Strategies for high-quality community-based participatory research partnerships in public health research

Abstract

Objectives

Community-Based Participatory Research (CBPR) is grounded in trusting, reciprocal, and authentic relationships. We aimed to identify key strategies and actionable next steps to establish and sustain high-quality community-academic partnerships that foster community-based health equity.

Study design

Qualitative thematic analysis.

Methods

We analyzed three recorded discussions from a roundtable session with community and academic partners from the Rapid Acceleration of Diagnostics–Underserved Populations (RADx-UP) program (2020-2025), which supported 142 community-engaged public health research projects aimed at reducing COVID-19-related health inequities.

Results

Key themes identified as most fundamental to support CBPR included establishing a long-term commitment, mutual co-learning among partners, flexible and sustained funding and resources, co-design of research and evaluation tools, and unwavering commitment to transparent communication and dissemination. Accurately assessing CBPR's impact requires using valid and reliable tools that assess whether community-academic partnerships are functioning well, identify opportunities to strengthen engagement, and measure both community- and system-level outcomes resulting from the partnerships.

Conclusions

Advancing community-based health research through high-quality CBPR partnerships requires ongoing flexibility, mutual trust, shared learning, and collaborative design core elements to achieve sustainable and equitable public health outcomes. Through these initiatives we can pave the way for high-quality community-academic partnerships that address critical priorities in population health research and processes for advancing health equity.

1. Introduction

Community-Based Participatory Research (CBPR) is grounded in trusting, reciprocal, and authentic relationships that are essential for generating meaningful findings, guiding sustainable, health-promoting community-based programs and initiatives, and informing policies to mitigate population-based health inequities [1,2]. From 2020 to 2025, the Rapid Acceleration of Diagnostics–Underserved Populations (RADx-UP) program supported 142 community-engaged public health research projects aimed at reducing COVID-19-related health inequities through testing and vaccination efforts for all Americans through robust community-academic partnerships [3]. RADx-UP studies also focused on strengthening data infrastructure and visualization, addressing anti-Asian sentiment, and building community capacity to advance health equity in vulnerable communities. These efforts were accompanied by intentional processes to initiate, sustain, and strengthen the quality of partnerships. While study outcomes often are driven by funding priorities and intervention goals, the formation and sustainability of these partnerships and the processes that support them remain critically understudied.

Building on RADx-UP priorities in support of robust CBPR practices, we convened a collaborative roundtable session at the American Public Health Association (APHA) 2024 Annual Meeting and Expo with community partners and academic researchers from the RADx-UP program. The session aimed to 1) articulate strategies for advancing integration of CBPR into ongoing public health research practice relevant to community-engaged research partnerships within the RADx-UP program and 2) generate specific actionable recommendations for population health researchers, funders, and community practitioners to implement in their respective settings to further advance CBPR. In this article, we present a qualitative thematic analysis of the recorded roundtable discussions from the session, summarize key findings, and present actionable next steps for supporting the processes to establish and sustain high-quality community-academic partnerships that foster community-based health equity.

Extending our prior work on promoting genuine and successful community-academic partnerships to foster health equity [2], we set out to understand processes that support high-quality community-academic partnerships by addressing the following core questions.

• 1.Why is CBPR foundational to population-based health equity, and what specific strategies or approaches can facilitate and expand future collaborations to promote health equity?
• 2.What specific strategies can effectively build and sustain strong community-academic partnerships, and what strategies can meaningfully engage communities in interpreting population health research findings and their dissemination?
• 3.How can funding mechanisms, evaluation metrics, and institutional policies be structured to support long-term, sustainable relationships between academic institutions and communities?

2. Methods

RADx-UP community partners and study investigators were invited to serve as facilitators through various working groups to help lead the roundtable discussions at the APHA 2024 Annual Meeting held in Minneapolis, MN. The roundtable session was open to all conference attendees. The session format was co-designed by a session working group (n = 12) comprising community partners, academics and study operations staff members. The session included 21 participants with about 6 individuals per table, including two session facilitators per table. Table S1 summarizes participant characteristics, populations served, and community partners.

