title: Ethical considerations for conducting health disparities research in community health centers: a social-ecological perspective.
abstract: Community health centers (CHCs) provide optimal research settings. They serve a high-risk, medically underserved population in the greatest need of intervention. Low socioeconomic status renders this population particularly vulnerable to research misconduct. Traditional principles of research ethics are often applied to participants only. The social-ecological model offers a comprehensive framework for applying these principles across multiple levels (participants, providers, organizations, communities, and policy). Our experience with the Trial Using Motivational Interviewing, Positive Affect and Self-Affirmation in African-Americans with Hypertension, a randomized trial conducted in CHCs, led us to propose a new platform for discussing research ethics; examine the social, community, and political factors surrounding research conducted in CHCs; and recommend how future research should be conducted in such settings.
authors.affiliation: Carla Boutin-Foster, Ebony Scott, Rosio Ramos, and Anna Rodriguez are with the Division of Clinical Epidemiology and Evaluative Sciences, Weill Cornell Medical Center, New York, NY. Jennifer Melendez, Balavenkatesh Kanna, and Walid Michelen are with the Lincoln Center for Clinical and Community Research, Lincoln Hospital/Generations Plus Northern Manhattan Network, New York City Health and Hospitals Corporation, Bronx, NY.
authors.forename: Carla
authors.initials: C
authors.lastname: Boutin-Foster
authors.forename: Ebony
authors.initials: E
authors.lastname: Scott
authors.forename: Jennifer
authors.initials: J
authors.lastname: Melendez
authors.forename: Anna
authors.initials: A
authors.lastname: Rodriguez
authors.forename: Rosio
authors.initials: R
authors.lastname: Ramos
authors.forename: Balavenkatesh
authors.initials: B
authors.lastname: Kanna
authors.forename: Walid
authors.initials: W
authors.lastname: Michelen
mesh_terms: D003151:Community Health Centers / Q000941:ethics*; D028744:Ethics Committees, Research; D032984:Ethics, Research; D054624:Health Status Disparities; D006801:Humans; D011204:Poverty Areas; D012107:Research Design; D012931:Social Environment