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Issue As health research funding institutions increasingly require researchers to engage with patients and the public, stakeholder involvement claims have become popular. However, there are renewed concerns that its underpinning participatory requirements are merely applied as a tick-box exercise. Widespread advocacy for the approach without due problematisation is troubling, as it may ultimately reinforce the social inequities that it originally intended to address. Description of the Problem Success histories avail the enormous potential of participatory research but important caveats caution against romanticizing the approach. Despite its enormous potential, there are increasing concerns that participatory research can become a risky method of social inquiry, with potential negative consequences. The “dark side” of participation speaks of the professional and personal risks for the researchers and stakeholders involved, where diverging interests and underlying power inequities are not acknowledged and adequately managed. Results Robust monitoring and evaluation frameworks that explicitly account for power dynamics are urgently needed to assess the distribution of both the benefits and costs derived from participatory research. We outline a socio-ecological framework to comprehensively examine micro, meso and macro level factors influencing processes and outcomes in participatory research, so power dynamics can be adequately monitored and addressed. Lessons If the credibility and legitimacy of participatory research is to be sustained, strategies to monitor and tackle power dynamics are urgently needed. Key messages Power dynamics in participatory research can operate at micro, meso and macro levels. We present a socio-ecological framework to evaluate power dynamics in participatory research.

The social ecology of power in participatory research