{ "abstract": "Introduction\n\nCommunity participation is a key strategy to reduce health inequities, particularly in rural or socially vulnerable settings. Participatory Action Research (PAR) provides methodological frameworks to actively engage communities across all phases of health interventions. However, systematic guidance on the concrete implementation of participatory action research is limited, and few studies explicitly evaluate the levels of community participation reached.Objective\n\nTo critically analyze qualitative studies implementing PAR in rural and vulnerable contexts by describing the participatory techniques employed, assessing the levels of community engagement achieved (based on the AdaptaGPS adaptation of the NICE NG44 guideline), and examining the utility and outcomes of these participatory approaches.Methods\n\nA qualitative systematic review was conducted following the PRISMA 2020 guidelines. Six databases (PubMed, Web of Science, Scopus, SciELO, IBECS, and CUIDEN Plus) and additional sources were searched up to April 2025. Eligible studies were qualitative and demonstrated a community participation level of ≥ 3. Methodological quality was assessed using the CASP tool, and findings were thematically synthesized.Results\n\nA total of 43 studies were included, employing a range of PAR techniques such as Photovoice, Community Advisory Boards, intersectoral coalitions, co-creation methods, and Indigenous-led approaches. Techniques embedded within existing community structures were more effective in fostering network-building and sustainability. Expressive methods promoted critical reflection and political awareness.Conclusions\n\nPAR techniques applied in rural and socially vulnerable contexts show strong potential for promoting empowerment and community-led transformation. Improving methodological rigor, systematizing participatory practices, and evaluating their structural impact on health equity are essential for advancing knowledge, informing policy, and strengthening practice in this field.Registration\n\nPROSPERO 2025 CRD420251059871 (May 27, 2025).", "abstract_shown": true, "affiliations": [ "Hospital of Alcañiz, Dr. Repollés 2, Alcañiz, Teruel, 44600, Spain.", "Aragon Institute of Health Research (IIS Aragón), Zaragoza, 50009, Spain.", "Amando-Loriga Caspe Primary Care Center, Joaquín Costa Avenue 0, Caspe, Zaragoza, 50700, Spain.", "Agri-Food Institute of Aragon (IA2), Zaragoza, 50009, Spain.", "EXER-GENUD (Growth, Exercise, Nutrition and Development), Faculty of Health and Sport Sciences, Zaragoza, Spain.", "Faculty of Health Sciences, University of Zaragoza, Domingo Miral Street s/n, Zaragoza, 50009, Spain.", "Research Group B53_23R: SAPIENF, University of Zaragoza, Zaragoza, Spain.", "Comprehensive Health Research Centre (CHRC), Universidade de Évora, Évora, 7002-554, Portugal.", "Departamento de Desporto e Saúde, Escola de Saúde e Desenvolvimento Humano, Universidade de Évora, Évora, 7000-671 , Portugal.", "Department of Nutrition and Dietetics, Faculty of Health Sciences, Istanbul Medipol University, Beykoz, Istanbul, 34810, Turkey.", "Agri-Food Institute of Aragon (IA2), Zaragoza, 50009, Spain. iguacel@unizar.es.", "Aragon Institute of Health Research (IIS Aragón), Zaragoza, 50009, Spain. iguacel@unizar.es.", "Faculty of Health Sciences, University of Zaragoza, Domingo Miral Street s/n, Zaragoza, 50009, Spain. iguacel@unizar.es.", "NUTRI-GENUD (Growth, Exercise, Nutrition and Development), Faculty of Health Sciences, University of Zaragoza, Zaragoza, Spain. iguacel@unizar.es.", "CIBEROBN - Biomedical Research Networking Center in Physiopathology of Obesity and Nutrition, Instituto de Salud Carlos III, Madrid, Spain. iguacel@unizar.es." ], "article_type": "systematic review", "arxiv": null, "author_total": 10, "authors": [ { "affs": [ 0, 1 ], "name": "Miriam Carmena Del Viso", "orcid": "0009-0003-8993-0684" }, { "affs": [ 2, 1 ], "name": "Umayma Beni-Abdellah", "orcid": "0009-0003-8046-447X" }, { "affs": [ 3, 1, 4 ], "name": "Ana Moradell", "orcid": "0000-0003-0330-5558" }, { "affs": [ 5, 6 ], "name": "Carlos Navas-Ferrer", "orcid": "0000-0003-2887-7835" }, { "affs": [ 5, 6 ], "name": "Isabel Blázquez-Ornat", "orcid": "0000-0002-8197-9884" }, { "affs": [ 7, 8 ], "name": "Armando Raimundo", "orcid": "0000-0001-9753-8381" }, { "affs": [ 9 ], "name": "Indrani Kalkan", "orcid": "0000-0001-6020-349X" }, { "affs": [ 5, 6 ], "name": "Isabel Antón-Solanas", "orcid": "0000-0002-8206-4803" }, { "affs": [ 10, 11, 12, 13, 14 ], "name": "Isabel Iguacel", "orcid": "0000-0003-4242-5464" }, { "affs": [ 3, 1, 4, 5 ], "name": "David Navarrete-Villanueva", "orcid": "0000-0001-6523-5511" } ], "bibtex": "https://research.draconitic.com/paper/1jm391pmqtkhk.bib", "cited_by": 0, "doi": "10.1186/s12889-026-28651-z", "fulltext_url": "https://europepmc.org/articles/PMC13700319", "id": "1jm391pmqtkhk", "issns": [ "1471-2458" ], "landing_url": "https://europepmc.org/article/MED/42928147", "language": "eng", "licence": "CC-BY-NC-ND", "licence_label": "CC BY-NC-ND", "licence_source": "article", "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/", "metadata_licence": null, "native_subjects": [ [ "lcc", "RA1-1270" ], [ "openalex", "3600|Community Health and Development" ] ], "openalex": "W7171624431", "pdf_url": "https://europepmc.org/articles/PMC13700319?pdf=render", "pmcid": "PMC13700319", "pmid": "42928147", "published": "2026-07-01", "publisher": "BMC", "ris": "https://research.draconitic.com/paper/1jm391pmqtkhk.ris", "sources": [ { "first_seen": "2026-10-30T12:21:20Z", "native_id": "MED:42928147", "source": "europepmc", "url": "https://europepmc.org/article/MED/42928147" }, { "first_seen": "2026-11-01T14:21:25Z", "native_id": "0ae466ded7f042ff892377dea3577be0", "source": "doaj", "url": "https://doi.org/10.1186/s12889-026-28651-z" } ], "subjects": [ { "field": "medicine", "origin": "lcc:RA1-1270", "subfield": "epidemiology-public-health" } ], "title": "Participatory action research in rural and vulnerable settings for community health: a systematic literature review.", "title_text": "Participatory action research in rural and vulnerable settings for community health: a systematic literature review.", "type": "peer-reviewed", "updated_at": "2026-11-03T14:20:52Z", "url": "https://research.draconitic.com/paper/1jm391pmqtkhk", "venue": "BMC public health", "versions": [] }