Designing and Implementing an Equity Planning Tool for International Research Partnerships

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ABSTRACT The Fogarty International Center is at the forefront of advancing National Institutes of Health (NIH) support for international research to promote health and reduce disease burden globally. A large part of this mission is linked to the successful creation and maintenance of international partnerships between institutions and research groups in low- and middle-income countries (LMICs) and high-income countries (HICs). Equity between LMIC and HIC research partners - defined as the prioritization of mutually beneficial inputs, processes, outputs, outcomes, and impact - is an ethical and practical imperative needed to achieve meaningful scientific aims and outputs within these partnerships that function in an inherently inequitable world. Despite the importance of establishing formal equitable practices and several recommendations and guidelines available to do so, tools for systematically acknowledging existing partnership inequities and methods to overcome them are not well-described. The goal of this proposal is to develop and pilot a pragmatic equity planning tool using experienced HIV- focused research partnerships between Uganda, an LMIC, and the United States (US), a HIC, as a case series given the dominance of the HIV epidemic on global health research paradigms over the past 40 years and the continued focus as a priority for many research partnerships in Uganda and the US. This will be accomplished through an explanatory quantitative to qualitative evaluation of these partnerships that generates a holistic understanding of best practices and barriers to equitable research practices (Aim 1). These results will inform the creation of an equity planning tool that consists of structured survey and focus group materials to systematically evaluate an international research partnership and create a summative report that highlights exemplar practices, identifies feasible areas for improvement, generates attainable program-level equity goals, and creates an action plan to achieve those goals (Aim 2). The equity planning tool will then be prospectively piloted and assessed for efficacy, feasibility, and acceptability within a research partnership (Aim 3). Collectively, this proposal seeks to elucidate a tool to recognize and, importantly, rectify equity-related issues and instigate change at a program level within international research partnerships. This K01 will provide Dr. Chelsea Modlin with the training she requires in advanced qualitative and ethnographic methods including reflexivity, empiric and applied methods in international research ethics, and developing global health program assessment tools. This award will also support preliminary research findings needed to pursue R01 funding to scale up the equity planning tool to other geographic areas and fields of global health research. This tool has the potential to assist with ensuring that the ongoing research practices, outputs, and legacies of international research collaborations benefit both research partners and ultimately, the global communities they serve.