Why urban communities in low- and middle-income countries participate in global health research: A scoping review and fuzzy cognitive mapping summary

BACKGROUND: Although community participation is a key strategy for decolonizing global health research, there are significant difficulties in the meaningful engagement of urban communities in low- and middle-income countries. Addressing barriers and leveraging enablers before beginning research could facilitate more equitable collaborations. To guide researchers in this endeavour, this scoping review mapped available evidence and identified factors influencing the participation of urban communities in global health research in low- and middle-income countries. METHODS: Following guidelines from the Joanna Briggs' Institute and PRISMA-ScR, we searched six databases for articles published in English and French without date restriction. Two independent reviewers screened articles in two stages. We used narrative synthesis to describe included studies and fuzzy cognitive mapping to summarize categories of factors influencing participation. RESULTS: We included 59 of 7,994 articles identified. Studies covered 36 countries on five continents, with half using qualitative methods. They addressed diverse health issues, one third of them targeting environmental health. Terminology and approaches for community participation varied greatly. We identified 251 distinct factors influencing participation through 1623 relationships. Fuzzy cognitive mapping summarized the most influential categories including researcher-community relationships, contextual adaptation of methods/activities, community decision-making power, ease of planning/implementation, and valuing different knowledge types. CONCLUSION: Results confirm that meaningful participation requires researchers sharing power and making space for community voices. Adopting reflexive and transformative approaches can balance power asymmetries in research partnerships for global health, a vital step in the broader efforts towards decolonization.