Abstract
BackgroundThe use of a Community Advisory Board (CAB) is one method of ensuring community engagement in community based research. To identify the process used to constitute CABs in Zambia, this paper draws on the perspectives of both research team members and CAB members from research groups who used CABs in Lusaka. Enabling and restricting factors impacting on the functioning of the CAB were identified.MethodsAll studies approved by the University of Zambia Bioethics Research Committee (UBNZABREC) from 2008 – 2012 were reviewed to identify those studies that were likely to include a CAB. Eight teams with studies that included a CAB were identified. For each of these studies, consent was obtained to conduct an informal interview with a research team member and to obtain contact details for one CAB member. In total 14 interviews were conducted with 8 research team members and 6 CAB members from 12–30 August 2013.ResultsIdentification of potential CAB members from the community and their participation in developing the terms of reference for CABs was perceived to have contributed to the success of the CAB. Due to the trust that the community had in members of their community the CABs were then in a stronger position to influence community participation in the research. Training of CAB members was identified as a factor that enhanced the functioning of a CAB. Lack of commitment and low literacy levels of CAB members posed a threat to the role of the CAB. Although compensation in the form of a stipend was not provided, CAB members were provided with transport reimbursements for attending meetings.ConclusionsSelection of CAB members from within the community contributed to community confidence in the CAB, enhancing its ability to act as an effective link between study team and community. This contributed positively to the conduct of the study and enhanced community awareness and acceptance of the research. However, establishment of study specific CABs has the potential to compromise CAB independence due to support provided by the research team in the form of transport reimbursements and other forms of support. Consideration should be given to establishing community wide Community Advisory Boards that could function across a range of studies to increase independent objective decision-making.
Highlights
The use of a Community Advisory Board (CAB) is one method of ensuring community engagement in community based research
Following contact with the Principal Investigator or other named investigator it was determined that 11 of the studies had a CAB, eight of the studies did not have a CAB and two studies were withdrawn after REC approval
Details of an additional two studies with a CAB were provided to the investigator by one of the study teams
Summary
The use of a Community Advisory Board (CAB) is one method of ensuring community engagement in community based research. In the context of HIV/AIDS research the U.S National Institutes of Health (NIH) first mandated the use of Community Advisory Boards (CABs) in clinical trials in 1987 [2] in response to AIDS activism in the 1980s. The roles that have been documented in the literature for the Community Advisory Board include functioning as a liaison between the researchers and the community, providing information to the community about the study including their rights to consent, generally improving the informed consent process, ensuring human subjects protection, advocacy for fair compensation for trial related injuries, protection of minorities and involvement in disseminating results to communities [2, 4]. The use of CABs has been associated with a sense of mutual trust and collective ownership when used in studies with long term follow-up
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