Dear Scientists: Community Ambassadors’ Perspectives on Community-Engaged Research

Abstract

There has been growing recognition of the importance of engaging communities in environmental health research. Among the various methods of community-engaged research, one approach is to work with community ambassadors – people who are active and well connected in their communities – to facilitate scientists’ interactions with community members. Drawing on our own experiences as community ambassadors in the WellHome Study, an investigation of indoor air quality in West London, UK, we offer 3 key insights to scientists interested in this model of community-engaged research. We argue, first, that community ambassadors can help scientists build trust and engage research participants. Second, we note the value of fully integrating community ambassadors into a project team and present suggestions for how this may be accomplished. Third, we underscore the importance of remunerating community ambassadors and the need for careful reflection on the amount and form of compensation. While much has been written about the advantages and challenges of community-engaged research, this commentary brings the voice of community members to the fore of these discussions. It highlights how the community ambassador model can bring mutual benefits, furthering research goals while also providing a meaningful experience for community members.

There has been growing recognition of the importance of working with communities to co-produce research on human and environmental health.^{1 -4} Among the various methods of participatory research, one approach is to work with community ambassadors – people who are active and well connected in their communities – to facilitate scientists’ interactions with community members. Researchers have found this to be an effective way for generating meaningful public involvement in research framing, implementation, and results dissemination.^5,6 But less has been written about how community members find such collaborations with scientists.

In this perspective, we share insights from our experiences as community ambassadors in the West London Healthy Home and Environment (WellHome) Study, which examined air quality within and outside 110 homes of children with asthma and allergies in West London. ⁷ We are a group of 9 women and 2 men in our 30s-70s who live in the neighborhoods where the project was implemented. Our ethnic and racial identities are diverse and include British/African Caribbean, Arab, North African, Bangladeshi, British Indian, Dutch-Indonesian, European, and white. We come from a range of professional and educational backgrounds. All of us are engaged in our communities in different ways. Our role in WellHome was to advise the project team, spread the word about the project, and work with the project’s community engagement coordinator to help recruit 110 households.

We developed our ideas for this paper through a series of discussions and wrote it in collaboration with 2 researchers from the project. Our experiences working within the project were not identical. We each brought with us contrasting professional and cultural expertise and joined the project at different times. We build on these varied experiences to outline 3 common messages to scientists who might be interested in employing this model of community engagement.

Building Trust With Research Participants

The WellHome Study was launched in the aftermath of the Covid-19 pandemic and targeted socioeconomically and racially diverse communities in West London, where there is considerable mistrust and suspicion surrounding science and public health. Convincing local households to participate in WellHome and host air quality sensors in their homes required careful communication and trust building. Here we played a substantial role as community ambassadors, helping bridge the gap between scientists involved in the project – almost all of whom were not from these neighborhoods and did not live locally – and community members.

We are from the community, have broad networks, and are personally invested. We have built connections over many years through our work with neighborhood associations, local charities, schools, religious institutions, and community centers. When we approached local people to talk to them about WellHome, we could do so as familiar faces, as equals, and as neighbors. This, undoubtedly, was a strong starting point for building trust.

In seeking to connect with potential research participants, we drew on our multiple forms of identity. Many of us, for example, are parents. When talking about this study with community members who had children with asthma, we were able to connect with them through our shared experiences of raising and caring for children. Some of us were also participants in the study so could reassure others about the prospect of having sensors in their home. We built on our varied racial, ethnic, religious, and cultural backgrounds to put people at ease, to understand the cultural barriers that may impact their participation, and try to work around those barriers to connect.

Importantly, we knew what language to use and were able to translate the science into terms that would resonate with community members. We avoided jargon and broke things down in a way that was relevant. Rather than talking about PM_2.5, for example, we referred to “small invisible particles in the air.” This helped establish rapport and was more inclusive. When communicating with community members for whom English was not their first language, the ability of some of us to speak multiple languages was also useful.

We were willing to give the time necessary to build trust. Often our conversations with potential participants touched on many topics beyond the study. Part of building a relationship was being open to hearing people’s stories, answering questions, and directing them toward other resources in the community. Sometimes it took multiple conversations to form a genuine connection and allay participants’ fears.

It was not always easy. There were some community members who we found easier to connect with than others, and some engagement settings that we felt more comfortable in than others. But overall the approach was successful, not only in recruiting households to the study (74% of whom were from minority ethnic backgrounds) but keeping community members updated as the research progressed.

