The Use of Graphic Facilitation to Support Adherence to OCAP® Principles in Research With Indigenous Communities

Abstract

Graphic facilitation is a creative, robust visual communication process and tool that can be used by researchers for several benefits including improving data integrity; mitigating barriers between researchers and participants; promoting participants’ ownership of data, decision-making, and creativity; and, co-creating knowledge, which is of particular interest among certain cultures and in some contexts. For Indigenous Peoples who traditionally use visual, oral, and narrative modalities as primary forms of communication, graphic facilitation is a methodology that aligns well with these modes of communicating. In this article, we describe our use of graphic facilitation in a community-led project exploring Indigenous parents’ perceptions of community strengths, needs and priorities related to healthy early childhood development and optimal parenting. In collaboration with the Indigenous Friendship Centre in Hamilton, Canada, we held a Community Gathering that was facilitated by a graphic artist experienced in working with the Indigenous community; the findings resulting from the Gathering are presented. We discuss how researchers can use graphic facilitation as a tool to ensure adherence to the OCAP® principles of data ownership, control, access, and possession for the Indigenous community and describe the potential for mitigating power imbalances. Finally, considerations for researchers contemplating using graphic facilitation as a tool for research projects with Indigenous people and communities are presented.

What is Already Known?

• Graphic facilitation is a visual communication tool that has several important benefits in research.

• The use of graphic facilitation in research aligns with the visual, oral, and narrative modalities of sharing knowledge commonly used by Indigenous communities.

What This Study Adds?

• This article details an exemplar of the successful use of graphic facilitation in research with an Indigenous community.

• Graphic facilitation is discussed as an approach to ensure data ownership, control, access, and possession (OCAP®) by Indigenous community members.

• Important considerations for researchers deciding whether to use graphic facilitation as a tool for research with Indigenous peoples, including recommended graphic facilitator characteristics and skills, are presented.

Introduction

Using images to communicate can transcend language and socioeconomic barriers, allowing for a broader audience to receive information (Darnhofer, 2018). With the rapid advancement of technology, smartphone culture has made images ubiquitous (Darnhofer, 2018) and a common way to communicate. Text messages are frequently accompanied by images (emojis or GIFs) and social media is flooded with visual images such as memes (Highfield and Leaver, 2016). Academia is not immune to these rapidly evolving forms of communication. Newer forms of visual methods are constantly being developed such as visual notetaking expressed as cartoons or comics at scientific conferences, and research results published as comic books (Darnhofer, 2018; Espiner and Hartnett, 2016). The rising interest in visual methods is apparent across several disciplines, including healthcare sociology, anthropology, psychology, and education, and is particularly present in research involving children and youth (Buckingham, 2009; Caldairou-Bessette, et al., 2020; Doucet, et al., 2022). As an illustration, the Lancet family of academic journals now publish graphical abstracts (The Lancet, n.d.), and a conference is held every year, dedicated to healthcare comics. Researchers are also being asked to develop visuals of their work - like co-author E.M.F. who was invited by a journal to create a visual abstract of her research for promotion on the journal’s social media platforms (Ferron et al., 2021).

In this article, we introduce a selection of visual communication methods for potential use in research focusing primarily on graphic facilitation, an interactive process whereby study participants and a graphic artist co-create a visual depiction of the discussion (Dean-Coffey, 2013). We describe our experience using graphic facilitation in a community-led project with an Indigenous organization in Hamilton, Ontario, Canada. Our experience is shared to elucidate the potential of graphic facilitation to promote ethical data practices in research with Indigenous communities. We encourage researchers conducting research with Indigenous communities to consider using graphic facilitation as one approach help to ensure data ownership, control, access, and possession (OCAP®) by Indigenous community members and partners; and describe the potential of graphic facilitation for mitigating power imbalances and harm in research with people marginalized by society.

