities involved in conducting a stand-alone literature review; (b) to describe and contrast the different types of review articles that can contribute to the eHealth knowledge base; (c) to illustrate each review type with one or two examples from the eHealth literature; and (d) to provide a series of recommendations for prospective authors of review articles in this domain.

9.2. Overview of the Literature Review Process and Steps

As explained in Templier and Paré (2015) , there are six generic steps involved in conducting a review article:

• formulating the research question(s) and objective(s),
• searching the extant literature,
• screening for inclusion,
• assessing the quality of primary studies,
• extracting data, and
• analyzing data.

Although these steps are presented here in sequential order, one must keep in mind that the review process can be iterative and that many activities can be initiated during the planning stage and later refined during subsequent phases ( Finfgeld-Connett & Johnson, 2013 ; Kitchenham & Charters, 2007 ).

Formulating the research question(s) and objective(s): As a first step, members of the review team must appropriately justify the need for the review itself ( Petticrew & Roberts, 2006 ), identify the review’s main objective(s) ( Okoli & Schabram, 2010 ), and define the concepts or variables at the heart of their synthesis ( Cooper & Hedges, 2009 ; Webster & Watson, 2002 ). Importantly, they also need to articulate the research question(s) they propose to investigate ( Kitchenham & Charters, 2007 ). In this regard, we concur with Jesson, Matheson, and Lacey (2011) that clearly articulated research questions are key ingredients that guide the entire review methodology; they underscore the type of information that is needed, inform the search for and selection of relevant literature, and guide or orient the subsequent analysis. Searching the extant literature: The next step consists of searching the literature and making decisions about the suitability of material to be considered in the review ( Cooper, 1988 ). There exist three main coverage strategies. First, exhaustive coverage means an effort is made to be as comprehensive as possible in order to ensure that all relevant studies, published and unpublished, are included in the review and, thus, conclusions are based on this all-inclusive knowledge base. The second type of coverage consists of presenting materials that are representative of most other works in a given field or area. Often authors who adopt this strategy will search for relevant articles in a small number of top-tier journals in a field ( Paré et al., 2015 ). In the third strategy, the review team concentrates on prior works that have been central or pivotal to a particular topic. This may include empirical studies or conceptual papers that initiated a line of investigation, changed how problems or questions were framed, introduced new methods or concepts, or engendered important debate ( Cooper, 1988 ). Screening for inclusion: The following step consists of evaluating the applicability of the material identified in the preceding step ( Levy & Ellis, 2006 ; vom Brocke et al., 2009 ). Once a group of potential studies has been identified, members of the review team must screen them to determine their relevance ( Petticrew & Roberts, 2006 ). A set of predetermined rules provides a basis for including or excluding certain studies. This exercise requires a significant investment on the part of researchers, who must ensure enhanced objectivity and avoid biases or mistakes. As discussed later in this chapter, for certain types of reviews there must be at least two independent reviewers involved in the screening process and a procedure to resolve disagreements must also be in place ( Liberati et al., 2009 ; Shea et al., 2009 ). Assessing the quality of primary studies: In addition to screening material for inclusion, members of the review team may need to assess the scientific quality of the selected studies, that is, appraise the rigour of the research design and methods. Such formal assessment, which is usually conducted independently by at least two coders, helps members of the review team refine which studies to include in the final sample, determine whether or not the differences in quality may affect their conclusions, or guide how they analyze the data and interpret the findings ( Petticrew & Roberts, 2006 ). Ascribing quality scores to each primary study or considering through domain-based evaluations which study components have or have not been designed and executed appropriately makes it possible to reflect on the extent to which the selected study addresses possible biases and maximizes validity ( Shea et al., 2009 ). Extracting data: The following step involves gathering or extracting applicable information from each primary study included in the sample and deciding what is relevant to the problem of interest ( Cooper & Hedges, 2009 ). Indeed, the type of data that should be recorded mainly depends on the initial research questions ( Okoli & Schabram, 2010 ). However, important information may also be gathered about how, when, where and by whom the primary study was conducted, the research design and methods, or qualitative/quantitative results ( Cooper & Hedges, 2009 ). Analyzing and synthesizing data : As a final step, members of the review team must collate, summarize, aggregate, organize, and compare the evidence extracted from the included studies. The extracted data must be presented in a meaningful way that suggests a new contribution to the extant literature ( Jesson et al., 2011 ). Webster and Watson (2002) warn researchers that literature reviews should be much more than lists of papers and should provide a coherent lens to make sense of extant knowledge on a given topic. There exist several methods and techniques for synthesizing quantitative (e.g., frequency analysis, meta-analysis) and qualitative (e.g., grounded theory, narrative analysis, meta-ethnography) evidence ( Dixon-Woods, Agarwal, Jones, Young, & Sutton, 2005 ; Thomas & Harden, 2008 ).

