Involving the seldom heard in participatory health research: challenges and strategies

Background Participatory health research is gaining increasing recognition in the public health sector. The people whose lives or work are central to wicked issues around health inequalities are integrated into the projects. Including diverse forms of knowledge and perspectives has the capability of strengthening health equity in specific settings. That proffers agency to the voices of those who are seldom heard. Often, participatory health research (PHR) is done with communities. Finding the truly isolated - those who are not connected to others or to services, the seldom heard - presents a challenge for research. Without hearing the voices of those most distanced from mainstream discourse we run the risk of misunderstanding issues pertinent to their lives. This narrative overview highlights this problem and aims to contribute a solution approach for research practice. Methods An extensive literature review for participatory research references in the German language was used and the international literature was also screened. Furthermore, the processes of three participatory research projects were evaluated. Results/Discussion The specified strategies to involve the seldom heard refer to lowered systemic barriers and improved local capacity for their participation. For example, before research can start, time should be given for a preparatory phase. This can be used to invest in relationships and co-operation to bridge the distance to research.