ABSTRACT
BACKGROUND: A significant challenge in Patient and Public Involvement and Engagement (PPIE) in health research is to include a wide range of opinions and experiences, including from those who repeatedly find themselves at the margins of society. OBJECTIVE: To contribute to the debate around PPIE by introducing a bottom-up methodology: cultural animation (CA). Cultural Animation is an arts-based methodology of knowledge co-production and community engagement which employs a variety of creative and participatory exercises to help build trusting relationships between diverse participants (expert and non-experts) and democratize the process of research. DESIGN: Three CA full-day workshops for the research project "A Picture of Health." PARTICIPANTS: Each workshop was attended by 20-25 participants including 4 academics, 5 retired health professionals who volunteered in the local community and 15 community members. Participants ranged in age from 25 to 75 years, and 80% of the participants were women over the age of 60. RESULTS: The CA workshops unearthed a diversity of hidden assets, increased human connectivity, led to rethinking of and co-creating new health indicators and enabled participants to think of community health in a positive way and to consider what can be developed. DISCUSSION: Cultural animation encourages participants to imagine and create ideal pictures of health by experimenting with new ways of working together. CONCLUSION: We conclude by highlighting the main advantages to PPIE as follows: CA provides a route to co-produce research agendas, empowers the public to engage actively with health professionals and make a positive contribution to their community.