Challenges and recommendations to improve institutional review boards' review of community-engaged research proposals: A scoping review

A Qualitative Study of the Ethics of Community Scientists' Role in Environmental Health Research from the Perspective of Community Scientists and Institutional Review Board Staff

BACKGROUND

Community engagement in research, including community scientists' (CSs) participation in environmental exposure assessments, promotes the bidirectional flow of information between communities and researchers and improves the development of interventions to reduce environmental health inequities. Nonetheless, institutional review boards (IRBs) with limited experience with CS research tend to struggle when reviewing protocols given CS participants' dual role as research participants and co-creators of data.

METHODS

We collected focus group data from 35 Latina housecleaners eliciting their bioethical reflections on their experience as CSs before and after participation in the collection of data about their exposures to chemical compounds in cleaning products. We shared findings from CS participants and collected impressions and challenges from IRB staff from five New York City biomedical research institutions. We used a modified approach to conventional content analysis to guide data analysis and combined deductive and inductive approaches to generate codes.

RESULTS

The CS participants emphasized their shared responsibility in the research process and bidirectional learning with the research team, which they saw as educating and empowering themselves and their broader community to create safer cleaning practices to improve the community's health and wellbeing. CS participants embraced the importance of sound science by their recognition that their community relied on the quality and accuracy of their work as CSs. Perspectives from IRB staff similarly recognized the value of participant engagement but emphasized the importance of disentangling CS activities as research participants from activities as research team members to better determine the appropriate mechanisms and authorities for assuring ethical protections.

DISCUSSION

Findings suggest that existing bioethical principles of beneficence, respect for persons, and justice, when interpreted by participants as inclusive of protections and benefits for both the CSs and their community's collective good, reflect the bioethical values of our CS participants. However, better guidance and training is needed for researchers, IRBs, and community collaborators to apply these values and respect and protect the full range of roles for community members participating in research. https://doi.org/10.1289/EHP15824.

The importance of rigor in pharmacy research: Challenges and solutions

Scientific rigor broadly refers to upholding basic principles within the conduct of research. Various threats associated with rigor exist in today's research environment, such as the replication crisis, the increasing prevalence of misconduct, and a loss of public trust in regulatory and educational institutions. The purpose of this commentary is to identify problems and solutions associated with research rigor, with a focus on pharmacy research. Problems exist at many levels, including within variable research training/funding, institutional pressures associated with career advancement, and norms associated with academic publishing. However, solutions are possible as methods of harm reduction, including (but not limited to) focused initiatives supporting rigor, team-based approaches to research that include diverse interested parties, and a reimagining of what constitutes value within science. Pharmacists and pharmacy researchers are called upon to uphold research rigor as a professional and ethical responsibility.

The Need for IRB Leadership to Address the New Ethical Challenges of Research with Highly Portable Neuroimaging Technologies

The emergence of innovative neuroimaging technologies, particularly highly portable magnetic resonance imaging (pMRI), has the potential to spawn a transformative era in neuroscience research. Resourced academic institutional review boards (IRBs) with experience overseeing traditional MRI have a special role to play in ethical governance of pMRI research and should facilitate the collaborative development of nuanced and culturally sensitive guidelines and educational resources for pMRI protocols. This paper explores the ethical challenges of pMRI in neuroscience research and the dynamic leadership role that IRBs should play to promote ethical oversight of emerging pMRI research.

Engaging stakeholders to strengthen support for community-engaged research at Stanford School of Medicine: An institutional assessment and action planning approach

Introduction

Despite the central role that patient and community engagement plays in translational science and health equity research, there remain significant institutional barriers for researchers and their community partners to engage in this work meaningfully and sustainably. The goal of this paper is to describe the process and outcomes of Engage for Equity PLUS at Stanford School of Medicine, which was aimed at understanding and addressing institutional barriers and facilitators for community-engaged research (CEnR).

Methods

A Stanford champion team of four faculty and two community partners worked with the University of New Mexico team to conduct two workshops (n = 26), focus groups (n = 2), interviews with leaders (n = 4), and an Institutional Multi-Stakeholder Survey (n = 35). These data were employed for action planning to identify strategies to build institutional support for CEnR.

Results

Findings revealed several key institutional barriers to CEnR, such as the need to modify organizational policies and practices to expedite and simplify CEnR administration, silos in collaboration, and the need for capacity building. Facilitators included several offices devoted to and engaging in innovative CEnR efforts. Based on these findings, action planning resulted in three priorities: 1) Addressing IRB barriers, 2) Addressing barriers in post-award policies and procedures, and 3) Increasing training in CEnR within Stanford and for community partners.

Conclusions

Addressing institutional barriers is critical for Academic Medical Centers and their partners to meaningfully and sustainably engage in CEnR. The Engage for Equity PLUS process offers a roadmap for Academic Medical Centers with translational science and health equity goals.

Community-Engaged Implementation Strategies in Occupational Therapy: A Scoping Review

IMPORTANCE

 Despite the potential of community-engaged implementation research (CEIR) in developing strategies to accelerate the translation of evidence-based interventions (EBIs), there is a noticeable knowledge gap in the current state of CEIR in occupational therapy. A synthesis of the concept, purpose, and operationalization of CEIR is necessary.

