SEARCH

SEARCH BY CITATION

Keywords:

  • NIH;
  • participatory research;
  • research funding

Abstract

  1. Top of page
  2. Abstract
  3. Introduction
  4. Methods
  5. Results
  6. Discussion
  7. Acknowledgments
  8. References

Objectives

To determine how grant funds are shared between academic institutions and community partners in community-based participatory research (CBPR).

Methods

Review of all 62 investigator-initiated R01 CBPR grants funded by the National Institutes of Health from January 2005 to August 2012. Using prespecified criteria, two reviewers independently categorized each budget item as being for an academic institution or a community partner. A third reviewer helped resolve any discrepancies.

Results

Among 49 evaluable grants, 68% of all grant funds were for academic institutions and 30% were for community partners. For 2% of funds, it was unclear whether they were for academic institutions or for community partners. Community partners’ share of funds was highest in the categories of other direct costs (62%) and other personnel (48%) and lowest in the categories of equipment (1%) and indirect costs (7%).

Conclusions

A majority of CBPR grant funds are allocated to academic institutions. In order to enhance the share that community partners receive, funders may wish to specify a minimum proportion of grant funds that should be allocated to community partners in CBPR projects.


Introduction

  1. Top of page
  2. Abstract
  3. Introduction
  4. Methods
  5. Results
  6. Discussion
  7. Acknowledgments
  8. References

Community-based participatory research (CBPR) is a form of research that focuses on building equitable relationships between academic institutions and community partners. Academic researchers and community members jointly define the research questions, determine how to answer the questions, and decide how to disseminate or act on the findings. Potential advantages of CBPR include the use of diverse perspectives and expertise; formulation of innovative research questions and study designs; increased participant recruitment and community capacity; and enhanced research relevance and impact.[1-6] Challenges in conducting CBPR include establishing trusting relationships, ensuring ongoing communication, assuring bilateral participation in project tasks, and sharing power in decision making.[7-11]

Because CBPR strongly emphasizes equitable relationships between academic institutions and community partners, we sought to examine how grant funds are shared in CBPR projects. Such sharing may be both a measure of equity and of community benefit from participation in research. We focused on investigator initiated (R01) grants funded by the National Institutes of Health (NIH) because such grants typically include detailed budgets and budget justifications and are available for public review under the Freedom of Information Act.

Methods

  1. Top of page
  2. Abstract
  3. Introduction
  4. Methods
  5. Results
  6. Discussion
  7. Acknowledgments
  8. References

A Community Partnership Board consisting of a diverse group of two dozen members, including community residents, participants in research studies, community-based providers, and faculty engaged in community-based research, meets three to four times per year to oversee activities of the Case Western Center for Reducing Health Disparities. The Board provided guidance and feedback in formulating this research question and in interpreting the findings of this study.

We used NIH Reporter to search for all R01 grants from January 2005 to August 2012 that contained the term “community-based participatory research” in the abstract.[12] Two coauthors independently reviewed the abstracts to confirm that the grants involved CBPR research projects. We then requested copies of the budgets and budget justifications for these grants from NIH.

Two coauthors independently reviewed each grant budget and budget justification and categorized each item as being for an academic institution (“academic”) or a community partner (“community”). If there were insufficient details in the grants to categorize specific items as being for academic institutions or community partners, they were categorized as “unclear.” A third reviewer helped resolve any discrepancies. We defined academic institutions as universities, colleges, and independent research institutes. We defined community partners as community organizations, government agencies, and community residents.

We looked separately at the lead applicant's budget and at each subcontract's budget. If a lead budget or subcontract was awarded to a community partner, we categorized the entire amount as community. If a lead budget or subcontract was awarded to an academic institution, we used the following criteria to determine if each budgetary line item should be categorized as academic or community:

Senior personnel

Salary support for senior personnel was categorized as academic if they had a university faculty appointment or worked at an independent research institute. Salary support for senior personnel was categorized as community if they worked for a community organization or government agency or were self-employed.

Other personnel

Salary support for other personnel was categorized according to employer, in a manner similar to that for Senior Personnel. However, other personnel were categorized as community if they had specialized community knowledge even if they worked for a university or independent research institute. For example, salary support for a university-employed Vietnamese-speaking individual who served as coordinator of a project to understand health needs of Vietnamese Americans was categorized as community.

