TABLE 2—

Challenges Associated With Upholding 4 Key Principles of Ethical Community-Engaged Research

Principle	Action
Embody ethical action	Address historical legacy of unethical research
Respect participants	Maintain confidentiality across participants’ multiple roles
	Be sensitive and responsive to partners’ perspectives and be culturally appropriate
	Pursue ongoing communication (e.g., deepen understanding, discuss disagreements)
Generalize beneficence	Achieve substantive roles for partners in research tasks and decision-making
	Manage conflicting priorities that compete with research activities
	Obtain funding for time needed to pursue partnering
	Devise alternatives or justifications for randomization or a control arm
	Manage work burden of community partners
	Modify survey instruments for cultural appropriateness
	Reach agreement on composition of partnership and compensation
	Address problems uncovered during research activities
	Achieve equitable benefits for all involved participants
Negotiate justice	Manage reluctance of community stakeholders to engage in research
	Stay aligned with study vision over time
	Ascertain the adequacy of success in partnering and trust
	Represent research aims and findings so all partners agree
	Maintain objectivity and scientific equipoise

Note. Each challenge was mentioned by at least 3 and fewer than 12 of the 29 interviewees. Challenges are listed from most to least frequent under each principle.