Practical Incorporation of Stakeholder-Informed Ethics into Research Funding Decisions

Research funding has been criticized as biased against novel initiatives and lacking diversity, which leads to further disparities. Patient and stakeholder engagement could support research that goes beyond traditional paradigms and increases diversity. However, best practices to engage stakeholders in research, including funding decisions, continue to be developed. We report on the implementation of stakeholder input in two federally funded initiatives, one that seeks to advance research reducing disparities, and the other seeks to advance deprescribing research. Overall, the review process includes stakeholders as decision makers and supports their efforts through group discussion and other activities. Reconciling stakeholder input that may differ from scientific peer review is a challenge within the decision for funding. Lessons learned include balancing stakeholder and scientific assessments and including guidance on stakeholder engagement to grant awardees.