Situating the Authors in the Project

When engaging in and reporting research with Indigenous communities, it is important to first situate the authors to be transparent about the intentions and motivations of the authors for the project. Briefly, the first author is a non-Indigenous nurse researcher with more than 10 years experience working with the Indigenous community at the Hamilton Friendship Centre – the Hamilton Regional Indian Centre (HRIC)- and other Indigenous-led organizations to meet their research goals related to parenting and early childhood. She help lead a Canadian Institutes of Health Research (CIHR) application for funding to support the community-led project outlined later in this paper; this application was developed in conjunction with the second author, and at the direction of two First Nations staff members (authors three & four) at the HRIC where the project was conducted. The second author is also a non-Indigenous nurse researcher with research interests and expertise in maternal and child health. She has worked collaboratively with the HRIC on the community-led project for several years. The third author is First Nations from Six Nations of the Grand River. She is a manager at the HRIC with expertise in early childhood education and child welfare. The fourth author is a First Nations Knowledge Holder from Six Nations of the Grand River. As a staff member at the HRIC she provides cultural safety training for non-Indigenous program leads and service workers within Southern Ontario. Both third and fourth authors were collaborators on the CIHR grant, and subsequently also contributed to the planning of, and engaged in, a Community Gathering that was the key activity of the project. Finally, the fifth author is a PhD prepared nurse and research coordinator with expertise in healthcare comics; she joined the team after the development and the initial implementation of the community-led initiative.

Visual Communication Methods and Research

The use of visuals such as graphs and figures have a long history in research (Darnhofer, 2018). Graphs are used in quantitative research to visually illustrate relationships in the data and to display data too numerous or complicated to present as text (Centers for Disease Control and Prevention, 2018, 2022). Photographs may be the object of study, but also a means of collecting data such as in the research designs of photovoice and photo-elicitation (Darnhofer, 2018; Pauwels, 2015; Wang and Burris, 1997). Comics and graphic recordings (the translation of a conversation into a drawing in real-time) are other visual communication methods that have utility in research.

Comics

Comics, sometimes known as graphic novel, sequential art, graphic literature, graphic narrative, and comics journalism are the hybrid of images and text presented in panels in sequential order (Chute, 2008). In healthcare, comics are known as graphic medicine where there is an “intersection of the medium of comics and the discourse of healthcare” (Czerwiec et al., 2020, p. 1). Comics, provide enjoyment to the viewer and increase attention, understanding, and recall of information (Espiner and Hartnett, 2016; Sturdee et al., 2018).

In North America, comics are often associated with humour and entertainment (Darnhofer, 2018). While humour can be an asset, it must be used with caution in research so as not to be perceived as being used at the expense of others or trivializing research results (Darnhofer, 2018). Alternatively, comics journalism is a form of comics where visual strategies are used to convey the seriousness of a subject (Weber and Rall, 2017, 2019).

Darnhofer (2018) described the use of visuals in comic-style posters to disseminate interview findings from research. During workshops, the authors describe the use of posters to communicate preliminary findings, leading to lively conversations among participants. The use of humour inherent in comic-style mediums promoted a relaxed and positive mood among group members, and the exaggerated and caricature nature of the comics assisted the group with discussing sensitive issues.

Graphic Recording

Visually capturing and representing conversations in real time by combining text, drawings, and colours has been labelled using a variety of titles, including graphic recording, sketch noting, chart writing, scribing, and graphic facilitation (Dean-Coffey, 2013; Mendonça, 2016; Parsons et al., 2019; Sibbet, 2001). Graphic recordings are typically a non-linear visual of complex concepts, ideas, and even moods, to synthesize the essence of a conversation (Dean-Coffey, 2013). To visually capture an event, meeting, or presentation, the artist or recorder may work alone without input or feedback from discussion participants (for example, with sketch noting) or in collaboration with participants as an iterative process (such as with graphic facilitation). Graphic recording has emerged from practice, not academia; consequently, researchers have little theory or written guidance on its use in research (Dean-Coffey, 2013). Instead, the practice is learned and advanced through apprenticeship and mentorship by other graphic recorders (Dean-Coffey, 2013).

