A scoping review of the use of music as an arts-based method in migrant health research

Identifying the research question

The research question guiding this scoping review is: “What is known about music as an arts-based method in migrant health research?” The identification of the research question involved an iterative process of searching and revising our key search terms with the aim of capturing the most pertinent literature relevant to our research goal. We collectively identified four core concepts encompassing the interdisciplinary focus of this scoping review. These are: ABR, music, migrants, and health. We specifically explored how music is utilised as an ABR method in the context of migrant health and wellbeing (Garry et al., 2020).

Identifying relevant studies

Eligibility criteria. All studies such as journal articles, books, book chapters and grey literature that integrated music in the research design or implementation, and self-identified as arts-based research, or incorporated music-making with migrant people(s); and physical, mental or social wellbeing were eligible for inclusion. Publications had to be in the English, and published between 2009 and 2020. The publication of Leavy’s definition of arts-based research in 2009 was the basis of our review (Leavy, 2009). All members of the research team contributed to discussions regarding eligibility criteria at the commencement of the scoping review (Garry et al., 2020).

Search strategy. The terminology used in our search strategy was developed in order to identify the most appropriate body of literature in line with our research question and objectives (Arksey & O’Malley, 2005). The design of our search strategy involved interdisciplinary knowledge sharing and joint decision-making by the research team around the definitions, concepts, and terminology involved (Levac et al., 2010). In order to test the suitability of search terms, preliminary searches were conducted in Taylor & Francis Online and CINAHL, searching article titles, abstracts, keywords and subject headings relating to our four key concepts: ABR, music, migrants and health. Our search strategy was further developed in collaboration with a senior faculty librarian. Our final search strategy included a comprehensive set of keywords (see Table 1: Key Search Terms; and the full search strategy as Extended data; Garry et al., 2023) which were adapted across all databases encompassing the broad fields of arts, social science and health. Our strategy included checking the reference lists of included papers and relevant book chapters in order to identify any potential eligible publications not retrieved in the initial database searches.

Electronic database searches were conducted in Scopus, Medline, Web of Science, CINAHL, ProQuest Academic Search Complete, Social Science Premium Collection, APA PsycINFO, Springerlink, Taylor & Francis Online, ProQuest Dissertations and Theses A&I. We used Google Advanced as a back-up search to identify any additional literature that was not already included through library database searching. Searches were conducted between June and August, 2020. The search terms were developed in relation to our core concepts to reflect the diversity of types of migrants and music forms, and a holistic understanding of health (Garry et al., 2020).

Study selection

Following completion of the search, two reviewers independently screened the studies by title and abstract (authors, 1 and 3) followed by full-text reviews guided by our inclusion and exclusion criteria. Any uncertainties or disagreements regarding inclusion or exclusion of sources were resolved by a third reviewer (author 5). Eligible studies were managed using Mendeley reference manager.

Charting the data

Data were extracted using an MS Excel spreadsheet. Charting elements and complementary questions included JBI recommended classifications such as publication details, and general study details such as aims/purpose, methodological design, study population, methods and methodological design (Peters et al., 2020). Additional categories, specific to our review, were used to guide the data extraction process. These included: definitions of ABR, forms of music, stages of the research where music was employed, details of migrant groups, research settings, study teams, ethical issues, health focus, evaluation of music, and limitations/quality issues. These additional charting elements supported the iterative process of collating, summarising, and reporting the results in line with our key question and objectives (Garry et al., 2020). One reviewer completed the data charting process, which was fully verified by a second reviewer (authors 1 and 5).

Collating, summarising and reporting the results

As recommended by the JBI Reviewer’s Manual (Peters et al., 2020), a narrative summary mapping the findings from the extracted data complements the charted results and is presented here in line with our key question and objectives. We engaged in qualitative thematic construction (Elo & Kyngas, 2008; Levac et al., 2010) through a process of identifying and grouping similar qualitatively described (Sandelowski, 2000) charted information to provide an overview of the literature in line with the purpose of the review. Findings were organised into thematic categories such as aims/purpose, methodological design, key findings about ABR, music, migrants and health, and gaps in the literature. Our analysis considered the meaning of the results in relation to our research question and objectives, and the broader implications of the findings in terms of future research and practice in the field (Garry et al., 2020).