Integration Into the Research Team

Our second insight relates to how community ambassadors are integrated into a project. We interacted primarily with the community engagement group within WellHome. We appreciated the occasions when we had the chance to engage with some of the 28 researchers on the project team. We enjoyed talking with the scientists at informal gatherings to which we were invited, such as holiday parties and summer picnics. Some of us also participated in a story-telling workshop that was open to both scientists and community ambassadors. Sharing our stories, as well as seeing how some of the scientists were equally as nervous speaking in public as some of us, was an effective way of connecting across difference and building the team.

Yet despite the efforts by project leaders, some of us did not feel fully part of the WellHome team. There were times and spaces where some of us did not feel that our presence and contributions were valued. While we developed a good understanding of the project’s overarching goals, we did not have a clear sense of who all the scientists affiliated with the project were or what they did. When some of us attended larger project meetings, there were many faces we did not know and sometimes we found it difficult to follow the highly technical discussions.

Fostering a sense of belonging for all members of a project team, regardless of background, culture, and academic training is challenging but essential. When people feel valued and fully part of something, they give their best work. Team building exercises could be an effective way to further develop relationships between community ambassadors and scientists and to create more equality. Scientists and ambassadors could interview one another, for example, participate in a fun activity together, or talk through some ice-breaker questions. Such activities might be light-hearted in tone, but a valuable way to break down walls.

There are also possibilities for mutual learning. A lot of effort was spent by WellHome researchers to make us comfortable with the science, so that we understood the key concepts and focus of the research. What if equal effort was spent in helping the scientists become more comfortable with the community, so that they better understood the setting in which their data was being gathered? Community ambassadors could even lead a training for scientists, helping break down the dynamic of one-way knowledge transfer and creating more of a space in which all members of a project team are learning and sharing their knowledge.

Compensation

We were paid as community ambassadors in the WellHome Study. Many of us have undertaken non-paid volunteer work in the past, and we appreciated that our contributions were recognized. While payment was not a driving factor in our decision to participate, it was an incentive and allowed us to commit time that might otherwise have been difficult to justify, given our other jobs and family care responsibilities. We also appreciated that the work schedule was flexible.

We had contrasting perspectives on the amount of compensation that we received (13GBP/hour). Some of us felt the payment (London living wage) was adequate and others did not. This difference is not surprising given our varied professional backgrounds and life circumstances. For some of us, this income was an important contribution toward household expenditures; for others, it was a nice bonus. Some of us had careers in which we were accustomed to much higher wages; others did not. For some, there were concerns about how this income might affect welfare benefits. Those of us with young children had to factor in the cost of childcare.

Researchers need to think carefully about how a figure, whether it is an honorarium payment or an hourly wage, will be interpreted by community members as an indicator of how they are being valued. These interpretations are unlikely to be uniform but, rather, will depend on community members’ individual circumstances. Some community participants may draw comparisons with what they imagine scientists are paid, which could cause tensions. Given the local knowledge and connections that community ambassadors can bring to a project, there is scope for scientists to justify a larger budget allocation for compensation in research proposals.

The mode of compensation is also significant. We were paid as casual workers and required to submit timesheets through the university’s online payroll system. Despite the guidance provided by the WellHome team, most of us struggled with the university’s complex bureaucratic procedures. It was also not always easy to capture our contributions in hours. How to log, for instance, a conversation at the school gates, or chat with a neighbor about the project? Some of us felt that fixed payments would have been better than an hour-based system. If community-engaged research is a goal, scientists and their institutions need to think creatively about financial procedures that work for community members. ⁸

Conclusion

Our experience working with the WellHome Project was, overall, very positive. We took pride in our affiliation with a prestigious university, enjoyed working together, and learned a great deal. We have highlighted, here, the value of community ambassadors in helping build trust in a community and facilitating research activities. We have also identified 2 constructive points for scientists to consider, relating to project team interactions and compensation.

We hope that these insights will be valuable to other scientists considering working with community ambassadors. A scientific collaboration with community ambassadors can be mutually beneficial, helping further research goals while also providing a meaningful experience for community members. There is great potential to maintain these relationships and continue with these collaborations beyond a single project. We often feel like our voices mean nothing. When you have an opportunity to make a difference, it means the world.