9.3. Types of Review Articles and Brief Illustrations

EHealth researchers have at their disposal a number of approaches and methods for making sense out of existing literature, all with the purpose of casting current research findings into historical contexts or explaining contradictions that might exist among a set of primary research studies conducted on a particular topic. Our classification scheme is largely inspired from Paré and colleagues’ (2015) typology. Below we present and illustrate those review types that we feel are central to the growth and development of the eHealth domain.

9.3.1. Narrative Reviews

The narrative review is the “traditional” way of reviewing the extant literature and is skewed towards a qualitative interpretation of prior knowledge ( Sylvester et al., 2013 ). Put simply, a narrative review attempts to summarize or synthesize what has been written on a particular topic but does not seek generalization or cumulative knowledge from what is reviewed ( Davies, 2000 ; Green et al., 2006 ). Instead, the review team often undertakes the task of accumulating and synthesizing the literature to demonstrate the value of a particular point of view ( Baumeister & Leary, 1997 ). As such, reviewers may selectively ignore or limit the attention paid to certain studies in order to make a point. In this rather unsystematic approach, the selection of information from primary articles is subjective, lacks explicit criteria for inclusion and can lead to biased interpretations or inferences ( Green et al., 2006 ). There are several narrative reviews in the particular eHealth domain, as in all fields, which follow such an unstructured approach ( Silva et al., 2015 ; Paul et al., 2015 ).

Despite these criticisms, this type of review can be very useful in gathering together a volume of literature in a specific subject area and synthesizing it. As mentioned above, its primary purpose is to provide the reader with a comprehensive background for understanding current knowledge and highlighting the significance of new research ( Cronin et al., 2008 ). Faculty like to use narrative reviews in the classroom because they are often more up to date than textbooks, provide a single source for students to reference, and expose students to peer-reviewed literature ( Green et al., 2006 ). For researchers, narrative reviews can inspire research ideas by identifying gaps or inconsistencies in a body of knowledge, thus helping researchers to determine research questions or formulate hypotheses. Importantly, narrative reviews can also be used as educational articles to bring practitioners up to date with certain topics of issues ( Green et al., 2006 ).

Recently, there have been several efforts to introduce more rigour in narrative reviews that will elucidate common pitfalls and bring changes into their publication standards. Information systems researchers, among others, have contributed to advancing knowledge on how to structure a “traditional” review. For instance, Levy and Ellis (2006) proposed a generic framework for conducting such reviews. Their model follows the systematic data processing approach comprised of three steps, namely: (a) literature search and screening; (b) data extraction and analysis; and (c) writing the literature review. They provide detailed and very helpful instructions on how to conduct each step of the review process. As another methodological contribution, vom Brocke et al. (2009) offered a series of guidelines for conducting literature reviews, with a particular focus on how to search and extract the relevant body of knowledge. Last, Bandara, Miskon, and Fielt (2011) proposed a structured, predefined and tool-supported method to identify primary studies within a feasible scope, extract relevant content from identified articles, synthesize and analyze the findings, and effectively write and present the results of the literature review. We highly recommend that prospective authors of narrative reviews consult these useful sources before embarking on their work.

Darlow and Wen (2015) provide a good example of a highly structured narrative review in the eHealth field. These authors synthesized published articles that describe the development process of mobile health ( m-health ) interventions for patients’ cancer care self-management. As in most narrative reviews, the scope of the research questions being investigated is broad: (a) how development of these systems are carried out; (b) which methods are used to investigate these systems; and (c) what conclusions can be drawn as a result of the development of these systems. To provide clear answers to these questions, a literature search was conducted on six electronic databases and Google Scholar . The search was performed using several terms and free text words, combining them in an appropriate manner. Four inclusion and three exclusion criteria were utilized during the screening process. Both authors independently reviewed each of the identified articles to determine eligibility and extract study information. A flow diagram shows the number of studies identified, screened, and included or excluded at each stage of study selection. In terms of contributions, this review provides a series of practical recommendations for m-health intervention development.