Consultation

This scoping review represents the work of the PART-IM (Participatory and Arts-Based Methods for Involving Migrants in Health Research) research cluster (2018–2023), Health Research Institute at the University of Limerick. The research cluster brings together arts-based and participatory scholars from medicine, nursing & midwifery, and the performing arts. The research cluster includes partners from an independent non-governmental organisation, Doras, working to promote and protect the rights of migrants through direct support, advocacy, and integration support. Through a series of research cluster meetings, NGO partners were involved in the design of the scoping review and provided feedback on the analysis and interpretation of the identified literature. They were invited to discuss preliminary findings with the aim of informing ideas about future research (Levac et al., 2010).

Search results

The initial literature search yielded 153 results which were exported to Mendeley reference manager. Following the removal of duplicates, 141 articles were screened by title and abstract, and full text where necessary. 105 records were excluded. 36 publications, including journal articles, reports, books and book chapters were read in full. Of these, 14 met the inclusion criteria (see Figure 1 and Table 2). No additional relevant publications were identified through checking the reference lists of included papers.

Figure 1.PRISMA flow diagram (Moher et al., 2009).

Objective 1: The extent of current publications using music in migrant health research and identifying itself as ABR

The fourteen publications identified in our review were written by a total of twenty-five authors, with a number of authors featuring in several publications. Lennette appears in five (Blomfield & Lenette, 2018; Blomfield & Lenette, 2019; Lenette, 2019; Lenette et al., 2019; Sunderland et al., 2015) Nunn in three (Nunn, 2016; Nunn, 2017; Nunn, 2018); and Bagley & Castro-Salazar in two (Bagley & Castro-Salazar, 2012; Bagley & Castro-Salazar, 2019). While some of the publications are single authored pieces (Hudson, 2016; Lenette, 2019; Nunn, 2016; Nunn, 2017; Nunn, 2018), all of the studies report on collaborative and/or participatory arts-based research projects with multidisciplinary (Hiltunen et al., 2020) and interdisciplinary (Harkins et al., 2016; Sunderland et al., 2015) teams. These include academics in collaboration with artists and participants from a variety of disciplinary and artistic backgrounds. In some cases, these roles are blended in the form of an artist-scholar (Millar & Warwick, 2019; Sunderland et al., 2015). Other studies were co-authored by artists and academics (Blomfield & Lenette, 2018; Blomfield & Lenette, 2019; Lenette et al., 2019) or between academics working in collaboration with artists from the specific migrant community in the study (Bagley & Castro-Salazar, 2012; Bagley & Castro-Salazar, 2019; Nunn, 2017). Several of the studies were in partnership with art galleries, multicultural centres or other community-based organisations (Bagley & Castro-Salazar, 2012; Bagley & Castro-Salazar, 2019; Harkins et al., 2016; Hiltunen et al., 2020; Hudson, 2016; Lenette, 2019; Nunn, 2016; Nunn, 2017; Nunn, 2018). Disciplines included music, humanities, health and human services (Sunderland et al., 2015), public health research and policy, and evaluation of the impact of community-based programmes (Harkins et al., 2016). Settings included refugee and asylum seeker detention centres (Blomfield & Lenette, 2018; Blomfield & Lenette, 2019), indoor and outdoor community locations and people’s homes (Blomfield & Lenette, 2018; Lenette, 2019; Nunn, 2016; Sunderland et al., 2015).

Migrant populations. Twelve of the publications discuss arts-based research projects exclusively involving migrant people. None of the authors provided a source reference to define the migrant population that they were working with, e.g. the UNHCR definition for refugee. Participants in the studies are described as undocumented Mexican-Americans and artists of Mexican birth or heritage (Bagley & Castro-Salazar, 2012; Bagley & Castro-Salazar, 2019); first, 1.5, and second generation Vietnamese-Australians, including artists and their family members (Nunn, 2017); refugee-background young people, including Karen young people in Bendigo, Australia, and Syrian and Kurdish Syrian young people in Gateshead, UK (Nunn, 2018); a young Somali asylum seeker woman (Blomfield & Lenette, 2018; Blomfield & Lenette, 2019); Somali-Australians, aged 13–18, described as the first generation of young people growing up in a Somali-Australian immigrant community (Nunn, 2016); Indigenous young adults in the context of migration from the reserve to the urban environment in Canada (Hudson, 2016); a group of South Sudanese Dinka women, mainly mothers and daughters, who had been living in Australia for 10–15 years (Lenette et al., 2019); refugee and asylum seeker members of the Brisbane-based Scattered People music initiative, including two Iranian women, a Kurdish male and female married couple, and one Sri Lankan male, aged between 24 and 50 years of age (Sunderland et al., 2015); and Yazidi young people, aged 11–18, from Iraq and Syria living in a camp in northern Greece (Millar & Warwick, 2019). Lenette’s (2019) book discusses multiple groups and refers, throughout, to “people with lived experiences of forced migration as Knowledge Holders” (p.12). The remaining two studies describe participants as recently arrived migrants and long-term residents (Hiltunen et al., 2020), and participants in El Sistema Scotland’s Big Noise music programme for children from disadvantaged backgrounds, including “migrant and minority ethnic children” (Harkins et al., 2016, p.33).

