Engaging Communities to Strengthen Research Ethics in Low-Income Settings: Selection and Perceptions of Members of a Network of Representatives in Coastal Kenya

There is wide agreement that community engagement is important for many research types and settings, often including interaction with ‘representatives’ of communities. There is relatively little published experience of community engagement in international research settings, with available informati...

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Published inDeveloping world bioethics Vol. 13; no. 1; pp. 10 - 20
Main Authors Kamuya, Dorcas M., Marsh, Vicki, Kombe, Francis K., Geissler, P. Wenzel, Molyneux, Sassy C.
Format Journal Article
LanguageEnglish
Published England Blackwell Publishing Ltd 01.04.2013
Wiley Subscription Services, Inc
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Online AccessGet full text
ISSN1471-8731
1471-8847
1471-8847
DOI10.1111/dewb.12014

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Abstract There is wide agreement that community engagement is important for many research types and settings, often including interaction with ‘representatives’ of communities. There is relatively little published experience of community engagement in international research settings, with available information focusing on Community Advisory Boards or Groups (CAB/CAGs), or variants of these, where CAB/G members often advise researchers on behalf of the communities they represent. In this paper we describe a network of community members (‘KEMRI Community Representatives’, or ‘KCRs’) linked to a large multi‐disciplinary research programme on the Kenyan Coast. Unlike many CAB/Gs, the intention with the KCR network has evolved to be for members to represent the geographical areas in which a diverse range of health studies are conducted through being typical of those communities. We draw on routine reports, self‐administered questionnaires and interviews to: 1) document how typical KCR members are of the local communities in terms of basic characteristics, and 2) explore KCR's perceptions of their roles, and of the benefits and challenges of undertaking these roles. We conclude that this evolving network is a potentially valuable way of strengthening interactions between a research institution and a local geographic community, through contributing to meeting intrinsic ethical values such as showing respect, and instrumental values such as improving consent processes. However, there are numerous challenges involved. Other ways of interacting with members of local communities, including community leaders, and the most vulnerable groups least likely to be vocal in representative groups, have always been, and remain, essential.
AbstractList There is wide agreement that community engagement is important for many research types and settings, often including interaction with 'representatives' of communities. There is relatively little published experience of community engagement in international research settings, with available information focusing on Community Advisory Boards or Groups (CAB/CAGs), or variants of these, where CAB/G members often advise researchers on behalf of the communities they represent. In this paper we describe a network of community members ('KEMRI Community Representatives', or 'KCRs') linked to a large multi-disciplinary research programme on the Kenyan Coast. Unlike many CAB/Gs, the intention with the KCR network has evolved to be for members to represent the geographical areas in which a diverse range of health studies are conducted through being typical of those communities. We draw on routine reports, self-administered questionnaires and interviews to: 1) document how typical KCR members are of the local communities in terms of basic characteristics, and 2) explore KCR's perceptions of their roles, and of the benefits and challenges of undertaking these roles. We conclude that this evolving network is a potentially valuable way of strengthening interactions between a research institution and a local geographic community, through contributing to meeting intrinsic ethical values such as showing respect, and instrumental values such as improving consent processes. However, there are numerous challenges involved. Other ways of interacting with members of local communities, including community leaders, and the most vulnerable groups least likely to be vocal in representative groups, have always been, and remain, essential. Adapted from the source document.
