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‘I never thought I’d be sitting here writing poetry about abortion, but here I am.’

Martha Nicholson

A blog by doctoral researcher Martha Nicholson on using reanimating data methods to co-produce policy recommendations with health professionals in Northern Ireland.

Reposted from The Open University with the author’s permission.

Co-producing knowledge is often proposed as way to ‘build bridges’ and establish equitable partnerships between academic institutions and research participants in the health system. But how might the co-production of knowledge and policy-relevant recommendations with health professionals work in practice?

In this blog, I present the creative co-production process I used to facilitate a safe and reflective space for nurses and midwives to discuss the issues around abortion care that were raised in my PhD research. Based on the interview data I collected, participants and I generated recommendations for how policy and practice can improve health professional’s knowledge on abortion care in Northern Ireland, and in turn make the health system a safer and more compassionate place to seek abortion care. These insights may provide useful inspiration for other researchers considering involving health professionals in the analysis of data on a stigmatised research topic.

What did the co-production process aim to achieve?

I used co-production sessions with five participants with the aim to 1) allow them to co-own the interview data collected in my PhD project, 2) to co-generate recommendations, and 3) create a safe space to talk about the topic of my interview data – abortion service delivery in Northern Ireland. Three midwives attended a group session, and two nurses joined one-on-one sessions (scheduling challenges!).

Step 1: Warming up with ‘a line of discovery’

Sessions started off by making commitments to 1) protect confidentiality, 2) respect each other, 3) and to support each other emotionally if needed. I then adapted an Alliance for Choice creative workshop activity and invited participants to write a chronology of their interactions with abortion along “a line of discovery”. We reflected on: “what started the conversation?”, “what feelings did they associate abortion with?”. This helped participants to start writing, thinking, reflecting, and to share their experiences. It laid the groundwork for the following activities by allowing us to let go of the formality of our professional identities.

Step 2: Reanimating data using blackout poetry

Archivists, activists, and academics have used techniques to “reanimate data” to explore change and continuities in intimate lives over time. Blackout poetry is used in the social sciences to generate a deeper connection with material, reveal the ghosts in a narrative and hold a mirror up to our analyses. It can also help researchers to reflect on their emotions when engaging with their research  I used blackout poetry in this workshop to give participants a tool to engage with the research data, and to explore how my gaze on the study data may differ to theirs.

To do this, I distributed quotes from my interview data that highlighted tensions between localised and authorised forms of knowledge. I invited participants to work with creative materials (card, pens, scissors, tape, and glue) to rehash the quotes, reveal a hidden story, using words that “glow” and resonate with them. They enjoyed the task, taking their time to pass around the quotes, consider the ones that meant something to them and explore ways of using the creative materials. One participant summarised the feeling in the room: “I never thought I’d be sitting here writing poetry about abortion, but here I am.” They accompanied their creative work with a title, note on what the poem is telling us and what needs to change. They also included annotations, doodles, and drawings, working with the materials they had to hand.

The participants’ work engaged with themes in the data: the urgency of time in abortion care, intersectionality of abortion restrictions, and poor resourcing of abortion care in Northern Ireland. They chose to work with testimonies that came up in the interview data about the de-prioritization of abortion care in hospitals, the injustice of the pre-2019 abortion ban, and the dominance of men in decision making about women’s health care. An excerpt from one participant’s poem entitled “Multifaceted” read:

We feel that we have to play down the bit about abortion.

You felt you had to play it down,

a wee bit.

And you kind of feel,

A wee bit of shame.

Just to keep the peace,

and not to have any confrontation with anybody.

Step 3: Generating recommendations for policy and practice

Together we watched a short video by the Array collective – an art collective in Belfast who use art and collective action to respond to sociopolitical issues affecting Northern Ireland. I wanted to show what art can do.

Building on these activities and discussions, participants noted down recommendations for how policy and practice could improve health professionals’ knowledge on abortion care. We read the recommendations and clustered them into broad themes. For example, several recommendations emerged for developing care pathways for marginalised people, protecting spaces for abortion care providers, and introducing mandatory training on abortion for multi-professional groups. 

Discussion and conclusion

The workshop created a safe space for participants to share their experiences of abortion care in their personal and professional lives. The reanimating data exercise gave them tools to explore hidden messages in the quotes, examine their experiences in relation to the quote, and allowed me to explore my own assumptions about the standpoints of the participants. I took this opportunity to reflect on my role as a researcher, learner, and advocate for abortion care. The recommendations that we arrived at proposed practical, structural, and ideological changes to the framing of abortion in Northern Ireland. This suggests that nurses, midwives, and other health professionals can be powerful advocates for change when given the time, tools, and spaces to do so. To conclude, using creativity in co-production sessions can help participants engage in difficult topics, facilitate a safe space for honest and reflective discussion and inspire ideas for change.