Defining arts-based research. While all studies self-identified as ABR, most of the publications assume an implicit understanding of ABR, focusing more on why one might use this approach rather than how it is defined. Lenette (2019) describes an ABR approach as “the use of any art form at any point in the research process, to generate, interpret, or communicate new knowledge” (p.27). She refers to McNiff (2008) to provide a definition of arts-based research as: “[The] systematic use of the artistic process, the actual making of artistic expressions in all of the different forms of the arts, as a primary way of understanding and examining experience by both researchers and the people that they involve in their studies” (McNiff, 2008 cited in Lenette, 2019 p. 28). Bagley & Castro-Salazar (2012) view a critical arts-based approach as a means to address social inequities related to prejudice, discrimination and disenfranchisement. Blomfield & Lenette (2018) use critical reflexive narratives to “open up broader discussions about artists’ responsibilities to produce counter-narratives that value refugees’ perspectives and voices” (p.322). Nunn (2016) uses a collaborative participatory arts-based approach in a film project aimed at increasing awareness of the experiences of first generation young people growing up in a Somali-Australian immigrant community. Two studies use a participatory arts-based approach to study the concept of belonging and (non)belonging (Hiltunen et al., 2020; Nunn, 2018). Nunn (2017) uses collaborative arts-based research as a means to produce and communicate new knowledge about migration generations (Nunn, 2017).

Health context. Our review did not yield any findings of music in ABR for migrant health research which had explicit clinical aims, or which took place primarily in a clinical setting. Nonetheless all 14 studies reflected socio-cultural aspects of health and wellbeing, and highlight the complexity and multi-dimensionality of negative and positive wellbeing from the perspectives of the participants. Studies focusing explicitly on music, health and wellbeing show that lived experiences of health and wellbeing are context specific and dependent on multiple factors (Harkins et al., 2016; Millar & Warwick, 2019; Sunderland et al., 2015). The development of confidence and self-esteem through enhancing musical expertise was “seen as especially relevant for migrant and minority ethnic children who struggled to learn in an English language environment” (Harkins et al., 2016). Sunderland et al. (2015) explored the impact of engagement in the Scattered People music initiative with refugee and asylum seeker background people using Schulz and Northridge’s (2004) health and wellbeing conceptual framework. In their study, wellbeing outcomes self-reported by participants generated themes that did not fit into the existing framework for understanding wellbeing. These are: “cultural expression, music making, and social identity” (p.3). Millar and Warwick (2019) explore musical engagement as a means to develop supports for young refugees in the context of protracted displacement through strengthening supportive environments, community action, and personal skill development.

Two studies focus on social justice issues associated with undocumented status in U.S., such as exclusion from health and other services (Bagley & Castro-Salazar, 2012; Bagley & Castro-Salazar, 2019). Nunn (2018) explores how young people negotiate resettlement, and notes the importance of generating and communicating understandings of those experiences through arts-based research in order to develop support networks in response. Lenette et al. (2019) focus on the experiences of women from South Sudanese backgrounds in an Australian resettlement context and note the importance of contributing “gender-specific and strengths-based perspectives to the literature on impacts of community-based arts initiatives” (p.757). Lenette notes that studies on health from a biomedical perspective are prolific in refugee research due to the many trauma related issues people face in the context of forced migration. She cautions that a disproportionate focus on these issues has often overshadowed the equally-important need to understand “sociocultural, ‘bottom-up’ perspectives, and the intersectionality of issues linked to wellbeing” (Lenette, 2019, p.7).

