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Abstract

This paper offers a reflexive, practice-based process evaluation of arts-based participatory methods (ABM) within a community-led violence prevention project in an Indigenous Andean community on Amantaní Island, Peru. Working within a Participatory Action Research (PAR) framework, the project engaged women and men through six creative methods – problem and solution trees, life history mapping with stones and petals, role play, body mapping, visioning drawings and Most Significant Change storytelling – drawing on visual, narrative and embodied modalities. These methods supported participants to articulate structural harms, strengthen confidence and public voice and co-design locally grounded solutions. By tracing how these activities unfolded in practice, we explore the relational, affective and political dimensions of ABM, showing how creative practices enabled trust-building, emotional expression and shifts in dialogue and power. We also reflect critically on the ethical tensions that emerged when working within externally funded, time-limited structures in a setting marked by high levels of gendered violence and marginalisation. This study contributes to growing scholarship on feminist and decolonial approaches to participatory research, offering concrete insights into the transformative potential and limitations of arts-based practice in under-resourced contexts marked by gendered and structural violence.

Keywords

Participatory action research (PAR)community-based participatory research (CBPR)reflexivity in research creative and participatory methods arts-based methods art in research community-driven change ethical research practices structural violence and resilience situated knowledges

Introduction

Arts-based and participatory approaches are increasingly recognised for their potential to foster meaningful engagement with structurally marginalised communities (Armijos and Ramirez Loaiza, 2024). Participatory action research (PAR), rooted in the theories of Kurt Lewin (1946) and Paulo Freire (2005), emphasises iterative cycles of reflection and action, and seeks to redistribute power in the research process by positioning communities as co-researchers in identifying problems and generating solutions (Cornish et al., 2023; Wilson, 2019). PAR is especially effective for working with marginalised and Indigenous communities, where colonial legacies of extractive research practices and systemic disadvantage persist (Adhikari et al., 2020; Chadwick, 2021; Frazier, 2020; Stanton, 2014; Wallerstein and Duran, 2010). When combined with arts-based methods (ABM), these approaches can create powerful spaces for trust-building, reflexivity and dialogue around sensitive topics such as violence against women (VAW) (Helmick, 2023; Thomas et al., 2022).

While both PAR and ABM are well-theorised in the literature, there remains a lack of detailed, practice-oriented accounts of how these methods unfold in complex field settings, particularly in Indigenous and under-resourced contexts (Coemans and Hannes, 2017; Tuhiwai Smith, 1999). In particular, the relational and ethical negotiations involved in applying creative methods are often under-explored, with much scholarship focussing on theoretical promise rather than on-the-ground realities (Armijos and Ramirez Loaiza, 2024; Coemans and Hannes, 2017; Thomas et al., 2022). Tensions between institutional research objectives and evolving community priorities are also rarely documented in detail.

This paper offers a reflexive, practice-based evaluation of the EVE Project Amantaní case study – a participatory, arts-based initiative conducted on Amantaní Island in the Peruvian Andes (2020–2023). The project aimed to explore community-led strategies for preventing VAW through creative methods including visual, narrative and embodied modalities. Co-led by researchers from UCL, the Peruvian health research consultancy, Hampi Consultores en Salud, and local community-based researchers, the project developed a series of participatory workshops that were grounded in local priorities and adapted in response to emergent needs.

Rather than assessing impact in a traditional sense, this article traces how arts-based participatory methods functioned as dialogic practices: how they supported relationship-building, shaped knowledge production and mediated epistemological and logistical tensions throughout the project. In doing so, we contribute to ongoing methodological debates about how arts-based and participatory approaches can be reimagined to centre local knowledge, redistribute power and support ethical, decolonial inquiry (Lepore et al., 2021; Shannon and Mannell, 2021; van der Riet and Boettiger, 2009).

Methodological context and research design

This paper presents a reflexive process evaluation of the Amantaní case-study of the EVE Project (Evidence for Violence prevention in the Extreme), which aims to generate evidence on community-led VAW prevention in high-prevalence contexts (Mannell et al., 2021). Amantaní was selected as a case study within the wider EVE Project because of its high prevalence of intimate partner violence and its status as a historically marginalised Indigenous island community. According to national surveys, 63.4% of women in the Puno region have experienced intimate partner violence – among the highest rates in Peru – and Quechua-speaking Indigenous women report particularly high rates of psychological and verbal abuse (National Institute of Statistics and Informatics (Peru), 2019). These figures are embedded in a broader context of racialised structural violence shaped by colonial legacies and epistemic exclusion (Mukerji et al., 2025).

On Amantaní, a remote island in southern Peru, we engaged 20 Indigenous community members in co-developing strategies to prevent VAW through participatory and arts-based methods (see Figure 1). The island is home to approximately 4000 predominantly Quechua-speaking residents, with livelihoods rooted in agriculture and tourism (Cheong, 2008; Gascón and Mamani, 2022). Limited infrastructure and sparse public services shape everyday life, and local governance is organised across 10 districts (Calderón et al., 2019, 2023).

Figure 1.

Project timeline. The Amantaní project unfolded over three phases. Phase 1 involved stakeholder interviews with local authorities and service providers to understand existing responses to VAW. Phase 2 introduced participatory workshops with women, using arts-based methods to surface community concerns and priorities. Informed by early reflections, Phase 3 expanded to include a men’s group and placed greater emphasis on skills-building, collaborative analysis, community planning and evaluation.

Initial workshops were deliberately women-only to help reduce risks of silencing or reprisal. However, this raised concerns among some men in the community, where male voices usually carry more weight. This tension informed the later expansion of Phase 3 to include men’s groups, which reshaped the project’s trajectory.

Our approach was anchored in PAR, with an emphasis on reflexivity, collective agency and knowledge co-production (Cornish et al., 2023; Wilson, 2019). ABM – including visual storytelling, collaborative drawing, metaphorical objects and embodied exercises – were embedded throughout not just as tools for data generation but as relational practices that enabled participants to express complex experiences in accessible, visual and embodied forms (Coemans and Hannes, 2017; Haraway, 1988). These methods helped navigate differences in language, literacy and power and were continually adapted through feedback and collaboration (Armijos and Ramirez Loaiza, 2024; Coemans and Hannes, 2017; Thomas et al., 2022).

The research was conducted through a triangulated partnership between UCL, Hampi and local facilitators, with facilitation and translation primarily led by Hampi’s Puno-based field team. This structure created logistical challenges but also enabled rich cross-cultural collaboration. Our methodological stance was reflexive and relational, with ongoing attention to positionality, community accountability and power dynamics (Sultana, 2015). Rather than presenting a neat narrative of success, we focus here on how methods evolved in situ – where they enabled connection, where they encountered limits, and what this reveals about the messy realities of participatory research (Frazier, 2020).

We draw on a wealth of project data to foster critical reflection. This includes transcripts of group discussions from the five Phase 3 participatory workshops and two project evaluation workshops (conducted with separate men’s and women’s groups). These are complemented by analysis of visual data created during these workshops, such as body maps and other drawings. Additionally, we draw on transcripts from an earlier participatory workshop conducted with women in Phase 2 and the problem/solution trees they created, as well as the transcripts of their individual life history interviews. Further, this evaluation incorporates insights from the project evaluation interview with local facilitators, as well as reflexive notes from UCL-Hampi team meetings. A full summary of all participatory workshops and the types of data collected is included in Supplemental Table S1. These diverse data sources allow us to examine our assumptions, positionality and the broader impacts of our practices across multiple layers of engagement.

Ethical considerations

Ethical clearance was granted as part of the broader EVE project from UCL (ref: 9663/002) and Comité Institucional de Bioética de Via Libre, Peru (ref: 6315). Participants were invited to take part in the research voluntarily, gave their written informed consent to participate and be recorded and for their creative works and photographs to be shared as part of the research process. Each group created their own workshop ground rules which further ensured locally-relevant ethical participation. All participant names are pseudonymised.

