The project “women 5.0 – Regional Care for Women over 49 by Outpatient Gynaecologists and General Practitioners” (“Frauen 5.0”) of the Institute of General Practice at the Charité – Universitätsmedizin Berlin assessed the regional situation of health care services for women aged 50 and older in three federal states in north-eastern Germany from 2017 to the beginning of 2020. The perspectives of outpatient general practitioners and gynaecologists, women and care providers in the region were equally analysed to create a robust data basis and to establish trust among the stakeholders. This allowed the development of a concept for an innovative model project of outpatient care “by the region for the region” in which all perspectives were taken into account and which can ensure a low-threshold, regionally equitable access to gynaecological health services for women aged 50 and older.
Taking part in the project was understood as active participation. As many stakeholders as possible were involved in the knowledge-generating process: decision-makers, members of the target group or implementers of the planned measures, who were all affected by the implementation of the project. The project followed central aspects of participatory research design according to von Unger (2014).
- Participation of stakeholders whose living and working conditions are in the focus of the research as co-researchers with decision-making power in the research process
- Processes of competence and empowerment: learning from each other, competence development and (self-)empowerment, and the associated merge of perspectives during the cooperation
- Understanding and changing the social realities of the stakeholders
In the course of the project, participation was realised along the continuum of participation according to Chung & Lounsbury (2006):
- Quantitative survey of primary care providers (general practitioners and outpatient gynaecologists) and questioning of patients with qualitative interviews (compliant participation, “usual” participation)
- Directed consultation by advisors from the specialist groups involved in the advisory board (simultaneously with step 1)
- Mutual consultation on the basis of the results of steps 1 and 2 with professional associations, associations of statutory health insurance physicians, medical associations and professional societies
- Collecting all results in an empowering co-investigation, which also invited health care providers to participate in the development of the research design
Within the two years of the project, (co-)researchers were thus able to shift from “usual”/compliant participation to active participation. The participants developed regional concepts for their region themselves and thereby had an influence on the research. This kind of participation also led to an adaptation of the publication form: the jointly developed concept was published as a policy brief/executive summary (in German), which was presented at the final symposium in January 2020. This publication form ensures that the concept is quickly forwarded and presented to decision-makers.
The project was funded by the Innovation Committee (Innovationsausschuss) of the Federal Joint Committee (Gemeinsamer Bundesausschuss) between July 2017 and February 2020. The consortium partner of the project is the Robert Koch Institute.
Chung, K., & Lounsbury, D. W. (2006). The role of power, process, and relationships in participatory research for statewide HIV/AIDS programming. Social Science & Medicine, 63(8), 2129-2140.
von Unger, H. (2014). Partizipative Forschung. Einführung in die Forschungspraxis. Wiesbaden: Springer VS.