Communities and academic researchers must collaborate to improve health equity, but finding each other and aligning goals can be challenging.
Researchers at the University of Washington School of Public Health (SPH) and the Institute of Translational Health Sciences (ITHS) have been looking for a way to make these connections easier. They developed a program called Community Voices, and have brought in researchers and community partners to shape the program and suggest ways to improve these partnerships. The findings from this work were published in the Journal of Clinical and Translational Science, and provide important insight into how to foster healthy community and researcher partnerships.
“One of the biggest benefits of community and academic partnerships is that researchers are addressing concerns that are important and a priority for the community rather than only being important from our own research perspective,” said Maggie Ramirez, assistant professor of Health Systems and Population Health at SPH and lead author of the paper. “In doing so, it helps to increase the likelihood that research will have impact.”
Working closely with community partners throughout the research process is a familiar area for Linda Ko, professor of Health Systems and Population Health and a leader at ITHS, which houses the Community Voices program. Ko uses community-based participatory research principles in her own research, which emphasizes viewing community members as equal partners across all stages of research.
Researchers like Ko who use a community-based participatory research approach often receive more requests for research projects from communities than their teams have capacity to respond to. This motivated Ko to develop the model of Community Voices, in the hopes of creating a system that can develop equitable, sustainable partnerships for researchers and communities.
The community members know what is happening in their community, so their requests need careful consideration and thoughtful response, Ko said. The program provides a hub for matching community groups with researchers and provides support and coaching for how to be collaborative and inclusive from start to finish.
There are many community organizations working to improve the health of their communities, but they don’t always have access to scientific expertise to analyze their work. This can make it challenging to secure funding, as funders want to know how their dollars will make an impact. It’s also a challenge for organizations looking to understand how to improve their work with communities or scale up their program.
“Community Voices enables communities to gather scientific expertise that they wouldn't have access to that strengthens their own work,” said Laurie Hassell, director of community engagement at ITHS who also worked on the study.
Meanwhile, researchers are often looking for community partners to study the public health impacts of their topic areas of interest. However, there’s been a long history in science of researchers taking advantage of communities, of pushing their research agendas on groups without letting them have a say in what is helpful to them, and those groups never hearing about the findings.
In developing Community Voices to address these problems, Ko worked with Hassell and Sonia Bishop, research scientist at UW’s Health Promotion Research Center. Together, they recruited community groups across Washington state, representing rural and urban areas, as well as 15 researchers at various points in their careers from across Washington, Wyoming, Alaska, Montana and Idaho regions to meet for several focus groups and individual interviews.
Part of the support Community Voices provides is how to establish clear communication before conflict arises. Communities and researchers develop a charter that both sides agree upon around developing a project, timeline, workload and a plan for how to resolve conflict as it arises.
From conversations with these groups, the researchers came up with five findings to inform equitable community partnerships through Community Voices:
- A community–academic partnership built on trust will offer mutual benefit.
- Community-initiated ideas will need to prioritize community needs.
- Matchmaking between community-based organizations and academic researchers will accelerate connections but should not replace time to foster partnership.
- Community Voices must go beyond matching and provide ongoing support and training.
- Fostering effective communication will be key to ensuring partnership success.
From focus groups, the team learned that when research and academic partnerships are done well, researchers can be viewed as part of a community. In a focus group, one participant described their perception of good partnerships:
“Once [academic researchers] get our trust, they got it, you know, with our communities. Once you’ve got it, we can move forward. And then if — then you become part of the community that we can’t wait to see when you come over that hill. I really like that researchers are now seeing that the road comes this way from Seattle just as much as it’s going that way.”
Ko indicated the individual who shared that perspective was from a tribal reservation. “Knowing the history, the trauma, the legacy of being taken advantage of, and then this person articulating that idea, we can see that healthy partnerships are very powerful.”
Building quality, long-term relationships, and ultimately health equity, comes down to trust, Bishop said. From focus groups, she heard community members mention how trust is built more easily if someone from their community already knows an academic researcher.
“There are multiple under-represented groups within Washington state, within King County, that have research ideas and don't have an academic partner to work with because no one has taken the time to build that trust,” Bishop said. “There’s ground work involved in building trust that can improve the public health of a community.”
Ko’s long-term vision for Community Voices is to create best practices on community academic partnerships across the spectrum of research, from bench science all the way to researchers like herself, who focus on dissemination and implementation. She hopes that researchers of all levels will view it as something they should think about as part of their research process.
“There are always ways to incorporate community voices, and once we do that, it really elevates the impact of the work,” Ko said. “It's not a process that slows us down, but it could eventually accelerate our work, because getting community voices into the development of our work helps us create something that will be more useful for the community.”