Objective 2: The research stages (participating, generating data, interpreting, disseminating) in which music features as an ABR method or part thereof

We extracted information about the musical elements and the role of music for data generation, interpretation and analysis from the research process descriptions in the papers.

Participation. The most significant role played by music as an arts-based method in all the studies is as a tool of participation, supporting sustained recruitment, and active creative and dialogic engagement in the research process.

While the exact nature or role of the musical element is not always clear, several of the studies are based on periods of participative engagement. In Harkins et al. (2016), a group of children worked with a filmmaker to make a (participant-led) documentary with the pre-set aim of capturing their experiences of participation in the music programme. Hudson (2016) based her research on a 12-week programme in which indigenous youths participated in arts-based workshops and field trips. In Nunn (2018) data were collected through 8–12 arts/music sessions over a period of three months. Millar and Warwick (2019) collected data over a five week period during which the young Yazidi music participants, resident in a refugee camp in northern Greece, were invited to participate in individual and group music lessons and workshops. In Hiltunen et al. (2020) researchers collaborated with practitioners and participants in three types of collaborative workshops over a period of three to four months. Lenette et al. (2019) highlight the importance of facilitating a culturally safe, women-only space in a workshop series for resettled South Sudanese Dinka women. Participatory music projects particularly created spaces of support for young people to reflect on their experiences and feelings (Harkins et al., 2016; Millar & Warwick, 2019; Nunn, 2018).

Data generation. Music is mainly discussed in terms of its role in generating knowledge through lived experiences of active engagement. Song performances generate knowledge by connecting people at an emotional level, encouraging empathetic responses, and creating a space for sharing experiences and stories (Lenette et al., 2019; Millar & Warwick, 2019; Sunderland et al., 2015). Collaboratively written lyrics constitute an important source of data and a means to represent lived experience (Lenette, 2019; Nunn, 2018). Well known pop songs can take on new meanings in the context of forced displacement, thereby communicating important messages relating to issues of social justice and the plight of detained refugee and asylum seeker people (Lenette, 2019). The opportunity to sing in a first or familiar language helps people to articulate feelings of pride in their heritage, while also expressing new and shared identities (Sunderland et al., 2015). Participant-observation is recognised as a key form of data generation where music facilitators/researchers immersed in the field can access knowledge by co-participating at the site of engagement, and sharing insights from practice (Millar & Warwick, 2019; Nunn, 2018). This is particularly insightful where community musicians can gain access to spaces, such as asylum seeker detention centres, sometimes inaccessible to researchers (Lenette, 2019).

Interpretation. The role of music as a tool for data interpretation is not widely discussed in the literature. Nunn (2017) notes that there were some gaps in understanding regarding the artistic representations of interview data, including karaoke, in “Translations-Generations”. She argues that non-literal research representations challenge audience members to interpret the work. While this is one of the benefits of artistic representations, it does “provoke consideration of the potential for arts-based representations to be as exclusionary as academic ones” (p. 13). Bagley & Castro-Salazar (2012) mention that the artists, including a musician, were given a free hand to interpret the interview data. Blomfield & Lenette (2019) explain the intent behind the use of instrumental background music in their documentary film project. Its purpose is to foreground the verbal narrative of the young female asylum seeker.

Dissemination. In the studies focusing exclusively on music, the performance of songs and instrumental music are the most common forms of dissemination. The Scattered People (Lenette, 2019; Sunderland et al., 2015) disseminate their music, and their political messages, through performance and recordings. Lenette (2019) notes that “singing is one of the most effective ways of disseminating such [political] messages to wide audiences” (p.184). In Sunderland et al. (2015) “[P]articipants felt that their music gatherings and performances had the potential to improve understandings of refugee experiences, and hopefully lead to more acceptance”. (p.10). Harkins et al. (2016) provide a link to the documentary film made by the young people, and this enables the reader/viewer to experience the children’s orchestral programme first-hand. Background music is used in film (Blomfield & Lenette, 2019; Nunn, 2016), and as pre-performance music at a live multi-arts event that included research-based post-performance karaoke for audience members (Nunn, 2017). Other multi-arts events drew on music, spoken word, photography, installation, painting and digital media “reflecting the complexities of refugee lives” (Nunn, 2018, p.32).