Sketch Notes

Sketch notes, a type of graphic recording, are rich visuals created in real-time by combining drawing, handwriting, hand-drawn typography, and shapes to capture ideas and experiences (Berman, 2011; Marquardt and Greenberg, 2012; Mendonça, 2016). Sketch notes not only summarize events but include the recorder’s additional notes and drawings of related and inspired ideas, such as future work and new questions (Marquardt and Greenberg, 2012). This practice also supports the recorder’s reflection of ideas drawn over several sketch notes, often making it easier for the artist to recall essential ideas and reflect on new ones (Dean-Coffey, 2013; Espiner and Hartnett, 2016; Marquardt and Greenberg, 2012). One does not need to be an artist to create sketch notes, making it an inclusive practice with several benefits for the practitioner, including enhanced recall of essential ideas over several sketch notes, enhanced concentration on complex ideas or within lengthy meetings, and the joy of creating (Sturdee et al., 2018). As a solo practice, however, the recorder’s interpretation of presentations or discussions without input from others raises potential ethical concerns for its use in research (Darnhofer, 2018; Marquardt and Greenberg, 2012; Mendonça, 2016). For instance, unbeknownst to individuals and the artist, sensitive information may be recorded and shared on social media (Marquardt and Greenberg, 2012). Thus, the use of sketch notes is not common practice in research.

Graphic Facilitation

Graphic facilitation is another form of graphic recording that is similar to sketch notes in terms of its use of visual elements. However, the critical difference is that graphic facilitation is an interactive process among participants, the graphic facilitator, and the visual output, whereas sketch noting is not (Dean-Coffey, 2013; Espiner and Hartnett, 2016; Hautopp and Ørngreen, 2018; Mendonça, 2016; Parsons et al., 2019; Sibbet, 2001). With graphic facilitation, research participants and the facilitator collaboratively create a visual representation of the discussion and interactions in narrative form. The process involves large visuals or charts in which the graphic facilitator translates and interprets participants’ discussions, utterances, and non-verbal behaviours into images in real-time and full view of participants (Dean-Coffey, 2013; Espiner and Hartnett, 2016; Hautopp and Ørngreen, 2018). Each visual or chart can be customized based on the group’s input to coincide with their objectives and the nature of the discussion. Graphic facilitation is a robust process with the potential to help group members feel heard and understood, in ways that traditional research tools and processes cannot (Mendonça, 2016). For example, researchers used graphic facilitation to enable participation of residents from a multi-ethnic and disadvantaged neighbourhood to contribute to the design of a health promotion intervention (Sandholdt et al., 2022)

To successfully use graphic facilitation, a strong facilitator is needed to support the process. A graphic facilitator has a unique skill set in that they listen intently to conservations, distilling each element into its essence and synthesizing the group’s core thoughts through drawn images, text, and metaphors (Dean-Coffey, 2013; Espiner and Hartnett, 2016; Hautopp and Ørngreen, 2018; Mendonça, 2016). The graphic facilitator skillfully leads discussion participants toward the agreed-upon meeting objectives while simultaneously encouraging participation, group ownership and sparking creativity (Dean-Coffey, 2013; Espiner and Hartnett, 2016; Mendonça, 2016; Sandholdt et al., 2022). Graphic facilitators notice obvious and subtle changes amongst group members, including agreement, disagreement, and challenges; laughter, applause, and surprise; changes in mood and energy; and even when people leave the group (Mendonça, 2016). Graphic facilitators do this all while interpreting the data and deciding which is relevant to capture and how (Dean-Coffey, 2013). Graphic facilitation lends itself well to research as it can meets ethical requirements of participant consent and serves as a method to clarify and approve the interpretations of data.

