Table 2.

Lessons Learned

Lesson	Examples
Shared funding is essential for demonstrating respect, trust, empowerment and sustainability.	Constant grant writing and submissions are required to support partnership activities. Grant roles are predefined and jointly agreed upon prior to submission. Funding opportunity announcements are jointly selected. Grant application outlines are jointly developed. Sections are assigned to each partner then reviewed and edited by the other partner. Budget decisions with budget justifications are decided prior to grant submission and included in the grant. Decisions are made on which group will submit the grant. Post grant award sessions jointly discuss plans for the research or educational programs supported by grants, and due dates for required progress reports. Training in procedures to submit invoices to the university are discussed.
Training and retraining of community partners is necessary.	Ongoing training in NIH and other research grant writing, grants management pre and post award and reporting, how to use data, research design, clinical trials 101, research ethics, human subject protections, data collection for mixed methods research, survey research (community organization roles). Training in bioethics and research ethics is critical for the acceleration of research and research translation and to remove the mystery and stigma views of the community toward clinical research and research professionals. This will support inclusion of community partners on IRB protocols for partnered research. Research 101 course is important because it teaches non-researchers research design, analysis, evaluation, and publications as a translation tool. Joint training also occurs.
Education and training of academic faculty and staff is necessary.	Ongoing training is provided in culturally appropriate strategies to support interaction with nonacademic community organizations and the public utilizing communication strategies to improve explanations of complex health matters and research results in a respectful and literacy appropriate manner. Joint training also occurs.
Mandatory evaluation of the partnership and programs is required to assess effectiveness and make changes where needed.	Evaluation research and program evaluation of all key program functions, processes, and activities for assessing immediate, intermediate and long-term program outcomes. We obtained external evaluation research support from MBH, Limited, an evaluation research firm in the DC area.
Addressing community distrust of academic institutions is important.	For community physicians, distrust of academic institutions is real and requires willingness on the part of academics to outreach to community partners for meetings by meeting outside of academia instead of requiring that community organizations always come to the university for meetings. Academic organizations must emphasize the value of community partner engagement in the success of the bidirectional partnership. The initial distrust by the Eastern Shore region health professionals was related to history and concern over losing patients to the academic institution. A commitment to transparency of motives is critically important.
Policy research, advocacy, and policy activities are important to support translation/dissemination of research results, support access to beneficial interventions and support science guided advocacy and regulations/legislation.	Education of elected officials and their staffs and other policy makers is important on advances in research and health indices for their constituents. Monitoring community health data and needs helps to guide policy and legislative action. Community training in advocacy using health data and research results is effective.
We observed the evolution of community health education programs and topics based on community interest, needs and requests.	Topics are informed by formative and survey research and discussions at community meetings. We started with health disparities and clinical trials education, then Mini Med Schools and health literacy in a clinical trials 101 course. We then incorporated bioethics and research ethics training, and recently the importance of biospecimen, tissue donation and research advances and biospecimen science.
Building trust between partners takes time and patience of all partners.	A long-term commitment to work together is necessary to achieve common goals such as improvement in community health, leveraging funding to support sustainability of programs, partnered research to identify needs and solutions.

IRB, institutional review board; NIH, National Institutes of Health.