Community-based participatory research (CBPR) and patient/ community engaged research (P/CEnR) are shown to be effective approaches that improve health inequities, particularly among disadvantaged populations. While the science of CBPR demonstrates promising partnering practices that lead to effective interventions, there are institutional and structural barriers to creating and sustaining patient/community research within academic health centers (AHCs). As the field matures, there is a growing need to enhance patient/community leadership so that communities can set their own research agendas and priorities.

Engage for Equity PLUS sought to address these challenges by implementing an engagement intervention aimed at transforming AHCs through supporting champion teams of academic, community, and patient partners to strengthen research infrastructures for P/CEnR. This paper uses a qualitative, case study analysis to describe how E2PLUS enabled champion teams at Stanford School of Medicine, Fred Hutchinson/University of Washington Cancer Consortium, and Morehouse School of Medicine to pursue institutional change strategies through coaching, workshops, contextual data analysis, and a community of practice.

This paper describes key themes of how E2Plus helped identify targets of change by a) using institutional data collection as core to generating critical consciousness of contextual conditions; b) implementing feasible E2PLUS strategies to leverage conditions for catalyzing a champion team for advocacy and achievable actions; c) identifying the critical role of patients/community members in stimulating change; and d) the role of continual collective reflection.

We discuss the overall implications for E2 PLUS for other AHCs working toward sustainable community/patient engaged research policies and practices.

Community-engaged research/community-based participatory research/patient-engaged research (CEnR/CBPR/PEnR) are increasingly recognized as important approaches for addressing health equity. However, there is limited support for CEnR/CBPR/PEnR within Academic Health Centers (AHCs). It is important for AHCs to measure and monitor the context, process, and policies in support for CEnR/CBPR/PEnR. The Engage for Equity (E2) team developed the first Institutional Multi-Sector Survey (IMSS) instrument to assess and explore CEnR/CBPR/PEnR-related practices at three AHCs.

Working with “champion teams” consisting of academic leaders, researchers, and patient/community partners at each AHC, we developed the IMSS to assess the following domains: institutional mission, vision, and values; CEnR/CBPR/PEnR policies/practices; community processes/structures; function of formal community advisory boards; climate/culture for CEnR/CBPR; perceptions of institutional leadership for CEnR/CBPR/PEnR. The survey was piloted to a convenience sample of CEnR/CBPR/PEnR participants at each AHC site.

A sample aggregated across all sites consisting of community (n = 49) and academic (n = 50) participants perceived high levels of advocacy for CEnR/CBPR/PEnR among their AHC research teams. Participants indicated that institutional leadership supported CEnR/CBPR/PEnR in principle, but resources to build CEnR/CBPR/PEnR capacity at their respective institutions were lacking. Differences in responses from community and academic partners are summarized.

While limited by survey length and question adaptation, the findings contribute to identification of institutional barriers and facilitators to CEnR/CBPR/PEnR in AHCs. These findings are critically important to support and improve CEnR/CBPR/PEnR practice in academic institutions and to elevate community partner voices and needs for advancing community and patient partners’ research.

The continued momentum toward equity-based, patient/community-engaged research (P/CenR) is pushing health sciences to embrace principles of community-based participatory research. Much of this progress has hinged on individual patient/community–academic partnered research projects and partnerships with minimal institutional support from their academic health institutions.

We partnered with three academic health institutions and used mixed methods (i.e., institution-wide survey (n = 99); qualitative interviews with institutional leadership (n = 11); and focus group discussions (6 focus groups with patients and community members (n = 22); and researchers and research staff (n = 9)) to gain a deeper understanding of the institutional context.

Five key themes emerged that were supported by quantitative data. First, the global pandemic and national events highlighting social injustices sparked a focus on health equity in academic institutions; however, (theme 2) such a focus did not always translate to support for P/CenR nor align with institutional reputation. Only 52% of academics and 79% of community partners believed that the institution is acting on the commitment to health equity (Χ2 = 6.466, p < 0.05). Third, institutional structures created power imbalances and community mistrust which were identified as key barriers to P/CenR. Fourth, participants reported that institutional resources and investments are necessary for recruitment and retention of community-engaged researchers. Finally, despite challenges, participants were motivated to transform current paradigms of research and noted that accountability, communication, and training were key facilitators.

Triangulating findings from this mixed-methods study revealed critical barriers which provide important targets for interventions to improving supportive policies and practices toward equity-based P/CenR.