A recognition that a cadre of junior investigators is needed to address large, and in many instances, growing cancer-related health disparities undergirds the NCI-CRCHD’s attempt to increase mentoring in CBPR. Furthermore, the CNP’s focus on CBPR and training of junior investigators has recently been identified as a high-impact action step to reducing cancer health disparities in the nation [7
]. This study provides encouraging results for the CNP’s training program, especially effort directed at underrepresented investigators. In comparison to their non-underrepresented counterparts, those from underrepresented groups generally reported spending more time on CBPR-related activities. Contrary to a commonly voiced concern regarding such activities distracting from conventional scholarly output, junior investigators from underrepresented groups responding to our survey had higher academic productivity, including more coauthored publications, grants submitted and funded, and had higher overall grant funding than their non-underrepresented counterparts.
It is interesting, and of some concern, that junior investigators from underrepresented backgrounds were more likely to rate institutional expectations as their most critical concern as a CBPR-focused investigator. While a degree of this concern may be related to underrepresented faculty generally reporting feelings of being overburdened by institutional expectations to serve on diversity-related committees [12
] or advising minority students versus conducting research [13
], junior investigators from underrepresented backgrounds should be encouraged that CBPR can be a main focus of a research program that can yield appropriate levels of academic productivity needed for tenure and promotion. However, for bona fide
CBPR to be manifest, senior faculty mentors who have an appreciation of the CBPR approach and understand its importance in the changing landscape of biomedical research, must actively advocate for administrative policy changes that recognize the value of CBPR [14
] and provide academic rewards to community-engaged investigators.
Given the criteria needed for academic advancement, it seems advisable for junior investigators to devise plans for procuring senior faculty, and other institutional support along a reasonable time line. The importance of mentorship is underlined by a 30-year old article in the Harvard Business Review stating that, “everyone who makes it has a mentor” [15
]. While junior investigators, regardless of underrepresented status, were generally positive about their senior mentors, it also must be acknowledged that additional mentoring might be required from individuals who understand the unique nuances and culture of the academic climate that underrepresented group members experience [16
]. “Empowerment mentoring,” cited as important by one junior respondent in this survey is the process through which one seeks out a mentoring team as exigencies arise and opportunities are anticipated. Junior investigators also mentioned the importance of peer mentoring, which has shown to result in higher productivity [19
] and discussion of social and professional concerns outside the bounds of the relationship with the senior mentor(s) [20
]. Given that junior investigators often balance professional and family/personal responsibilities, mentorship in these areas can be beneficial.
It is essential that junior investigators demand and help to create a supportive environment. Of all the factors that affect research productivity, none is as powerful as the workplace [21
]. To succeed, investigators who are committed to disparities research need to be in an environment that is supportive of writing manuscripts and grants, appreciative of the CBPR imperative, and willing to explore incentives for research [16
]. The fact that junior investigators from underrepresented backgrounds are relatively productive is encouraging. However, there is opportunity for senior mentors to increase the productivity of these investigators, particularly with manuscript development. Junior investigators from underrepresented backgrounds reported making three presentations per year, but only publishing one manuscript per year (either as peer or co-authored). Senior mentors could assist junior investigators to transition their presentations into publications, as well help to identify other data sources for them to use for publications as they wait on their CBPR-related work to progress.
While the results from this survey are a positive reflection of the CNP’s training efforts in some ways, we must keep in mind that, as with most voluntary surveys, the overall response rate was low (about 4 respondents/CNP). Our concern in obtaining IRB approval was to ensure anonymity of responses. This made it impossible to either define the denominator or to link the responses of junior investigators to those of senior faculty mentors. While anything less than 100% response could be associated with a response bias, there might be information bias even in the presence of very high overall response [24
]. Future work in this arena should be conducted in a context in which the denominator and individual identifiers are known. This would allow for quantitative verification of the interesting finding of high relative academic productivity in underrepresented junior faculty. This finding also must be considered in light of the fact that this is the first CNP round (though some Centers were part of the Special Population Network); therefore, overall productivity may reflect the fact that many junior investigators are <5 years out from training.
The qualitative results presented here provide important leads for future work, irrespective of the population base from which they arise; there are many intriguing results evident here that should be followed up. One avenue which warrants further exploration is in the area of work-life balance, particularly among CBPR investigators. As noted by some respondents in our survey, challenges of CBPR include that it requires a greater level of resources (both personal and institutional) in comparison to traditional research. Thus, examining how CBPR-focused investigators advance academically by balancing their professional and family responsibilities would be beneficial to current investigators and those who are interested in addressing health disparities using CBPR.