Equipment, travel, support, and other direct costs

Costs for items to be used by study personnel were categorized according to whether the personnel who were to use them were categorized as academic or community. All stipends or other expenses (e.g., travel or child care) provided for community members to be research subjects or to serve on advisory boards were categorized as community. All expenditures related to conducting research in community settings (e.g., space rental or refreshments) were also categorized as community.

Indirect costs

Indirect costs associated with the lead applicant's budget and each subcontract's budget were categorized according to whether the awardee was an academic institution or community partner.

Note that for three grants, there were insufficient budgetary details to accurately distinguish salary support for senior personnel from salary support for other personnel in years 2–5. For these grants, we assumed that the ratio of senior to other personnel salary support in years 2–5 was similar to the ratio in year 1.

Statistical analyses

We used descriptive statistics (mean, standard deviation, percentage) to examine the amount of grant funds in each category. We used the Mann-Whitney rank-sum test to examine sharing of funds when grants did or did not involve community partners as lead applicants or subcontracting applicants. All analyses were conducted with JMP 7.0, SAS Institute, Cary, NC, USA).

Results

  1. Top of page
  2. Abstract
  3. Introduction
  4. Methods
  5. Results
  6. Discussion
  7. Acknowledgments
  8. References

Of 62 R01 grants identified with the term “community-based participatory research” in the abstract, 1 did not propose a CBPR project, 1 was not obtained from NIH despite multiple requests, and 11(18%) did not have sufficient budgetary detail (e.g., had modular budgets) to analyze. The remaining 49 (79%) evaluable grants are described in Table 1. The largest number of grants were funded by the National Cancer Institute and the National Heart, Lung, and Blood Institute. Of all evaluable grants, 25 (51%) involved an academic institution as the lead applicant with or without other academic institutions as subcontracting applicants, 23 (47%) involved an academic institution as the lead applicant and one or more community organizations as subcontracting applicants, and 1 (2%) involved a community organization as the lead applicant. The most common types of community partners were cultural/ethnic organizations and healthcare providers while the most common research foci were cancer and obesity/physical activity.

Table 1. Characteristics of 49 community-based participatory research grants
Funding institute
  1. *Some grants involved more than one community partner

 National Cancer Institute14 (29%)
 National Heart, Lung, and Blood Institute10 (20%)
 National Institute on Drug Abuse5 (10%)
 National Institute of Environmental Health ­Sciences4 (8%)
 National Institute of Child Health and ­Human Development4 (8%)
 National Institute of Mental Health4 (8%)
 Other8 (16%)
Lead applicant, subcontracting applicant
 Academic Lead, ± Academic Subcontract25 (51%)
 Academic Lead, Community Subcontract23 (47%)
 Community Lead, Academic Subcontract1 (2%)
Lead or subcontracting community partners*
 Cultural/ethnic organization14 (34%)
 Healthcare provider7 (17%)
 Disease specific organization6 (15%)
 Government agency6 (15%)
 Faith-based organization2 (5%)
 Other6 (15%)
Award start year
 2011–201214 (29%)
 2009–201012 (24%)
 2007–200819 (39%)
 2005–20064 (8%)
Length of project
 5 years31 (63%)
 4 years11 (22%)
 3 years5 (10%)
 2 years2 (4%)
Research focus
 Cancer10 (20%)
 Obesity/physical activity9 (18%)
 Alcohol/drug use9 (18%)
 HIV/hepatitis6 (12%)
 Cardiovascular disease5 (10%)
 Other10 (20%)
Target population
 Hispanic or Latino10 (20%)
 Asian or Pacific Islander10 (20%)
 American Indian or Alaska Native9 (18%)
 African American/Black4 (8%)
 Minority/low income communities8 (16%)
 Children/adolescents6 (12%)
 Other2 (4%)
Geographic region
 South16 (33%)
 West15 (31%)
 Northeast9 (18%)
 Midwest7 (14%)
 International2 (4%)

The total direct and indirect costs for all 49 grants was $139 million, or an average of $2.8 million per grant. On average, 68% of all grant funds were for academic institutions and 30% were for community partners (Table 2). For 2% of funds, it was unclear whether they were for academic institutions or for community partners. Community partners’ share of funds was highest in the categories of other direct costs (62%) and other personnel (48%) and lowest in the categories of equipment (1%) and indirect costs (7%).