OBJECTIVE

 To identify the contexts, purposes, and operationalization of CEIR, focusing on implementation strategies in occupational therapy.

DATA SOURCES

 PubMed/MEDLINE, Embase, CINAHL, Scopus, and Web of Science.

STUDY SELECTION AND DATA COLLECTION

 We included studies that were explicit and intentional about CEIR and that focused on implementation strategies to support the translation of occupational therapy interventions, clinical guidelines, practice models, theories, or assessments. We extracted the research context (e.g., partners, recruitment), purpose (e.g., why community-engaged research was used), and operationalization (e.g., community engagement [CE] activities, how their findings inform the research) using thematic analysis.

FINDINGS

 Of 3,219 records, 6 studies were included. Involved partners were mainly occupational therapy practitioners from existing networks. CEIR that focuses on implementation strategies informs various aspects of research design, ranging from study design to sustainability, by developing community-academia partnerships, building implementation capacity, and creating implementation strategies across diverse research areas. Current research has used various but mostly traditional CE activities (e.g., focus groups).

CONCLUSIONS AND RELEVANCE

 We synthesized evidence on CEIR focused on implementation strategies in occupational therapy. Intentional efforts are needed to collaborate with diverse partners, explore innovative CE activities, produce equitable outputs, and develop multilevel implementation strategies to accelerate the translation of EBIs into practice. Plain-Language Summary: In this review, we synthesize evidence on the contexts, purposes, and operationalization of community-engaged implementation research (CEIR), focusing on implementation strategies in occupational therapy research. We found that current implementation efforts mainly rely on occupational therapy practitioners as community partners and use traditional recruitment methods and community engagement activities. In turn, they develop implementation strategies that mainly target practitioners without comprehensive, multilevel implementation support. We suggest more equitable collaboration with diverse partners to effectively promote the implementation and dissemination of evidence-based interventions in occupational therapy practice.

Behind the scenes of research ethics committee oversight: a qualitative research study with committee chairs in the Middle East and North Africa region

BACKGROUND

Research cites shortcomings and challenges facing research ethics committees in many regions across the world including Arab countries. This paper presents findings from qualitative in-depth interviews with research ethics committee (REC) chairs to explore their views on the challenges they face in their work with the oversight of research involving human populations.

METHODS

Virtual in-depth interviews were conducted with chairs (n = 11) from both biomedical and/or social-behavioral research ethics committees in six countries, transcribed, coded and subject to thematic analysis for recurring themes.

RESULTS

Two sets of recurring themes impede the work of the committees and pose concerns for the quality of the research applications: (1) procedures and committee level challenges such as heavy workload, variations in member qualification, impeding bureaucratic procedures, member overwork, and intersecting socio-cultural values in the review process; (2) inconsistencies in the researchers' competence in both applied research ethics and research methodology as revealed by their applications.

CONCLUSIONS

Narratives of REC chairs are important to shed light on experiences and issues that are not captured in surveys, adding to the body of knowledge with implications for the region, and low- and middle-income countries (LMICs) in other parts of the world. International research collaborations could benefit from the findings.

IRB Consent Guidelines: Potential Barriers to Diversity in Research

Despite initiatives aimed at improving study participation and inclusion among ethnic and racially minoritized and marginalized populations, participation remains low. While necessary to ensure ethical practice in human participant research, certain Institutional Review Board (IRB) guidelines may introduce additional barriers in research involving these populations. This work outlines guidelines pertaining to consent translation for non-English speaking populations and offers discussion on a greater emphasis for more inclusive methods for marginalized communities. The University of Wisconsin's IRB approved alternative oral consent processes after the community partner determined that standard translation processes would be inefficient. Researchers used translated consent materials for four different ethnic groups (Hmong, Karen, Karenni, and Burmese). We provided recorded consents in each respective language to participants before study participation and obtained verbal consent prior to study participation at the study location. We experienced time and resource constraints in both access to translators and the consent-translation process itself. Furthermore, many participants were unable to read in their native language making standard written consent processes both difficult and impractical. Oral discussion and verbal consent processes were efficient. Adjustments to consent-related guidelines may prevent and eliminate time and resource-related barriers in consent processes. In eliminating such barriers, subsequent improved efficiency in both study design and study promotion areas can work to better promote diversity in research among populations that emphasize oral language and in instances where literacy rates in written non-English language may be lower.

Coping Strategies as a Moderator for the Association between Intimate Partner Violence and Depression and Anxiety Symptoms among Transgender Women

Evidence suggests that intimate partner violence (IPV) is associated with negative mental health outcomes. There is currently limited research on the impact of IPV on the outcomes of mental health for transgender women. The current study aimed to examine the relationship between intimate partner violence, coping skills, depression, and anxiety in a sample of transgender women. Hierarchical regression analyses were conducted examining the relationship of IPV and depression and anxiety symptoms, where coping skills moderate this relationship. The results suggest that those with experiences of IPV are more likely to have symptoms of depression and anxiety. For individuals with no experiences of IPV and low depression, high levels of emotional processing coping and acceptance coping buffered this relationship. For individuals with more experiences of IPV and more depressive symptoms, coping skills did not show to buffer this relationship. These same coping skills did not show evidence for buffering anxiety symptoms for transgender women with low or high levels of IPV. The results, implications, and limitations of this study and suggestions for further research are discussed.