By taking a reflexive approach to research methodology, this article contributes to discussions on power dynamics and knowledge production in the social studies of children. The author describes and analyzes three research methods that she used with children — drawing, child-led tape-recording and focus group discussions. These methods were carried out during 15 months of research in a low-income urban settlement in Zambia with children (ages 8—12) caring for sick parents or guardians. The research raises two points concerning current conceptions of children’s research methodology. First, it is necessary to investigate what so-called ‘child-oriented’ research methodologies accomplish for adult researchers. Second, acknowledging that children have their own reasons for participating in research and investigating these reasons may offer a more comprehensive view of children’s experiences and needs.

Rural residents in underserved areas face many barriers to health services, including colonoscopies for colorectal cancer (CRC) screening, but rural healthcare providers may assist patients navigating these challenges due to familiarity with local contexts. In 2017 to 2018, we interviewed clinical practitioners and staff (n = 40) at 13 primary care and gastroenterology locations across rural Southern Illinois. We used a semi-structured interview guide that addressed system, provider, and patient levels including domains related to barriers, facilitators, and needs for intervention. This article focuses on 3 main elements related to distance and transportation that emerged from inductive coding. First, providers described long distance travel for care as normalized but not necessarily preferable. Second, they identified and described distance-related challenges specific to CRC screening, and third, providers discussed strategies, mostly related to transportation, they use to navigate those challenges. Finally, they suggested a variety of broader solutions to reduce distance and transportation barriers to screening. Overall, distance to care remains a challenge to increasing CRC screening and contributes to disparities in rural communities. To increase early detection and reduce rural cancer disparities, efforts to increase screening and follow-up must address ways to help patients and providers navigate this distance within their local communities and contexts.

Background: Children are the focus of numerous health interventions throughout the world, yet the extent of children’s meaningful participation in research that informs the adaptation, implementation, and evaluation of health interventions is not known. We examine the type, extent, and meaningfulness of children’s participation in research in qualitative health intervention research. Method: A scoping study was conducted of qualitative published research with children (ages 6–11 years) carried out as part of health intervention research. Following Arksey and O’Malley’s scoping study methodology and aligned with the PRISMA-ScR guidelines on the reporting of scoping reviews, the authors searched, charted, collated, and summarized the data, and used descriptive and content analysis techniques. Ovid MEDLINE was searched from 1 January 2007 to 2 July 2018 using the keywords children, health intervention, participation, and qualitative research. Study selection and data extraction were carried out by two reviewers independently. Results: Of 14,799 articles screened, 114 met inclusion criteria and were included. The study identified trends in when children were engaged in research (e.g., post-implementation rather than pre-implementation), in topical (e.g., focus on lifestyle interventions to prevent adult disease) and geographical (e.g., high-income countries) focuses, and in qualitative methods used (e.g., focus group). While 78 studies demonstrated meaningful engagement of children according to our criteria, there were substantial reporting gaps and there was an emphasis on older age (rather than experience) as a marker of capability and expertise. Conclusions: Despite evidence of children’s meaningful participation, topical, geographical, and methodological gaps were identified, as was the need to strengthen researchers’ skills in interpreting and representing children’s perspectives and experiences. Based on these findings, the authors present a summary reflective guide to support researchers toward more meaningful child participation in intervention research.

