OBJECTIVES: To engage patients in community-engaged research and promote health equity, The PATIENTS Program from University of Maryland Baltimore developed over the past decade a 10-step framework for continuous engagement to achieve authentic patient engagement in all stages of the research process. Continuing in this direction, our objectives are: (1) to describe the challenges that patients may encounter at each step of the 10-step framework for continuous engagement, and (2) to propose recommendations to support health equity and partnership between patients and researchers.

METHODS: We identified challenges at each step of the framework and proposed a VALUE (Valued - Authentic - Literate - Understood - Empowered) approach to assess and resolve challenges related to patient engagement. Valued refers to the importance given to the patient's experience; Authentic suggests that the engagement is not tokenistic; Literate refers to the patient’s and the researcher’s knowledge in clinical research; Understood relates to the researcher's level of understanding of the patient's needs and vice versa; Empowered refers to actions taken to strengthen the partnership and the patient's ability to solve problems related to patient engagement. Patients and researchers should be accountable to each other as they go through each step of the VALUE approach to ensure full engagement of partnership members during the assessment and resolution process.

RESULTS: We identified challenges that prevented full engagement of the patient at each step of the framework. The VALUE approach helps in addressing these challenges by assessing that the patient is valued, authentic, literate, understood and empowered during the engagement process.

CONCLUSIONS: The challenges and recommendations that emerged from The PATIENTS Program in building partnership with community leaders and organizations, have helped to advance the science of patient engagement and the vision of health equity.