Research partnerships with community health centers: Collaborative approaches considered from a research ethics perspective

With its Clinical Research Enterprise Roadmap initiatives, the NIH urges investigators to seek partnerships with community-based health providers and to develop new ways to cooperate across organizations. This call challenges researchers and community providers to consider new types of institutional preparation to enter into these collaborations, and in turn, to address some uncharted research ethics issues regarding the balance of interests and capacities required for adroit management of research collaborations. While community health center organizations are attractive research partners in that they provide consistent care to large, predictable patient populations, most have minimal infrastructure for management of research relationships. This imbalance can be viewed as an ethical challenge to partnership development. Drawing on our own federally qualified health center (FQHC) organization experience as a participating partner in 7 NIH-funded investigations, we identify key approaches that helped us to negotiate and achieve a balance of interests within our research partnerships, while maintaining a focus on the integrity of our health center mission, operations and financial solvency. We identify seven domains for partnership preparation: (1) shared interest in the research question; (2) alignment of research intent with health center clinical and administrative practices; (3) engagement of health center management in the study design process; (4) acknowledgement of the full operational and research management costs to the health center, (5) clarity regarding the collection, storage and sharing of protected information; (6) strengthening of the health center workforce to participate in research processes; and (7) health center engagement in interpretation and dissemination of results.