Tips on facilitating co-production workshops with research participants

  1. Apply for funding to be able to reimburse participants for their time. I offered my participants £50 Love2Shop vouchers for a half day workshop (8.30-1.30pm) as well as coffee and lunch.
  2. Show a video or presentation on creative methods to give participants the tools and inspiration to make something of their own. I showed my participants this video on art activism from the OU, Array Collective and Alliance for Choice.
  3. Allow time for participants to share their expectations and engage in a warmup activity to get everyone comfortable with speaking up and using the creative materials at hand.
  4. Secure a private space, free of interference or disruption. I used an Open University Belfast conference room which was spacious and in an accessible location.
  5. Consider what you define as ‘data’ in the co-creation sessions. You may like to keep notes of the ideas and discussion that participants engage in. I decided not to voice record to maintain the privacy of my participants, but others may wish to do so.
  6. Ensure that co-production workshops plans have been reviewed by research ethics committee, and that participants give informed consent for their data to be used in research outputs like this one.
  7. Break up the sessions with a coffee or lunch break to allow participants time to rest and re-charge between sessions.

This blog was original posted at: https://wels.open.ac.uk/research/centre-study-global-development/blog/i-never-thought-id-be-sitting-here-writing and is reproduced here with permission by the author.

For more information please contact: martha.nicholson@open.ac.uk

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Making poems with data and data with poems

Ali Ronan

Setting up and getting going: Film-maker, Sue Reddish and I had met earlier to discuss the filming and go over the plan for the evening. We arrived at the venue in Manchester at 6.  There were 10 young women there plus 2 youth workers. Hebe the artist and youth worker came at the same time. And then another young women then joined us. Hebe is well known to the group and I had met some of them before, I also know the youth workers well.

We did a quick name round + our chosen pronoun + whether people been on TV or radio/ round which raised some laughs and generated some curiosity about why people had been on TV etc.  I introduced Sue and she talked through the consent form and the way that she would do the filming. 2 young women did not want their faces to be filmed but were happy to be recorded, otherwise everyone was happy with the filming.

Time travel: We then introduced the project and talked very briefly about the 1980s at that point.  We did another game introducing ourselves plus our date of birth to a 1988 Top of the Pops soundtrack. We also had to say one thing that happened in the eyar that we were born. The dates of birth in the group ranged from 1951-2003 so this got us talking about the decriminalisation of section 28, the new labour landslide victory, the 2002 commonwealth games, the introduction of the right for gay people to adopt, the release of the film Body guard, John Major and Spitting Image, rationing and the end of World War two, the 1999 solar eclipse and the release of the first Toy story film. A lot of discussion was then generated about the 1980s and 1990s. We mentioned the miners’ strike, Greenham and Section 28.  Section 28 generated more discussion about sex education now and the difficult discussions that are being had in Birmingham and in Manchester around the rights of parents and faith groups to have a say over the Relationships and Sex Education curriculum.

Who am I? Each person was given a Who am I? sheet to complete and used the answers to create a soundscape. Hebe encouraged the group to draw something on the sheet that describes or represents you in some way, something that is important to you or a symbol or shape that you associate with yourself. This generated more discussion about identity.

  • I am an activist
  • I am Israeli,
  • I am a student,
  • I am resilient,
  • I am happy, I am a lesbian
  • I am autistic,
  • I am a non-binary woman,
  • I am brown,
  • I am wonderful,
  • I am a daughter,
  • I am a sister,
  • I am patient,
  • I am a walker,
  • I am a community member,
  • I am 16 years old,
  • I am a good friend,
  • I am indecisive,
  • I am a woman,
  • I am organised,
  • I am a friend,
  • I am frowning,
  • I am kind,
  • I am an aspiring gardener,
  • I am a youth worker.

Warming up: We then broke for coffee and started again with a warmup moving game – creating a rainstorm with  tapping, clicking, stamping, jumping. There was lots of laughing.

Working with data: We introduced some interview extracts that I had chosen from the selection that Niamh Moore had used during a workshop at Sapphormation – a festival in Manchester for ‘women who love women’. The extracts were taken from the one interview in the archive with a young women, Hannah, who explicitly identifies as ‘gay’ plus one extract from the interview with Sarah whose first sexual experience was with a woman.

The young women split into groups of three and each had a look at a couple of extracts. They read the extracts out loud and talked about the data. The brief was to see what stood out for them, to highlight it and talk about it.

The young women were really engaged with the material, sitting on the ground and pouring over the interviews. I went around, clarifying anything and trying to provoke more discussion. After about 10 minutes of lively discussion in the small groups, we asked them to tell us what they thought. They were interested in the short extracts and they were happy to read them out, to talk about the questions and how the interviews were conducted. They felt many of the questions were intrusive.

We then sat down at the table and used the interviews + magazines to cut up and create collages or poems or whatever- this created much more discussion.

We read the poems out, we talked about words and phrases that had meant something to the young women. We talked about the magazines – they were intrigued by the notices of meetings etc.

Hebe talked to the group about how we could take the project forwards. She suggested making some kind of banner that the group could put up when they are in session as part of the ritual of coming into the space and setting up the session. She suggested a table cloth but left this open for further discussion. The poems could be a starting point Hebe suggested, we could edit them down further to identify key words or to create an image- like a young women’s group coat of arms of the things that are important to us. Hebe opens things up to the group and we agree to think some more.

We said good bye – a quick post–it note of one word feedback on the session: Insightful, open, exciting, powerful, intriguing, brilliant, fantastic.