Positionality of team members

Our partnership between UCL and Hampi extended over several years, including regular online meetings, capacity-strengthening activities and co-authored publications. Based at UCL’s Institute for Global Health, the UK team approached this work as feminist global health researchers with long-standing commitments to participatory and decolonial research in VAW prevention. UK team members had previously led participatory research in the Peruvian Amazon, Samoa and South Africa, co-developing community-led theories of change, creative data collection methods and tools for measuring meaningful change. One author, an artist-researcher, brought experience in arts and health, while others specialised in community-based participatory research, VAW prevention and mental health. These skills converged in the co-development and adaptation of a flexible suite of arts-based tools, for example body mapping, problem and solutions trees, role play and vision drawings – tailored to the local context through dialogue with Peruvian partners. The Peruvian team included a psychiatrist with expertise in systemic therapy and participatory mental health, and two Andean anthropologists who served as core facilitators. Their positionalities – as urban, educated, Quechua or Aymara-identifying professionals – highlighted the complexity of ‘insider’ status. While only one UK team member (the lead author) visited Amantaní due to pandemic delays and budget constraints, she learnt Latin American Spanish and worked closely with Peruvian partners over 4 years to support culturally resonant and ethically grounded research design.

Reflecting on power within and beyond the project

Power was negotiated not just across institutions or identities, but through the everyday operations of the project: who sets the agenda, who adapts activities, who speaks and who listens. Facilitators, for example, played a central role in shaping workshop delivery, debriefing after each session and identifying emotional, logistical and cultural risks. While this decentralised structure aimed to disrupt top-down knowledge flows, it also revealed enduring hierarchies of funding, language and academic recognition.

Throughout the project, the team worked to resist extractive logics by embedding practices of care, such as psychological debriefing, flexible timelines and iterative decision-making, while investing in long-term relationships and shared authorship. Yet power asymmetries persisted, shaped by the project’s initiation by a Global North institution, its location in a remote Indigenous community and its dependence on time-limited external funding. These structural dynamics constrained the scope of action and raised difficult questions about sustainability and accountability once the official project period ended.

The team embraced ‘slow research’ (Costas Batlle and Carr, 2021; F. Amauchi et al., 2022) to allow for iterative adaptation and responsiveness, and took deliberate steps to avoid over-promising. As both Costas Batlle and Carr (2021) and F. Amauchi et al. (2022) note, slow research is an ethical and epistemological stance that prioritises relational pace, reflexivity and trust-building over efficiency, challenging the extractive and colonial logics of output-driven academic practice. Participants co-designed local action plans, some of which could be advanced independently, while the UK team sought (unsuccessfully) to secure further funding. A particularly frustrating funding decision delay of over a year left facilitators and community members in limbo, highlighting the limitations of academic systems to support ongoing grassroots work. Despite intentions and efforts, not all expectations could be met – producing ethical discomfort and underscoring the emotional burden of unmet commitments. These experiences highlight a key contradiction in PAR: while its principles advocate long-term engagement, the realities of academic funding cycles and institutional constraints often make sustained, community-led action difficult to achieve (Wallerstein and Duran, 2010).

These tensions point to a broader ethical challenge in North–South research collaborations. Community expectations of sustained engagement often clash with externally imposed project cycles and short-term funding streams, which can inadvertently reproduce extractive dynamics despite participatory intentions (Escobar, 2018; Tuhiwai Smith, 1999). More equitable, long-term funding structures are needed to enable sustained accountability and reduce the risk of leaving communities with unmet commitments once external researchers depart.

Across these relational and methodological negotiations, it became clear that participation was not a fixed process but one continuously shaped by shifting priorities, trust dynamics and emergent understandings of harm. As the project evolved, so too did its thematic focus. While VAW was the original entry point, participants gradually reframed the discussion towards intersecting concerns such as education, economic insecurity, discrimination and environmental change. This reframing did not dilute the project’s focus on VAW, but embedded it within a broader understanding of structural and community-level harm (Brown et al., 2023; Lowe et al., 2022; Mannell et al., 2022).

Findings: Working with arts-based methods in practice

ABM were central to the project’s participatory approach, used both to generate data and to create inclusive, dialogic spaces for exploring sensitive issues such as violence, gender roles and community wellbeing. These techniques enabled participants to express complex, embodied and often non-verbal experiences that may not have emerged through conventional interviews or surveys (Barone and Eisner, 2011; Coemans and Hannes, 2017; Malchiodi, 1988).

Table 1 summarises the core arts-based methods used in this project. The six creative practices explored in this paper illustrate the range of modalities used and how each contributed to reflection, knowledge production and community-building. These methods were adapted from existing feminist and participatory toolkits, for example Zindagii Shoista (Mastonshoeva et al., 2019), Stepping Stones (Welbourn, 2002) and Indashyikirwa (Dunkle et al., 2020), and facilitated by trained local staff in separate women’s and men’s groups. For a full overview of all participatory workshops conducted during Phases 2 and 3 and the data collected see Supplemental Table S1.

Table 1.

Key arts-based methods explored in this paper.

Method	Modalities	Purpose in project	Example output
Problem and solution trees	Visual, narrative	To co-analyse systemic causes and effects of key issues (e.g. violence against women, COVID) and identify possible responses	Diagrams linking root causes to impacts and proposed actions
Stones and Petals life histories	Narrative, tactile/visual	To map life histories, build trust and elicit emotionally resonant narratives in metaphorical form	Life journeys marked by positive (petals) and negative (stones) turning points
Role plays	Embodied, narrative	To explore conflict, gender dynamics and power hierarchies through enacted scenarios and reflection	Enacted family conflicts, community power dynamics, tourist-local interactions
Body mapping	Embodied, visual	To externalise embodied experiences of violence, stigma and strength using symbolic representation	Symbolic drawings and mixed-media pieces showing where discrimination and resilience is felt in the body
Visioning the future	Visual, narrative	To express collective hopes and articulate future aspirations, leading to community action planning	Drawings depicting ideal futures (e.g. improved tourism, environmental care, cultural preservation)
Most Significant Change (MSC)	Narrative, visual	To evaluate project impact through personal storytelling and group discussion of meaningful change	Illustrated stories of change shared and selected in group deliberation (e.g. friendship, confidence)

These activities were not neutral tools, but epistemologically situated practices – anchored in feminist and decolonial values that recognise the legitimacy of visual, emotional and experiential knowledge (Fricker, 2017; Haraway, 1988) and particularly effective in a context of linguistic and cultural diversity.

The creative methods used in the workshops also reflected the positionalities and preferences of both facilitators and participants. The lead author, who designed many of the workshop activities, brought a strong interest in visual and symbolic methods that are often therapeutic and empowering – an influence that shaped the choice of activities and the kinds of data generated. However, these methods were not imposed. Facilitators adapted them based on their own interests and local expertise, helping ensure cultural relevance and emotional resonance.

Throughout the Amantaní project, arts-based methods were central to fostering trust, enabling reflection and supporting co-produced analysis. These creative practices were not simply techniques for data generation, but structured experiences that allowed participants to express themselves, connect with others and articulate new understandings of power, gender and community change. The following vignettes offer a closer look at six key participatory methods used in the project: (1) problem and solutions trees, (2) stones and petals lifelines, (3) role play, (4) body mapping, (5) visioning and (6) Most Significant Change – each illustrating how creative tools opened space for dialogue, emotion and transformation. Together, they demonstrate how ABM moved the project from extractive research to shared meaning-making, and from individual stories to collective strategies.

Problem and solutions trees: Mapping root causes and collective solutions

This collaborative mapping activity became a pivotal turning point in the project, helping reframe the scope from a narrow focus on VAW to a more holistic understanding of intersecting structural harms. Conducted midway through the Phase 2 workshops, the problem and solutions tree enabled women to express their experiences of inequality without the pressure of discussing violence explicitly.

Extensively used in development and aid settings, problem and solutions trees provide a participatory approach to working through layers of determinants and developing potential interventions (Snowdon et al., 2008). The method used a tree metaphor to guide analysis (see Figure 2). In the first phase, participants wrote down challenges faced by women in their community – without labelling them as ‘VAW-related’. These were collected, shuffled to ensure anonymity and shared ownership, then collaboratively sorted into ‘roots’ (structural causes), ‘trunks’ (visible problems) and ‘branches’ (outcomes). As women mapped their cards, patterns emerged: entrenched gender norms, poverty, malnutrition and lack of educational access were identified as foundational ‘roots’. The ‘trunk’ reflected daily realities such as economic dependence, exclusion from decision-making and constrained mobility. At the ‘branches’, participants named domestic violence, social isolation, gossip, psychological abuse and the marginalisation of single women.