There is wide agreement that community engagement is important for many research types and settings, often including interaction with 'representatives' of communities. There is relatively little published experience of community engagement in international research settings, with available information focusing on Community Advisory Boards or Groups (CAB/CAGs), or variants of these, where CAB/G members often advise researchers on behalf of the communities they represent. In this paper we describe a network of community members ('KEMRI Community Representatives', or 'KCRs') linked to a large multi-disciplinary research programme on the Kenyan Coast. Unlike many CAB/Gs, the intention with the KCR network has evolved to be for members to represent the geographical areas in which a diverse range of health studies are conducted through being typical of those communities. We draw on routine reports, self-administered questionnaires and interviews to: 1) document how typical KCR members are of the local communities in terms of basic characteristics, and 2) explore KCR's perceptions of their roles, and of the benefits and challenges of undertaking these roles. We conclude that this evolving network is a potentially valuable way of strengthening interactions between a research institution and a local geographic community, through contributing to meeting intrinsic ethical values such as showing respect, and instrumental values such as improving consent processes. However, there are numerous challenges involved. Other ways of interacting with members of local communities, including community leaders, and the most vulnerable groups least likely to be vocal in representative groups, have always been, and remain, essential. [PUBLICATION ABSTRACT]
There is wide agreement that community engagement is important for many research types and settings, often including interaction with 'representatives' of communities. There is relatively little published experience of community engagement in international research settings, with available information focusing on Community Advisory Boards or Groups (CAB/CAGs), or variants of these, where CAB/G members often advise researchers on behalf of the communities they represent. In this paper we describe a network of community members ('KEMRI Community Representatives', or 'KCRs') linked to a large multi-disciplinary research programme on the Kenyan Coast. Unlike many CAB/Gs, the intention with the KCR network has evolved to be for members to represent the geographical areas in which a diverse range of health studies are conducted through being typical of those communities. We draw on routine reports, self-administered questionnaires and interviews to: 1) document how typical KCR members are of the local communities in terms of basic characteristics, and 2) explore KCR's perceptions of their roles, and of the benefits and challenges of undertaking these roles. We conclude that this evolving network is a potentially valuable way of strengthening interactions between a research institution and a local geographic community, through contributing to meeting intrinsic ethical values such as showing respect, and instrumental values such as improving consent processes. However, there are numerous challenges involved. Other ways of interacting with members of local communities, including community leaders, and the most vulnerable groups least likely to be vocal in representative groups, have always been, and remain, essential.There is wide agreement that community engagement is important for many research types and settings, often including interaction with 'representatives' of communities. There is relatively little published experience of community engagement in international research settings, with available information focusing on Community Advisory Boards or Groups (CAB/CAGs), or variants of these, where CAB/G members often advise researchers on behalf of the communities they represent. In this paper we describe a network of community members ('KEMRI Community Representatives', or 'KCRs') linked to a large multi-disciplinary research programme on the Kenyan Coast. Unlike many CAB/Gs, the intention with the KCR network has evolved to be for members to represent the geographical areas in which a diverse range of health studies are conducted through being typical of those communities. We draw on routine reports, self-administered questionnaires and interviews to: 1) document how typical KCR members are of the local communities in terms of basic characteristics, and 2) explore KCR's perceptions of their roles, and of the benefits and challenges of undertaking these roles. We conclude that this evolving network is a potentially valuable way of strengthening interactions between a research institution and a local geographic community, through contributing to meeting intrinsic ethical values such as showing respect, and instrumental values such as improving consent processes. However, there are numerous challenges involved. Other ways of interacting with members of local communities, including community leaders, and the most vulnerable groups least likely to be vocal in representative groups, have always been, and remain, essential.
There is wide agreement that community engagement is important for many research types and settings, often including interaction with 'representatives' of communities. There is relatively little published experience of community engagement in international research settings, with available information focusing on Community Advisory Boards or Groups (CAB/CAGs), or variants of these, where CAB/G members often advise researchers on behalf of the communities they represent. In this paper we describe a network of community members ('KEMRI Community Representatives', or 'KCRs') linked to a large multi-disciplinary research programme on the Kenyan Coast. Unlike many CAB/Gs, the intention with the KCR network has evolved to be for members to represent the geographical areas in which a diverse range of health studies are conducted through being typical of those communities. We draw on routine reports, self-administered questionnaires and interviews to: 1) document how typical KCR members are of the local communities in terms of basic characteristics, and 2) explore KCR's perceptions of their roles, and of the benefits and challenges of undertaking these roles. We conclude that this evolving network is a potentially valuable way of strengthening interactions between a research institution and a local geographic community, through contributing to meeting intrinsic ethical values such as showing respect, and instrumental values such as improving consent processes. However, there are numerous challenges involved. Other ways of interacting with members of local communities, including community leaders, and the most vulnerable groups least likely to be vocal in representative groups, have always been, and remain, essential.