Objective 3: Identify whether particular musical practices are used more than others as part of the research design and implementation

Only three studies focus exclusively on music (Harkins et al., 2016; Millar & Warwick, 2019; Sunderland et al., 2015). Lenette (2019) includes a chapter on community music, focusing mainly on the Brisbane-based Scattered People music initiative. Lenette et al. (2019) and Nunn (2017); Nunn (2018) discuss music alongside other art forms. In the remaining studies, the role of music is less prominent, or is unclear. Singing is the most highly reported musical activity (Harkins et al., 2016; Lenette, 2019; Lenette et al., 2019; Millar & Warwick, 2019; Nunn, 2017; Nunn, 2018; Sunderland et al., 2015), followed by songwriting (Lenette, 2019; Lenette et al., 2019; Millar & Warwick, 2019; Nunn, 2018; Sunderland et al., 2015), background music in documentary filmmaking (Nunn, 2016; Blomfield & Lenette, 2019) and orchestral music (Harkins et al., 2016). Bagley & Castro-Salazar (2012); Bagley & Castro-Salazar (2019) mention that one of the collaborating artists was a musician, but the performance examples discussed in the articles do not include the musical element. Hudson (2016) mentions music as part of a dataset that emerged from an arts-based programme for a number of young people, but the article focuses on two indigenous youths and on photography. Hiltunen et al. (2020) mention exploring sound as an expressive tool and listening to “the rhythms, tones and silences in each other’s languages” (para. 23). They also mention “belonging through music” (para. 22) as one of several film themes in the filmmaking workshops, and “sound and video poems” (para. 25) as artistic outputs from creative writing workshops. However, there is no further elaboration on these examples. In one study, singing and dancing were not included in the research design but emerged spontaneously in a participant-led project with a group of South Sudanese Dinka women in Australia. The knowledge generated through the shared musical engagement was then incorporated into the research (Lenette et al., 2019).

Objective 4: Identify the key strengths and challenges discussed in the literature around the use of music as a research tool in migrant health research

While strengths, challenges and ethical considerations were not always explicitly named as such by the authors, the following points can be extrapolated based on their project descriptions.

Strengths. Lenette (2019) notes that ABR “integrates artistic practice with research processes as a crucial way to understand lived experiences” (p.27), and challenges “dominant research models that may fail to create culturally safe research spaces” (p.31). She highlights a number of positives that emerge from ABR into musical engagement in the context of refugee and asylum seeker experiences of detention in Australia. These include music’s capacity to reveal knowledge related to health and wellbeing; to provide a sense of comfort and security; to help maintain cultural songs and practices; and to connect people from different cultures with each other and the wider community. Music has the capacity to provide an escape from daily realities, and can help to alleviate “stress, loneliness, uncertainty and hopelessness” (p.195). Millar & Warwick (2019) found that “activities involving music practice can impact positively on young people’s wellbeing, enabling the development of emotional expression, improved social relations, self-knowledge, and positive self-identification” (p.67). Nunn (2017) argues that karaoke is a highly appropriate form which facilitated embodied affective engagement with the research data. Sunderland et al. (2015) note the capacity of arts-based music research to add new culturally relevant categories to existing health and wellbeing frameworks.

Challenges. Nunn (2018) refers to inherent risks in participatory arts projects in general. In the “Dispersed Belongings” project, not all experiences of the research presentation events were positive. Some people were nervous about performing, while one Syrian woman and her family experienced criticism over her involvement in the performance. In addition, she lost trust in the research project team as they could not prevent Syrian audience members from videoing the performance (p.36). Nunn (2017) explains that the inclusion of non-text based artworks and the use of the Vietnamese language designed to make the work more accessible to non-English speaking first generation Vietnamese Australians “was not as successful as it might have been in facilitating an ethical and accessible mode of dissemination” (p.13) due to challenges experienced by some audience members in interpreting the artistic work. Sunderland et al. (2015) specify the small number of participants as a limitation but note that rich data emerged from the collaboration, suggesting that future research could draw comparisons to studies with marginalised groups who are not engaged in musical activities. Similarly, Harkins et al. (2016) suggest that, while qualitative methods suited the study focus, the lack of a validated wellbeing measurement framework limits the potential for comparison with other studies.

