Table 2.

Challenges for CTSA hubs in the context of emergency, practices to address them, and lessons learned derived from the AC&P E-Scan (adapted from Volkov & Hoyo 75)

Focus areas	Challenges identified	Practices and lessons learned	Adaptive capacity domains
Engaging communities	Uncertainty Lack of trust Miscommunication	Building collaborative environments to manage fair and efficient access Bi-directional communication Attentive, responsive, active listening	Institutions and entitlements
Integrating special and underserved populations	Mistrust of the research process Disproportionate burden, health disparities	Overcoming reliance on sometimes exclusionary technology and methods Optimizing design for accessibility, specific needs	Knowledge, information, and learning
Increasing quality and efficiency	Explaining a portfolio of CTSA mission, roles, services to internal and external collaborators Red tape hinders efficiency and innovation	Improving visibility, flexibility, efficiency of CTSA services Facilitating novel/pragmatic approaches to expedite health care and research solutions	Innovation
Cultivating translational workforce	Widespread disruption of research activities and training Institutional, structural and personal barriers	Leveraging existing assets and capabilities Adapting traditional tools and technology to new conditions	Assets
Informatics	Lack of sufficient, reliable clinical and research information Lack of engagement with diverse populations	Developing massive, interoperable clinical/research data infrastructure Making concerted efforts to optimize knowledge dissemination	Innovation
Leadership and administration	Critical need for coordinated response among widespread disruption	Collaborating to strengthen networks of comprehensive support for research community Cultivating trustful partnership and shared decision making	Flexible, forward-looking decision-making