Figure 2.

Problem and solutions trees created by women participants during Phase 2. This collaborative mapping activity enabled participants to explore interconnected challenges faced by wofaní.

This format allowed participants to express complex and sensitive dynamics in metaphorical, visual terms, surfacing issues that might not have emerged through direct questioning. However, while the activity was generative, it also had limitations. Having used it extensively in other sites, we recognised that repeated use could reduce participants’ enjoyment and sense of novelty. In Amantaní, facilitators placed strong emphasis on keeping workshops lively, varied and enjoyable, reflecting participants’ own stated priorities. For this reason, the method was used sparingly with the men’s group and not returned to extensively in the evaluation phase. In the final workshop, for example, Venn diagramming was introduced as an alternative to explore interconnections and sustain energy.

In the second part of the activity, the group constructed a ‘solutions tree’. Using a mirrored structure, they identified actions to address each root cause. Suggested responses ranged from mutual respect and empathy to expanded educational access, parenting support and improved services from institutions like the Justice of Peace and health centres. Participants offered locally grounded strategies, for example, involving godparents (compadres) in couple counselling, or demanding state support to expand services on the island. These proposals were not abstract aspirations, but practical reflections of lived constraints and possibilities. At the same time, some of the suggestions raised expectations that were difficult to meet within the project’s scope, revealing a tension between the community’s expansive vision and the practical constraints of project priorities, institutional infrastructure and available expertise and funding (Torre, 2009; Wallerstein and Duran, 2010). For instance, women proposed advocating for the establishment of state services such as CEMs (Centros de Emergencia Mujer) and expanded mental health provision on the island, as well as securing internet connectivity and professional training for health staff. Others suggested organising across all 10 Amantaní communities to strengthen women’s collective voice. These proposals reflected urgent priorities but extended well beyond the remit and resources of the project, highlighting the ethical challenge of navigating expectations when systemic change was sought but only limited support could be offered.

The tree structure was revisited in Phase 3, during a workshop focussed on the impacts of COVID-19. Building on their earlier analysis, participants mapped how the pandemic exacerbated the structural ‘roots’ previously identified, deepening economic insecurity and heightening social isolation. The familiar metaphor allowed participants to reflect on change over time, while reinforcing a sense of agency and analytical continuity.

This method did not simply generate data, it facilitated collective analysis and systems thinking. It also fostered an important discursive shift: away from the idea that violence is a private issue and towards an understanding of it as a social and structural phenomenon. In this way, the activity exemplified how arts-based participatory methods can act as both diagnostic and dialogic tools – supporting trauma-informed, decolonial approaches to community-led inquiry (Frazier, 2020; Tuhiwai Smith, 1999).

By foregrounding communal perspectives and system-level causes, these participatory mapping exercises helped shift the project from a narrow ‘problem’ frame to a more holistic, strengths-based one. Participants were supported to articulate their priorities and develop locally grounded understandings of violence, justice and community wellbeing, laying the groundwork for later collaborative planning and action.

Stones and petals: Mapping life histories

This tactile and symbolic exercise invited participants to reflect on their life journeys by arranging stones and flower petals to mark significant moments.

In this reflective exercise, women laid out a physical lifeline on the ground using string, placing stones to represent painful or negative experiences and petals for joyful or empowering moments (see Figure 3). This activity was not only a method of recall but a ritualised act of embodiment, one that allowed participants to narrate their lives in ways that were visual, tactile and deeply affective. Participants could choose to share their life stories aloud in the group or privately with a facilitator. This simple yet powerful method allowed women to take control of their narratives (Garratt et al., 2021), weaving together stories of hardship, resilience and transformation.

Figure 3.

Creating life histories with stones and petals. Participants created visual timelines using stones to represent difficult events and petals for moments of joy. This method allowed for non-verbal emotional expression, particularly around themes of loss, family conflict and resilience. The tactile process of selecting and arranging these objects helped surface memories and meanings that were later shared in individual life history interviews. The activity supported trauma-informed storytelling while offering participants a dignified and symbolic language for their life histories.

For many, this was the first time they had articulated the arc of their lives so publicly or intentionally. Griselda, for instance, spoke through tears about her husband’s sudden illness and death, describing how grief was compounded by blame and abandonment from her in-laws. Yet she also placed large petals to mark the birth of her children and her involvement in the project, which she described as ‘a joy’, giving her purpose and connection after years of profound sorrow: ‘Now I feel happy working with this project too’.

Luisa’s timeline included both painful separations and professional milestones, like founding her own guesthouse. Her narrative was steeped in agency: ‘I did everything by myself. . . now I’m even practicing English’, she said. Her lifeline was adorned with many petals, symbolising resilience and forward momentum. Meanwhile, Milagros’ lifeline centred around her limited formal education, which remained a source of pain: ‘My stone will always be my [incomplete] studies’. Still, her path also bloomed with hope: her marriage, pregnancy and new aspirations to return to school. She shared, ‘I liked the activity. I feel so happy. I have learned a lot’.

At the same time, the method presented some practical and emotional challenges. The physical timelines, while powerful as symbolic artefacts, would have been difficult to interpret without supporting discussion. Unlike drawn or written timelines used in traditional life mapping (e.g. Garratt et al., 2021), the stones and petals provided little contextual detail on their own. The depth and quality of the follow-up interviews varied considerably, with some offering rich insight and others remaining relatively surface-level. These inconsistencies prompted further facilitator training before Phase 3, including the integration of a strengths-based interviewing approach that supported more grounded, narrative-rich dialogue (Mukerji et al., 2025).

Emotionally, the exercise was intense. While many participants found it cathartic, it could also be draining for both participants and facilitators (Flaherty and Garratt, 2023; Phillips et al., 2022). Some participants chose not to share publicly, reflecting the early-stage dynamics of the group and the need for emotional safety (Armstrong et al., 2023). In retrospect, facilitators noted that the activity might have yielded more dialogic engagement if introduced later in the process, once trust and group cohesion were more firmly established (Armstrong et al., 2023; Malpass et al., 2023).

Despite these challenges, the stones and petals life mapping method foregrounded women’s agency alongside their experiences of marginalisation. It demonstrated how creative, non-verbal practices can surface memory and meaning in ways that traditional interviews may miss (Denov and Shevell, 2021; Phillips et al., 2022), while also reinforcing the importance of careful timing, facilitator preparation and emotional support in participatory work on trauma and transformation (Dickson-Swift et al., 2009; San Roman Pineda et al., 2023).

Power in practice: Exploring status, voice and gender through role play

Role-playing was one of the most dynamic tools for exploring power, voice and gender in embodied and relational terms.

Used across Phases 2 and 3, role-playing created emotionally resonant, participatory spaces for examining complex social norms. In early workshops, women performed scenarios in which they sought help after experiencing violence, highlighting the social barriers and occasional openings in local help-seeking pathways. These early exercises helped surface relational dynamics and supported conversations about agency and community response.

In the Phase 3 domestic violence workshop, paired activities explored power from gendered perspectives. Activities were adapted from participatory group-based training interventions from other contexts which have been found to be effective in preventing VAW (International Rescue Committee, 2014; Rolleri et al., 2015). The women’s group engaged in ‘Persons and Things’, a roleplay illustrating how it feels to be controlled or disempowered. Participants voiced discomfort and frustration when cast as the ‘thing’, prompting rich discussions about relational dynamics and autonomy.

Meanwhile, the men’s group explored social hierarchies through a status card game. Participants held numbered cards to their foreheads, unaware of their own status and interacted accordingly. This led to candid reflections: ‘I felt empowered, as if I had high rank’, said Carlos; Walter noted feeling mocked and excluded. These embodied experiences resonated deeply, especially as participants connected them to real-life hierarchies in the community. The group then mapped out those with power: mayors, religious leaders, tenientes and those without: children, single mothers, women without partners. These lists sparked further dialogue on shifts in local leadership, including women’s increasing roles since the pandemic.

