Community engagement (CE) is an ethical obligation and an integral part of TB research. It can improve trial implementation and participant outcomes by building trust between affected communities and trial implementers. It also allows affected communities to participate in all stages of the research cycle – from setting the research agenda through to evidence-based policy change based on research results.
A comprehensive program of CE is being supported by the STREAM clinical trial at all 13 Stage 2 sites with the objective of raising awareness of TB and the trial and making complex information accessible to affected communities; providing psychosocial support to trial participants and family members, which can help improve retention and adherence rates; and creating a critical feedback link between affected communities and trial staff to ensure community views on key implementation issues are communicated and considered.
As part of STREAM’s support for CE, CABs, comprised of representatives from non-governmental and community-based organizations, TB survivors and other community representatives, were established and are supported as coordinating mechanisms for CE at all trial sites. Funding is provided for CE activities developed by the CABs, including feedback to and from the study team regarding STREAM, stakeholder meetings, CAB member training and capacity building, attendance at health policy meetings, community outreach, psychosocial support for STREAM participants, and cross-site experience sharing.
Achievements
The commitment to CE throughout Stage 2 of the STREAM trial yielded significant achievements including development of program design tools, contributions to the creation of sustainable CE institutions, and improvements in STREAM trial implementation.
Although there are accepted principles confirming the need for CE in TB trials, there are limited practical resources available to trial stakeholders to guide development and implementation of CE activities. The STREAM trial’s focus on developing and documenting its experience means that new tools are available for future TB trials seeking to implement impactful CE programs. The trial’s focus on sustainability of CE institutions should also contribute to better and more durable CE programs at STREAM sites and globally. Finally, the experience to date as part of STREAM has offered an exceptional opportunity to evaluate key operational successes and lessons learned related to CE. To read more about those lessons learned, read the Community Engagement Practical Recommendations guide.
Community Engagement Resources
Community Engagement Lessons Learned: A Community Perspective
Practical recommendations for CE from the STREAM clinical trial
STREAM Community Engagement Logic Model
Video: Introduction to Community Engagement
STREAM Community Engagement Plan: English, Georgian or Romanian