Objectives: This article reviews an evaluation vector model driven from participatory action research leveraging a collective inquiry system named SMILE (Stanford Mobile Inquiry-based Learning Environment).
Methods: SMILE has been implemented in a diverse set of collective inquiry generation and analysis scenarios including community healthcare-specific professional development sessions and community-based participatory action research projects. In each scenario, participants are given opportunities to construct inquiries around physical and emotional health-related phenomena in their own community.
Results: Participants formulated inquiries as well as potential clinical treatments and hypothetical scenarios to address health concerns or clarify misunderstandings or misdiagnoses often found in their community practices. From medical universities to rural village health promotion organizations, all participatory inquiries and potential solutions can be collected and analyzed. The inquiry and solution sets represent an evaluation vector that helps educators better understand community health issues at a much deeper level.
Conclusions: SMILE helps collect problems that are most important and central to their community health concerns. The evaluation vector, consisting of participatory and collective inquiries and potential solutions, helps the researchers assess the participants’ level of understanding of issues around health concerns and practices while helping the community adequately formulate follow-up action plans. The method used in SMILE requires much further enhancement with machine learning and advanced data visualization.
Social Learning, Telemedicine, Public Health, Public Health Informatics, Community-Based Participatory Research
Community- and organization-based research studies, which are conducted by directly involving local participants or indigenous researchers mainly for transforming social inequalities, have been described as action research (AR), participatory research (PR), participatory action research (PAR), or community-based participatory research (CBPR) . Although these terms are often interchangeably used, what connects them all is the final outcome of such efforts. PAR is usually carried out more for the sake of action or transformation as an outcome rather than the sake of conducting research. Action facilitates community engagement, encourages culturally responsive strategies, and focuses on rendering better health services as well as adequately addressing health disparities the participating communities may be facing .
PAR can help a group or community and even historically disempowered or marginalized communities to set their own goals and equip themselves with the strategies of change to influence policymakers who may be governing the communities [2,3]. PAR was often used in rural areas  or developing countries for needs assessments , planning, and evaluating health services . Recently, PAR has been used in healthcare research, which is based on reflection, data collection, and action to improve health and reduce health inequities through involving community members and consumers who seek to be active and more powerful agents over the practices of local or regional clinics and the knowledge of surveillance system as a part of efforts to improve their own communal health .
Practitioners in healthcare have applied PAR for clinical setting-based projects  to explore health-related topics affecting particular populations within a community [2,6], for example, diabetes and obesity , multiple sclerosis and other chronic illnesses [8,9], and HIV/AIDS prevention [6,10-12]. Such a method also has been employed to address communal issues of diverse populations (i.e., culturally and ethnically) [11,12].
In the process of PAR, participants meet in peer-group meetings periodically for a certain period of self-reflection and action planning (i.e., so-called, stepping stone approach) or interchanging with members from different peer groups together (i.e., often called, mixed sessions) . These discussions allow the participants to examine similarities, differences, awareness of health problems and well-being, respect for others, and positive solutions among the community participants . Oftentimes, it becomes somewhat complex for practitioners to translate and integrate theory-based knowledge into evidence-based practice effectively. Therefore, an ontological inquiry process has been considered to enhance possibilities for action in a way-of-being  and other types of modern communication technologies. For example, the increasing penetration rate of mobile phones and Internet use have made tremendous improvements in numerous aspects of PAR to date. Utilizing mobile devices to access health-related information and service by the public is not just a trend but a new practice of innovation , which is so-called mobile health (mHealth) . At the same time, such a mobile ecosystem helps researchers gather new kinds of data that were otherwise impossible.
Stanford Mobile Inquiry-based Learning Environment (SMILE) is one of the advanced communication technologies leveraging crowd-sourcing for collective inquiries. In the field of public health, it has been used for connecting communities of health practitioners or indigenous members of communities to exchange inquiries and solutions to cause a paradigm shift within the participating community by enabling participants to become active agents in their own education, practice, and empowerment process [16,17].
Due to the infancy stage of the use of social media for healthcare and education, uncertainty is abundant among researchers who have employed traditional research methods. However, due to its pervasiveness, immediacy, and wide outreach capability, the need to leverage such important technology is increasingly critical in healthcare .
Therefore, the purpose of this article is to review how interactive technologies such as SMILE can be leveraged to enhance PAR-type projects and how such intervention may work to help active participants create, solve, evaluate, present, share, and reflect communal inquiries and action plans central to the highly idiosyncratic nature of local communities.
PAR was often used in rural areas or developing countries for analyzing community healthcare needs or planning and evaluating health services . Recently, PAR has been used in healthcare research, which is based on reflection, data collection, and action to improve health and reduce health inequities. In such efforts, community members, as active agents, collectively analyze and improve local services  or enhance their knowledge. With the advancement of information and communication technologies, there is an unprecedented number of opportunities to enhance various aspects and processes of PAR at multiple levels. One immediate area of enhancement in PAR is to leverage an intervention using information and communication technologies such as SMILE.
Unlike traditional survey methods used in PAR, SMILE collects problems and potential solutions that are most important and central to the condition of their local community. Collective inquiries, along with hypothetical scenarios with healthcare phenomena, policies, practices, or action plans based on divergent thinking ideas, provide an insightful evaluation vector more appropriate for the participating community. This article demonstrated the applicability of SMILE in public health by introducing a few different cases of SMILE in the developing countries, which have not been discussed in previous literature.
It is the hope that researchers and educators involved in PAR for public health and education leverage interventions such as SMILE to design data collection strategies, which are more contextualized and meaningful to local communities and analyze such data in ways that can leverage analysis models backed by machine learning and augmented intelligence. In doing so, new insights can be uncovered; therefore, creative healthcare and education plans may be developed to bring about transformation, which is long overdue in rural communities of the developing regions.
The Kavian Scientific Research Association (KSRA) is a non-profit research organization to provide research / educational services in December 2013. The members of the community had formed a virtual group on the Viber social network. The core of the Kavian Scientific Association was formed with these members as founders. These individuals, led by Professor Siavosh Kaviani, decided to launch a scientific / research association with an emphasis on education.
KSRA research association, as a non-profit research firm, is committed to providing research services in the field of knowledge. The main beneficiaries of this association are public or private knowledge-based companies, students, researchers, researchers, professors, universities, and industrial and semi-industrial centers around the world.
Our main services Based on Education for all Spectrum people in the world. We want to make an integration between researches and educations. We believe education is the main right of Human beings. So our services should be concentrated on inclusive education.
The KSRA team partners with local under-served communities around the world to improve the access to and quality of knowledge based on education, amplify and augment learning programs where they exist, and create new opportunities for e-learning where traditional education systems are lacking or non-existent.
FULL Paper PDF file:New Evaluation Vector through the Stanford Mobile Inquiry-Based Learning Environment (SMILE) for Participatory Action Research
This work was partially supported by the National Research Foundation of Korea Grant funded by the Korean Government (NRF-2014S1A5B8044097). The authors are very thankful to the editorial board of Healthcare Informatics Research.
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Professor Siavosh Kaviani was born in 1961 in Tehran. He had a professorship. He holds a Ph.D. in Software Engineering from the QL University of Software Development Methodology and an honorary Ph.D. from the University of Chelsea.