Table 2. Allocation of grant funds between academic institutions and community partners (n = 49)
Budget categoryMean grant funds, $1,000 (standard deviation, row percent)
 AcademicCommunityUnclear
Senior/key personnel530 (275, 79%)132 (242, 20%)6 (45, 1%)
Other personnel427 (444, 49%)417 (426, 48%)21 (101, 2%)
Equipment5 (19, 99%)0.08 (0.3, 1%)0 (0, 0%)
Travel27 (33, 46%)17 (28, 30%)14 (30, 24%)
Participant/trainee support costs8 (39, 75%)3 (11, 25%)0 (0, 0%)
Other direct costs122 (98, 35%)216 (212, 62%)120 (29, 4%)
Total direct costs1,113 (536, 57%)784 (531, 40%)54 (146, 3%)
Indirect costs828 (397, 93%)59 (97, 7%)0 (0, 0%)
Total direct and indirect costs1,941 (851, 68%)842 (587, 30%)54 (146, 2%)

Among 24 grants that involved a community partners as a lead applicant or a subcontracting applicant, community partners’ share of total funds was 35% and share of indirect costs was 13%. Among 25 grants that did not involve a community partner as a lead applicant or a subcontracting applicant, community partners’ share of total funds was 22% (p = 0.01) and share of indirect costs was 1% (p < 0.001).

Discussion

  1. Top of page
  2. Abstract
  3. Introduction
  4. Methods
  5. Results
  6. Discussion
  7. Acknowledgments
  8. References

We found that academic institutions are allocated more than twice the amount of CBPR grant funds as community partners in NIH-supported projects. The proportion of funds allocated to community partners was highest in the categories of other direct costs and other personnel and lowest in the categories of equipment and indirect costs. Strengths of our study include a comprehensive examination of investigator-initiated grants over a 7-year period, prespecified criteria for categorizing budgetary items as academic or community, and independent review of budgetary details by multiple coauthors. Using our approach, only 2% of budgetary items could not be classified as academic or community.

Prior work related to this topic has focused on assessing how well investigators adhere to principles of CBPR. One report cited fiduciary transparency and fairness as key ethical principles in conducting CBPR studies.[13] A survey of 25 community network programs funded by the National Cancer Institute concluded that most sites did well on CBPR principles related to building on community strengths, facilitating colearning, and using iterative processes to develop community capacity. By contrast, sites varied in how well power and funds were shared. Of 22 sites that responded to the survey, 5 (23%) said that funds were split equally with community groups.[14] However, this survey did not explicitly quantify allocation of grant funds as we have done.

Our findings suggest that the extent of sharing of grant funds may be an additional way to examine adherence to the principles of CBPR. While the optimal amount of sharing may vary from project to project, we urge funders and reviewers to explicitly consider this topic in awarding grants.[15] Funders may wish to specify a minimum proportion of total grant funds to be allocated to community partners in CBPR projects. Our methods for defining academic institutions and community organization and for categorizing budget items as academic versus community may be useful in evaluation of fund sharing.

The difference in allocation of indirect costs between academic institutions and community partners ($828,000 vs. $59,000; Table 2) was especially striking and may need to be addressed specifically by funders. Funders may want to encourage community partners to be lead applicants or subcontracting applicants as this was associated with increased sharing of both total funds and indirect costs. In addition, funders may negotiate higher indirect cost rates (ratio of indirect to direct costs) with community partners. In our sample, the ratio of indirect to direct costs was less than 10% for community partners (Table 2). While funders typically prefer to use their appropriations to make more grants at lower average costs, insufficient indirect costs may limit the ability of community partners to participate in research.[16] Academic institutions may also be able to use their expertise to help community partners negotiate higher indirect cost rates.

Several limitations must be considered in interpreting our findings. First, we focused on a modest number of NIH-funded R01 grants because such grants typically include detailed budgets and are available for public review. As a result, our findings may not apply to other NIH grants or to grants funded by other organizations. Second, it may be argued that specific budgetary items categorized as community should instead be categorized as academic, for example, salary support for university-employed study coordinators with specialized community knowledge. Thus, our calculation of community share may be an overestimate. Third, we were unable to categorize some budgetary items as academic or community because of a lack of specificity in certain budgets and budget justifications. However, these items represented a very small proportion of total grant funds. Fourth, we focused on allocation of funds as described in grant applications. The actual allocation of funds after awards were made is not available to us and may differ somewhat from the applications. Fifth, we were unable to determine how well the proposed projects adhered to CBPR principles. Finally, we were unable to determine the impact of sharing on project outcomes.