Graphic facilitation, both as a process and a tool (visual output), has several important benefits in research (Darnhofer, 2018; Dean-Coffey, 2013; Espiner and Hartnett, 2016; Giwa et al., 2021; Mendonça, 2016; Sandholdt et al., 2022). First, graphic facilitation can improve data integrity by addressing issues with audio-recording interviews and focus groups (Giwa et al., 2021). Some interview participants are reluctant to speak their true thoughts while being recorded and focus group participants may present themselves in ways they perceive as more socially favourable, which can negatively affect the integrity of data collection and quality (Giwa et al., 2021). The creation of a graphic during an interactive discussion between participants and facilitator not only adds richness to the data but negates the need for an audio recording as graphic facilitation occurs simultaneously with the added benefit of input and clarification from participants in real time. Second, the use of a graphic can mitigate barriers between researchers and participants, as participants feel more confident in their ability to interpret the graphic and share their opinions (Darnhofer, 2018). In effect, graphic facilitation can give a voice to all the individuals in the room, encouraging participation from those who may feel they have less power, control, or knowledge than other group members (Dean-Coffey, 2013). This can lead to new partnerships as group members see their concerns and contributions reflected back to them visually and within the group discussion (Mendonça, 2016). Third, when participants are physically facing the visual rather than facing each other across a table, they are co-creating with the graphic facilitator, which can serve to diffuse tension, take pressure off any one individual, and promote group ownership and decision-making (Dean-Coffey, 2013). Fourth, the co-creation of knowledge, which is foundational to graphic facilitation, may resonate in some non-Western cultures where ways of knowing are ingrained, intuitive, and based on holistic processes, which are at odds with the rationalistic and objective viewpoints common to some forms of Western-oriented research methods (Buckingham, 2009; Dean-Coffey, 2013). When participants from other cultures are involved in the graphic facilitation, the process can help the group move past barriers in understanding that may exist when text alone is not able to capture true meaning (Dean-Coffey, 2013). Fifth, graphics developed through co-creation can facilitate positive research experiences, by creating feelings of excitement, and inspiring creativity (Espiner and Hartnett, 2016; Mendonça, 2016; Parsons et al., 2019; Sandholdt et al., 2022). Both the process and the visual output can be empowering (Buckingham, 2009) and facilitate feelings of self-efficacy toward finding and developing solutions as complex ideas are more effectively conveyed through images than text (Espiner and Hartnett, 2016). Finally, because graphic facilitation is a powerful engagement tool where participants collaborate with each other toward a common goal, the process can 'fast-forward’ data analysis (Parsons et al., 2019), as the researcher and participants identify preliminary findings from their discussion (Darnhofer, 2018; Dean-Coffey, 2013; Espiner and Hartnett, 2016; Giwa et al., 2021; Sandholdt et al., 2022).

Despite the benefits of graphic facilitation and its end products, the method is not without some challenges. Graphic facilitation may force participants out of their comfort zone as it encourages active participation in group settings, which may be uncomfortable for some (Dean-Coffey, 2013). Others may still choose to remain silent and not verbally participate. It may also be challenging for the researcher or group to work with a graphic facilitator if they are not accustomed to interdisciplinary collaboration (Dean-Coffey, 2013). Finally, for graphic facilitation to be a worthwhile process, the researcher or group must be explicit about the intention and goals of the group process so that the facilitator can support the objectives (Dean-Coffey, 2013).

Graphic Facilitation in Research with Indigenous People

Researchers should not presume that all cultures use written language as their primary form of communication. Instead, researchers should collaboratively identify culturally appropriate forms of communication in research with participants and community groups, to demonstrate respect and honor for participants and to maintain data integrity. Graphic facilitation as a visual communication method has potential utility in research with Indigenous cultures, among others, where written language may not be the preferred form of communication. Indigenous knowledge systems have been used since time immemorial, and are living, and continuously evolving (Morton Ninomiya et al., 2022; The Truth and Reconciliation Commission of Canada, 2015). Indigenous knowledge is thus not bound to only written text, and instead, is commonly orally passed down through generations.

At its core, graphic facilitation is a process of co-creating and synthesizing several voices. Due to this defining characteristic and other strengths, graphic facilitation was selected by the authors as a visual communication method to utilize in a collaborative research project with the Indigenous community in Hamilton, Ontario, Canada. It was collectively envisioned by all authors that graphic facilitation would support collaboration with community members, and importantly, allow for and honour the cultural perspectives and rights of Indigenous community members in the project.

Case Study: Use of Graphic Facilitation in a Community-led Project

A community-led project focused on an exploratory needs assessment of Indigenous parents raising young children was initiated, with financial support from the CIHR. As part of the project needs assessment, a Community Gathering was held in collaboration with the community partner, the local Indigenous Friendship Centre – the HRIC- to achieve their project goals.

Goal of the Community Gathering

The goal of the Community Gathering was to identify what Indigenous parents perceived as community strengths, needs, and priorities relevant to their role as a parent of an infant or toddler; and what was most needed to support healthy early childhood development and optimal parenting. The Community Gathering was intended to inform and be the catalyst for a future research proposal on the development and potential evaluation of an intervention to address a community-identified need.