9.3.2. Descriptive or Mapping Reviews

The primary goal of a descriptive review is to determine the extent to which a body of knowledge in a particular research topic reveals any interpretable pattern or trend with respect to pre-existing propositions, theories, methodologies or findings ( King & He, 2005 ; Paré et al., 2015 ). In contrast with narrative reviews, descriptive reviews follow a systematic and transparent procedure, including searching, screening and classifying studies ( Petersen, Vakkalanka, & Kuzniarz, 2015 ). Indeed, structured search methods are used to form a representative sample of a larger group of published works ( Paré et al., 2015 ). Further, authors of descriptive reviews extract from each study certain characteristics of interest, such as publication year, research methods, data collection techniques, and direction or strength of research outcomes (e.g., positive, negative, or non-significant) in the form of frequency analysis to produce quantitative results ( Sylvester et al., 2013 ). In essence, each study included in a descriptive review is treated as the unit of analysis and the published literature as a whole provides a database from which the authors attempt to identify any interpretable trends or draw overall conclusions about the merits of existing conceptualizations, propositions, methods or findings ( Paré et al., 2015 ). In doing so, a descriptive review may claim that its findings represent the state of the art in a particular domain ( King & He, 2005 ).

In the fields of health sciences and medical informatics, reviews that focus on examining the range, nature and evolution of a topic area are described by Anderson, Allen, Peckham, and Goodwin (2008) as mapping reviews . Like descriptive reviews, the research questions are generic and usually relate to publication patterns and trends. There is no preconceived plan to systematically review all of the literature although this can be done. Instead, researchers often present studies that are representative of most works published in a particular area and they consider a specific time frame to be mapped.

An example of this approach in the eHealth domain is offered by DeShazo, Lavallie, and Wolf (2009). The purpose of this descriptive or mapping review was to characterize publication trends in the medical informatics literature over a 20-year period (1987 to 2006). To achieve this ambitious objective, the authors performed a bibliometric analysis of medical informatics citations indexed in medline using publication trends, journal frequencies, impact factors, Medical Subject Headings (MeSH) term frequencies, and characteristics of citations. Findings revealed that there were over 77,000 medical informatics articles published during the covered period in numerous journals and that the average annual growth rate was 12%. The MeSH term analysis also suggested a strong interdisciplinary trend. Finally, average impact scores increased over time with two notable growth periods. Overall, patterns in research outputs that seem to characterize the historic trends and current components of the field of medical informatics suggest it may be a maturing discipline (DeShazo et al., 2009).

9.3.3. Scoping Reviews

Scoping reviews attempt to provide an initial indication of the potential size and nature of the extant literature on an emergent topic (Arksey & O’Malley, 2005; Daudt, van Mossel, & Scott, 2013 ; Levac, Colquhoun, & O’Brien, 2010). A scoping review may be conducted to examine the extent, range and nature of research activities in a particular area, determine the value of undertaking a full systematic review (discussed next), or identify research gaps in the extant literature ( Paré et al., 2015 ). In line with their main objective, scoping reviews usually conclude with the presentation of a detailed research agenda for future works along with potential implications for both practice and research.

Unlike narrative and descriptive reviews, the whole point of scoping the field is to be as comprehensive as possible, including grey literature (Arksey & O’Malley, 2005). Inclusion and exclusion criteria must be established to help researchers eliminate studies that are not aligned with the research questions. It is also recommended that at least two independent coders review abstracts yielded from the search strategy and then the full articles for study selection ( Daudt et al., 2013 ). The synthesized evidence from content or thematic analysis is relatively easy to present in tabular form (Arksey & O’Malley, 2005; Thomas & Harden, 2008 ).