There is wide agreement that community engagement is important for many research types and settings, often including interaction with 'representatives' of communities. There is relatively little published experience of community engagement in international research settings, with available information focusing on Community Advisory Boards or Groups (CAB/CAGs), or variants of these, where CAB/G members often advise researchers on behalf of the communities they represent. In this paper we describe a network of community members ('KEMRI Community Representatives', or 'KCRs') linked to a large multi-disciplinary research programme on the Kenyan Coast. Unlike many CAB/Gs, the intention with the KCR network has evolved to be for members to represent the geographical areas in which a diverse range of health studies are conducted through being typical of those communities. We draw on routine reports, self‐ ;administered questionnaires and interviews to: 1) document how typical KCR members are of the local communities in terms of basic characteristics, and 2) explore KCR's perceptions of their roles, and of the benefits and challenges of undertaking these roles. We conclude that this evolving network is a potentially valuable way of strengthening interactions between a research institution and a local geographic community, through contributing to meeting intrinsic ethical values such as showing respect, and instrumental values such as improving consent processes. However, there are numerous challenges involved. Other ways of interacting with members of local communities, including community leaders, and the most vulnerable groups least likely to be vocal in representative groups, have always been, and remain, essential. Reprinted by permission of Blackwell Publishers
Author Marsh, Vicki
Molyneux, Sassy C.
Kombe, Francis K.
Kamuya, Dorcas M.
Geissler, P. Wenzel
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References_xml – reference: V. Marsh, et al. Beginning community engagement at a busy biomedical research programme: experiences from the KEMRI CGMRC-Wellcome Trust Research Programme, Kilifi, Kenya. Soc Sci Med 2008; 67: 721-733.
– reference: C.S. Molyneux, et al. Understanding of informed consent in a low-income setting: three case studies from the Kenyan Coast. Soc Sci Med 2004; 59: 2547-2559,
– reference: R.R. Sharp & M.W. Foster. Grappling with groups: protecting collective interests in biomedical research. J Med Philos 2007; 32: 321-327,
– reference: C. Rotimi, et al. Community engagement and informed consent in the International HapMap project. Community Genet 2007; 10: 186-198.
– reference: D.A. Diallo, et al. Community permission for medical research in developing countries. Clin Infect Dis 2005; 41: 255-259,
– reference: V.M. Marsh, et al. Experiences with community engagement and informed consent in a genetic cohort study of severe childhood diseases in Kenya. BMC Med Ethics 2010; 11: 13.
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– volume: 22
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  year: 2007
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  article-title: The role of community‐based organizations in household ability to pay for health care in Kilifi District, Kenya
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– volume: 32 2 5 5
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  year: 2007 2010 2010 2010
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  article-title: Grappling with groups: protecting collective interests in biomedical research 360 Degrees of human subjects protections in community‐engaged research Nine key functions for a human subjects protection program for community‐engaged research: points to consider Nine key functions for a human subjects protection program for community‐engaged research: points to consider
  publication-title: J Med Philos Sci Transl Med J Empir Res Hum Res Ethics J Empir Res Hum Res Ethics
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  year: 2010
  end-page: 26
  article-title: Community members employed on research projects face crucial, often under‐recognized, ethical dilemmas
  publication-title: Am J Bioeth
– volume: 4
  start-page: 26
  year: 2011
  end-page: 39
  article-title: Working with Concepts: The Role of Community in International Collaborative Biomedical Research
  publication-title: Public Health Ethics
– volume: 11
  start-page: 13
  year: 2010
  article-title: Experiences with community engagement and informed consent in a genetic cohort study of severe childhood diseases in Kenya
  publication-title: BMC Med Ethics
– volume: 10
  start-page: 186
  year: 2007
  end-page: 198
  article-title: Community engagement and informed consent in the International HapMap project
  publication-title: Community Genet
– volume: 41 307
  start-page: 255 679
  year: 2005 2005
  end-page: 259 681
  article-title: Community permission for medical research in developing countries Global voices of science. It takes a village: medical research and ethics in Mali
  publication-title: Clin Infect Dis Science
– volume: 4
  start-page: 45
  year: 2011
  end-page: 64
  article-title: Transport to Where?
