Assessing the context within academic health institutions toward improving equity-based, community and patient-engaged research
Prajakta Adsul, Shannon Sanchez‐Youngman, Elizabeth Dickson, Belkis Jacquez, Alena Kuhlemeier, Michael Muhammad, Katherine J. Briant, Bridgette Hempstead, Jason A. Mendoza, Lisa G. Rosas, Anisha B. Patel, Patricia Rodríguez Espinosa, Tabia Henry Akintobi, Paige Castro‐Reyes, Lori Carter‐Edwards, Nina Wallerstein
Abstract
Abstract Introduction The continued momentum toward equity-based, patient/community-engaged research (P/CenR) is pushing health sciences to embrace principles of community-based participatory research. Much of this progress has hinged on individual patient/community–academic partnered research projects and partnerships with minimal institutional support from their academic health institutions. Methods We partnered with three academic health institutions and used mixed methods (i.e., institution-wide survey ( n = 99); qualitative interviews with institutional leadership ( n = 11); and focus group discussions (6 focus groups with patients and community members ( n = 22); and researchers and research staff ( n = 9)) to gain a deeper understanding of the institutional context. Results Five key themes emerged that were supported by quantitative data. First, the global pandemic and national events highlighting social injustices sparked a focus on health equity in academic institutions; however, (theme 2) such a focus did not always translate to support for P/CenR nor align with institutional reputation. Only 52% of academics and 79% of community partners believed that the institution is acting on the commitment to health equity (Χ 2 = 6.466, p < 0.05). Third, institutional structures created power imbalances and community mistrust which were identified as key barriers to P/CenR. Fourth, participants reported that institutional resources and investments are necessary for recruitment and retention of community-engaged researchers. Finally, despite challenges, participants were motivated to transform current paradigms of research and noted that accountability, communication, and training were key facilitators. Conclusions Triangulating findings from this mixed-methods study revealed critical barriers which provide important targets for interventions to improving supportive policies and practices toward equity-based P/CenR.