Subsequent roleplays focussed on household decision-making and communication styles. In one dramatisation, a husband insisted that his wife join him to work on the farm; she refused, citing childcare duties. The dramatised conversation escalated into accusations and stubbornness, with participants observing that the husband spoke with ‘a strong demeanour’ and the wife responded ‘arrogantly’. The group agreed that mutual inflexibility blocked resolution. In contrast, another scenario portrayed a father-son disagreement over a romantic relationship, resolved through calm discussion and eventual respect for the son’s autonomy: ‘If you love her. . . it’s up to you’. A third role play depicted a warm and coordinated family negotiating chores and school responsibilities with humour and affection – what participants recognised as an ideal example of ‘power with’.

Discussions following the roleplays revealed heightened emotional awareness and a growing willingness to question inherited gender roles. Role-playing also helped participants engage with broader social dynamics. In the tourism and exploitation workshops, they acted out interactions between tourists and local guides, farmers or vendors, surfacing tensions around pride, vulnerability and exploitation. One empathy-based exercise asked participants to roleplay a tourist harassing a local woman. Though emotionally charged, and requiring careful facilitation, the exercise opened space for critical discussions about consent, shame and the community’s role in perpetuating – or interrupting – gendered harm.

These scenarios prompted emotional awareness and a growing willingness to challenge patriarchal norms. Through facilitators’ gentle guidance emphasising patience, kindness and active listening, participants began to reimagine social roles and relational dynamics. The activities often referenced local idioms, kinship metaphors and shared humour (e.g. ‘tiger mates’, a term coined by the men’s group), reinforcing the cultural grounding of the work.

Yet, while roleplay was one of the most engaging and energising methods used, it was not without limitations. Certain adaptations were necessary to ensure cultural relevance, for example, facilitators noted that using playing cards to indicate status felt too unfamiliar and potentially confusing, so this was changed to numbered paper slips. Additionally, while role-playing produced compelling discussions and group cohesion, it was sometimes unclear how these ‘in the moment’ activities supported individual reflection or generated data that could be easily analysed or coded.

There is also a broader methodological tension. While the exercises helped surface power dynamics, they didn’t always enable a transfer of power. That is, while participants performed empowered scenarios, and reflected critically on inequality, the method itself did not necessarily change existing hierarchies or decision-making structures. These limitations highlight a central challenge in participatory work: the line between representation and transformation, between recognising injustice and acting upon it (Cahill, 2007).

Nevertheless, role-playing provided a shared, affective language for navigating deeply entrenched norms. It helped participants rehearse new relational behaviours, explore empathy and begin to shift how power was felt, spoken and imagined in both home and community life, as well as in the project itself.

Body mapping: Embodied discrimination and resilience

Body mapping enabled participants to visualise and narrate their experiences of structural violence, resilience and identity through creative and embodied expression.

Conducted during Phase 3 with both men’s and women’s groups, this activity offered one of the most emotionally resonant opportunities for reflection in the project. Originally adapted from feminist participatory toolkits (Sweet and Ortiz Escalante, 2017; Zaragocin and Caretta, 2021), it invited participants to draw outlines of bodies in small groups and symbolically represent how discrimination affected them physically and emotionally. Questions such as ‘How does being discriminated against make you feel?’ and ‘Where do you feel strength in the face of discrimination?’ guided the process. The resulting body maps not only made visible the somatic impact of inequality (Johnson et al., 2018; Williams et al., 2019), but also foregrounded agency, recovery and relational strength.

Women used bold-coloured pens to depict visceral responses to discrimination, describing headaches, nausea, tightness in the chest and even nosebleeds (see Figure 4). One participant, Maria, described, ‘When they say something ugly to you, I feel something sad, a pain in my heart. And then, as you think about it a lot, your head hurts and your stomach hurts . . . and you get nauseous’. Heidy reflected that anger sometimes made her physically sick. Several described symbolic sensations like a lump in the throat, or pain in the eyes from crying. Yet amidst this pain, participants frequently located strength and resilience in their hearts and heads, often tied to their children: ‘I say, I am strong’, Luisa noted, ‘For my daughter, I have to be better’. Such statements underscore how body mapping connected deeply personal emotions to relational and intergenerational resilience.

Figure 4.

Body maps produced by the men’s (top right, bottom left) and women’s groups (top left and bottom right). Participants used symbolic drawing and collage to represent how discrimination affects their bodies and where they find strength.

Men used both drawing and newspaper clippings. One group illustrated emotional duality – sadness and depression on one half of the body, recovery and resilience on the other (see Figure 4). In their discussion, they linked humiliation to bitterness, chest pain and headaches, but also identified arms and hands as sources of strength and resistance. A striking visual symbol in one map was a photo of a skull placed near the heart, used to represent the extent to which prolonged discrimination could ‘kill’ a person emotionally or physically. Another map showed a friend’s comforting gesture as a moment of healing, acknowledging the role of solidarity in overcoming emotional harm.

While the emotional depth of the activity was clear, several challenges emerged. Facilitators initially worried that participants might resist drawing around bodies, or that the reflective questions were too abstract. The materials were also limited, and the insights for this activity may have differed if more diverse or textured resources for collage and symbolism were available. The activity’s broad focus, combining both harm and resilience in a single image, may have also diffused its analytic sharpness. In future iterations, creating separate body maps for discrimination and for sources of strength might help participants more clearly explore both the weight of trauma and the pathways to healing.

Despite these constraints, body mapping catalysed both catharsis and mutual support. The embodied format made discrimination tangible, while the shared presentation created space for witnessing, support and affirmation. As one of the facilitators observed: ‘You have noticed how discrimination, as well as affecting us emotionally, also affects us physically’. The maps opened up dialogue about embodied trauma, coping strategies and motivation, often centred on children and family. Despite the difficult content, participants frequently ended their presentations by locating inner strength and committing to perseverance.

Visioning the future: Drawing possibilities, planning change

This collaborative exercise used drawing to articulate shared aspirations and imagine future possibilities for Amantaní.

Conducted during the tourism and exploitation workshop, the visioning activity exemplified how creative methods can support participants in articulating collective hopes and designing locally grounded strategies for change. Working individually and in groups, participants used drawing and writing to depict visions of a thriving future. These drawings were then used to guide discussion and co-develop action plans.

In the men’s group, drawings focussed on infrastructure and state investment (see Figure 5, left panel). Their images included new roads, mobile phone towers and upgraded homes to receive tourists. The facilitator summarised their vision for 2038, stating, Amantaní ‘has more telephone network antennas, it has more roads that connect tourist circuits, viewpoints were built in the upper parts, all the inhabitants have adequate homes to receive and host tourists’. They also emphasised the need for local healthcare facilities to address emergency needs. Walter advocated for engaging government support, noting ‘For the health centre, the presence of the state is needed more than anything’. This future-oriented thinking revealed not just ambition but also a recognition of structural dependency on state resources and policy action.

Figure 5.

Vision drawings of a thriving Amantaní: infrastructure, identity and ecological care. These two drawings (by Horacio on the left and by Carolina on the right), created during a collaborative visioning exercise, depict aspirations for the future of tourism and community life in Amantaní. Together, these visions illustrate how arts-based planning enabled participants to imagine transformation on their own terms – grounded in both physical change and cultural continuity.

The women’s group drew attention to social and environmental priorities (see Figure 5, right panel). Their drawings featured shared spaces for festivals, collective clean-up campaigns and traditional rituals. Carolina stressed: ‘We should gather with all the communities and conduct a general cleaning to give a good impression’. Luisa reflected on the dual benefit of these activities: ‘It’s not just for tourists but for ourselves as well’. This group also prioritised cultural preservation with Carolina noting ‘It’s important to invite everyone to come visit as Amantaní is a beautiful place where they can experience our rituals and culture’.

While the visual outputs offered rich insights, several challenges emerged during this activity. One limitation was interpretive: the meaning of participants’ drawings was often difficult to decode without their accompanying verbal explanations. Some symbols or scenes appeared ambiguous when viewed in isolation, and only through discussion did their significance (whether practical, emotional or symbolic) become clear. This highlights a core feature of arts-based participatory methods: their power lies not in the artefacts alone, but in the relational processes of making, sharing and interpreting together (Leavy, 2020).