  publication-title: Journal of Cultural Economy
– volume: 112 10
  start-page: S21 13
  issue: Suppl 1
  year: 2009 2009
  end-page: S31
  article-title: Ethical and practical challenges surrounding genetic and genomic research in developing countries Impact of social stigma on the process of obtaining informed consent for genetic research on podoconiosis: a qualitative study
  publication-title: Acta Trop BMC Med Ethics
– volume: 61
  start-page: 292
  year: 1971
  end-page: 296
  article-title: Community advisory boards and maximum feasible participation
  publication-title: Am J Public Health
– year: 2012
  article-title: Evolving Friendships and Shifting Ethical Dilemmas: Fieldworkers' Experiences in a Short Term Community Based Study
  publication-title: Developing World Bioethics
– volume: 91
  start-page: 1938
  year: 2001
  end-page: 1943
  article-title: The role of community advisory boards: involving communities in the informed consent process
  publication-title: Am J Public Health
– volume: 7
  start-page: 16 147
  issue: 5
  year: 2009 2008
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  article-title: Challenges of establishing a Community Advisory Board (CAB) in a low‐income, low‐resource setting: experiences from Bagamoyo, Tanzania Building community partnerships: case studies of Community Advisory Boards at research sites in Peru, Zimbabwe, and Thailand
  publication-title: Health Res Policy Syst Clin Trials
– volume: 66
  start-page: 1379
  year: 2008
  end-page: 1392
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  publication-title: Soc Sci Med
– volume: 67
  start-page: 721
  year: 2008
  end-page: 733
  article-title: Beginning community engagement at a busy biomedical research programme: experiences from the KEMRI CGMRC‐Wellcome Trust Research Programme, Kilifi, Kenya
  publication-title: Soc Sci Med
– year: 2012
  article-title: Profile: The Kilifi Health and Demographic Surveillance System (KHDSS)
  publication-title: Int J Epidemiol
– volume: 59 11 67
  start-page: 2547 975 708
  year: 2004 2006 2008
  end-page: 2559 982 720
  article-title: Understanding of informed consent in a low‐income setting: three case studies from the Kenyan Coast Editorial: Popular concerns about medical research projects in sub‐Saharan Africa – a critical voice in debates about medical research ethics Taking social relationships seriously: lessons learned from the informed consent practices of a vaccine trial on the Kenyan Coast
  publication-title: Soc Sci Med Trop Med Int Health Soc Sci Med
– volume: 43
  start-page: 61
  year: 2012
  end-page: 67
  article-title: Seeing ‘With my Own Eyes’: Strengthening Interactions between Researchers and Schools*
  publication-title: IDS Bulletin
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Snippet There is wide agreement that community engagement is important for many research types and settings, often including interaction with ‘representatives’ of...
There is wide agreement that community engagement is important for many research types and settings, often including interaction with 'representatives' of...
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SubjectTerms Adolescent
Adult
Advisory committees
Aged
Benefits
Bioethics
Clinical Trials as Topic - ethics
Communities
community engagement
Community involvement
community network
Community-Based Participatory Research - ethics
Conflict (Psychology)
Conflict of Interest
developing countries
Ethics
Female
Geographic location
Group composition
Health
Humans
Informed Consent - ethics
Interdisciplinary Communication
International Cooperation
Intervention
Kenya
Leadership
Local communities
Low income
Low Income Groups
Male
Middle Aged
Moral Obligations
Perceptions
Poverty
Questionnaires
representation
Research Ethics
Research methods
Research Personnel - ethics
Research Personnel - standards
Research Personnel - trends
Researcher-Subject Relations - ethics
Social Environment
Social Perception
Values
Vulnerability
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Title Engaging Communities to Strengthen Research Ethics in Low-Income Settings: Selection and Perceptions of Members of a Network of Representatives in Coastal Kenya
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