Framework Guiding the Community Gathering

The framework of the 4 Rs – Relevance, Respect, Responsibility and Reciprocity – was applied to the Community Gathering to promote a safe space for community members to learn from one another and to share their vision for the health of parents and children (Kirkness and Barnhardt, 1991). The goal of the Gathering was deemed to be relevant to the Indigenous community in Hamilton, along with the HRIC, who value engaging in community-led research initiatives; and, were interested in examining how to best support the health and wellness of Indigenous parents with infants/toddlers in their programming. Community processes were respected, and responsibility was demonstrated by inviting an Indigenous Knowledge Holder to lead the Gathering, with researchers assisting only when appropriate. Respect and reciprocity were honoured with the delivery of a care package to each participant’s home prior to the Gathering, along with an honorarium to thank them for their time. Care packages consisted of a smudging kit (shell, Sage, matches, and feather) and a craft that could be completed during the Gathering meeting. Care packages were assembled and delivered in a reusable bag designed with colourful Indigenous art. Reciprocity was also prioritized by the project as a whole, which was designed to inform HRIC programming and community needs.

Overview of the Community Gathering

The Community Gathering was convened with local Indigenous parents of young children (<5 years of age), a Knowledge Holder, staff from the HRIC, and researchers (first two authors). The attendees consisted of First Nations and Métis community members, as well as researchers. From this point forward, participants will be identified as Indigenous when referred to collectively. The intent of Community Gathering was to brainstorm ideas for future research projects based on community-identified priorities and needs, and, as such, we did not require ethics approval to conduct the Community Gathering; this was confirmed with the local research ethics boards: The Hamilton Integrated Research Ethics Board (HiREB) and the University of our Research Ethics Board. No personal data was collected. Subsequent research projects resulting from this planning meeting have sought and gained ethics approval from both aforementioned ethics boards.

The Community Gathering, although initially intended to be in person, was held virtually due to the COVID-19 pandemic. The Gathering commenced with a Smudging Ceremony led by a First Nations Knowledge Holder. Next, the Knowledge Holder provided teachings on Indigenous parenting. Following the teachings, parents were divided into small groups to discuss what supports or services they used to assist with parenting their child and what they perceived as supportive and as service gaps. A large group discussion followed where parents identified the most important support or service needs necessary to support their parenting and their children’s health. Graphic facilitation was used as a strategy to capture the essence of the discussion during this Gathering.

Why was Graphic Facilitation Used?

Graphic facilitation was used as a mechanism to document in real time the discussion at the Community Gathering. The decision to use graphic facilitation was motived by several factors. First, since the Gathering was virtual, it likely would be challenging for parents to speak up spontaneously in this context. Graphic facilitation encouraged discussion as it was interactive. Second, Indigenous parents might perceive a power differential between them, HRIC staff, and the researchers. Graphic facilitation was a strategy to bridge this gap, as the facilitator was experienced in working with Indigenous communities and might be better perceived as a neutral third party in the discussion. Finally, and most importantly, graphic facilitation was used to ensure the research adhered to the principles of OCAP® (ownership, control, access, and possession). The HRIC did not have the infrastructure to store written data and audio-recordings of the discussion or to widely share the data with community members; using a graphic facilitator ensured that the discussion was recorded as a printed graphic (i.e., large scale poster) that could be displayed at the HRIC. Thus, the Indigenous community could own and control the data from the Community Gathering.

Process of Using Graphic Facilitation for the Community Gathering

The service of a professional graphic facilitator was acquired to “record” the Community Gathering. The research team met with the graphic facilitator prior to the Gathering to discuss the meeting aims, technical requirements for the facilitation, and made plans on how to address any technical issues that might arise. A contract with a confidentiality agreement to protect the data that would be generated in the Community Gathering was signed between the lead researcher and the graphic facilitator. The trained graphic facilitator, who had experience working with Indigenous communities, attended the virtual Community Gathering and created a graphic recording of the discussion. The graphic was created by the facilitator using their artistic drawing skills in real time while the group discussion was taking place. The graphic illustration captured the key highlights or ideas from the discussion. It was viewable by participants as it was being created through screen sharing on the virtual meeting platform. At various points during the discussion, the graphic facilitator sought feedback and confirmation that ideas being captured on the graphic appropriately represented the points the participants were bringing forward. During the Gathering, written notes were also taken by student research assistants. These written notes provided the graphic facilitator with additional details to add to the graphic recording after the Gathering had ended. The research notes were shared amongst the research team members who led the organization of the community meeting. They were available to all team members (including two First Nations co-authors) who were part of the Indigenous community that participated in the meeting, and to other community members upon request. The graphic facilitator emailed a copy of the complete draft of the graphic recording to all attendees of the Gathering for input and feedback. The graphic recording then underwent minor adjustments based on feedback from attendees. A final copy of the graphic was emailed to all participants once it was finalized. Due to the ongoing pandemic, the graphic was posted electronically on the publicly accessible project website as the HRIC was not open to the public. Following the pandemic, the graphic was sent to the HRIC to be hung in the Friendship Centre for all to see.