Another challenge related to feasibility. Although the drawings reflected participants’ genuine hopes for a better future, some of the proposed changes, such as major infrastructure upgrades or expanded state services, were aspirational and may have been difficult to achieve given the community’s existing resources, political influence and geographic isolation. While visioning was designed as a space for expansive thinking, the absence of clear pathways for action or institutional follow-through risked generating frustration if aspirations could not be pursued further. Facilitators worked to ground these visions in local action plans where possible, but the tension between imagination and implementation remained.

Despite these limitations, the visioning session successfully catalysed forward-facing dialogue. It affirmed participants’ right to hope and plan, and supported the development of community-defined priorities. As with other methods, its value lay not only in the content generated, but in the collective sense-making and future orientation it inspired.

Most significant change: Co-evaluating impact

This reflective exercise in the final evaluation workshop invited participants to narrate and analyse the project’s effects in their own terms.

Participants worked individually and in small groups to reflect on the most significant changes they had experienced since joining the project. Designed as a multi-modal session combining drawing, discussion and one-on-one interviews, the Most Significant Change (MSC) activity¹ enabled both women’s and men’s groups to articulate what mattered most to them after nearly 3 years of participation.

Facilitators began by inviting participants to reflect on changes across personal, familial or community levels. Working in small groups, participants discussed their thoughts, then created individual visual or written representations of their chosen ‘most significant change’ and shared their stories with the group. This process encouraged participants to articulate personal change through visual or written storytelling, grounding abstract ideas in concrete, emotionally resonant narratives.

In plenary discussion, participants collectively selected the changes that resonated most. These stories were not just shared, they were explained, discussed and collectively evaluated. The activity revealed the value placed on emotional connection, confidence and community dialogue, not just tangible outputs.

For example, in the men’s group, Walter’s drawing entitled Amistad (Friendship) showed a circle of men from across the island’s 10 districts (see Figure 6, left). He reflected:

In the drawing, we can see that we are gathered, and in this way, with our relatives, we have been able to share those ideas we have [. . .] we have met, tiger mates, we are from different communities, from the ten communities, and we were able to share our ideas, wisdom.

Figure 6.

Most significant change drawing examples from men’s and women’s groups. Left: ‘Amistad’ (men’s group) shows social connection across districts. Right: ‘My Story During the Project’ (women’s group) depicts a personal shift from family conflict to emotional warmth and self-reliance.

In the women’s group, this exercise provided a structured yet creative setting for participants to share meaningful personal stories and interpret their own growth and learning. For Maria, the project sparked transformation across multiple dimensions of her life:

Upon entering the project, I didn’t know how to behave in the face of a family issue [. . .] Now I treat my partner with more affection, as well as my in-laws, because now I stand financially on my own.

Her two-panel drawing (Figure 6, right) depicted a transformation from familial tension to mutual affection, visually narrating emotional resilience through everyday shifts in behaviour and self-worth.

Such stories underscored how empowerment was often experienced not only as public voice but as changes in everyday relationships and emotional wellbeing. This exercise underscored the community-wide resonance of the project, not just as a series of workshops, but as a vehicle for building new networks, strengthening inter-district solidarity and challenging entrenched norms.

While the MSC activity was powerful in surfacing participant-defined change, it was not without limitations. Not all participants chose to draw, some preferred to write their ideas instead. The team understood this as a reflection of creative autonomy: participants were invited to express themselves in the form that felt most comfortable. Still, the predominance of written responses raised useful questions about what counts as ‘arts-based’ and underscored the importance of maintaining flexible, inclusive methods that accommodate different literacies, preferences and levels of confidence, particularly in research with marginalised or under-resourced communities (Coemans and Hannes, 2017; Leavy, 2020; Thomas et al., 2022).

Time constraints during the workshop meant that some stories felt rushed or underdeveloped. Facilitators noted that, with more time, participants may have elaborated their reflections in greater detail (Phillips et al., 2022). Moreover, the highly personal nature of the activity made cross-comparison or quantification difficult, reminding us that the richness of arts-based evaluation lies in narrative and relational insight, rather than standardised metrics (Cahill, 2007).

Together, the six methods described above demonstrate how arts-based approaches can function not simply as data collection tools but as catalysts for connection, reflection and change. Their use was grounded in sustained, ethically attuned engagement and adapted through ongoing dialogue between participants and facilitators. In what follows, we move beyond method description to reflect on how these practices fostered emotional openness, shifted power dynamics and seeded new forms of community dialogue and collective imagination.

Discussion: Reflections on outcomes and learning

This final section synthesises what emerged from the Amantaní project, drawing out the iterative, relational and affective dimensions of arts-based participatory methods (ABM). Rather than presenting fixed or measurable outcomes, we reflect on the processes of transformation that unfolded through the creative workshops, highlighting moments of learning, resistance, discomfort and hope.

Building on the six detailed vignettes above, we offer a grounded account of how ABM shaped participant experience and meaning-making across different stages of the project. These methods were not only tools for data generation, but dialogic practices that supported self-expression, collective reflection and the co-construction of knowledge.

Process over product: Shifts in confidence, expression and voice

Across both men’s and women’s groups, participants described increased confidence, improved communication and a stronger sense of public voice. For many women, participation marked a turning point in self-perception and self-expression. Maria shared: ‘We always learn, and now there is confidence to speak’. Valentina reflected in the evaluation workshop: ‘Before they said that women shouldn’t speak. But now, we’re not afraid to speak’.

These shifts were made possible through a deliberate and inclusive design. Initial workshops focussed exclusively on women to ensure a safe space for reflection, but facilitators reported that some community members questioned the legitimacy of a women-only approach. In response, the project adapted to include parallel workshops with men, maintaining gender-sensitive facilitation while broadening community engagement. This approach avoided forced confrontation and helped build wider legitimacy, while continuing to centre equity and inclusion.

Women’s increased confidence was one of the clearest outcomes of the participatory process. Through skills-building and creative reflection, participants reported that the project had influenced family dynamics and confidence in addressing conflicts, as Heidy’s comment below illustrates:

Before the project, I didn’t know how to defend myself, I didn’t know how to act in a problem, I didn’t know how to treat and educate my children. Now I know how to handle a problem, always talking, conversing, treating my children well.

The women also reported feeling more comfortable speaking in public and challenging gendered expectations. As Heidy reflected:

I’ve changed quite a bit. I was very shy, couldn’t easily talk to anyone. Now, yes, I can talk to other people

Crucially, these changes were not simply the result of content delivered but were rooted in form, that is the aesthetic, affective and interactive structures of ABM. Drawing, dramatisation and storytelling activated different ways of knowing and allowed participants to explore sensitive or taboo subjects in accessible, non-linear ways (Denov and Shevell, 2021; Flaherty and Garratt, 2023). As Renan, one of the facilitators remarked:

If you use a more rigid, serious methodology, that doesn’t help much for people to open up. In contrast, the methodologies we are using now require them to participate, and through laughter, they share what is really happening in their lives. For me, these types of workshops are very effective . . .

These embodied, visual and relational methods supported a broader shift from silence to self-expression, helping participants, particularly women, to speak up in public spaces, question gender norms and imagine new ways of being within their families and communities. This foundation of expression and inclusion set the stage for the deeper emotional work that followed, where complexity, care and discomfort were not only surfaced, but actively held.

Holding complexity: Emotional depth and ethical tensions

Creative methods often invited emotional and embodied responses. Exercises like body mapping and role-playing helped participants surface experiences of discrimination, powerlessness and violence, but also resilience, solidarity and care. These activities prompted moments of catharsis and collective recognition, but also carried emotional and ethical weight.

For facilitators, the stone and petals lifeline activity required careful ethical and emotional sensitivity. It invited vulnerability and required holding space for grief, anger, pride and hope. In one interview, a facilitator who had also lost her husband shared her own story in solidarity with a participant, an exchange that underscored the porous boundaries between researcher and participant and the emotional labour inherent in participatory, relational methods (Klocker, 2015). This activity revealed the power of creative methods not just to collect stories, but to process them, creating a space where participants could narrate their lives on their own terms. It also reminded the research team of the ethical responsibility to honour these stories with care, to be mindful of emotional boundaries and to ensure that support structures were in place when working with potentially cathartic tools. Peer support and regular debriefs were essential, yet the project highlighted a wider need for more formalised psychosocial support in participatory work on violence and inequality (San Roman Pineda et al., 2023; WHO, 2016).