The session began with the moderator providing an introduction and a comprehensive overview that framed the goals and context for the discussions to follow. Participants then self-selected into one of three roundtable groups. Facilitators guided the discussions using a standardized set of questions centered on the value of CBPR in population health research, effective funding strategies, and fostering equitable community-academic partnerships [[4], [5], [6], [7], [8]]. Discussions occurred at each table, with participants documenting ideas through written notes and audio-recordings. Each group later shared key insights during a whole-group discussion, fostering collective reflection and dialogue.

2.1. Analysis

Three session facilitators independently reviewed all transcripts to develop a preliminary coding framework. The coding team was comprised of three highly trained researchers and evaluators, bringing expertise in CBPR, program evaluation, and qualitative methodology. Coder one identifies as a female, Latina social work researcher with experience conducting CBPR for the past 20 years. Coder two identifies as a White female research and evaluation scientist with experience tailoring methods to meet community needs. Coder three identifies as a White female community psychologist with 25 years of research and evaluation experience. Each coding team member independently reviewed all transcripts to develop a preliminary coding framework. The coding team met virtually to collaboratively review, discuss, and refine codes until reaching unanimous consensus. Each coding member then individually open-coded one out of three audio-recorded table discussions. From these codes, key themes were juxtaposed against the research questions and illustrative quotations were selected to vividly support and exemplify each theme. Study findings were then co-interpreted across the session working group. Throughout each step, an audit trail of key documents (i.e., transcripts, codebook, coder notes, thematic analysis document) were kept in a secure file location.

3. Results

Several key strategies were identified from our analysis of the roundtable session for effectively implementing CBPR to advance population-based health equity and build sustainable community-academic partnerships. These strategies include cultivating trust, fostering mutual learning, employing collaborative research designs and approaches, advocating for flexible funding mechanisms and investment in infrastructure, and prioritizing clear communication and dissemination. Table 1 presents the strategies for advancing the integration of CBPR principles with illustrative quotations from the roundtable session.

Table 1.

Strategies for Advancing Integration of CBPR principles with Illustrative Quotations from the RADx-UP Roundtable Session.

Themes	Session Quotations
Build trust through ongoing, reciprocal and authentic engagement, transparency, shared power, and capacity building.	“So we need to really build up the continuity of the relationship and also participate in their community events and some cultural events or something. So, the trust and relationship building is one thing we feel is very, very fundamental and essential.” “… you hit on key words that I don't always hear in health partnerships, which are reciprocity and mutual benefits. I think the key is just talking to the partners that you have somebody that builds trust with them, and you find out what their priorities are. One of the hardest things about this work is that they have certain assets that we don't always value, we just focus on their needs.” “That's another thing, really give them the feeling of ownership. So they feel, oh, okay, we are working as a team. So also the community leaders promoting advocacy is very important.” “The feedback that we got from our community engagement coordinators was that many people were hesitant, but they were also trained to explain the origin of the question and why it was important, but not push ’em. And that's how they maintain trust, which is if we have to report missing data, we'd rather do that than break the trust with our community members.”
Develop mutual capacity (co-learning) for community-academic collaboration.	“… using community organizing principles, things like short-term victories, getting them involved in short-term projects that can produce some results, getting people involved in learning, co-learning with us. So by co-learning, I mean both directions. So having community organizations teach academics about community organizations and their area of expertise as well as the other way around.” “Another thing is really co-learning and building the community capacity. They don't understand study, they don't understand your data-collecting protocol. They don't understand IRB or human subjects protection. So building the capacity is [on the] way, it's really on the way, side by side.”
Utilize collaborative research designs and engage trusted community members to encourage community participation.	“… one area where we've kind of started implementing in the last 4 years and had success is we've been recruiting what we call community engagement coordinators from the neighborhoods we're going into. And then we trained them in the studies in data consents, data integrity, and what exactly we're doing. And then they go back into their own neighborhoods … if their neighbor says, listen, I've talked to them, I know about this. What they're really trying to do is help our community. We saw a massive increase in our ability to recruit and enroll. We saw an increase in our retention. We saw an increase in our data integrity. We had a much lower rate of missing data because they understood the study well enough.” “… achieving equity at a community level starts with the relationships. When we work with our partners in [state], we do identify with them their priorities. So they're at the table immediately and it's not [the university] academic team always driving the decision-making from the get-go.”
Advocate for flexible funding to allow researchers dedicated time to form meaningful trusted partnerships.	“I think that's where it also gets into funding. They've got to give us enough time to work with partnerships.” “So what we're hoping to do is build those sustainable relationships you've been able to do with that sustained funding, which will allow us to not just dip in, take data and dip out, as you were saying, but to really develop a core of leaders who really understand community leaders, who really understand and become conversant in academic research or what we might do together policy-wise.”
Invest in infrastructure to sustain Community-Based Participatory Research (CBPR) long-term.	“I think that it would be wonderful if funders would create a CBPR award that is specifically to fund their development of infrastructures. So, it's specifically working on funding the matchmaking process and understanding that there's going to be times where this will be a separate funding, funding just to maintain the relationships in the boards, in the training. Recognizing the amount of training that we did, it's years, and I still have board members that have been working with us for 14 years. That is infrastructure that once it's gone, it's going to start all over again, right? [You] want to continue maintaining these people engaged for decades if you can.” “Once they're trained, these [community engagement coordinators from the neighborhoods], we can pull for them for other studies and say, would you like to do a study for this or for that? And then they end up recruiting more people in their neighborhood because they're like, ‘I see what you're doing.’”
Engage in effective communication and dissemination tailored to the community.	“And we need to really talk and communicate with community people. We are making [a] contribution for our community. This is science, this data, your contribution can really allow the policy makers and decision makers, they can hear what our needs [are] and they feel they are part of the team and they are making contribution to the science … really give them the feeling of ownership. So they feel, ‘Oh, okay, we are working as a team.’” “A big part of our practice was the dissemination to do board reports, donor reports, and all of those different elements for the nonprofit partners. Then for the cities to have different taxpayer reports and different elements of the work that was happening and thinking very differently because that's something I think that doesn't happen a lot. Even when people give the data back.” “… once this data comes back, we can share that with these coordinators. And then just casually, we have formal forms of dissemination as well. But casually, they can say, ‘Oh, by the way, that study you were in, let me tell you what they did. Let me show you that toolkit. Isn't this interesting?’ And we've seen a lot of success with that model.” “We have workshops every 3 months or so and lots of communication back and forth with [our community partner]. Our field coordinator is always in touch with them when we do the training for the program. They see the protocol … and so they ask really specific questions … and my response to them is always, well, tell us … what actually works or tell us what the concerns are …. This is implementation science.”