In conclusion, a majority of CBPR grant funds are allocated to academic institutions. In order to enhance the share that community partners receive, funders may wish to specify a minimum proportion of total grant funds that should be allocated to community partners in CBPR projects. In addition, further research is needed to determine the outcomes of CBPR projects that have low versus high levels of fund sharing.

Acknowledgments

  1. Top of page
  2. Abstract
  3. Introduction
  4. Methods
  5. Results
  6. Discussion
  7. Acknowledgments
  8. References

We appreciate the help of Julie Pencak, Catherine Sullivan, and Mary Ellen Lawless and of the NIH staff that processed our Freedom of Information Act requests. This work was supported in part by grants MD002265 and UL1TR000439 from the National Institutes of Health, Bethesda, Maryland.

References

  1. Top of page
  2. Abstract
  3. Introduction
  4. Methods
  5. Results
  6. Discussion
  7. Acknowledgments
  8. References
  • 1
    Israel B, Schulz A, Parker E, Becker A. Community-based participatory research: policy recommendations for promoting a partnership approach in health research. Educ Health: Change Learn Practice 2001; 14(2): 182197.
  • 2
    Israel BA, Coombe CM, Cheezum RR, Schulz AJ, McGranaghan RJ, Lichtenstein R, Reyes AG, Clement J, Burris A. Community-based participatory research: a capacity building approach for policy advocacy aimed at eliminating health disparities. Am J Public Health 2010; 100(11): 20942102.
  • 3
    Wallerstein N, Duran B. Using community-based participatory research to address health disparities. Health Promot Pract 2006; 7(3): 312323.
  • 4
    Minkler M, Wallerstein N. Community-based participatory research: from process to outcomes. San Francisco, Calif: Jossey-Bess; 2008.
  • 5
    Minkler M, Wallerstein N. Community-based participatory research: a strategy for building healthy communities and promoting health through policy change. A Report to the California Endowment. University of California Berkley; 2012.
  • 6
    LaVeaux D, Christopher S. Contextualizing CBPR: key principles of CBPR meet the indigenous research context. Pimatisiwin 2009; 7(1): 17.
  • 7
    Freeman E. Challenges of conducting community-based participatory research in Boston's neighborhoods to reduce disparities in asthma. J Urban Health 2006; 83(6): 10131021.
  • 8
    Strickland CJ. Challenges in community-based participatory research implementation: experiences in cancer prevention with Pacific Northwest American Indian tribes. Cancer Control 2006; 13(3): 230236.
  • 9
    Resnik D, Kennedy C. Balancing scientific and community interests in community-based ­participatory research. Account Res 2010; 17(4): 198210.
  • 10
    Cashman SB, Adeky S, Allen AJ 3rd, Corburn J, Israel BA, Montaño J, Rafelito A, Rhodes SD, Swanston S, Wallerstein N, et al. The power and the promise: working with communities to analyze data, interpret findings, and get to outcomes. Am J Public Health 2008; 98(8): 14071417.
  • 11
    Trickett EJ. Community-based participatory research as worldview or instrumental strategy: is it lost in translation(al) research? Am J Public Health 2011; 101(8): 13531355.
  • 12
    National Institutes of Health Research Portfolio Online Reporting Tools [updated 2012; cited September 1, 2012]. Available from: http://projectreporter.nih.gov/reporter.cfm.
  • 13
    Bastida E. Ethics and community-based participatory research: perspectives from the field. Health Promot Pract 2010; 11(1): 1620.
  • 14
    Braun K. Operationalization of community-based participatory research principles across the National Cancer Institute's community network programs. Am J Public Health 2012; 102(6): 11951203.
  • 15
    Minkler M, Glover Blackwell A, Thompson M, Tamir H. Community-based participatory ­research: implications for public health funding. Am J Public Health 2003; 93(8): 12101213.
  • 16
    Rosenzweig RM. The politics of indirect costs [updated 1998; cited April 1, 2013] Available from: http://www.unc.edu/~pcg/741/documents/Indirect%20Costs.pdf.