These reflections also extend to researcher wellbeing. Just as participants required safe and supportive spaces, facilitators and researchers also navigated disclosures of trauma, grief and conflict, which carried emotional demands of their own. This aligns with recent calls we have contributed to, to embed psychological safety and structured care mechanisms into qualitative and participatory research (San Roman Pineda et al., 2023; Zschomler et al., 2023). Arts-based methods themselves may offer part of the solution. For instance, the lead author has facilitated body mapping and other creative practices with early career researchers to process experiences of emotionally demanding fieldwork, fostering peer support, collective reflection and resilience (Brown, 2025). Integrating such approaches alongside more formal institutional mechanisms could help ensure that emotional safety is not only an ethical concern for participants but a core principle of the research process as a whole.

Method as relationship: Tensions and trust in co-production

Despite shared commitments to co-production, the project encountered familiar tensions around roles, timelines and expectations. Limited cycles of engagement, shifting schedules and unequal institutional power dynamics created moments of frustration and ambiguity. These challenges were not simply logistical, they reflected the deeper tensions of conducting participatory research across structural asymmetries, including Global North–South funding imbalances and differing institutional cultures (Dannecker, 2022; Voller et al., 2022).

Yet, the relational nature of arts-based methods offered a way to navigate, if not fully resolve, these tensions. Facilitators acted as bridges across linguistic, cultural and institutional divides, helping to sustain continuity, adapt tools and hold space for participation on participants’ own terms. Methods such as the problem/solution tree and visioning exercises exemplified this flexibility: while designed to meet research goals, their form and pacing were reshaped through real-time facilitation and community-driven priorities.

At times, this also meant balancing methodological rigour with enjoyment and playfulness. In Amantaní, facilitators emphasised that sustaining energy and creating a sense of fun were not just ‘extras’, but essential to building trust, reducing fatigue and enabling deeper reflection. As others have noted, participatory and arts-based methods rely on affective engagement as much as analytic structure (Denov and Shevell, 2021; Lenette, 2022). Choosing to vary activities, rather than repeat the same tool across multiple sessions, reflected a commitment to responsiveness and care – an acknowledgment that participant enjoyment is itself a methodological consideration in sustaining meaningful co-production.

ABM also provided opportunities to surface and reconfigure power dynamics. In role plays and collaborative analysis activities, participants rehearsed different ways of being in relationship – with one another, with institutions and with systems of authority. Rather than being passive recipients of research, they became co-authors of meaning and narrative (Lenette, 2022; Phillips et al., 2022). This was especially visible in the visioning and Most Significant Change exercises, where participants articulated both critique and possibility through collective reflection.

These moments illustrate how methods and relationships were co-constitutive. Creative tools supported trust-building, and trust, in turn, enabled more open, meaningful engagement with sensitive topics like violence, discrimination and gender roles. However, this process was uneven and contingent. Not all participants engaged in the same ways, and not all activities led to dialogue or clarity. Rather than seeing this as a failure, we understand it as part of the ethical terrain of participatory arts-based research: a practice that is inherently iterative, relational and shaped by ambiguity as much as insight (Lenette, 2022; Phillips et al., 2022).

From insight to transformation: ABM as a scaffold for change

Taken together, the six vignettes above show how arts-based approaches moved beyond diagnosis to become practices of transformation in their own right. Participants reflected on structural inequalities, but also imagined alternatives and practised different relational behaviours, from ‘power over’ to ‘power with’, from silence to expression, from disempowerment to mutual respect.

These changes often manifested as small-scale shifts in dialogue, self-confidence or relationship dynamics, but with potentially wider ripple effects. As Guillermo summarised in a role play debrief, ‘When a man treats his wife with love, she’ll respond in kind’. In other workshops, participants proposed community clean-ups, intergenerational rituals or shared hosting practices as tangible steps towards more inclusive tourism and governance.

ABM, then, functioned not just as research tools but as a scaffold for collective reimagining. These methods helped participants articulate pain and possibility, and offered researchers a more plural and textured understanding of what ‘impact’ might mean in contexts shaped by layered inequality.

Conclusion: Arts-based methods as situated, relational practice

This paper has explored how arts-based methods (ABM) can support transformative, participatory research on violence prevention and community wellbeing. Across the Amantaní project, creative methods functioned not merely as data collection tools but as relational practices, creating space for participants to share stories, process emotion and imagine alternatives to everyday hierarchies and harm.

Rather than offering a replicable toolkit, the project underscored the importance of adapting methods to local norms, emotional dynamics and cultural practices. What mattered was not simply what activities were used – drawing, body mapping, stones and petals, role play – but how, with whom and to what end. The adaptation process reflects an emergent principle of flexibility and contextual responsiveness in the application of ABM (Coemans and Hannes, 2017; Lenette, 2022; Phillips et al., 2022; Sultana, 2015; Thomas et al., 2022).

Equally, the impact of these methods lay not in the ‘products’ created (i.e. body maps, drawings, dramas) but in the processes they enabled. Activities often catalysed emotional openness, humour and collective insight, surfacing experiences that had previously remained unspoken. In doing so, ABM supported the development of emotional literacy and reflective dialogue. Participants reflected that acting out scenarios helped them see things differently, highlighting how embodied and affective expression became central to learning and transformation.

Facilitators observed how confidence and self-awareness grew over time, especially among women who had previously felt silenced in public meetings. These subtle changes reflected a move towards greater agency and voice, where participants not only shared stories but increasingly took ownership of group dialogue and decision-making. ABM, in this sense, helped to reconfigure who is seen as knowledgeable and whose perspectives are heard, echoing feminist and decolonial calls to value lived experience and relational knowledge (Haraway, 1988; Tuhiwai Smith, 1999; Vargas and Killean, 2023; Zaragocin and Caretta, 2021).

However, these transformations also surfaced ethical tensions. Disclosures of violence, interpersonal conflict and social exclusion placed emotional demands on both participants and facilitators. While informal peer support was helpful, the project revealed a need for more formal mechanisms of care in participatory research, particularly when dealing with trauma or shame. The ethical affordances of ABM – its openness, its emotional immediacy – are also its risks. As such, any use of these methods must attend closely to emotional safety and ethical preparedness, particularly in contexts of vulnerability.

Finally, the most enduring outcomes of the Amantaní project may not be its action plans or policy suggestions, but the small relational shifts it enabled: women speaking up in community meetings; men reflecting on their use of power at home; young people seeing their perspectives taken seriously. These shifts are hard to quantify, but they represent deep cultural work, reconfiguring relationships, building solidarity and making space for more respectful, inclusive dialogue.

In this way, arts-based methods should be understood not as technical fixes or illustrative tools, but as situated, dialogic practices. They work best when they are grounded in trust, guided by local meaning-making and open to contradiction and complexity. Their power lies in their capacity to foster not only analysis, but also connection, care and co-creation – outcomes that may seem modest but carry the potential to ripple outward across communities and time.

Supplemental Material

sj-docx-1-mio-10.1177_20597991251379980 – Supplemental material for From violence to strength: A reflexive evaluation of arts-based participatory research in Amantaní, Peru

Supplemental material, sj-docx-1-mio-10.1177_20597991251379980 for From violence to strength: A reflexive evaluation of arts-based participatory research in Amantaní, Peru by Laura J Brown, Blenda Milagros Abarca Díaz, Renan Espezua, Carla Cortez-Vergara, Hattie Lowe, María Calderon and Jenevieve Mannell in Methodological Innovations

Footnotes

The authors extend their heartfelt thanks to the community members of Amantaní who participated in this research. Their lived experiences,cultural knowledge and collaborative engagement were instrumental in shaping the insights and findings of this study. We deeply appreciate their generosity,enthusiasm and unwavering commitment to sharing their perspectives and expertise,without which this project would not have been possible. Their contributions serve as the foundation for the critical reflections and outcomes presented in this paper

Declaration of conflicting interest

The authors declared no potential conflicts of interest with respect to the research,authorship,and/or publication of this article.

Funding

The authors disclosed receipt of the following financial support for the research,authorship,and/or publication of this article: This work was supported by UK Research and Innovation (grant number MR/S033 629/1).

