Inside an Occupational Therapy–Disability Community Partnership to Promote Health Management: Ethnography of a Research Collaboration

Abstract

Abstract Importance: Disability studies–informed occupational therapy is predicated on full and equal partnerships among occupational therapy practitioners, researchers, and disability communities. Community-based participatory research (CBPR) is an approach to research that aligns with this vision yet is not without challenges. Understanding the tensions that arise from stakeholders’ perspectives and priorities is critical for promoting collaboration between occupational therapy professionals and disability community partners. Objective: To understand the group dynamics and relational processes of a CPBR team in the context of an intervention development study focused on health management for people with disabilities (PWD). Design: This 9-mo ethnographic study included semistructured interviews and participant observation. Data were analyzed thematically. Setting: Community-based multiagency collaborative. Participants: Nine participants (6 academic team members, 4 of whom were trained as occupational therapists; 2 disability partners; and 1 managed-care organization representative) took part. Three participants self-identified as PWD. Findings: CBPR processes, although productive, were fraught with challenges. Team members navigated competing priorities, varying power dynamics, and multifaceted roles and identities. Flexibility was needed to address diverse priorities, respond to unexpected challenges, and facilitate the project’s success. Conclusions and Relevance: Deep commitment to a shared goal of health care justice for PWD and team members’ willingness to address tensions promoted successful collaboration. Intentional relationship building is needed for occupational therapy researchers to collaborate with members of disability communities as equal partners. What This Article Adds: Disability studies–informed occupational therapy research demands that team members intentionally nurture equitable relationships through shared governance, clear communication, and recognition of the fluid nature of power dynamics.