Meeting Findings Captured by the Graphic

To demonstrate the resourcefulness of graphic facilitation, the meeting findings from the Community Gathering will be briefly described. The graphic facilitator created two graphics from the Gathering, one that depicted the findings from the small and large group discussions, and a second that illustrated the traditional teachings by the Knowledge Holder. After discussing the manuscript with attendees at the Gathering, it was decided that out of respect for the sacredness of local and traditional knowledge, we would not share the second graphic which focused on the teachings of the Knowledge Holder. Instead, we will describe the meeting findings as illustrated in the first graphic (Figure 1). In this graphic, the main elements parents perceived as community strengths and needs in relation to their parenting and the health of their children have been made visual. Parents found strengths in services that they had used and felt were helpful in their parenting role. Parents noted that HRIC provided: social support, most notably in times of crisis; a community connection with opportunities to build relationships; and essential support services such as access to housing. Health promotion programs in the community such as the Healthy Babies, Healthy Children Program, and nutrition programs at a local hospital were viewed as helpful. Parents felt postpartum care was essential, including breastfeeding support and the wrap around care provided by midwives following birth. Care that was relational and non-judgemental, such as that provided by midwives, was viewed as important. Parents valued services that helped link their parenting with their culture and helped them support their child’s development of their Indigenous identities. Support through the provision of items such as groceries and baby care products was also recognized as very helpful.

Figure 1.

Growing together community gathering graphic.

Parents identified areas of challenge and need in relation to their use of services to support their parenting role. Some wanted to see more “hands-on” programs, including age-appropriate activities for their children. Enhanced integration of culture into programming was desired, as well as inclusion of the family into programs (vs. individual-focused programs). A need for more life skills training on how to care for a baby was suggested, as was the need for service providers to be more open and upfront when they recognize that a child needs additional support for their development. Parents also felt that access to information and support was an area for improvement. They wanted more information and access to resources and/or a navigator or handbook to help support them. One recommendation was a single centre offering 24-h support. Gathering attendees specifically noted that more support was needed for mothers experiencing domestic abuse. Finally, access to programming was also noted as challenging. The use of virtual programming was difficult for some parents trying to participate when in-person programs were not available due to the COVID-19 pandemic restrictions.

Graphic Facilitation as a Method of Adhering to OCAP® Principles

From our use of graphic facilitation, it is evident that the method can be an excellent way to promote ethical data practices in research with Indigenous communities. It can be used as an approach to ensure data ownership, control, access, and possession (OCAP®) by Indigenous community members. In the sections that follow, an overview of the OCAP® Principles is presented, and then a discussion of how graphic facilitation, as a method of visual communication, assists in promoting adherence to these essential principles is provided.

Principles of Ownership, Control, Access, and Possession (OCAP®)

OCAP® represents a tool that supports the rights of First Nations people in Canada to their data collected through research (First Nations Information Governance Centre [FNIGC], 2022). The OCAP® acronym represents four principles related to data: ownership, control, access and possession (First Nations Information Governance Centre [FNIGC], 2022). The tool was created in response to unethical research practices as identified by the Report of the Royal Commission on Aboriginal Peoples (Hurley and Wherrett, 2000). Historical instances of research conducted without community consent or involvement, and the removal of data from communities without their consent or knowledge, sparked the need to articulate the rights of First Nations in research and in relation to data (First Nations Information Governance Centre (FNIGC), 2022). While specifically generated by First Nations in Canada, the principles are applicable to all research with Indigenous Peoples, including Métis people and Inuit and their communities. Briefly, ownership refers to the rights of an Indigenous community or group of individuals to own their data (First Nations Information Governance Centre (FNIGC), 2022). Control refers to the rights of Indigenous Peoples to be involved in and manage all research processes from start to finish, including how knowledge is used and disseminated (First Nations Information Governance Centre (FNIGC), 2022). Access to data is the right of Indigenous people engaged in research, along with the power to determine how access is achieved (First Nations Information Governance Centre (FNIGC), 2022). Finally, possession refers to the physical ownership of data (First Nations Information Governance Centre (FNIGC), 2022).