Ethical considerations. There were no specific ethical issues related to any one art form, with the exception of awareness of the editing process as a political act in filmmaking (Blomfield & Lenette, 2018). Lenette (2019) draws attention to ethical issues such as “reciprocity, power differentials, and assumptions of ‘vulnerability’ and ‘anonymity’” (p.86). While she emphasises the importance of using a trauma-informed approach which is sensitive to participants’ past circumstances, she argues that “the determination of ‘vulnerability’ should be contextual and project-specific” (p.91). Two studies note the importance of incorporating a flexible ethical framework “to avoid latent harm within the research process” (Millar & Warwick, 2019, p.72), and as a means to “engage refugee participants in meaningful ways” (Sunderland et al., 2015, p.6). Other ethical considerations relate to decisions around the use of photography (Hiltunen et al., 2020), valuing diverse experience and knowledge (Lenette et al., 2019), and adopting ethical guidelines specifically relevant to indigenous communities (Hudson, 2016). Blomfield & Lenette (2018) focus exclusively on the ethical considerations for artists engaging in collaborative work with refugees and asylum seekers. While ABR researchers advocate for the role of art in creating counter-narratives and challenging negative perceptions of migrants, they caution against any simplistically positive depiction of art and artists in the ABR process, noting that artists are not immune to the perpetuation of detrimental tropes around the people their work attempts to ‘represent’ (Blomfield & Lenette, 2018).

Limitations

We acknowledge the relatively small number of results in this review, which points to a lack of research in this area. This presents challenges in terms of making comparisons with other research and research methodologies in the field. We have been monitoring new publications since 2020 and there are few (Nunn, 2022; Wells et al., 2020(first published online in Dec. 2020)). These studies wholly reflect the findings and analysis presented here. This low level of publications in the three years is reflective of the field and our findings. Studies were confined to the English language and limited to publication dates between 2009 and 2020. Publications about music projects that may align with the concept of ABR but do not self-identify as ABR have not been included.

Recommendations for future research

There is evidence that there is a positive impact of music as ABR in migrant health research. However, the identified limitations and gaps in these publications form the basis of our four key recommendations:

(1) Increased detail on the musical element in ABR

In order to fully assess the value of music as ABR, it is necessary to have detailed information on the musical element itself. Additional detail concerning musical decision making processes, repertoire, musical forces, and examples of lyrics, as well as a discussion on the creative process of selecting, composing, rehearsing and performing would help shed light on the dynamics of musical practice in the context of migrant health research.

(2) Explicit identification of research as ABR

While our focus was on music as an arts-based research method, our search did not yield any publications in music-specific journals. Even a cursory examination of publications related to participatory music practices with migrants in both clinical and community settings show significant evidence of research which broadly fits Leavy’s (2009) definition of ABR quoted earlier, as the use of any art form at any point in the research process. Lenette (2019) specifically identifies community music, for example, as a form of ABR. Nonetheless, many of these musical practices and publications do not themselves use the terminology of ABR.

While it would be easy to dismiss this as a point of nomenclature, it presents significant issues of access for interdisciplinary researchers who may easily miss such publications, if they cannot identify them through a keyword search that includes arts-based research/ABR. Where ABR is used, its explicit identification will facilitate the inclusion of ABR publications which focus on music with other, more visible ABR publications in film, theatre, creative writing and photography.

(3) Greater recognition of a multi-arts understanding of music in the context of ABR

While our search focused on music as an arts-based research method, the results yielded mostly multi-arts projects within which music was one of several artistic practices.

In participatory, multi-arts experiences, it is recognised that artistic practices rarely exist in isolation. Understanding music within a wider multi-arts context allows for a holistic engagement with not only the sonic dimensions of experience, but also the gestural, tactile, poetic and visual. This whole person engagement supports migrant health research that is sensitised to the need for anti-oppressive research methods in contexts such as post-conflict trauma.

(4) Harnessing the participatory potential of ABR using music and singing across the research cycle to increase migrant involvement in health research

The identified studies demonstrate that music in ABR is most common for recruitment and engagement but that it can be used in all aspects of the research cycle. Music was evident in data generation, interpretation and dissemination. Thus ABR using music and singing has a role to play in increasing migrant participation in health research and encouraging researchers to think more creatively about the tools and material practices (Kothari, 2001) that they use in and for the co-design of participatory migrant health research projects.