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Colleges and Universities Virtual Listening Session #2

Tuesday, February 1, 2022, 1:00pm-2:30pm ET

Brief Overview

The purposes of the listening session were to listen and learn about perspectives and experiences related to racial and ethnic equity in the biomedical research enterprise among individuals who represent, work within, attend, or are otherwise connected to U.S. colleges and universities. The UNITE listening session, facilitated by an outside contractor, was attended by more than 200 participants. Dr. Noni Byrnes, Director of the Center for Scientific Review (CSR) at NIH, welcomed attendees and summarized the mission and goals of UNITE.

Summary of Discussion

• Topic 1: The overall state of racial and ethnic equity in the biomedical sciences

  The group identified several factors that maintain inequities within colleges and universities at the faculty member and student levels. Participants pointed to the need to enhance the depth of education around diversity, equity, inclusion, and racism among investigators. Many biomedical researchers and educators have a cursory understanding of the history of racial groups in the U.S., and do not understand that race is a social construct. The perspective that racial groups are biologically distinct persists, which has implications for research and education in the biomedical sciences. There is also a need to ensure that Chief Diversity Officers are experts in this field of study to prevent unintentional harm and ensure that efforts go beyond implicit bias training.

  Participants discussed challenges and opportunities in obtaining NIH funding for racial and ethnic minority investigators, particularly for those at Historically Black Colleges and Universities (HBCUs) and Tribal Colleges and Universities (TCUs), who also have greater needs for infrastructure support and are often engaged in community-based science. NIH systems and forms were characterized as complex and difficult to understand for those unfamiliar with the NIH funding process, which creates barriers for less resourced institutions and community-based organizations. Participants also emphasized the importance of adopting inclusive language that does not reinforce racism and health inequities and discontinuing use of the term “human subjects,” which can be perceived as reductionist. Providing inclusive mentorship to students and expanding NIH funding mechanisms such as diversity supplements would diversify NIH grantees by facilitating inclusion of applicants with terminal master’s degrees. To further assist smaller universities in underserved communities to obtain funding, participants recommended collaborations with larger NIH-funded institutions for knowledge-sharing and infrastructure support.

• Topic 2: Opportunities and challenges to racial and ethnic equity in career pathways and within the workforce – education, hiring and research opportunities

  The discussion centered on the need to prioritize pathways to entry and advancement in biomedical science fields. Outreach efforts such as inclusive mentorship should be expanded to reach students at early ages with the goals of enhancing health literacy and awareness of healthcare and biomedical research careers. Few programs address societal, community, and individual level barriers to entry and advancement including structural racism, stigma, and racial and ethnic trauma. Meaningful incorporation of strategies to address these significant issues would increase the pool of applicants and the success of pathway program participants. Participants also described challenges experienced by underrepresented minority (URM) persons seeking research positions. One recommendation was to reassess the academic and professional credential requirements for positions on research teams, as some roles and responsibilities can be performed effectively without a PhD or a master’s degree. Participants also suggested that NIH support programs to improve health literacy and awareness of health research to encourage more URM persons to enter research careers and to increase participation in clinical research among people impacted directly by health disparities. To ensure accountability for expanding the pathways for URM persons, NIH should publish metrics to track progress.

• Topic 3: Practices and policies as barriers to racial and ethnic equity

  The group discussed practices and policies associated with racial and ethnic disparities in NIH (R01-equivalent) funding. The primary perceptions were that the grants process is biased against URM researchers and does not effectively support the communities being studied. The sentiment was expressed that the NIH grants process is structured so that “the rich get richer” because eligibility requirements and the review process for R01 grants prioritize applications from large, well-funded institutions and discriminate against Black/African American researchers, respectively. Participants also indicated that NIH peer reviewers and program officials undervalue community-based science and the skills offered by community scientists. They suggested that eligibility for community-based research grants should include scientists who do not have doctoral degrees, yet have the needed research, cultural, and linguistics skills to conduct research and work within communities.

  The discussion also focused on the need for greater diversity and representation on research teams. Principal Investigators (PIs) and research teams often do not represent the communities being studied and have low cultural awareness, which can increase cultural barriers and misunderstandings. More collaborations with grassroots community organizations to establish research teams that reflect and serve as voices of the community would ensure that research leads to actual impact. The group encouraged NIH to consider the implementation of meaningful metrics that encourage both diversity and inclusion. Metrics should hold grantees accountable for their commitments around diversity and cultural awareness and ensure that research funding is allocated appropriately to promote health equity.

• Topic 4: Opportunities, needs and challenges in racial and ethnic health disparities and health equity research

  The discussion centered on supporting racial and ethnic minority and medically underserved communities at multiple levels by engaging local community organizations, business partners, and non-traditional groups. Participants were pleased that NIH has the National Institute on Minority Health and Health Disparities (NIMHD) but emphasized that such research should also be funded by other Institutes and Centers to reduce competition among investigators who focus on similar areas. The group encouraged NIH to create infrastructure and research funding mechanisms for sustainable partnerships between scientists and community-based organizations to better support the needs of the communities. Training on how to navigate the system at NIH would improve the probability of success in receiving grants focused on health disparities.

• Topic 5: Actions and initiatives to address racial and ethnic equity within your institution

  The group discussed diversity, equity, and inclusion (DEI) initiatives at their institutions. Many organizations are currently utilizing implicit bias training, but there is a need to go beyond this type of training. Some organizations have developed educational programs around DEI and held listening sessions to facilitate transparent conversations on diversity, race, and racism. There is an increased emphasis on “community science” and models to reengage communities about science and university efforts. Participants encouraged developing and sharing institutional efforts, DEI metrics, and research findings within the surrounding community to promote health literacy.

• Topic 6: Proposed solutions for NIH: Tactics, actions, initiatives, policy, and engagement

  The group offered several solutions to increase equity. They suggested that NIH consider providing and mandating educational programs and training to promote health equity for staff across Institutes and Centers. They encouraged NIH to increase support for community engaged science and community-based participatory research (CBPR) that values community-identified needs and partners and rethinks scientific models and investigator phenotypes. Addressing barriers to URM persons’ effective navigation of career opportunities would expand pathways. Education innovation was suggested as a means of reducing healthcare profession shortages in underserved areas. Participants are seeking changes and transparent metrics to quantify and track impact. Finally, when ideas are solicited, active listening, responses, and measurable and sustainable change should follow.

NIH is grateful for the participation and perspectives provided by the wide variety of stakeholders in these listening sessions. For more information about past listening sessions, and to follow the efforts of UNITE, please visit the UNITE webpage at nih.gov/ending-structural-racism.

The opinions and perspectives presented in this summary reflect those of listening session participants, and do not necessarily reflect the perspectives or practices of the NIH.