Growing Skills in Community Research Collaborations

MCL Guidance

By Sarah Garrett

I’ve been fortunate to participate in a number of studies that engage community members. In some studies, community members have provided light consultation. In other studies, there has been a deep collaboration between researchers and community members who guide the project. The MEND study, which I recently concluded, was the latter kind of project. It involved a deep collaboration during which I, the researcher, learned from and alongside 4 community advisers.

I tried to approach MEND with the same spirit I’ve tried to bring to other community engaged work—humility, gratitude, curiosity, respect. However, I discovered that we needed different study operations in order to realize these qualities in this deep academic-community collaboration. In this post, I share some operational processes – mundane, nitty-gritty, everyday project details that typically are not described in reports of community-based participatory research methods – that I think helped me to rise to the occasion of this collaborative work. These processes clustered in three areas: information management and data sharing; responsive and appropriate project operations; and honest, flexible, and creative approaches to getting to the North Star of the project. 

Information management & data sharing

Though I don’t always achieve it, I’ve found excellent project management to be particularly important in community engaged research. Unless they are employed as day-to-day collaborators, advisers are typically less immersed in the project than the academic members of the study team. It is crucial therefore that the research design, procedures, and analysis are accessible, transparent, and clear for everyone. I think this is particularly important for how the team manages study information and shares data. In the MEND study the team used multiple strategies.

One of the MEND community collaborators suggested we initiate an online “living document” to foster transparency. This ever-expanding document included notes from meetings; our proposed study timeline; links and instructions for accessing redacted, qualitative transcripts; links to an overview page of all of the scholarly and applied products we were developing; contact information for each other; and other resources I describe below. We housed it on GoogleDocs. This digital “home base” proved to be the centerpiece of communications and information sharing for our team across and between our 40 community advisor meetings.

Beyond the living document of project resources, additional data enriched and informed our collective meetings-based analytic work. MEND team and MCL members Stephen Zamarripa, Erica Chan, and I developed a Google spreadsheet with deidentified information about each study respondent such as their demographics, setting, and role. We added new insights to the spreadsheet as the study progressed. This simple GoogleSheets resource allowed our team to have easy access to a snapshot of individual MEND respondents and the sample as a whole. We drew on this resource during meetings with community members to contextualize transcripts and quotations that we read together. During calls, a member of the research team had access to the complete qualitative data (in ATLAS.ti) and shared it on-screen if advisors wanted more information. Having key data at our digital fingertips supported collaborators’ orientation to the project and enhanced the ease and quality of the team’s synchronous analytic discussions.

Responsive and appropriately-paced project operations

For us, good project management also called for responsive project operations. Some of our operations translated unnecessarily-complex academic practices or unpacked invisible curricula, e.g. procedures related to conflict of interest (COI) and journal copyright. We academics become used to these opaque forms and procedures, but these can be difficult and alienating for people outside academe. I was grateful that two MEND advisors were frank about their negative experiences with COI and copyright materials.  I worked with them to develop a “cheat sheet” that turned the jargon into a straightforward guide.

Another important but easily overlooked operational consideration is building in generous time to explore data together. Recognized as a key need in CBPR, having appropriately-paced project operations help ensure that those of us on the academic side have the chance to learn deeply from our community collaborators.

Across projects that I have worked on, I have always been enriched by the expansive discussion that comes from team immersion in qualitative data. But such learning has been particularly profound in collaborations with community members, with whom we academics partner specifically to engage perspectives and wisdom that we lack. The exploratory, inductive work of qualitative research provided rich opportunities for MEND community collaborators to generate new insights, research ideas, and critical reflections for the project. Building ample and flexible time across phases of the study was critical for our research team to learn from and respond to community feedback. Generous time in data exploration together also provided community partners with more opportunities to build research skills.

Honesty, flexibility, and creativity in getting to project’s North Star

During busy projects, it can be easy to forget the real-world goal of the research — its North Star. But collaborating with community members provides an opportunity to stay closer to it. I’ve found that working together toward the project’s North Star requires and benefits from honesty, flexibility, and creativity from beginning to end.

Clarity and transparency about North Star goals and expectations matters even before a project begins. For example, when recruiting community advisers to a study, I have tried to be transparent and concrete about what the project can realistically accomplish and which North Star goals lie outside its reach. The concrete and applied goal of MEND was to guide the implementation of clinician implicit bias training. This felt doable to the research team and meaningful for community advisors. It represented a clear step towards the study’s North Star of advancing birth equity.

In a new study I am launching, however, the aims translate less tangibly into real-world payoffs. MEND-S aims to shed light on the initiatives that hospitals use to try to mitigate inequities in maternal health outcomes; it will also describe the barriers and facilitators hospitals encounter as they enact these initiatives. The work will advance science, but this payoff is more academic than real world. MEND-S will provide data to inform interventionists’ planning and healthcare leaders’ decisions. Impact on day-to-day clinician-patient interaction falls, for now, outside its scope. I tried to be clear about the real-world limitations of MEND-S as I sought to recruit new community advisors to the work. I hope this approach will build a foundation of trust and shared expectations with the team. I also hope that it will lay the groundwork for partnerships that can translate the scientific work of the project into real-world pay offs in the future.

On some occasions, community members have pushed me to be more ambitious and resourceful in pursuing North Star goals. During MEND, the lead community collaborator/co-investigator provided a memorable push. We were concluding data collection. I had asked her whether there was anything we hadn't done that she thought would be important for us to do—a question I asked periodically during the 18-month project. She looked at me and said, “Is there anything we can do right now to actually change something?” She knew a webinar, policy memo, and scholarly manuscripts were in our future, but she (accurately) saw no concrete way that we were going to influence anything before the study concluded. Her comment shook me out of complacency. Academically, we were exceeding our goals. But from the perspective of a community member sharing precious time and decades of wisdom, more was possible. Spurred by this, she and I brainstormed and ultimately implemented two novel approaches to try to approach, engage, and support select hospitals in improving their antibias practices.

Building in the time, responsive operations, and flexibility to learn from, be inspired by, and act on the insights community advisors bring to research has immeasurably benefited my research. Recognizing that we academics solicit the involvement of community advisors precisely because they bring otherwise un-/under-represented wisdom and experiences to research, I hope I can continue to design and refine my projects to make space for those contributions. I invite MCL blog readers to get in touch with practices that have helped them to reach these goals as well