26 May 2026
Dr Melissa Stepney
Co‑produced and participatory health research brings researchers into close, often intimate, contact with people’s lives and experiences. When working alongside communities to explore sensitive questions – such as mental health, identity or care -who we are, how we show up, and how we make sense of interactions all matter.
Qualitative and participatory traditions have long engaged with concepts such as positionality, reflexivity and self‑awareness, and these ideas are well-established across the social sciences. Yet even with this rich scholarship in disciplines outside of health and medical sciences, they can still feel abstract, confusing or easily reduced to a methods‑section checklist, especially for researchers new to co‑production. In this blog, I unpack these concepts and also introduce cultural humility, exploring how they can support a more grounded, relational and ethical approach to co‑produced health research.
Positionality is about who we are – our identities, social locations, values and histories – and how these shape the research encounter. This includes our race, gender, class, disability, geography, and more. It recognises that we never enter research as neutral or detached. Positionality statements are increasingly becoming a requirement in research: going beyond the individual is also important. For example, when building our research teams we should ask ‘who is missing?’ and ‘who should be involved to bring different perspectives, values or identities?’.
Reflexivity is the ongoing practice of examining our own beliefs, assumptions, and experiences as part of the research process. It asks us to notice how who we are shapes what we see, how we interpret, and the kinds of relationships we build in the field. This active self‑reflection is often considered a hallmark of qualitative research because it foregrounds the researcher’s role in the production of knowledge, rather than pretending we are objective or detached observers. Although typically associated with qualitative and participatory traditions, reflexivity is increasingly recognised within quantitative research too. See Jamieson et al. (2023) and Ryan (2006) for useful introductions to reflexivity in quantitative approaches.
Self-awareness is the underlying skill that makes reflexivity possible. It involves noticing our internal states – our reactions, discomforts, pre-conceptions – and recognising how they may affect others. One of the largest studies on the topic found that although many people believe they are self‑aware, only 10–15% actually meet ‘criteria’ for self awareness (Eurich, 2018). The same research distinguishes between internal self‑awareness (how clearly we see ourselves) and external self‑awareness (how well we understand how others see us), suggesting that introspection alone may not reliably improve either of those.
Developing self‑awareness is therefore an active, ongoing process. Many different fields offer tools for exploring the ‘self’ and ‘hidden self’, from organisational psychology and psychoanalytic theory to contemplative, yogic and mindful traditions. These approaches remind us that increasing self‑awareness is both learnable and central to becoming more attuned, ethical and relational in co‑produced research.
Cultural humility expands these ideas by emphasising curiosity, openness, and accountability. It also goes a step further than simple ‘cultural awareness’. Cultural awareness involves recognising our own cultural characteristics, which may include our language, norms, worldviews, traditions and cultural experiences. However, humility emphasises that we may never fully understand another person’s cultural experience despite our well intentions or how well informed we feel. Unlike “cultural competence,” cultural humility is not about mastering knowledge of others; it is a lifelong practice of:
This stance is central to co-production, where knowledge is created together, not extracted upon.
Co-produced research foregrounds relationships. Our identities and assumptions shape:
Rather than striving for an impossible objectivity (which may be more common in quantitative approaches), these practices help us acknowledge that research is intersubjective – there is no “view from nowhere.” Reflexivity and cultural humility invite us to see the dynamics at play, especially when working with communities whose experiences, identities or histories differ from our own.
They also help us recognise that research is emotional. Fieldwork, interviews and positionality statements can surface vulnerability. Attending to this is a vitally important part of ethical practice, towards ourselves as much as towards participants.
Time pressures and reporting requirements mean reflexivity can easily become a fixed paragraph of identity labels or shopping list of things that don’t have much substance. But as many scholars argue, reflexivity is richer when it is relational, ongoing and supported by others.
This might involve:
Not all reflexivity needs to be made public. Ethical research includes protecting the researcher’s wellbeing and boundaries too – something which historically has not been paid much attention to (see Bhui et al, 2026 for more on this).
Finally, this is not about perfection or confession. But it may mean slowing down and resisting a research culture that rewards speed, efficiency and deliverables. For example, when applying for grants often more time (not less) is needed for these aspects of work. Crucially this cannot rest on solely the goodwill of individual researchers. Creating space for reflexivity, self‑awareness and cultural humility requires research infrastructure that properly resources this labour, recognises its emotional demands, and builds it into project planning from the outset. Funders (hopefully) increasingly recognise that it’s important to have realistic timelines, valuing process as well as outcomes. Researchers must be keep being transparent about the time, skills and emotional work involved. Without this structural support, calls for deeper reflexivity risk becoming yet another uncompensated expectation placed on already stretched researchers. The benefits are clear: when adequately resourced, these practices strengthen the integrity of our work, deepen relationships with participants, and bring greater richness and meaning to co‑produced research.
Dr Melissa Stepney is a researcher focusing on mental health, gender, and the experiences of marginalised young people. She collaborates closely with marginalised young people and communities to improve health and care services.
Bhui K, Mooney R, Stepney M et al. Improving Research Inclusion: learning from NIHR and Research Council funded studies in England [version 2; peer review: 2 approved with reservations, 1 not approved]. NIHR Open Res 2026, 5:102 (https://doi.org/10.3310/nihropenres.14116.2)
Mand, K., Lavis, A., Stepney, M., Mooney, R., & Bhui, K. (2026). No ethics needed? Towards an ethics of care for public and patient involvement and engagement. Health Expectations, 29, e70638. https://doi.org/10.1111/hex.70638
Ryan, L. and Golden, A., 2006. ‘Tick the box please’: A reflexive approach to doing quantitative social research. Sociology, 40(6), pp.1191-1200.
Jamieson, M.K., Govaart, G.H. and Pownall, M., 2023. Reflexivity in quantitative research: A rationale and beginner’s guide. Social and Personality Psychology Compass, 17(4), p.e12735.