One of the most highly cited scoping reviews in the eHealth domain was published by Archer, Fevrier-Thomas, Lokker, McKibbon, and Straus (2011) . These authors reviewed the existing literature on personal health record ( phr ) systems including design, functionality, implementation, applications, outcomes, and benefits. Seven databases were searched from 1985 to March 2010. Several search terms relating to phr s were used during this process. Two authors independently screened titles and abstracts to determine inclusion status. A second screen of full-text articles, again by two independent members of the research team, ensured that the studies described phr s. All in all, 130 articles met the criteria and their data were extracted manually into a database. The authors concluded that although there is a large amount of survey, observational, cohort/panel, and anecdotal evidence of phr benefits and satisfaction for patients, more research is needed to evaluate the results of phr implementations. Their in-depth analysis of the literature signalled that there is little solid evidence from randomized controlled trials or other studies through the use of phr s. Hence, they suggested that more research is needed that addresses the current lack of understanding of optimal functionality and usability of these systems, and how they can play a beneficial role in supporting patient self-management ( Archer et al., 2011 ).

9.3.4. Forms of Aggregative Reviews

Healthcare providers, practitioners, and policy-makers are nowadays overwhelmed with large volumes of information, including research-based evidence from numerous clinical trials and evaluation studies, assessing the effectiveness of health information technologies and interventions ( Ammenwerth & de Keizer, 2004 ; Deshazo et al., 2009 ). It is unrealistic to expect that all these disparate actors will have the time, skills, and necessary resources to identify the available evidence in the area of their expertise and consider it when making decisions. Systematic reviews that involve the rigorous application of scientific strategies aimed at limiting subjectivity and bias (i.e., systematic and random errors) can respond to this challenge.

Systematic reviews attempt to aggregate, appraise, and synthesize in a single source all empirical evidence that meet a set of previously specified eligibility criteria in order to answer a clearly formulated and often narrow research question on a particular topic of interest to support evidence-based practice ( Liberati et al., 2009 ). They adhere closely to explicit scientific principles ( Liberati et al., 2009 ) and rigorous methodological guidelines (Higgins & Green, 2008) aimed at reducing random and systematic errors that can lead to deviations from the truth in results or inferences. The use of explicit methods allows systematic reviews to aggregate a large body of research evidence, assess whether effects or relationships are in the same direction and of the same general magnitude, explain possible inconsistencies between study results, and determine the strength of the overall evidence for every outcome of interest based on the quality of included studies and the general consistency among them ( Cook, Mulrow, & Haynes, 1997 ). The main procedures of a systematic review involve:

• Formulating a review question and developing a search strategy based on explicit inclusion criteria for the identification of eligible studies (usually described in the context of a detailed review protocol).
• Searching for eligible studies using multiple databases and information sources, including grey literature sources, without any language restrictions.
• Selecting studies, extracting data, and assessing risk of bias in a duplicate manner using two independent reviewers to avoid random or systematic errors in the process.
• Analyzing data using quantitative or qualitative methods.
• Presenting results in summary of findings tables.
• Interpreting results and drawing conclusions.

Many systematic reviews, but not all, use statistical methods to combine the results of independent studies into a single quantitative estimate or summary effect size. Known as meta-analyses , these reviews use specific data extraction and statistical techniques (e.g., network, frequentist, or Bayesian meta-analyses) to calculate from each study by outcome of interest an effect size along with a confidence interval that reflects the degree of uncertainty behind the point estimate of effect ( Borenstein, Hedges, Higgins, & Rothstein, 2009 ; Deeks, Higgins, & Altman, 2008 ). Subsequently, they use fixed or random-effects analysis models to combine the results of the included studies, assess statistical heterogeneity, and calculate a weighted average of the effect estimates from the different studies, taking into account their sample sizes. The summary effect size is a value that reflects the average magnitude of the intervention effect for a particular outcome of interest or, more generally, the strength of a relationship between two variables across all studies included in the systematic review. By statistically combining data from multiple studies, meta-analyses can create more precise and reliable estimates of intervention effects than those derived from individual studies alone, when these are examined independently as discrete sources of information.

