title: "It was like reading a detective novel": Using PAR to work together for culture change.
abstract: Participatory action research (PAR), with its focus on engagement and collaboration, is uniquely suited to enhancing culture change initiatives in dementia care. Yet, there is limited literature of its application to culture change approaches in care settings, and even less in dementia specific care contexts. To address these gaps in the literature, the purpose of this paper is to examine the complexities of a PAR project aimed at changing the culture of dementia care in two diverse dementia care settings, including a long term care (LTC) and community care setting. Drawing from data gathered throughout the PAR process, we unpack the challenges experienced by participants working together to guide culture change within their respective care settings. These challenges include: overextending selves through culture change participation; fluctuating group membership; feeling uncertainty, confusion and apprehension about the process; frustratingly slow process; and seeking diverse group representation in decision making. We also highlight the potential for appreciative inquiry (AI) to be integrated with PAR to guide a process whereby participants involved in culture change initiatives can develop strategies to mitigate challenges they experience. We view the challenges and strategies shared here as being constructive to would-be culture change agents and hope this paper will move others to consider the use of PAR when engaging in culture change initiatives.
authors.affiliation: Department of Recreation and Leisure Studies, University of Waterloo, Canada.
authors.forename: Darla
authors.initials: D
authors.lastname: Fortune
authors.affiliation: Department of Recreation and Leisure Studies, University of Waterloo, Canada.
authors.forename: Janet
authors.initials: J
authors.lastname: McKeown
authors.affiliation: Department of Recreation and Leisure Studies, University of Waterloo, Canada.
authors.forename: Sherry
authors.initials: S
authors.lastname: Dupuis
authors.affiliation: Faculty of Nursing, University of Windsor, Canada.
authors.forename: Lorna
authors.initials: L
authors.lastname: de Witt
mesh_terms: D003156:Community Mental Health Services; D055812:Community-Based Participatory Research; D003704:Dementia / Q000628:therapy*; D006302:Health Services Research; D006801:Humans; D007400:Interprofessional Relations; D008134:Long-Term Care / Q000458:organization & administration; D015279:Organizational Culture; D018802:Patient-Centered Care / Q000458:organization & administration; D011364:Professional Practice
keywords: Appreciative inquiry; Culture change; Dementia; Long-term care; Participatory action research