Abstract
Public health research and programming has historically and continues to exclude resource-deprived communities. Health research on priority populations has reinforced systems of oppression through extractive, disempowering, and harmful practices—communities often have little to no control over the research process and how their information is used. Meaningful stakeholder engagement requires an intersectional lens to better integrate the lived experiences, needs, and realities of priority communities. However, methods and practices for operationalizing principles of intersectionality theory remains unexplored within the domain of public health stakeholder engagement.
To fill this knowledge gap, we conducted a scoping review on intersectional approaches to stakeholder engagement across the Medline and Embase databases and identified 30 studies for inclusion. Data was extracted on each study’s public health intervention, target population, level of engagement from communication to coproduction, engagement approach, and outcome of stakeholder engagement. We defined and evaluated the extent to which intersectionality was applied using the Intersectionality-Based Policy Analysis Framework.
All included studies conducted stakeholder engagement with population groups who experience oppression and inequity across multiple determinants of health. Key priority populations examined in the review include Indigenous communities, 2SLGBTQIA+ folks, immigrants, and individuals with lived experiences with financial or housing insecurity. The most commonly observed stakeholder engagement approaches were focus groups, one-on-one interviews, and community-based participatory action research. We found that studies with higher levels of participation from communities utilized more methods of engagement within a single program, on average. Furthermore, studies who aimed to coproduce and empower communities through stakeholder engagement achieved more sustainable and culturally relevant public health programs.
An intersectional lens to stakeholder engagement prompts public health researchers and practitioners to reflect upon their positions of power and privilege in relation to the communities they work with. The most effective and meaningful approaches to stakeholder engagement aimed to minimize power imbalances, wherein communities were considered as equal partners in the research and program development process. The findings from this review were synthesized in an action-oriented checklist of promising practices, which compliments the Public Health Agency of Canada’s Sex- and Gender-Based Analysis Plus tool.