Walk together children with no wasted steps: community-academic partnering for equal power in NIH proposal development.

Community-based participatory research (CBPR) approaches equitably involve community members and researchers throughout the research process. A developing literature examines problems in CBPR partnerships, but less is written about community groups using CBPR to access university resources to address community-prioritized health concerns. We sought to examine issues in two stages of a National Institutes of Health (NIH)-funded CBPR partnership: (1) joint proposal preparation, and (2) grant administration. We used a case study approach to analyze data (partner dialogs, meeting notes, interviews, and press coverage) from a longstanding community-academic partnership. The partnership received NIH Partners in Research Program funding. During joint proposal preparation, issues included (1) learning to practice operating principles, such as "talking in ways that all people can understand," (2) streamlining proposal design to facilitate communication with community members, and (3) addressing inequities inherent in community-academic budget sharing. During the administration phase, issues included (1) community partner struggles with administrative requirements, (2) inequities in indirect cost (IDC) allocations, and (3) the impact of a natural disaster. Separately funded CBPR grants can contribute to community partner development, but make substantive demands on small, grassroots community organizations. Funders should consider taking more responsibility in developing community resources and infrastructure to ensure that grassroots community groups have the power to be equal partners. More accurate accounting of costs and benefits of CBPR to vulnerable communities should be in place to ensure communities receive adequate return on the time they invest in partnering with universities.