The session also highlighted significant barriers and challenges that can inhibit or undermine community-academic partnerships in population-based health research and reduce potential for CBPR success. Key challenges include limited resources and rigid funding structures, persistent mistrust of academic researchers, and misalignment between institutional goals and community priorities. Other barriers to successful and robust partnerships are inconsistent engagement (e.g., researchers disengaging once funding ends), limited community research capacity, misunderstanding of community needs, burdensome or irrelevant data collection methods and metrics, lack of accessible data, poor communication between population health researchers and community stakeholders, and inadequate academic incentives (e.g., tenure criteria) to foster genuine CBPR partnerships.

Key themes identified as most fundamental to support successful community-academic partnerships in population health research included establishing a long-term commitment, mutual co-learning among partners, flexible and sustained funding and resources, co-design of research and evaluation tools, and unwavering commitment to transparent communication and dissemination. The roundtable discussions also sparked new questions among participants about overcoming persistent barriers to effective collaboration through intentional processes and policy implementation. Specifically, these challenges included methods for addressing funding constraints, limited resources, deep-seated distrust, unrealistic timelines, misaligned priorities, communication breakdowns, inconsistent engagement related to lack of academic incentives or support, and obstacles surrounding data collection and accessibility.

4. Discussion

Overall, our findings are largely confirmatory of established CBPR principles, reinforcing prior evidence that long-term commitment, mutual co-learning, shared decision-making, and transparent communication are foundational to effective community–academic partnerships [[4], [5], [6], [7], [8]]. Our findings map directly onto key domains of established engagement frameworks (e.g., NAM, PCORI) [9,10]. Trust-building underscores the importance of reciprocal, transparent relationships; mutual learning reflects co-learning and bidirectional exchange; and collaborative research approaches operationalize shared leadership and partnership. Furthermore, the need for flexible funding and infrastructure investment highlights the structural requirements for sustained engagement, while clear communication and dissemination reinforce transparency and accessibility. Together, these findings provide empirical support for core principles of stakeholder-engaged research.

