Participatory action research: towards (non-ideal) epistemic justice in a university in South Africa

ABSTRACT

The paper explores the possibilities for promoting epistemic justice in a South African university setting through a participatory action-based photovoice research project in which university researchers worked alongside undergraduate students with no prior experience of doing research. The student voices are employed to understand how learning as capability development and agency expansion can advance epistemic justice in a university setting of hierarchical relationships that make participatory action research challenging. The paper considers how, in this project, spaces of epistemic democracy intersected with the expansion of multidimensional functionings, resulting in more epistemic justice for the student-researchers. The paper considers the possibilities for change through a participatory project toward promoting epistemic justice at the individual level. It also explores some criticisms of the limits of such individual development in the face of structural challenges.     

A population study of low-rate smokers: quitting history and instability over time.

This study used 1 longitudinal and 2 cross-seconal population surveys to compare stability of low-rate daily smokers (less than 5 cigarettes per day) with other daily smokers and occasional smokers. Few low-rate smokers maintained consumption level; 36% retained smoking status after 20 months, compared with 82% and 44% for regular daily and occasional smokers, respectively. In a dynamic process, established smokers quit smoking and/or modified (decreased or increased) consumption. Low-rate and occasional smokers quit at higher rates than regular daily smokers (odds ratios 3:1) but were replenished by new members, many converted from regular daily smoker. The overall trend is an increasing proportion of low-consumption smokers while smoking prevalence declines. The dynamic process has implications for tobacco control efforts and for addiction theory.     

Examination of potential disparities in suicide risk identification and follow-up care within the Veterans Health Administration

To improve the identification and intervention of suicide risk, the Veterans Health Administration implemented the use of electronic patient record flags (PRF) to indicate when a veteran is identified as high risk for suicide and to increase the clinical contacts made with the veteran. The current study utilized an intersectional approach to assess potential disparities in the likelihood of receiving a PRF and the likelihood of receiving post-PRF follow-up care among veterans with substance use disorders (SUDs). Among 458,092 veterans who received a SUD diagnosis in 2012, Black veterans were less likely to receive a PRF, although Black-disabled veterans and Black-female veterans were more likely to receive a PRF. Homelessness was related to greater likelihood of receiving a PRF and post-PRF care. Hispanic/Latinx veterans who experienced homelessness were more likely to receive post-PRF care, while disabled veterans who experienced homelessness were less likely. Hispanic/Latinx, female veterans, and Black-disabled veterans were significantly less likely to receive post-PRF care. Overall, few marginalized or intersecting identities were associated with decreased PRF or decreased follow-up care. There are opportunities for specific strategies that promote engagement in VA follow-up services for veterans identifying as Hispanic/Latinx women, disabled Black veterans, and disabled homeless veterans.