The review by Gurol-Urganci, de Jongh, Vodopivec-Jamsek, Atun, and Car (2013) on the effects of mobile phone messaging reminders for attendance at healthcare appointments is an illustrative example of a high-quality systematic review with meta-analysis. Missed appointments are a major cause of inefficiency in healthcare delivery with substantial monetary costs to health systems. These authors sought to assess whether mobile phone-based appointment reminders delivered through Short Message Service ( sms ) or Multimedia Messaging Service ( mms ) are effective in improving rates of patient attendance and reducing overall costs. To this end, they conducted a comprehensive search on multiple databases using highly sensitive search strategies without language or publication-type restrictions to identify all rct s that are eligible for inclusion. In order to minimize the risk of omitting eligible studies not captured by the original search, they supplemented all electronic searches with manual screening of trial registers and references contained in the included studies. Study selection, data extraction, and risk of bias assessments were performed inde­­pen­dently by two coders using standardized methods to ensure consistency and to eliminate potential errors. Findings from eight rct s involving 6,615 participants were pooled into meta-analyses to calculate the magnitude of effects that mobile text message reminders have on the rate of attendance at healthcare appointments compared to no reminders and phone call reminders.

Meta-analyses are regarded as powerful tools for deriving meaningful conclusions. However, there are situations in which it is neither reasonable nor appropriate to pool studies together using meta-analytic methods simply because there is extensive clinical heterogeneity between the included studies or variation in measurement tools, comparisons, or outcomes of interest. In these cases, systematic reviews can use qualitative synthesis methods such as vote counting, content analysis, classification schemes and tabulations, as an alternative approach to narratively synthesize the results of the independent studies included in the review. This form of review is known as qualitative systematic review.

A rigorous example of one such review in the eHealth domain is presented by Mickan, Atherton, Roberts, Heneghan, and Tilson (2014) on the use of handheld computers by healthcare professionals and their impact on access to information and clinical decision-making. In line with the methodological guide­lines for systematic reviews, these authors: (a) developed and registered with prospero ( www.crd.york.ac.uk/ prospero / ) an a priori review protocol; (b) conducted comprehensive searches for eligible studies using multiple databases and other supplementary strategies (e.g., forward searches); and (c) subsequently carried out study selection, data extraction, and risk of bias assessments in a duplicate manner to eliminate potential errors in the review process. Heterogeneity between the included studies in terms of reported outcomes and measures precluded the use of meta-analytic methods. To this end, the authors resorted to using narrative analysis and synthesis to describe the effectiveness of handheld computers on accessing information for clinical knowledge, adherence to safety and clinical quality guidelines, and diagnostic decision-making.

In recent years, the number of systematic reviews in the field of health informatics has increased considerably. Systematic reviews with discordant findings can cause great confusion and make it difficult for decision-makers to interpret the review-level evidence ( Moher, 2013 ). Therefore, there is a growing need for appraisal and synthesis of prior systematic reviews to ensure that decision-making is constantly informed by the best available accumulated evidence. Umbrella reviews , also known as overviews of systematic reviews, are tertiary types of evidence synthesis that aim to accomplish this; that is, they aim to compare and contrast findings from multiple systematic reviews and meta-analyses ( Becker & Oxman, 2008 ). Umbrella reviews generally adhere to the same principles and rigorous methodological guidelines used in systematic reviews. However, the unit of analysis in umbrella reviews is the systematic review rather than the primary study ( Becker & Oxman, 2008 ). Unlike systematic reviews that have a narrow focus of inquiry, umbrella reviews focus on broader research topics for which there are several potential interventions ( Smith, Devane, Begley, & Clarke, 2011 ). A recent umbrella review on the effects of home telemonitoring interventions for patients with heart failure critically appraised, compared, and synthesized evidence from 15 systematic reviews to investigate which types of home telemonitoring technologies and forms of interventions are more effective in reducing mortality and hospital admissions ( Kitsiou, Paré, & Jaana, 2015 ).

9.3.5. Realist Reviews

Realist reviews are theory-driven interpretative reviews developed to inform, enhance, or supplement conventional systematic reviews by making sense of heterogeneous evidence about complex interventions applied in diverse contexts in a way that informs policy decision-making ( Greenhalgh, Wong, Westhorp, & Pawson, 2011 ). They originated from criticisms of positivist systematic reviews which centre on their “simplistic” underlying assumptions ( Oates, 2011 ). As explained above, systematic reviews seek to identify causation. Such logic is appropriate for fields like medicine and education where findings of randomized controlled trials can be aggregated to see whether a new treatment or intervention does improve outcomes. However, many argue that it is not possible to establish such direct causal links between interventions and outcomes in fields such as social policy, management, and information systems where for any intervention there is unlikely to be a regular or consistent outcome ( Oates, 2011 ; Pawson, 2006 ; Rousseau, Manning, & Denyer, 2008 ).