Ethical considerations

This study was approved by University College London,UK (ref: 9663/002) and Comité Institucional de Bioética de Via Libre,Peru (ref: 6315). Participants were invited to take part in the research voluntarily,gave their written informed consent to participate and be recorded and for their creative works and photographs to be shared as part of the research process. Each group created their own workshop ground rules which further ensured locally-relevant ethical participation. All participant names are pseudonymised.

ORCID iDs

Laura J Brown

Blenda Milagros Abarca Díaz

Hattie Lowe

Data availability statement

The datasets generated and analysed during the current study are not publicly available due to not being able to anonymise the data in a small community where people are likely to recognise the stories being told,but are available from the corresponding author on reasonable request.

Supplemental material

Supplemental material for this article is available online.

Author biographies

Dr. Laura J. Brown explores the intersections of environment,gender,and health,with a focus on creative and participatory methodologies. As a Senior Research Fellow at UCL’s Institute for Global Health,she worked on The EVE Project,a community-based study on preventing violence against women in high-prevalence settings in Peru and Samoa. She also contributed to the Siyaphambili Youth project,examining HIV risk among young people in South Africa. Currently,Laura is building an arts-for-health business,aiming to integrate her research expertise with arts-based approaches to promote health and wellbeing.

Blenda Milagros Abarca Díaz is a social scientist and anthropologist with expertise in public management and participatory research. She has worked extensively with community-based researchers in Amantaní,facilitating workshops and collecting data in culturally appropriate ways. Blenda brings a deep understanding of local contexts and is committed to empowering Indigenous communities through participatory methodologies.

Renan Espezua is a social scientist and anthropologist specializing in participatory research and public management. With years of experience working closely with community-based researchers in Amantaní,Renan has led workshops and data collection efforts that centre Indigenous knowledge and community priorities.

Dr. Carla Cortez-Vergara is a Peruvian psychiatrist specialising in child and adolescent mental health,systemic therapy,and mental health prevention. She has extensive clinical and research experience addressing mental health challenges across populations,with a focus on early childhood development and participatory research. Based in Lima,Carla works at the intersection of mental health and community-based participatory approaches to improve family and community wellbeing.

Hattie Lowe is a feminist researcher and PhD student at UCL’s Institute for Global Health. With over five years of experience in participatory methods and qualitative research,her work focuses on gender norms,violence prevention,and reproductive health. Hattie has contributed to projects on VAWG (violence against women and girls) prevention and sexual health in LMICs,including developing intervention manuals and theories of change. She is passionate about community-based approaches to co-produce evidence that promotes meaningful,sustainable change in women’s and adolescent health.

Dr. Maria Calderón is a Peruvian medical doctor with expertise in infectious diseases and evidence-based public health research. She leads Hampi Consultores en Salud,coordinating participatory health needs assessments in Indigenous communities like Amantaní. Maria has worked with the Peruvian Ministry of Health,focusing on health technology assessments and policy briefs. As part of the EVE Project,she oversaw local research activities. Currently,Maria is a Research Fellow in infectious diseases at Newcastle Upon Tyne Foundation Trust.

Dr. Jenevieve Mannell is a Professor of Social Science and Global Health at UCL and a UKRI Future Leaders Fellow. Specialising in community-based violence prevention,she leads projects in Afghanistan,Peru,Samoa,and South Africa. Jenevieve’s work focuses on participatory methods to address violence against women and girls in high-prevalence settings,and she has published extensively on community participation and gender-based violence. With a background in gender studies and social psychology,she advocates for the inclusion of marginalised communities in shaping research and policies about their lives.

References

Adhikari

Pell

Cheah

(2020) Community engagement and ethical global health research. Global Bioethics 31(1): 1–12.

Armijos

Ramirez Loaiza

(2024) Creative research with indigenous women: Challenging marginalisation through collective spaces and livelihoods practices. Disaster Prevention and Management 22: 817–841.

Armstrong

Flynn

Salt

, et al. (2023) Trust and temporality in participatory research. Qualitative Research 23(4): 1000–1021.

Barone

Eisner

(2011) Arts Based Research. Thousand Oaks, CA: Sage. Available at: https://uk.sagepub.com/en-gb/eur/arts-based-research/book234540 (accessed 07 January 2025).

Brown

(2025) Arts-based wellbeing workshops. Available at: https://www.incalculable.co.uk/workshops (accessed 27 August 2025).

Brown

Lowe

Gibbs

, et al. (2023) High-risk contexts for violence against women: Using latent class analysis to understand structural and contextual drivers of intimate partner violence at the national level. Journal of Interpersonal Violence 38(1–2): 1007–1039.

Cahill

(2007) The personal is political: Developing new subjectivities through participatory action research. Gender, Place & Culture 14(3): 267–292.

Calderón

Alvarado-Villacorta

Barrios

, et al. (2019) Health need assessment in an indigenous high-altitude population living on an island in Lake Titicaca, Perú. International Journal for Equity in Health 18(1): 94.

Calderon

Cortez-Vergara

Brown

, et al. (2023) Assessing essential service provision for prevention and management of violence against women in a remote indigenous community in Amantaní, Peru. International Journal for Equity in Health 22(1): 204.

10.

Chadwick

(2021) On the politics of discomfort. Feminist Theory 22(4): 556–574.

11.

Cheong

(2008) Sustainable tourism and indigenous communities: The case of Amantaní and Taquile Islands [MSc, University of Pennsylvania]. University of Pennsylvania. Available at: https://repository.upenn.edu/entities/publication/dd2ec881-8281-4ebf-bd0e-37e00f408514 (accessed 14 May 2024).

12.

Coemans

Hannes

(2017) Researchers under the spell of the arts: Two decades of using arts-based methods in community-based inquiry with vulnerable populations. Educational Research Review 22: 34–49.

13.

Cornish

Breton

Moreno-Tabarez

, et al. (2023) Participatory action research. Nature Reviews Methods Primers 3(1): 34.

14.

Costas Batlle

Carr

(2021) Trust and relationships in qualitative research: A critical reflection on how we can value time. In Clift

Gore

Gustafsson

, et al. (eds) Temporality in Qualitative Inquiry. London: Routledge, pp.158–171.

15.

Dannecker

(2022) Collaboration in a ‘North–South’ context: The role of power relations and the various context-based conditions. The European Journal of Development Research 34(4): 1716–1726.

16.

Denov

Shevell

(2021) An arts-based approach with youth born of genocidal rape in Rwanda: The river of life as an autobiographical mapping tool. Global Studies of Childhood 11(1): 21–39.

17.

Dickson-Swift

James

Kippen

, et al. (2009) Researching sensitive topics: qualitative research as emotion work. Qualitative Research 9(1): 61–79.

18.

Dunkle

Stern

Chatterji

, et al. (2020) Effective prevention of intimate partner violence through couples training: A randomised controlled trial of Indashyikirwa in Rwanda. BMJ Global Health 5(12): 1–22.

19.

Escobar

(2018) Designs for the Pluriverse: Radical Interdependence, Autonomy, and the Making of Worlds. Durham and London: Duke University Press.

20.

F. Amauchi

Gauthier

Ghezeljeh

, et al. (2022) The power of community-based participatory research: Ethical and effective ways of researching. Community Development 53(1): 3–20.

21.

Flaherty

Garratt

(2023) Life history mapping: Exploring journeys into and through housing and homelessness. Qualitative Research 23(5): 1222–1243.

22.

Frazier

(2020) When fieldwork “fails”: Participatory visual methods and fieldwork encounters with resettled refugees. Geographical Review 110(1–2): 133–144.

23.

Freire

(2005) Pedagogy of the Oppressed: Vol. 30th Anniversary Ed. New York: Continuum.

24.

Fricker

(2017) Evolving concepts of epistemic injustice. In: Kidd

Medina

Pohlhaus

(eds) The Routledge Handbook of Epistemic Injustice, 1st edn. London: Routledge, pp.53–60.

25.

Garratt

Flaherty

Barron

(2021) Life mapping. In: Barron

Browne

Ehgartner

, et al. (eds) Methods for Change: Impactful Social Science Methodologies for 21st Century Problems. Manchester: University of Manchester. Available at: https://aspect.ac.uk/wp-content/uploads/2021/10/Elizabeth-Garrett-A4-Guide-27-Sept-1.pdf (accessed 17 June 2025).

26.

