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Peer-reviewedCC BY-NC-NDBMC public health

Participatory action research in rural and vulnerable settings for community health: a systematic literature review.

  • Miriam Carmena Del Viso1,2
  • Umayma Beni-Abdellah3,2
  • Ana Moradell4,2,5
  • Carlos Navas-Ferrer6,7
  • Isabel Blázquez-Ornat6,7
  • Armando Raimundo8,9
  • Indrani Kalkan10
  • Isabel Antón-Solanas6,7
  • Isabel Iguacel11,12,13,14,15
  • David Navarrete-Villanueva4,2,5,6
15 affiliations
  1. 1Hospital of Alcañiz, Dr. Repollés 2, Alcañiz, Teruel, 44600, Spain.
  2. 2Aragon Institute of Health Research (IIS Aragón), Zaragoza, 50009, Spain.
  3. 3Amando-Loriga Caspe Primary Care Center, Joaquín Costa Avenue 0, Caspe, Zaragoza, 50700, Spain.
  4. 4Agri-Food Institute of Aragon (IA2), Zaragoza, 50009, Spain.
  5. 5EXER-GENUD (Growth, Exercise, Nutrition and Development), Faculty of Health and Sport Sciences, Zaragoza, Spain.
  6. 6Faculty of Health Sciences, University of Zaragoza, Domingo Miral Street s/n, Zaragoza, 50009, Spain.
  7. 7Research Group B53_23R: SAPIENF, University of Zaragoza, Zaragoza, Spain.
  8. 8Comprehensive Health Research Centre (CHRC), Universidade de Évora, Évora, 7002-554, Portugal.
  9. 9Departamento de Desporto e Saúde, Escola de Saúde e Desenvolvimento Humano, Universidade de Évora, Évora, 7000-671 , Portugal.
  10. 10Department of Nutrition and Dietetics, Faculty of Health Sciences, Istanbul Medipol University, Beykoz, Istanbul, 34810, Turkey.
  11. 11Agri-Food Institute of Aragon (IA2), Zaragoza, 50009, Spain. [email protected].
  12. 12Aragon Institute of Health Research (IIS Aragón), Zaragoza, 50009, Spain. [email protected].
  13. 13Faculty of Health Sciences, University of Zaragoza, Domingo Miral Street s/n, Zaragoza, 50009, Spain. [email protected].
  14. 14NUTRI-GENUD (Growth, Exercise, Nutrition and Development), Faculty of Health Sciences, University of Zaragoza, Zaragoza, Spain. [email protected].
  15. 15CIBEROBN - Biomedical Research Networking Center in Physiopathology of Obesity and Nutrition, Instituto de Salud Carlos III, Madrid, Spain. [email protected].
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Abstract

Introduction

Community 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

To 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

A 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

A 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

PAR 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

PROSPERO 2025 CRD420251059871 (May 27, 2025).

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Cite

BibTeXRIS
BibTeX
@article{viso2026participatory,
  title = {{Participatory action research in rural and vulnerable settings for community health: a systematic literature review.}},
  author = {Miriam Carmena Del Viso and Umayma Beni-Abdellah and Ana Moradell and Carlos Navas-Ferrer and Isabel Blázquez-Ornat and Armando Raimundo and Indrani Kalkan and Isabel Antón-Solanas and Isabel Iguacel and David Navarrete-Villanueva},
  journal = {BMC public health},
  year = {2026},
  month = jul,
  doi = {10.1186/s12889-026-28651-z},
  url = {https://europepmc.org/article/MED/42928147},
  note = {CC BY-NC-ND},
}
RIS
TY  - JOUR
TI  - Participatory action research in rural and vulnerable settings for community health: a systematic literature review.
AU  - Miriam Carmena Del Viso
AU  - Umayma Beni-Abdellah
AU  - Ana Moradell
AU  - Carlos Navas-Ferrer
AU  - Isabel Blázquez-Ornat
AU  - Armando Raimundo
AU  - Indrani Kalkan
AU  - Isabel Antón-Solanas
AU  - Isabel Iguacel
AU  - David Navarrete-Villanueva
PY  - 2026
DA  - 2026/07/01
JO  - BMC public health
DO  - 10.1186/s12889-026-28651-z
UR  - https://europepmc.org/article/MED/42928147
AB  - Introduction  Community 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  To 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  A 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  A 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  PAR 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  PROSPERO 2025 CRD420251059871 (May 27, 2025).
SN  - 1471-2458
ER  -