To circumvent these limitations, Pawson, Greenhalgh, Harvey, and Walshe (2005) have proposed a new approach for synthesizing knowledge that seeks to unpack the mechanism of how “complex interventions” work in particular contexts. The basic research question — what works? — which is usually associated with systematic reviews changes to: what is it about this intervention that works, for whom, in what circumstances, in what respects and why? Realist reviews have no particular preference for either quantitative or qualitative evidence. As a theory-building approach, a realist review usually starts by articulating likely underlying mechanisms and then scrutinizes available evidence to find out whether and where these mechanisms are applicable ( Shepperd et al., 2009 ). Primary studies found in the extant literature are viewed as case studies which can test and modify the initial theories ( Rousseau et al., 2008 ).

The main objective pursued in the realist review conducted by Otte-Trojel, de Bont, Rundall, and van de Klundert (2014) was to examine how patient portals contribute to health service delivery and patient outcomes. The specific goals were to investigate how outcomes are produced and, most importantly, how variations in outcomes can be explained. The research team started with an exploratory review of background documents and research studies to identify ways in which patient portals may contribute to health service delivery and patient outcomes. The authors identified six main ways which represent “educated guesses” to be tested against the data in the evaluation studies. These studies were identified through a formal and systematic search in four databases between 2003 and 2013. Two members of the research team selected the articles using a pre-established list of inclusion and exclusion criteria and following a two-step procedure. The authors then extracted data from the selected articles and created several tables, one for each outcome category. They organized information to bring forward those mechanisms where patient portals contribute to outcomes and the variation in outcomes across different contexts.

9.3.6. Critical Reviews

Lastly, critical reviews aim to provide a critical evaluation and interpretive analysis of existing literature on a particular topic of interest to reveal strengths, weaknesses, contradictions, controversies, inconsistencies, and/or other important issues with respect to theories, hypotheses, research methods or results ( Baumeister & Leary, 1997 ; Kirkevold, 1997 ). Unlike other review types, critical reviews attempt to take a reflective account of the research that has been done in a particular area of interest, and assess its credibility by using appraisal instruments or critical interpretive methods. In this way, critical reviews attempt to constructively inform other scholars about the weaknesses of prior research and strengthen knowledge development by giving focus and direction to studies for further improvement ( Kirkevold, 1997 ).

Kitsiou, Paré, and Jaana (2013) provide an example of a critical review that assessed the methodological quality of prior systematic reviews of home telemonitoring studies for chronic patients. The authors conducted a comprehensive search on multiple databases to identify eligible reviews and subsequently used a validated instrument to conduct an in-depth quality appraisal. Results indicate that the majority of systematic reviews in this particular area suffer from important methodological flaws and biases that impair their internal validity and limit their usefulness for clinical and decision-making purposes. To this end, they provide a number of recommendations to strengthen knowledge development towards improving the design and execution of future reviews on home telemonitoring.

9.4. Summary

Table 9.1 outlines the main types of literature reviews that were described in the previous sub-sections and summarizes the main characteristics that distinguish one review type from another. It also includes key references to methodological guidelines and useful sources that can be used by eHealth scholars and researchers for planning and developing reviews.

Typology of Literature Reviews (adapted from Paré et al., 2015).

As shown in Table 9.1 , each review type addresses different kinds of research questions or objectives, which subsequently define and dictate the methods and approaches that need to be used to achieve the overarching goal(s) of the review. For example, in the case of narrative reviews, there is greater flexibility in searching and synthesizing articles ( Green et al., 2006 ). Researchers are often relatively free to use a diversity of approaches to search, identify, and select relevant scientific articles, describe their operational characteristics, present how the individual studies fit together, and formulate conclusions. On the other hand, systematic reviews are characterized by their high level of systematicity, rigour, and use of explicit methods, based on an “a priori” review plan that aims to minimize bias in the analysis and synthesis process (Higgins & Green, 2008). Some reviews are exploratory in nature (e.g., scoping/mapping reviews), whereas others may be conducted to discover patterns (e.g., descriptive reviews) or involve a synthesis approach that may include the critical analysis of prior research ( Paré et al., 2015 ). Hence, in order to select the most appropriate type of review, it is critical to know before embarking on a review project, why the research synthesis is conducted and what type of methods are best aligned with the pursued goals.

