| Grant proposal development |
Much in the way community-based participatory research requires engagement of community and members of the intended population in the proposal writing and protocol development, use of multidisciplinary teams from the beginning is critical for improving HIV research. Grant writing team composition should ideally include professionals and community representatives who can provide insight into the research question as well as who will do the work; what PIs may think is feasible may not actually be feasible when front line staff are involved. -
Even for studies that are mono-method (e.g., qualitative or quantitative), those trained in alternative methods may be able to add layers of understanding to the research question or methods that would not otherwise be available.
For example, a basic scientist working to recruit from an HIV clinic for a study of markers of cardiac co-morbidities might benefit from a qualitative researcher to understand the biases implicit in a clinic-based sample. That same study might benefit from inclusion of the perspective of outreach workers who can discuss expected recruitment challenges.
Allowing sufficient time for conversations prior to writing so that team members do not feel that they are being included superficially and similarly seeking external reviews from peers from other disciplines and from community members beyond the typical Community Advisory Boards but into the community identified for the study. Accepting constructive criticism during the proposal phase lays the foundation for integration of multiple disciplines throughout the study. Intentional inclusion of racial, ethnic, gender, and sexual minorities on faculty and research staffs, and mentoring to support grant submissions and participation on existing studies.
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| Study implementation |
The PI can set the stage for study implementation that is inherently multidisciplinary. Consistent with the idea of developing shared communication and vocabulary across siloes, listening and modeling listening behavior is of paramount importance. Setting up regular cross-cutting meetings of staff in shared spaces that accept the time constraints of all parties is useful: rather than making teams always go to the PI, having the PI go into spaces of the different collaborators can indicate dedication to meeting the needs of all team members. Community outreach early post-award and at all phases (instrumentation, intervention, dissemination) will aid in more culturally appropriate recruitment and data collection but is not automatic just through opt out communications (e.g., if you have any comments on the survey, please provide them, otherwise we assume they are all right with you vs. dates for inclusion of feedback). Hiring of research faculty and staff representative of the populations being studied. Use of community participatory approaches to gain community insight at every step of the research process. Formal engagement and time to provide iterative changes for instrumentation or design and thoughtful settings to elicit the views of community members and research team members is necessary. Regular collaborator check-ins as well as oversight and ongoing quality assurance for staff can maintain the level of cross-cutting engagement throughout the implementation phase. Encourage research staff to have a direct relationship and better rapport with the patient population than say the study PI, this can assist with patient recruitment. This is particularly paramount when it comes to HIV infection and issues of disclosure for example. People want to be contacted by people who are already familiar with their status whom they trust.
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| Analysis and dissemination |
Mirroring the above, analytic approaches should continue the collaborative paradigm by setting primary goals (for papers, reports, presentations) with all areas of expertise represented. Work with staff in all positions and also with community stakeholders regarding interpretation of findings prior to completion of manuscripts. Often even studies that have qualitative components are rapidly reduced to quantitative papers due to the nature of the peer-reviewed literature and differential challenges in having qualitative papers accepted in many journals. Promoting dissemination by research team members using their methods to evaluate the hypotheses under examination continues the multidisciplinary thread and supports a richness of understanding of the data to emerge. It also allows evaluation of data in multiple ways in order to best inform the field. Sharing authorship with staff who do the work for a paper as well as allowing multiple disciplined researchers to be the lead authors on papers in their domain offers the team recognition and appropriate credit. Often in academic settings, authorship is assigned to faculty members, omitting those who do the majority of the work. Worse, when authorship is given to those on tenure tracks without consideration of the efforts put forward by each staff member, the collaborative spirit of the group may be undermined. Finally, working with community members themselves towards interpretation of findings, authorship, dissemination, and ultimately data sharing when possible is key.
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