| 108 collection methods which involve more than talking with research participants with dementia. Visual methods such as photovoice (13, 20, 21) and visual stimuli including prompt cards (22), DVDs (23) and alternative and augmented communication aides (24) have all been reported to promote engagement during data collection by people with dementia. Projective and enabling techniques are another form of visual approach used in consumer research to enhance discussions and overcome some challenges with responding to direct questioning, especially about sensitive topics (25). Emerging from psychotherapeutic settings, they rely on the idea that ‘someone will project their own (perhaps unacceptable or shameful) feelings or beliefs onto an imaginary person or situation’ enabling them to say more through ‘accessing thoughts, feeling or meanings which are not immediately available’ (26). Techniques utilise visual stimuli and hypothetical or imaginary situations and ask participants to provide thoughts on others in a similar or different circumstance; word associations; completing a task; and constructing or ordering different choices about a given topic or scenario (25-27). However, these techniques have not been extensively tested in health services research with people with dementia (13). This research aimed to develop and test the use of two projective and enabling techniques (word associations and researcher-driven photo elicitation). The aim was to explore researchers’ reflections on whether, and how, the techniques supported the engagement and participation of people with dementia during interviews and focus groups. The study was conducted as part of the international ‘Co-Designing Dementia Diagnosis and Post-Diagnostic Support’ (COGNISANCE) project, which focused on understanding and improving dementia diagnosis and early post-diagnostic support in five countries (28). Method Ethical Approval and Consent Process All participants were provided with written and verbal information about the project and how and when they could withdraw from the study. All had opportunity to ask questions. In Australia, participants provided written consent confirming their understanding of the study demands, intended use of their data, and risks and benefits of involvement. In Canada, the Netherlands and Poland only verbal consent was required by the ethics committee; (this was
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