Participatory action research (PAR) is a social, practical and collaborative process in which the building of relationships with participants is crucial. It has two distinct features, one is community based and driven to generate knowledge or understanding about what will bring about change; the other is its quality improvement cycle, whereby the actions, reactions, interventions and change are monitored, reviewed and adjusted according to the response. In practical terms, PAR methodology is carried out as a series of planning, acting, observing and evaluating cycles; in other words, reflection and reflexivity are inherent in the process. The challenges of engaging with PAR are to ensure that participants are encouraged to collaborate fully with the process and drive the process, power imbalances are discussed and the recognition that change and action may not always be possible. There are also challenges when studies are written up in a reflexive manner because being reflexive is not as straightforward as it seems. It involves deep introspection, as the researchers become aware of how their own agenda, experiences and motivation can contribute to interactions with participants and potentially influence the knowledge and actions created.

This specially themed issue draws nine papers together to enrich our understanding of PAR and action-oriented research for transformations (Bradbury et al., 2019b). The aspiration in this presentation is to consider future directions in the domain of healthcare. In relation to the Action Research Journal’s vision, researchers should aim to develop Sustainable Development Goals when engaging in credible quality improvement projects that are monitored and adaptable in the relevant setting (Bradbury et al., 2019a). Our emphasis is therefore to concentrate more on reflexivity, transformation and the implications when developing future studies.