Graphic Facilitation and the OCAP® Principles

The use of graphic facilitation in research with Indigenous communities has many benefits, including the potential to mitigate power imbalances, co-create knowledge, and promote data integrity. In our community-led project, a graphic was created during a discussion with community members in real-time. This engagement of community members in discussion, with researchers only assisting when needed, helped to mitigate power imbalances and ensure the co-creation of knowledge. When using graphic facilitation, graphic facilitators can work collaboratively with members of the research team, participants, and other community members after data has been collected to be sure the resulting graphic reflects their experiences and intents. Most importantly, however, graphic facilitation can promote the principles of OCAP®, particularly within communities that do not yet have the infrastructure to store and promote access to data for interested community members. It is a creative approach to adhering to the OCAP® principles of ownership, control, access, and possession.

First, Indigenous Peoples have the right to ownership of their data, yet this can be difficult to ensure when organizations or communities do not have processes in place to store and allow community access to data (First Nations Information Governance Centre (FNIGC), 2022). Historically, researchers have maintained ownership of data, which has led to the exploitation and abuse of Indigenous communities and their knowledge such as not receiving credit for their knowledge or their knowledge being used in ways that were not in line with community interests or desires (Morton Ninomiya et al., 2022). Depicting data visually through graphic facilitation allows for a more accessible way for community members to own their data. Organizations, such as the HRIC who continue to own their data after project completion, can then choose to use the graphics in whatever way suits their needs. They can make the graphics available for community members in many ways, such as publicly accessible websites, on social media, by printing and posting hard copies of the graphics in their community centres or distributing in newsletters. The graphics can be referred to later to inform new projects and programming, and organization staff and clients can more easily interpret findings to use them to better serve the needs of their community. In this way, graphic facilitation promotes active ownership of the data as it is readily available in electronic and hardcopy forms and can be used by community members to meet their needs. Second, Indigenous Peoples have the right to control their data, including how data is conveyed and shared. Graphic facilitation promotes community control of data as participants engage in real-time with the graphic facilitator to create the visual image and provide feedback throughout the meeting, as well as afterwards. Meeting participants are provided with time after the meeting to reflect on the discussion and the resulting images and give additional feedback. The final image(s) and its messages are under the control of the participants. The organization, in our case the HRIC, then has control over how the data is displayed to community members going forward, as described previously.

Third, data should be accessible to the community from which it came. While many Nations and Indigenous-led organizations have infrastructure in place to both store data and make it accessible to community members, not all do, particularly in urban areas (Gupta et al., 2020). As a result, creative ways to make data accessible to participants and community members are necessary. The visual representation of data (meeting minutes, discussion content, interview data, and so on) in graphic format makes findings accessible for those with low literacy levels or when English is not the primary language. In our case, graphic facilitation allowed for the visual representation of traditional teachings related to parenting that not everyone in the community has access to. Sharing these graphics at the HRIC and on the publicly available project website provided an opportunity for all members of the community to receive local teachings about parenting. In addition, electronic and hard copies of the graphics can be made available to community members in the most effective ways, as dictated by community partners and community members themselves. In our case, the graphics were shared electronically on a website and via email. Graphics can also be printed and distributed in hard copy and enlarged to a poster size and placed on walls in high traffic areas of community centres. Making data available graphically promotes the accessibility of data in many ways and is a great opportunity to promote this principle of OCAP® (First Nations Information Governance Centre (FNIGC), 2022).

Finally, data should remain in the possession of the Indigenous community, to be managed and used as they determine to be appropriate. While many First Nations communities in Canada have governing processes in place, such as research ethics committees, and data access and storage policies, not all communities yet have this capacity. In our experience, urban communities often do not have governing authorities present (apart from institutionally led ethics boards), and to maintain possession of data, individual Indigenous-led organizations are commonly left responsible for their own methods of storage and management. In our project, since HRIC did not have local on-site capacity to hold sensitive research data, a decision was made in consultation with them that data resulting from our community-led project would be stored by the local First Nations community, in their research databases. This reserve community has the existing infrastructure to safely store sensitive data as well as permit community access to it. Consideration of HRIC’s challenges with storing and managing sensitive data and the desire to support their control, access, and possession of their own data, influenced our choice to engage in graphic facilitation during our project.