9.5. Concluding Remarks

In light of the increased use of evidence-based practice and research generating stronger evidence ( Grady et al., 2011 ; Lyden et al., 2013 ), review articles have become essential tools for summarizing, synthesizing, integrating or critically appraising prior knowledge in the eHealth field. As mentioned earlier, when rigorously conducted review articles represent powerful information sources for eHealth scholars and practitioners looking for state-of-the-art evidence. The typology of literature reviews we used herein will allow eHealth researchers, graduate students and practitioners to gain a better understanding of the similarities and differences between review types.

We must stress that this classification scheme does not privilege any specific type of review as being of higher quality than another ( Paré et al., 2015 ). As explained above, each type of review has its own strengths and limitations. Having said that, we realize that the methodological rigour of any review — be it qualitative, quantitative or mixed — is a critical aspect that should be considered seriously by prospective authors. In the present context, the notion of rigour refers to the reliability and validity of the review process described in section 9.2. For one thing, reliability is related to the reproducibility of the review process and steps, which is facilitated by a comprehensive documentation of the literature search process, extraction, coding and analysis performed in the review. Whether the search is comprehensive or not, whether it involves a methodical approach for data extraction and synthesis or not, it is important that the review documents in an explicit and transparent manner the steps and approach that were used in the process of its development. Next, validity characterizes the degree to which the review process was conducted appropriately. It goes beyond documentation and reflects decisions related to the selection of the sources, the search terms used, the period of time covered, the articles selected in the search, and the application of backward and forward searches ( vom Brocke et al., 2009 ). In short, the rigour of any review article is reflected by the explicitness of its methods (i.e., transparency) and the soundness of the approach used. We refer those interested in the concepts of rigour and quality to the work of Templier and Paré (2015) which offers a detailed set of methodological guidelines for conducting and evaluating various types of review articles.

To conclude, our main objective in this chapter was to demystify the various types of literature reviews that are central to the continuous development of the eHealth field. It is our hope that our descriptive account will serve as a valuable source for those conducting, evaluating or using reviews in this important and growing domain.

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• Cite this Page Paré G, Kitsiou S. Chapter 9 Methods for Literature Reviews. In: Lau F, Kuziemsky C, editors. Handbook of eHealth Evaluation: An Evidence-based Approach [Internet]. Victoria (BC): University of Victoria; 2017 Feb 27.
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• Introduction
• Overview of the Literature Review Process and Steps
• Types of Review Articles and Brief Illustrations
• Concluding Remarks

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REVIEW article

This article is part of the research topic.

Reviews in Veterinary Surgery

Small Animal Patient Preoperative Preparation: A Review of Common Antiseptics, Comparison Studies, and Resistance Provisionally Accepted

• 1 Texas A and M University, United States

The final, formatted version of the article will be published soon.

This review aims to describe commonly used antiseptics in veterinary medicine including their mechanism of action, spectrum of activity, potential adverse effects, and application techniques.Additionally, it provides a review of the veterinary literature comparing antiseptics, a discussion of effectiveness and efficacy studies, and the potential for increased resistance to biocides and antimicrobials. This review concludes that appropriate selection and use is necessary to prevent the occurrence of surgical site infections, adverse effects, and potential for increasing resistance to antimicrobials. Continued research is needed to fill gaps in the current knowledge such as optimal preparation procedures for various surgical sites, standardization of efficacy and effectiveness testing, and the clinical impact of decreased susceptibility to chlorhexidine and other antiseptics.

Keywords: antiseptic, Antiseptic action, Surgery, Skin preparation agents, skin preparation techniques

Received: 22 Jan 2024; Accepted: 19 Mar 2024.

Copyright: © 2024 Thieman and Nye. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) . The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Mx. Kelley Thieman, Texas A and M University, College Station, United States

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