Creating Institutional Infrastructure to Advance Health Equity through Community Engagement

Community engaged (CE) and participatory research approaches in health research emerged nearly two decades ago as an attempt to tackle pervasive health inequity. CE and participatory approaches center the priorities of people in communities who are disproportionately impacted by chronic health conditions. They are strengths-based and recognize the expertise embedded in communities and the fact that people know what they need to be healthy. Moreover, impacted people have a nuanced understanding of pressing health and social issues.

Although the benefits of CE and participatory approaches have been established, their adoption remains limited by health researchers. Institutional norms, policies and practices can deter the uptake of CE and participatory approaches yet efforts to advance these approaches often rely on strategies focused on individual researcher capacity and preparedness. As such, these efforts can fall short, stifled by institutional norms that do not support the intended behavioral change. We argue that researchers will only partner if (1) they see value in it and (2) there are systems in place to encourage and support partnerships. As such we call for upstream approaches to advance the uptake of CE.

The National Center for Translational Science funds CE Programs at more than 60 Clinical Translational Science Award (CTSA) sites across the country. CTSA sites are intended "to get more treatments to more patients more quickly" and community engagement programs, meanwhile, are intended to ensure research is responsive to, and engages communities in translational science. These are infrastructure awards designed to build institutional capacity for translational science and as such are well positioned to influence the change needed to advance CE, which facilitates translational science.

The BU CTSA site CE program aims to build institutional infrastructure that supports researchers working in partnership with communities to study and advance local health priorities. Given, ideology shapes environments and in turn behavior, our team has focused on systems change. Efforts have focused on 1) procedures and policies surrounding hiring and workforce, fiscal arrangements and institutional review as well as promotion, and 2) language justice in clinical and translational research. Collaborative strategies have been employed including tactics such as one-to-ones, leadership forums, educational sessions, advisory boards and dissemination.

This round table is designed to engage participants in a critical discussion focused on systems change. The presenters will describe efforts underway at BU to change institutional norms, policies and practices while also responding to the priorities of researchers and communities.on 4-16-2023-->