The popularity of Participatory Action Research (PAR) increases the risk of tokenism and blurring the boundaries of what might be considered ‘good’ PAR. This became a pressing issue when we were invited by the City of Amsterdam to conduct PAR on digital inequality with vulnerable citizens in Amsterdam, within serious constraints of time and budget. We decided to take up the challenge to offer citizens an opportunity to share their needs. This paper aims to increase the transparency of the complex reality of a PAR process in order to help new researchers learn about the challenges of PAR in real-life situations, and to open up the discussion on the quality and boundaries of PAR. Though we managed to implement some core ethical principles of PAR in this project, two were particularly under pressure: democratic participation and collective action. These jeopardized collective learning and might unintentionally feed stereotypes regarding people’s capabilities. Nevertheless, this small and local study did manage to create ripples for change.

An emerging body of research indicates that active arts engagement can enhance older adults’ health and experienced well-being, but scientific evidence is still fragmented. There is a research gap in understanding arts engagement grounded in a multidimensional conceptualization of the value of health and well-being from older participants’ perspectives. This Dutch nation-wide study aimed to explore the broader value of arts engagement on older people’s perceived health and well-being in 18 participatory arts-based projects (dance, music, singing, theater, visual arts, video, and spoken word) for community-dwelling older adults and those living in long term care facilities. In this study, we followed a participatory design with narrative- and arts-based inquiry. We gathered micro-narratives from older people and their (in)formal caregivers (n = 470). The findings demonstrate that arts engagement, according to participants, resulted in (1) positive feelings, (2) personal and artistic growth, and (3) increased meaningful social interactions. This study concludes that art-based practices promote older people’s experienced well-being and increase the quality of life of older people. This study emphasizes the intrinsic value of arts engagement and has implications for research and evaluation of arts engagement.

Whilst the transformation towards digital healthcare is accelerating, there is still a substantial risk of excluding people with a distance to the online world. Groups like people with a low socioeconomic position, people with a migrant background or the elderly, who are already most at risk of experiencing health inequalities, are simultaneously experiencing increased digital exclusion. Researchers play a role in determining how eHealth access is framed and can thus impact how the barriers to its use are addressed. This qualitative meta-review critically evaluates the way researchers (as authors) discuss eHealth use in digitally marginalised groups. Specifically, it seeks to understand how eHealth is framed to address existing health systems problems; how the barriers to eHealth use are presented and which solutions are provided in response; and who authors suggest should be responsible for making eHealth work. The results of this review found four paradoxes in how current literature views eHealth use. Firstly, that health systems problems are complex and nuanced, yet eHealth is seen as a simple answer. Secondly, that there are many political, social and health systems-based solutions suggested to address eHealth use, however most of the identified barriers are individually framed. This focus on personal deficits results in misallocating responsibility for making these systemic improvements. Thirdly, although eHealth is meant to simplify the tasks of patients and healthcare workers, these are the groups most often burdened with the responsibility of ensuring its success. Lastly, despite tailoring eHealth to the user being the most suggested solution, researchers generally speak about groups as a homogenous entity - thus rendering tailoring difficult. Ultimately, this review finds that a shift to focus research on addressing systemic issues on a systems level is necessary to prevent further exacerbating existing health inequalities.

The paper presents an alternative conceptualization of participation in order to offer legitimation and guidance for (new) scholars, policymakers and citizens, and to prepare them for the work that needs to be done to develop genuine participation practices that bring about positive change. Metaphors like the participation ladder not only explain and shape our communication but also shape the way we think and act. Metaphors can shape our perceptions and actions in ways we do not notice. So if we believe the critiques are correct and that participation encompasses much more than a hierarchical set of social relations that are devoid of context, we need an alternative lens that prepares us for the right expectations and unanticipated actions. Inspired by the work of the German philosopher Hannah Arendt, we shift away from a focus of participation ladders in decision-making to foreground acting and work instead, as this might help to overcome some of the current obstacles to designing genuine collaborative processes.

Digital inequality is a critical issue in our knowledge economy. Often digital inequality is framed as a problem that only older people encounter. This rather stereotypical portrayal can result in improvised and unsuccessful policy actions. The goal of the article is to take the experiences of citizens who never or seldom use information and communication technology as a point of departure to show the impact and outcomes of digitalization on the lives of people with a low socioeconomic position (LSEP) and across different intersections, such as gender, poverty, ethnicity, and age. The results of this qualitative study emphasize that not being able to use the Internet negatively impacts feelings of belonging and self‐confidence. Citizens need to invest continually in new or different equipment and in skills to keep up. Opportunities to invest are shaped at the nexus of gender, class, educational level, and occupational status. Therefore, simply training people in particular digital skills is insufficient. We show that the complexity of digital inequality and its interrelatedness with social inequalities along lines of class, age, gender, and ethnicity demand that policy and practices address digital inequality across the entire scope.

Purpose: Lifestyle interventions can be effective in the management of overweight and obesity in children. However, ineffective guidance towards interventions and high attrition rates affect health impacts and cost effectiveness. The aim of this study was to gain insight into the factors influencing participation, in particular guidance towards, adherence to and completion of an intervention. Methods: A narrative literature review was performed to identify factors related to participation, leading to the development of the “Stages towards Completion Model”. Semi-structured interviews (n = 33) and three focus group discussions (n = 25) were performed with children and parents who completed two different group lifestyle interventions, as well as with their coaches. Results: The main barrier to participating in a lifestyle intervention was the complex daily reality of the participants. The main facilitator to overcome these barriers was a personal approach by all professionals involved. Conclusions: Participation in a lifestyle intervention is not influenced by one specific factor, but by the interplay of facilitators and barriers. A promising way to stimulate participation and thereby increase the effectiveness of interventions would be an understanding of and respect for the complex circumstances of participants and to personalize guidance towards and execution of interventions.