The power of symbolic capital in patient and public involvement in health research

Louise Locock, Anne-Marie Boylan* (Corresponding Author), Rosamund Snow, Sophie Staniszewska

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

65 Citations (Scopus)
7 Downloads (Pure)


Policy-makers and health research funders increasingly require researchers to demonstrate that they have involved patients in the design and conduct of research. However, the extent to which patients and public have the power to get involved on an equal footing is dependent on their economic, cultural, social and symbolic capital.To explore power relations in patient and public involvement (PPI) in research, particularly how patients may wield symbolic capital to develop a more equal relationship.Narrative interviews with a maximum variation sample of 38 people involved as patients, carers or public in health research, analysed thematically.Symbolic capital may be demonstrated in a range of ways (sometimes alongside or in the absence of other forms of capital): illness experience, technical illness knowledge and the challenging outsider. Symbolic capital is unstable and dependent on others for recognition and legitimacy. Nonetheless, participants identify a gradual shift in power relations over time.Research into PPI has been conceptually and theoretically poor, limiting our understanding of its mechanisms and wider contextual elements. Our findings demonstrate the importance of reflecting on the forms of power and capital wielded by the health research community, and of acknowledging the way in which PPI is challenging the status quo. As one of the first papers to conceptualize how different forms of symbolic capital operate and their critical role in challenging the balance of power, our findings may help researchers better plan their PPI activities and reflect on their own power.
Original languageEnglish
Pages (from-to)836-844
Number of pages9
JournalHealth Expectations
Issue number5
Early online date24 Nov 2016
Publication statusPublished - Oct 2017


  • Bourdieu
  • Patient and public involvement
  • power
  • qualitative research


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