Challenges in the conduct of community-based research.

Community-based research is an excellent opportunity for medical students to learn outside the boundaries of a medical college, where health-related conditions and factors can be studied in a larger social context. It also brings a variety of other educational and social learning with it. The research question is usually a community-driven issue. There are multiple ways to arrive at a research question. Sampling poses a unique challenge, especially in terms of availability of a sampling frame. However, accessing electoral rolls, census data and approaching community leaders of voluntary agencies working in a particular area can be a suitable way. The interview schedule should be culturally and socially appropriate and locally validated if possible. Prior preparation of a timetable of activities is much needed, including slack time and contingency plans to fall back on as some social situations might make the area inaccessible. An important team member in these situations is a chaperone from the community who can facilitate these social interactions, including negotiations for the time of the participant. There may be sociocultural problems, which plague the research as much as they affect the community, which the researcher has to be sensitized to. Extra effort is needed to achieve a high response rate in community-based studies. Refusals by selected participants and their nonavailability despite 2-3 household visits need to be addressed with patience and perseverance. Several ethical issues arise during the research, and careful thought has to be given to avoid exploitation of the communities.