It is important for researchers to recognize that due to the issues previously discussed, not all organizations have capacity to store sensitive data securely. All efforts should be taken to ensure data remains with the Indigenous community in a way that they can manage and that they have capacity to store it. However, if limitations exist to secure storage, the graphic representation of data is an excellent way to ensure possession, as most, if not all organizations have capacity to store digital files. Graphically displayed data has already been analyzed into a meaningful format and in most cases, sensitive data can be eliminated from the graphic, making the use of security features (encryption or password protected files) less, if not at all necessary. This, in turn, promotes meeting all four of the OCAP® principles through facilitating ownership, control, access, and possession of the data, as data is not locked on an electronic drive or in a filing cabinet, but rather, made available in numerous formats and contexts to facilitate all community members’ access (First Nations Information Governance Centre (FNIGC), 2022).

Recommendations for Choosing a Graphic Facilitator

When considering the use of graphic facilitation in projects with Indigenous communities, one must ensure the facilitator selected is trained in cultural safety, has a track record of positive interactions and collaboration with other Indigenous communities, and has excellent graphic design, facilitation, and communication skills. Just as research with Indigenous communities should be community-led, so should graphic facilitation. Graphic facilitation methodology is group-led at its foundation, which will assist in ensuring data collection is community-led. The graphic facilitator, however, should be made aware of who in a group is a member of the Indigenous community ahead of time, so they can prioritize insights from community members and lean more towards their direction than that of non-Indigenous participants. The graphic facilitator must have an understanding of colonization, including its past and continued impact on Indigenous Peoples, power imbalances and hierarchies, and the harm these cause marginalized individuals, as well as an appreciation and respect for Indigenous cultures, traditions, and knowledge. Facilitators must be willing and able to collaborate and be led transparently, authentically, and sincerely with members of the Indigenous community, as well as the research team, to ensure the resulting graphic(s) accurately depicts the messages the community wants to convey.

Limitations of Using Graphic Facilitation in Research

The use of graphic facilitation in research is not well documented. Existing literature focuses on the practice of graphic facilitation and not its use in research, or specifically, data collection. In this paper, we documented the case of the successful use of graphic facilitation in a community-led project. It is unclear whether this success was due solely to the method chosen (graphic facilitation), or also due in part to the unwavering engagement of the community partner, the enthusiastic vocal participation of community members, and/or the skill of the facilitator. Graphic facilitation may pose a challenge to researchers when working with communities where there may be limited enthusiasm for a project or when community members are hesitant to verbally share their ideas. A trusting relationship between researchers and a community is needed for the full potential of graphic facilitation to be realized. In addition, lack of access to a skilled graphic facilitator with appropriate experience working with a particular community may be an additional barrier to using graphic facilitation. Although the case of graphic facilitation discussed in this paper was with the Indigenous community, overall, there remains a significant lack of understanding concerning the use of graphic facilitation with Indigenous communities. This article seeks to add to the literature on the use of this method in research but represents only a preliminary understanding of its potential from our experience using graphic facilitation with an Indigenous-led organization.

Conclusions

In summary, graphic facilitation has been demonstrated as a creative way to break down power imbalances, empower participants, and improve the communication of ideas without the dependency on written word in health-related projects. This article describes its use in research with an urban Indigenous community in Hamilton, Canada, and its potential to assist researchers in adhering to the OCAP® principles of data ownership, control, access, and possession. Researchers should consider using graphic facilitation in their future research to promote adherence to OCAP® principles, particularly for Indigenous communities and organizations that have limited capacity to store data and make it accessible to community members. The graphic facilitator involved in research with Indigenous communities must have a thorough understanding of colonization and its past and continued impact on Indigenous Peoples, cultural safety training, respect for Indigenous cultures, traditions and knowledges, and excellent collaboration and communication skills. Researchers should take time to document the use of graphic facilitation in the literature, including its potential uses, benefits, and challenges, to assist in further developing the use of this method in research.