At the same time, we highlight areas where our findings extend the literature. In particular, our results underscore the critical role of flexible and sustained funding mechanisms and infrastructure as key structural enablers of engagement, as well as the need for valid and reliable tools to rigorously assess partnership functioning and both community- and system-level outcomes. Although tracking outcomes is critical for evaluating the impact of CBPR, it is equally essential to assess the quality of collaboration using process metrics that integrate academic rigor with the lived experiences and insights of community members [7,[10], [11], [12], [13]]. This dual focus ensures that community-engaged research is evaluated not only for its effectiveness but also for the integrity and equity of the collaborative process. Accomplishing these goals may require that public health researchers adopt a new mindset toward community-engaged research initiatives, including prioritizing extended planning timelines to ensure collaboration and co-design from the start, infusing continuous opportunities for listening and reciprocal engagement, and involving open and early dialogue with community partners about the potential impact of public health initiatives on the community.

The following priorities represent a set of actionable items to be refined and expanded in close partnership with community collaborators to advance public health through community-engaged research partnerships.

• •Strengthen and expand bi-directional capacity-building initiatives tailored to deepen partnerships by fostering trust and supporting both population health researchers and community partners with the resources and skills needed for meaningful collaboration.
• •Disseminate at all phases of public health research studies, not just at the end.
• •Include multiple dissemination strategies; disseminate findings with lay summary products in addition to publications and presentation of the work at appropriate conferences.
• •Share case studies or a toolkit to find collaboration networks and build capacity.
• •Take a scientific approach to data collection, in which the intended use of the data is clearly defined and their potential to positively impact the community is demonstrated and shared in “real time.”
• •Foster sustainability efforts to ensure that these community-academic partnerships thrive even beyond the duration of study funding.
• •Develop a set of user-friendly metrics in the context of population health equity research to evaluate the process and impact of CBPR, measure success effectively, enhance accountability, and assess depth of the work.

4.1. Limitations

Given that all participants were members of the RADx-UP funded consortium and APHA attendees, this work may suffer potential selection bias and social desirability bias. Future research in broader contexts, or scaling the work through larger population health quantitative studies, would be valuable to validate and generalize these findings. However, given the ongoing need for high-quality community-academic partnerships to advance population-based and community-driven health equity, and the diverse, representative range of RADx-UP projects showcased during the session, these findings offer valuable insights for scaling and strengthening community-engaged partnerships nationally. This work also did not benefit from balanced representativeness across academic, research, and community organization types. Although the roundtable session design and format were co-led by a community partner to promote representativeness, future sessions should also sponsor community partners to ensure that financial barriers are not precluding participation.

4.2. Conclusions

We present a qualitative thematic analysis of recorded roundtable discussions with community and academic partners from the RADx-UP program focusing on key findings and actionable next steps for supporting population health research through establishing and sustaining high-quality community-academic partnerships. Study findings underscore that advancing population-based health research through high-quality CBPR partnerships requires ongoing flexibility, mutual trust, shared learning, and collaborative design core elements to achieve sustainable and equitable public health outcomes. Accurately assessing CBPR's impact requires using valid and reliable tools and infrastructure that assess whether population health community-academic partnerships are functioning well, identify opportunities to strengthen processes and quality of engagement, and measure both community- and system-level outcomes resulting from the partnerships in support of health equity. Through these initiatives we can pave the way for high-quality community-academic partnerships that address critical priorities in public health and processes for advancing health equity.

Ethical statement

The RADx-UP Coordinating and Data Collection Center (CDCC) operations received approval from the Duke Health IRB under protocol number IRB# Pro00106873.

Author contributions

All authors conceptualized the work. Emily D'Agostino, Debra Oto-Kent, and Miriam Nuño designed the data collection instruments. Miriam Nuño, Rachel Kaufmann, and Emily D'Agostino coordinated and supervised data collection. All authors contributed to the data collection. Rumour Piepenbrink, Liliane Windsor, and Dana Keener Mast conducted the qualitative data analysis. All authors contributed to the first draft, reviewed and edited the work, and provided final approval of the version to be submitted. Emily D'Agostino and Miriam Nuño supervised the study.

Funding

Research reported in this Rapid Acceleration of Diagnostics – Underserved Populations (RADx-UP) publication was supported by the National Institutes of Health under Award Number U24MD016258.

Declaration of competing interest

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Appendix A. Supplementary data

The following is the Supplementary data to this article.