Gascón

Mamani

(2022) Community-based tourism, peasant agriculture and resilience in the face of COVID-19 in Peru. Journal of Agrarian Change 22(2): 362–377.

27.

Haraway

(1988) Situated knowledges: The science question in feminism and the privilege of partial perspective. Feminist Studies 14(3): 575–599.

28.

Helmick

(2023) Expressing trauma through therapeutic art-based trauma-informed practice with/in a collective happening. Studies in Art Education 64(3): 324–343.

29.

International Rescue Committee (2014) Part 3: Implementation guide preventing violence against women and girls: Engaging men through accountable practice. A transformative individual behavioral change intervention for conflict-affected communities. Available at: https://gbvresponders.org/wp-content/uploads/2014/09/EMAP-Implementation-Guide.pdf (accessed 17 June 2025).

30.

Johnson

Leighton

Caldwell

(2018) The embodied experience of microaggressions: implications for clinical practice. Journal of Multicultural Counseling and Development 46(3): 156–170.

31.

Klocker

(2015) Participatory action research: The distress of (not) making a difference. Emotion, Space and Society 17: 37–44.

32.

Leavy

(2020) Method Meets Art: Arts-based Research Practice. London: Guilford Publications.

33.

Lenette

(2022) Cultural safety in participatory arts-based research: How can we do better? Journal of Participatory Research Methods 3(1): 1–15.

34.

Lepore

Hall

Tandon

(2021) The Knowledge for Change Consortium: A decolonising approach to international collaboration in capacity-building in community-based participatory research. Canadian Journal of Development Studies 42(3): 347–370.

35.

Lewin

(1946) Action research and minority problems. Journal of Social Issues 2(4): 34–46.

36.

Lowe

Brown

Ahmad

, et al. (2022) Mechanisms for community prevention of violence against women in low- and middle-income countries: A realist approach to a comparative analysis of qualitative data. Social Science & Medicine 305: 115064.

37.

Malchiodi

(1988) Creative process/therapeutic process: Parallels and interfaces. Art Therapy 5(2): 52–58.

38.

Malpass

Breel

Stubbs

, et al. (2023) Create to Collaborate: using creative activity and participatory performance in online workshops to build collaborative research relationships. Research Involvement and Engagement 9(1): 111.

39.

Mannell

Amaama

Boodoosingh

, et al. (2021) Decolonising violence against women research: A study design for co-developing violence prevention interventions with communities in low and middle income countries (LMICs). BMC Public Health 21(1): 1147.

40.

Mannell

Lowe

Brown

, et al. (2022) Risk factors for violence against women in high-prevalence settings: A mixed-methods systematic review and meta-synthesis. BMJ Global Health 7(3): e007704.

41.

Mastonshoeva

Shonasimova

Gulyamova

, et al. (2019) ZINDAGII SHOISTA - LIVING WITH DIGNITY: Mixed-methods evaluation of intervention to prevent violence against women in Tajikistan. Available at: https://www.international-alert.org/publications/zindagii-shoista-living-dignity-evaluation/ (accessed 06 February 2025).

42.

Mukerji

Mannell

Lowe

, et al. (2025) Identifying Indigenous strengths for health and wellbeing: Targeting the legacy of colonial masculinities in Peru. Social Science & Medicine 372: 117993.

43.

National Institute of Statistics and Informatics (Peru) (2019) Violencia contra las mujeres, niñas y niños. In Encuesta Demográfica y de Salud Familiar-ENDES 2018. Available at: https://www.inei.gob.pe/media/MenuRecursivo/publicaciones_digitales/Est/Lib1656/index1.html (accessed 06 February 2025).

44.

Phillips

Christensen-Strynø

Frølunde

(2022) Arts-based co-production in participatory research: Harnessing creativity in the tension between process and product. Evidence & Policy 18(2): 391–411.

45.

Rolleri

Verani

Lees

, et al. (2015) Wanawake Na Maisha A Gender Transformative Intimate Partner Violence Prevention Curriculum for Women in Mwanza, Tanzania. Available at: https://prevention-collaborative.org/wp-content/uploads/2021/08/Maisha-Wanawake-Na-Maisha_FINAL_Dec2015.pdf (accessed 17 June 2025).

46.

San Roman Pineda

Lowe

Brown

, et al. (2023) Viewpoint: Acknowledging trauma in academic research. Gender, Place & Culture 30(8): 1184–1192.

47.

Shannon

Mannell

(2021) Participation and power: Engaging peer researchers in preventing gender-based violence in the Peruvian Amazon. In: Bell

Aggleton

Gibson

(eds) Peer Research in Health and Social Development, 1st edn. London: Routledge, pp.102–115.

48.

Snowdon

Schultz

Swinburn

(2008) Problem and solution trees: A practical approach for identifying potential interventions to improve population nutrition. Health Promotion International 23(4): 345–353.

49.

Stanton

(2014) Crossing methodological borders. Qualitative Inquiry 20(5): 573–583.

50.

Sultana

(2015) Reflexivity, positionality and participatory ethics: Negotiating fieldwork dilemmas in international research. ACME: An International Journal for Critical Geographies 6(3): 374–385.

51.

Sweet

Ortiz Escalante

(2017) Engaging territorio cuerpo-tierra through body and community mapping: A methodology for making communities safer. Gender, Place & Culture 24(4): 594–606.

52.

Thomas

Weber

Bradbury-Jones

(2022) Using participatory and creative methods to research gender-based violence in the global south and with indigenous communities: Findings from a scoping review. Trauma, Violence, and Abuse 23: 342–355.

53.

Torre

(2009) Participatory action research and critical race theory: Fueling spaces for Nos-Otras to research. The Urban Review 41(1): 106–120.

54.

Tuhiwai Smith

(1999) Decolonizing Methodologies: Research and Indigenous Peoples. London and New York: Zed Books Ltd. Available at: https://nycstandswithstandingrock.wordpress.com/wp-content/uploads/2016/10/linda-tuhiwai-smith-decolonizing-methodologies-research-and-indigenous-peoples.pdf (accessed 07 January 2025).

55.

van der Riet

Boettiger

(2009) Shifting research dynamics: Addressing power and maximising participation through participatory research techniques in participatory research. South African Journal of Psychology 39(1): 1–18.

56.

Vargas

Killean

(2023) Women’s experiences of environmental harm in Colombia: Learning from Black, decolonial and indigenous communitarian feminisms. In: Milne

Davies

Heydon

, et al. (eds) Gendering Green Criminology. Bristol: Bristol University Press, pp. 229–250.

57.

Voller

Schellenberg

Chi

, et al. (2022) What makes working together work? A scoping review of the guidance on North–South research partnerships. Health Policy and Planning 37(4): 523–534.

58.

Wallerstein

Duran

(2010) Community-based participatory research contributions to intervention research: The intersection of science and practice to improve health equity. American Journal of Public Health 100(S1): S40–S46.

59.

Welbourn

(2002) Stepping stones: Shifting gender inequities to combat HIV. Agenda: Empowering Women for Gender Equity 53(53): 54–60.

60.

WHO (2016) Ethical and safety recommendations for intervention research on violence against women. In Building on lessons from the WHO publication “Putting women first: ethical and safety recommendations for research on domestic violence against women.” Available at: https://apps.who.int/iris/bitstream/handle/10665/251759/9789241510189-eng.pdf (accessed 07 January 2025).

61.

Williams

Lawrence

Davis

, et al. (2019) Understanding how discrimination can affect health. Health Services Research 54(S2): 1374–1388.

62.

Wilson

(2019) Community-based participatory action research. In Liamputtong

(ed.) Handbook of Research Methods in Health Social Sciences. Singapore: Springer, pp.285–298.

63.

Zaragocin

Caretta

(2021) Cuerpo-Territorio: A decolonial feminist geographical method for the study of embodiment. Annals of the American Association of Geographers 111(5): 1503–1518.

64.

Zschomler

Mcquaid

Bridger

, et al. (2023) A Toolkit to Support Researcher Wellbeing (RES-WELL): Practical strategies for UK research institutions, funders, and researchers in the context of emotionally or ethically challenging research. Available at: https://www.ucl.ac.uk/population-health-sciences/sites/population_health_sciences/files/res-well_toolkit_0.pdf (accessed 27 August 2025).

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