Based on ethnographic fieldwork in Lusaka, Zambia, this article puts forth the concept of imaginal caring to examine a form of caring that is fantastical, exaggerated, and counterfactual. To develop this concept, I take the vantage point of young children (ages eight through twelve) who lived in households with persons who were suffering from tuberculosis and HIV. The children were involved in providing day-to-day care in many ways. They were also constrained in their efforts to give and show care because of their social positions, their access to resources, and their small human bodies. Through a series of examples, I demonstrate the ways in which children created and played with often visual images of giving care to family members in the past, present, and future. I show that fantastical imaginations and images of children’s involvement in caring not only expressed that they cared for others but also served as ways for them to provide or perform care. There were high social and personal stakes for children in not being able to care for others, and children’s efforts to care imaginally responded to such stakes, envisioning futures different from those scripted for them by global health discourses and the conditions of marginalization and exclusion into which they were born. Mukusupawila Ukulingana no mulimo wakufwailikisha muncende ishaba mu Lusaka, mu Zambia, uyu mulandu uleleta palwalala ilangulushi lya kusakamana kwa kwelenganya mu kweesha ukusanga umusango umo uwa kusakamana uwasumbulwa ukucila mu cipimo, kabili uwabulamo ifishinka. Mu kupanga ili langulushi, nasenda ulubali lwa baice (abamyaka cine-konse konse ukushinta pamyaka ikumi limo na ibili) abo abaikele mu ndupwa umwali abantu abalecushiwa na malwele ya icifuba ca ntanda bwanga (TB) na kashishi ka bulwele bwa kondoloka (HIV). Abana balibulilemo ulubali mu kusakamana abalwele cila bushiku mu nshila isha pusana pusana. Abana bali abashupikwa mukwesha kwabo ukwa kupeela no kulanga ukusakamana pa mulandu wa mikalile yabo, ishuko lyabo ilya kusanga ifyakubomfya, ukubikapo fye ne mibili yabo iinono. Ukupitila mu filangisho ifingi, ndelangisha inshila isho abana abanono balepanga elyo no kubomfya ifimpasho ifimoneka ifya kusakamana abalupwa mu nshita iyapita, ino, elyo ne ya kuntanshi. Ndelangisha ukutila ukwelenganya ne fimpasho ifyapulamo ifya kuibimbamo kwa bana takwalanga fye ukuti balesakamana abantu bambi (abalwele/abalupwa), lelo kwabombele nge nshila shabo isha kupeelelamo nangu ukubomba umulimo wa kusakamana. Kwali amaafya ayengi elyo ayakulu mubwikashi bwa bana abaleesha ukusakamana bambi. Kabili amaka ya bana mu kusakamana kwa kwelenganya, yalyafwilishe kuli ayo amaafya, ukwelenganya ubupusano bwa kuntanshi ukufuma kuli ifyo ifyalembwa pali bena mu malyashi yabumi aye sonde lyonse elyo ne mibeele ya kusuulwa no kupatululwa, iyo bafyelwemo. Mwacidule Kulinganiza ndi nchito yofufuza-fufuza mu madera ya Muzinda wa Lusaka, mu dzoko la Zambia, iyi mbiri ibweretsa ganizo lachisamaliro chofanizira moyetsa kupeza maonekedwe yachisamaliro chakuya, chozama koma chimene chiribe Mfundo zeni-zeni. Pomanga iri ganizo, ndatenga choonerako cha ana ang’ono-ang’ono (ali ndi zaka zisanu ndi zitatu mpaka khumi ndi ziwiri) amene anakhala mu mabanja anali ndi anthu wodwala chifuwa chabefu (TB) ndi matende ya Kaliwondewonde (HIV). Ana anali kutenga mbali yasamara wodwala tsiku ndi tsiku munjira zo siyana-siyana. Anali wobvutika mukugwapo kwawo kopereka ndi kuonetsa chisamaliro chifukwa cha mukalidwe wawo, kukwanisira kupeza zofunikira ndipo kuchepepa kwamathupi yawo. Kupyorera mu zisanzo zambiri, ndiri kuonetsa njira zimene ana anapanga ndi kusewenzetsa kawiri kawiri zifaniziro zoonetsa kupatsa chisamaliro ku anthu mubanja kudala, tsopano ndipo kutsogoro. Ndiri kuonetsa kuti kuyerekeza ndi zifanizo zozama zakugwapo kwa ana pa nchito yachisamariro sizinali kuonetsa kusamalira kwawo ku anthu ena koma kumaonetsa njira zawo zopatsa ndi kusamalira. Kunali mabvuto yayakulu ku ana pa kusagwapo kwawo mu kusamalira anthu ena, ndipo kugwapo kwawo kogwapo kofanizira kunagwebana ndi mabvuto ayo pamene anali kuganizira tsogoro losiyanako ndi zolembedwa mu nkhani yaumoyo yadziko lonse lapansi ndi mukhalidwe wachisankulo ndi kusayesedwa ngati anthu zimene anabadwiramo.