Community Partnerships in Clinical Research: A Framework for Sustainability and Resilience.

Variable health outcomes across populations remain chronic challenges in modern healthcare, due in part to an imbalance in participation in clinical research. Rather than base novel therapeutics on narrow cohorts that limit validity and generalizability, we should broaden our commitments to developing solutions that benefit all populations. Many participants remain hesitant due to mistrust in research and medical institutions; however, novel approaches are necessary to bridge the gap in research representation. These concerns are particularly prominent in Indigenous communities, which have faced a long history of unethical research practices. Community-based participatory research methods can aid researchers in improving research access by centering community engagement at the core of the research partnership and enabling co-creation of research priorities. We have created a community-academic partnership with an Indigenous community in Montana over almost two decades, built on mutual respect and learning. Drawing on our partnership, we present community-engaged strategies that together form a framework for building meaningful, enduring community partnerships that foster trust in research. This framework can help to ensure that clinical research opportunities are more broadly available, supporting the diffusion of health innovations to every patient.