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Table 1 Engaging Community Researchers in public health research: practical issues

From: Researching health inequalities with Community Researchers: practical, methodological and ethical challenges of an ‘inclusive’ research approach

Stage Challenges Useful practice
Pre-recruitment and recruitment Representativeness: CRs may identify with a particular section of a community and will not be able to represent all community perspectives. Including people with the range of relevant characteristics such as gender, age and ethnicity can be hard. Engage with community organisations and potential CRs at the time of designing the study
Recruitment routes: using community organisations to recruit CRs may limit the pool of people who hear about the opportunity and the perspectives that are included in the team. Communities vary in their degree of collective identity meaning that CRs may be more difficult to recruit for some groups than others.
Establish a wide range of contact points and modes of advertising the role so as to reach all sections of the communities of focus
Allow sufficient time for recruitment
Involve appropriate local people in the selection process
Include an interactive selection procedure that establishes applicants’ skills and experiences and gives them a chance to learn about the role
Person specification: recruiting CRs with necessary skills and experience, especially cultural awareness and linguistic skills, can be difficult. Understand people’s motivations for becoming a CR and how this might affect their engagement
Ascertain the personal circumstances of CRs and how these might affect their engagement and need for support
Payment: paying CRs can create conflict if other local people see this as unfair and think that the money should be ‘for the community’.
Plan to over recruit CRs so as to manage dropout and limited engagement
Nature of contract: the irregular nature of work may be an issue for recruitment and retention, especially if it spans several months. Agree with all stakeholders an appropriate rate of payment for CRs and ensure this is transparent.
Carefully consider the pros and cons of compensating participants and agree an appropriate approach in consultation with all stakeholders
Training and capacity development Developing and delivering a training programme: ensuring all CRs gain the appropriate skills, knowledge and confidence to undertake the role can be challenging when they come with a diverse range of experience, skills and education. Use your detailed knowledge of the group of CRs to tailor the training appropriately
Duration: finding a block of time may not be easy for CRs given personal circumstances and competing priorities.
Ongoing support and development: engaging CRs as part of the research team will mean a need for ongoing training and support throughout the project as different stages of the research unfold.
Include a comprehensive training programme that covers various aspects of the project from start to finish and is delivered in instalments throughout the project period
Involve the CRs in identifying their learning needs, preferred learning styles and how they can support each other’s development
Use a familiar and informal venue, flexible timing, limited paper-based work, interactive and informal modes of delivery, as these are likely to facilitate learning
Ensure that any special needs are catered for such as linguistic, practical (e.g. child care) and cultural (e.g. space for prayers, halal food) factors
Retention Competing priorities: Other job opportunities, health issues, personal priorities, and waning interest can impact upon CR retention. Devote sufficient time for team building, establishing trust and mutual respect
Be responsive to the needs of the CRs. Schedule in regular times and spaces for support and reflection
Concerns relating to losing state benefits: CRs may drop out if they are worried about working too many hours or contravening other rules.
Be flexible with CRs’ working patterns and payment systems. Link CRs to sources of advice on benefit entitlements and regulations
A stressful role: aspects of the CR role can be experienced as stressful, including: learning new information about the community, being in public in a new role, misunderstandings and conflict with community members, and completing a demanding schedule of work.
Have contingency plans so that individual CRs do not feel too much pressure to complete work alone
Conducting the research: supervision and ‘duty of care’ Coordination and completion of work: competing commitments can mean that CRs do not complete allocated work. Formally agree contracts with CRs and set out expectations clearly on all sides
Provide close supervision and support through informal meetings as this may help in identifying any problems early on
Managing a diverse team: CRs may tend to associate with people in the team who they identify with (perhaps on the basis of a shared ethnic or other identity), and this can undermine cohesiveness and shared learning.
Provide ongoing attention to motivate CRs and demonstrate the value of their contribution to the project
Boundaries in supervision: there can be a risk of getting over-involved in CRs’ lives and transgressing professional boundaries. Ensure opportunities for CRs to voice concerns and problems; encourage openness, regular contact and approachability across the team
Collecting and analysing data Conducting data collection: cultural norms, personal beliefs and contextual factors may make it difficult for some CRs to engage in particular data collection activities. For instance, they may find particular topics sensitive or shameful or they may face barriers to engaging with certain respondents. Develop a detailed collective understanding of the socio-cultural, religious and political context within which the study is being conducted and how this may impact upon the CRs’ role
Plan work allocation together with CRs rather than assume what is acceptable, convenient and doable
Analysis and interpretation: CRs can struggle to be reflexive with normative understandings and preconceptions sometimes constraining the process of developing new insights.
Allocate work so that it takes account of the strengths, weaknesses and personal attributes of individual CRs
Outputs and dissemination: project timescales and the need for efficiency can often make it difficult to involve CRs in report writing and production of other research outputs.
Include time and opportunities for developing reflexivity. Assess the findings explicitly in terms of the extent to which they are credible to different stakeholder perspectives
Cost research projects realistically to ensure that CRs can be kept involved right through to the dissemination and implementation phases
Beyond project end Lingering negative effects: CRs may feel disappointed as the project comes to an end. CRs may also feel indebted to community members and may face negative reactions, particularly if there is little tangible impact of the research at community level. Be aware of potential unintended negative impacts of the research and ensure that the training provided to CRs equips them to avoid or manage such situations
Include debriefing sessions that reinforce the need to maintain confidentiality beyond the end of the project
Explore the potential to develop ‘mobilisation to action’ plans that can be operationalised by CRs beyond the end of the research period
Contribute to the continued professional development of CRs by connecting them to other opportunities and accrediting their involvement in the project