Table 2. Challenges Associated with Upholding Four Key Principles of Ethical Community-Engaged Research^*.

Embodying Ethical Action

Addressing historical legacy of unethical research

Respecting Participants

Maintaining confidentiality across participants' multiple roles

Being sensitive, responsive to partners' perspectives; culturally appropriate

Pursuing ongoing communication (e.g., deepening understanding, discussing disagreements)

Generalizing Beneficence

Achieving substantive roles for partners in research tasks and decision-making

Managing conflicting priorities that compete with research activities

Obtaining funding for time needed to pursue partnering

Devising alternatives or justifications for randomization or a control arm

Managing work burden of community partners

Modifying survey instruments for cultural appropriateness

Reaching agreement on composition of partnership and compensation

Addressing problems uncovered during research activities

Achieving equitable benefits for all involved participants

Negotiating Justice

Managing reluctance of community stakeholders to engage in research

Staying aligned with study vision over time

Ascertaining the adequacy of success in partnering, trust

Publicly representing research aims and findings such that all partners agree

Maintaining objectivity and scientific equipoise

^*each challenge mentioned by at least 3 and less than 12 of 29 interviewees; listed from most to least frequent under each principle